Effect of a CVIS instructional program regarding therapeutic communication on student learning and anxiety

This quasi-experimental, pretest-posttest design study explored the effect of a computer video-interactive system (CVIS) instructional program regarding therapeutic communication on senior baccalaureate nursing students' learning and anxiety as they anticipated interaction with patients in psychiatric settings. The 75 subjects were randomly divided into two groups. Group I received a basic lecture and a supplementary CVIS instructional program on therapeutic communication, while Group II received the same lecture discussion on therapeutic communication and a videotape. Two hypotheses were tested, using analyses of covariance. Hypothesis I, that Group I would score significantly higher on a therapeutic communication posttest than would Group II, was supported (P less than .001). This finding validates previous observations that computer-video interaction programs do enhance learners' application of knowledge. Hypothesis II, that Group I would evidence significantly less state anxiety at posttest than would Group II, was not supported. Although there were no significant differences for state anxiety scores between the groups at either pretest or posttest, these scores remained higher than reported normative state anxiety scores. This finding suggests that anticipated interaction with psychiatric patients is an anxiety-inducing situation for nursing students.     

Augmenting the critical care data base of junior medical students with an emergency medicine lecture curriculum: a controlled study

A mandatory lecture course in emergency medicine, consisting of 13 lectures, was given to junior medical students over 3 years at Texas Tech University Regional Academic Health Center--El Paso. The performance of the students on a 25-question pretest and posttest was compared to a statistically similar group of their classmates on geographically separate campuses of Texas Tech University School of Medicine undergoing an otherwise comparable junior year clinical curriculum. Both groups exhibited improvement in posttest scores from pretest score values; additionally, students exposed to the lecture series at Texas Tech--El Paso performed significantly higher on the posttest, compared to the other campuses. We conclude that some emergency medicine material is successfully learned by junior medical students during their required third year clerkships; however, important learning objectives within the domain of emergency medicine can be most successfully taught if a mandatory junior year lecture course in emergency medicine is also incorporated into the third year curriculum.     

Knowledge, retention, and attitude effects of computer-assisted instruction

The effects of computer-assisted instruction (CAI) and lecture upon knowledge, retention, and attitudes of baccalaureate nursing students were compared in this research study. Retention was of particular interest, since few nursing CAI studies have investigated this concept. A two-group posttest design with a second posttest eight months later was used. Lesson content for both the CAI and lecture groups was the nursing research problem. The CAI group used an interactive tutorial written in BASIC. The lecture group was presented the same content using transparencies. There were no significant differences in knowledge, retention, or attitudes between the CAI and lecture group. Attitudes toward CAI were positive. CAI is as effective as lecture for learning knowledge and retention.     

The effect of teaching method on objective test scores: problem-based learning versus lecture

This study investigated the effect of teaching method on objective test scores of students in a school of nursing. The hypothesis stated there was a difference between objective test scores of students who were taught content on diabetes using problem-based learning (PBL) and students taught the same content using the traditional lecture method. Junior nursing students enrolled in the Adult Health I nursing course in the fall of 2001 were taught the diabetes content using lecture as the teaching method, while students enrolled in the same course in the spring of 2002 were taught the same content using PBL. A pretest and posttest were administered to both groups of students. Both the pretest and posttest scores of the two groups were compared using an independent t test, and no statistically significant difference was found in the scores of the two groups. The results of this study support the null hypothesis: that there is no difference in objective test scores based on teaching method (lecture versus PBL).     

Immediate knowledge retention among nursing students in live lecture and video-recorded lecture: A quasi-experimental study

