The newly revised Essentials of Baccalaureate Education for Professional Nursing Practice states that "a solid base in liberal education provides the cornerstone for the practice and education of nurses."1(p3) Liberal education is thought to provide professional nurses with some of the necessary skills needed to practice nursing, including critical thinking, effective communication, collaboration with others, appreciation of diversity, and the integration of knowledge from the sciences and humanities to solve problems. However, liberal education is viewed by many faculty as separate from the nursing curriculum: the courses taken prior to the nursing courses. Seeking strategies that would require students in our required gerontology nursing course to incorporate principles of liberal education, we developed the Life Review Project.
The Life Review Project has several components that are completed over the course of the semester. Students are required to read Tuesdays With Morrie,2 a true story of the life lessons learned by the author from his old friend and teacher during the last months of his life. Morrie reminisces about his life as he deals with the physical, mental, and spiritual challenges of declining health and impending death. Students are able to relate the course content about aging to this very personal, touching story of a courageous man, as told to his friend. In addition to reading the book, the learning experience is enriched by showing clips from the movie based on the book at intervals throughout the semester.
In the second component of the Life Review Project, each student selects an adult, aged 65 years or older, with whom to conduct a life review. Using Tuesdays With Morrie as a guide, the students create an interview protocol. Questions asked over the course of multiple meetings with the older adult cover biographical information starting with childhood and questions that address how they perceive the meaning of their lives, their hopes and dreams, and their thoughts about death and dying.
Once the life review is completed, students are encouraged to develop a creative format for presenting the material to the class. Common choices include scrapbooks, poster presentations, and PowerPoint presentations. The students also write a reflective summary about what they learned after spending time with their older adult. Finally, near the end of the semester, students do an oral presentation of their Life Review Projects for their classmates and the instructor.
The use of life review, or reminiscence therapy, is well documented as an effective nursing intervention for the promotion of therapeutic communication that enhances self-esteem, diminishes depression, and promotes closure for elders.3-5 This makes the Life Review Project a valuable teaching tool with benefits for both the students and the elders they interview. This project also meets important criteria for a liberal education. Students have an opportunity to improve their written and oral communication skills, enhance critical thinking and creativity, apply their knowledge of gerontology, and gain a new appreciation for the elderly that defies the negative stereotypes of aging so ingrained in our culture.
As expected, students are often not enthusiastic when first told about the Life Review Project. However, as their projects get underway, a change in attitude is noted. They see past events through the eyes of someone who has actually witnessed or been a part of them, bringing history alive for the students. Those who interview a grandparent discover how very little they actually knew about someone they love. And they discover that these older adults have wonderful, interesting stories to tell and wisdom to share.
The creativity shown in the students' documentation and presentation of their Life Review Projects is impressive. A good example is a beautifully assembled scrapbook one student made with photographs, drawings, and mementos portraying significant events and aspects of her 84-year-old grandmother's life (Figure 1). The student later presented it as a gift to her grandmother. In explaining why she chose this approach, the students said, "she truly represents the idea that age is just a number. [Having traveled] to nations all over the world, her life is an example of someone living life to its fullest and not letting age get in the way."
Another student created a paper mache globe that demonstrated the travels of the older adult she interviewed. And still another student made a life-size stand-up cardboard cutout of her grandfather, complete with labels designed to present him in a holistic way. Figure 2 shows the "clock" that one student made to demonstrate the "times" in the life of James, a family friend. The student said, "He was the only 'older person' I knew... I was in a bit of denial that he fit into that category at 65. I made a clock to show that just because he was put into the 'geriatric population,' that didn't mean his biological clock was up. I used pictures of him from each decade of his life for the numbers and since he's only 65, the pictures ended at half past six. The rest of the numbers were things he wanted to accomplish for the rest of his life, such as traveling and spending time with family. When you look at someone's life with this type of visual representation, it really shows how much more living they have to do."
The Life Review Project is one way to help students meet the liberal education requirement from the Essentials of Baccalaureate Nursing Education. This assignment allows students to think critically and creatively and gain a sense of appreciation for diversity found among older adults and assists students with their communication skills. It also provides students a brief exposure to literature, enabling them to apply knowledge from an everyday situation to nursing practice. The assignment has proven to be a valuable tool in ensuring that liberal education is addressed in our nursing course.
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