mapping is a technique that allows students to understand the relationships
between ideas by creating a visual map of the connections. Concept
maps allows the student to (1) see the connections between ideas
they already have, (2) connect new ideas to knowledge that they
already have, and (3) organize ideas in a logical but not rigid
structure that allows future information or viewpoints to be included.
students face a great need to understand the larger questions and
problems of their chosen field. Unless there is understanding, students
may only commit unassimilated data to short-term memory and no meaningful
learning will occur. Meaningful learning is most likely to occur
when information is presented in a potentially meaningful way and
the learner is encouraged to anchor new ideas with the establishment
of links between old and new material (All & Havens, 1997).
Concept mapping is an effective teaching method for promoting critical
thinking and is an excellent way to evaluate students' critical
thinking because it is a visual representation of a student's thinking.
concept map is an effective teaching tool that is fun, interactive, and
effective. It can be used in a variety of settings. The concept map mirrors
more closely real clinical situations by being dynamic as priorities shift.
It is an innovative teaching tool that engages the student and prepares
the student for future clinical decision-making in a complex and diverse
map consists of nodes or cells (often a circle) that contain a concept,
item or question and links (lines). The links are labeled and denote direction
with an arrow symbol. The labeled links indicate the relationship between
the nodes. Words are used to label the links in order to more explicitly
- What is
the central word, concept, research question or problem around which
to build the map?
- What are
the concepts, items, descriptive words or telling questions that can
be associated with the concept, topic, research question or problem?
- Use a
top down approach, working from general to specific or use a free association
approach by brainstorming nodes and then develop links and relationships.
- Use different
colors and shapes for nodes and links to identify different types of
- Use different
colored nodes to identify prior and new information.
- Use a
cloud node to identify a question.
information to a question in the question node.
a preliminary concept map is helpful. This can be done by writing all
of the concepts on Post-its, or by using a computer software program.
Post-its allow a group to work on a whiteboard or butcher paper and to
move concepts around easily This is necessary as one begins to struggle
with the process of building a good hierarchical organization. Computer
software programs are even better in that they allow moving of concepts
together with linking statements and also the moving of groups of concepts
and links to restructure the map. They also permit a computer printout,
producing a nice product that can be e-mailed or in other ways easily
shared with collaborators or other interested parties (Novak, n.d.).
and Evaluating with Concept Maps
is very useful in student preparation for clinical experiences. When used
for the assessment and care of a patient with multiple health problems,
data gathered allows the student to create a concept from the concepts
or data collected. A common way to begin a concept map is to center the
"reason for seeking care" or medical diagnosis on a large blank
paper. Assessment data are arranged and linked to the center concept according
to how the student thinks they fit bets. As concepts or data are added,
links and relationships become evident and may change. Grouping and categorizing
concepts give a holistic aspect to clinical decisions (King & Shell,
map enables students to synthesize relevant data such as diagnoses, signs
and symptoms, health needs, learning needs, nursing interventions, and
assessments. Analysis of the data begins with the recognition of the interrelatedness
of the concepts and a holistic vie of the client's health status as well
as those concepts that affect the individual such as culture, ethnicity,
and psychosocial state.
preliminary concept map is complete, answering additional questions enable
the student and instructor to make connections between concepts and begin
formulating judgments and decisions. Once complete, the student and the
instructor see all components simultaneously, providing a deeper and more
complete understanding of the client's total needs. Development of the
concept map forces the student to act upon previous knowledge, connect
it with new knowledge, and apply it. It requires the student to have a
mental grasp of the situation, rather than relying on rote memory. Review
of the map with the student gives the instructor an opportunity to evaluate
the student's thinking and an opportunity for immediate feedback on discrepancies
and "missing links" (King & Shell, 2002).
data in patient record. These data are typical of what student nurses
find in medical records when gathering information for care plans or other
assignments (King & Shell, 2002).
Concept Map with fictitious client data (King & Shell, 2002).
