Within the realm of higher education there are a variety of methods that instructors employ in order to facilitate student learning. However, to use a blanket approach is generally ill-advised and counterproductive to the educational process. Recalling Bloom's taxonomy, it is evident that student learning occurs on a spectrum from the acquisition of knowledge through evaluation of the learning encounter. Therefore, when we apply Bloom's taxonomy to the previously assertion that visual learners may not be able to learn instruments through pictorial depictions, it becomes apparent that the acquisition of knowledge may be able to be presented pictorially. For example, if an educator was teaching a class in perioperative nursing, the instructor must consider that in order to learn and then apply the information, the student has to be engaged. Students learning this information that are visual learners, may be able to study this information (knowledge and comprehension) through a memorization method. They may be able to apply this information in clinical simulation settings, and synthesize this information into various projects with other learners. The same concepts hold true for auditory learners, using verbal cues for instruments and verbal association methods (mnemonics, etc) in order to recall information and apply it to the clinical setting. In these examples the link between nursing education and learning styles is evident (Whiteley, 2014).

In the construction of lessons, educators must also be aware of the generational learning preferences that exist. Robb, (2013) examined the learning preferences of Millennial nursing students. In doing so, she notes several times that Millennial students valued instructional methods that enhanced their knowledge. For example, physically demonstrating tasks that are expected in nursing assessment, or using graphical depictions of fetal circulation. In using a multimodal approach, a new era of nurses gain an enhanced understanding of the sciences requisite to the safe practice of nursing. Not only do educators carry this obligation in instructional techniques, but they also carry the obligation to enhance critical thinking skills. While some could view instructional methods as compensatory in nature, the assertion could be made that learning styles enhance the educational experience. To state that learning to preference stunts the student's critical understanding of the process is not supported in the literature. Again, using Bloom's taxonomy, it would become apparent that once students acquire the knowledge and understanding of how to apply it to practice, higher level thinking (drawing from the learning enhanced by learning preference) should take over and be able to synthesize learned information into new information. Reinforcement of this notion is evident in Whiteley (2014), where the author notes the use of the Socratic method to have students take pause and critically think through an answer before providing one- regardless of learning preference.

Detractors of preference oriented learning could state that the tools to assess learning style lack reliability and validity. This can be mitigated through the appropriate selection and use of a tool that has proven test-retest reliability and validity. Once such example of this is the Index of Learning Styles whose reliability and validity are discussed in detail by Felder and Spurlin (2005). Although the article is from 2005, it has seminal information and the quality of the literature subsequent to this study does not meet the standard discussed by Felder and Spurlin.

In consideration of the above, we are able to see that student nurses learn in a multitude of different ways, and that a "one size fits all" approach to education, neglecting the learning preferences of the student actually is what serves as a disservice to nursing students. The failure of the educational establishment to assess learning styles, incorporate said styles into curricula, and evaluate students based on Bloom's taxonomy can lead to student failure and the death of the nursing profession.

REFERENCES:

Felder, R. M., & Spurlin, J. (2005). Applications, reliability and validity of the index of learning styles. International journal of engineering education, 21(1), 103-112.

Hallin, K. (2014). Nursing students at a university—A study about learning style preferences. Nurse education today, 34(12), 1443-1449.

Robb, M. (2013). Effective classroom teaching methods: A critical incident technique from millennial nursing students’ perspective. International journal of nursing education scholarship, 10(1), 301-306.

Whiteley, T. R. (2014). Using The Socratic Method and Bloom’ s Taxonomy of the Cognitive Domain to Enhance Online Discussion, Critical Thinking, and Student Learning. Developments in Business Simulation and Experiential Learning, 33.

Within the realm of higher education there are a variety of methods that instructors employ in order to facilitate student learning. However, to use a blanket approach is generally ill-advised and counterproductive to the educational process. Recalling Bloom's taxonomy, it is evident that student learning occurs on a spectrum from the acquisition of knowledge through evaluation of the learning encounter. Therefore, when we apply Bloom's taxonomy to the previously assertion that visual learners may not be able to learn instruments through pictorial depictions, it becomes apparent that the acquisition of knowledge may be able to be presented pictorially. For example, if an educator was teaching a class in perioperative nursing, the instructor must consider that in order to learn and then apply the information, the student has to be engaged. Students learning this information that are visual learners, may be able to study this information (knowledge and comprehension) through a memorization method. They may be able to apply this information in clinical simulation settings, and synthesize this information into various projects with other learners. The same concepts hold true for auditory learners, using verbal cues for instruments and verbal association methods (mnemonics, etc) in order to recall information and apply it to the clinical setting. In these examples the link between nursing education and learning styles is evident (Whiteley, 2014).