Aim/ObjectiveTo determine if video-recorded lecture provided better immediate knowledge retention than live lectureBackgroundIn line with the call to increase nationally graduated nurses as recommended by KSU 2030 Vision, educational institutions in Saudi Arabia are required to increase the enrollment to the Bachelor of Science in Nursing program. As a result, there is increased number of sections or groupings which created a need for additional faculty. However, to mitigate the impact of faculty shortage, the Administration embarked on exploring innovative teaching strategies that would ensure that lecture contents across groups of students are uniform and instructions are similar. Hence there is a need to explore innovative teaching strategies that would ensure that contents across groups of students are uniform, and instructions are similar.DesignThe study employed a quasi-experimental design to examine if video-recorded lectures provided better immediate knowledge retention than live lectures.MethodsA total of 160 s -year nursing students were randomly assigned to either of the two teaching strategies (video-recorded lecture or live lecture). Data were collected at a public university in Riyadh, Saudi Arabia. Both lectures covered the interpretation of arterial blood gases (ABG) and all students had no prior knowledge on the subject. Pretest and posttest using the same 16 questions were administered to both groups. Each item was comprised of a combination of ABG results. Students were to choose the correct answer from four choices of interpretations of the ABG result. ABG is assessed to determine gas exchange, ventilator control and acid-base balance among patients with acute or chronic illnesses. Assessment of immediate knowledge retention was conducted using a questionnaire comprised of 16 multiple-choice items to be used in both the pretest and posttest. Each item was comprised of a combination of ABG results.ResultsThe live lecture group's posttest mean score did not differ significantly from that of the video-recorded lecture group; t (156.52) = 0.47, p = 0.64, d = −0.08. The odds ratio is 1.27 and the probability is 95%. CI:.64, 2.50.ConclusionThis study found no difference between video-recorded lectures and live lectures in terms of providing immediate knowledge retention. Video-recorded lectures are a viable complementary teaching strategy. There is a need to enhance the instructional design so that learning objectives are more clearly defined, contents are aligned with the learning objectives, teaching strategies should include active participation from learners and outcomes should be assessed based on the learning objectives.     

The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial

AimThis study investigated the effect of flipped learning on first-year nursing students’ blood pressure knowledge levels and self-directed learning skills.BackgroundFlipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills.DesignThis study adopted a pretest-posttest open-label randomized controlled trial.MethodThe sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS).ResultsThere was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009).ConclusionThe experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and “self-monitoring,” “motivation,” and “self-confidence” subscale scores than the pretest score.     

A comparison of problem-based learning and lecture-based learning in an adult health nursing course

PURPOSE: This study aimed to compare the effects of the problem-based learning (PBL) method with the traditional lecture method on learning in the cardiorespiratory nursing section of the Adult Health Nursing course. METHOD: A pretest-posttest experimental design was used. A total of 71 second-year nursing students in a three-year nursing program in Korea participated: 35 students in the PBL group in the fall semester of 2002, and 36 students in the traditional lecture group in 2003. The seven PBL packages were developed by the authors, based on an analysis of relevant learning content and clinical scenarios. RESULTS: The level of knowledge in the PBL group was significantly higher than that of students in the lecture group (t=2.007, p=.045). All PBL students with higher and lower grades showed a significant increase in the posttest score. But in the lecture group, only students with higher grades showed a notable increase. No statistically significant difference was found between the PBL and lecture groups in the level of attitude toward learning (t=1.669, p=.100). Learning motivation was significantly higher in the PBL group (t=2.608, p=.012). CONCLUSION: Students in the PBL group gained more knowledge and had higher motivation toward learning compared to students in the lecture group.     

Spinal cord injury computer-assisted instruction for medical students

OBJECTIVE: To determine if a computer-assisted instruction program would improve fourth-year medical students' knowledge base related to spinal cord injury, as determined by pretest and posttest scores. DESIGN: A multimedia computer-assisted instruction program was developed and offered on a volunteer basis to an entire class of fourth-year medical students (n = 168). Effectiveness of the instructional content was evaluated with pretests and posttests, and overall user satisfaction with the module was assessed with the courseware evaluation. RESULTS: The responses yielded 83 sets of completed pretest and posttest pairs and 80 sets of fully completed courseware evaluations. Mean posttest score was significantly higher than the mean pretest score (pretest, 6.65 +/- 1.44, vs. posttest, 7.36 +/- 1.38; df = 82, t = -4.74, P < 0.001). Courseware evaluations yielded positive ratings in all areas, including applicability and usability. CONCLUSIONS: The significantly increased posttest scores suggest that the students left the program with an expanded knowledge base in the content areas of spinal cord injury medicine covered in the computer-assisted instruction program.     

