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Primary care nurses’ learning styles in the light of David Kolb

Estilos de aprendizaje de las enfermeras de atención primaria a la luz de David Kolb

ABSTRACT

Objectives:

to identify primary care nurses’ learning styles in the light of David Kolb’s Experiential Learning Theory.

Methods:

a descriptive and exploratory qualitative study. A semi-structured interview script was used for data collection and content analysis for data processing.

Results:

primary care nurses showed different learning styles: diverging, which combines active experimentation and reflective observation; assimilating, which combines reflective observation and abstract conceptualization; converging, which associates abstract conceptualization and concrete experience; and accommodating, which unites concrete experience and active experimentation.

Final Considerations:

learning through experience requires that knowledge be understood and transformed. Nurses learn in different ways, as they have different learning styles. Therefore, recognizing nurses’ learning styles is important to foster ongoing professional development and ensure safe nursing care.

Descriptors
Nurses; Problem-Based Learning; Primary Care Nursing; Learning; Education; Continuing

RESUMEN

Objetivos:

identificar el estilo de aprendizaje de los enfermeros de atención primaria a la luz de la Teoría del Aprendizaje Experiencial de David Kolb.

Métodos:

estudio cualitativo descriptivo y exploratorio. Se utilizó un guión de entrevista semiestructurada para la recolección de datos y análisis de contenido para el procesamiento de datos.

Resultados:

las enfermeras de atención primaria mostraron diferentes estilos de aprendizaje: divergente, que combina la experiencia activa y la observación reflexiva; asimilador, que combina la observación reflexiva y la conceptualización abstracta; convergente, que asocia conceptualización abstracta y experiencia concreta; y acomodante, que une experiencia concreta y experiencia activa.

Consideraciones Finales:

el aprendizaje a través de la experiencia requiere que el conocimiento sea comprendido y transformado. Las enfermeras aprenden de diferentes maneras, ya que tienen diferentes estilos de aprendizaje. Por lo tanto, reconocer los estilos de aprendizaje de las enfermeras es importante para fomentar el desarrollo profesional continuo y garantizar una atención de enfermería segura.

Descriptores
Enfermeras; Aprendizaje Basado en Problemas; Atención Primaria de Salud; Aprendizaje; Educación Continua

RESUMO

Objetivos:

identificar o estilo de aprendizagem dos enfermeiros de atenção primária à luz da Teoria da Aprendizagem Experiencial de David Kolb.

Métodos:

estudo qualitativo descritivo e exploratório. Utilizou-se um roteiro de entrevista semiestruturado para a coleta dos dados, e a análise de conteúdo, para o tratamento dos dados.

Resultados:

enfermeiras que atuam na atenção primária apresentaram diferentes estilos de aprendizagem: divergente, que combina experiência ativa e observação reflexiva; assimilador, que combina observação reflexiva e conceitualização abstrata; convergente, que associa conceitualização abstrata e experiência concreta; e acomodador, que une a experiência concreta e a experiência ativa.

Considerações Finais:

aprender pela experiência requer que o conhecimento seja compreendido e transformado. Enfermeiras aprendem de modos diferentes, pois apresentam diferentes estilos de aprendizagem. Portanto, reconhecer os estilos de aprendizagem dos enfermeiros é importante para fomentar o desenvolvimento profissional contínuo e garantir um cuidado de enfermagem seguro.

Descritores:
Enfermeiras; Aprendizagem Prática; Atenção Primária à; Saúde; Aprendizagem; Educação Continuada

INTRODUCTION

Nursing is a science and a profession in which its practitioners offer humanistic and scientific care. With techniques and processes for health promotion, prevention, recovery and rehabilitation, nursing offers personalized, culturally determined and safe services to individuals, families and communities(11 Queirós PJP, Fonseca EPAM, Mariz MAD, Chaves MCRF, Cantarino SG. Significados atribuídos ao conceito de cuidar. Rev Enferm Ref. 2016;4(10):85-94. https://doi.org/10.12707/RIV16022
https://doi.org/10.12707/RIV16022...

2 Grady PA. Advancing Science, Improving Lives: NINR’s new strategic plan and the future of nursing science. J Nurs Scholarsh. 2017;49:247-8. https://doi.org/10.1111/jnu.12286
https://doi.org/10.1111/jnu.12286...

