Creating Safe Learning Environments that Encourage Growth and Active learning.

Patricia Benner, R.N. Ph.D., FAAN, John Benner, Doctoral Candidate

New graduate nurses face heavy patient loads, daily life-or-death decisions, nursing work groups with high-turnover rates, and inexperienced co-workers, all made more difficult by the new levels of hospital care demands created by the COVID-19 epidemic. Evidence grows that new graduates are not prepared to meet the current challenges to perform optimally, collaborate with care team members, prevent, and catch mistakes, and deliver quality (Brown, J., Hart, L. Wludyka, P., 2022; Chan & Burns, 2021; AACN 2021; Kavanagh & Szweda, 2017).  What teaching practices, in clinical, simulation and classroom cultures prepare nurses ready to face the current demands of practice? What teaching practices and emotional climates for learning promote or deter practice-readiness of newly graduated nurses?

Many nurse educators believe that because nursing is a high stake and demanding profession, they should make the classroom reflect these high stakes reality, including the emotional climates of practice demands, hoping to inoculate their students against the stress of their future professional lives. Aware that the knowledge base required for skilled nursing is large and complex, educators present as much information in the short time they have by focusing on information giving in classroom lectures and high reading and written assignment loads. Consequently, most nursing students confront cognitive overload in their courses (Benner, Sutphen, Leonard-Kahn & Day, 2010) that limits the amount of usable information a student can integrate.

Complex learning is disrupted when a stressful, pressured leaning environment prevails. Remembering more, complex, nuanced knowledge requires minds free from a fight or flight mode found in high stress environments. The emotional climate of the classroom directly impacts students’ learning outcomes. It is the primary responsibility of the educator to set that emotional tone and set and maintain behavioral expectations to promote learning relationships and emotional tones that are safe, civil and conducive to mastering complex learning.

Nursing Practice and Teaching requires High Levels of Interpersonal and Helping Skills

Central to nursing are caring practices, and how we teach should be congruent with the relational aspects of nursing. Student-teacher relations should be attentive, connected, confer dignity, respect, recognition and knowledge of students’ talents, learning, interests, challenges, and concerns. Small things like making sure you know and pronounce students’ names correctly, and giving students an opportunity introduce themselves are small recognition practices that communicate interest and care. Ice breakers, small conversation starters such as “what song most describes your first day of clinical?” or lighthearted questions like that spark personal reflection in pair-share or small group conversations get students talking about themselves and serve to invite participation in low stakes conversations prior to more challenging questions.

In her book “Creating and Sustaining Civility in Nursing Education,” Dr. Cynthia Clark makes several evidence-based suggestions for first day of class practices that help set a tone for inclusive and civil classrooms (Clark, 2017, pp. 192–197).  These suggestions include the following recognition practices and norm setting because as the saying goes, “you never get a second chance to make a first impression.”

  1. Send out a welcome email 1-2 weeks before class starts with location and schedule information and an agenda for the first day.
  2. Start the class with greetings that allow students to give a brief introduction about themselves.
  3. Have students create folded paper name tents to facilitate learning names.
  4. When possible, attach digital images to the roster to help you learn names more quickly.
  5. Use the syllabus to set behavioral and learning expectations (along with communicating assignments and session topics) for the course and go over the syllabus in detail on the first day. Include your teaching philosophy, late assignment policy,
  6. Co-create discussion norms with your students like ones below. These norms can be based on school of nursing norms as well as professional standards.

Here is an example of discussion norms Dr. Clark uses in her own classroom:

  • Engage in respectful interactions
  • Listen well while others are speaking
  • Assume goodwill; encourage and inspire each other
  • Respect differences and be open to other points of view
  • Make thoughtful contributions to group work
  • Be on time and respect one another’s time
  • Use electronic and media devices for class purposes only
  • Sit near the door in anticipation of phone/text message
  • HAVE FUN! (Clark, 2017, p. 206)

A safe classroom does not mean a classroom without discomfort and challenge! A peaceful classroom is not one without conflict, but where inevitable conflict is resolved skillfully. Astute teachers pose authentically challenging ethical dilemmas that will cause students to disagree and it is essential that teachers establish norms for how disagreements of opinion can be effectively and respectfully discussed. Making explicit discussion norms at the start of the course provides the foundation for constructive disagreement, lively debates, and inquiry without preset answers. Classroom learning climates should support students’ natural curiosity. Students are active learners by nature and passive only when this natural drive to engage is suppressed. Curiosity is natural but can be thwarted in classes where information giving dominations and students become passive recipients, blocking their naturally occurring curiosity (Lonergan, 1959). Active learning is far more effective learning in terms of fostering the retention and situated use of knowledge.

