The correlation of metacognitive ability, self-directed learning ability and critical thinking in nursing students: A cross-sectional study

Exploring self-directed learning readiness and related factors: the role of time management skills in nursing students

BACKGROUND

Previous studies have reported varying levels of self-directed learning readiness and time management skills among nursing students, and the relationship between these two skills has not been extensively explored. Consequently, this study aimed to assess self-directed learning readiness and its influencing factors, with a specific emphasis on the role of time management skills among nursing students.

METHODS

This cross-sectional study involved the participation of 110 undergraduate nursing students who were conveniently recruited for the research. The data collection tools included a demographic information form, Fisher's Self-Directed Learning Readiness questionnaire, and the Time Management Inventory developed by Britton and Tesser. The collected data were analyzed using STATA-14 statistical software.

RESULTS

The findings revealed that 96.4% of the nursing students demonstrated readiness for self-directed learning. The mean overall score for self-directed learning readiness was 162.3 ± 6.1 out of 200, indicating a relatively high level of readiness. The mean score for time management skills was 98.1 ± 5.0 out of 135, suggesting satisfactory proficiency in this area. In terms of the relationship between self-directed learning readiness and its associated factors, time management skills, academic probation history, grade point average, place of residence, and level of interest in the field of study collectively accounted for 9.2% of the variance in self-directed learning readiness. Among these factors, academic probation history, grade point average, and place of residence emerged as statistically significant predictors (P < 0.05).

CONCLUSIONS

The study findings indicate that the level of self-directed learning readiness and time management skills among the nursing students were considered acceptable. Academic probation history, grade point average, and place of residence emerged as significant predictors of self-directed learning readiness. These results highlight the importance of considering students' academic background and living conditions to effectively enhance their level of self-directed learning readiness. Further research is recommended to explore additional factors that may influence self-directed learning readiness among nursing students.

Effect of a simulation game on nursing students' reflective thinking skills: a mixed methods study

BACKGROUND

This study aimed to investigate the effect of a simulation game called "The Ward" on reflective thinking skills of senior nursing students.

METHODS

A convergent mixed methods parallel research design was conducted between February-April 2018. The sample for this study was a convenience sample (n = 23) of senior nursing students. Student Information Form, Reflective Thinking Scale and a structured interview form were used as data collection tools. During study, simulation game was played once a week for seven weeks. Descriptive statistics (frequency, percentage, mean) were used for analyzing data, t test for dependent groups tests were applied to determine differences within group and qualitative data was analyzed with content analysis.

RESULTS

After playing the simulation game, nursing students' reflective thinking scores (pre-test = 39.70 ± 5.15; post-test = 67.39 ± 8.13) increased significantly (p < 0.05). It was found students noticed their shortcomings and mislearnings by comparing their existing knowledge in setting of teamwork and cooperation created by the game, and consequently students' motivation increased or decreased. The teamwork and collaboration created with in the simulation game caused students to gain self-confidence, to expand their perspectives, to develop effective decision-making skills, to increase their motivation, to discover their own incomplete knowledge, skills or mislearnings.

CONCLUSIONS

These results support that the simulation games can be used to improve reflective thinking level of students. This finding shows that nursing education curriculum needs to be restructured using new methods such as simulation games aimed at improving students' reflective thinking skills. In this direction nurse educators should be involved with policy making and policy makers to develop strategies to ensure that graduated nursing students should gain reflective thinking skills. In addition nurse executives should encourage using simulation and simulation games in service training to improve nurses' reflective thinking skills and life long learning.

Effectiveness of the small private online course-based flipped teaching program for enhancing nursing students' self-directed learning ability in the Surgical Nursing course: A practical study

Small private online course-based flipped teaching is an innovative hybrid instructional approach that merges online and offline activities, fostering autonomous learning among students prior to class and facilitating the assimilation of knowledge within the confines of the classroom. To determine the effectiveness of the small private online course-based flipped teaching model on undergraduate nursing students' self-directed learning abilities, we performed a practice version of the small private online course-based flipped teaching program as a quasi-experiment, specifically designed for the Surgical Nursing course and assessed its effectiveness in students' self-directed learning abilities. To this end, a total of 264 students from the 2019 nursing major cohort were selected. Three classes comprising 131 students were randomly selected as the experimental group, and three other classes, comprising 133 students, were set as the control group. The results revealed no significant differences in the scores of self-directed learning abilities between the experimental and control groups before the experiment. After the experiment, the average scores on each dimension of the self-directed learning abilities improved significantly, and the final score of the experimental group was higher than that of the control group. The small private online course-based flipped teaching model can promote undergraduate nursing students' self-directed learning abilities, owing to its practicality and feasibility for the selected course.

The relationship between psychological capital and self-directed learning ability among undergraduate nursing students-a cross-sectional study

Background

Psychological capital has become a prominent focus in positive psychology, highlighting the positive influence of higher psychological capital on individuals. Self-directed learning ability is a fundamental skill for students, vital for enhancing academic performance and professional development, and is integral to the continuous learning process of nursing students. Recognizing the relationship between psychological capital and self-directed learning ability is crucial for the progress and development of undergraduate nursing students.