3 Grady PA, Gough LL. Nursing Science: claiming the future. J Nurs Scholarsh. 2015;47:512-21. https://doi.org/10.1111/jnu.12170
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-44 Watson J. Clarifying the discipline of nursing as foundational to development of professional nursing. Texto Contexto Enferm. 2017;26(4):editorial. https://doi.org/10.1590/0104-07072017002017editorial4
https://doi.org/10.1590/0104-07072017002...
).

For a safe and effective nursing care, it is necessary to recognize the importance of fostering learning through experience, seeking to develop each individual’s know-how-to-be and know-how-to-do(55 Bresolin P, Martini JG, Lazzari DD, Galindo IS, Rodrigues J, Barbosa MHPA. Aprendizagem experiencial e diretrizes curriculares nacionais de enfermagem: revisão integrativa de literatura (2013-2017). Cogitare Enferm. 2019;24. https://doi.org/10.5380/ce.v24i0.59024
https://doi.org/10.5380/ce.v24i0.59024...
). Continuous professional development is a strategy and an ethical commitment of nurses to promote the strengthening of the specific skills necessary for professional performance. Learning takes place throughout life, from initial training and continuously, in the context of work and in the process of continuing education. Primary care nurses recognize their training needs to improve professional performance. These include skills related to leadership and management, clinical practice, quality of care monitoring, and research practice(66 Holloway K, Arcus K, Orsborn G. Training needs analysis: the essential first step for continuing professional development design. Nurse Educ Pract. 2018;28:7-12. https://doi.org/10.1016/j.nepr.2017.09.001
https://doi.org/10.1016/j.nepr.2017.09.0...

7 Page M, Pool L, Crick M, Leahy R. Empowerment of learning and knowledge: Appreciating professional development for registered nurses in aged residential care. Nurse Educ Pract. 2020;43:102703. https://doi.org/10.1016/j.nepr.2020.102703
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-88 Nascimento JSG, Nascimento KG, Oliveira JLG, Alves MG, Silva AR, Dalri MCB. Simulação clínica para desenvolvimento de competência em enfermagem na ressuscitação cardiopulmonar: revisão sistemática. Rev Latino-Am Enfermagem. 2020;28:e3391. https://doi.org/10.1590/1518-8345.4094.3391
https://doi.org/10.1590/1518-8345.4094.3...
).

In his Experiential Learning Theory, Kolb argues that the individual is able to learn, create and recreate his own knowledge, based on the lived experience(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.). His ideas were initially thought in the field of education(1010 Kolb AY, Kolb DA, Passarelli A, Sharma G. On becoming an experiential educator: the educator role profile. Simul Gaming. 2014;45(2):204-34. https://doi.org/10.1177/1046878114534383
https://doi.org/10.1177/1046878114534383...
-1111 Meerts-Brandsma L, Sibthorp J. Considering transformative learning for adolescents enrolled at semester schools. J Transformative Educ. 2021;19(1):7-28. https://doi.org/10.1177/1541344620936779
https://doi.org/10.1177/1541344620936779...
), but have been used in different fields of vocational training(1212 Fuentes-Nawrath, J, Llermaly-Rodríguez S, Silva-Rodríguez M. Tipos Psicológicos y Estilos de Aprendizaje en Estudiantes de la Carrera de Odontología en la Universidad de La Frontera, Chile. Int J Odontostomatol. 2018;12(2):182-7. https://doi.org/10.4067/S0718-381X2018000200182
https://doi.org/10.4067/S0718-381X201800...

13 Matzumura Kasano JP, Gutiérrez-Crespo H, Pastor-García C, Zamudio-Eslava LA, Ruiz-Arias RA. Metodología activa y estilos de aprendizaje en el proceso de enseñanza en el curso de metodología de la investigación de una facultad de ciencias de la salud. An Fac Med. 2018 79(4), 293-300. https://doi.org/10.15381/anales.v79i4.15632
https://doi.org/10.15381/anales.v79i4.15...
-1414 Russell-Bowie D. Mission impossible or possible mission? Changing confidence and attitudes of primary preservice music education students using Kolb’s Experiential Learning Theory. Aust J Music Educ. 2013;(2):46-62. https://files.eric.ed.gov/fulltext/EJ1061833.pdf
https://files.eric.ed.gov/fulltext/EJ106...
) as well as in the field of nursing(1515 Gomes RLV, Bellan RB, Lima LS. Modelagem de um software problematizador baseado nos estilos de aprendizagem do estudante de enfermagem. Nuev Ideas Inf Educat TISE[Internet]. 2014[cited 2020 Sep 10]. Available from: http://www.tise.cl/volumen10/TISE2014/tise2014_submission_332.pdf
http://www.tise.cl/volumen10/TISE2014/ti...

