PROBLEM SOLVING IN NURSING EDUCATION

1. PROBLEM SOLVING METHODS
SUBMITTED TO, SUBMITTED BY,
Mrs. Mitali Biswas Mrs. Aswathy M U
Assistant professor MN 1st year

2. INTRODUCTION
Problem solving is an instructional method or
technique where by the teacher and pupils
attempt in a conscious, planned and
purposeful effort to arrive of some
explanation or solution to some
educationally significant difficulty for the
purpose of finding a solution.

3. Evolution of problem solving
approach
• William James in
1907,advocated problem
solving as a field of
enquiry into human
problems

4. Evolution of problem solving
approach
John Dewey
‘Reflective thinking’
• Identifying and
formulating a problem
• Collecting facts that
lead to a solution
• Examining each
solution
• Decide the action to be
taken

5. Concepts and Assumptions
• According to
perlman(1957)
problem solving work
must be a ‘concious,
focused, goal directed
activity between client
and caseworker’
Helen Harris Perlman

6. Evolution of problem solving
approach

7. PROBLEM SOLVING
DEFINITION
A systematic approach to defining the
problem (question or situation that presents
uncertainty, perplexity or difficulty) and
creating a vast number of possible solution
without judging these solutions.
OR

8. Contd..
Problem solving is a tool, a skill and a process;
It is a TOOL because it can help you solve an
immediate problem or to achieve a goal.
It is a SKILL because once you have learnt it you
can use it repeatedly.
It is also a PROCESS because it involves taking a
number of steps

9. PROBLEM SOLVING
The problem solving is a
process of overcoming
difficulties that appears to
interfere with the
attainment of goal. It is a
procedure of making
adjustment in spite of
interferences. (SKINNER)

10. CRITICAL THINKING
Critical thinking is an intellectual process of
actively and skilfully conceptualizing,
applying, analysing, synthesizing, or
evaluating information.
The information can be gathered from or
generated by observation, experience,
reflection, reasoning or communication.

11. DECISION MAKING
The act of narrowing down the possibilities,
choosing a course of action, and determining
the action’s potential consequences.

12. SKILLS NEED FOR SOLVING A
PROBLEM
Knowledge
Motivation
Experience
Communication skills
Learning skills
Group skills

13. What is a problem?

14. PROBLEM
 A problem is a part of a situation, that has
some kind of barrier, so that it cannot
complete its function and cannot reach its
purpose (Shibata, 1998).

15. What is a problem?
Scenario not matching the desired situation needing
improvement- challenge /opportunity
Anytime actual performance does not match
expectations
Problem don’t occur without a reason
In any situation with a problem, there must be a
historical point;when actual performance started to
deviate
Something happened at the time x which caused the
problem to occur
It is important to distinguish between symptoms of a
problem and its cause

16. FEATURES OF A PROBLEM
Problem should be meaningful and interesting
Problem should be correlation with life
Problem should have correlation with other subjects
Problem should arise out the real needs of the
students
Solution to the problem should be found out by
students themselves working under guidance and
supervision of the teacher
The student must possess some background of the
problem, which they are going to discuss

17. BARRIERS TO PROBLEM SOLVING
 Failure to recognize the problem- not sure what the
problem is
 Conceiving the problem too narrowly, not sure what is
happening
 Making a hasty choice, not sure what you want
 Failure to consider all consequences, not enough
resources
 Failure to consider the feasiblility of the solution
 Failure to know to communicate what is possible
 Team attitudes like lack of accountability,fear of change,
lack of trust and doubts
 Failure to consider the flexibility of the solution.

