The role of open learning in nurse education. Does it have a place?

A perceptible shift has begun, away from mass lectures towards more flexible, novel and adaptable methods of teaching and learning. A variety of terms (open, distance, flexible) have been used to describe such instructional methods, a key characteristic of which is that they do not require constant and/or synchronous contact between teacher and learner. This paper explores students' views of a distributed learning initiative within a University in the South of England. The initiatives were in response to increase in the number of students in each intake which was just one of the recent changes called for by the Government. This evaluation consisted of a longitudinal research project following two cohorts of nursing students (n=288) through the first two years of their education (and will continue in the final year). The study assessed the perceived influence of distributed learning (DL) on their academic education and professional training as well as their satisfaction with the workbooks. The evaluation used a mixture of qualitative and quantitative data collection, questionnaires and focus groups. DL was seen as a flexible way of studying for students. Students were able to study a topic area at their own pace and at a time convenient to them. The activities in the workbook stimulated discussions and triggered ideas and thoughts for both students and lecturers. With the commencement of the workbooks lecturers were given the opportunity to reflect on their teaching styles and were encouraged to utilise a number of different teaching and learning methodologies.     

Evaluation of a computer assisted instruction resource in nursing education

The STEP-DIET program, a computer assisted instruction (CAI) tool, was developed to prepare dietetic students for their hospital based practical training in the academic setting. This study aimed to evaluate the potential for using the programme within nursing education. The evaluation framework of Kirkpatrick [I. Forsyth, A. Jolliffe, D. Stevens (Eds.), Evaluating a Course, second ed. Kogan Page, London, p. 5] was employed to assess student response to STEP-DIET and its effectiveness as a teaching tool, with regards to perceived learning achievements. Knowledge and attitudes towards nutrition education were also investigated. Quantitative and qualitative methodologies were employed, with nine second and six final year BSc (Adult) nursing students completing questionnaires and taking part in two focus groups, separated by year group. Students rated STEP-DIET highly in terms of design and content and reported a number of perceived learning achievements including increase in nutritional knowledge, understanding of Type 2 diabetes management and the dietitian's role, however there was a reluctance to accept CAI as a teaching method. Students reported a poor knowledge of nutrition, but recognised its importance. This study demonstrates that multidisciplinary learning by the sharing of resources has benefits to students. However, the integration of CAI into taught programmes needs to be managed to take into account student's reluctance to rely on this method of instruction.     

Experiences of online learning: students' perspective

This paper explores students' views of an online learning initiative within a post-registration degree in nursing in Hong Kong. A self-administered questionnaire was used for data collection. One hundred and ninety eight students completed the study. Online learning was seen to be convenient allowing students to study at their own pace and time. Students reported that online learning enabled them to hold a higher level of accountability for their own learning and to learn independently. Not all experiences were positive. A major hindrance to online learning was the inadequate opportunity for human interaction which was deemed necessary for establishing peer support and developing in-depth group discussion on subject matter. These findings provide a guide for further development and improvement in online teaching and learning methodologies.     

Undergraduate nursing students’ experiences of online education: A cross-sectional survey

During the coronavirus pandemic, UK Academics were required to adjust their learning and teaching environment and pedagogical approaches, with little guidance or time. Feelings of frustration and uncertainty around student engagement were commonplace across Higher Education Institutions. This was heightened in professionally regulated courses, such as nursing. The shift to online learning created a situation where academics were frequently faced with a ‘sea of black screens’ and unable to ascertain student engagement.This study investigated undergraduate nursing students’ experience of online education during the COVID-19 pandemic. An anonymous survey was distributed to each year of the undergraduate nursing programme and data subsequently analysed. Responses from 54 students revealed that engagement varied between different year groups. There were significant differences between those with pre-COVID (traditional face-to-face) teaching experience (years 2 and 3) and those without (year 1) in regard to self-reported engagement with online learning. The findings from this study revealed some powerful and emotional insights into the experience of online learning amongst UK students undertaking an undergraduate nursing programme during the COVID-19 pandemic.     