Objective

This study aims to investigate the correlation between psychological capital and self-directed learning ability in undergraduate nursing students, as well as to explore the factors that influence these variables.

Methods

A cross-sectional survey was conducted with 667 full-time undergraduate nursing students from a nursing school in Taizhou, China. Psychological capital and self-directed learning ability were assessed using the Psychological Capital Questionnaire and Self-Directed Learning Scale, respectively. Correlation and stepwise multiple regression analyses were then carried out to evaluate the relationship between psychological capital and self-directed learning ability among the participants.

Results

The study revealed that the psychological capital score averaged at 103.24 ± 15.51, while the self-directed learning scale score averaged at 230.67 ± 27.66. Variations in psychological capital scores were noted based on factors including grade level, being an only child, growth environment, monthly living expenses, parental education level, voluntary selection of nursing major, and club experience. Similarly, differences in self-directed learning scores were associated with factors such as grade level, gender, parental education level, and voluntary selection of nursing major. Moreover, a positive correlation was identified between the overall psychological capital scores and the total self-directed learning ability scores among nursing students. Notably, the multiple regression analysis highlighted that optimism and resilience played significant roles as predictors of self-directed learning ability.

Conclusion

Psychological capital is positively correlated with the self-directed learning ability of nursing students, with optimism and resilience identified as crucial predictors. Nursing educators can utilize strategies rooted in positive psychology and perseverance to improve the self-directed learning ability of nursing students.

Augmenting intensive care unit nursing practice with generative AI: A formative study of diagnostic synergies using simulation-based clinical cases

BACKGROUND

As generative artificial intelligence (GenAI) tools continue advancing, rigorous evaluations are needed to understand their capabilities relative to experienced clinicians and nurses. The aim of this study was to objectively compare the diagnostic accuracy and response formats of ICU nurses versus various GenAI models, with a qualitative interpretation of the quantitative results.

METHODS

This formative study utilized four written clinical scenarios representative of real ICU patient cases to simulate diagnostic challenges. The scenarios were developed by expert nurses and underwent validation against current literature. Seventy-four ICU nurses participated in a simulation-based assessment involving four written clinical scenarios. Simultaneously, we asked ChatGPT-4 and Claude-2.0 to provide initial assessments and treatment recommendations for the same scenarios. The responses from ChatGPT-4 and Claude-2.0 were then scored by certified ICU nurses for accuracy, completeness and response.

RESULTS

Nurses consistently achieved higher diagnostic accuracy than AI across open-ended scenarios, though certain models matched or exceeded human performance on standardized cases. Reaction times also diverged substantially. Qualitative response format differences emerged such as concision versus verbosity. Variations in GenAI models system performance across cases highlighted generalizability challenges.

CONCLUSIONS

While GenAI demonstrated valuable skills, experienced nurses outperformed in open-ended domains requiring holistic judgement. Continued development to strengthen generalized decision-making abilities is warranted before autonomous clinical integration. Response format interfaces should consider leveraging distinct strengths. Rigorous mixed methods research involving diverse stakeholders can help iteratively inform safe, beneficial human-GenAI partnerships centred on experience-guided care augmentation.

RELEVANCE TO CLINICAL PRACTICE

This mixed-methods simulation study provides formative insights into optimizing collaborative models of GenAI and nursing knowledge to support patient assessment and decision-making in intensive care. The findings can help guide development of explainable GenAI decision support tailored for critical care environments.

PATIENT OR PUBLIC CONTRIBUTION

Patients or public were not involved in the design and implementation of the study or the analysis and interpretation of the data.

Nursing diagnoses for people hospitalized with heart failure: an integrative review

OBJECTIVES

to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.

METHODS

an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.

RESULTS

analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.

FINAL CONSIDERATIONS

evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.

The mediating role of nutritional care literacy on the relationship between self-directed learning ability and nursing competence

BACKGROUND

Nurses' nursing competence and nutritional care literacy directly affect patients' health and safety. Self-directed learning ability was pervasive throughout the entire work process of nursing work and was the basis for improving both. However, there are few studies has explored the mechanism from the perspective of nutritional care literacy. The purpose of this study was to analyze the relationship between self-directed learning ability and nursing competence, and to explore the mediating role of nutritional care literacy between self-directed learning and nursing competence among clinical nurses in China.

METHODS

A cross-sectional survey was conducted among 805 clinical nurses recruited from seven general hospitals in Hunan Province, China, between January 25 and March 6, 2022. The self-directed learning ability, nutritional care literacy and nursing competence of nurses were evaluated through investigation. A total of 799 questionnaires were received, resulting in an response rate of 99.25%.We performed an intermediary modeling to examine the mediating roles of nutritional care literacy on the relationship between self-directed learning ability and nursing competence in clinical nurses.

RESULTS

Self-directed learning ability was positively correlated with nutritional care  literacy (r=0.792, P<0.001) and nursing competence (r=0.696, P<0.001). Nutritional care literacy was positively correlated with nursing competence (r=0.658, P<0.001). Nutritional care literacy mediated the relationship between self-directed learning ability and nursing competence. The mediating effect accounted for 32.48% of the total effect and 48.10% of the direct effect .