18. AVOIDING PITFALLS
Giving up too early
Jumping straight to
conclusion about the cause
Not getting the right
people involved
Not collecting all the
relevant data

19. APPROACHES OF PROBLEM SOLVING
METHOD
INDUCTIVE APPROACH
DEDUCTIVE APPROACH
ANALYTIC APPROACH
SYNTHETIC APPROACH

20. INDUCTIVE APPROACH
It is the process of developing generalization
from specific observations. In this the
student arrives at the general conclusion and
formulate generalisation through the
observation of particular facts and concrete
example.
Specific General

21. DEDUCTIVE APPROACH
It is the process of developing specific
predictions from general principles. Here the
learner procedes from general to particular,
abstract to concrete. A reconstructed formula
or definition is explained to students and
they are asked to solve a problem using that.
General Specific

22. ANALYTIC APPROACH
Analysis means breaking up of the problem
so that it ultimately gets connected with
something which is already known.It is the
process of unfolding of the problem or
conducting its operation to know its hidden
aspects.
Unknown Known

23. SYNTHETIC APPROACH
It is opposite of analytic approach. It begins
from something already known and connect
with the unknown part of the statement
Known Unknown

25. METHOD OF PROBLEM SOLVING
PROCESS
1. Setting the problem statement
2. Analyse the problem
3. Identify many potential solution and choose
the best solution
4. Plan of action
5. Implement the solution
6. Evaluation and revision

26. STEP-1
SETTING THE PROBLEM
STATEMENT

27. DESCRIBE THE PROBLEM
• Defining the problem is a crucial step that
involves digging deeper to identify what it is
that needs to be solved. Diagnose the
situation so that your focus is on the
problem, not just its symptoms.

28. CHOOSE WHAT YOU WOULD DO FIRST
FROM THE LIST
Write down a list of possible causes.
Write down everything you know about the
problem.
View the problem from different perspective.
Identify the component of the problem.
State the problem clearly and specifically.

29. SETTING THE PROBLEM STATEMENT:-
A problem statement is a single sentence
embraces your understanding of the
problem. Not the cause of the problem, but
the problem it self.
Setting the problem statement is the single
most important action you will take in the
whole problem solving process.
It is important that you must be prepare to
put in time and effort to get it right

30. NECESSITY OF THE PROBLEM
STATEMENT:-
A clear problem statement enables you to
decide what work must be completed to find
the cause.
Keeping the problem statement visible
during the search for the causes and keeps
effort focused in the right area.

31. DEFINE THE PROBLEM:-
1. Where did the problem start? Where it exist or
not?
2. What do i know about the problem? What is the
current state and desired state?—What can you
see is causing the problem? What result I seek?
3. How is it happening?
4. When is it happening?
6. Whom is it happening to? No blaming
7. Why is it happening?
8. Which part causes it?

32. The important thing you should keep
in mind
You should
Stating and restating the problem
Analyze the problem
List everything you know about the problem
List what you want the solution to achieve

33. The problem statement should
include
It should be clear and precise
Understandable to a person with no
knowledge of the problem area.
Based on the description of the problem.
Include details about the problem including
who, what, when, where and how
Address the scope of the problem to identify
boundaries of what you can reasonably solve

34. The problem statement does not
include
Any mention of
possible causes
Any potential solutions

35. STEP 2
ANALYSE THE PROBLEM

36. ANALYSE THE PROBLEM
In this step you are aiming to develop a detailed
specification of the problem.
It also determine who is involved and when and
how often the problem occurs
The purpose of this is to determine, what the
problem is not.
If things are going well, then they cannot be part
of the problem.
By analysing what is right you can eliminate
potential causes of the problem and limit the
scope of your investigation.

37. ANALYSE THE PROBLEM
It include
What? Question; is right or wrong
Where? To locate the problem, where the
problem exists and where it does not
When? to discover the timing of the problem;
when it occurs and when it does not, when first
and last seen
Who: is involved and who is not
How? To explore extent

38. STEP 3
IDENTIFY MANY POTENTIAL
SOLUTIONS & CHOOSE THE BEST
SOLUTION

40. CHOOSE THE BEST SOLUTION
A systematic approach to questioning, ensure
you don’t miss any important areas.
If you don’t ask the right questions, you can’t
possibly get the right answers.
The best questions nearly always start with:
WHAT? WHY? WHEN?
WHO? WHERE? HOW MUCH?
Because such questions cannot be answered
with a single word, but require some form of
comment.

