The effect of problem-based learning in nursing education: a meta-analysis

Collaborative project-based learning in global health: Enhancing competencies and skills for undergraduate nursing students

BACKGROUND

Despite the importance of collaboration and communication in global health, existing educational approaches often rely on traditional one-way instruction from instructor to student. Therefore, this study aimed to evaluate the effectiveness of a newly developed undergraduate curriculum on global health in enhancing nursing students' competencies in global health and communication, problem-solving, and self-directed learning skills.

METHODS

A 15-week course "Global Health and Nursing" was designed for undergraduate nursing students, and a collaborative project-based learning method was used. Study participants were undergraduate nursing students enrolled in the course. The study was a multi-method study and included quantitative and qualitative components. It employed a one-group pretest-posttest design to quantitatively assess the impact of the curriculum. Additionally, student experiences with the learning process were qualitatively explored through a focus group interview. A total of 28 students participated in this study, and 5 of them participated in the focus group interview.

RESULTS

The collaborative project-based learning method significantly improved global health competency (t = - 10.646, df = 22, p < 0.001), with a large effect size. It also improved communication skills (t = - 2.649, df = 22, p = 0.015), problem-solving skills (t = - 3.453, df = 22, p = 0.002), and self-directed learning skills (t = - 2.375, df = 22, p = 0.027). Three themes were found through the focus group interview: (a) Promoting global health competency; (b) Fostering life skills through collaborative projects; and (c) Recommendations for future classes. The focus group interview indicated that overall, the study participants were satisfied with the collaborative project-based method for global health education.

CONCLUSIONS

This study confirms that project-based learning significantly boosts the competencies and skills of students, recommending its broader adoption in nursing education. Nursing instructors should consider adopting this teaching approach for global health education at the undergraduate level. Future studies may employ a longitudinal design to assess the prolonged effects of the collaborative project-based learning approach, particularly focusing on the long-term retention of skills and the broader applicability of this model across different educational settings.

Construction and application of procedural pathways combined with information management in nursing staff skills training system

OBJECTIVE

To explore the application effect of procedural pathways combined with information management in the construction of nursing staff skills training system.

METHODS

This was a quasi-experimental study with a control group and an experimental group. A total of 300 newly admitted nurses or nurses who required training within three years of admission were selected as the experimental group, and 267 nurses who were trained in the same hospital during the same period in 2020 were selected as the control group. The experimental group received skills training using a system that combines procedural pathways with information management, while the control group received traditional teaching mode. The outcome measures included theoretical score, operation score, nurse competency, patient satisfaction, and nursing-related adverse events. The data were analyzed using t-test, chi-square test, and rank-sum test.

RESULTS

The experimental group had higher scores in theoretical assessment, skills assessment, nurse competency, and patient satisfaction, and lower incidence of nursing-related adverse events than the control group (P < 0.05).

CONCLUSION

The strategy of procedural pathways combined with information management provides a new perspective and method for nursing operation skills training, effectively improves clinical nursing quality and ensures patient safety.

Using staged teaching and assessment approaches to facilitate inter-university collaboration and problem-based learning

This article describes the segmented module design and problem-based learning approaches employed to enable parts of a higher education environmental health module (course) to be shared between universities in Wales, Northern Ireland, and Australia. The module requires students to identify the needs and assets of a community then design community-based interventions to address problems and undertake an evaluation of those interventions. Accreditation body and the degree program learning outcome requirements in the UK and Australia were found to hold many comparable knowledge, skills, and graduate attribute criteria, eliminating a potential barrier for international learning and teaching collaboration between higher education institutions. Instead, barriers to collaboration were associated with institutional issues and practicalities such as timetabling and assessment requirements. Taking a segmented approach to module design allowed staged and varied levels of collaboration between participating institutions, all delivering modules (courses) with similar learning outcomes. This provided a more sustainable environment to facilitate shared learning and teaching and fostered closer relations between programs, within these constraining factors. Students using problem-based learning and its group-working component exhibited the development of leadership, communication, and independent learning skills.

The impact of an integrated PBL curriculum on clinical thinking in undergraduate medical students prior to clinical practice

BACKGROUND

Problem-based learning (PBL) is a widely adopted educational approach in medical education that aims to promote critical thinking and problem-solving in authentic learning situations. However, the impact of PBL educational mode on undergraduate medical students' clinical thinking ability has been limitedly investigated. This study aimed to assess the influence of an integrated PBL curriculum on clinical thinking ability of medical students prior to clinical practice.