Student nurse satisfaction levels with their courses: part I -- effects of demographic variables

Recent years have seen an increased emphasis on the monitoring of the quality of learning and teaching in higher education. This has led to more attention being paid to evaluating student perceptions of their learning experiences. This article (Part I of two on the subject) examines the factors that influence student satisfaction with their modular courses. Seven factors categorized into two sets are scrutinized: Part I investigates the effects of four demographic variables, while Part II explores the effects of three academic (educational)-related variables. In this report, the study research design, tool and sample are described, and an analysis of the demographic variables of gender, disability, ethnicity and age-bracket is undertaken, whereby their effects on performance and satisfaction levels of students are considered. Employing a questionnaire, data from 460 students attending various multidisciplinary health care modules at the School of Health Care, Oxford Brookes University for the first term of the academic year 2000/2001 were analysed. The questionnaire was found to be reliable and there were no differences in satisfaction between students who provided their registration numbers and those who did not, suggesting that the results are generalizable to the greater student population of the School of Health Care. The study found no differences in performance or satisfaction levels according to gender, but disabled students indicated less satisfaction although the differences were not significant. Fewer students of 'non-white' ethnicity felt that their learning experience was intellectually stimulating, and that the information about their modules was satisfactory and readily available. Student age significantly predicted performance and 'mature' students performed better and showed higher satisfaction than 'traditional' students. The findings and their implications for nurse education and curriculum design are discussed, with support from a growing number of studies investigating student nurse satisfaction and quality issues of learning and teaching in higher education.     

Improvement of learning domains of nursing students with the use of authentic assessment pedagogy in clinical practice

With evolving healthcare demands, nursing educators need to constantly review their teaching methodologies in order to enhance learners’ knowledge and competency of skills in the clinical settings. Learning is an active process in which meaning is accomplished on the basis of experience and that authentic assessment pedagogy will enable nursing students to play an active part in their learning.The study was conducted with an aim to examine nursing students’ learning domains through the introduction of the authentic assessment pedagogy during their clinical practice. A quasi-experimental study (n = 54) was conducted over a period of 10 weeks at a local tertiary hospital. The experimental group was exposed to the authentic assessment pedagogy and were taught to use the assessment rubrics as an instrument to help enhance their learning. Students were assessed and scored according to the assessment rubrics, which were categorized into four domains; cognitive, psychomotor, affective and critical thinking abilities.The findings indicated that an overall score for the four domains between the experimental and control groups were significant, with p value of <0.05. Critical thinking scores were indicative of consistent improvement within the experimental group. The findings confirmed that learning outcomes of the nursing students were enhanced through the early introduction of the authentic assessment pedagogy in the clinical setting.     

A systematic review and meta-analysis of outcomes of interprofessional education for healthcare students from seven countries

AimThis study aimed to analyze the effectiveness of the learning outcomes of the interprofessional education (IPE) model for healthcare students.BackgroundInterprofessional education (IPE) is an important teaching and learning model that involves two or more professions engaging or working together to improve the knowledge of healthcare students. However, the specific outcomes of IPE for healthcare students are unclear as only a few studies have reported them.DesignA meta-analysis was conducted to draw broad conclusions on the impact of IPE on healthcare students’ learning outcomes.MethodsThe CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Web of Science, and Google Scholar databases were searched for relevant articles in the English language. To investigate the effectiveness of IPE, a pooled estimate of knowledge, readiness for and attitude toward interprofessional learning, and interprofessional competence were analyzed using a random effects model. The methodologies of the studies evaluated were assessed using the Cochrane risk-of-bias tool for randomized trials, version 2. Sensitivity analysis was performed to ensure the rigor of the findings. STATA 17 was used to perform the meta-analysis.ResultsEight studies were reviewed. IPE had a significant positive impact on healthcare students’ knowledge (Standardized Mean Difference [SMD]: 0.43; 95% Confidence Interval [CI]: 0.21–0.66). However, its impact on readiness for and attitude toward interprofessional learning and interprofessional competence was nonsignificant and needs further investigation.ConclusionIPE enables students to develop their knowledge of healthcare. This study provides evidence that IPE is a better strategy for enhancing healthcare students’ knowledge than traditional/discipline-specific teaching techniques.     

