content outline for nursing student strategies for success€¦ · web viewsuccess strategies ....

Success Strategies for Nursing Students

Success Strategies

for Nursing Students

Prepared By: N. Gail Yearick, RN, BSN

1


November, 2006Welcome

Dear Nursing Student,

This collection of information has been assembled to assist you through your nursing education journey. These topics were selected after researching the experiences and needs of associate degree nursing students. It is my wish that this will be the start of a wonderful and exciting career for you in the nursing profession as well as the beginning of unending educational exploration!

Best Wishes!

N. Gail Yearick, RN, BSN

2


Table of ContentsI. Nursing School

A. What to expect B. Care planning processC. Student Nursing Associations

II. Personal ManagementA. Time managementB. PrioritizationC. Stress managementD. MotivationE. ConfidenceF. Personal health management

III. Strategic Learning ToolsA. ConcentrationB. Reading strategiesC. Note-takingD. Study SkillsE. Study groups

IV. Testing StrategiesA. Test anxietyB. Test preparationC. Test-taking

V. Students with Special NeedsA. English-as-a-Second-Language

1. English Language and Culture2. Minority student nursing associations

B. Students with Concentration Problems 1. Compensatory strategies 2. Accommodations for Special Needs

VI. References

3


Nursing SchoolWhat to expect …

Everyone who starts nursing school knows what they hope to accomplish by the end of the program – graduation from the nursing program along with the opportunity to take the state nursing licensure exam and to enter the practice of nursing. What many students do not know is exactly what to anticipate in the journey toward achieving these goals. Being aware of the expectations and having the tools to assist you in meeting these requirements will help you in being successful in this process.

Nursing school encompasses different types of learning opportunities. These include lectures and activities in the classroom as well as laboratory and clinical experiences. Clinical experiences will be added to your experiences each week. They will take you to different healthcare settings, including long-term care facilities, acute care hospitals and community health settings.

Care Planning

Care planning is like the skeleton upon which nursing care for individual patients is built. The care planning process includes five (5) steps: assessment, establishing a nursing diagnosis, planning outcomes and interventions, implementing those interventions, and evaluating the success of the process. Learning how to carry out this process will enhance your clinical practice.

Let’s review this process now.

Assessment

Assessment refers to the activities of assessing your patients. This includes looking, listening and feeling for clues about their condition. You will assess their physical, mental and psychosocial status through assessment techniques that you learn in nursing school. You will consider the information that you discover from your assessment to formulate a nursing diagnosis. The nursing diagnosis is one of the keys to successful nursing practice.

Nursing Diagnoses

A nursing diagnosis is defined as “a clinical judgement about individual, family, or community responses to actual or potential health problems/life processes” (NANDA, 1990). Nursing diagnoses “provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable” (NANDA).

For your reference, here are the formats for nursing diagnoses with some sample diagnoses:

Actual Diagnosis: Problem related to Etiology as evidenced by Symptoms.Example: Ineffective airway clearance related to decreased energy as manifested by ineffective cough.

Risk Diagnosis: Risk for (or Potential for) Problem related to Etiology.Example: Risk for injury related to altered mobility and mental disorientation.

Wellness Diagnosis: Condition related Contributing Factors as evidenced by Indications.Example: Effective individual coping related to adequate support systems as evidenced by client’s active participation in medical treatment regimen.

Factors to consider when formulating nursing diagnoses include the following:

4


Client’s medical diagnoses Your assessment findings: subjective (what the client says to you) and objective (what you

see, hear and feel) Medications (especially side effects) Diagnostic test results

Planning

The planning phase of the care planning process includes identification of outcomes or goals that address the nursing diagnoses and interventions or actions that will assist the client in achieving those outcomes. In developing these steps of the care plan, you should refer to the nursing diagnosis for clues.

Outcomes

The outcomes should be aimed at resolving the problem, preventing the risk, or sustaining the wellness condition. Relevant outcomes will address the symptoms, etiology or indications in a way that leads to achieving the ideal situation for the client - given their personal circumstances. Outcomes are client-centered and state what client behavior is expected. These behaviors may be passive or active on the part of the client. The client’s maintaining lab values within normal limits is passive, while the client’s performing deep breathing exercises every two hours is an active behavior.

Outcomes need to be both realistic and measurable. To be realistic, consideration needs to be given to the client’s condition to determine what is actually feasible. To be measurable, an observable behavior must be specified along with a time frame for that behavior to be achieved. For example, lab values may be specified to be within normal limits throughout the pateint’s hospital stay. The example cited above of deep breathing exercises every two hours included the time parameter of every two hours.

Interventions

Nursing interventions will include strategies to assist the client in achieving the outcome(s). Unlike the outcomes, the intervention is healthcare provider-centered and will state what members of the healthcare team, including the nurse, will do to address the condition identified in the nursing diagnosis.

Implementation

Implementation refers to the actual application of the care plan. This will be where the interventions are carried out to facilitate the client’s achievement of the outcomes that have been identified.

Evaluation

Evaluation includes two (2) steps: The determination of whether the client has met the outcomes Decisions about whether or not changes need to be made to the care plan

If the client is not meeting the outcome(s), consideration needs to be given as to whether the outcomes were realistic and measurable and/or whether the interventions were appropriate and adequate in helping the client to achieve the outcomes. If problems are found with the outcomes or interventions, the care plan should be revised for the client. Professional Nursing Associations

5


Nurses do not practice in isolation but rather are part of group of professionals who are larger than themselves individually. Professional nursing organizations have been established to inspire professional camaraderie. Membership and participation in these organizations allows nurses to put their voices together to speak out on issues in a powerful way. Many nursing organizations address clinical specialties while some others draw ethnic groups together. Others address the interests of the profession at large. You can obtain listings of and information about professional nursing associations by researching the internet.

The nursing organization most relevant to you as a nursing student will probably be the National Student Nurses Association (NSNA). Most states have their own student nurses’ associations that are constituents of the NSNA. Additionally, some colleges have their own ethnic or multi-cultural nursing associations. These efforts offer additional support to minority students. The nursing department administration at your college should be able to provide information to you about these associations and how to become members.

6


Personal ManagementTime Management

Efficient time management is essential to your success in nursing school. With only so many hours in a day and the volumes of information that you must learn to become prepared to enter the nursing profession, you must carefully consider how to accomplish everything. Here are some strategies for effectively managing your time.

1. At the beginning of each semester, prepare a calendar that includes all the activities in your life. This calendar should be updated as changes occur. Activities to be included on this calendar include:

Scheduled classes Class assignments, including reading and required submissions Scheduled tests Planned school activities, such as clinical rotations and extracurricular activities Work Family activities

2. Every Sunday, the upcoming week’s schedule should be reviewed. This will help you avoid surprises and assure that all necessary activities are included. This review should include:

Daily classes Review of class notes to see if any additions are needed Allotment of time for working on assignments and projects Test preparation

3. Each evening, you should review the schedule for that day and for the following day. This review should include:

Checking to see that all scheduled tasks for the day have been accomplished and checked off

Moving unaccomplished tasks to future dates as needed Reviewing the day’s class notes and making additions

The following suggestions are offered by the Academic Skills Center at Dartmouth College (2001).

1. Count all your time as time to be used and make every attempt to get satisfaction out of every moment.

2. Find something to enjoy in whatever you do.3. Try to be an optimist and seek out the good in your life.4. Find ways to build on your successes.5. Stop regretting your failures and start learning from your mistakes.6. Remind yourself, "There is always enough time for the important

things." If it is important, you should be able to make time to do it.7. Continually look at ways of freeing up your time.8. Examine your old habits and search for ways to change or eliminate

them.9. Try to use waiting time-review notes or do practice problems.10. Keep paper or a calendar with you to jot down the things you have to

do or notes to yourself.

7


11. Examine and revise your lifetime goals on a monthly basis and be sure to include progress towards those goals on a daily basis.

12. Put up reminders in your home or office about your goals.13. Always keep those long term goals in mind.14. Plan your day each morning or the night before and set priorities for

yourself.15. Maintain and develop a list of specific things to be done each day, set

your priorities and the get the most important ones done as soon in the day as you can. Evaluate your progress at the end of the day briefly.

16. Look ahead in your month and try and anticipate what is going to happen so you can better schedule your time.

17. Try rewarding yourself when you get things done as you had planned, especially the important ones.

18. Do first things first.19. Have confidence in yourself and in your judgment of priorities and stick

to them no matter what.20. When you catch yourself procrastinating-ask yourself, "What am I

avoiding?"21. Start with the most difficult parts of projects, then either the worst is

done or you may find you don't have to do all the other small tasks.22. Catch yourself when you are involved in unproductive projects and

stop as soon as you can.23. Find time to concentrate on high priority items or activities.24. Concentrate on one thing at a time.25. Put your efforts in areas that provide long term benefits.26. Push yourself and be persistent, especially when you know you are

doing well.27. Think on paper when possible-it makes it easier to review and revise.28. Be sure and set deadlines for yourself whenever possible.29. Delegate responsibilities whenever possible.30. Ask for advice when needed.

Stress Management

Nursing school imposes a separate and distinct level of stress on students. Students are expected to acquire a great deal of knowledge and demonstrate the ability to apply that knowledge in a relatively short period of time. Training programs for registered nurses, whether in pursuit of an Associates Degree in Nursing (ADN) or Baccalaureate Degree in Nursing (BSN), typically include four semesters of learning. During these four semesters, many students enter the nursing program with no experience in the healthcare environment. They are expected to quickly progress and be able to demonstrate an adequate clinical skill level to be deemed competent to enter the nursing profession. This can impose high levels of stress on an individual.

While a certain level of stress is useful for maintaining optimal motivational levels for learning, it is well known that being overly stressed may result in impeding learning. Studies of nursing students’ experiences have revealed that excessive stress is commonly felt while participating in nursing education programs. High levels of stress actually have been found to prevent students from performing at their best level.

The stressors that students encounter in nursing school have been identified by students of nursing for many years and are not likely to change. In fact, as technological advances are made, nurses must be prepared to function in these highly technological settings - while remembering to focus on the patient. Additionally, when nursing students graduate and enter practice settings; they are likely to encounter continued stress due to inadequate resources and budgetary restrictions. For these reasons, it is important that nursing students develop methods for managing their stress

8


levels. This strategy enables the student to have both a positive learning experience while in school as well as to be prepared to effectively cope upon entering the profession.