CONCLUSIONS

This study confirmed the positive correlation between self-directed learning ability, nutritional care literacy, and nursing competence. Nutritional care  literacy played a mediating role in the relationship between self-directed learning ability and nursing competence. The findings not only provide a novel strategy for cultivating nursing professionals and improving nurse disease care abilities, but also offer a new perspective for nursing educators and managers.

Nurturing Success: E-Learning readiness and academic self-efficacy in nursing students

BACKGROUND

As nursing education embraces e-learning as a vital component of its pedagogical approach, understanding the interplay between students' readiness for E-learning and their academic self-efficacy becomes imperative in nurturing successful learning outcomes amidst evolving educational paradigms.

PURPOSE

This study aimed to explore the relationship between e-learning readiness, academic self-efficacy, and the academic achievement of nursing students within the dynamic educational environment.

DESIGN

This study employed a cross-sectional design.

METHODS

A total of 208 nursing students were recruited through convenience sampling at the end of the second semester in 2022. The evaluation included the utilization of Grade Point Average, the Online Learning Readiness Scale, and the Academic Self-Efficacy Scale.

FINDINGS

Previous research has indicated a significant positive correlation between academic achievement and readiness for e-learning, suggesting that higher levels of readiness for e-learning among nursing students lead to improved academic achievement (p ≤ 0.001). Additionally, the findings of the current study revealed a notable positive correlation between academic achievement and academic self-efficacy (p ≤ 0.001).

CONCLUSION

This study provides valuable insights into the critical role of academic self-efficacy and e-learning readiness in enhancing academic achievement among nursing students.

Effects of an unfolding case study on clinical reasoning, self-directed learning, and team collaboration of undergraduate nursing students: A mixed methods study

BACKGROUND

Clinical reasoning is an essential nursing competency that students must develop to provide safe patient care. Developing and utilizing unfolding case studies, which present constantly changing patient conditions to improve students' clinical reasoning and to foster communication and self-reflection, can help to achieve that imperative.

OBJECTIVES

To develop an unfolding case study and to test its effectiveness in improving clinical reasoning, team collaboration, and self-directed learning.

DESIGN

A mixed methods design.

SETTING

One university in Southern Taiwan.

PARTICIPANTS

Forty nursing students.

METHODS

An unfolding case study was developed based on the clinical reasoning model and unfolding cases model. The Nurses Clinical Reasoning Scale, Self-Directed Learning Instrument, and Questionnaire of Group Responsibility and Cooperation in Learning Teams were used. Forty nursing students completed questionnaires and nine of them participated in focus group discussions. Wilcoxon signed-rank, Spearman correlation, regression, and inductive content analysis were used to analyze data.

RESULTS

Students' abilities in clinical reasoning, self-directed learning, and team collaboration were statistically significantly improved after implementation of the unfolding case study. Emergent themes included "patient-centered communication," "group inspiration and learning," "thinking critically and reflecting on oneself," and "applying theoretical knowledge in care to meet patients' changing needs."

CONCLUSIONS

Unfolding case studies provide a safe environment in which nursing students may learn and apply knowledge to safe patient care.

Design and practice of blended teaching of internal medicine nursing based on O-AMAS effective teaching model

BACKGROUND

Self-directed learning (SDL) ability is the basis for cultivating nursing students' ability to find and solve problems, lifelong learning, and providing high-quality nursing talents for healthcare. The O-AMAS (Objective, Activation, Multi-learning, Assessment, Summary) model adheres to the teaching philosophy of student-centered, result-oriented, combines the advantages of online and offline teaching, enriching teaching resources and learning channels, diversifying teaching and evaluation methods, and emphasizing integrating and applying knowledge conducive to improving students' SDL ability and achieving teaching objectives. This study explored the course design, practical, and application effects under the O-AMAS effective teaching model in internal medicine nursing to provide a basis and reference for combining effective teaching models with blended teaching in future nursing courses.

METHODS

This study is a self-controlled before-after trial. The participants were 76 nursing undergraduates from Hunan Normal University. This study utilizes the O-AMAS effective teaching model to design internal medicine nursing courses and implement blended online and offline teaching. Main links: The overall course design and application are student-centered, after clarifying macro and micro multi-dimensional learning objectives, with online and offline blended teaching environments activated students' learning behavior and diversified teachers' teaching activities, then based on instant and dynamic provide effective feedback; finally, students take the initiate to make a brief and potent summary under the teacher guidance. After the course, a unified assessment of the learning effect of nursing students was conducted, including the evaluation of the SDL ability of nursing students, a final comprehensive evaluation grade, and a teaching satisfaction survey.

RESULTS

The nursing students' SDL ability scores are higher than before teaching, and the results were statistically significant (P < 0.05). The final average comprehensive evaluation grade of nursing students was 78.38 ± 7.12. More than 96% of the students are satisfied with this course.

CONCLUSION

Applying for internal medicine nursing blended teaching integrated with the O-AMAS effective teaching model is conducive to improving nursing students' SDL ability, academic grades, and teaching satisfaction.

