Pakistan Journal of Medical Sciences


ISSN 1681-715X





Volume 25

 April - June 2009 (Part-I)

Number 2


PDF of this Article

Teaching experience and reflection

Saleema Gulzar1, Shahid Shamim M2, Catherine Lobo3


The standard of education can be improved if educators actively assess themselves or have someone else evaluate their teaching skills. Reflection on multiple aspects of teaching can be used as a powerful tool for worldwide educationists. Teaching, particularly in nursing discipline, strives to move beyond the simple divulgence of facts and knowledge. It widens student’s horizons, stimulates their intellects, and teaches them to become self directed. This manuscript is a qualitative review of observations in a class of nursing with context to teaching skills and its impact on students’ interest in learning during the class. The authors have used their reflections to discuss the ways to improve teaching methodology and related them with various teaching learning theories.

KEY WORDS: Reflection, Teaching strategies, Humour in teaching, Role play, Teaching theories, Self directed learning, Teaching and learning principles, Andragogy approach.

Pak J Med Sci    April - June 2009    Vol. 25 No. 2    338-341

How to cite this article:

Gulzar S, Shamim SM, Lobo C. Teaching experience and reflection. Pak J Med Sci 2009;25(2):338-341.

1. Ms. Saleema Gulzar, BScN, MScN
Senior Instructor, School of Nursing,
Aga Khan School of Nursing, Karachi.
2. Dr. Muhammad Shahid Shamim, MBBS, FCPS, FRCS
Associate Professor of Surgery,
Department of Medical Education,
Dow University of Health Sciences, Karachi.
3. Ms. Catherine Lobo, RN, RM, DWA, DTA
Senior Instructor, School of Nursing,
Aga Khan School of Nursing
Karachi - Pakistan.


Dr. Muhammad Shahid Shamim,
B-122, Block “I”, North Nazimabad,
Karachi - Pakistan.

* Received for Publication: March 21, 2009

* Accepted: April 16, 2009


"The task of the excellent teacher is to stimulate apparently ordinary people to unusual effort. The tough problem is not in identifying winners: it is in making winners out of ordinary people" (K. Patricia Cross).

This quotation shows a great significance of teaching and the true role of a teacher. Teaching is not merely to reform students or to make them expert technicians, it is to widen their horizon; inflame their intellects; and teach them to be self directed. Therefore teaching in any discipline and particularly in nursing, should always strive to move beyond simply divulging of facts and knowledge or even training of certain skills. Instead, teachers have the broad responsibility of serving as guide and mentor on an intellectual journey, opening and broadening curious minds by exposing students to creative thoughts and ideas. This manuscript was prepared after observing a class of nursing students, conducted by one of the authors, as a reflective process of faculty in order to portray learning experiences for better teaching methods.


There were 33, third year diploma nursing, students in the session/ class being observed for reflections. Teacher was a trained faculty with 25 years of teaching experience. The topic of this session was "Mental Health Nursing". The observer was present in the back row of classroom, without the students’ awareness of her presence. The notes taken by the observer during the session were discussed among the authors and reflections were developed before preparing the manuscript.

Observations: It was observed in the session that faculty was adding jokes periodically in the beginning of the class. After creating a conducive environment for learning, she further moved on and began the topic by sharing the learning objectives for the session. Subsequently she asked a question, pertinent to the topic, ‘what students thought of cognitive disorder?". Students, in the attempt of trying to define the term in their own words started actively participating in the discussion.

The faculty used ‘lecture method (didactic) with discussion’ with the help of using transparencies. Transparencies were well typed; clear and easily visible even from a distance. However, there were few slides about dementia and delirium which were directly photocopied from the book. It seemed difficult for students in back seats to understand the written material on these photocopied slides. Here, the experience of teacher spoke for itself; she overcame this concern by reading and simultaneously discussing the content from transparencies so that the students could get most out of it. She moved the topic by showing them transparency about difference between dementia and delirium. While discussing the theoretical aspect, she was integrating this information with practice; such as, she stimulated their critical thinking by posing a question, "How does it affect patients when there is recent memory loss?" and students came up with various responses and their statements showed that they are able to integrate theory into practice. The students were then asked the differences between delirium and dementia and about their recovery room experiences of patients recovering from the effects of anesthesia related to this.

