INTRODUCTION I co-teach a 7 credit medical/surgical nursing course to senior Associate Degree Nursing students. This course covers a tremendous amount of information in a very short period of time. Because the majority of my students have multiple life roles that compete with their student role, I tried an exercise to help them focus on the learning task at hand and ready themselves to participate actively in a three-hour class that is predominantly lecture.

Although I used this brief focusing exercise before teaching nursing concepts, it could precede any class, exam, or situation in which students need to put aside other life distractions and focus attention on the learning task at hand. The activity takes approximately 10–15 minutes.


  • To assist students to focus on the content of a lecture class and participate actively in the learning activity.
  • To provide an opportunity for a fun and motivating learning experience.


  • Post-it notes (1 for each student)
  • Pens/pencils
  • Music to create a tranquil environment, such as Pachelbel’s Cannon in D (optional)
  • Handout: Rating the Visualization Activity (See Support Materials section below)


1. Hand out a Post-it note to each student before you begin the lecture or presentation.

2. Ask students to write on the Post-it note one or more concerns that could interfere with their learning during this class period. (For example, worry about a test score or an expensive car repair.)

3. Ask students to stand when they have finished writing. (In this way, you will know when everyone is finished.)

4. When all the students are standing, ask them to stick the Post-it note to the underside of their chairs.

5. Ask students to sit down, close their eyes, and get comfortable in preparation for a visualization exercise.  (If using music, begin it now.)

6. Read the following visualization slowly, pausing between thoughts: “Take a deep, cleansing breath through your nose and exhale through your mouth. Breathe in slowly, exhale slowly. Find your own rhythm for your breathing. Keep breathing in and out slowly as you listen to my voice. Breathe in, out. In, out. Slow, deep breaths. Find a calm spot in your mind where you can rest and relax…a quiet place where you can go to escape your worries for a time. Use all of your senses. In this quiet place, visualize yourself setting aside your distractions and preparing yourself to listen to and participate fully in the upcoming lecture and discussion. Concentrate on your ability to stay focused on your learning. See yourself opening your notebook. Feel the weight of the pen in your hand.  Picture yourself in total control of your thoughts. Hold onto that feeling of control. When you are ready, gently come back to our classroom. Now take a final deep, cleansing breath. Open your eyes and, being fully focused, let’s begin today’s class.”

7. Proceed with the lecture or presentation.

8. At the end of the presentation, ask the students to complete a rating scale indicating how effective they thought this visualization activity was in helping them focus and actively participate in the learning experience.


Since I co-teach the medical/surgical nursing course and the other instructor was responsible for the first few lectures, the day I used this activity was my first interaction with the students. I wondered how they would accept this type of activity from an unknown instructor, and I was a bit nervous. The students had just completed an exam on content unrelated to my presentation, and as I walked around the room before class, I heard many of them discussing the exam and worrying about their grade. When I initially handed out the Post-it notes and described what I wanted the students to write on them, a number seemed hesitant to write anything down. They asked if they would have to tell the group what they had written on the note. Once I assured them that what they wrote would remain private, the students became really involved. A number of students even asked for more Post–it notes to write additional problems or concerns. Interestingly enough, even though some of the students expressed a fear about telling the group what they wrote, I noticed quite a few of them showing their neighbors their Post-it notes. There was much laughter when I instructed the group to stick their notes under their seat and then sit down. During the visualization exercise, some lay their heads on the desk while others sat back in their chairs with hands folded in their laps. I observed all of the students participating in the breathing exercise, keeping their eyes closed, and listening intently to what I was saying. After the focusing activity, the students were highly engaged in the presentation and discussion, in contrast to many other times in the past when my voice was the only one heard throughout the entire three hours of class. This time the students asked questions to clarify information and added commentary about patients they had cared for. Their contributions were thoughtful and focused on the content. I was very pleased with the degree of interaction that occurred throughout the class period.


Following the completion of the lecture I asked the students to complete a rating scale to measure the effectiveness of the visualization activity.  On a scale of 1-10 (10=high), two students rated the activity as only a “1.”  Eight students rated the activity either a 4 or 5. However, 20 out of the 30 students (67%) rated the activity as 6 or above. Their comments suggest the value of the activity for many students:

“I forgot about everything once you started the lecture.”

“It made me focus on the renal system and not think about the exam. Great idea.”

“Put enough focus on it initially that I was able to forget for awhile.”

“I think it was worthwhile.”

“Very helpful in getting my concentration back to the subject.”

“It was nice to be able to clear my mind and to get started.”

“Helped to clear my mind by consciously focusing on it.”

“I actually think it’s the breathing that really helps.”

“Helped somewhat clear mind after exam.”

I found the following student comments extremely interesting because they all mentioned that the focusing activity helped them to focus initially but as the discussion continued, they found distractions once again interfering with their learning:

“Helped for a little while.”

“It helped me focus at the beginning, but I started to become distracted towards the end.”

“I guess the focus activity helped, but your structure and lecturing style helped a lot too.”

“The activity per se didn’t do much, but the laughing about it did.”

“It helped me focus for a little, but then I started to think about them.”

“I don’t think it helped much, but you kept my attention and focus just great.”

Overall, I believe the activity was successful in helping many of my students focus their attention on the content of the lecture.


I have always had difficulty recognizing the benefit of meditation, focusing activities, and use of visual imagery in my life. I believed I had no time for this type of activity. I was also nervous about introducing this activity to a group of students I did not know. But I am taking a course this semester called the Heart of Teaching. The focus of this course is to explore the heart, body, and mind of teaching. Each class begins with some form of relaxation/meditation activity.  I am always surprised at how good I feel after the activity is completed. For this reason I chose to attempt this focusing activity with my students, and their reactions have helped me realize the importance of attending to the entire student–mind, body and heart. It is clear to me how important it is to recognize that our students have very busy lives and many distractions that will take their attention away from the learning activity. But “recognition” is not enough. My students’ positive reaction to this experiment helped me realize the need to incorporate activities into my classes that help students focus and maintain attention on the task at hand. These types of activities assist them to develop the mental self-discipline and self-management skills necessary for academic success.

I will definitely use this activity again, but with modifications. It is obvious from some of the student comments that the focusing activity helped initially, but some began to lose focus by the end of the three-hour presentation. Besides ensuring adequate breaks and some active learning activities, I will incorporate another focusing activity into the presentation, possibly half way through the time allotted.  I will develop a different focusing activity as I don’t think repeating the initial activity during the same class would work as well.


The idea and design of this activity was taken from More Instant Teaching Tools for Health Care Educators, by Michele L. Deck, Med, BSN, RN, ACCE-R (Mosby-Year Book, Inc., 1998.) Ideas for the visualization were taken from a variety of stress management/relaxation articles found on the web.


Handout: Rating the Visualization Activity

Directions: Using the 10 point rating scale below, please indicate how effective you think the visualization activity was in helping you focus on the class. A score of “1” indicates “not effective at all” and a score of “10” indicates “very effective.”


LOW   1 2 3 4 5 6 7 8 9 10  HIGH

Also, please write below how the visualization activity did or did not help you to focus on the class:

–Kay Grotelueschen, Faculty, Nursing, Madison Area Technical College, WI 

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