Translation and psychometric validation of the Chinese version of the metacognitive awareness scale among nursing students

Objective

This study endeavors to translate and psycho-metrically validate the metacognitive awareness inventory scale (MAS) for nursing students in China.

Method

A total of 592 nursing students were enlisted from four universities situated in the eastern, southern, western, and northern regions of China. Content validity and reliability were evaluated using the content validity index and item-total correlation coefficient, and Cronbach's alpha coefficients, respectively. Convergent validity examined the goodness of fit among sub-scales through the average extracted variance and composite reliability.

Results

Exploratory factor analysis confirmed the first-order and second-order factor models, contributing to a cumulative variance of 89.4 and 59.5%, respectively. The Cronbach's alpha values were 0.963 and 0.801, respectively. Confirmatory factor analysis outcomes indicated an excellent overall fit index for the model, satisfying the convergent validity criteria and achieving a target coefficient of 96.0%, which is consistent with the original scale structure.

Conclusion

The Chinese version of the MAS (C-MAS) is a reliable and valid instrument for assessing metacognitive awareness among Chinese nursing students. Further research should consider a broader sample of nursing students across China to reinforce the scale's applicability.

Photovoice: An active learning tool with community nursing students

OBJECTIVE

To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community.

METHODS

A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data.

RESULTS

Seventy eight percent of the students felt that photovoice was an interesting and useful tool for nurses, 89% affirmed it helped stimulate reflection on social and health inequities in times of pandemic, 82% described that it developed many emotions and feelings and 86% would like to disseminate their photographs directly to stakeholders, citizens, and politicians. Three themes were identified in the data: "stimulate critical reflection", "develop emotional skills", and "encourage action".

CONCLUSIONS

Photovoice is a successful active learning pedagogical approach that engages nursing students to develop critical awareness while connecting with their communities, with the real world. It fosters students' sensitivity and motivation and encourages them to take action. Teachers need to introduce new scaffolds for active learning, such as photovoice, to provide innovative academic support that nurtures and develops the next generation of nurses appropriately.

The mediating effect of self-directed learning ability between professional identity and burnout among nursing students

Objectives

Burnout influences students' academic performance and mental health. This study analyzed the relationship between professional identity, self-directed learning ability, and burnout, and examined the mediating effect of self-directed learning ability between professional identity and burnout among nursing students.

Methods

884 nursing students were recruited at two medical universities in China. Demographic information, Academic Burnout Scale, Professional Identity Questionnaire for Nursing Students, and Self-directed Learning Instrument were distributed to collect data.

Results

Both professional identity (β = -0.17) and self-directed learning ability (β = -0.43) showed negative associations with students' burnout. Meanwhile, there was a partial mediating effect of self-directed learning ability between professional identity and burnout (-0.24, 95% CI = -0.30, -0.20).

Conclusions

Nursing educators should emphasize on developing effective strategies to improve nursing students' professional identity and self-directed learning ability to prevent or reduce their burnout.

Gamification in the classroom: Kahoot! As a tool for university teaching innovation

Objectives

The purpose of this study has been to evaluate the use of gamification in the classroom, in terms of its effects on attention, concentration, creativity, and generic capabilities, for university students enrolled in a Bachelor's degree program in Physiotherapy.

Methods

An experimental design was implemented, using three groups differentiated by their time of exposure to the game (0 min, 30 min, or 60 min per week). The sample consisted of 73 s-year students from a Bachelor's degree program in Physiotherapy. The theoretical content for each class was taught during a period of 4 months, reinforced by use of the Kahoot! Online platform. Selective attention and concentration were evaluated using the d2 Test of Attention; creative intelligence using the Creative Intelligence Test (CREA); and generic capabilities using the capabilities subscale of the Student Engagement Questionnaire (SEQ).

Results

The study's participants had a mean age of 19.51 ± 0.9 years, and it has demonstrated that use of Kahoot! For longer periods of time, i.e., more than 60 min per day, can improve essential skills in university students, such as attention, creativity, critical thinking, self-managed learning, adaptability, problem solving, and computer literacy. This study's results show that integrating Kahoot! Into the educational environment, especially with longer sessions that allow for deeper immersion in the game, produces benefits by stimulating various cognitive aspects and enhancing complex skills.

Conclusion

This study has demonstrated that use of Kahoot! Improves key skills such as attention, creativity, and critical thinking, especially when longer sessions are used. It is also suggested that its use should be balanced with other educational activities, in order to achieve comprehensive development for the students.

A comparative vignette study: Evaluating the potential role of a generative AI model in enhancing clinical decision-making in nursing

AIM

This study explores the potential of a generative artificial intelligence tool (ChatGPT) as clinical support for nurses. Specifically, we aim to assess whether ChatGPT can demonstrate clinical decision-making equivalent to that of expert nurses and novice nursing students. This will be evaluated by comparing ChatGPT responses to clinical scenarios to those of nurses on different levels of experience.

DESIGN

This is a cross-sectional study.