Psychiatric-mental health education with integrated role-play and real-world contact can reduce the stigma of nursing students towards people with mental illness

Stigma and negative attitudes towards people with mental illness are frequently found among nursing students. Interventions targeting mental illness stigma are the critical elements in altering the status. The aim of the present study was to examine the effects of the psychiatric-mental health education with role-play and real-world contact on stigma of nursing students towards people with mental illness in China. A single group pretest and posttest study design was adopted and total 373 students were recruited whilst 343 completed the course. We integrated the role-play and contact with patients in the routine psychiatric-mental health education. After the education was completed, the students' stigma towards people with mental illness were positively changed (pretest mean score of stigma: 53.77, posttest mean score of stigma: 49.01, 95% CI: 2.63–6.87) and their willingness to care for the people with mental illness was also significantly increased (pretest mean score of willingness: 5.45, posttest mean score of willingness: 7.38, 95% CI: −2.22–−1.65). The psychiatric-mental health education especially with integrated role-play and real-world contact is an effective way to reduce nursing students’ stigma and negative attitudes towards people with mental illness and increases their willingness to care for people with mental illness.     

Graduate nursing students' precourse and postcourse perceptions and preferences concerning completely web-based courses

Web-based nursing courses have proliferated rapidly in recent years, but few data are available about course outcomes. A pretest/posttest survey design of student perceptions and preferences was used to evaluate two graduate-level on-line nursing courses (required research and elective aging issues courses; N = 31 and N = 29, respectively) on the basis of Billings' outcomes evaluation framework for nursing Web-based courses. Students in both courses were favorable or at least neutral in their perceptions of outcomes at both pretest and posttest, but favorable shifts in perceptions also occurred from pretest to posttest. Most students remained stable in their preferences for format of instruction (on-line or classroom), and most favored an on-line format. Almost all students indicated they would take the course they took if they had the decision to make over again. Students who took the elective aging issues course had somewhat more favorable perceptions overall at posttest, compared to the required research course, but some differences were accounted for by pretest score differences between the groups. While outcomes were positive for both courses, the results also highlight specific needs for adequate socialization and support of students, particularly for first-year graduate students who are taking Web-based courses.     

Effectiveness of an audience response system in teaching pharmacology to baccalaureate nursing students

It has been proposed that students' use of an audience response system, commonly called clickers, may promote comprehension and retention of didactic material. Whether this method actually improves students' grades, however, is still not determined. The purpose of this study was to evaluate whether a lecture format utilizing multiple-choice PowerPoint slides and an audience response system was more effective than a lecture format using only multiple-choice PowerPoint slides in the comprehension and retention of pharmacological knowledge in baccalaureate nursing students. The study also assessed whether the additional use of clickers positively affected students' satisfaction with their learning. Results from 78 students who attended lecture classes with multiple-choice PowerPoint slides plus clickers were compared with those of 55 students who utilized multiple-choice PowerPoint slides only. Test scores between these two groups were not significantly different. A satisfaction questionnaire showed that 72.2% of the control students did not desire the opportunity to use clickers. Of the group utilizing the clickers, 92.3% recommend the use of this system in future courses. The use of multiple-choice PowerPoint slides and an audience response system did not seem to improve the students' comprehension or retention of pharmacological knowledge as compared with those who used solely multiple-choice PowerPoint slides.     

Infection control programmed instruction: an alternative to classroom instruction in baccalaureate nursing education

The purpose of this study was to determine whether self-managed learning in the form of a programmed unit of instruction (PUI) in the basic principles of infection control is an acceptable alternative to a standard lecture format for teaching infection control to nursing students. A sample of 108 subjects was selected from third-year baccalaureate nursing students at two universities. The subjects were randomly assigned to two groups. The experimental group was given the pretest, the PUI (treatment), the post-test, and a Likert scale opinionnaire of the PUI. The control group was pretested and presented the same content in a lecture format, then post-tested. A pretest-post-test control group design was used for data analysis and a one-way analysis of covariance was performed on the post-test means of the groups. Analysis of covariance (ANCOVA) was applied to the post-test means of the groups, with pretest scores and educational setting as covariates. Results indicate that nursing students who complete an infection control PUI score higher on post-tests than those who attend a lecture (p less than .001), regardless of pretest scores and educational setting. Subjects using the PUI also preferred this format and found the content manageable.     