Formation in nursing requires that students and faculty encounter and address issues of systemic bias in health care, and especially their own hidden biases. Such consciousness raising requires a safe and confidential classroom climate for learning (Beard,  2021). Unfortunately, the values of emotional safety and civility can become screens for people with privileged identities to hide from the discomfort of revealing and discussing the ongoing nature of racial, gender and other forms of identity-based discrimination that they benefit from regardless of their intent (Blaisdell, 2018). It is not only possible, but necessary, to engage with this discomfort compassionately and effectively confront what biases we as teachers, or our students are experiencing. When considering classroom civility and safety with regards to identity-based discrimination, begin from the perspective of seeking safety for the most marginalized identities, in question, and work up from there. For example, in covering topics of ablism in health care, first consider the experiences and concerns of students with disabilities in your class. Students should be encouraged to speak from their own experience rather than speaking for people or groups to which they do not belong.

Just as people living in polluted communities have traces of those contaminants in their bodies, regardless of their healthy intentions, all people growing up in societies with biases (i.e., ALL PEOPLE) will to some degree absorb those biases and must have learning experiences that allow them to recognize and resist those biases. Students and even teachers will inevitably express stereotypes or enact other microaggressions, just as people downwind of chemical spills or industrial zones will have traces of the pollutants in their bloodstream and show symptoms to varying degrees. The solution to this is not to “cancel” or “call out” students for punishment or shame, but rather call in students with more accurate information, or appropriate terms and support them taking accountability in order to foster greater empathy towards one another (Ross, 2019).  The teacher’s responsibility is to model accountability, respect and caring in any class or communication with students, and this means also being open to being called-in yourself. When you have made a mistake, thank students for bringing your attention to the mistake, identify what you can do to make amends and take immediate action to correct the mistake. For example, should you mispronounce a student’s name or misgender a student and are corrected by them, thank them, use the corrected language, and don’t make a scene about how changing your behavior may be difficult for you. Show your respect and care by correcting your language and moving on if no further repair is needed. Teacher responsiveness to correcting their own blind-spots models showing the kind of respect and care you expect students to treat each other and their clients with.

Teaching Better Than We have been Taught

Teachers can unwittingly teach as they, themselves have been taught. Assessing one’s teaching style, relationships with students, quality of learning environments and emotional climates can allow for consciousness raising about how well one’s teaching facilitates students’ learning. Uncovering metaphors for teaching and examining one’s own role models used for teaching can foster critical examination and improvement of teaching strategies and emotional climates for learning.   Are teaching styles growth-oriented? Do they create active learning? (See Benner, 8/16/2019). An educator’s metaphors for teaching set up the kinds of environment and learning opportunities they create. Does a teacher view themselves as a fountain of knowledge, or their students as blank slates waiting to be filled (a banking metaphor)? These kinds of metaphors lead to one-way information giving and create passivity in students.

Paulo Freire (1970, 2000) introduced the banking metaphor as a dominant and oppressive metaphor for teaching. In Freire’s banking metaphor, the teacher is the primary agent and instigator in the classroom, depositing information to passive students who are taught to receive information, rather than engage in the classroom as active inquirers and learners who generate, discover, uncover, disclose, and create new knowledge. Information-giving was the dominant mode of instruction observed in nursing education classrooms in The Carnegie Study of Nursing Education (Benner, Sutphen, Leonard-Kahn, & Day, 2009) with “classifying” and “categorizing diagnoses” a frequent strategy for how information was presented. These kinds of tasks do not line up with how nurses actually  use their knowledge in practice nor do they stimulate experiential learning that fosters clinical reasoning, nor the situated use of knowledge in actual clinical situations (Benner, 10/12/22b).

The Cartesian representational view of the mind cannot account for the precognitive, direct perceptual grasp of reality and other forms of intentionality, essential to learning (Benner, 2022a; Benner, In Press). Everyday experiential learning is generated by meaningful, purposeful, skilled behavior, self-defining commitments, engagement with others and with concerns and projects. Perception and skilled know-how are connected to the person’s concerns, and agency, and member-participant involvement with projects, and relationships in actual situations rather than being mediated only by pre-existing mental representations (Dreyfus, 1990; Dreyfus, 1992; Dreyfus & Taylor, 2016; Benner, 2022a; Benner, In Press, Benner & Wrubel, 1989). A Situated Cognition View of the mind gives a better account of experiential learning (Lave & Wenger, 1991; Robbins & Ayede, 2009). has presented examples of excellent teachers who have described and demonstrated their metaphors for teaching that position themselves and students for active learning and collaboration: Dr. Linda Felver (Benner, 8/22/2019) has two metaphors; “making soup” and “improvisational acting,” which are highly compatible with each other and offer a stark contrast to a banking and “Sage on stage metaphors. Felver’s two metaphors create the interactive, inquiry-oriented learning required in any practice discipline. In describing her invitation to students to join her in making soup together on the first day of class, she brings a large pot with many soup ingredients to make her point. She is confident that each student brings essential ingredients for learning and enrichment. Dr. Felver’s metaphor of ‘making soup with students’ is a perfect counter to the banking metaphor of teaching, where students are viewed as passive recipients of information rather than sources of knowledge, questions, and other ingredients based upon their diverse backgrounds, and students’ experiential learning.