Students were then given a ten minutes break. At the end of this break, students again assembled and requested if class can be shortened and dismissed earlier. Faculty had sensed their feeling of tiredness and took an adult approach, leaving the remaining objectives for students to cover on their own. As per students’ request, she provided her own material (transparencies) for self study and added that after going through the material if they have any queries they can come and clarify with her. At the end she summarized the key points of the session.


Reflection: Studies have suggested that the use of humor in the classroom reduces tension, improves classroom environment, augments student-teacher rapport and facilitates learning. Humor by the teacher creates a caring, more flexible atmosphere and improves communication with students. This also reduces the authoritarian position of teacher and student anxiety.1,2 Situation becomes less of a threat for learners, as a partnership between students and instructor develops, thereby beginning the class in a relaxed environment. It also instilled a sense of readiness into the students; which is one of the significant principles of teaching and learning.

Throughout her class the faculty was posing thought provoking questions in a smooth tone, which enabled students to think critically and reflect deeply, which is one of the important components of effective-teaching.3 This was evident by the manner in which students interacted among themselves and with he teacher to come up with responses to these questions.

The use of transparencies was found to be creative, as it gave the faculty opportunity to discuss topic at her pace, move from one aspect to the other smoothly and also conveyed indirect lessons on good communication skills. Regarding preparation of transparencies, what we know from our past experience of teaching is that our slides are considered appropriate if they contain five bullet points that can be visualized from a distance of five feet.4 It was observed that transparencies that are photocopied directly from text book are not appreciative.

We found interactive lecture to be a good tool for students where they can be actively involved during the session. Students can question, clarify and challenge while the teacher conveys information. Lecture can be interspersed with discussion; however, time constraints may affect discussion opportunities. Effectiveness is connected to appropriate questions and discussion; often requires teacher to "shift gears" quickly. Therefore teacher should be prepared to allow questions during a lecture, as appropriate. Teacher should also anticipate difficult questions and prepare appropriate responses in advance.5,6

This observation also revealed that faculty was well prepared because students were asking questions for clarification and seeking more information which faculty was able to respond spontaneously thus clarifying their concepts. In the scenario of dementia and delirium, faculty was applying cognitive learning theory, which focuses on what goes on "inside" the learners’ mind. According to this viewpoint, learning involves perceiving the information, its interpretation based on what is already known, and then reorganizing this information into new insights or understanding.7

Faculty encouraged students to recall their recovery room experiences where the effect of anesthesia is really pertinent. She was thus trying to integrate concepts of dementia and delirium with the clinical experience. There by progressing from simple to complex and known to unknown, that is crucial teaching and learning principles. This inspired students to foresee their role as nurses in practice setting. Through that approach she was applying cognitive theory.8 She was also reinforcing key concepts, by doing so; she had applied the behavioral learning theory. Moreover, she showed individual’s and peer’s respect with encouragement, and thus she had integrated the learning theory of humanism and caring.9 According to Bloom’s taxonomy faculty was asking high order question whereby students could pursue the scenario analytically and learning the application of the key concept.