16 Lisko SA, O’Dell V. Integration of theory and practice: experiential learning theory and nursing education. Nurs Educ Perspect [Internet]. 2010 [cited 2020 Nov 07];31(2):106-8. Available from: https://pubmed.ncbi.nlm.nih.gov/20455368/
https://pubmed.ncbi.nlm.nih.gov/20455368...

17 Oliveira SN, Prado ML, Kempfer SS, Waterkemper R. Morera JAC, Berandi MC. A pedagogia por trás da experiência clínica simulada: uma percepção de estudantes de enfermagem. Rev Iberoam Educ Invest Enferm [Internet]. 2015 [cited 2020 Jul 11];5(3):56-63. Available from: https://www.enfermeria21.com/revistas/aladefe/articulo/173/
https://www.enfermeria21.com/revistas/al...

18 Poore JA, Cullen DL, Schar GL. Simulation-based interprofessional education guided by Kolb’s Experiential Learning Theory. Clin Simul Nurs. 2014;10(5). https://doi.org/10.1016/j.ecns.2014.01.004
https://doi.org/10.1016/j.ecns.2014.01.0...
-1919 Ruoff AB, Kahl C, Oliveira SN, Melo LV, Andrade SR, Prado ML. Aprendizagem experiencial e criação do conhecimento: aplicações em Enfermagem. Rev Min Enferm[Internet]. 2016[cited 2019 Sep 07];20:e986. Available from: https://cdn.publisher.gn1.link/reme.org.br/pdf/e986.pdf
https://cdn.publisher.gn1.link/reme.org....
). For David Kolbe, in the learning process, practical experiences help building skills, knowledge and attitudes for problem-solving, hence the importance of fostering the acquisition of learning through experience(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.). It is necessary to observe how individuals learn and what is their learning preference for the construction of knowledge and what style the person adopts to learn the new.

Kolb’s Experiential Learning Theory defines that the process by which knowledge is created happens through the transformation of experience. Knowledge results from the combination of obtaining and transforming experience. For Kolb, experiential learning occurs through stages and styles. There are four stages: concrete experience (CE), in which one learns by feeling, being involved; reflective observation (RO), in which one learns by observing, reflecting, listening; abstract conceptualization (AC), which makes use of logic, reasoning, creating ideas and systematizing; active experimentation (AE), in which one learns through action, decision making, having their planned action seeking to influence the environment. The stages form a learning cycle in which knowledge will result in the union of the experience achieved and its modification(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.).

The combination of two stages forms a learning style. There are also four learning styles, namely: diverging, combined by CE and RO; assimilating, combined by RO and AC; converging, combined by AC and AE; and accommodating, combined by AE with CE. Learning styles are preferences of each individual in the way of perceiving, organizing, processing and understanding information. For Kolb, effective learning requires cyclical movement through the four learning styles, although there is usually preference for one style over another(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.-1010 Kolb AY, Kolb DA, Passarelli A, Sharma G. On becoming an experiential educator: the educator role profile. Simul Gaming. 2014;45(2):204-34. https://doi.org/10.1177/1046878114534383
https://doi.org/10.1177/1046878114534383...
).

In the context of primary care, nurses acquire knowledge individually and simultaneously, collectively, through the experiences lived in their daily lives, whether in the managerial scope or in their process of caring for each person or the community. In every working day, there is always something to be learned.

In order for nurses to be attentive to their continuous professional development, they should be encouraged to realize that their experiences can help them develop the necessary skills for safe care(2020 Nalom DMF, Ghezzi JFSA, Higa EFR, Perez CRFB, Marin MJS. Ensino em saúde: aprendizagem a partir da prática profissional. Ciênc Saúde Colet. 2019;24(5):1699-708. https://doi.org/10.1590/1413-81232018245.04412019
https://doi.org/10.1590/1413-81232018245...
). When perceived in the work environment and how this environment favors it, its action can be better developed. By finding their style, they can benefit from it to improve their learning. At the same time, formulators of continuing education programs can adapt their proposals to nurse characteristics. Comparing the theoretical formulations of Kolb (1984) and the experience of nurses’ daily life, we sought to answer the following question: what learning styles are manifested in primary care nurses’ daily lives?

