The purpose of this study was to determine the impact of using Visual Thinking Strategies (VTS) in baccalaureate nursing education on observational and communication skills in a didactic upper level course. VTS has been used in medical and nursing education to increase observational skills and improve communication, as well as change the way students see and think (Chin, 2017; Moorman et al, 2017; and Klugman et al, 2011). As nurse educators work to bridge student connections from classroom to practice, teaching about caring for families is an increasingly important construct for students to understand on a multitude of levels. The definition of family varies according to the person being cared for and among caregivers and is deeply personal.
Methods:
In this multisite study, 144 students who were in their upper level of undergraduate baccalaureate courses studying the care of families were asked to participate in a graded homework assignment as part of their course. As a way to demonstrate the various ways people define family, this study called on students to create a work of art that symbolized family to them. The student who created the work of art observed while the rest of the class discussed their creation in the classroom. The faculty member used VTS to discuss the student’s creation. In this study, VTS included a student-centered discussion that asked 3 questions about each work of art; 1. What is going on here? 2. What are you seeing that makes you say that? And 3. What more can you find? Students engaged in discussions about each work of art during class. After all the students finished the experience, they were asked to complete 6 questions in an anonymous Qualtrics survey about their experience. Survey questions included: 1. Were you aware of visual thinking strategies before this class? 2. What did you think of creating a visual representation family? 3. What was the impact on your observational skills? 4. What was the impact on your communication skills? 5. Would you participate in a similar activity in the future? And 6. What impact will VTS have, if any, on your clinical skills in the future? Data analysis was completed determining qualitative content analysis and results obtained. The goal of content analysis is to establish frequencies and categories within data (Hsieh & Shannon, 2005). IRB approval was obtained prior to data collection from the Northwestern University and was deemed exempt in the Midwestern University. No incentives were provided for participation. Demographic data was not collected on participants.
Results:
Of the eligible 144 students, 92 students (63.8%) completed the study. Twenty-four students from the Midwestern University and 72 students from the Northwestern University (NU) started the study (N=96). Final profile of students who completed the study: 24 from the Midwestern University (MU) and 68 from the Northwestern University (n=92). Results from the first question found that less than half of the student were aware of Visual Thinking Strategies before the class activity (n=41, 30 from NU, 11 from MU). Over half of the students (57.6%; n=53) reported that VTS aided them in learning about people’s different perception on what family is and how they differ from one’s own views (n= 27), enabled them to think about their own families and how much they mean (n=21), and enabled them to think about families in a novel way or outside the box (n=5). About 3.3% (n=3), felt that VTS was a waste of time. Over 57.8% of nursing students reported thinking deeper and more abstractly or had increased evidence to back up their observations (n=52). Regarding the impact of VTS on communication skills, 66.3% of students thought that VTS was either beneficial, increased ability to give reasoning behind thoughts, or allowed students to be open in their communications (n=61). When asked if they would be interested in participating in a similar activity in the future, 81.5% (n=75) stated yes. Regarding VTS impact on future clinical skills, 66.3% of students (n=61) reported that VTS either increased their awareness and understanding of family, increased their ability to be considerate and nonjudgmental, or increased understanding that every family is different.
Conclusion:
Baccalaureate nursing education benefits with the inclusion of VTS to increase observational and communication skills (De Santis et al, 2016; Moorman, 2015). This multisite study impacts nursing education and provides baccalaureate nursing student with increased skills vital to safe and effective patient care. This assignment also allows students an opportunity to explore definitions of family and to express how these relationships vary from person to person. This experience gives students the opportunity to discuss and explore personal ways that one defines family and to express what meaning family has for them. Knowledge gained from this study aligns with implementation of evidence-based practice and promotion of healthy communities by increasing insight into how one defines and works with families.