The affective outcomes of course work on computer technology in nursing.

At the University of Iowa, nursing students are introduced to computer technology as one unit in a course designed to explore nursing as a profession. A single group, pretest/posttest design was used to evaluate changes in attitudes associated with the course work. Relationships of attitudes scores and eight background variables were studied. Posttest attitudes scores were significantly higher than pretest scores. The attitudes scores were positively related to skills scores at a statistically significant level of .05, with no significant relationship between attitudes scores and knowledge base scores. Four of the eight background factors were related to the attitudes scores at a statistically significant level of .05.     

Factors affecting learning in a coronary artery disease rehabilitation class.

One hundred patients with coronary artery disease (CAD) were studied to determine which factors affect their baseline knowledge and retention of knowledge about CAD and whether CAD classes are an effective teaching tool. All patients were given a pretest about CAD. Patients then attended a 1-hour rehabilitation class about CAD. One month later, they were given an identical posttest. Pretest scores had a negative correlation with patient age and positive correlations with the number of years of formal education, the number of previous myocardial infarctions, and the number of previous CAD classes attended. Posttest scores had a positive correlation with the number of previous CAD classes attended. There was a significant relationship between learning and marital status, with married patients learning better than unmarried patients. Comparison of patients' pretest and posttest scores revealed a highly significant improvement. Based on the results of this study, the CAD rehabilitation class is an effective tool for rehabilitation of the cardiac patient; additional teaching effort should be focused on unmarried patients. Factors such as age, education, smoking and alcohol consumption histories, and number of previous CAD classes attended do not affect learning in the interventional phase.     

Effects of a nursing education intervention on parents' knowledge of hydrocephalus and shunts.

The purpose of this nursing intervention study, which used a pre- and posttest design, was to determine the effect of an education program on parents' knowledge of hydrocephalus and shunt dynamics in a sample of parents of children with hydrocephalus. Study participants were parents of hydrocephalic children treated with an initial shunt or a shunt revision. The convenience sample of 41 subjects was divided into two groups (A or B). Group A participants were parents whose child received an initial shunt. Group B participants were parents whose child was admitted for a shunt revision. The shunt education intervention had three components: a shunt handbook, a preoperative teaching session with the clinical nurse specialist and a subsequent reinforcement teaching session. The pre- and posttest were the same seven multiple choice questions on hydrocephalus and shunts. In both groups, the pretest was given before the shunt education intervention. The posttest was given 2-3 weeks after the patient's surgery. There was a statistically significant change in the scores from the pre- and posttests for Group A (p = 0.0092). The nursing education appeared to have a positive effect upon this group's knowledge of hydrocephalus and shunts.     

Medical Student Knowledge of Morphine for the Management of Cancer Pain

Inadequate training of physicians contributes to the undertreatment of cancer pain. To address these concerns, the University of Kentucky has introduced a 4-week course for final-year medical students that teaches the principles of clinical pharmacology and pain management. The purposes of this study are to assess the knowledge deficits of final-year medical students about the use of morphine for cancer pain and to assess the efficacy of a short course on cancer pain management. Eighty-six final-year medical students completed a 22-item questionnaire assessing their knowledge and attitudes toward the use of morphine for cancer pain. Students indicated their agreement with each statement on a four-point scale (one, strongly disagree; four, strongly agree). All students then completed a compulsory short course on pain management. The course content included a 1-hr lecture on chronic nonmalignant pain, a 1-hr lecture on acute pain management, and a 1-hr lecture on cancer pain management. In addition, students completed small-group, problem-based learning modules on several aspects of pain management. After the course, all students completed the same 22-item survey. The alpha reliability score of the pretest instrument was 0.55, and the posttest reliability was 0.86. Upon course completion, students agreed most strongly (mean ± SEM) that morphine should be given on a regular schedule for cancer pain (3.41 ± 0.08), that cancer pain management frequently requires co-analgesics (3.36 ± 0.06), and that patients with good pain relief function better than those with continuing pain (3.39 ± 0.08). A comparison of pretest and posttest means on specific items suggested that the greatest amount of learning took place in the following content areas: morphine is a good oral analgesic; increases in cancer pain should be treated by increasing the morphine dose; respiratory depression is not a concern for cancer pain patients; and morphine can be used over a wide range of doses. The regular use of morphine was recognized as the treatment drug of choice for cancer pain. The students showed improved knowledge scores on ten of the 22 items on the posttest survey. A significant increase in learning occurred on six knowledge and attitude items. On only one item (nausea as a side effect of morphine) did the knowledge scores decrease on the posttest. A significant minority (40%) of senior medical students had deficits in knowledge about the use of morphine for cancer pain. The risk of addiction, respiratory depression, and tolerance were misunderstood by a significant minority (25%) of students.     