METHODS

Emergency room registered nurses (i.e. experts; n = 30) and nursing students (i.e. novices; n = 38) were recruited during March-April 2023. Clinical decision-making was measured using three validated clinical scenarios involving an initial assessment and reevaluation. Clinical decision-making aspects assessed were the accuracy of initial assessments, the appropriateness of recommended tests and resource use and the capacity to reevaluate decisions. Performance was also compared by timing response generations and word counts. Expert nurses and novice students completed online questionnaires (via Qualtrics), while ChatGPT responses were obtained from OpenAI.

RESULTS

Concerning aspects of clinical decision-making and compared to novices and experts: (1) ChatGPT exhibited indecisiveness in initial assessments; (2) ChatGPT tended to suggest unnecessary diagnostic tests; (3) When new information required re-evaluation, ChatGPT responses demonstrated inaccurate understanding and inappropriate modifications. In terms of performance, the mean number of words utilized in ChatGPT answers was 27-41 times greater than that utilized by both experts and novices; and responses were provided approximately 4 times faster than those of novices and twice faster than expert nurses. ChatGPT responses maintained logical structure and clarity.

CONCLUSIONS

A generative AI tool demonstrated indecisiveness and a tendency towards over-triage compared to human clinicians.

IMPACT

The study shows that it is important to approach the implementation of ChatGPT as a nurse's digital assistant with caution. More study is needed to optimize the model's training and algorithms to provide accurate healthcare support that aids clinical decision-making.

REPORTING METHOD

This study adhered to relevant EQUATOR guidelines for reporting observational studies.

PATIENT OR PUBLIC CONTRIBUTION

Patients were not directly involved in the conduct of this study.

The state of health professions students' self-directed learning ability during online study and the factors that influence it

BACKGROUND

Universities have widely switched from traditional face-to-face classes to online instruction as a result of the epidemic. Self-directed learning is becoming the new norm for university students' learning styles. The ability of health professions students to learn independently during online study directly impacts the effectiveness of online medical education. The ability to learn on their own initiative may be affected by health professions students' professional identities, defined as their positive perceptions, evaluations, emotional experiences, and identity as professionals related to medicine. This study aimed to look into the current status and the factors that influence health professions students' self-directed learning ability (SDLA) during online study and its relationship with professional identity.

METHODS

This study was conducted from September to November 2022 at a medical school in East China. An online questionnaire was used to collect participants' status of online learning, self-directed learning ability (SDLA), and professional identity.

RESULTS

One thousand two hundred ninety-eight health professions students demonstrated intermediate self-directed learning ability during online study. In terms of teacher-student interaction (F = 14.778, P < 0.001), student-student interaction (F = 15.713, P < 0.001), and learning concentration (F = 13.424, P < 0.001), there were significant differences in health professions students' self-directed learning ability. Professional identity and self-directed learning ability positively correlated (r = 0.589-0.802, P < 0.01). Academic atmosphere and professional identity were significant predictors.

CONCLUSIONS

The self-directed learning ability of health professions students while receiving instruction online is at an intermediate level and is influenced by several factors. Developing health professions students' professional identities can enhance their ability for self-directed learning.

The effect of metacognition and self-directed learning readiness on learning performance of nursing students in online practice classes during the COVID-19 pandemic period

AIM

This study was a descriptive correlation investigation to determine the effects of metacognition and self-directed learning readiness on learning performance of nursing students in online practice classes during the COVID-19 pandemic.

DESIGN AND METHODS

In this descriptive cross-sectional study, 135 subjects were randomly selected from junior students of one university in South Korea.

RESULTS

In this study, metacognitive knowledge in nursing students showed a positive relationship with subjective learning performance (r = 0.34, p = 0.002) and objective learning performance (r = 0.38, p = 0.016). Metacognitive control in nursing students also showed a positive relationship with subjective learning performance (r = 0.37, p = 0.001) and objective learning performance (r = 0.41, p < 0.001). Self-directed learning readiness in nursing students showed a positive relationship with subjective learning performance (r = 0.38, p = 0.011) and objective learning performance (r = 0.40, p < 0.001).

CONCLUSION

For effective online practical education, nursing students' internal characteristics of metacognition and self-directed learning should be identified in advance, and schools should strive to help nursing students' learning performance by developing and applying education systems or contents.

The effects of musical feedback training on metacognition and self-directed learning

Introduction

Metacognition and self-directed learning are key components in educational research, recognized for their potential to enhance learning efficiency and problem-solving skills. This study explores the effects of musical feedback training on these competencies.

Methods

The study involved 84 preservice teachers aged 18 to 21. Participants were randomly assigned to either an experimental group, which received musical feedback training, or a control group.

Results

The findings indicate that musical feedback training effectively improved metacognitive abilities. However, its impact on the readiness for self-directed learning was inconclusive. A notable difference in metacognition and self-directed learning readiness was observed between the experimental and control groups during the session, indicating a significant interaction effect. Furthermore, a positive correlation was identified between metacognition and self-directed learning.

Discussion

These results contribute to educational discourse by providing empirical evidence on the utility of musical feedback training in fostering metacognition. They also highlight the importance of consistent and long-term engagement in self-directed learning practices. The significance of these findings advocates for incorporating music feedback training into music education curricula to enhance metacognition and improve overall learning efficiency.