41. HOW DO YOU DECIDE WHICH
QUESTION TO ASK
Essentially your problem statement and
description of the problem are the best
starting points for generating questions.
Some techniques are also important for
arising the questions;

42. BRAIN STROMING
• Brainstorming is a
process of group
discussion to produce
the ideas.

43. Cont..
-To generate as many ideas as possible about:-
•The overall nature of the problem.
•The actions to be taken to solve the problem.
•Possible causes of the problem.
•Specific aspects of the problem.
-A member of the group gives an idea, you know
it is completely irrelevant. What should you do?
•Write down the idea as stated.
•Modify the idea to make it relevant. Ask the
members of the group whether they think the
idea is relevant

44. EXAMPLES
How could we improve access to healthy
food in our community?
How could we improve school attendance?
How might we limit cold and flu transmission
among students?

45. BUG LISTING
• When listing the things they
liked, the group got a very
different set of ideas.
• It is quick and easy to use
and very useful for getting a
feel about the problem.

46. REVERSALS
• “REVERSALS” is a simple technique for a
change to an opposite direction or course of
action.
• You simply take an issue that you planned to
brainstorm and reverse it.

47. EXAMPLES-
How to attract more customers into my
store?
How to reduce the number of customers
visiting my store?
How to improve the quality of customer
service?
How to reduce the quality of customer
service?

48. STEP 4
PLAN OF ACTION

49. PLAN OF ACTION
During this step, you determine
What steps must be taken
Designating tasks where necessary
Decide on dead lines for completing the actions
Estimate the costs of implementing them.
Best solution is selected based on the careful
judgement, which is supposed to solve the
problem swiftly and smoothly

50. PLAN OF ACTION
Typically,this stage involves narrowing down
the possible ways to implement the solution
you’ve chosen, based on any constraints that
apply.
The complexity of the plan will depend on
the situation, but it should include the who,
what, and when of your proposed solution

51. STEP 5
IMPLEMENT THE SOLUTION

52. IMPLEMENT THE SOLUTION
The final step of the problem-solving process
is to practically solve the problem by
implementing the selected solution.
Decide how you will move forward with your
decision by determining the steps you must
take to ensure that you move forward with
your solution.
Now, execute your plan of action.

53. STEP 6
EVALUATION AND REVISION

54. EVALUATION AND REVISION
• To judge the effectiveness of the solution
• To redefine the problem and revise the
problem-solving process in case the initial
solution fails to manage the problem
effectively
• Monitor your decision

55. EVALUATION AND REVISION
Assess the results of your solution.
• Are you satisfied with the results?
• Did your solution resolve the problem?
• Did it produce a new problem?
• Do you have to modify your solution to
achieve better results?
• Are you closer to achieving your goal?
• What have you learned?

56. SOLVING A PROBLEM INVOLVES A
NUMBER OF COGNITIVE ACTIVITIES
Ascertaining what the
problem really is
Identifying the true causes
of your problem
Generating creative
solutions to the problem
Evaluating and choosing
the best solution
Implementing the best
solution.

58. ASSESSMENT
• Recognizing a problem is of primary
importance because if the problem goes
unrecognized, there is no attempt to find a
solution
• Eg:-patient who repeatedly complains of
severe postoperative pain on the second day
after surgery

59. ANALYSIS
CHOICES ACTIONS
Solution-focused •Give pain medication.
•Withhold pain medication.
•Ask physician to order
more effective medication.
•Instruct in visualization
and relaxation.

60. ANALYSIS
• CHOICES ACTIONS
Cause-focused •Examine wound for signs of
infection or complications, such
as a constrictive dressing.
•Check vital signs.
•Check laboratory findings.
•Talk to patient to determine
level of anxiety or other problems.
•Observe patient.

