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Introduction
In this unit of study, one of the assessment items requires you to complete a concept map. It is anticipated that this module will assist you in how to develop concept maps, by providing you with the theoretical background, but also the practical means as to how to construct a concept map. In this unit of study they have been included to assist students with understanding and interpreting complex altered physiology and how this may manifest in patients. Concept maps are constructs that assist students with understanding complex material. They are graphical representations of concepts that deal with specific subject matter (Novak and Canas, 2008; All and Havens, 1997). The word ‘concept’ means ‘a general notion or idea, or scheme or plan’. With this in mind, concept maps are constructions of successive concepts that assist in developing a compendium for developing knowledge and understanding about a more complex concept or concepts. Concept maps are especially helpful for health professional student learning by providing a visual ‘road map’ of patient conditions. They may be used to understand the underlying altered physiology and pathophysiological processes that have occurred in patients, or used to develop management strategies, such as nursing practice. For instance, when patients develop an increase in core temperature often they have an increase in heart rate that coincides with the hyperthermic state. The relationship between one concept (increased core temperature - hyperthermia) and others, (such as an increased heart rate – tachycardia) can be understood using concept maps. At the completion of this module, students will have had the opportunity to:
• understand the philosophy of concept maps
• outline the steps required to construct a concept map,
• have an understanding of the key features of a concept map.

Concept Maps
• Concept map organisation
• Concept maps consist of successive concepts which are joined with a line. The line needs to have an arrow to indicate direction. Importantly, to increase the understanding of the concept map, a word or a few words are inserted between the concepts to demonstrate what process is occurring between the successive concepts. These words are usually referred to as ‘linking words’.
• The concept map should be arranged in a hierarchical way. This means that conceptual relationships can be illustrated on both horizontal and vertical planes. The general consensus is that the concept map commences at the top of the page and as the map develops the movement is down the page. Therefore, in developing a concept map one may start with the central concepts at the top of the page and as one moves down the page, the concept map becomes more specific. However, this is not always the case and some concept maps are aligned in the horizontal plane, with side-to-side perspective. Nevertheless, there remains a hierarchical nature to the concept map that can ascertained when viewing the map. An overview of this design can be found in the following two figures. Figure one demonstrates that concept maps are used in a variety of ways and for different purposes. Look at these and take a while to digest the significance of the links. These are theoretical basis for concept map development.

• Figure one. Concept map presentation suggesting some of the concepts that could be included. For instance, the concept map may represent organised knowledge, or assist in answering an specific question. 
http://cmap.ihmc.us/docs/CmapAboutCmapsLarge.png

• In figure two, the primary concept is presented at the top and subsequent concepts which arise from the primary concept are mapped underneath. Yet, there are connections between concepts at different levels. Importantly, there are loops which may either stimulate or negate the effect of particular concepts.

• # - these are joining lines which link both similar and different levels of concepts
• Figure two. Concept map overview. The different level of concepts are similar in shape and colour. For instance, this could be a map of a disease process. The first concept is how the disease arose eg. infection caused by translocation of bacteria into the upper lungs. The secondary concepts are the immediate consequences of the primary concept. In this case, this would cause a non-specific (inflammatory process) and specific immune response, it would also activate coagulation, increase neural impulses and cause local tissue damage. The tertiary concepts would be the pathophysiological processes in detail, that is, how the secondary concepts are manifest as clinical signs and symptoms. The examples are the signs and symptoms, eg. cough, pain, increased sputum, white cell count, shortness of breath.

Concept Maps
Educational perspective
The original intention of concept maps were to explain science to children (Novak and Canas, 2008). However, there have been many variations. Concept mapping has been used in education (early childhood, secondary, tertiary), business applications (software design, teamwork, technology) and the disciplines of psychology, nursing, and medicine. Concept mapping has been used in nursing education (Beitz, 1998). To develop deep learning, students learn by summarising, developing relationships between information components, and categorising concepts such that content can be translated into context. Concept maps facilitate the acquisition of learning and promote critical thinking. This is achieved by increasing adding building blocks of content and having the ability to combine these to develop more sophisticated constructs.
Nurses need to problem-solvers and make effective decisions based on the presenting conditions of the patient (Gul and Boman, 2006). Often, nurses are required to synthesise large volumes of information and make clinical decisions based on their interpretation of the data. The data are collected from both objective and subjective aspects. Whilst the presenting clinical manifestations may be obvious, the underlying altered physiology is complex, multi-faceted and often difficult to understand. It has been found that concept maps greatly improve foundational knowledge and crucially allow the nurse to combine new information to improve overall understanding (Beitz, 1998). Moreover, concepts maps assist students to present large bodies of knowledge in graphical form which allows greater creativity, analysis, and critical thinking (All and Havens, 1997). Suggested readings
All, A.C., and Havens R.L. (1997). Cognitive/concept mapping: A teaching strategy for nursing. Journal of Advanced Nursing, 25 (6), 1210-1219.
Beitz, J. M. (1998). Concept mapping; Navigating the learning process. Nurse Educator, 23 (5), 35-41.
Carter, J. A., and Solomon, M.A. (1994). Cognitive mapping: An activity for health education. Journal of Health Education, 25 (2), 108-109.
Clayton, L.H. (2006) Concept mapping: An effective, active teaching - learning method. Nursing Education Perspectives, 27(4):197-203.
Gul, R.B., and Boman, J.A. (2006). Concept mapping: A strategy for teaching and evaluation in nursing education, Nursing Education in Practice, 6: 199-206.
Novak, J.D. and Canas, A.J. (2008). The theory underlying concept maps and how to construct and use them. Florida Institute for Human and Machine Cognition, 2008, available at: http://cmap.ihmc.us/Publications/ResearchPapers/
TheoryUnderlyingConceptMaps.pdf