With the second metaphor—improvisational art, Linda Felver strives to capture the lively original insights from her students that create new understandings in her science classes, in this case, pathophysiology. From Dr. Felver’s perspective, each student comes with a wealth of their own life experience of health promotion and illness prevention. Each comes with life-long encounters with healthcare that have cultivated insights, questions, and perspectives. Dr. Felver lives her metaphors in her classroom. She expects to learn from her students and that her students will learn from each other. They will become an active learning community, making a delicious pot of soup where the sum is greater and richer than any one person’s contribution could be, teacher included. They will create the art of inquiry and understanding in their improvisational use of concepts, clinical experiences, and questions about how patient experience and health care delivery could be improved. (Benner, 8-16-2019 p. 1.)  Her two metaphors demonstrate inclusion, respect for diverse experiences, students’ rich life and clinical experiences, in an expectation for a learning community where everyone has valuable contributions.

Assessing the kinds of student questions and interaction reveals the kind of learning community being created in your classroom. For example, how often do student to student interactions occur in the classroom? Are most interactions teacher generated?  How often do students generate student to student questions, puzzles, lines of inquiry in the classroom with and without being prompted by the teacher?

Dr. Cynthia Clark developed a Civility Index for Faculty teachers can use in evaluating their own classroom practices. (Clark, 2017, p. 191) that we have included below with its scoring rubric.

Teaching from a Stance of Knowing Students and Their Concerns

Like expert nurse clinicians engaging in caring practices that focus on “knowing the patient” (Tanner, Benner, Chesla, & Gordon, 1993) likewise, teachers must understand their students’ approaches to learning, their interests and motivation.  To do situated coaching in clinical learning, teachers need to understand their students’ strengths and interests in learning, as well as areas where they are unsure or struggling. Former President of the Carnegie Foundation for Advancement of Teachng, Dr. Lee Shulman often noted that students’ greatest learning disability is the invisibility of the student.

Most students struggle, with their increasing knowledge and awareness about the possibility and dangers of making a mistake, particularly around medication administration (Rodriguez, 2007).  Bringing these fears into classroom discussions is as essential along with readings on medication errors (Benner, Sutphen, Leonard-Kahn, Day, 2010 See p.100, educator, Dianne Pestolesi’s account of making a serious medical error). Nursing students become keenly aware that they could make a clinical mistake (error in medication or treatment, critical omission, and so on) in ways they had not anticipated, and this can prompt a considerable source of anxiety and worry by students (Rodriquez, 2007).  Fear of making a clinical mistake cannot be removed, but can be discussed, and precautions taught, along with the ethical and appropriate actions for disclosing errors (Rodriguez, 2007). Once students can more openly address their concerns about making errors, and understand them as a serious and common risk in health care, strategies for checking for accuracy, seeking clinical consultation, and equally important, ameliorating and correcting errors by honest and quick reporting of any medical error can help students better prevent and cope with the risks of making errors (Benner, Sutphen, Leonard-Kahn & Day 2010, P. 100).

Characteristics of Safe, Generative Learning Environments:

Four important characteristics for creating safe and positive learning environments are  Safety; Engagement; Connectedness; and Support  (Owusu-Ansah, Kyei-Blandson, 2016)


physically, emotionally, and mentally. Students must feel safe to fail since failure is a major impetus and ever-present possibility in experiential learning (Eyler, 2018). The power of failure experiences for learning is blocked if the emotional climate is one of censure, blame and shame. Failure is a powerful form of learning in safe environments. Simulation can be a safe learning environment for learning from failure, without shame, blame or intimidation.  Some educators will coach a student to prevent a failure in a simulation, seeking to avoid embarrassment over a failure, but this robs the student of a safe opportunity for learning from failure. Failure and risk cannot be removed from nursing practice but work and school climates can be created for accepting and learning from failure without inducing blame, shame or guilt.