OBJECTIVES

To identify primary care nurses’ learning styles in the light of David Kolb’s Experiential Learning Theory.

METHODS

Ethical aspects

The research met the standards of Resolution 466/2012 of the Brazilian National Health Council (CNS - Conselho Nacional de Saúde), Ministry of Health. The researchers clarify that data collected during the research, as well as its conservation, grouping and statistical analysis, access by third parties, publication and partial or total elimination, will follow the steps established in Law 13.709/18 (General Data Protection Law). The data subjects were also guaranteed the right to secrecy and anonymization of their participation, their informative self-determination, access to the data block concerning their participation in an unrestricted manner and in an easy-to-reach form, and the unrestricted right to request a personal response in the event of publication of data that does not comply with those that have been collected. The researchers are aware that, according to Art. 42 of Law 13.709/18, due to the exercise of personal data processing activity, causing to others property, moral, individual or collective damage, in violation of personal data protection legislation, will be required to repair it.

Study design

This is a qualitative, descriptive study developed with primary care nurses in the city of Manaus. The study followed the COnsolidated criteria for REporting Qualitative research (COREQ) norms(2121 Souza VRS, Marziale MHP, Silva GTR, Nascimento PL. Tradução e validação para a língua portuguesa e avaliação do guia COREQ. Acta Paul Enferm. 2021;34:eAPE02631. https://doi.org/10.37689/acta-ape/2021AO02631
https://doi.org/10.37689/acta-ape/2021AO...
).

Methodological procedure

The instrument applied is semi-structured interview type. Participants were Family Health Strategy nurses, and the technique used to carry out the research was Bardin’s content analysis for data analysis.

Study setting and data source

The study was developed in primary care units, called Basic Family Health Units (BFHU), located in health districts of Manaus, Amazonas, Brazil, which are distributed in four districts: East, North, West and South(2222 Prefeitura de Manaus. Secretaria de Saúde de Manaus. Localização das Unidades de Saúde [Internet]. 2019[cited 2019 Sep 07]. https://semsa.manaus.am.gov.br/localizacao-das-unidades-de-saude/
https://semsa.manaus.am.gov.br/localizac...
).

BFHU nurses who were part of the clinical nursing staff at the study site were included. Those who were on vacation or any type of leave during the data collection period were excluded. Sampling was based on the convenience criterion, and the collection outcome was based on the saturation criterion.

Data source

Nine nurses from nine BFHU located in nine different districts of Manaus participated in the study, two in the South district, two in the West, two in the North and three in the East. The choice of BFHU was given by a prior consultation on the website of the Department of Health of Manaus. Of the participants, 6 (66.7%) were female, and 3 (33.3%) were male. Participants’ age ranged between 42 and 60 years old. The prevalent age group was from 36 to 55 years (88.9%), with a mean age of 45.7 years. Nurses’ job tenure worked at BFHU ranged from three months to 10 years, with a mean of 5.8 years, with 33.3% having worked at BFHU for up to two years, and 66.7% having worked at BFHU for more than five years.

Data collection and organization

Data were collected between January and March 2020 through semi-structured interviews. Prior contact was made with BFHU’s managers to present the objectives and procedures and invite nurses, as well as to schedule the interview place and time.

The interview script was composed of questions to characterize the profile of participants and Kolb’s learning styles. Objective questions included full name, age, sex, time of professional activity in the strategy and time of activity in other health settings. The open-ended questions were: would you tell how was your insertion in the work process? Do you learn from your professional experience? How? Would you tell me a story of your service that generated learning? What learning opportunities do you consider to exist in the service?

The interviews were conducted by the main researcher, who conducted previous training with the researcher who supervised the study through simulation. They were performed face-to-face, audio-recorded and later transcribed manually, in full by the main researcher. They were stored in individual files, in the researchers’ personal computer, being identified by alphanumeric code: N - nurse; E - East health district, N - North, W - West; S - South. The serial number was 1 to 9. The interviews were conducted in the participants’ workplace, in an appropriate space to ensure privacy. The interviews lasted 40 minutes on average.