61. When healthcare providers are rushed or
impatient, it’s easy to become solution-
focused—and solutions are important—but part
of thinking critically is to remain cause-focused
as well:
•WHY does the patient have continuing post-
operative pain?
•Which is the best solution?
•How should I proceed?
•What should I do first?
In this case, the healthcare provider is a nurse
and reviews the possible solutions and possible
causes to arrive at a priority list that combines
both.

62. OUTCOMES
 When considering problems and solutions,
the healthcare provider should always
identify the outcome. In this case, one
outcome may be:
“Patient will have pain level of 1-2 with first-
tier pain medications within 24 hours.”

63. PLAN
The plan evolves from analysis:
Priority 1 •Give pain medication.
Priority 2 •Examine wound.
•Take vital signs
Priority 3 •Talk to patient.
•Observe patient.
Priority 4 •Check laboratory findings.
•Instruct in visualization and
relaxation

64. IMPLEMENTATION
• After administering the pain medication(the
immediate solution to the problem), the
nurse then examines the wound (looking for
causes) and finds that it is erythematous and
swollen with purulent discharge, and the
patient’s blood pressure, pulse, respirations,
and temperature are elevated.

65. EVALUATION AND REFINEMENT
• There is clear evidence of wound infection, so
the next step is to check laboratory findings and
call the doctor
• It’s always easiest to focus on one problem at a
time, but the reality is that one problem often
leads to another problem
• The plan and priorities often change.
• The physician ordered a wound culture, CBC and
differential, dressing changes, and a broad-
spectrum antibiotic

66. EVALUATION AND REFINEMENT
• There is no one-model-fits-all solution.
Because this patient’s pain was severe,
relieving pain was a priority,
• But if the pain had been milder or if there
had been previous indications of infection,
then the priority listing may have changed
and the patient examined prior to
administration of pain medication.

67. EVALUATION AND REFINEMENT
• If the nurse had been too busy to examine
the patient, assumed the patient was just
hypersensitive to pain, or had returned in 2
or 3 hours to examine the patient, then the
nurse would have exercised poor problem-
solving ability by focusing only on the
immediate solution to the problem and
ignoring the underlying cause.

68. EVALUATION
• Evaluation is an ongoing
• For example, if guidelines regarding
handwashing techniques are issued and
posted, demonstrations given, and
individuals observed, it’s not safe to assume
that without ongoing evaluation compliance
will remain high.
• People tend to return to their level of
comfort.

69. COMMUNICATION
The nurse must communicate
with
• other nurses in reports
• Physicians and other
healthcare professionals
• patients and families.

70. COMMUNICATION
• We should use care when communicating to
express ideas clearly
•Ask for clarification: I’m not sure I understood
that. Could you explain it to me again?
•Rephrase: I understood you to say that the
wound culture was taken. Is that correct?
•Ask for more information: How much drainage
is there?

71. COMMUNICATION
• For example, if during the report about the
patient’s pain, the nurse stated, “the patient
asked for pain medication every 2 hours and
complained all day,”
• The listener may assume this is simply a
difficult and complaining patient.

72. COMMUNICATION
• A more accurate communication would be:
“the patient complained of severe pain every
2 hours because her wound is red, swollen,
and draining purulent discharge.”
• communication goes in both directions

73. USES OF PROBLEM SOLVING IN
NURSING

74. USES OF PROBLEM SOLVING IN
NURSING
• Develop ability to analyse the problem and to take proper
judgement/solution in the critical condition
• It helps the students to solve this problem in real life
situation without much stress
• It helps the student to solve the similar problem in future
with confidence.
• It develops critical thinking of pupil.
• In the class/group it will develop mutual understanding
among the group members.
• It helps the care giver/nurse to develop a skill to help the
patient.
• Develop ability in nurse to select the problem solving
strategy according to patient’s abilities and life style