Mapping for Clinical Care Planning
and Schuster (2002) describe the use of concept care plans instead of
the column format care plans. Both students and faculty found that the
concept care plans were specific to the client, concise, and organized
care. The concept maps enabled a holistic view of the client and covered
all client problems, and students learned to integrate and understand
relationships between client problems. Faculty found that students learned
to think critically and did not copy care plans from books as they did
when using the column format. Schuster (2000) describes in detail the
use of concept maps to replace traditional column care plans.
clinical data collected, students develop a basic skeleton diagram of
the health problems. The client's major medical diagnosis is written
in the middle and then associated nursing diagnoses are added flowing
outward. The nursing diagnoses written on the map are the actual problems,
not potential problems. At this stage of the care planning process,
it is more important that students recognize and focus on major problem
Step 2: Data to support diagnosis.
step, students analyze and categorize data gathered. Students identify
and group priority assessments related to the reason for admission and
identify and group clinical assessment data, treatments, medications,
and medical history data related to nursing diagnoses.
Step 3: Relationships
can use different colored pen, dotted lines, etc to indicate relationships.
This is illustrated by dotted lines in the Figure below. Faculty can
verbally ask students to explain why they linked diagnoses if not obvious.
A student soon recognizes that most of the problems the patient has
are interrelated. Students and faculty can see the whole picture of
what is happening with the client by looking at the map.
Step 4: Nursing
interventions and evaluation.
number each medical and nursing diagnoses on their map. Either on the
back of the map or a separate page, corresponding nursing interventions
are listed for each of the numbered nursing diagnoses on the map. The
interventions include key areas of assessment and monitoring as well
as procedures or other therapeutic interventions. Faculty can have students
write or verbally discuss rationale for nursing interventions.
Step 5: Using
clinical, students update the map in order to evaluate effectiveness
of nursing care.
can also be used as a group activity. Initially, it may be more effective
if the instructor demonstrates the development of a concept map from raw
data and asks students as a group to make links, associations, and conclusions
while emphasizing the dynamic nature of the concept map as new or changing
data is added.
Shell (2002) the use of concept mapping as a teaching tool in clinical
conferences. Using actual client data, the students are instructed to
analyze and synthesize diagnoses, sign, symptoms, health needs, ethical/legal
concerns, leadership/management issues, as well as nursing interventions
that included assessment, planning, client teaching needs, and evaluation.
Discussions allowed students to make connections not previously appreciated.
This exercise offers the opportunity for increasing knowledge of client
situations and practicing clinical decision making.
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& Havens, R. (1997). Cognitive/concept mapping: A teaching strategy
in nursing. Journal of Advanced Nursing, 25(6), 1210-1219.
A., & Schuster, P. (2002). Evaluation of outcomes in nursing students
using clinical concept map care plan. Nurse Educator, 27(4), 149-150.
K., & Ulrich, D. (1997). Unfolding case studies: An experiential
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K., & Ulrich, D. (2001). Unfolding case studies: Experiencing the
realities of clinical nursing practice. Upper Saddle River, NJ: Prentice
J. (2002). The 60-second nurse educator: Creative strategies to Inspire
Learning. Nursing Education Perspective, 23(5), 222-237.
M., & Shell, R. (2002). Teaching and evaluating critical thinking
with concept maps. Nurse Educator, 27(5), 214-216.
L. (2000, March). Critical thinking through case studies. Workshop presented
at Creative Teaching for Nursing Educators, Memphis, Tennessee.
J. (n.d.). The theory underlying concept maps and how to construct them.
Retrieved from http://cmap.coginst.uwf.edu/info/
P. (2000). Concept mapping: Reducing clinical care plan paperwork and
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a topic of choice, perhaps a medical diagnosis and relevant client
data. Write the concepts on post-it notes (perhaps using different
colors to represent concepts and examples).
2. Arrange the pieces of paper, on a poster board, so that the ideas
go directly under the ideas they are related to (often this is not
possible because ideas relate to several concepts). At this point,
add concepts that help explain, connect, or expand the ideas.
3. Draw lines from the main concepts to the concepts they are related
to. It may be necessary to rearrange the notes of paper.
4. Label the lines with "linking words" to indicate how
the concepts are related.
5. Copy the results onto a single sheet of paper.
6. Use of computer software will enable you to manipulate nodes