A step ahead: teaching undergraduate students to be peer teachers

Nurses have a responsibility to share knowledge with others. However, many are reluctant to undertake teaching, feeling unprepared for the responsibility. With this in mind, a semester-long compulsory core unit was designed and implemented in 2009 to equip final year students with knowledge and skills to enable facilitation of teaching and learning in practice. As part of the summative assessment, third (final) year students taught vital signs in first year skills laboratories. To evaluate the strategy, the Peer Teaching Experience Questionnaire (adapted from Iwasiw and Goldenberg, 1993) was administered to third year students and Clinical Teaching Preference Questionnaire (Iwasiw and Goldenberg, 1993) to first years. Focus groups were conducted with third year volunteers to explore issues in greater detail. One hundred and five (75%) third year and 112 (52%) first year students completed questionnaires. In addition, 11 third year students participated in a focus group. Overall, third year students reported increased confidence in their knowledge and teaching abilities, reflected on their own learning and found the experience rewarding, acquiring skills they considered would be helpful in graduate years. Many suggested there should be more opportunities for such types of learning and interaction. First year students reported feeling comfortable learning skills with senior peers, as well as being able to learn from their experiences. Overall, both groups recognised strongly that teaching was part of nurses' roles.     

Examining the influence of professional identity formation on the attitudes of students towards interprofessional collaboration

An expectation of introductory interprofessional education (IPE) is improvement in attitudes towards other professions. However, the theory surrounding professional identity formation suggests this expectation may be premature. The objective of this study was to quantify first-year health professional students’ attitudes towards their own and other professions and to investigate the relationship between strength of professional identity and attitudes towards other professions and interprofessional learning. Using a pre/post-test design, researchers administered the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS) to 864 first-year healthcare students in the Academic Health Center (AHC) at the University of Minnesota. The findings showed a decline in student attitudes towards their own and other professions. Additionally, a positive correlation between a weakened professional identity and readiness for interprofessional learning was demonstrated. This study found that an introductory IPE course did not positively affect student attitudes towards other professions, or strengthen professional identity or readiness for interprofessional learning. Analysis of the findings support the successive stages of professional identity formation.     

A blended learning teaching strategy strengthens the nursing students’ performance and self-reported learning outcome achievement in an anatomy,physiology and biochemistry course – A quasi-experimental study

In nursing, bioscience is regarded as one of the cornerstones of nursing practice. However, bioscience disciplines as anatomy, physiology and biochemistry are considered challenging for students and the failure rate is high. In this study we explore a blended learning teaching strategy in an anatomy, physiology and biochemistry course for first year Bachelor nursing students. In the blended learning teaching strategy, short narrated online digital resources of bioscientific terms and concepts were integrated into the teaching design along with digital metacognitive evaluations of learning outcomes. Results show that compared to students receiving traditional face-to-face teaching, the students with a blended learning approach performed better on their national exam with a small to medium effect size (Cohen’s d=0.23). Student course evaluations supported the blended learning delivery with small to medium effect sizes. The students reported that the digital resources supported their learning outcome achievement, that they better understood the teacher’s expectations and that they were more satisfied with their virtual learning environment. This study adds to the growing literature of blended learning effectiveness in higher education, and suggests the use of digital resources as an enrichment of teaching and enhancement of students’ study experience.     

Some attitudes towards teaching and learning in Thai nursing education

This paper offers a discussion of some of the attitudes towards teaching and learning in Thai nursing education. It illustrates the strict, hierarchical set of relationships that exist between people throughout all aspects of Thai society. It then relates these relationships to those between teachers and students of nursing and how those relationships effect the ways in which students receive and deal with knowledge. Other attitudes towards learning, communication and student/lecturer relationships are also noted. It is hoped that the paper helps those, in other cultures, to reflect on their own practices.     

Readiness for interprofessional learning: a cross-faculty comparison between architecture and occupational therapy students

Abstract

Health and wellbeing includes a need for built environments to accommodate and be inclusive of the broadest range of people and a corresponding need to ensure graduates are ready to engage in this field of interprofessional and inter-industry practise. All too often, interprofessional education in higher education is neglected with a tendency towards educational silos, particularly at a cross-faculty level. This paper reports on an initiative that embedded universal design practice education into the curricula of first year architecture and third year occupational therapy students and evaluated the impact on students’ readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) was given to students at the beginning and end of the semester during which students participated in a variety of online and face-to-face curriculum initiatives. Results showed that at the beginning of semester, occupational therapy students were significantly more positive about interprofessional learning than their architecture counterparts. Post-results showed that this trend continued but that occupational therapy students became less positive on some items after the interprofessional learning experience. This study provides insights into the interprofessional learning experiences of a group of students who have not previously been studied within the available literature.     

