NURS 450-001: Cognitive Approaches to Problem Solving

Pam O'Hara

solving a problem: anxiety about studying

5-step plan

•Behavior

•Feelings

•Thoughts

•Evaluation of thoughts

•Solving the problem: A plan of action

Nurses cognitive self assessment model (ncsam)

•“Identify, evaluate, and restructure cognitive distortions related to test talking”

•Based on cognitive behavioral therapy

•Aims to improve problem-solving skills and test-taking behaviors

•What a person thinks > feelings > behavior

•Correct unhealthy, irrational thoughts

• use this technique of writing in a “worry log” when feeling bad to reflect

thought-stopping

uBehavioral technique to reduce negative thoughts

uStop and redirect negative thoughts to positive ones

uUsed in individuals with anxiety, depression, and low self-esteem

uUse this technique for repetitive, intrusive, anxiety-provoking thoughts

usnapping a rubber band helps to SNAP you out of it. You snap out the negative thought.

guided visualization

uForm mental pictures of positive changes in yourself

uHelps stress-related and physical illnesses

uHeadaches, chronic pain, anxiety

uMust be relaxed

uWhen completed return to a full state of alertness

uStand up and walk round

uWait 10 minutes before driving

uComfortable position, clothing, close your eyes

uPractice at least twice a day

Metacognitive Techniques to Enhance Learning

“thinking about thinking”

uHaving control over our thinking process

uHelps you focus on what you need to know and how to learn it

u“Am I understanding what I’m studying?” “How can I study better?” “How will this help me be a better nurse?”

uHelps connect information you already know!

reciprocal teaching

uTeach someone else

uThink of multiple choice questions

To teach you must also understand it! Forces you to ”think out loud

stress response

• can affect cognition and emotions

• can happen during testing → muscle tension

• can even happen during positive or surprising events

• emergent situations → body becomes alert & energized (fight or flight)

NCLEX testing time

do NOT put off this exam. You perform better when you study immediately & take the exam in 1-2 months.

first-question freeze

Feeling of not knowing answers to first 1 – 2 questions

“Freeze up”: Difficulty moving beyond the first question(s)

Usually due to anxiety/nervousness at start of test

Extended time to calm down

Tip: Progressive relaxation techniques

clumping

missing several questions in a row

Indicates problem with 1^st question missed in a series

Anxiety/panic over one missed question distorts thinking → causes student to be distracted & select incorrect answers on next several questions

losing steam

Difficulty maintaining concentration

Start strong, finish weak

Majority of missed questions are seen toward end of test

Tip: Practice MORE test questions

catastrophic fantasy

Worry about consequences of failing (“My life will be over;” “I’ll never be a nurse”)