Journal of Professional Nursing

Using Adult Learning Theory to Enhance Clinical Teaching

Jill Wilkinson, RGON, PG Cert TT, MA (Hons), PhD (cand) Senior Nursing Lecturer, School of Nursing and Health Studies, Whitireia Community Polytechnic, Porirua

Reference:  Wilkinson, J. (2004). Using adult learning theory to enhance clincial teaching. Nursing Praxis in New Zealand, 20(1), 36-44.


Becoming competent with the ‘skills of nursing’ gives a student nurse a strong sense of self-efficacy and is foundational to the development of the ‘thinking of nursing’ and critical thinking. Such a qualitative shift towards critical thinking involves a student approach to learning that is often referred to as deep, as opposed to surface. Deep approaches result in a high level of engagement with the meaning or significance of the information, and an ability to apply the information in new situations. Although registered nurses engage in silent dialogue about specific clinical situations the critical thinking is indiscernible to the student nurse. It is important that the latter see evidence of critical thinking in the health professionals around them if they are to attempt to develop critical thinking for themselves. Ultimately, student motivation to approach learning using deep strategies is dependant on their perception of its necessity. Helping student nurses understand clinical situations in the way that is characteristic of expert nursing is the essence of clinical teaching. Thinking about when and why learning occurs may be of assistance to preceptors teaching students of nursing. In this article four theories of adult learning theory are discussed (self directed learning; experiential learning; constructivist theory; and critical thinking) as well as theories about motivation to learn. Suggestions for how the theory may be applied to the clinical learning environment are offered.

Adult learning theory, motivation, critical thinking, student nurses, preceptors, clinical teaching

“I know that nursing knowledge is more than what we can learn about in books or lectures. I think that I mean the way in which nurses pass on knowledge about nursing” (Participant in study by Street, 1992, p.143). For registered nurses, working with students of nursing can be a highly rewarding experience. To achieve this end they need to think about when and why learning occurs. According to Ramsden (1992) learning is a qualitative shift in thinking that brings about changes in one’s understanding of reality. He says that teaching should therefore be concerned with helping students understand things in the way that experts do. Experts in nursing practice have the opportunity to pass on their ‘knowing’ about nursing. Clearly more than what can be learned from books is involved, otherwise students would come to practice already prepared. Nurses are educated to nurse, not born to nurse, which means that students do not instinctively have access to the kind of knowledge that is necessary for nursing. They must learn it.

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