However, at times it was felt that another alternative strategy could have been used in order to teach this objective effectively, such as "role play". Role plays not only make the teaching interesting but it also instills a sense of empathy, which is a pertinent facet of caring in nursing profession. Role playing provides students with a chance to act out, rather than merely talk about, ways to solve problems effectively. Many students find this to be an enjoyable and instructive supplement to class discussions. It also gives teachers the opportunity to provide students with supervised practice in dealing with "real life" problem situations. Role playing can be an effective way to help learners integrate their social problem solving skills. Role playing enables students to (a) practice calming down during a problem situation; (b) act out solutions in an effective, cooperative way; (c) observe the consequences of their actions; and (d) practice persistence and overcoming obstacles.10 Moreover, "Role-playing" is an attempt by individuals to place themselves in position of others and deal with unfamiliar circumstances. Such experiences increase their understanding of the role they have adopted along with the circumstances they face. Therefore, successful role-plays will have a clear scenario, in which roles and circumstances are clearly defined. Those taking part in the exercise must be given sufficient guidance so that any role ambiguity is minimized.11

It is proven that short breaks in between sessions are helpful particularly when class is scheduled after lunch, a time when most of the students appeared low. Literature also revealed that it increases learner’s energy and refreshes them, thereby, impacting on their learning capability.12,13 Encouraging the students with reading materials and guidance is seen as a integral part of developing self directed learning.14 The concept of self directed learning is supported by Thomas Caruthers saying that "an efficient teacher is one who makes him or her self progressively unnecessary".

Summarization also helps in winding up and focusing on condensed information in major areas of the topic. Literature portrayed that summarization requires a reader to distinguish between important, less important, and trivial information and to make a judgment about what are the main ideas and supporting details of the learning objectives.10

It was also learnt through this observation that while teaching, faculty applied numerous teaching learning theories simultaneously, like the blind man exploring the elephant, each theory highlighted an important dimensions that affected the over all learning process. Reflecting the whole situation, the teacher had portrayed the role of facilitator, mentor and true leader in order to promote learning in an effective fashion to instill values of a good human being, the ultimate goal of education.


Nursing education is a dynamic teaching learning process intended to impart a specific, holistic body of nursing knowledge to the learner and serves as a basis for practice of nursing profession. Our observations augmented the benefits of using humour, interactive discussion, encouragement, role playing and raising critical questions as important tools during class room teaching. We also conclude that constant self assessment and reflection can be used as a guiding tool by educators.


1. Chiasson P. 2002. Humour in the Second Language Classroom; it’s not a Laughing Matter. Canadian Association of Second Language Teachers - Retrieve on line on 18th June 2005.

2. Loomax RG, Moosavi SA. Using Humor to Teach Statistics; Must they be Orthogonal? Paper presented at the annual meeting of the American Educational Research Association, San Diego, April 17th, 1998.

3. Spencer C. Critical thinking in nursing: teaching to diverse groups. Teaching and Learning in Nursing 2008;3(3):72-5.

4. Tice E. Educating adults. Adult Learning 1971;9(1):18-23. 

5. Instructional Methods Information, Updated March 25, 2005 retrieve on line from on, 18th June 2008.

6. Wiggins R. Development of knowledge, attitudes and commitment to teach diverse student populations. J Teacher Education 1999;50(2):94-105. 

7. Bastable B. Nurse as educator principles of teaching and learning for nursing practice. London: Sudbury 2003.

8. Ironside PM. New pedagogies for teaching thinking. The lived experiences of students and teachers enacting narrative pedagogy. J Nursing Education 2003;42:509-16.

9. Billings DM, Halstead JA. Teaching in nursing: A guide for faculty. Philadelphia: W. B. Saunders Company 2005.

10. Jeffries PR. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives 2005;26(2):96-103. 

11. Overstreet M. The use of simulation technology in the education of nursing students. Nursing Clinics of North America 2008;43(4):50-9.

12. Wankat P, Oreovicz F. Teaching: breaking the 15 minutes barrier 2003;12(8). Retrieve online from on 18th June 2007.

13. Royse M. How gaming is used as an innovative strategy for nursing education. Nursing Education Perspectives 2007;28:263-7.

14. Qualey DT. The evolution of classroom teaching. Teaching and Learning in Nursing 2008;3(4):55-9.


Professional Medical Publications
Room No. 522, 5th Floor, Panorama Centre
Building No. 2, P.O. Box 8766, Saddar, Karachi - Pakistan.
Phones : 5688791, 5689285 Fax : 5689860