Preparing the future nurses for nursing research: A creative teaching strategy for RN‐to‐BSN students

Developing effective teaching strategies to stimulate students' interest and enthusiasm are urgently needed in current research courses. The purposes of the study were to implement the Cookie Experiments teaching strategy in research course and examine the effects of the strategy on students' attitudes towards nursing research. The study was a pretest–post‐test design with 95 students at a Registered Nurses to Bachelor of Science in Nursing (RN‐to‐BSN) program enrolled in the nursing research course. Results indicated that there was a significant effect of the Cookie Experiments teaching strategy on students' attitudes towards research. Although students perceived a median high score of pressure from the research course, they regarded that the pressure is conducive to their learning of research. Students highly suggested to continuously applying this teaching strategy in the future nursing research courses. Developing and using various teaching strategies with attractive and hands‐on methods to motivate nurse students, learning research is strongly recommended.     

A three-step method of self-reflection using reflective journal writing

Fiscal and financial constraints present a challenge for nurse educators to broaden the diversity and scope of teaching/learning methodologies. One method designed to promote autonomy and self-direction of nursing students is self-reflection combined with reflective journal writing. This paper describes a three-step process of self-reflection encompassing critical appraisal, peer group discussion and self-awareness. This process of self-reflection was initiated with one group of clinical nursing students. Using student and teacher feedback, implications for employing this teaching/learning strategy in clinical practice are suggested.     

Efficacy of team-based learning in knowledge integration and attitudes among year-one nursing students: A pre- and post-test study

BackgroundDue to a lack of knowledge and clinical exposure, the fresh year one nursing undergraduates often faced difficulty in contextualising their learning and integrating knowledge and skills into clinical settings.AimThe purpose of this study was to evaluate the efficacy of team-based learning among year one nursing undergraduates in knowledge integration and application and attitudes towards working within teams.MethodsThis study used a prospective, one-group pre-test and post-test design with the intervention of team-based learning (TBL) on year one nursing undergrads. The students first completed a pre-module quiz to establish their knowledge level before attempting the ungraded iRAT, followed by the tRAT and the practical sessions. A post survey on the participants’ attitudes towards working within teams in TBL was conducted at the end of the module.Findings125 students reported an improvement in their knowledge and application in nursing practice. More than 70% of the students agreed that team-based learning approach enhanced their learning.DiscussionTBL has enabled the students to acquire and retain copious content knowledge and also conferred upon them the ability to use the content to solve problems in their future professional practice. The majority of the students were generally satisfied with their experiences working as a team to learn, indicating that their team has worked well together and felt respected by other team members.ConclusionTBL approach is effective in improving knowledge for fresh year one nursing undergraduates with no prior background in the content and clinical exposure.     

Investigating perceptions of the academic educational environment across six undergraduate health care courses in the United Kingdom

AimTo compare how health care professional students perceive their academic learning environment in one Higher Education Institution (HEI).MethodThe Dundee Ready Education Environment Measure (DREEM), a scale that measures students' perceptions of their academic classroom learning environments, and demographic items were completed by 673 undergraduate students enrolled in health professional courses at the University of Huddersfield, United Kingdom. Respondent scores, partitioned by demographic variables, were obtained on the total DREEM scale and on the individual sub-scales. Analysis of variance techniques were utilized to investigate associations between demographic variables on the total DREEM score and sub-scale scores.ResultsAll students from all year levels reported total DREEM scores between 101 – 150, indicating a more positive than negative perception of their academic learning environments. Both profession and year of study were found to be significantly associated with total DREEM scores, with occupational therapists, physiotherapists and nurses scoring higher than operating department practice students; and first year students scoring higher than third year students. A significant interaction between these two factors was found to exist, indicating that the impact of the year of study does not apply equally over the different professional groups of students.ConclusionsStudents in this study reported positive perceptions about their academic classroom learning environments and teaching delivered. Further interrogation of the DREEM sub-scale dimensions at a programme/cohort level may offer course teams' further information to inform continuous quality improvement.