Concept Maps
Concept map construction
This next section will outline concept map construction and use an example that will be pertinent to nursing practice. As outlined above, concept maps are a series of successive concepts joined with arrowed lines and linking words included to enhance meaning between concepts. These are simple overviews and do not present the true extent of concept maps when used to present complex relationships. Patients present with clinical manifestations that have arisen due to homeostatic imbalance. For instance, a patient with coronary heart disease (coronary artery atherosclerosis) may have a cluster of signs and symptoms (angina, dyslipidaemia (abnormal concentrations of lipoproteins), increased cardiac enzymes, anxiety, and so on). In the majority of cases, these clinical manifestations have taken years to present and the person may have numerous risk factors (age, smoking, hypertension, obesity) that contributed to the development. Therefore, to adequate link the altered physiology and pathophysiology in this case is complex. Concept maps allow students to present these cases in graphical form and ties all of the concepts together.
To illustrate how concept maps maybe constructed, the following examples are provided to illustrate the planning and development phases. The example that will be used has been introduced above, how an increase in body temperature may cause and increase in heart rate. In altered physiological maps, as you have been asked to undertake, clinical manifestations that MAY arise can be included. In this example, not all patients who have an increased body temperature have an increase in heart rate. This often occurs but not exclusively, therefore, it is judicious to include manifestations that may arise but are not present. This is especially usefully when planning nursing practice as the nurse can anticipate issues that may arise.
One other important component is to choose a patient with a common presentation in your clinical area. If you choose patients with rare or exotic conditions, the altered physiology is unlikely to be fully elucidated and therefore, there may be significant sections of the map that you cannot complete. This will severely disadvantage you and should not be undertaken. If you want to consider patients that are not common to your area, you should discuss this with the unit coordinator to seek further advice. Your concept map should be about presenting your understanding of the altered physiological processes that are responsible for the patients’ clinical manifestations, in this case 3 signs and 3 symptoms. Also, just because students may select similar types of patients does not mean the maps will be the same. Concept maps are unique and enable the learner to develop a style that adequately presents their ideas and knowledge in graphical format.
The phases of construction will be presented on the following phases. Remember this is an overview, is not meant to be the only way of constructing maps.

Concept maps
Helpful websites and software
Whilst we do not usually recommend Wikipedia as a reputable source for citations in scholarly work, the above links will assist you in exploring what concepts map are. 
http://en.wikipedia.org/wiki/Concept_map The following sites contain information about concept maps, including background reading. It is not necessary to read all the webpages or articles, but it would be helpful in your ability to understand what concept maps are and how to construct them. http://www.ericdigests.org/1998-1/concept.htm http://designing.flexiblelearning.net.au/gallery/activities/conceptmap.htm 
http://users.edte.utwente.nl/lanzing/cm_home.htm 
https://www.msu.edu/~luckie/ctools/ 
http://cmap.ihmc.us/publications/researchpapers/theorycmaps/theoryunderlyingconceptmaps.htm
You may also consider constructing you concept map using software, rather than hand written. I have included a concept map constructed using software for comparison (see below). It should be emphasised that whilst they look cleaner, the software needs to be learnt and you need to spend time arranging the layout. The choice is yours. The following Wikipedia link contains a list of software sites which have concept mapping tools. There are free ware and proprietary that can be used to develop and construct concept maps. http://en.wikipedia.org/wiki/List_of_concept_mapping_software It should be emphasised that the software needs to be downloaded and installed on your computer and there are inherent risks in performing these tasks. Please review the following to inform your decision about downloading software. http://windows.microsoft.com/en-US/windows-vista/Downloading-files-from-the-Internet-frequently-asked-questions I have included two links to two commonly used programs: VUE and CMAP. They are both freeware and you are not required to pay for these programs. Remember, it is your choice if you want to use the software. http://vue.tufts.edu/ http://cmap.ihmc.us/ How to use VUE concept mapping software can be viewed on the following Youtube site. http://www.youtube.com/watch?v=i6baom1dff8 Example of software enabled concept map ©2011 University of Sydney
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