HealthOctober 30, 2019

Moving beyond monologue in the classroom

By Sue Forneris, PhD, RN, CNE, CHSE-A, FAAN and Mary Fey, PhD, RN, CHSE-A, ANEF

As educators, there's no question that we know how to teach... right?

Our early Greek philosophers differentiated human beings from other species based on our ability to use language. Yet, when one reads further about the use of language, we find that language should be informative, expressive, directive - used to reason, express ideas, argue a point, provide direction.

There is no doubt that good educators are gifted in the use of language. However, the correct use of language - providing direction, being informative, expressing ideas - is most effective when our learners are engaged in meaning making. The ability to engage the minds of our learners by using dialogue to make meaning is at the heart of great education.

This blog is focused on just that, using dialogue in a purposeful way. Great educators move beyond the monologue and instead of teaching content, they collaborate with learners, helping them think about how to use the content. When we engage our learners in this reflective discourse, we are engaging their minds.

Now we want to engage your minds. We will ask you to think about something familiar, therapeutic communication, but in an unfamiliar way. The twist here is taking the familiar apart. During this journey, the nonitalicized text is the familiar. The italicized text is the explanation, the underpinning of the unfamiliar technique being used.

Nursing and boundaries with communication

The teaching of therapeutic communication and its inherent boundaries in professional nursing is a fundamental content in nursing education. However, with multiple ways to engage in communication today, such as through text, email, or pictures, the art of therapeutic communication can be lost. We want you to reconnect with your inner learner by thinking about an experience you have had where virtual, verbal, or nonverbal communication made an impact on you, either positive or negative.

STOP, WAIT, don"t click out! We get it. We know you"re thinking, “Just tell me about today's communication pitfalls and how the internet has made communication way more complex. Don"t make me do anything.” Learners on the receiving end often feel this way. So"¦stretch yourself and take a quick journey with us. You are our learner today and we would like to use boundaries within therapeutic communication to set the context for your learning. We will then explain various strategies that use dialogue to help learners make meaning. Our expectation is that you will take time to read this blog, click on the links below, and reflect on our points. You are in control!


Introducing an activity that is active requires transparency on the part of the educator, establishing expectations, clarifying roles, and creating a learning environment in which the learner feels safe to engage in the activity.


We are going to take you through an activity that involves watching a 4.5-minute communication YouTube video clip using “Friends” as our learning encounter. See what you think! Often, engaging the senses and the opportunity to experience a variety of encounters, and then reflecting on whether you had the same experience, opens the door to examine the art, and non-art, of connecting with others, demonstrating the importance of nonverbal communication. 

By introducing you to examples of nonverbal communication and providing a mechanism for you to check them out, we are framing our learning activity. We norm the activity by providing a means for you to get your bearings and find a learning connection. We did this by providing you with a link to a website. In the classroom you can do the same thing, or you may want to open the conversation by recounting related experiences and asking learners how they may be familiar. Norming is a way to understand how learners see the learning objective, giving them an opportunity to get in touch with their prior knowledge.


When was the last time you were on the receiving end of an encounter in which nonverbal communication had a significant impact? OR, when an email or text was misleading about the intended communication? What were your immediate reactions? How did you feel? What was the outcome? Did it get your attention? For some, nonverbal matters more. For others, the verbal takes priority. Still others believe, “it's not what one says, but rather, how you make someone feel that matters.” So, when it comes to professional therapeutic communication, is there a “right” and “wrong” way - or is it grey?

Activating prior knowledge means helping learners make connections with their experiences so they can begin to link new information. This activity helps learners make sense out of what they are learning by seeing how it fits with what they already know. When we help learners make those connections before, during, and after providing the content, we are teaching them a critical comprehension strategy.


Now, take a minute to think about how nonverbal, verbal, or virtual scenarios can create communication pitfalls when it comes to therapeutic communication. Write them all down. Make a list. Then take another minute and compare your pitfalls to some common ones. How did you do? Similar? Different? Send this blog link to colleagues and ask them to watch the video clip. Check in with them to see how they reacted. Share your ideas. How would they discuss nonverbal communication in a contextual way?

One way of structuring content is by chunking and checking in. Chunking means breaking down longer and more complex explanations into digestible pieces, or “chunks.” This can help with understanding and recall because smaller pieces of information are easier to process. After you give a piece of information, check in with your learners to see how they are doing. 

You can do this by explicitly asking and watching and looking for responses. Only move on to the next chunk when you are confident you have achieved understanding with the previous chunk. Use think-pair-share as a way to “check in” with your learners.


Nonverbal communication can push us to the edge of boundaries in our work. How do we differentiate professional from personal boundaries? How would nonverbal communication blur the lines between personal and professional communication? Where does one boundary end and the other begin?

Setting the course is taking a basic concept and moving it forward in a different way - sometimes using a different context. In this case, a communication video was used as a contextual way of understanding communication and then launching into an exploration of boundaries between personal and professional communication. We used it here to set the course for new thinking and providing an example for how one might think critically and creatively.


So, as we come to the end of our blog, we hope that we have started your journey into exploring active dialogue strategies for something familiar and common. We hope that this sparked your own ideas for engaging in meaningful discourse with your learners in the classroom.

Forneris, S.G. & Fey, M. (Eds.) (2018). Critical conversations: The NLN guide for teaching thinking. Washington, D.C.: National League for Nursing.

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