The Academic Skills Center at Dartmouth College (2001) offers the following methods for managing stress effectively:

Add balance to life; don't overdo studies or play. Know and accept what kind of person you are: strengths and

weaknesses. Get a thorough physical exam. Take "time outs", especially during study. Expand your support network, reinforce friendships. Exercise regularly. Watch your breathing. Walk loosely and walk more. Learn and practice relaxation skills. Study each subject regularly for moderate periods of time. Discuss problems with friends, family, dean or counselor.

The Academic Skills Center at Dartmouth College (2001) offers the following excerpt to students at their website. It is from an article by Geoffrey Cowley in Newsweek, June 14, 1999,:

As Stanford psychiatrist David Spiegel puts it, "Living a stress-free life is not a reasonable goal. The goal is to deal with it actively and effectively."

One approach is to emulate people who are naturally resistant to stress. Some people weather devastating experiences with uncanny serenity. By studying them, researchers have discovered that they share distinctive habits of mind.

They tend to focus on immediate issues rather than global ones. Stress-resistant people also tend to share an optimistic "explanatory

style." They assume their troubles are temporary ("I'm tired today") rather

than permanent ("I'm washed up") and specific ("I have a bad habit") rather than universal ("I'm a bad person")

They credit themselves when things go right, while externalizing their failures ("That was a tough audience," not "I gave a wretched speech").

Aside from dealing directly with stressors and the stressful responses they elicit, you should also consider using relaxation techniques to lower your personal threshold for becoming “stressed out”. These techniques include doing any activity that leads you to relax. They may be either active or passive.

Active and passive approaches may include the following either alone or in combination:

Physical exercise

9


Counseling Socializing with family and friends Meditation Yoga Massage Music Cinematherapy Aromatherapy Naps Bubble bath and a glass of wine

Selecting activities to reduce stress and to promote relaxation is highly individualized. You should experiment and find what you most enjoy and find helpful. You need to strike a balance to prevent excessive levels of stress and to perform your best.

Motivation

Motivation is necessary for achieving any goal. Some people are more motivated than others. Additionally, some people are motivated to excel while others have just enough “push” to get the job done. Many factors influence the levels of motivation that we have to set goals and then to pursue them.

If you have entered nursing school, you have set the goals of passing your nursing courses, graduating from the program, passing the NCLEX-RN exam, and working as a nurse. It is critical that you keep these goals uppermost during your journey through nursing school. This will help to keep you focused on why you are working so hard to master the nursing curriculum.

While in nursing school, this must be considered your primary job. You must carefully block out time to allow for studying and participation in the classes, lab sessions, and clinical shifts. You need to solicit as much support as possible from family and friends. They should provide encouragement and assist in meeting other needs, such as child care or household maintenance.

Motivation includes the drive to accomplish goals in combination with the ability to avoid procrastination. Maintaining adequate motivation will assist in avoiding procrastination. The Center for Advancement of Learning at Muskingum College (n.d.) suggests the following actions to support a non-procrastination plan:

A Non-Procrastination Plan

Make a Schedule

Allocate specific times to complete tasks using semester, monthly, weekly, or daily planners.

Get Motivated

It does no good to make a schedule unless it will be followed. Work with a friend to motivate each other. Consider how long-term and short-term goals will be fulfilled by getting things done on time. Visualize how it felt to get tasks done on time in the past, and remember how stressful it was to put off work.

Reevaluate Your Priorities

10


How do you prioritize success in school, social life, work, and other activities in your life? If school is your first priority, that work must come before any other activities. If you decide success in school is not your first priority, then don't expect high grades.

Take Responsibility

Don't make excuses to yourself for procrastinating, and don't blame others when distracted. Saying "I'm so busy I never get to..." is just an excuse and form of procrastination. Staying on track is a personal responsibility. It's in your hands.

Cause and Effect Relationships

Step back and critically examine cause and effect relationships in your life. How do you explain failures? To what factors do you attribute them? Be honest. Did you receive a poor grade on a project because you started it late or didn't put in enough time? Avoid rationalizations like "The prof hates me" or "I didn't understand the assignment." Thoughtfully examine the consequences of your behavior.

Working "Under Pressure"

Some people describe themselves as "working better under pressure." If you feel this way, honestly and critically the validity of this statement. When you work under pressure, are you really turning in your best work? If not, procrastination is having a negative impact on you. If you really think you are doing your best, make sure the pressure comes from you and not someone else.

Variety is the Spice of Life

Make two activity lists: "Things I like to do" and "Things I have to do." Mix up activities from both lists and work on each activity for a short period of time. Alternating between fun and distasteful tasks helps to maintain motivation and interest.

Think Small

Because it is easier to put off overwhelming tasks than small ones, divide major assignments into smaller parts and work on one part at a time.

Be Realistic

Some people procrastinate because they have too much to do. They have every intention of doing things in a timely manner, but they run out of time. There are only 24 hours in a day. Thoughtfully examine your obligations and responsibilities. Is your schedule realistic? Are you involved in too many activities? Don't "spread yourself too thinnly" because none of your projects will get the full attention they deserve.

Focus on Assets

11


Some people are good at summarizing major ideas. Others write exceptionally well. Some people work well with others. Find out what your assets are. Then work them into everything you do. This will improve your confidence and motivation for tackling a distasteful job.

Rewards

Reward yourself lavishly when tasks are completed on time. Make the reward appropriate for the difficulty and boredom of the task.

Confidence

Life as a nursing student is laden with opportunities for feeling unsure of yourself. You will be presented with many new and unfamiliar circumstances in an environment with high expectations. You must be kind to yourself and remember that you are a student and that learning takes time. In fact, as a nurse, you will never stop needing to learn and to be open to changing to practice in the most current evidence-based manner so that you can offer the best standard of care to your patients. Achieving a sufficient level of self-confidence is essential as you progress in nursing school and in life in general. Having a high level of self-esteem is important as you proceed in the nursing program working to build self-confidence in your new role as a nurse.

The UT Learning Center at the University of Texas at Austin (2006) offers the following suggestions for building self-esteem:

STRATEGIES FOR BUILDING SELF-ESTEEM

Crises of self-esteem are a part of the human experience. When you feel troubled by low self-esteem, review the suggestions below and choose those that are relevant to your situation and work on them. Be patient with yourself: change takes time and steadfast work.

1. Free yourself from "shoulds". Live your life on the basis of what is possible for you and what feels right to you instead of what you or others think you "should" do. "Shoulds" distract us from identifying and fulfilling our own needs, abilities, interests and personal goals. Find out what you want and what you are good at, value those, and take actions designed to fulfill your potential.

2. Respect your own needs. Recognize and take care of your own needs and wants first. Identify what really fulfills you — not just immediate gratifications. Respecting your deeper needs will increase your sense of worth and well-being.

3. Set achievable goals. Establish goals on the basis of what you can realistically achieve, and then work step-by-step to develop your potential. To strive always for perfectionist, absolute goals — for example, "Anything less than an A in school is always unacceptable" — invites stress and failure.

4. Talk to yourself positively. Stop listening to your "cruel inner critic." When you notice that you are doubting or judging yourself, replace such thoughts with self-accepting thoughts, balanced self-assessment and self-supportive direction.

5. Test your reality. Separate your emotional reactions — your fears and bad feelings — from the reality of your current situation. For example, you may feel stupid, anxious and hopeless about a project, but if you

12


think about it, you may still have the ability and opportunity to accomplish something in it.

6. Experience success. Seek out and put yourself in situations in which the probability of success is high. Look for projects which stretch — but don't overwhelm — your abilities. "Image" yourself succeeding. Whatever you accomplish, let yourself acknowledge and experience success and good feelings about it.

7. Take chances. New experiences are learning experiences which can build self-confidence. Expect to make mistakes as part of the process; don't be disappointed if you don't do it perfectly. Feel good about trying something new, making progress and increasing your competence.

8. Solve problems. Don't avoid problems, and don't moil about them. Face them, and identify ways to solve them or cope with them. If you run away from problems you can solve, you threaten your self-confidence.

9. Make decisions. Practice making and implementing positive decisions flexibly but firmly, and trust yourself to deal with the consequences. When you assert yourself, you enhance your sense of yourself, learn more, and increase your self-confidence.

10. Develop your skills. Know what you can and can't do. Assess the skills you need; learn and practice those.

11. Emphasize your strengths. Focus on what you can do rather than what you cannot. Accept current limitations and live comfortably within them, even as you consider what strengths you might want or need to develop next.

12. Rely on your own opinion of yourself. Entertain feedback from others, but don't rely on their opinions. Depend on your own values in making decisions and deciding how you feel about yourself and what is right for you to do.

Personal Health Management

Maintenance of personal health is critical to academic success in nursing school. Being alert and paying attention in learning sitautions may not occur with compromised health. Proper sleep, nutrition, exercise and relaxation is necessary for good health. Adequate rest is essential to optimal performance. Having a healthy balance of these elements may assist with your ability to concentrate as teaching occurs. Health concerns should be addressed with a healthcare practitioner so that proper diagnoses and treatment may be obtained. As noted with good stress management, ideal personal health management needs to be carried out in an ongoing manner.

Improper sleep can cause many problems for students. These range from inability to learn to inability to recall what you have learned. Additionally, for nursing students, adequate sleep is essential prior to attending clinical shifts where you are responsible to provide care for patients.

The Academic Skills Center at Dartmouth College (2001) cites Peter Hauri from the Upjohn Company who offers the following guidelines for getting adequate sleep.

TEN RULES TO BETTER SLEEP

1. Sleep as much as needed to feel refreshed and healthy during the following day, but not more. Curtailing time in bed a bit seems to solidify sleep: excessively long times in bed seem related to fragmented and shallow sleep.

13


2. A regular arousal time in the morning seems to strengthen circadian cycling and to finally lead to regular times of sleep onset.

3. A steady daily amount of exercise probably deepens sleep over the long run, but occasional one-shot exercise does not directly influence sleep during the following night.

4. Occasional loud noises (e.g., aircraft fly-overs) disturb sleep even in people who do not awaken because of the noises and cannot remember them in the morning. Sound-proofing the bedroom might be advisable for people who have to sleep close to excessive noise.

5. Although an excessively warm room disturbs sleep, there is no evidence that an excessively cold room solidifies sleep, as has been claimed.

6. Hunger may disturb sleep. A light bedtime snack (especially warm milk or similar drink) seems to help many individuals sleep.

7. An occasional sleeping pill may be of some benefit, but the chronic use of hypnotics is ineffective at most and detrimental in some insomniacs.