Strengthening Geriatric Content in an Associate Degree Nursing Program: A Pilot Study

The purpose of this pilot study was to strengthen geriatric content in an associate degree nursing 1st semester freshman fundamentals course and evaluate changes in the scores related to students’ knowledge and attitudes toward older adults. A quasi-experimental within-subject pretest–posttest design was utilized. The Facts on Aging Quiz and Multifactorial Attitude Survey were used to assess knowledge and attitudes of 22 nursing students at the beginning and end of the semester. Although there was no significant statistical increase in knowledge, there was an overall increase in knowledge. Three of the 20 statements showed a statistically significant increase in attitude. The results of this study may be helpful for education and practice in providing appropriate education to associate degree nursing students in the care of older adults.     

Immunization update: a community-based nursing education program

BACKGROUND: Nurses play key roles as advocates, educators, and researchers to eliminate barriers to access as well as educate the public on the importance of vaccines for children in the United States. METHOD: Fifty-four nurses attending a community-based immunization program completed a pretest questionnaire which included identification of related practice behaviors and general knowledge questions. Twenty-four responded to a similar posttest survey 6 months later. The investigators compared knowledge pretest and posttest scores with a t test. Behavioral changes were compared between the pretest and posttest group by analyzing the percentage of change between the time period. RESULTS: The mean score in the knowledge section increased significantly from a pretest mean of 52% to 75% during the posttest period (p < 005). Behavior change was not statistically significant because of the low number of posttest responses indicating actual immunization practices in the clinical setting. The investigators analyzed trends in practice by comparing percentages of responses. CONCLUSION: These findings suggest that a multifaceted, community-based nursing continuing education program including both local, ethnic community perspectives and information related to the latest standards of practice can impact knowledge levels and some practice behaviors.     

Improvement of nursing students' critical thinking skills through problem-based learning in the People's Republic of China: a quasi-experimental study

Abstract A quasi-experimental, two-group pretest–post-test design was conducted to examine the effect of problem-based learning on the critical thinking skills of 46 Year 2 undergraduate nursing students in the People's Republic of China. The California Critical Thinking Skills Test Form A, Chinese-Taiwanese version was used as both a pretest and as a post-test for a semester-long nursing course. There was no significant difference in critical thinking skills at pretest, whereas, significant differences in critical thinking skills existed between the problem-based learning and lecture groups at post-test. The problem-based learning students had a significantly greater improvement on the overall California Critical Thinking Skills Test, analysis, and induction subscale scores compared with the lecture students. Problem-based learning fostered nursing students' critical thinking skills.     

Effect of acquisition of knowledge on self-evaluation and the relationship of self-evaluation to perception of real and ideal self-concept.

To investigate the effect of knowledge acquisition on self-evaluation and self-concept 69 graduate nursing students--25 in an experimental group, 18 in control group I, and 26 in control group II--enrolled in three nursing courses provided demographic data, self-evaluation of entering behavior, and personality test data. The latter two tests were given on pre- and posttest bases. Seven hypotheses were tested. Overall results showed: The experimental group which was taught by means of mastery learning acquired significantly more knowledge than the control groups which received the traditional lecture-discussion method of learning; there was an inverse relationship between knowledge acquisition and self-evaluation of entering behavior; positive correlation between "amount of overestimation or underestimation of previous knowledge' and extremes of self-concept was partially supported; in general, single students were less able to evaluate accurately by what they thought they knew than were married subjects; employment was inversely related with knowledge acquisition and course grade. The relationship between self-concept and acquisition of knowledge was not significant.