In the construction of lessons, educators must also be aware of the generational learning preferences that exist. Robb, (2013) examined the learning preferences of Millennial nursing students. In doing so, she notes several times that Millennial students valued instructional methods that enhanced their knowledge. For example, physically demonstrating tasks that are expected in nursing assessment, or using graphical depictions of fetal circulation. In using a multimodal approach, a new era of nurses gain an enhanced understanding of the sciences requisite to the safe practice of nursing. Not only do educators carry this obligation in instructional techniques, but they also carry the obligation to enhance critical thinking skills. While some could view instructional methods as compensatory in nature, the assertion could be made that learning styles enhance the educational experience. To state that learning to preference stunts the student's critical understanding of the process is not supported in the literature. Again, using Bloom's taxonomy, it would become apparent that once students acquire the knowledge and understanding of how to apply it to practice, higher level thinking (drawing from the learning enhanced by learning preference) should take over and be able to synthesize learned information into new information. Reinforcement of this notion is evident in Whiteley (2014), where the author notes the use of the Socratic method to have students take pause and critically think through an answer before providing one- regardless of learning preference.

Detractors of preference oriented learning could state that the tools to assess learning style lack reliability and validity. This can be mitigated through the appropriate selection and use of a tool that has proven test-retest reliability and validity. Once such example of this is the Index of Learning Styles whose reliability and validity are discussed in detail by Felder and Spurlin (2005). Although the article is from 2005, it has seminal information and the quality of the literature subsequent to this study does not meet the standard discussed by Felder and Spurlin.

In consideration of the above, we are able to see that student nurses learn in a multitude of different ways, and that a "one size fits all" approach to education, neglecting the learning preferences of the student actually is what serves as a disservice to nursing students. The failure of the educational establishment to assess learning styles, incorporate said styles into curricula, and evaluate students based on Bloom's taxonomy can lead to student failure and the death of the nursing profession.

REFERENCES:

Felder, R. M., & Spurlin, J. (2005). Applications, reliability and validity of the index of learning styles. International journal of engineering education, 21(1), 103-112.

Hallin, K. (2014). Nursing students at a university—A study about learning style preferences. Nurse education today, 34(12), 1443-1449.

Robb, M. (2013). Effective classroom teaching methods: A critical incident technique from millennial nursing students’ perspective. International journal of nursing education scholarship, 10(1), 301-306.

Whiteley, T. R. (2014). Using The Socratic Method and Bloom’ s Taxonomy of the Cognitive Domain to Enhance Online Discussion, Critical Thinking, and Student Learning. Developments in Business Simulation and Experiential Learning, 33.

In consideration of the argument that nursing theory is becoming more obsolete as modern practice leans towards outcomes and utilization of EBP, I would like to make the following assertions.

First, the statement that "The middle range theory, while a bit more tangible, is still abstract and hard to quantify relating to patient outcomes." I would note that two Middle Range theories (MRTs) are still readily applicable to nursing practice and therefore, patient outcomes. Benner's model of Novice-to-Expert serves as a guide to professional development and the increasing expertise of the clinical nurse. I believe it would go without saying that more clinically competent nurses are not only aware of their actions, but are able to respond more quickly in critical situations as they gain proficiency and expertise (Benner, 2000). The clinically proficient/expert nurse is also able to recognize departures from the norm more quickly than those with less expertise thereby reducing time to treatment and failure to rescue. In addition, Benner's model also includes an element of research and the ability of the nurse to further nursing science and expand on the body of nursing knowledge. With this in mind, as current nurses recognize both their voice in healthcare/nursing and their ability to recognize care delivery improvements, one could argue that more proficient nurses are enabled to make changes through application of this theory throughout their career. Another theory and perhaps a but more tangible for daily practice is that of Martha A.Q. Curley, PhD. Dr. Curley is associated with the AACN's synergy model which examines the relationships that patients have with nursing. More specifically, the theory notes that the patient's need should be paired with the strengths of a particular nurse when planning care assignments, considering primary nursing models, etc. Namely, this theory would be applied on a unit and each patient's needs assessed and the conclusions of that assessment guide nursing care. Using this theory, the patient's needs are met and the plan of care tailored for each patient.

Secondly, while I agree with the notion that nursing has shifted towards a model embracing EBP, theory is very relevant in research as theoretical frameworks not only guide some portion of the researcher's work, but theory also contributes to the rigor of the research endeavor. Therefore, theory adds to the credibility of research. When we consider EBP, we must be very aware that by definition, EBP adds the best scientific (research) evidence with patient and provider preferences. Essentially, in this argument theory plays a role in the development of EBP and clinical pathways.

Lastly, Thorne and Sawatzky (2014) note that through the generation of new knowledge, the profession could benefit from nursing scholars who could appreciate the "philosophical and theoretical nature of knowledge within a socially mandated practice discipline." They further assert that theory also helps nurses defend certain practices for which there is no evidence.

Through these examples we see that nursing theory has real application to practice, research, and professional development. All of these contribute and effect patient outcomes.

REFERENCES:

Benner, P. (2000) From Novice to Expert: Excellence and Power in Clinical Nursing Practice. New York, NY: Pearson

Curley, M.A.Q. (2007). Synergy: The unique -relationship between nurses and patients.

Indianapolis, IN: Sigma Theta Tau International.

Thorne, S., & Sawatzky, R. (2014). Particularizing the general: Sustaining theoretical integrity in the context of an evidence-based practice agenda. Advances in Nursing Science, 37(1), 5-18.