8. Caffeine in the evening disturbs sleep, even in persons who do not feel it does.

9. Alcohol helps tense people to fall asleep fast, but the ensuing sleep is then fragmented.

10. Rather than trying harder and harder to fall asleep during a poor night, switching on the light and doing something else may help the individual who feels angry, frustrated, or tense about being unable to sleep.

14


Strategic Learning ToolsConcentration

When confronted with large volumes of information to learn, often including information that may seem complex, the need to set yourself up for effective concentration is paramount to your success. This includes identification of an appropriate area and time schedule to enhance your efforts. The following suggestions are offered by the Cook Counseling Center at Virginia Tech (2006) regarding concentration:

Concentration: Some Basic Guidelines

1. Set aside a place for study and study only!

A. Find a specific place (or places) that you can use for studying (for example, the campus libraries, vacant classrooms, quiet areas in the student center, bedroom at home, etc.)

B. Make a place specific to studying. You are trying to build a habit of studying when you are in this place. So, don't use your study space for social conversations, writing letters, daydreaming, etc.

C. Insure that your study area has the following:

good lighting ventilation a comfortable chair, but not too comfortable a desk large enough to spread out your materials

D. Insure that your study area does not have the following:

a distracting view of other activities that you want to be involved in

a telephone a loud stereo a 27-inch color TV a roommate or friend who wants to talk a lot a refrigerator stocked with scrumptious goodies

2. Divide your work into small, short-range goals.

A. Don't set a goal as vague and large as ... "I am going to spend all day Saturday studying!" You will only set yourself up for failure and discouragement.

B. Take the time block that you have scheduled for study and set a reachable study goal. (for example: finish reading 3 sections of chapter seven in my Psych. text, or complete one math problem, or write the rough draft of the introduction to my English paper, etc.)

15


C. Set your goal when you sit down to study but before you begin to work.

Set a goal that you can reach. You may, in fact, do more than your goal but set a reasonable goal even if it seems too easy.

Reading Strategies

Everyone has to identify an approach to reading that is effective for them. This is especially important in nursing school where there is so much to read. A couple examples of specific strategies are discussed at a website, How-To-Study.com: A Study Skills Resource Site (n.d.). These strategies include the SQRW and the REDW. The SQRW reading strategy is summarized as follows:

A Strategy for Reading Textbooks

SQRW is a four-step strategy for reading and taking notes from chapters in a textbook. Each letter stands for one step in the strategy. Using SQRW will help you to understand what you read and to prepare a written record of what you learned. The written record will be valuable when you have to participate in a class discussion and again when you study for a test. Read to learn what to do for each step in SQRW.

Survey. Surveying brings to mind what you already know about the topic of a chapter and prepares you for learning more. To survey a chapter, read the title, introduction, headings, and the summary or conclusion. Also, examine all visuals such as pictures, tables, maps, and/or graphs and read the caption that goes with each. By surveying a chapter, you will quickly learn what the chapter is about.

Question. You need to have questions in your mind as you read. Questions give you a purpose for reading and help you stay focused on the reading assignment. Form questions by changing each chapter heading into a question. Use the words who, what, when, where, why, or how to form questions. For example, for the heading "Uses of Electricity" in a chapter about how science improves lives, you might form the question "What are some uses of electricity?" If a heading is stated as a question, use that question. When a heading contains more than one idea, form a question for each idea. Do not form questions for the Introduction, Summary, or Conclusion.

Read. Read the information that follows each heading to find the answer to each question you formed. As you do this, you may decide you need to change a question or turn it into several questions to be answered. Stay focused and flexible so you can gather as much information as you need to answer each question.

Write. Write each question and its answer in your notebook. Reread each of

16


your written answers to be sure each answer is legible and contains all the important information needed to answer the question.

As you practice using SQRW, you will find you learn more and have good study notes to use to prepare for class participation and tests.

HINT: Once you complete the Survey step for the entire chapter, complete the Question, Read, and Write steps for the first heading. Then complete the Question, Read, and Write steps for the second heading, and so on for the remaining headings in the chapter.

How-To-Study.com (n.d.) summarizes the REDW strategy as follows:

Reading Comprehension: The REDW Strategy for Finding Main Ideas

REDW is a good strategy to use to find the main idea in each paragraph of a reading assignment. Using this strategy will help you comprehend the information contained in your assignment. Each of the letters in REDW stands for a step in the strategy.

ReadRead the entire paragraph to get an idea of what the paragraph is about. You may find it helpful to whisper the words as you read or to form a picture in your mind of what you are reading. Once you have a general idea of what the paragraph is about, go on to the next step.

Examine Examine each sentence in the paragraph to identify the important words that tell what the sentence is about. Ignore the words that are not needed to tell what the sentence is about. If you are allowed to, draw a line through the words to be ignored. For each sentence, write on a sheet of paper the words that tell what the sentence is about.

Decide Reread the words you wrote for each sentence in the paragraph. Decide which sentence contains the words you wrote that best describe the main idea of the paragraph. These words are the main idea of the paragraph. The sentence that contains these words is the topic sentence. The other words you wrote are the supporting details for the main idea.

Write Write the main idea for each paragraph in your notebook. This will provide you with a written record of the most important ideas you learned. This written record will be helpful if you have to take a test that covers the reading assignment.

Use REDW to help you understand the information in your reading assignments.

17


A great deal of the reading that you will be expected to complete in nursing school is about complex topics. The Center for Advancement of Learning at Muskingum College (n.d.) offers the following suggestions for reading difficult material.

CHALLENGING READING MATERIAL

Reading assignments may be challenging if the information is highly specialized or technical, or if the material is beyond the student's level of preparation. In these situations it is common for students to lose interest and motivation. The following tips may help students get through difficult reading assignments.

Repetition. o Read over the assignment once. Switch to another task for a

period of time or sleep on it. Re-read the material later or on the following day. Review the assignment periodically.

Remediation. o Consult supplemental resources for learning fundamental

information needed to understand the reading assignment. Possibilities include introductory textbooks, student workbooks or study guides to textbooks, lab manuals, and survey books.

Consult with Professionals. o Additional help in understanding difficult readings may be

obtained from the instructor during office hours, from graduate assistants, and from professional tutors. Peer tutors or upper-class majors may also provide valuable assistance.

Essential Words. o Focus on key words in the text. Emphasize verbs and nouns

only; ignore or cross out unnecessary adjectives and adverbs. Look for terms in bold print or italics.

Review and Summarize. o Review after reading each paragraph of text. Identify the main

idea of each paragraph. Be sure to understand each paragraph before moving on to the next. Review at the end of each section as well as at the end of the chapter. Develop your own summary of the chapter and compare it to the summary presented in the book.

Make Reading More Active. o Comprehension may be improved if one uses senses other than

vision while reading. Stimulate the auditory sense by reading aloud or listening to tape recordings of the text. Take notes during or after reading difficult material.

Make Reading Interactive. o Work with another student. Read to each other, and take turns

summarizing sections or chapters of text. "Teach" each other the more difficult concepts, making liberal use of visual aids. Relate the material to personal experiences.

Review Questions. o Evaluate your understanding of the material by answering the

review questions at the end of the chapter or in student study guides and workbooks. If questions are not available, make up your own by converting the section headings into questions.

Words and Definitions.

18


o Look up the definitions of all unfamiliar words, even if they are not in bold print or italics. Compile a written list of unfamiliar words (and definitions) that appear repeatedly, or record the words and definitions on audio tapes and listen to them for review. Use a dictionary to look up non-technical words, and consult the glossary in the book for technical word definitions. Place a colored paper clip on the glossary pages for quick access.

Note-taking

The Cornell Method of note-taking is recommended by multiple learning institutions. This system requires that the student identify key words and list relevant points or pertinence. This method of note-taking forces the student to categorize information and provides a good outline for later study.

The Center for Advancement of Learning at Muskingum College (n.d.) provides the following directions for using the Cornell method:

Directions for using the Cornell method are as follows.

Divide the paper Use loose leaf notebook paper and write on one side of the page only. Divide the paper vertically by drawing a line from top to bottom about

2" from the left side of the page.

Documentation o Write the following information at the top of each page: student

name, course, date, and page number. Record Notes

o During lecture, record the main ideas and concepts on the right side of the page. This is the notes column.

o Rephrase the information in your own words before writing it down.

o Skip one line between ideas and several lines between topics. o Avoid writing in complete sentences; use symbols and

abbreviations instead. o The format or style of the notes can vary, but avoid using a

formal outline. Suggestions for organizing the notes are:

19

http://www.muskingum.edu/~cal/database/general/notetaking3.html#Abbreviations%23Abbreviations

http://www.muskingum.edu/~cal/database/general/notetaking3.html#Abbreviations%23Abbreviations

http://www.muskingum.edu/~cal/database/general/notetaking3.html#Outline%23Outline


Paragraph Style: For unstructured information, record notes in paragraph style with short, telegraphic sentences and phrases.

Topic and Ideas Style: For expanded topic information, record topics and ideas.

Sentence Style: For ideas and concepts, record notes in short sentences.

Definition Style: For main topics and features, record definitions and explanations of words in short phrases.

Review and Clarify As soon after class as possible, review the notes in the

right column and clarify any ambiguous information. Compare the information with the book and/or other

students' notes. Then pull the main ideas, concepts, terms, places, dates,

and people from the right column and record them in the left-hand recall column.

Summarize Prepare a summary of the lecture material and record it at the end of

the notes. o The summary may be in sentences or short phrases. It should

include only the main ideas from the lecture. Study

o Use both sections of the notes to prepare for quizzes and exams.

Study Skills

Study skills are essential for nursing students. Here are some general principles about the use of study skills.

Schedule study time into sessions of 20 to 30 minutes, which is the average attention span of most people. Breaks should be scheduled between these sessions.

Develop a plan that schedules study time for all necessary topics as this will increase your chances of covering all necessary material.

Squeeze studying into small periods of spare time, such as time between classes.

Memorization

To be successful in nursing school students need to be able to memorize information as well as to apply that information to perform critical thinking. Memorized facts provide the base of knowledge that is needed to perform as a nurse, making the clinical decisions that are best for the clients. People remember approximately 10% of what they read, 20% of what they hear, 30% of what they see, 50% of what they see and hear together, 70% of what they say if they are thinking about what they are saying, and 90% of what they do (Muskingum College, n.d.). Given this information the wisest strategy for study success would be to use a combination of methods that offer opportunities to engage the material to be learned in a variety of ways. A variety of study strategies will be discussed in this section. You may want to experiment with them to find the most effective ones for you.

The Academic Skills Center at Dartmouth College (2001) offers the following strategies for assisting your memory.