75. TEACHER ROLE IN PROBLEM SOLVING

76. TEACHER ROLE IN PROBLEM SOLVING
 The students to define the problem clearly
 Got them to make many suggestions by encouraging them:
 To analyse the situation in parts
 To recall previously known similar cases and general rules that
apply
 To guess courageously and formulate guesses clearly
 Get them to evaluate each suggestion carefully by encouraging
them:
 To maintain a state of doubt or suspended conclusion
 To criticize the suggestion by appeal to know facts , minister and
experiment
 Get them to organize the material by proceeding:
 To build on outline on the board
 To use diagrams and graphs
 To formulate concise statement of the net out come of discussion

77. MERITS OF PROBLEM SOLVING
It help to stimulate thinking
It help to enhance the reasoning power
Helps to increase knowledge
Helps to develop good study habits
Help the student to be self dependent
Discussion help to develop the power of expression of
the students
Help to maintain discipline
Learning become more interesting
It gives power of critical judgement
It helps to verify an opinion

78. DEMERITS OF PROBLEM SOLVING
Generally speaking problem – solving involves mental
activity only.
Small children do not posses sufficient background
information & therefore they fail to participation in
discussion.
Students may not have adequate reference and
sources books.
It involves lot of times.
It need very capable teacher to provide effective
guidance and knowledge to students.
It is a time consuming process, teacher may find it
difficult to complete the syllabus

80. Problem-Solving Training:Effectson
the Problem-Solving Skills and Self-
Efficacy of Nursing Students
• Conducted by Gulsum Ancel at İstanbul University in
İstanbul, April 2014.
Conclusions and Recommendations
• This study shows that training for problem-solving
through a structured management course improves
confidence in problem-solving skills and self-efficacy
beliefs. In light of this,nursing students should be
trained in more creative ways than just traditional
methods,and PS strategies related to management
should be integrated into the nursing process.
• Further study is needed to clarify the relation
between training programs and perceived problem-
solving in different samples.

81. BIBILOGRAPHY
• K P Neerja (2004); Textbook Of Nursing Education; 1st Edition; Jaypee
Brothers Medical Publishers; P 348- 350
• Quinn Francis M. And Suzanne J. Hughes (2007); Principles And Practise
Of Nursing Education; 5th Edition, Nelson Thorns Ltd; Uk; P 70-72
• Basavanthappa B T (2009); Nursing Education; 2nd Edition; Jaypee
Brothers Medical Publishers; P 381-382, 458-459
• B Sankaranarayanan , B Sindhu(2012); Learning And Teaching Nursing; 4th
Edition, Jaypee Brothers Medical Publishers, P 79, 82-85
• Critical Thinking In Nursing. (2010). Prentice Hall. Retrieved May 28,
2011,
• http://wps.prenhall.com/chet_kozier_fundamentals_8/61/15681/40143
46.cw/index.html
• Fallacies. (2007). University of North Carolina at Chapel Hill.
• Lipe, SK, & Beasley, S. (2004). Critical Thinking in Nursing: A Cognitive
Skills Workbook.Philadelphia,PA: Lippincott, Williams, & Wilkins.
• http://www.criticalthinking.org/pages/nursing-and-health-care/801
• https://nursing.lsuhsc.edu/AcademicSuccessProgram/StrategiesProblem
Solving.aspx
• https://files.eric.ed.gov/fulltext/EJ1121973.pdf

82. THAT’S ALL!

83. You are ready for the evaluation

84. 1.The act of narrowing down the
possibilities, choosing a course of
action, and determining the action’s
potential consequences is
A) critical thinking
B) decision making
C) communication
ANS: B

85. 2.Problem solving is a tool, a skill
and a _________
ANS : PROCESS

86. 3.State true/false.
Deductive approach is the process of
developing generalization from
specific observations.
ANS : FALSE

87. 4. Techniques important for
arising questions to identify the
potential solutions
• Brain storming
• Bug listing
• Reversal

88. CONGRATULATIONS!

89. THANK YOU FOR PARTICIPATING!
Hope you learn 