Engaging in HIV Education at the Intersection of Cognitive & Affective Learning

Purpose: The purpose of this article is to report on grounded educational experiences and teaching techniques designed to meet students at the intersection of the cognitive and affective learning domains. This critical pedagogical examination attempts to address student engagement on the topic of HIV Care by outlining a dynamic view of how nursing educators can approach attitudinal change on a stigmatized topic.

Rationale/Background: A generation after the emergence of Human Immunodeficiency Virus (HIV) in the United States (U.S.) stigma and healthcare disparities related to HIV remain. For those who lived through and/or cared for patients during the emergence of HIV the salience of this disease is indisputable. However, a new generation of healthcare provider students poses challenges for educators because student engagement can vary from a deep emotional connection to the realities of  people living with HIV (PLHIV) to resistance in learning or discussing HIV or even, at times, an apathetic response to the lived experiences of PLHIV.  

Brief description of undertaking or best practice:

Teaching/Learning Strategies:

Films: Films can provide a medium that facilitates a human connection with the experience of HIV as well as an historical lesson, including the critical role activism played in fueling AIDS research and drug development.  Reflection Scenarios: Students are asked to reflect and answer, “What if you were diagnosed with HIV.” They are also asked to express this experience through a photograph or a piece of artwork.  Case Scenarios: Examples include people from different environments that are newly diagnosed with HIV (a gay man, a sex worker, and a health care provider). This is followed with a person with advanced HIV disease so that students can see what it can look like when patients are not diagnosed and treated early.  Teaching as an Improvisational Art is the ability to draw laughter and tears through storytelling, exemplars and, at times, with humor. Students need to feel what having HIV in their lives could feel like so they connect with patients who are diagnosed or living with HIV.  Sharing of Self can be a crucial part of creating connections with students. The degree to which a faculty member does this is a careful balance of sharing one’s own struggles and humanity while avoiding becoming self-centered and over-revealing. Specific examples of how this is done will be shared.

Outcomes achieved/documented:

An email, quoted with permission, begins, “I just wanted to tell you about the experience I had at work this weekend and how thankful I was for having had your lecture.” She goes on to describe a patient and family interaction where she applied her newly gained knowledge about HIV and made a difference. This and other outcomes will be shared in our presentation.

Conclusions for clinical education:

Nurse educators can use dynamic teaching strategies that intersect the cognitive and affective domains to help students connect with the stigmatized topic of HIV. Understanding the lived experience of PLHIV will poise healthcare providers to decrease healthcare disparities and to provide quality care for this group.