NINE WAYS TO AID YOUR MEMORY

20


It is more natural to forget something than to remember it. If you intend to remember something, apply as many of the following techniques as possible.

Be flexible. Experiment with many learning procedures. Be willing to abandon outmoded and faulty learning procedures so you will be free to acquire new and more efficient methods.

Overlearn. In order to retain anything learned, you must practice and reorganize it into your current ongoing activity. One way to do this is to incorporate the learned material as part of your present habit system. Use it in speaking and writing. Act out the material as a rehearsal of a part in a play-a process known as role-playing. This is especially helpful in learning a foreign language.

Schedule. Schedule your study time so that the time at which something is learned or relearned is close to the time at which it will be used.

Rephrase and explain. Try a little role-playing. Take the point of view of the teacher, for a change. Rephrase and explain the material, in your own words, to a classmate. Allow your classmate to criticize your presentation. Then let the classmate be the teacher, while you criticize. If you can't explain something, you don't really know it.

Many students adopt the so-called warm-body attitude toward learning. A "warm" feeling toward one particular answer becomes the basis for its selection, regardless of whether one really knows why the answer is correct. This attitude is the result of classroom examining procedures in which true-false and multiple-choice items are used exclusively for testing. Testing in this manner encourages the attitude that mere recognition of the most probable answer constitutes learning.

Even though a particular course may not require adequate recall by using more penetrating recall-type questions, don't allow yourself to fall into this warm-body learning trap. Insist on testing yourself! If you can explain the material, most certainly you can pass any "objective" test calling for superficial recognition. However, the reverse is most certainly not true. Learning only to a point of recognition, and depending on your ability to ferret out the correct response, is insufficient for total-recall kinds of tests. Sooner or later this habit will result in total failure in a demanding test situation.

Eliminate accidental and unrelated associations. A study situation in which a phone is constantly jangling produces breaks in the mental association process. Remove the receiver. The only suggestion that can be made for the elimination of television during the study period is to donate the set to a family that is not involved in higher education.

Eliminate previous mistakes. Take note of all previous mistakes and make every effort to eliminate them from future practice. It has been shown experimentally that consciously reviewing mistakes,

21


making note of exactly why they were incorrect, helps to reinforce the correct response. This process is sometimes referred to as negative practice.

Decide on an order of importance. Some things are more important than others. In a particular study unit, decide what these are and organize the important material into an outline or framework. "Over-learn" this particular framework.

Become emotionally involved. Assume the attitude that you fully believe the viewpoint of the author. Strive for perfection. You may never achieve it, but you will most certainly improve your performance. Learn to discuss your current beliefs calmly with people holding different attitudes. Cite authorities to back up your position.

Use mechanical memory aids. When material is complicated, it may be necessary to use mechanical memory aids. For example, suppose you had reason to believe that a certain table showing all of the endocrine glands of the body with their secretions and functions would be called for in an examination. In order to be sure that you would be able to recall all of the glands, you memorized the first letter or syllable of each gland, and organized them into three very strange words: Anpothy Paramed Adcorpan, the novelty of which aided recall. This could be deciphered as follows: An=anterior pituitary, po=posterior pituitary, thy=thyroid, par=parathyroid, amed=adrenal medulla, adcor=adrenal cortex, pan=pancreas, etc.

Specific study methods have been identified by different learning institutions to aid with memorization. Some of these methods are described below.

Mnemonics

Mnemonics refers to organizing material by arranging key words in an order where the first letter of each is arranged into an order that forms a word or acronym that is more easily memorized. Each letter is then used as a cue to recall a word or phrase.

Example:What are the qualities of a scientist? (mnemonic answer: PIPOC)P erserveranceI ntelligenceP atienceO riginalityC uriosity

Grouping

Grouping is a strategy that can be helpful when trying to recall a long list of items. Rather than attempting to remember the entire list, where items in the middle tend to be forgotten, the long list is broken down into several smaller lists making it easier to commit to memory.

Alphabetizing

Alphabetizing offers an easy and quick method for list memorization. Note that this strategy may be used in combination with other strategies, such as grouping or mnemonics.

22


Rhymes, Songs, and Poems

Rhymes, songs, and poems may offer an easier strategy for remembering information than rote memorization.

The Center for Advancement of Learning at Muskingum College (n.d.) offers these guidelines for the use of rhymes, songs and poems in studying:

To remember information using rhymes, songs and poems, follow these steps.

Identify the new information to be remembered. Try to link the new information with a song or tune already known.

Familiar tunes like "Old MacDonald" or "Bingo" are often effective. If no song works, try to work the information into a simple poem. If a poem cannot be formed, repeat the information in a rhythmic

manner to aid remembering.

Study Cards

The use of study cards is helpful in memorization as they engage the learner in both kinesthetic and visual manners. The more ways that a student engages in learning information the more likely the student will recall that information. If the student also verbalizes the writings on the cards they will be also engaging their sense of hearing.

Outlining

Outlining material to be remembered can be effective when there is a large volume of information to be recalled. This is done by identifying key points from the body of information and then arranging it in a logical order that can be more easily remembered.

RCRC Strategy

The RCRC strategy (Read, Cover, Recite, Check) is useful for memorizing information. It may be helpful in learning definitions and facts. This would be a good way for nursing students to study medication dosing and laboratory values. Muskingum College (n.d.) provides the following steps for this strategy.

Read: Read and reread a portion of the information. Cover: Cover the material with a piece of paper. Recite: Recite what you have read in your own words. Check: Check the accuracy of recitation against the written

material.

Rehearsal Strategies

Rehearsal strategies are intended to be repeated a number of times to commit new information to memory. These methods allow for active participation in learning, which improves learning. Muskingum College (n.d.) offers the following information about rehearsal strategies.

Practice Makes Perfect ?!

23


Students should be taught to thoroughly check the accuracy of information to be rehearsed prior to beginning the process. Practice may indeed make perfect, but students may be practicing perfectly information that is inaccurate or incomplete.

Recitation and Review Strategies

The following strategies of recitation and review make rehearsal a more active process. Students should be encouraged to use more than the visual sense (reading) when reviewing information.

Self-monitoring, or reading aloud to oneself or another person Read or speak into a tape recorder and listen to the tape while

reviewing Provide rehearsal in a realistic context (e.g. study in the testing room,

reduce interference) Daily distributed review, or spread sessions throughout the day

For more information on recitation and review, see the Reciting and Spacing Reviews section of this page.

Task Checklists

To maintain focus, keep an ongoing checklist of studying: the types of problems to be solved, the skills to be mastered, and the major ideas, terms, theories, formulas, and equations to be memorized. Make the task descriptions as brief as possible.

Study Actively

Effective rehearsal involves doing something with new information. Several of the suggestions listed below may be used both for rehearsal (implanting information in short-term memory) as well as for encoding (implanting information in long-term memory).

Develop flash cards Transfer notes into alternative note-taking formats Rewrite notes or enter them into a computer Develop questions on the material Use new terms in sentences or in a journal Work example problems Tutor or lecture another student Develop summaries or outlines of the material

According to Herrman, Raybeck and Gutman (1993, p. 91-92), "rehearsal is particularly useful for two kinds of situations: when you want to keep information in consciousness, but are not concerned about establishing a long-term memory; or when you are not motivated to use a more challenging or elaborate manipulation to establish a long-term memory." They suggest several rehearsal strategies for improving memory performance:

24


Act out the information to be remembered. For example, when studying by yourself pretend to be a historical figure, or when studying with a group pretend to be atoms diffusing from an area of high concentration to an area of lower concentration.

Articulary rehearsal involves repeating information syllable by syllable, noting the placement of the tongue at each stage.

Rhythmic rehearsal entails repeating an item in a rhythmic manner, by syllables or with a beat.

Spaced rehearsal involves repeating information aloud or mentally with increasing intervals of time between each repetition. For example, say "property depreciation," wait 1 second, repeat "property depreciation," wait 2 seconds, repeat "property depreciation," wait 4 seconds, repeat "property depreciation," wait 8 seconds, etc.

Cumulative rehearsal involves repeating items in a list in successively larger groups, starting with the first item each time. For example, say "cell," then say "cell, tissue," then say "cell, tissue, organ," then say "cell, tissue, organ, system."

Visual Aids

Visual aids can be powerful tools to assist with learning. Combining the use of these tools with other learning tools that engage the other senses actively will enhance the learning. Some examples of visual aids include:

Tables Flow charts Outlines Concept maps (fishbone diagram, spider maps)

The ability to visualize these items when in situations calling for recall of information is often used unconsciously. Students may intensify the effectiveness of this strategy by calling upon formalizing their use of visualization and by calling upon other senses to cement the new information into their memory. Muskingum College (n.d.) provides the following directions for visual association.

Identify the new information to be remembered. Identify an image from existing knowledge that reminds you of the new

information. o Make the image large, exaggerating features and enlarging it to

unusual or unnatural proportions. o Make the image as bizarre or unusual as possible. o Produce associations that are different from what might be

expected. o Images may be still or, better yet, animated. When motion is

added to a mental picture, it helps the mind to retain it. o Add sounds or smells to the image if you can.

Chaining

Chaining is a study strategy where the student links concepts to each other, two at a time. This strategy seems especially to some of the material that nursing students must learn, such as pathophysiology where one physiological response leads to the next which leads to the next and so on. Muskingum College offers the following directions for using the chaining strategy.

25


Identify the list of information to be remembered. Arrange the list of items in order, if they need to be remembered as

such. Look at the first pair of items. Develop a vivid mental picture that

links the two items. Look at the next pair of items, numbers two and three in the list.

Develop a vivid mental picture that links the two items. Repeat the process until all items in the list have been chained.

Color Coding

Color coding is a highly versatile study strategy as it may be used during many different study activities, such as reading, note-taking and test preparation. Color coding may be used as a way of organizing information, such as highlighting main ideas in a particular color, pertinent details in a different color, and subtopics in yet a third color. Color coding may be done by writing or highlighting in different colors. Muskingum College (n.d.) offers these suggestions for using color coding.

Try writing flash cards about different topics in different colors of inks or on different colors of index cards.

Use different colors of ink to arrange information in outline form. To distinguish main points from supporting details, write the former in one color and the latter in another. To distinguish information related to different topics, write the main points and supporting details for each topic in a unique color of ink.

Identify important information in the notes or textbook by using colored highlighters.