Data analysis

Data analysis occurred through Bardin’s content analysis(2323 Bardin L. Análise de Conteúdo. Edição revista e actualizada. Edições 70. Lisboa (PRT). LDA 2010.), in three phases: pre-analysis; material exploration; and treatment of results. In the pre-analysis phase, data text skimming was performed in order to become familiar with them, analyzing and exploring the corpus of the study. In the second phase, the material was explored to find learning styles. Speeches were grouped and clipped, in order to clarify the meaning of the speeches, without the use of software. The third and last stage was interpretation of results and dialogue with existing literature on the subject.

RESULTS

It was possible to identify the four learning styles, two nurses with diverging style (N/E-9 and N/E-8), two with assimilating style (N/W-2 and (N/N-6), three with converging style (N/E-3, N/S-5 and N/S-7) and two nurses with accommodating style (N/W-1 and N/N-4). The data are summarized in the following tables:

Chart 1 presents the stages, the diverging style characteristics and participants’ speeches that were classified in that style.

Chart 1
Diverging style nurses

Chart 2 presents the combination of stages, the characteristics present in assimilating style and the speeches of participants.

Chart 2
Assimilating style nurses

Chart 3 presents converging style, its stages and characteristics, as well as the corresponding speeches of nurses.

Chart 3
Converging style nurses

Finally, Chart 4 presents the combination of stages, characteristics and speeches of participants with accommodating style.

Chart 4
Accommodating style nurses

DISCUSSION

Kolb considers the stages and learning styles as inseparable, i.e., to achieve the styles, it is necessary to combine the stages that can start in any of their phases, transit and combine them, thus forming a style(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.).

Learning through experience requires understanding and transformation to learn, absorb, resolve, and return knowledge to the environment. The way of learning is linked to actions that require the human being the ability to experience and reflect the action, creating and recreating knowledge(1616 Lisko SA, O’Dell V. Integration of theory and practice: experiential learning theory and nursing education. Nurs Educ Perspect [Internet]. 2010 [cited 2020 Nov 07];31(2):106-8. Available from: https://pubmed.ncbi.nlm.nih.gov/20455368/
https://pubmed.ncbi.nlm.nih.gov/20455368...
).

Nursing students’ experiential learning is a process of direct recognition, in which it directs students to believe, consider and execute the experiences and skills recently taught. Nursing students perform practices at the beginning of graduation. It is these practical activities that make them reflect on learning and insert what has been learned, accumulating knowledge(2424 Cheng YC, Huang LC, Yang CH, Chang HC. Experiential learning program to strengthen self-reflection and critical thinking in freshmen nursing students during COVID-19: a quasi-experimental study. Int J Environ Res Public Health. 2020;17(15:5442. https://doi.org/10.3390/ijerph17155442
https://doi.org/10.3390/ijerph17155442...
-2525 Costa LCS, Avelino CCV, Freitas LA, Agostinho AAM, Andrade MBT, Goyatá SLT. Undergraduates performance on vaccine administration in simulated scenario. Rev Bras Enferm [Internet]. 2019;72(2):345-53. https://doi.org/10.1590/0034-7167-2018-0486
https://doi.org/10.1590/0034-7167-2018-0...
).

David Kolb addresses this grasping and understanding of learning using stages (CE, RO, AC and AE) and learning styles (diverging, assimilating, converging and accommodating), which demonstrate characteristics that are correlated with the way individuals learn. The use of development structures capable of improving situations that generate learning is linked to stages and styles. To achieve knowledge, individuals develop preferences in the way of learning, and this is marked by past experiences and current learning needs. For every two stages combined, a learning style(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.) is formed.

Diverging style learns best when using simulation, readings, discussions, observations. There are studies that worked with nursing students, describing that they learn from real experience and uses reflection to internalize experience(1616 Lisko SA, O’Dell V. Integration of theory and practice: experiential learning theory and nursing education. Nurs Educ Perspect [Internet]. 2010 [cited 2020 Nov 07];31(2):106-8. Available from: https://pubmed.ncbi.nlm.nih.gov/20455368/
https://pubmed.ncbi.nlm.nih.gov/20455368...
). Diverging individuals work with varied situations, seeking alternative solutions in an organized way; they relate well, are creative, recognize problems. People with diverging styles often prefer to work in groups and receive personal feedback(2626 Witt J, Colbert S, Kelly PJ. Training clinicians to be preceptors: an application of Kolb’s Theory. J Nurs Pract. 2013;9(3):172-6. https://doi.org/10.1016/j.nurpra.2012.07.031
https://doi.org/10.1016/j.nurpra.2012.07...
).