Nursing students' critical thinking and associated factors in Vietnam: A multicenter cross-sectional study

AIMS

This study aimed to evaluate the critical thinking abilities of senior nursing students in Vietnam and determine factors associated with their critical thinking disposition and skills.

BACKGROUND

Assessing critical thinking competence is crucial for determining senior nursing students' preparedness for entering the healthcare workforce and can be used to examine current nursing education's ability to cultivate nursing students' critical thinking. However, little research was found on critical thinking among Vietnamese nursing students.

DESIGN

A multicenter cross-sectional research design.

METHODS

A convenience sample of 533 senior nursing students from six universities in Vietnam participated in this study. All participants completed the online questionnaires, including basic information, a subscale of the Motivated Strategy for Learning Questionnaire (MSLQ), Critical Thinking Disposition Scale (CTDS), and Critical Thinking Self-Assessment Scale (CTSAS).

RESULTS

The mean score for the CTDS was 42.81 (standard deviation (SD) = 5.29), while the mean score for the CTSAS was 168.29 (SD = 44.43). Results of the multiple linear-regression analysis showed that an increase in self-study hours per day (B = 0.41, p = 0.007), higher self-efficacy in learning and performance (B = 0.26, p < 0.001), and a more-supportive environment (B = 0.97, p < 0.001) were predictors of critical thinking disposition. Moreover, an increase in self-study hours per day (B = 4.09, p = 0.001), higher self-efficacy in learning and performance (B = 2.65, p < 0.001), a more-supportive environment (B = 7.74, p < 0.001), and more experience with research (B = 7.03, p = 0.03) were predictors of critical thinking skills.

CONCLUSIONS

This study revealed that senior nursing students in Vietnam possess a moderate level of critical thinking abilities. Those students who dedicate more hours to self-study, demonstrate higher self-efficacy in learning and performance, experience a supportive environment, and engage in more research activities exhibit better critical thinking disposition and skills. The findings highlight the ongoing need to enhance critical thinking disposition and skills of nursing students in Vietnam. It is suggested that nursing faculty members should develop the appropriate strategies to improve nursing students' critical thinking disposition and skills.

The relationship between critical thinking and job performance among nurses: A descriptive survey study

AIM

This study investigated the relationship between nurses' critical thinking skills and job performance and whether critical thinking and its subdomains predict job performance.

BACKGROUND

It is expected that nurses may use critical thinking skills to provide evidence-based quality patient care in health care settings. However, there is limited evidence about whether critical thinking is related to job performance among nurses.

DESIGN

This was a descriptive, cross-sectional survey study.

METHODS

The study included 368 nurses working in the inpatient wards of a university hospital in Turkey. The survey included a demographic information questionnaire, the Critical Thinking Scale in Clinical Practice for Nurses and the Nurses' Job Performance Scale. The collected data were analysed using descriptive statistics, comparisons, reliability and normality tests, correlation and regression analysis.

RESULTS

Participating nurses got average scores from the critical thinking and job performance scale and sub-scales, and there was a positive, mid-level and statistically significant correlation between the scale scores. According to the multiple linear regression analysis results, personal critical thinking, interpersonal and self-management critical thinking and the total critical thinking scores positively affected the job performance scores of nurses.

CONCLUSION

As critical thinking predicts nurses' job performance, managers of hospitals and nursing services should consider training programs or activities to increase nurses' essential thinking competencies, thus improving clinical nurses' performances.

Critical thinking among institutional academic advisors and sociodemographic, professional and academic variables: A multicenter correlation study

BACKGROUND

In nursing education, essential skills include Critical Thinking (CT). There is scant evidence on how nurse educators could promote CT in students in a clinical context.

OBJECTIVE

To analyse the level of CT and correlated variables in healthcare nurses overseeing the clinicals of nursing undergraduates.

METHODS

The study population were all nurse educators for clinicals at hospitals with nursing undergraduates. To evaluate the CT skills of nurses the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 practice) was administered. Frequencies, percentages and measures of central tendency and scatter were obtained. A bivariate analysis was performed to analyze the correlation between the nurse educators' CT level and the sociodemographic, professional and academic levels. The nonparametric Mann-Whitney and Kruskal-Wallis tests were used to compare two independent groups. Statistical significance was defined as P < .05.

RESULTS

The total number of participants was 639. The highest mean CT level was seen in clinical nurses involved in undergraduate nursing instruction and with experience of up to 10 years (mean CT score = 372 (33.3), p = .007). Global CT levels were similar in women and men (mean CT score: 364 (31.9) in women and 358 (40.5) in men, p = .187), with statistically significant differences only observed in the intellectual and cognitive indicator (P = .022).

CONCLUSIONS

CT levels are high in teaching healthcare professionals in the clinical environment.