Study Groups

Study groups offer a wonderful opportunity for sparking motivation as accountability to group members may help to keep you enthusiastic about accomplishing the learning tasks. The idea behind study groups is to divide learning into smaller tasks that are accomplished by individual members and then collectively shared with the group to enhance everyone’s learning. Muskingum College (n.d.) discusses examples of how study groups can be used.

Exam Preparation Study Group o For a management class, the instructor is going to test students

over lecture notes and required readings. o Members of the study group divide the material into the

following topics: product strategies, process strategies, location strategies, and human resources strategies.

o Each member writes a summary of his/her topic, combining both lecture and reading material.

o Each member also makes up three essay questions for his/her material.

o The study group meets to exchange information. Homework Completion Study Groups

o A geology lab assignment involves walking around campus and identifying different types of rocks.

o Members of the study group divide the area into four parts: residence hall area, quad area, recreation area, and south campus.

o Each member tours one of the areas and records the rocks in it.

26


o Then the study group tours all the areas together and each member explains his/her results for his/her area.

Notetaking Study Group o Three students who are auditory learners are having trouble

keeping up with notetaking in Arts and Humanities. o Each member of the group takes notes for about 18 minutes

during class. o When not taking notes, the other members of the group listen

closely to the lecture and just write down the major points. o Then the group meets after class to put the notes together in

an organized manner, to check for discrepencies, and to review main points.

Learning Strategies Study Group o A group of biology students form a study group for an

introductory course. o They discuss strategies for learning the material for the exams. o They decide to use flash cards, tables, and sample questions. o Each member of the group is responsible for applying one of

these strategies to the exam material. o They meet to exchange their results.

Reading Study Group o A marketing reading assignment is divided into parts and

assigned to members of a study group. o Each member intensively reads his/her section and prepares a

summary. o Then each member skims the other sections. o The study group meets to exchange notes and discuss the

reading.

When deciding to form a study group it is important to proceed in an organized manner to facilitate learning and to avoid problems that can occur. How-To-Study.com (n.d.) offers the concrete advice regarding the formation of study groups.

Getting a Study Group Started

Study groups don’t just happen. Here is what you should do to get a study group started:

Get to know your classmates by talking with them before class, during breaks, and after class. When selecting a classmate to join your study group, you should be able to answer YES for each of the following questions:

o Is this classmate motivated to do well? o Does this classmate understand the subject matter? o Is this classmate dependable? o Would this classmate be tolerant of the ideas of others? o Would you like to work with this classmate?

27


Invite enough of these classmates to work with you in a study group until you have formed a group of three to five. A larger group may allow some members to avoid responsibility, may lead to cliques, and may make group management more of an issue than learning.

Decide how often and for how long you will meet. Meeting two or three times a week is probably best. If you plan a long study session, make sure you include time for breaks. A study session of about 60 to 90 minutes is usually best.

Decide where you will meet. Select a meeting place that is available and is free from distractions. An empty classroom or a group study room in the library is a possibility.

Decide on the goals of the study group. Goals can include comparing and updating notes, discussing readings, and preparing for exams.

Decide who the leader will be for the first study session. Also decide whether it will be the same person each session or whether there will be a rotating leader. The leader of a study session should be responsible for meeting the goals of that study session.

Clearly decide the agenda for the first study session and the responsibilities of each group member for that session.

Develop a list of all group members that includes their names, telephone numbers, and email addresses. Make sure each group member has this list and update the list as needed.

Characteristics of a Successful Study Group

Once started, a study group should possess the following characteristics to be successful:

1. Each group member contributes to discussions.

2. Group members actively listen to each other without interrupting. Only one group member speaks at a time.

3. The other group members work collaboratively to resolve any concern raised by a group member.

4. Group members are prompt and come prepared to work.

5. The group stays on task with respect to its agenda.

6. Group members show respect for each other.

7. Group members feel free to criticize each other but keep their criticisms constructive and objective. This can encourage group members to reveal their weaknesses so that the group can help to strengthen them.

8. Group members feel free to ask questions of each other.

28


9. At the end of each study session, an agenda including specific group member responsibilities, is prepared for the next session.

10. Above all, the positive attitude that “we can do this together” is maintained.

Possible Pitfalls of a Study Group

A study group can be a very positive learning experience. However, there are pitfalls to be avoided. Here are some cautions:

1. Do not let the study group get distracted from its agenda and goals.

2. Do not let the study group become a social group. You can socialize at other times.

3. Do not allow group members to attend unprepared. To stay in the group, members should be required to do their fair share.

4. Do not the let the session become a negative forum for complaining about teachers and courses.

5. Do not allow one or two group members to dominate the group. It is important that all members have equal opportunities to participate.

29


Testing StrategiesTest anxiety

The meaning of text anxiety is just what it says – too much anxiety about a test. Most people experience some level of anxiety prior to and/or at the time of testing. In fact a certain level of anxiety inspires us to perform at our peak level. However, when a student is overly anxious, effective test preparation and test-taking can be elusive.

Graduation from nursing school and entry into the profession is dependent upon testing successfully. Nursing students must become savvy in coping with test anxiety to accomplish their goals.

To determine how to best deal with test anxiety, it is helpful to determine whether this is a challenge for you. The following questions are offered by How-To-Study.com to assess if you are affected by test anxiety.

You probably have test anxiety if you answer YES to four or more of the following:

1. I have a hard time getting started studying for a test.

2. When studying for a test, I find many things that distract me.

3. I expect to do poorly on a test no matter how much or how hard I study.

4. When taking a test, I experience physical discomfort such as sweaty palms, an upset stomach, a headache, difficulty breathing, and tension in my muscles.

5. When taking a test, I find it difficult to understand the directions and questions.

6. When taking a test, I have difficulty organizing my thoughts.

7. When taking a test, I often “draw a blank.”

8. When taking a test, I find my mind wandering to other things.

9. I usually score lower on a test than I do on assignments and papers.

10. After a test, I remember information I couldn’t recall during the test.

Strategies for minimizing test anxiety are offered at How-To-Study.com.

Here are some things you can do before, during, and after a test to reduce your test anxiety.

30


1. Use good study techniques to gain cognitive mastery of the material that will be covered on the test. This mastery will help you to approach the test with confidence rather than have excessive anxiety. Employ the tips we provide at Preparing to Study.

2. Maintain a positive attitude as you study. Think about doing well, not failing. Think of the test as an opportunity to show how much you have learned.

3. Go into the test well rested and well fed. Get enough sleep the night before the test. Eat a light and nutritious meal before the test. Stay away from junk foods.

4. Stay relaxed during the test. Taking slow, deep breaths can help. Focus on positive self-statements such as “I can do this.”

5. Follow a plan for taking the test. Don’t panic even if you find the test difficult. Stay with your plan!

6. Don’t worry about other students finishing the test before you do. Take the time that you need to do your best.

7. Once you finish the test and hand it in, forget about it temporarily. There is nothing more you can do until the graded test is returned to you. Turn your attention and effort to new assignments and tests.

8. When the graded test is returned to you, analyze it to see how you could have done better. Learn from your mistakes and from what you did well. Apply this knowledge when you take the next test.

You have to know the material to do well on a test. You have to control test anxiety to show what you know.

The Academic Skills Center at Dartmouth College (2001) offers the following guidelines, adapted from the Harvard Law School Health Service, to combat test anxiety.

1) Try to stay on a reasonably regular schedule of reviewing, eating, sleeping, and relaxing. Start at least a week, or preferably two, before exams begin.

2) Don't attempt to study 24 hours a day; your efficiency and capacity to retain material will rapidly decrease.

3) Don't force yourself to study beyond your normal limits of concentration. If you find yourself able to concentrate for only ten or twenty minutes, study for only that period of time and then take a short break. Your concentration should return. In fact, short and regular study periods are more productive than lengthy single sessions.

4) Eat a well-balanced diet and drink lots of fluids. Excessive amounts of coffee may produce confusion and even disorganization of thought processes.

31

http://www.how-to-study.com/Preparing%20to%20Study.htm


5) Don't use drugs or alcohol -- they can decrease your ability to think clearly. Take medication only under the supervision of a physician.

6) Be conservative and reasonable about the demands you place on yourself.

--adapted from: Harvard Law School Health Service --this handout prepared by Alison Burrell '95

Test Preparation

Test preparation begins when the course begins and should be ongoing each day during the course through the use of study skills, such as the ones described in the Study Skills section of this resource. However some strategies specific to test preparation will be discussed in this section. The University of Texas at Austin offers excellent advice regarding self-management during exam weeks.

How to Survive Exam Weeks

Do you find yourself panicking when you have several exams to take in a short period? Do you feel a lot more stress during mid-terms and finals?

If so, then the following suggestions should prove useful.

DEALING WITH TENSION. Expect a certain amount of tension. It is normal during an exam period. Actually a little anxiety helps to heighten your awareness and can enhance your performance.

1. TAKE TIME TO RELAX. Cope with your excess tension before and between exams through rest, exercise and deep muscle relaxation. For example, long walks and bike rides are excellent ways to release nervous energy and maintain your stamina for the duration of your exam period.

2. ADOPT A POSITIVE APPROACH. To avoid becoming too anxious, look at the exam as the application step of your study efforts, instead of a threatening new experience.

3. ANXIETY IS CONTAGIOUS. Keep away from people who are highly anxious before exams, because their nervousness may tend to increase your own.

4. PLAN REWARDS. Schedule a meal, a movie, a handball game, a visit with a friend periodically throughout finals. Plan a treat when they're all done. These help keep your spirits up.

SCHEDULE FOR EXAMS. Prepare a general schedule. Write down the time of each exam and plan how much time you can allot to studying for each course; remember that your hardest course will require more time.

1. START EARLY. Schedule your study periods to avoid last-minute cramming.

32


2. ALLOW LARGE BLOCKS OF TIME FOR STUDYING. Block out hour spans for getting down concepts and basic relationships.

3. ALLOW SHORT PERIODS FOR REVIEW. Use the odd moments, in the shower or walking across campus, for recall and review. Run through the information frequently; this will ensure that you remember it and it will broaden your understanding.

4. VARY WHAT YOU STUDY. Don't study for two similar courses consecutively. It is better to break the pattern with a completely different study approach. For example, study chemistry and then French instead of chemistry and then physics.

5. SCHEDULE BREAKS. Respect your concentration span. Especially if you haven't studied much all semester, it may be difficult to study for several hours at a time. Starting your exam period with impossibly long study periods is likely to leave you exhausted before it is all over.

6. STAY WITH YOUR ROUTINE. Stick to your normal daily routine as much as possible. If you do get off your routine and need extra time, avoid staying up all night; go to bed at your regular time and get up a couple of hours earlier than you normally would, to continue studying. You will be able to understand and remember more when you are rested than you would if you postpone rest.