The nurses participating in this study, classified with diverging style, showed these characteristics when they established a relationship with other situations experienced. They used the analogy in the face of new situations, putting into practice an alternative solution and creativity to carry out the exam. They recognize problems and, when they observe things from another perspective, they do not see difficulties in the situations experienced and in their conduct.

Assimilating style learns using storm of ideas, questions for reflection, lectures, text reading, projects, images, diagrams and models. People with an assimilating learning style are less focused on people and more interested in abstract ideas and concepts. They prefer a concise, logical and linear approach, assimilating students as readings and having time to think about things(2626 Witt J, Colbert S, Kelly PJ. Training clinicians to be preceptors: an application of Kolb’s Theory. J Nurs Pract. 2013;9(3):172-6. https://doi.org/10.1016/j.nurpra.2012.07.031
https://doi.org/10.1016/j.nurpra.2012.07...
). The two nurses classified as assimilating individuals showed logic with the creation of a spreadsheet, moving from a way of seeing the situation to other ways of understanding that optimize the action, by gathering various information, acting systematically.

With regard to converging style, they learn better by logical reasoning, applying both theory and common sense. They are good at solving practical problems, at using hypotheses to solve a problem and make decisions, they use understanding and ideas separate from actual experience(1616 Lisko SA, O’Dell V. Integration of theory and practice: experiential learning theory and nursing education. Nurs Educ Perspect [Internet]. 2010 [cited 2020 Nov 07];31(2):106-8. Available from: https://pubmed.ncbi.nlm.nih.gov/20455368/
https://pubmed.ncbi.nlm.nih.gov/20455368...
,2626 Witt J, Colbert S, Kelly PJ. Training clinicians to be preceptors: an application of Kolb’s Theory. J Nurs Pract. 2013;9(3):172-6. https://doi.org/10.1016/j.nurpra.2012.07.031
https://doi.org/10.1016/j.nurpra.2012.07...
). The three nurses, thus classified in the present study, presented in their speeches situations that show practical application of ideas, decision-making, resolution of technical problems and tasks.

In accommodating style, people demonstrate learning by practicing, facing challenges, taking risks. They are better suited to circumstances, prefer practical activities and experiences, and often rely on intuition rather than logic, tending to adopt a practical and experiential approach. People with this style have the ease of learning fieldwork, case studies, laboratories, simulations, homework and readings(2020 Nalom DMF, Ghezzi JFSA, Higa EFR, Perez CRFB, Marin MJS. Ensino em saúde: aprendizagem a partir da prática profissional. Ciênc Saúde Colet. 2019;24(5):1699-708. https://doi.org/10.1590/1413-81232018245.04412019
https://doi.org/10.1590/1413-81232018245...
,2626 Witt J, Colbert S, Kelly PJ. Training clinicians to be preceptors: an application of Kolb’s Theory. J Nurs Pract. 2013;9(3):172-6. https://doi.org/10.1016/j.nurpra.2012.07.031
https://doi.org/10.1016/j.nurpra.2012.07...
). The two nurses classified with accommodating style showed that they execute plans, face the challenge, as in solving the demand before the deadline, seek to solve problems, even if they ask for help from other co-workers, because they act more by the feeling of solving a problem than by logic, as in this case to seek to help and not leave patients without meeting their demand. The nurses presented the resolution of their problems, working with other people to achieve their goals. Asking for help solving a problem with the support of others was described in another study(2727 Dias GPP, Sauaia ACA, Yoshizaki HTY. Estilos de aprendizagem Felder-Silverman e o aprendizado com jogos de empresa. Rev Adm Empres. 2013;53(5):469-84. https://doi.org/10.1590/S0034-75902013000500005
https://doi.org/10.1590/S0034-7590201300...
-2828 O’Connor S, Daly C.S, MacArthur J, Borglin G, Booth RG. Podcasting in nursing and midwifery education: an integrative review. Nurse Educ Pract. 2020;47:102827. https://doi.org/10.1016/j.nepr.2020.102827
https://doi.org/10.1016/j.nepr.2020.1028...
) as well as involvement in new experiences.