Relationship between optimism, emotional intelligence, and academic resilience of nursing students: the mediating effect of self-directed learning competency

Background

The evolution toward future education following the 4th industrial revolution and the coronavirus disease 2019 (COVID-19) pandemic have changed nursing education dramatically. Online classes have become a new paradigm of education, and are expected to develop and be maintained in various forms even after the end of COVID-19. Therefore, attention is focused on finding ways to improve learners' achievements in a distance learning environment. This study aimed to examine the mediating effects of self-directed learning competency on the relationships between optimism, emotional intelligence and academic resilience among nursing students.

Methods

A cross-sectional descriptive design was conducted using convenience sampling of 195 nursing students in South Korea. Data were analyzed with descriptive statistics, Pearson's correlation coefficients, multiple regression, and mediation analysis using SPSS/WIN 26.0 program.

Results

There were significant positive correlations among self-directed learning competency, optimism, emotional intelligence and academic resilience. The self-directed learning competency acts as a mediator in explaining relationship between optimism, emotional intelligence and academic resilience, respectively.

Conclusion

This study provides the evidence for the role of self-directed learning competency in the relationship between optimism, emotional intelligence and academic resilience in nursing students. Rapid changes in education are inevitable due to changes in clinical settings and the impact of repeated infectious disease outbreaks including the COVID-19 pandemic. This study suggests strengthening positive psychology and self-directed learning capability of nursing students as a strategy to prepare for changes in education and clinical areas.

Effects of BOPPPS combined with TBL in surgical nursing for nursing undergraduates: a mixed-method study

BACKGROUND

Surgical Nursing is a core subject for nursing undergraduates that requires active and effective learning strategies to cultivate students' autonomous learning competencies and critical thinking. The effects of BOPPPS (Bridge-in, Objectives, Pretest, Participatory Learning, Post-test and Summary) model combined with team-based learning (TBL) have rarely been explored in Surgical Nursing courses.

OBJECTIVE

To explore the effects of BOPPPS combined with TBL in Surgical Nursing for nursing undergraduates.

METHODS

A mixed research method of quasi-experimental study design and descriptive qualitative research was used. The control group included 27 nursing undergraduates who had finished the Surgical Nursing course using traditional learning. The experimental group included 36 nursing undergraduates were enrolled in to receive the Surgical Nursing course in the teaching mode of BOPPPS combined with TBL. The quantitative data of students' Surgical Nursing final scores, autonomous learning competencies and critical thinking ability of the two groups were collected and compared by t-test. Qualitative results were obtained through semi-structured interviews and data were analyzed by thematic analysis method.

RESULTS

Compared with the traditional learning mode, BOPPPS combined with TBL significantly improved nursing students' final examination scores, autonomous learning competencies and critical thinking ability (p < 0.05). Qualitative results from 14 undergraduate nursing students' interviews were summarized into five themes: (1) stimulating learning interest; (2) improving autonomous learning ability; (3) improving the sense of teamwork; (4) exercising critical thinking; and (5) suggestions for improvement.

CONCLUSIONS

The combination of BOPPPS and TBL positively impacted nursing students by improving their autonomous learning competencies and critical thinking ability. The study suggests BOPPPS combined with TBL learning as an effective, alternative learning mode.

Metacognition and learning transfer under uncertainty

OBJECTIVES

This study examined the possible correlation between metacognition and learning experience transfer of nursing students after engaging in an urgent and cognitively demanding clinical situation.

METHODS

This is a one-group post-test- only study design in which participants engaged in an emergency care scenario simulation and completed the Meta-Cognitive Awareness Scale - Domain Specific (MCAS-DS).

RESULTS

Study results revealed that participants' metacognitive awareness is significantly correlated to the learning transfer (p=0.0001) and GPA (p=0.006). There is also a positive correlation between learning transfer and GPA (p=0.04), clinical settings-based training experience (p=0.021) and metacognitive confidence (p=0.0001).

CONCLUSIONS

This study may imply that academic achievement can be used as a potential screening tool to identify students requiring metacognitive training. It may also imply that metacognitive abilities can be enhanced indirectly through considering factors that may influence the transfer of learning such as increasing the hours of clinical training.

The effect of evidence-based nursing education on nurses' clinical decision making: A randomized controlled trial

Introduction

Nurses are the largest group of health-care providers and their clinical decisions have an essential role in patients' clinical condition. Evidence-based nursing has been proposed as a health-care method based on the latest findings and evidence. Therefore, we aimed to determine the effect of evidence-based nursing education on dialysis nurses' clinical decision-making.

Material and Methods

This single-blind experimental study conducted in 2021 at dialysis wards of teaching hospitals affiliated to Urmia University of Medical Sciences. In this study, a total of 60 dialysis nurses were recruited using convenience sampling and allocated to two groups of intervention (n = 30) and control (n = 30). Data were collected at three time points of before, 1 week after, and 1 month after the intervention using a demographic questionnaire and the Lauri and Salantera Clinical Decision-Making Questionnaire (LSCD-MQ). Nurses in the intervention group received 12 sessions of evidence-based nursing education, while nurses in the control group received no intervention.

