Nurse educators guide students to achieve academic goals using scholarly reading and writing. Although student engagement in scholarly reading and critical thinking is crucial to further nursing science, graduate students often lack the skills and experience needed to read and analyze scholarly writings in depth. They may be unprepared for graduate-level reading as a means for knowledge acquisition and application. Faculty perception that students do not engage with texts is not new (Aldridge, 2019). Educational strategies are needed to improve student reading literacy and the critical analysis of written texts in the field of nursing. We provide a case example of the use of portable document format (PDF) software to enhance the critical analysis of written texts in a master of science in nursing (MSN) theory course.
Typically, faculty select reading materials that they perceive as beneficial to advance student learning. However, students may not readily grasp the value of a faculty member's selections and may struggle to consume and relate the course materials to their experiences and current knowledge. This well-intentioned selection of content is instructor-centered and does not meet the needs of the problem-oriented adult learner. From our own observations, graduate students appear to read only an article's abstract and select direct quotations from the abstract without reading and analyzing findings from the actual content of the text. We determined that faculty need to initiate student-centered reading, direct student reading processes, and focus student attention on more substantial components of a scholarly work.
THEORETICAL AND RESEARCH BACKGROUND
Understanding the needs of adult readers as proposed by Knowles (1984) was pinnacle in the creation of this instructional strategy. According to Knowles, adults have experience and internal motivation, are problem-orientated, practice self-direction, and possess a readiness to learn. We applied Knowles' assumptions to reading assignments with the use of PDF software to make student reading and critical thinking visible. In this innovative student-centered teaching strategy, students annotate research articles using PDF software and respond to reading prompts. Assignments are developed to build reading skills and achieve student learning objectives, which include comprehending critical scholarship.
Recent research demonstrates that reading to solve problems, reading with structured guidance, and student-centered learning all improve student learning outcomes. In a study of reading comprehension, Hart and Stebick (2016) concluded that readers must problem-solve to comprehend written texts. They propose that educators provide explicit instructions to readers, many of whom do not naturally apply critical thinking to reading. Understanding written texts is inherent to the development of critical thinking. Lin, Preston, Kharrufa, and Kong (2016) used technology and structured reading to enhance critical reading and reasoning with nine post-master's graduate students who spoke English as a second language. They concluded that this strategy also facilitated complex task completion. In a study by Hou (2018), faculty engagement in the student-centered learning process demonstrated more advanced student learning outcomes compared to faculty-centered learning among 341 first-year medical students.
PARADIGN CASE: PROCESS AND OUTCOMES
In our MSN nursing theory course, students identified a particular clinical challenge. Faculty provided guidance by suggesting key search terms related to the assignment. Students selected reading materials to expand their understanding of the case and added self-selected search terms to represent the clinical problem in conjunction with faculty-selected terms. This strategy resulted in students finding appropriate articles to achieve personal and course objectives. Student agency in selecting a clinical problem and related reading materials successfully enhanced the synthesis of concepts illustrated in faculty-selected reading materials.
Faculty defined the assignment as a "paradigm case": an experience that changes thinking in a fundamental way. The process involved students describing a meaningful experience in their nursing practice that might also be challenging to understand or transformational in the evolution of nursing practice. Students were instructed to present a one-page narrative conveying this experience. The narrative helped faculty guide student selection of 10 relevant scholarly articles, as well as key search terms related to course content. Student-specific terms selected from their paradigm cases were also selected. For example, a student whose case focused on employee vaccination rates combined the faculty-provided search term systems theory with the student problem term vaccine behavior. This support allowed students to find reading materials compatible with their interests and consistent with the self-directed characteristic that adult learners possess.
Once students identified articles of interest, they read each article and identified content related to course topics, recording their reactions to the reading. Faculty provided specific guidance, which helped students locate theoretical components within the articles. They instructed students to examine the introduction, the theoretical background, and the selection and measures of variables within each article in order to identify conceptual, theoretical, and empirical aspects related to theory. Being asked to identify specific theoretical concepts from their individual reading selections motivated students to read closely and comprehensively, which fostered critical thinking and active reading skills. Following are sample tasks drafted for this purpose: a) Identify the philosophical stance of the authors, b) Identify conceptual/theoretical/empirical elements, c) Identify cultural theory elements, d) Identify concepts from systems theory, e) Identify caring theory elements.
Students in this cohort enrolled simultaneously in the nursing theory course and a graduate research course. This context created an unexpected challenge for faculty. At first, students found it difficult to concentrate on the theoretical components of an article due to an instinctive impulse to critique the research findings in the annotations, which students were learning to do in the research course. Faculty had to reassess pedagogical practices to mitigate this complication, responding to this challenge with frequent and directive feedback.
USING PDF SOFTWARE
Students used commercially available PDF software to annotate articles employing comment bubbles, underlining, color coding, and highlighting (our institution's academic software bundle includes Adobe(R) products). Students were notified that open access readers, such as FoxIt(R), could be used, and if they did not have access to software, they could submit a hand-annotated article. Faculty introduced the concept of annotation with an editorial by Hicks and Roberts (2018) and included a wiki-how resource entitled "Annotate-an-Article" to supplement the course material.
Students submitted their first annotation using PDF technology to practice this new technique and solicit low-stakes feedback. For the next three weeks, they submitted three graded annotations each week, completing 10 annotations during the first two to five weeks of the course. Annotating the articles oriented students to the task of active reading and self-directed learning. In addition, these 10 annotations formed the initial collection of source material used in students' final summative paper.
In our experience, the use of the PDF software with guided reading and writing prompts influenced MSN student scholarship as evidenced by a transition in their writing from directly quoting an author to writing an article summary and analysis in their own words. Initially, students read to find and point to the "right answer." Critical thinking expanded as students had more reading experience. Students demonstrated their ability to think critically when they supported inferences about their articles based on what was and was not included in the assigned reading. In addition, we observed that student engagement with reading facilitated transition from use of nonstandard English toward the standardized English found in scholarly writing. Finally, students moved from writing what seemed like a list of disjointed ideas to creating written work that connected concepts from theory to their understanding of the world.
Centering the assignments on a paradigm case contributed to the originality of the final summative paper on the structure and function of theory. Students could not exploit another person's annotation as their own due to the personal nature of the paradigm case, an unanticipated benefit of this pedagogical approach. Together, the outcomes demonstrate the effectiveness of the use of a paradigm case with PDF software annotation. Graduate student performance related to close reading of text, figures, and tables contributed to critical thinking and the ability to consider multiple viewpoints while using standardized English with better logical development of final papers and original work.
CONCLUSION
This case example describes the development of a series of course assignments that use available PDF technology to advance student scholarship in an MSN program. We reported on the theoretical and research background for development of the assignments, the implementation of the strategy, and our observations of student outcomes in response to visible reading with PDF software annotation. Future research to measure the impact of guided reading on the literacy of graduate students would provide more insight on strategies for improvement of critical thinking in graduate education.
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