Learning styles combined with stages allow individuals to learn, understand and transform their way of learning through experience. Learning requires individuals to recognize the best way to gain knowledge. These ways of learning are linked to learning styles(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.).

Recognizing learning styles assumes relevance in the current context in which information technologies, especially the use of virtual resources, have taken a leading role in the educational context. This scenario was strongly induced by the COVID-19 pandemic experienced throughout 2020, in which remote education began to be widely used. An integrative review that synthesized evidence on podcasting in nursing and midwifery education pointed out that undergraduate nursing students who had a preference for auditory learning seemed to enjoy listening to podcasts and learned a lot from them. However, others did not like to use technology or preferred traditional teaching approaches. Also, nurses stated that they sometimes combined podcasting with other activities, such as reading lecture slides, notes, reading textbooks and discussing digital content in study groups and online forums, as this seemed to improve learning(2525 Costa LCS, Avelino CCV, Freitas LA, Agostinho AAM, Andrade MBT, Goyatá SLT. Undergraduates performance on vaccine administration in simulated scenario. Rev Bras Enferm [Internet]. 2019;72(2):345-53. https://doi.org/10.1590/0034-7167-2018-0486
https://doi.org/10.1590/0034-7167-2018-0...
,2828 O’Connor S, Daly C.S, MacArthur J, Borglin G, Booth RG. Podcasting in nursing and midwifery education: an integrative review. Nurse Educ Pract. 2020;47:102827. https://doi.org/10.1016/j.nepr.2020.102827
https://doi.org/10.1016/j.nepr.2020.1028...

29 Bortolato-Major C, Mantovani MF, Felix JVC, Boostel R, Silva ATM, Caravaca-Morera JA. Debriefing evaluation in nursing clinical simulation: a cross-sectional study. Rev Bras Enferm [Internet]. 2019;72(3):788-94. https://doi.org/10.1590/0034-7167-2018-0103
https://doi.org/10.1590/0034-7167-2018-0...
-3030 Rasheed SP, Younas A, Mehdi F. Challenges, extent of involvement, and the impact of nurses’ involvement in politics and policy making in in last two decades: an integrative review. J Nurs Scholarsh. 2020;52:446-55. https://doi.org/10.1111/jnu.12567
https://doi.org/10.1111/jnu.12567...
). The findings of this study reaffirm that there are different ways to learn.

The study on students’ learning in the first period of the nursing school(2424 Cheng YC, Huang LC, Yang CH, Chang HC. Experiential learning program to strengthen self-reflection and critical thinking in freshmen nursing students during COVID-19: a quasi-experimental study. Int J Environ Res Public Health. 2020;17(15:5442. https://doi.org/10.3390/ijerph17155442
https://doi.org/10.3390/ijerph17155442...
) describes that, when students are led to develop practices that generate learning, they are able to transform knowledge. When teachers are encouraged to use methods capable of changing the absorption of knowledge, everyone wins, because learning from experience requires students to grasp, understand and read on the way they learn. In addition to technical skills, experiential learning can also be useful for developing nurses’ political skill and increasing interest and motivation to participate in policy formulation(3030 Rasheed SP, Younas A, Mehdi F. Challenges, extent of involvement, and the impact of nurses’ involvement in politics and policy making in in last two decades: an integrative review. J Nurs Scholarsh. 2020;52:446-55. https://doi.org/10.1111/jnu.12567
https://doi.org/10.1111/jnu.12567...
).

Moreover, continuous professional development is a requirement, including to enhance the science of implementation, which plays a fundamental role in the adoption and integration of evidence-based practices to improve quality of care. Nurses need to provide safe, effective, patient-centered, timely, efficient, and equitable health care. Individuals and communities cannot wait to receive the best possible care. We now need well-equipped nurses and nursing scientists who can facilitate implementation efforts to improve health and health care(3131 Boehm LM, Stolldorf DP, Jeffery AD. Implementation science training and resources for nurses and nurse scientists. J Nurs Scholarsh. 2020;52:47-54. https://doi.org/10.1111/jnu.12510
https://doi.org/10.1111/jnu.12510...
-3232 Gomes RG, Fava SMCL, Lima RS, Sanches RS, Gonçalves MFC, Resck ZMR. Desenvolvimento da competência de avaliação clínica do paciente crítico por acadêmicos de enfermagem: contribuição da simulação. Esc Anna Nery. 2020; 24(4):e20190384. https://doi.org/10.1590/2177-9465-EAN-2019-0384
https://doi.org/10.1590/2177-9465-EAN-20...
).