Results

The results showed the mean score of clinical decision-making had a significant decreasing trend over time (p < 0.001) so that it decreased significantly 1 week after the intervention (72.83 ± 4.90) compared with before the intervention (69.5 ± 67.34) in the intervention group. Moreover, participants' decision-making moved toward analytical decision-making. The results also indicated there was a significant difference between the baseline mean score of clinical decision-making and the postintervention mean scores obtained 1 week (p = 0.025) and 1 month (p = 0.001) after the intervention. However, this difference was not found to be significant in the control group (p = 1.000).

Conclusions

The study results indicate the positive effect of evidence-based education on nurses' clinical decision-making. Therefore, nurses are recommended to apply evidence-based education methods to improve their level of clinical decision-making. Health officials are also recommended to hold in-service evidence-based workshops to update nurses' knowledge.

Mediating effects of self-directed learning on the relationship between critical thinking and problem-solving in student nurses attending online classes: A cross-sectional descriptive study

BACKGROUND

With the increased prevalence of online education due to the coronavirus 2019 pandemic and advancements in information technology, essential competencies, such as critical thinking, self-directed learning, and problem-solving ability, should be examined among student nurses taking online classes.

OBJECTIVES

Based on the findings of several studies suggesting that critical thinking does not affect problem-solving, this study aimed to examine the relationship among critical thinking, self-directed learning, and problem-solving in student nurses attending online classes, and to determine whether self-directed learning could mediate the relationship between critical thinking and problem-solving.

DESIGN

Cross-sectional, descriptive design.

SETTING

K University in South Korea.

PARTICIPANTS

In total, 138 junior and senior nursing students were enrolled.

METHODS

The critical thinking disposition scale for nursing students, self-directed learning scale, and problem-solving scale for college students were used to quantify participants' responses.

RESULTS

Our results revealed significant positive correlations among critical thinking, self-directed learning, and problem-solving. Furthermore, self-directed learning (β = 0.78, p < 0.001) had a significant mediating effect on the relationship between critical thinking and problem-solving ability (Z = 5.10, p < 0.001).

CONCLUSION

Developing and implementing appropriate self-directed learning programs are critical for improving problem-solving ability affected by critical thinking among student nurses engaged in online education.

Differential validation of nursing diagnoses: An integrative literature review on the use of the method

PURPOSE

This review aimed to analyze the use of differential validation of nursing diagnosis.

METHODS

Integrative literature review with search on international databases. The diagnoses, the type of the diagnosis differential validation, the sample, the method, main results, and the limitations were extracted. Ten studies were included.

FINDINGS

Differential diagnostic validation publication dates from 1994, and Brazil was the predominant country.

CONCLUSIONS

This method seems helpful in improving diagnosis accuracy, particularly those related to subjective, behavioral, or complex human responses.

IMPLICATIONS FOR NURSING PRACTICE

Using this model may facilitate understanding the specificity of nursing diagnosis, which is critical for teaching clinical reasoning and for new opportunities to research.

Analysis of Critical Thinking Path of College Students Under STEAM Course

This study examined the differences in critical thinking levels among students with different levels of academic engagement in STEAM courses. In this study, 30 college students were selected as subjects. Before experimenting, they received the academic engagement test and were divided into high, medium, and low groups based on their performance. Then, each group received three STEAM sessions and was asked to complete a topic discussion task. The results show that there are significant differences in the critical thinking level of students with different levels of academic engagement. Specifically, the students with a medium level of academic engagement had the highest critical thinking. Research has shown that the level of academic engagement affects the critical thinking of students in STEAM courses.

Enhancing generic capabilities and metacognitive awareness of first-year nursing students using active learning strategy

Background

Developing students’ generic capabilities is a major goal of university education as it can help to equip students with life-long learning skills and promote holistic personal development. However, traditional didactic teaching has not been very successful in achieving this aim. Kember and Leung’s Teaching and Learning Model suggests an interactive learning environment has a strong impact on developing students’ generic capabilities. Metacognitive awareness is also known to be related to generic capability development. This study aimed to assess changes on the development of generic capabilities and metacognitive awareness after the introduction of active learning strategy among nursing students.

Methods

This study adopted a quasi-experimental single group, matched pre- and posttest design. It was conducted in a school of nursing at a university in Hong Kong. Active learning approaches included the flipped classroom (an emphasis on pre-reading) and enhanced lectures (the breaking down of a long lecture into several mini-lectures and supplemented by interactive learning activities) were introduced in a foundational nursing course. The Capabilities Subscale of the Student Engagement Questionnaire and the Metacognitive Awareness Inventory were administered to two hundred students at the start (T0) and at the end of the course (T1). A paired t-test was performed to examine the changes in general capabilities and metacognitive awareness between T0 and T1.

Results

A total of 139 paired pre- and post-study responses (69.5 %) were received. Significant improvements were observed in the critical thinking (p < 0.001), creative thinking (p = 0.03), problem-solving (p < 0.001) and communication skills (p = 0.04) with the implementation of active learning. Significant changes were also observed in knowledge of cognition (p < 0.001) and regulation of cognition (p < 0.001) in the metacognitive awareness scales.

Conclusions

Active learning is a novel and effective teaching approach that can be applied in the nursing education field. It has great potential to enhance students’ development of generic capabilities and metacognitive awareness.