The results of this research showed that the students played an important role in their own learning process and used varying method for learning. The activities that students do for their self-directed learning were categorized into four categories that are “sensory perceptions”, “knowledge construction”, “problem orientation” and “interaction with others” (Table 1). As follows, the meaning of each theme and subtheme has been reported using the participant’s direct quotations.
SDL activities Sensory perceptions Visual Perception
Knowledge Construction Active engagement in situation
Absorption of information based on cognitive map
Selecting appropriate learning strategy
Problem orientation Active Questioning
Interaction with others Interpersonal participation
1. Sensory perception: the students used visual and auditory senses through precise observation and active listening for learning. Therefore, this main category consists of two sub-categories included: “visual perception” and “auditory perception”.
1.1. Visual perception: The students stated that they learnt deeply those subjects or procedures which were presented through photos and films or those ones which were trained practically by the instructor or other health care formers in the hospital. They said that this type of learning rest in their mind for many years. One of the students stated: “about learning for me, most of the things rest in my mind, were the films. Films stayed more in my mind rather than theory....for example I wanna search about an issue in the internet, I accidentally found a film called periocardio sentesis and I watched it, it exactly rest in my mind” (p2). Another student also said: “then the instructor at that clinic did a deed which got remained in my mind forever, even up to the dooms day. That experience never gonna out of my mind. The instructor fastened the tourniquet, she tightened it and pressed that edema by her own fingers in a way that it got away, then that vein got bulged out, and she got the vein by a needle...” (p3).
1.2. Auditory perception: participants’ another activity for SDL was active listening. They processed, analyzed and memorized what they had listened, to learn it. According to participants, acquiring and analyzing various useful ideas and information during nursing and medical rounds assist them to increase their knowledge. One of the students noted: “I always like to be at their (physicians’) rounds and listened to their discussion... for the first time in BS course which Bechet disease was not taught to us, we were taken clinical course.... a doctor at a round talked about it, it was so interesting for me ” (p6) . another student stated, “we got the round with our instructor, I saw for the first time a patient having Pemphigus, then our instructor explained so much about that. Her explanation is still in my mind” (p?).
2. Knowledge construction: In addition to sensory perception, the participants were using “active engagement in situation”, “active rehearsal”, “absorption of information” and “selecting appropriate learning strategy” in their learning process.
2.1. Active engagement in situation: In addition to sensory learning, our participants made an effort to improve their own learning by active involvement in performing procedures. They preferred practical and experimental methods rather than other methods. They noted that those subject which they got involved with, practically, could make more permanent learning for them. “For learning, I agree with practical work, more. I mean if I don’t do something in practice, I learn nothing. I got forget. Even if I memorize it, it is in vain. I like it to be practical more” (p2).
Furthermore the students were trying to carry out the theoretical points in practical forms and, then, studying the results. “For example when I studied physics or chemistry, I got to do all research in home. For example by the dishes and the things which were available and it was possible to do the tests in a way that I understood well all things” (p6).
In addition, the students achieved some experiences out of events and incidents happened in the environment and they were using these experiences for providing more effective cares in future. “One night the patient was falling down the bed. Well, it was an experience for me in other situations, to raise the side rails and also check the patient repeatedly. There is no any other option; well it is impossible to restrain the patient. He/she must be in my sight and under my precise supervision, I should look at her/him more carefully and in the conditions that the patient may probably get agitated, we ask his/ her visitor to stay with him/her at the bedside. So I myself experience it, it’s according to my own experience” (p2).
2.2. Active rehearsal. The students mostly were using repeating methods in order to learn and memorize the subjects which were supposed to be memorized. Moreover, they were also applying some strategies such as summarizing, note taking and highlighting for learning more, and establishing the subjects in their mind. One of the students stated: “I often try to repeat, because one or two times repetition is not enough for me. I usually try to repeat more, if it’s practical, it got remained in the mind and it is not necessary to read it anymore, but اگر مطلب حفظی باشه just by repeating and repeating, it got remained in my mind” (p2). Another student says: “In my study process, I’m used to taking notes, I mean, I usually take the note and highlight the subject by underlying or highlighting it by other colour. It helps me so much and I can remind even where that word was.... This note taking helps me a lot; usually I’m in this way and repeating, you know!” (p 4)
2.3. Absorption of information based on cognitive map: During the process of researching and learning the materials, the students were making an attempt to achieve a general view point about the subject and also make a connection between new subject and their previous knowledge. Then prepared for learning more specific materials. “Firstly I get started with the general subject [for searching]. For example I wanna know that what I get about a disease as a whole. I got a search a lot in Google.... after I got a general idea about it; I seek the details... for example about falling in old people, I used the key word “falling” for searching to see what it gives me. Then when I found the issues, books and articles which were presented, I got search with more details” (p3). Another student said: “well according to the information which I have, you know, I don’t accept all things I got [in searching]. Those things based on the books I read, and those things I’m sure they are true, [I pick] them...” (p2).
2.4. Selecting appropriate learning strategy: The students noted that considering their condition, they preferred to select learning strategies which were easier to conduct and spent less time and cost. They also preferred those strategies which help to understand more deeply and induce more long-tem learning. In addition, the students generally preferred visual, practical and interpreting strategies of learning rather than other strategies.
“I got challenged with myself to determine which one of these [learning method] are better. I consider different points. I select the one which is easier, doesn’t take my time a lot, remains in my mind and at least I got what it means.” (p2). The other student stated about it, “There was a language class which cost was very high. I don’t know I got progressed if I taken it up or not? I’m not sure, but I didn’t take up! But, instead, I got a one of a language scholar, I asked him/her to test my language level, he/she found my level. Then I asked him/her to introduce me a series of books. Well I got to buy, you know, one fifth or one seventh part of the cost of the class, I paid for books. Now I have a lot of books which I refer to them when it is needed” (p 4).
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