THE NIGHT BEFORE. As you approach the first exam, and the time between exams,

1. SPEND YOUR LAST HOURS CALMLY REVIEWING WHAT YOU'VE LEARNED. Try not to tackle new material then.

2. AVOID STAYING UP ALL NIGHT. The shorter you are on sleep the less clearly you will be able to think and write what you know on the exam.

3. CRAM SELECTIVELY. The night before an exam when you are more anxious than usual is one of the least effective times for study. Your ability to deal with concepts and synthesize material is greatly reduced, and even your ability to memorize is impaired by marked anxiety. Cramming only serves to make you more frantic about the exam and, hence, less prepared to do your best. If you do come up to exam time unprepared, use your last minute studying as a review of key concepts, instead of trying to learn it all. Be realistic about what you can accomplish: set priorities based on what you expect to be emphasized on the test. Stay calm.

4. DON'T GO TO THE MOVIES. Don't get involved in any activities that might either interfere with what you have been learning or make you feel so guilty that you come home to study far into the night to make up for lost time. Review and relax.

TAKE CARE OF YOURSELF. In addition to taking an organized and calm approach to studying, you need to make common sense and moderation a general life style during this and other times of stress.

Some strategies related to anticipation of the exam content and format are suggested by Muskingum College (n.d.) and are worth considering.

Expectations about Exam Content and Organization

33


One reason some students experience test anxiety is uncertainties about the content and organization of the exam. They do not know what to expect on the exam. Some of the most common concerns are listed below (D. Applegate, CAL).

When and where will the test be administered? Which topics, chapters, and readings will be covered on the test? What proportion of the questions is from lecture? From readings? From

lab? What are the most important ideas? What kinds of questions - essay, identification, multiple choice, etc. -

will be asked? Is the exam open-book or closed-book? Do students have to memorize formulas, or is a "cheat sheet" allowed? What ancillary materials - blue book, calculator, ruler, etc. - are

required or permitted? What level of detail does the instructor expect in the answers? Does the instructor look for accurate regurgitation of memorized facts

or for interpretation of information? Who will administer the exam - the instructor or a teaching assistant? Who grades the exams - the instructor or a teaching assistant? How will the questions be graded - full or partial credit, by hand or by

machine? Does the instructor deduct points for spelling or grammar mistakes?

There are a number of ways to answer these questions. The following tips are based, in part, on Lunenfeld and Lunenfeld (1992) and Kesselman-Turkel and Peterson (1981).

Examine the syllabus.

Many of the aforementioned questions can be answered simply by checking the syllabus. Most instructors describe testing procedures, including the types of questions and the ancillary materials permitted, in the syllabus. Look at the course schedule; topics listed here will probably appear on the test. Check the syllabus before meeting with the instructor; he/she may be put off if you ask questions whose answers are clearly indicated in the syllabus.

Ask the instructor.

One of the best ways to clarify expectations is to consult with the instructor well in advance of the test. It is better to get information "from the horse's mouth" than from a secondary source. Ask for clarification during or after class, or better yet, make an appointment to visit the instructor during his/her office hours. Have a list of questions ready to ask when you meet with the instructor.

In some cases, the instructor will reward you with information just for coming to see him/her. But if the instructor seems hesitant to answer questions related to the topics or ideas on which the exam focuses, don't press him/her. Similarly, if he/she says "you should know everything" and when pressed doesn't offer more clarification, check the syllabus, old exams, the book, or talk with other students for insights. Instructors are sometimes unwilling to divulge too much.

34


Analyze the instructor's behavior.

If the instructor offers few hints and you've never had a test from him/her before, try analyzing his/her behavior for clues. Consider the types of information emphasized in lecture, the nature of assignments, and the manner of lecture presentation. Ask yourself: Does the instructor focus on details? Does he/she emphasize facts or ideas? Would he/she ask "trick" questions? What's his/her goal in teaching and attitude toward testing? Has he/she encouraged students to evaluate and interpret concepts?

Look at old tests.

Old exams are a valuable source of information concerning the topics or ideas emphasized, the types of questions asked, the way questions are worded, the level of detail the instructor expects in answers, and grading procedures. If copies of old tests are not available, say on reserve at the library, ask the instructor if this accommodation is possible. Some instructors will do this, but only if asked.

Consult with other students.

Talk with students who have taken the class before. Not only may they have old tests, but they may provide insights into instructor expectations, main ideas, and grading procedures. Current classmates may have ideas about the major topics to study.

Use the textbook.

Most texts provide review questions at the end of each chapter or unit. These should give you ideas of what may be asked on the test. Or try turning the chapter headings into questions. Check the index listing of people and concepts; the more page references, the more important the idea.

Use text workbooks.

Student workbooks that accompany the text are an excellent source of review questions for the reading material. They can give you an idea of what topics might be covered on the exam and what the questions may look like.

Practice Test Questions

Doing practice test questions is a wonderful way to prepare for an exam. Study groups could work together to prepare test questions for group members to use. Muskingum College (n.d.) offers the following guidelines for using this approach for test preparation.

Consider the types of questions. Find out what types of questions will be asked on the test:

essay, multiple choice, true-false, etc. Look on the syllabus, ask the instructor, examine old tests, or

talk with former students in the class.

35


Write practice questions. There are several approaches to writing practice questions.

Turn the section headings in the book into questions. Take sets of related pieces of information and write questions focusing on that relationship. Look for the main ideas presented in each lecture and form them into questions. Change the numbers given in math problems and rework them. Ask the instructor for a few sample questions to get an idea of the how he/she writes questions.

Until you become accustomed to the strategy, you may want to use prewritten questions instead of making up questions. There are several sources of practice questions: old exams, review questions at the end of each chapter in the textbook, and student workbooks accompanying the text.

Because writing one's own questions requires thorough examination of the test material, students should attempt to move in this direction as they become more proficient.

Record the questions. Depending on personal learning strengths and preferences,

students may choose to record the practice questions as a list on paper, individually on flash cards, or as a list on audio cassettes.

Answer the questions. There are three options at this stage. Students may answer the

questions as they write them. Or, students may answer the questions later, using the notes and readings as references. In either case, students may want to record the page numbers on which the answers are found in the notes or book.

The third option is to use the questions to as a practice test after reviewing for the exam. This is done without the use of notes or other study materials.

Record the answers. Again, students may record the answers on paper, flash cards,

or audio tapes. Review the answers periodically.

To be really effective, practice questions should be reviewed periodically to test recall and to improve understanding.

Look at the flash cards during "down" time between classes or while standing in line. Listen to the tapes while commuting to school or to work.

Change the order. Shuffle the questions so the information is not learned in a

particular order. This insures that one is actually learning the information itself,

rather than order of questions and answers. This also helps one to prepare for tests in which the questions

are arranged oddly; instructors don't always arrange questions topically or in the order in which the information was covered in class.

Practice. It takes time to gain proficiency in this strategy. Both writing the questions and predicting what might be asked

on the test require practice.

36


These skills should improve as students are exposed to a variety of tests and as they learn more about their instructors' test-writing habits.

Don't lose heart when your questions don't appear on the test. If you've used the strategy effectively, chances are you know the material well enough to answer different questions.

Confidence

Students should do whatever they can to enhance their confidence in their exam preparation and test-taking skills prior to taking an exam. A good level of self-confidence will help to diminish test anxiety and to prompt optimal performance. If a student believes they will do well on an exam, they are more likely to do so.

Being over prepared is a good strategy for making oneself more confident and minimizing test anxiety. Study until you are certain that you know the material. Test yourself on the material either independently or with a study group to assure your knowledge of the material.

Test-taking

Effective test-taking requires that you approach the exam with strategies to aid you in responding correctly to test items. In this section discussion will include suggestions for responding to multiple choice questions, which are the most popular types of questions on exams in nursing school, as well as being the format used on the NCLEX-RN state licensure exams.

DETER Strategy for Test-Taking

The DETER strategy offers an overall approach to test-taking that is relevant to all test types. How-To-Study.com (n.d.) offers the following explanation of this approach.

D = Directions

Read the test directions very carefully. Ask your teacher to explain anything about the test directions you do

not understand. Only by following the directions can you achieve a good score on the

test. If you do not follow the directions, you will not be able to demonstrate

what you know.

E = Examine

Examine the entire test to see how much you have to do. Only by knowing the entire task can you break it down into parts that

become manageable for you.

T = Time

Once you have examined the entire test, decide how much time you will spend on each item.

If there are different points for items, plan to spend the most time on the items that count for the most points.

37


Planning your time is especially important for essay tests where you must avoid spending so much time on one item that you have little time left for other test items.

E = Easiest

The second E in DETER reminds you to answer the items you find easiest first.

If you get stuck on a difficult item that comes up early in the test, you may not get to answer items that test things you know.

R = Review

If you have planned your time correctly, you will have time to review your answers and make them as complete and accurate as possible.

Also make sure to review the test directions to be certain you have answered all items required.

Information Dumping

Information dumping is a test-taking strategy that may help you in recalling information that you are afraid that you will forget or confuse. With this strategy you quickly write down information that you want to remember when beginning the test either on the test booklet or scrap paper, as allowed by the instructor. Examples of information that you may want to include may be names, dates, formulas, mnemonics or visuals that helped you memorize test material. Be sure that this is allowed by the instructor to avoid allegations of cheating.

Multiple Choice Tests

How-To-Study.com (n.d.) offers the following suggestions regarding responding to multiple choice test items.

1. Circle or underline important words in the item. This will help you focus on the information most needed to identify the correct answer choice.

2. Read all the answer choices before selecting one. It is just as likely for the last answer choice to be correct as the first.

3. Cross out answer choices you are certain are not correct. This will help you narrow down the correct answer choice.

4. Look for two answer choices that are opposites. One of these two answer choices is likely to be correct.

5. Look for hints about the correct answer choice in other items on the test. The correct answer choice may be part of another item on the test.

6. Look for answer choices that contain language used by your teacher or found in your textbooks. An answer choice that contains such language is usually correct.

7. Do not change your initial answer unless you are sure another answer choice is correct. More often than not, your first choice is correct.

8. Choose “all of the above” if you are certain all other answer choices in the item are correct. Do not choose “all of the above” if even just one of the other answer choices is not correct.

38


9. Choose “none of the above” if you are certain all other answer choices in the item are incorrect. Do not choose “none of the above” if even just one of the other answer choices is correct.