Unfortunately, some teachers adopt teaching approaches that intimidate or create anxiety in students, thinking that strictness and highly structured learning expectations, encourage attention and learning. But “strictness” and “high standards” are NOT the same as academic rigor, and often intimidate students, causing anxiety that interferes with learning. Some teachers are unaware that their teaching and relational behaviors are anxiety producing and stressful for students. Or if they are aware of high anxiety levels in their classrooms and student interactions, may not know how to change the emotional tone of their classrooms and teacher-student interactions.  It can be useful to have a trusted nurse educator, or learning specialist observe your teaching and assess the learning climate your relational teaching style creates for students. Learning specialists can offer insights and alternative approaches to create a more supportive and effective learning climate.  Nurse educators teach students how to engage in helping and caring practices with patients. It is incongruous and creates conflicted messages, if teachers,’ in kind, do not model helpful, caring stances and attitudes toward their students.


is essential to effective and collaborative learning environments. Students need engagement, interaction, collaborative learning with the classmates. Such an engaged learning community increases student to student learning and expectations and skills  in collaboration. One student’s experiential learning shared can enhance classmates’ insights and openness to experiential learning in their clinical practice.

Ethical comportment in teaching shows up in how the teacher creates engaged, safe and interactive learning environments.

Learning design specialists are good at assessing and helping teachers diminish “cognitive overload,” a major problem in nursing education (Benner, Sutphen, Leonard-Kahn & Day, 2009. Not only do teachers need to attend to overloading their curricula with more “information” than can be covered effectively in within the time frame of the curriculum, each lesson/classroom/seminar, and clinical learning must be designed to minimize cognitive overload. Cognitive overload creates anxiety for students and teachers without improving their knowledge base. While responsibility and planning for the emotional climate of teaching and learning rests largely with the teacher, students too have responsibility for contributing to an engaged, interactive, emotional climate for learning.

During the reign of cognitivism (Dreyfus & Dreyfus, 1988), a view of the mind as an information processing computer dominated, the role of emotions as the portal for attentiveness, perception, and learning were all but ignored. In the information processing model of the mind, emotion was seen as disruptive “noise” that interfered with rationality and thinking. While emotions such as anxiety, fear and a sense of alienation stemming from a sense of not belonging, and other disruptive emotions block perception and learning, at the same time perception and learning require positive emotions related to curiosity, openness and receptivity, attunement, and interest. Additionally, the emotions accompanying curiosity, such as excitement and engagement, are essential for perception and learning. These positive emotions are linked to rationality, discernment, and judgment (Damasio, 1994; Dreyfus, 1992; 2009).

Strategies for including emotions such as openness, responsiveness, excitement, etc. include designing assignments that stimulate the students’ curiosity and interest. For example, use of short student videos or students’ description and discussions of new insights gained or changes in understanding based on a clinical experience, help students connect with and share experiences of curiosity and interest that energize learning. These classroom disclosures about student learning, and students’ insights about changes in understanding (‘ah-hah experiences’ can infuse the class with a contagion and enthusiasm for learning. Another effective strategy is the use of first-person experience-near narratives about clinical learning (Benner, Hooper-Kyriakidis, Stannard, 2011).

In sum, emotion is a gateway for perception, attunement, and more. Objectified, removed, decontextualized information is not quickly, noticed, learned nor remembered. It lacks emotional connection, embodiment, and situatedness. Adding significance and positive emotions of engagement and connection make online learning more salient and exciting (Brown, Collins, Duguid, 1989).


refers to the students’ sense of connectedness to what they are learning and with whom they are learning. Learning is enhanced and increased through peer learning. Connectedness can be easily lost in online classes if careful attention is not given to student-to-student interactions and student-initiated questions. Group learning projects, discussions and sharing of experiential learning from clinical simulations and clinical practice are other strategies for making courses dialogical, highly interactive and connected.


of students’ learning through open, inquiry-oriented learning climates are essential. and often requires enlisting campus levels of assistance and resources for students having learning difficulties. Having to rapidly implement online learning has been a challenge for nursing students and faculty during the COVID-19 restrictions to face to face meetings. The transition to online learning was rapid, often leaving limited time for developing effective online courses. Students with children, or family members also working at home who required care and support often disrupted students’ online learning. Understanding and support for managing demands outside the classroom can help our students managing complex adult demands in addition to their education (See Benner, 2/5/2021). Strategies for engagement and interaction require more careful planning and design in an online learning context.


Supportive learning environments do not occur without planning, design and a commitment on the part of faculty and students.. Open, safe, connected, lively learning environments are not a luxury, they are essential to good learning outcomes!


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