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  1. Hart, Leigh B. MSN, RN, CCRN


This article describes a method of instruction designed to stimulate many different cognitive styles in an RN critical care course. The class met on Friday evenings after many of the participants had just completed their workweek. Developing a stimulating classroom experience was imperative to counter the effects of fatigue felt by many of the nurses. A combination of technology and traditional teaching methods was used to facilitate as many different cognitive styles as possible in a single class period. The PowerPoint computer program was used to provide vivid visual representation of the class content as it was presented through a combination of lecture, concept mapping, and case study.


Cognitive style refers to an individual's preferred method of obtaining and assimilating information from the environment. The Modified Hill Cognitive Style Mapping Instrument assesses 28 different elements that form an individual's cognitive style (Ehrhardt, 1981; 1983). The instrument results in a map of stronger and weaker preferences for these elements. Examples of these elements include a preference for obtaining meaning through written information, oral presentation of information, independent problem solving, and deductive thinking (Ehrhardt, 1981; 1983). These elements are not ranked as superior or inferior methods of obtaining information but are individual characteristics that are consistent throughout a person's life and not subject to modification.


Multiple cognitive styles will be present in any group of learners. If individuals are in an environment that is not conducive to their cognitive style they will not gain the full benefit of the learning experience. Thus, creating a course to stimulate these diverse combinations of cognitive style is challenging. Several different methods of instructions, integrated with PowerPoint technology (Microsoft; Redmond, WA) can facilitate learning by stimulating many cognitive styles in one class period.


Approximately 3 hours are needed to implement this mixture of teaching methods. The initial class consisted of nine students although a larger number of students could be accommodated. The participants were given large sheets of easel paper and instructed to bring colored pencils and rulers to class. The classroom was equipped with tables that provided space for the students to spread out during the construction of the concept map.


The initial 20 minutes of the class were dedicated to the presentation of the pathophysiology of the disease process to be covered. The pathophysiology served as the basis for a concept map. The concept map is defined by All and Havens (1997) as "graphic or pictorial arrangements of the key concepts that deal with a specific matter" (p. 1210). The use of cognitive/concepts mapping as a teaching strategy encourages learners to assimilate new data into material that they already know (All & Havens, 1997).


The pathophysiology was presented as a concept map using PowerPoint to depict a colorful and graphic representation of the disease process. The draw command can be mastered and creatively used to illustrate the principles presented (see Figure 1). The individual elements of the pathophysiology can be introduced, discussed, and interrelated one point at a time using the PowerPoint animation command. This portion of the class was designed for learners who prefer auditory and visual stimulation.


The participants took notes during this component of class by initiating their own concept map. The colored pencils allowed participants to be creative in the map's construction and served as a method of interrelating concepts through color coding. This is a more refreshing method of taking notes compared to the traditional pen and paper method.


A case study presentation on the disease process followed. The case study method is a valuable tool for developing analytical abilities in nursing students (Johnson & Purvis, 1987). The case study contains elements of patient care from actual clinical situations. The learners integrate the assessment findings, nursing treatments, and medical treatments from the case study into the concept map. Ninety minutes were allotted for this activity, and the participants were allowed breaks as needed during this time.


The educator may circulate through the room during the case study integration into the concept map to serve as a facilitator who provides direction and answers questions. The participants are encouraged to work according to their preference in groups or individually. Consistent with the study of cognitive styles, not everyone prefers working in a group situation. Individual cognitive styles consist of a high or low preference for working under supervision, with friends, or independently. Participants with a low preference for independent learning may do well in a group learning experience. Additionally, insisting that someone with a high preference for independent learning work in a group situation is not an effective teaching method.


PowerPoint was used again at the conclusion of the class. The educator provided a visual rendition of the concept map using the illustration possibilities of the draw command to integrate the case study information into the concept maps' pathophysiology (see Figure 2). This allowed the educator to demonstrate how the knowledge the participants explored is applicable to an actual clinical experience. Providing learners with feedback is an important component in linking knowledge to practice (Greenwood, 1993). The participants were told that their maps are their own creations and will differ in appearance from the concept map constructed by the educator. However, location of the components that correspond to the appropriate pathophysiology process should be the same. This part of the learning experience was designed to stimulate multiple preferences for reasoning. These preferences include looking for similarities and differences, applying rules, using logic, and weighing all factors.