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• Case Studies

Students on nursing programmes who experience difficulties with language and comprehension may have developed their own particular learning style that is different to that of other students. For example they may find themselves at an advantage over other students if they find it easier to develop their creative thoughts, but may have difficulties communicating their thoughts through written means, preferring instead to undertake coursework in the form of an oral assessment.

Teaching students with individual difficulties is about identifying the individual skills required to perform a particular task and focusing on those to establish appropriate interventions and teaching strategies that may be appropriate for a student. It is associated with identifying the individual strengths and weaknesses of each student and considering how these can be best utilised to maximise the effectiveness of the learning programme. Effective teaching is also concerned with being flexible and empowering students to adopt and perfect their own individual learning styles.

Students with language and/or comprehension difficulties may find a programme of study more demanding that other students and may have to work twice as hard to achieve what they are striving for. It is crucial that all students within a group are educated to accept different learning styles and adopt their own learning practices in order to accommodate difference students' learning needs. This should eventually lead to a supportive atmosphere within the learning environment.

It is also important to remember that just because a student has a difficulty acquiring and developing effective language and/or comprehension skills, this doesn't mean that they can't improve or that they will always require extra study support. All students within a group will develop at different rates, will be starting from different stages, and will end up at different stages, and will have overcome different barriers to their individual learning along the way.

It may be helpful to bear the following strategies in mind:

• If possible, learn as much as possible about the profiles in terms of strengths and weaknesses of all students within a group. If a student has particular difficulties with language and/or comprehension, this may need to be achieved through an individual assessment.
• Understand the students' different learning styles and consider the effects these might have on their emotional as well as their cognitive development.
• Understand as much as possible about the different demands that the programme of study is having on the students.
• Match the demands of the programme against the individual student profiles to identify any specific learning needs, but try to do this realistically and positively.
• Adopt any appropriate interventions: e.g. extra literacy skills sessions, teaching of organisational skills, confidence building exercises, provision of appropriate IT equipment and/or support working memory by making information easier to manage.

More specific teaching strategies to consider for nursing students with language and/or comprehension difficulties are as follows:

• Ensure that written information is clearly laid out and unambiguous
• Use a clear font such as Arial, size 12, or above on cream paper (this reduces the effects of glare)
• Provide written materials well in advance and ensure they are available in a range of formats
• If students are expected to undertake a large amount of reading prior to and during clinical placement, Clinical Educators should identify the key/essential material
• Be aware that extra time may be needed to complete reading and writing tasks
• Provide verbal explanation as an adjunct to written information if necessary
• Accept a degree of untidy writing, inaccurate spelling, poor use of punctuation, lack of too many capital letters as long as the meaning is clear
• Student could be encouraged to use electronic dictionaries/thesauri and keep and add to their own personal lists of medical terminology as necessary
• It may be helpful to formulate a glossary of essential terminology to issue to the students prior to or at the commencement of the placement
• Give the student clear guidelines for specific record keeping formats and if necessary provide help with planning and structure
• If errors occur give feedback on the sequence of steps required to complete the writing task effectively
• Provide some proof reading for patient records
• Offer good examples of previously written patient notes

Remember that many students who have experience difficulties with their language and/or comprehension may well already be operating at a high level once they gain entry into Higher Education. It is likely that they will have had to demonstrate a high level of determination and hard work in order to overcome the barriers they have already faced with their learning, and it is important to remember this and not just to dismiss students as lazy or not motivated.

The following link contains two case studies, the first involves a student nurse describing his difficulties reading and retaining information and what strategies he employed with his tutors to overcome his challenges. The second relates to a student who had 'behavioural difficulties' and mild dyslexia at school undertaking a Modern Apprenticeship in a nursing home in 1997.

Case Study