Abstract
Guided Visual Metaphor (GVM) is a six-step, learner-centered, creative strategy for teaching nursing diagnosis that combines multidimensional visual and verbal techniques. Learner-participative components include drawing and labeling, reflection, strength and problem identification, nursing diagnosis selection, prioritization, and discussion. The GVM was implemented over a four-week period with 19 associate degree students enrolled in their first nursing course. Positive student evaluations for the GVM, as well as positive learner outcomes, support its continued use. Teacher evaluation of the product (nursing diagnostic statement) was based on three levels of diagnostic skills criteria. Following week four, all students met all Level 1 and Level 2 skills criteria for each nursing diagnosis. Seventy-four percent met at least one Level 3 (highest level) criterion for one or more nursing diagnosis. Fifty-eight percent met at least one Level 3 criterion for two or more nursing diagnoses. Students also required less teacher guidance with each subsequent use of the GVM.

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