The Cook Counseling Center at Virginia Tech (n.d.) offers some strategies to use with difficult exam questions. Here are their recommendations.

Strategies to use with difficult exam questions

A. Translate the questions into your own words.

B. Read each option carefully.

C. Use a strategy.

Attack unfamiliar words by sounding them out, by breaking them into familiar parts with meanings you know, by looking at the surrounding words and sentences for clues to the meaning of the word.

Use your general knowledge. Ask yourself, "What do I already know about ____________"?

Anticipate the answer and look for the one most like what you expect. Be flexible. You may not always find exactly the choice you are looking for. Then, you must choose the best of the options available.

Use logical reasoning. For each possible answer, ask yourself, "What would happen if . . . "?

Use process of elimination with multiple choice questions for which more than one option is correct.

← Pick out the options you are sure are correct. ← Pick out the options you are sure are incorrect. ← Rule out all answers which contain wrong options. ← Rule out all answers which omit options you are sure of. ← Select the best remaining answer.

If you guess at an answer, check your guess against what you already know and against what your logical reasoning tells you.

Adapted from Kentucky State University Reading Lab

Post-Test Review

Once the test has been completed often a test review will be offered to students. This may be done once the test is graded or prior to the grading. In either case it is wise for students to attend this review as it offers the opportunity to gain insight into how the instructors who prepared the test were thinking and what to expect in future exams. Hopper (2006) offers a dozen reasons to review a returned test, which are well worth sharing.

39


A Dozen Reasons to Review a Returned Test

Check the point total to make sure it is right. Look for mistakes in grading.

Know what questions you missed and why you missed them. The reason you missed the question is often as important in taking your next test as the answer.

Study the instructor's comments especially for essay questions so that you will know what is expected next time.

Look for kinds of questions and tricky questions that the instructor likes to use.

See if the questions came from the text or the lecture. Concentrate more on that source for the next exam.

Correct and understand what you missed. This is information you need to know. It may appear on a later test or the final.

Analyze the type of problems you missed so you can review strategies for that type of question.

Review to get an idea what kind of test the instructor might give next time.

Review to put information back into long term memory. You want to ask questions while the test is "fresh." Review how you studied for the exam. Look for better ways.

Maintaining Self-Image

Despite how you do on a test it is important to maintain a healthy self-image. The experience of each exam should be used to identify methods for doing better on future tests. Although adequate grades for passing the course are the ultimate goal, much can be learned from an exam that you fail, specifically how to do things differently on the next test.

You need to focus on what you did right and identify what could have been done better or differently. Evaluate your test preparation strategies and your approach to test-taking and determine how you what changes you will make as you approach the next exam.

Additionally, acknowledge the positive aspects of your performance in the nursing program. These successes can be viewed as examples of your personal success and remind you that you can be successful in test-taking. You need to focus on the positive and ignore any negative self-talk or comments from others that distract you from being positive. You can succeed in this nursing program if you set your mind to it!

40


Students with Special NeedsEnglish-as-a-Second-Language

Students with English-as-a-Second-Language (ESL) often face unique challenges, including the adaptation to American culture, language barriers and social isolation. There are some strategies that can be undertaken to assist with minimizing these challenges and enhancing educational success with students with ESL.

English Language and Culture

The University of Texas at Austin offers specific advice regarding English acquisition to students with ESL. These strategies would also assist the non-native American student with becoming more comfortable with the American culture. Some of these suggestions are specific to the University of Texas at Austin but can be adapted to other learning institutions.

HOW TO GET MORE PRACTICEIN ENGLISH CONVERSATION

Many hours of speaking and listening are needed to produce fluent speech in your second language. These hours do not need to be in the classroom alone — natural conversation with minimal correction is better for fluency than drills. So stop worrying about mistakes you might make in using English and go out and talk! Making an effort to have conversations regularly is very important to improving your speaking and listening skills, especially if you do not speak English at home. Here is a list of suggestions for getting into conversations in English:

1. Sign up for informal classes. You'll learn something and there will be lots of chances to discuss class matters with other students and teachers.

2. Visit the academic department that teaches your native language (or the Department of Linguistics if there is not such a department). Ask to post a notice that you would like to exchange conversation practice with an American who is learning your language. Include your name, phone number and when you can be reached on the notice.

3. Volunteer your time to help handicapped students, old people, children or others. You will learn more about American life and feel useful as well.

4. After class, ask another student to explain a point you didn't understand or disagreed with. Continue this conversation over a cup of coffee or glass of beer at the Texas Union! Form a study group with other students to discuss the course and prepare for exams. Talk to your professors during their office hours about course concerns.

5. Ask Reference Librarians for research assistance at the libraries. Their job is to help students with such questions, and they can give you excellent suggestions for your work. If you're not familiar with the resources of the libraries, take the self-guided tour which is on cassette tape. Ask for this at the information desk in the main lobby of the PCL.

41


6. Join a club or recreational sports activity on campus. These are often advertised in the Daily Texan and new people are welcome in most of the groups.

7. In the grocery story, ask the vegetable or meat counter clerk how to cook some item of food.

8. In a restaurant, ask the waiter or waitress what a dish is made of and how it is prepared.

9. Get an American roommate. There are lists of prospective roommates at the UT Housing and Food Office in Kinsolving Dorm or you can add your name to the list. Also, pay attention to the Texan for announcements of a "Roommate Fair" and look around the Union bulletin boards for "Roommate Wanted" signs.

10. If you belong to a church, join the local one, or at least visit there and get to know a few members. Some churches have special activities for international students.

11. Watch the news on television or listen to it on the radio. Try to understand what is being said. Make a list of words, phrases or news stories you don't understand and ask an American friend about them. Pay special attention to idioms.

12. Read the comics in the newspaper. Clip any that confuse you and ask a friend to explain them. You'll find many idiomatic and slang expressions and also learn more about the American sense of humor!

13. If you live with your family or other people from your country, set aside a period of time every day, for example during dinner, to speak nothing but English. This provides excellent practice for you and them too.

Minority student nursing associations

Often minority nursing students have difficulties meeting nurses who are of their ethnic or cultural background. Getting in touch with nurses from similar cultural and ethnic backgrounds should help to minimize social isolation. Included here is a list of nursing associations addressing cultural and/or ethnic minorities within nursing practice in the United States. This listing was provided at minoritynurse.com (2006):

Minority Nursing Associations

Aboriginal Nurses Association of Canada56 Sparks Street, Suite 502Ottawa, ON K1P 5A9, Canada(613) 724-4677http://www.anac.on.ca/

Asian American/Pacific Islander Nurses Association400 N. Ingalls, Suite 3160Ann Arbor, MI 48109-0482(734) 998-1030Contact: [email protected]://www.aapina.org

42

http://www.aapina.org/

mailto:[email protected]

http://www.anac.on.ca/


American Assembly for Men in NursingP.O. Box 130220Birmingham, AL 35213Contact: Byron McCain, (205) 802-7551http://aamn.org

National Alaska Native American Indian Nurses AssociationContact: Beverly Patchell, President, [email protected]

National American Arab Nurses AssociationP.O. Box 43Dearborn Heights, MI 48127(313) 982-4070www.n-aana.org

National Association of Hispanic Nurses1501 16th St., NWWashington, DC 20036Tel: (202) 387-2477Fax: (202) [email protected]

National Black Nurses Association, Inc.8630 Fenton St., Suite 330Silver Spring, MD 20910Tel: (800) 575-6298Fax: (301) [email protected]://www.nbna.org/

National Coalition of Ethnic Minority Nurse Associations6101 West Centinela Ave., Suite 378Culver City, CA 90230(310) 258-9515Fax (323) [email protected] www.ncemna.org

Philippine Nurses Association of AmericaContact: Rosario May Mayor, [email protected] www.philippinenursesaa.org

Students with Concentration Problems

43

http://www.philippinenursesaa.org/


http://www.ncemna.org/


http://www.nbna.org/


http://www.thehispanicnurses.org/


http://www.minoritynurse.com/associations/www.n-aana.org

http://www.nanaina.org/


http://aamn.org/


Students who have difficulty with concentration will be challenged by nursing curriculums as they need to be able to focus to learn large amounts of information. Muskingum College (n.d.) offers several suggestions to assist these students in their college education experience. These suggestions are as follows.

Task Orientation, Organization & Preparation, Time Management, Study Skills and Compensatory Considerations

Task Orientation

Staying on target when completing a task may be difficult for attention deficit students. The following suggestions may help students remain task oriented. Students may apply the strategies themselves or enlist the assistance of a facilitator.

Make the task definite

Determine what must be done to complete the task. Make sure the directions and expectations for the task are fully

understood. Seek clarification of instructions from the instructor rather than from

other students.

Divide and Conquer

Break the task into smaller, more manageable parts. Develop some sort of structure that makes sense to the student. Develop a time schedule for completing each part. Work on one part at a time, switching to another part when boredom

rears its ugly head. Organize each part of the task into separate folders. Reward yourself after completing each part of the task.

Feel strongly the urge to do the task

Relate completion of the task to one's academic goals. Relate completion of the task to one's short-term goals, long-term

goals, and ambitions.

Get started at all costs

Try to ignore difficulties you anticipate. Don't think of things you would rather be doing, or just budget time to

do them and get them out of the way. If other commitments are fogging your concentration, make a list of

things to do later; this will get them off your mind temporarily. See the Concentration section of this page for more information.

Prepare an effective study area

For tips, see the Eliminating External Distractions and Organization and Preparation Considerations sections of this page.

44


Concentrate

Work on concentration strategies to help you stay focused. See the Concentration section of this page for specific suggestions.

Reduce stress

Face personal problems and sources of stress directly. See the Eliminating External Distractions section this page for more

information.

Evaluate

Constantly, objectively and realistically evaluate progress toward completing the task.

If necessary, enlist the assistance of an outside party (instructor, advisor, tutor, counselor, parent, trusted friend) for evaluating progress.

Organization and Preparation Considerations

Being organized and prepared to learn eliminates one strong distraction that may inhibit attending and listening. If you are organized and prepared, it is one less thing to worry about! Being organized and prepared for class and study sessions can enhance attending and listening. Additional strategies are described in the Organization page of the General-Purpose Learning Strategies main stack.

Organization and Preparation for Class

Think about the subject matter before class; those five minutes spent walking to class are the perfect time for this.

Arrive early to class so you can select a seat in the least distracting part of the room (see the section on Eliminating External Distractions of this page).

While waiting for class to begin, review previous day's notes to get in the frame of mind of the subject.

