Lunch with the theorists: A clinical learning activity

Lunch with the theorists: A clinical learning activity
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Citation

Melrose, S. (2006b). Lunch with the theorists: A clinical learning activity. Nurse Educator, 31(4), 147–148.

Applying theoretical knowledge to practice is the heart of clinical teaching and educators need to facilitate students’ personal processes of translating this knowledge in creative, lively, and relevant ways. In the Post LPN to BN program at Athabasca University, Alberta, Canada, we created an assignment in the psychiatric mental health course where students envision what it might be like to engage in lunch conversation with theorists they have only read about.

The process of conceptualizing well-known theorists in a familiar every day activity can help de-mystify the ideas these individuals espouse. Rather than simply reiterating information, the assignment requires learners to personalize both the people who created the theories as well as the immediate relevance of the ideas to current practice.

The task is only one artifact in a comprehensive portfolio assignment that also includes writing scholarly papers, assessing incidence and prevalence of disease, evaluating referral instruments, practicing with licensing examination questions, and constructing clinical case studies. Balancing these more academic learning activities with a playful affect-centered requirement enhances educational measurement possibilities for clinical instruction and has been well received by students.

Inviting Theorists to Lunch

Imagine that you have an opportunity to join Hildegard Peplau and 2 psychological theorists for lunch. In your portfolio, write up a 1-page or 2-page account of the kind of conversation that might occur among your group. No references are required, however, your work is expected to demonstrate an understanding of the ideas and thinking purported by the theorists that you have chosen. You are invited to incorporate humor and to present the disagreements that would be expected between members of your lunch group. Be sure to join in the discussion yourself and interject your own thoughts. Submit your assignment by course mail attachment to your instructor by the end of week 6. Post your work in the Lunch With the Theorists forum.

Students receive these instructions in a course study guide at the beginning of their psychiatric clinical rotation. Because our course also has an online component, the final written work is shared by posting in a forum. Throughout the course, students are encouraged to share their ideas, plans, and personal interpretation of knowledge for their lunch with fellow students, staff members, and instructors. In the mental health clinical area, members of the staff team come from a variety of disciplines other than nursing. Physicians, psychologists, social workers, recreational therapists, and chaplains may all join the lunch discussions. Therefore, in addition to content presented in a final written piece, the process of discussing practical applications of theory continues throughout the learning experience.

These instructions could be adapted to any clinical or classroom educational event. The activity is designed to engage learners in a personal way, to build on their existing knowledge and to involve others in collaborative discussions.

Although measuring completed lunch assignments against evaluative criteria is not straightforward, educators can honor learner creativity when designating marks. Strengths such as demonstrating clear understanding of a concept by applying it to a conversational message can be identified. Similarly, selecting appropriate topics for the theorists to address requires a comprehensive knowledge base. Comparison and differentiation are required when the theorists are expected to disagree. On the other hand, areas to grow become clear when learners attribute a comment to a theorist that does not seem to relate to published accounts of their work. And, creating surface conversations that do not address deeper implications can reveal important knowledge deficits.

In our course, students have presented a variety of different approaches to the assignment. Some framed their lunch conversations around suggestions theorists might offer clients they met in the clinical area. Others have incorporated their perceptions of what theorists might suggest if they could attend their own family gatherings or workplace settings. Several targeted their discussion around care for individuals with a particular illness.

Student Examples

One student approached the assignment by reflecting on how she might offer a nursing contribution to a devastating current event. She imagined she would be working as a nurse-volunteer with victims of the 2005 Hurricane Katrina disaster and asked Hildegard Peplau, Eric Erickson, and Victor Frankl for their suggestions and advice. Addressing each theorist by their first name, she included comments from Hildegard about the nurse-patient relationship, comments from Eric on stages of psychosocial development, and comments from Victor on finding meaning and purpose in life. When Eric seemed to place an overemphasis on developmental stage, Hildegard assured the lunch group that nurses can establish relationships at any developmental stage. This student concluded her work with a research idea for Victor.

Another student immersed herself in a scenario where she hoped to assist the families of 4 policemen tragically killed while investigating a marijuana growing operation in a nearby town. Her conversation was with Hildegard Peplau, BF Skinner, and Abraham Maslow. She included comments from Hildegard explaining that the nurses’ role might be one of offering resources or counseling. She also included comments from Abraham that the families’ needs for safety and security might be compromised. After comments from BF that the families should be taught the steps of mourning and offered positive reinforcement when they displayed them, this student scripted a fairly sharp retort from Hildegard. Hildegard disagreed with BF that all behavior is learned and questioned whether we can or even should be telling someone how to act, rewarding them when the act as they have been told, and expecting a rosy result.

Lessons Learned

As these examples illustrate, the experience of looking for theorists to talk with, sitting around the lunch table with them, and discussing possibilities for bringing their work to life invites learners to interpret theoretical knowledge in different ways. Feedback has been positive and course evaluations reflect that students enjoyed the assignment. Although theorists were drawn from the fields of psychiatric nursing and psychology for this lunch, the assignment could be modified to work with theorists from any discipline or nursing specialty area.

Students found it humorous to address esteemed scholars by their first name. The invitation to incorporate a conversational tone rather than academic writing was welcome. The requirement to share their final product with peers as well as an instructor invited a commitment to the process. And, perhaps most importantly, the lively conversations among participants, staff teams, and instructors leading up to presenting the final product illustrated the collaborative possibilities inherent within this simple lunch assignment. The process of co-creating this assignment at different stages of development was genuinely collaborative.

In contrast, practical suggestions for implementing this strategy can also be drawn from the difficulties these participants experienced. Initially, students did express some questions about what the final product was expected to look like. Also, the idea that incorporating peer and instructor feedback prior to submitting work was collaboration rather than cheating was a new concept for some students. Further, when one students’ public lack of understanding about a theoretical concept became apparent, it was difficult to build in private remedial strategies.

In conclusion, the simplicity of this assignment is appealing. Imagining what famous people might say if they joined us for lunch is intriguing, and adapting the idea to an educational event can add a playful element to the experience.

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