A survey on the current situation of using figurative expressions in nursing was conducted to obtain basic data for examining explanations and educational methods that use “metaphors” to promote student understanding in nursing education. Therefore, this study defined figurative expressions as “explanations expressed in easy-to-understand words or used in easy-to-understand metaphors to promote student understanding in practice and precepting situations.” To understand the current status of the use of figurative expressions in clinical practice, a self-administered questionnaire survey and a group interview survey were conducted among nurses with experiences in teaching practical training. The Ethics Review Committee for Research Involving Human Subjects of Shizuoka University approved the study, an explanatory letter indicating the study purpose and methods was sent by mail, and the survey was initiated upon submission of a signed and sealed consent form by the survey participants. The survey was conducted from August to September 2021. A progressive model was used for summary content analysis. The results revealed the following explanations: “explanation compared to daily necessities,” “explanation compared to daily activities,” “explanation by demonstration using daily necessities,” “explanation using strong impressions,” “explanation paraphrased in general terms,” “explanation replaced by students’ past experiences,” “explanation using nonverbal expressions (including pictures and gestures),” “explanation from principles to explanation,” “encouraging students to think like the person giving the explanation,” and “encouraging students to think like someone close to them.” The agreement rate among the categories after content analysis was confirmed by calculating the kappa coefficient of five respondents including the analyst using the SPSS Statistics 26 statistical software. The mean agreement rate was 48.1%.
The survey revealed that figurative expressions are used in practical instruction. Specifically, paraphrases and
similes such as “explanation in general terms,” “explanation compared to daily necessities,” and “explanation
compared to daily activities” were used to explain a high percentage of students. To deepen students’ understanding of patients, such as their position and psychological state, they were encouraged to think from the perspectives of the patients and their families. The results also revealed that paraphrases and similes were very commonly used in teaching. Furthermore, the use of metaphors and similes was divided into two types according to the lesson content: those that used metaphors and similes and those related to students’ knowledge and experience, indicating a commonality between the lesson content and explanation method.
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