Participants’ reports about their learning experiences in different scenarios, social, cultural and technological contexts are in line with Kolb’s theory, when he considers that learning is a cumulative process of knowledge that should make sense for a learner. Nurses’ experiential learning occurs in the interaction with the environment, in the work context, being determined by the learning styles of each one. These movements make up lifelong learning, promoting continuous professional development.

Finally, there is an observation here. The study on theories by Kolb(99 Kolb DA. Experiential learning: experience as the source of learning and development. Nova Jersey: Prentice Hall; 1984.) presented the Kolb Learning Style Inventory 4.0, which brings a new integration of learning styles into the learning cycle through the expansion of learning style types from 4 to 9 and the introduction of the concept of learning flexibility - the extent to which individuals adapt their learning style to the demands of the learning situation. The new model maintains the integration of styles across the learning cycle, emphasizing that learning requires different styles at different stages of the learning process. However, in this study, we chose to work with the four initial stages proposed by Kolb in 1984, because we understand that the model meets what we propose in this research: to highlight the importance of recognizing nurses’ different learning styles for the success of continuous professional development.

Study limitations

The study was developed in BFHUs, and there are few studies based on Kolb’s theoretical framework about pedagogical practices in the continuing training of nursing professionals in this scenario. In this sense, this study can be replicated in other contexts of Primary Health Care, expanding the discussion of the theme and the results obtained here.

Contributions to nursing

Being able to recognize which learning style each nurse has can facilitate the way knowledge is acquired and passed on. Therefore, nurses’ learning styles characteristics favors the process of continuing education. Acquired knowledge improvement favors the care that should be given to individuals, family and community, emerging in nursing professionals a different way of teaching.

FINAL CONSIDERATIONS

The research data allowed us to identify primary care nurses’ learning styles in the light of David Kolb’s Experiential Learning Theory, allowing us to recognize how we can enhance nurses’ learning. Identifying, recognizing and enhancing experiential learning contributes to transforming theoretical and practical knowledge and improving the skills necessary for the performance of their duties.

The identification of different learning styles of nurses may contribute to the adequacy of continuing education programs, guiding institutional and governmental training policies. The styles demonstrate how nurses acquire learning through daily experience, which allows them to think of instructional drawings that meet the different ways of learning.

Experiential learning characteristics are the act of learning in practice, reflecting on knowledge, exploring the new, using theoretical concepts, accepting challenges. Learning styles are manifested when nurses use their practice to solve daily questions or when they think about how to solve a given situation. For these styles to be considered by managers and planners of training programs, nurses need to show how they like to learn, how they feel more comfortable seeking knowledge, whether through feelings, reflections, projections or actions.

For this, it is necessary to observe and offer tools capable of enhancing the process of learning through experience, recognizing how different learning styles can be fostered. It is necessary to understand how nurses receive theoretical knowledge and, mainly, to know what they know and how they acquire learning from practice. Thus, learning is exponentiated, improving the assistance provided to individuals, family and community by the continuing development of professional skills.

ACKNOWLEDGMENT

I would like to thank my friends, Isac Silva de Jesus, Enock Barroso dos Santos and Linda Karolinne Rodrigues Almeida Cunha, and my husband, Rodrigo da Silva Martins. The support of all was fundamental.

  • FUNDING
    This work was carried out with the support of the Amazonas State Research Support Foundation (FAPEAM - Fundação de Amparo à pesquisa do Estado do Amazonas), by the Stricto Sensu Graduate Studies Support Program (POSGRAD - Programa de Apoio à Pós-Graduação Stricto Sensu) 2021/2022, Process 01.02.016301.02424/2021-85.

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Edited by

EDITOR IN CHIEF: Antonio José de Almeida Filho
ASSOCIATE EDITOR: Ana Fátima Fernandes

Publication Dates

  • Publication in this collection
    09 Sept 2022
  • Date of issue
    2022

History

  • Received
    21 Jan 2022
  • Accepted
    11 Apr 2022
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