Take the appropriate materials to class: note books, books, pens, pencils, calculator, etc.

Complete assignments in a timely manner. Do assigned readings before they are to be covered in class (even for

math courses). You have to read them some time, so best to do it before class. If you don't have time to read the assignments thoroughly, at least skim over them to get the main points.

Take an outline of the readings or a summary of the main points with you to class.

Prepare a list of questions over readings and previous notes; you will be ready to ask intelligent questions when you feel your attention slipping.

Organize course papers into three-ring notebooks or folders.

Organization and Preparation for Study Sessions

45


Have a specific place to study, or a place that can come to be associated with studying.

Organize your workspace (desk, books, notes, school supplies) and have everything you will need close at hand. Tips are given in the Spatial Organization section of the Organization page in the General-Purpose Learning Strategies main stack.

Work in a distraction-free area (see the Eliminating External Distractions section of this page).

Develop a regular routine of eating, studying, relaxing, and exercising. Develop daily activity schedules and weekly planners, and stick to

them. Specific strategies are given in the Time Management page of the General-Purpose Learning Strategies main stack.

Make reminders to yourself about assignments and display them in prominent places in your room.

Break down large projects into more manageable tasks, then set deadlines for completing the smaller tasks. See the Time Management page of the General-Purpose Learning Strategies main stack for strategies.

Buy your own books and supplies rather than borrowing them.

Time Management Considerations

While time management is covered in more detail in the Time Management page of the General-Purpose Learning Strategies main stack, some basic points are relevant to a discussion of attention and listening.

Course Schedules

The number of classes as well as their content should be carefully considered when scheduling courses.

A student who has difficulty paying attention might choose not to enroll in classes longer than 50 minutes if possible, especially lecture courses in which little student action occurs.

A student who has difficulty paying attention might choose not to enroll in back-to-back courses without a break.

Personal Time

Daily, weekly, monthly and semester schedules should be organized to assist in time management.

Time should be allocated in the schedules for adequate study time as well as leisure time.

It is very important for students to periodically evaluate how they planned to spend time and how it was actually spent. This helps to develop an awareness of time management practices.

Students should make class preparation part of their everyday routines.

Different subjects and activities should always be interspersed during short study periods to avoid boredom.

Tutoring Sessions

46


The following strategies can make tutoring (and other intensive academic) sessions more productive for attention deficit students.

Divide each session into different tasks, spending 15-20 minutes on each.

Provide a review at the beginning and end of each session and/or each new activity.

Consider rescheduling sessions to find the optimal time that is appropriate for the student's interest or activity level.

Divide assignments into realistic time frames in consultation with daily, weekly, monthly or semester planners.

Group Learning

The following strategies can make group sessions more productive for attention deficit students.

The goals and expectations of the study group should be clearly outlined.

The group should meet for short periods of time, or should divide the session into smaller tasks, spending 15-20 minutes on each task.

The group should meet in a distraction-free area (see the Eliminating External Distractions section of this page).

If the attention deficit student has poor social skills or impulse control, he/she should be introduced gradually to group learning situations; in addition, supervision by a mediator may be helpful until the student becomes accustomed to the situation.

Study Skills Considerations

Study skills, as discussed in other pages of the General-Purpose Learning Strategies main stack, may aid in sustaining student attention.

Strategies such as SQ3R help students attend while reading.

Color coding and highlighters help the student pay attention to more important information.

Visual aids such as charts, graphs, flashcards, and timelines may help students to focus.

Time management strategies, such as spacing reviews and time planners, help students to maintain their attention on the task at hand.

Compensatory Considerations

Compensatory equipment is often useful to the attention deficit student.

Textbooks and reading assignments on tape help the student to focus while reading.

47

http://www.muskingum.edu/~cal/database/general/time.html


Taping lectures provides a fairly complete, permanent, auditory record of lectures. Students may use tapes to improve the quality of notes if they trouble paying attention for the entire class.

Accommodations for Special Needs

Legislature requires that learning institutions offer accommodations for students with certain conditions that might prevent them from being successful in educational endeavors. If you have a learning, health, emotional, or physical condition that interferes with your ability to perform in school you need to consult with the nursing department at your school to see how you may proceed to be considered for accommodations.

The following table, offering examples of student characteristics and possible accommodations was developed by the University of the State of New York, the State Education Department, and the Office of Vocational and Education Services for Individuals with Disabilities (2006).

Examples of Student Characteristics and Possible Accommodations

Student Characteristics Possible Effecton Test-taking

Possible Accommodations

Poor attention/distractibility.Has difficulty remaining on task.

May have difficulty concentrating on test items for extended length of time and completing exam in allotted time. May be distracted by other students.

Separate setting free from distractions

On-task focusing prompts

Provide breaks during exam period

Extended time Study carrel

May have difficulty following or remembering directions.

Directions read more than standard number of times

Directions provided for each page of questions

Directions simplifiedMay have difficulty dividing attention between the test booklet and recording answers on a separate answer sheet.

Record answers directly in test booklet

Processes written information at a slow rate.

May not be able to complete exam within standard timeframe.

Extended time

May become fatigued/distracted.

Separate setting Directions read Tests read orally* Multiple day

48


Poor physical /motor coordination /writing difficulties.

Unable to or has difficulty recording responses using paper and pencil in standard manner.

Use of computer/word processor or other writing aids.

Respond orally to scribe Separate setting when

using scribe Use of adaptive writing

utensilsDifficulty recording answers on a separate answer sheet.

Record answers directly in test booklet

Allow additional space for writing

Writing tasks completed at a slow rate.

Extended time

Unable to or has difficulty using paper and pencil to solve computations.

Use of calculator/math tables*

Use of graph paper to align numbers when doing computations

Difficulty following/understanding directions.

May not understand what the test requires them to do.

Directions read orally Directions simplified Additional examples of

directions provided Key words or phrases of

directions highlighted

May have difficulty remembering directions.

Directions reread for each page of questions

Visual Impairments

Unable to or has difficulty accessing test in standard print format and requires tactile or oral means to obtain information.

Braille Tests read orally* Tape recorder

49


May have low or limited vision and has difficulty with standard print.

Large type Magnifier Tests read when fatigue

sets in due to eye strain* Special desk or book

stand to hold materials for easier reading

Extended time Increase spacing between

test items Fewer items per page

Unable to use paper and pencil to solve computations

Use of calculator/talking calculator*

Use of graph paper to align numbers

Difficulty tracking from test to answer sheet.

Record answers on test booklet

Templates to reduce visible print

May have low or limited vision and has difficulty with detailed visual tasks such as printed material, graphs, charts, diagrams, etc.

Highlighting entire graphs to increase contrast from color of page

Special lighting Oral description of

graphs, charts, etc. presented in a neutral manner

Difficulty maintaining place in a standard test booklet.

Use of templates to reduce visible print

Visual-perceptual difficulties

Difficulty focusing on individual items if too many items are presented.

Large type Increase spacing between

test items Fewer items per page Use of templates to

reduce visible print

Emotional/ Mental Health Impairments

Displays test anxiety. Extended time Breaks during test

Exhibits inappropriate behavior.

Separate location On-task focusing

prompts

50


Administered medication which may affect the student’s physical stamina.

Test administered during optimal times when student is most alert

Health Impairments/ Poor stamina

Unable to sit for extended lengths of time without changing position.

Extended time Breaks provided for rest

periods Adaptive furniture

Unable to complete test within standard time allotted due to fatigue.

Multiple day testing Separate setting

Increased fatigue as duration of taking test increases.

Use of scribe when fatigue affects ability to write

Tests read when fatigue affects ability to read*

Difficulty with reading Reading skills below grade level of test.

Oral reading of tests or sections of tests that do not measure reading comprehension

Slow reading pace. Test read orally to student individually in a separate location to accommodate individual student pace*

Extended timeHearing Impairments Unable to or has difficulty

accessing oral directions or listening sections of test in standard manner.

Use of sign language interpreter for oral directions and listening passages

Listening passages may be signed more than once

Written directions provided

Extended time Separate setting Amplification devices Preferential seating in

front of interpreter

Difficulty with auditory processing

Difficulty remembering and/or understanding oral directions.

Repeat directions more than standard number of times

Directions simplified Provide written

directions

51


Preferential seating Repeat listening section

more than standard number of times

52


References

Academic Skills Center, Dartmouth College. (2004). Learning strategies: Maximizing your academic experience. Retrieved 10/25/06 at http://www.dartmouth.edu/~acskills/success/index.html

Hopper, C. (2006). The study skills help page learning strategies for success. Retrieved 10/24/06 at http://www.mtsu.edu/~studskl/

How-To-Study.com: A Skills Resource Center. (n.d.). Retrieved 10/23/06 at http://www.how-to-study.com/studygroups.htm

MinorityNurse.com. (n.d.). Minority nursing associations. Retrieved 11/28/06 at http://www.minoritynurse.com/

Muskingum College Center for Advancement of Learning. (n.d.). Learning strategies database. Retrieved 10/23/06 at http://www.muskingum.edu/~cal/database/general/

The University of the State of New York, the State Education Department, & the Office of Vocational and Education for Individuals with Disabilities. (2006). Test access and accommodations for students with disabilities. Retrieved 10/27/06 at http://www.vesid.nysed.gov/specialed/publications/policy/testaccess/policyguide.htm

University of Minnesota Duluth Student Handbook. (2006). Study Strategies. Retrieved 10/27/06 at http://www.d.umn.edu/kmc/student/loon/acad/strat/

UT Learning Center, University of Texas at Austin. (2006). Resources. Retrieved 10/25/06 at http://www.utexas.edu/student/utlc/lrnres/handouts.html

Virginia Tech Cook Counseling Center. (2006). Concentration: Some basic guidelines. Retrieved 10/23/06 at http://www.ucc.vt.edu/stdysk/concentr.html

53

http://www.ucc.vt.edu/stdysk/concentr.html

http://www.utexas.edu/student/utlc/lrnres/handouts.html

http://www.d.umn.edu/kmc/student/loon/acad/strat/

http://www.vesid.nysed.gov/specialed/publications/policy/testaccess/policyguide.htm

http://www.vesid.nysed.gov/specialed/publications/policy/testaccess/policyguide.htm

http://www.muskingum.edu/~cal/database/general/

http://www.minoritynurse.com/

http://www.how-to-study.com/studygroups.htm

http://www.mtsu.edu/~studskl/

http://www.dartmouth.edu/~acskills/success/index.html

content outline for nursing student strategies for success€¦ · web viewsuccess strategies ....

Documents