ABSTRACT Nurse educators, under pressure to prepare graduates who are able to think critically and solve problems in a variety of clinical practice settings, require active teaching strategies to promote meaningful learning, instead of relying on traditional methods that promote rote memorization. A review of the current state of the science with regard to concept mapping demonstrates that this teaching-learning method assists nurse educators to prepare graduates to think critically in the complex health care environment. However, further research is needed to determine the effectiveness of concept mapping on the graduate's performance on the NCLEX exam and on critical thinking and prioritization skills in the clinical environment.
Key Words Concept Mapping--Critical Thinking--Nursing Education --Teaching-Learning Method
THE ABILITY TO THINK CRITICALLY and solve problems in a variety of clinical practice settings is a requirement for new nurse graduates. For faculty, factors such as increased patient acuity, shorter hospital stays, and increasing demands on transitional care, long-term care, and home health care have contributed to a growing need to use active teaching strategies to promote meaningful learning. As Black, Green, Chapin, and Owens have stated, "The student in the new millennium can no longer depend on rote memorization to make the transition from theory to clinical" (1, p. 6). * Concept mapping is an active teaching strategy that can help nurse educators prepare graduates to think critically in today's complex health care environment. THIS ARTICLE examines empirical studies on the use of concept maps as a teaching-learning method in nursing and discusses the effectiveness and limitations for teaching and learning and implications for nursing education.
Definitions and Theoretical Framework Meaningful learning, based on Ausubel's assimilation theory of learning (2), is the theoretical foundation for concept mapping. Ausubel used the term meaningful learning to identify a process of integrating new knowledge acquired by individuals with relevant knowledge that they already possess. He believed that as an individual learns new knowledge, knowledge is rearranged and reordered to allow the learner to develop meaning and understanding of the concepts. Learning is more likely to occur when information is presented in meaningful ways that assist the learner to develop links between the old and new concepts.
Novak and Gowin first introduced concept mapping in 1984 to facilitate the process of meaningful learning. They defined the concept map as a schematic diagram that represents key concepts in a framework of propositions (3, p. 15). The authors also outlined criteria that can be used by nurse educators when evaluating the student's concept map. These specifically address the student's understanding and linkage of concepts.
In 1997, All and Havens defined concept mapping as a pictorial arrangement of key concepts that are unique to a specific subject (4). Koehler noted that in nursing education, concept maps are developed from assessment data collected by students either through case studies or their clinical assignments (5). The concept map develops as students diagram the relationships among various clinical data.
Concept mapping assists students to develop relationships among different bits of information (4,6-10) and build on previous knowledge and skills (7,11). As a motivator for student learning (12), concept maps result in higher academic achievement (12-14). In nursing education, maps have been used to help students develop critical thinking skills (6,9,10,15,16), provide holistic, patient-centered care (9), prepare for clinical learning activities (7), and link theory to clinical practice (1,10,17). Irvine noted that concept mapping assists in the development of meaningful learning and may help nurse educators become more effective as teachers (18).
Concept maps have been used in lectures (4-6,12), group work (5), class discussion (19), skills laboratories (19), and clinical learning activities (4-7,12,20). They are also used in continuing education activities (21,22), staff development (21-23), and in patient education (24).
Several authors have recommended replacing traditional care plans with concept mapping (5,9,20). The rationale for this recommendation is based on the notion that care plans typically are done in a retrospective manner with emphasis on students' using the correct format as they develop a single patient problem. Often this process is very structured, resulting in students' copying information directly from textbooks.
The Identification of Research Studies A literature review was conducted to identify research studies on the use of concept mapping as a teaching-learning method in nursing education. Computerized searches of PubMed, CINAHL, ERIC, and Academic Search Premier databases from 1980 to November 2004 used the following keywords: concept mapping, nursing education, and research. The goal was to find evidence on which to base nursing education recommendations for the use of concept mapping as a teaching-learning …