By Emily Ip
This discussion question is a central theme in the field of nursing and medical education. Defining an expert vs. novice not only in a student’s learning practice but in a licensed medical practitioner is immense. The current learning method is “see one, do one, teach one”, yet, in my opinion, is a very poor way of instruction and challenges the learning/transfer theory that Bransford, Brown, and Cockings (2000) espouses. In the medical environment, the general thought is that the longer a person has been in practice the greater expert they become. This thought is flawed and has many layers. Student nurses are closest to the textbook and studies grounded in current evidence-based practice. “Expert” practitioners are relying on medical information that they were taught when they were in school, which most likely was one to two decades prior. While they have their experiences that lead to their patient care decisions, they are more often not learned on new practices, new technology, or new research that has been distinguished. When I am in the clinical setting with nursing students, often they find medical errors or new theories as to why the patient is ill.
Two of Bruning’s (2011) cognitive themes stand out for me regarding my professional practice. Bruning (2011) asserts that mental frameworks organize memory and guided thought. This can be seen in the structure of nursing curriculum and the need for new frameworks due to the fact that current methodologies are not keeping pace with the necessity for a modern nurse. As patient acuities continue to increase, present-day curriculum is not keeping pace. I agree with Bruning (2011) that developed frameworks can organize memory and guide thought, which is why new curriculum needs to be developed to direct reasoning for the 21st-century nurse. The other Bruning (2011) theme that relates to nursing education would be the notion that extended practice is required to develop cognitive skills. This theme, I eluded to in the above paragraph. The current teaching modality of “see one, do one, teach one” directly contrasts Bruning’s (2011) theme. Learning skills that affect a patient’s care trajectory should be legitimatized by allowing a nursing student abundant time to hone and develop the skill so that it can solidify into deep cognitive concepts.