NUR 502 Module 1 Learning Theory Paper example

Experience as the Curriculum: Applying Knowles's Andragogy to Teaching a New Skin Tear Protocol in Long-Term Care

[Student Name]

Southern New Hampshire University

NUR 502: Teaching and Learning in Nursing

Module One Learning Theory Paper

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[Date]

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Experience as the Curriculum: Applying Knowles's Andragogy to Teaching a New Skin Tear Protocol in Long-Term Care

The Teaching Problem

A composite 120-bed long-term care facility has adopted a new protocol for preventing and treating skin tears in frail older residents. The protocol replaces adhesive strips and gauze with non-adherent silicone dressings, adds a simple classification of tear type, introduces an arrow on the dressing to show the direction of removal, and requires long-sleeved protective garments and padded rails for residents at high risk, consistent with international consensus recommendations on skin tear prevention and classification (LeBlanc et al., 2013). The facility's 28 licensed practical and registered nurses have an average of 14 years of experience, and many learned wound care long before the current products existed. Several have said openly that the old way works fine.

The nurse educator's past approach has been a thirty-minute lecture in the break room followed by a signature sheet. After the last such session, a chart audit found that fewer than half of skin tears were dressed according to the new product guide. The problem is not that the nurses cannot learn. It is that the teaching has not been designed for who they are. This paper applies Knowles's theory of adult learning, often called andragogy, to redesign the education.

Knowles's Andragogy in Brief

Malcolm Knowles proposed that adults learn differently from children and described a set of assumptions about adult learners that should guide teaching (Knowles et al., 2015). Adults need to know why they should learn something; they see themselves as responsible for their own decisions; they bring a large reservoir of experience; they become ready to learn when learning helps them handle real situations; they are oriented toward solving problems rather than mastering subjects; and they respond more to internal motivators such as professional pride than to external rewards. Nursing education texts have adopted these assumptions widely for staff development and patient teaching (Bastable, 2019). The sections below apply each assumption to the skin tear protocol.

Applying the Six Assumptions

The need to know. Experienced nurses will not change a routine without understanding why. The session will open with the facility's own data: 46 skin tears in six months, 19 of which were reopened during dressing changes, and photographs, used with permission, of tears worsened by adhesive strips. This answers the question the nurses will be asking silently: what is wrong with what we do now?

Self-concept. Adults resent being treated as passive recipients. Instead of a lecture, nurses will review the protocol in small groups and identify any steps they think will not work on their units. The educator will treat their objections as information and revise the local procedure where they identify real barriers, such as the placement of supplies.

Experience. With 14 years of average experience, the nurses have treated hundreds of skin tears. Andragogy suggests that this experience should become the curriculum rather than an obstacle to it. Nurses will describe a skin tear that healed poorly and one that healed well, and the group will compare them with the new classification, which often shows that experienced nurses were already making some of the right distinctions without words for them.

Readiness to learn. Adults are most ready when learning helps with a current task. Rather than teaching all content in advance, the educator will introduce the new dressing at the bedside when nurses are caring for residents with tears, using the facility's actual residents, with consent, as the teaching cases.

Problem orientation. The content will be organized around problems nurses face, such as how to handle a tear on an arm with fragile skin that is still bleeding, rather than around topics such as wound physiology.

Internal motivation. Nurses in long-term care often take pride in knowing their residents well. The educator will frame the protocol as a way to protect residents they care about and will recognize nurses whose units show the greatest improvement, rather than relying on warnings or mandatory signatures.

Comparing the Two Approaches

The redesigned education differs from the old lecture in almost every feature. The lecture assumed that nurses needed information; the andragogical design assumes they need reasons, participation and relevance. The lecture treated experience as irrelevant; the new design uses it as the starting point. The lecture measured success by attendance; the new design measures it by practice, using a repeat chart audit three months after the sessions and direct observation of five dressing changes on each unit. The redesign takes more time, about two short sessions plus bedside coaching rather than one lecture, but that time is justified if it produces the practice change that the lecture did not.

The redesign also changes the educator's role. In the lecture, the educator was the expert delivering content. In the andragogical design, the educator becomes a facilitator who brings the data, asks questions, coaches at the bedside and adapts the plan based on what the nurses report. For many educators this shift is uncomfortable, because it means giving up some control over the session, but it is the shift that makes experienced learners take ownership of the change.

Limitations of the Theory

Andragogy has limits. Its assumptions describe adults in general, but not every adult learner is self-directed or confident. Some nurses in the facility have limited computer skills and may be anxious about any change, and they may need more structure and reassurance than andragogy suggests. The theory also says little about how to teach complex psychomotor skills, which require demonstration and supervised practice. Critics have noted that the distinction between adult and child learning is less sharp than Knowles originally proposed, and that many of his principles apply to learners of all ages (Knowles et al., 2015). The educator will therefore combine andragogy with explicit skill demonstration and return demonstration for dressing application, and will offer one-on-one support for nurses who prefer it.

Conclusion

A lecture failed to change skin tear care in this facility because it treated experienced nurses as blank slates. Knowles's andragogy offers a better design: start with why the change matters, invite nurses to shape the protocol, build on their experience, teach at the moment of need, organize around real problems and appeal to professional pride. Combined with hands-on skill practice to compensate for the theory's limits, this approach gives the new protocol a realistic chance of becoming daily practice.

References

Bastable, S. B. (2019). Nurse as educator: Principles of teaching and learning for nursing practice (5th ed.). Jones & Bartlett Learning.

Knowles, M. S., Holton, E. F., III, & Swanson, R. A. (2015). The adult learner: The definitive classic in adult education and human resource development (8th ed.). Routledge.

LeBlanc, K., Baranoski, S., Christensen, D., Langemo, D., Sammon, M. A., Edwards, K., Holloway, S., Gloeckner, M., Williams, A., Sibbald, R. G., & Regan, M. (2013). International Skin Tear Advisory Panel: A tool kit to aid in the prevention, assessment, and treatment of skin tears using a simplified classification system. Advances in Skin & Wound Care, 26(10), 459-476. https://doi.org/10.1097/01.ASW.0000434056.04071.68