METHODS

Two hundred and sixty-seven third-year undergraduate medical students at Nantong University were recruited in this study and were independently assigned to either the PBL or control group. The Chinese version of the Clinical Thinking Ability Evaluation Scale was used to assess clinical thinking ability, and the students' performance in the PBL tutorials was assessed by tutors. All participants in both groups were required to complete the pre-test and post-test questionnaires to self-report their clinical thinking ability. A paired sample t-test, independent sample t-test and one-way analysis of variance test (ANOVA) were used to compare the difference in clinical thinking scores among different groups. Multiple linear regression was conducted to analyze the influencing factors correlated with clinical thinking ability.

RESULTS

The clinical thinking ability of most third-year undergraduate medical students at Nantong University was at a high level. The PBL group had a higher proportion of students with high-level clinical thinking ability in the post-test compared to the control group. The pre-test scores of clinical thinking ability were similar between the PBL and control groups, but the post-test scores of clinical thinking ability in the PBL group were significantly higher than those in the control group. Additionally, there was a significant difference in clinical thinking ability between the pre-test and post-test in the PBL group. The post-test scores of sub-scales of critical thinking ability were significantly higher than the pre-test in the PBL group. Furthermore, the frequency of reading literature, time of PBL self-directed learning, and PBL performance score ranking were influencing factors on the clinical thinking ability of medical students in the PBL group. Moreover, there was a positive correlation between clinical thinking ability and the frequency of reading literature, as well as the scores of the PBL performance.

CONCLUSIONS

The integrated PBL curriculum model has an active impact on improving undergraduate medical students' clinical thinking ability. This improvement in clinical thinking ability may be correlated with the frequency of reading literature, as well as the performance of the PBL curriculum.

Virtual simulation and problem-based learning enhance perceived clinical and cultural competence of nursing students in Asia: A randomized controlled cross-over study

BACKGROUND

Both clinical and cultural competencies are of paramount importance in ensuring patients' safety and high-quality care. While problem-based learning (PBL) is a widely applied pedagogy in nursing education, an emerging technology-based pedagogy, virtual simulation provides a realistic clinical learning experience for students. It can be an effective solution for continuing clinical and cultural learning across countries in the era of the pandemic.

OBJECTIVES

This study aimed to compare the effectiveness of virtual simulation and PBL on the perceived clinical and cultural competence for nursing students.

DESIGN

A randomized controlled cross-over study design was used.

SETTINGS AND PARTICIPANTS

Sixty-one undergraduate and postgraduate nursing students from five Asian regions were selected for participation.

METHODS

Participants were randomized to receive either virtual simulation (group A) or PBL (group B) for one day, followed by another intervention on the second day. Three self-reported questionnaires were used: Clinical Competence Questionnaire (CCQ), Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals-Student Version (IAPCC-SV), and demographic questionnaire.

RESULTS

The results revealed that students in both arms had significant improvements in CCQ total score (A: d = 21.500, P < 0.001; B: d = 16.710, P = 0.001), nursing professional behavior (A: d = 8.233, P < 0.001; B: d = 6.323, P < 0.001), and advanced nursing skills (A: d = 2.533, P = 0.008; B: d = 2.129, P = 0.029) after two interventions. In addition, both arms demonstrated significant improvements in IAPCC-SV total score (A: d = 3.467, P = 0.037; B: d = 4.032, P = 0.010) and cultural skills (A: d = 0.767, P = 0.012; B: d = 1.000, P = 0.001). No significant differences were observed between the two arms.

CONCLUSIONS

The findings indicated that both virtual simulation and PBL were effective in promoting students' perceived clinical and cultural competence. As both education modes have their own uniqueness and effectiveness in both outcomes, the combination of both could enhance the variability of learning modalities. Notably, the use of virtual simulation first could engage students better in learning and achieve better educational outcomes.

The effect of Problem-Based Learning on Care Management skills: A quasi-experimental study

OBJECTIVE

to assess the preliminary effect of Problem-Based Learning on Care Management skills.

METHOD

a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression).

RESULTS

the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05).

CONCLUSION

despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.

Effects of Problem-Based Learning Strategies on Undergraduate Nursing Students' Self-Evaluation of Their Core Competencies: A Longitudinal Cohort Study

To respond to patients' increasing demands and strengthen nursing professionals' capabilities, nursing students are expected to develop problem-solving skills before they enter the workforce. Problem-based learning (PBL) is expected to provide effective simulation scenarios and realistic clinical conditions to help students achieve those learning goals. This article aims to explore the effects of PBL strategies on nursing students' self-evaluation of core competencies. This longitudinal cohort survey study evaluated 322 nursing students attending Chung Shan Medical University, Taiwan, in 2013 and 2014, where PBL teaching strategies are used in all four undergraduate years from freshman to senior. Based on their undergraduate academic levels, students were categorized into three groups- one-year PBL exposure, two-year PBL exposure, and three-year exposure. A core competency questionnaire was administered twice to ask participants to self-assess five professional competencies: learning attitude, problem identification, information analysis, execution, and life-long learning. The results showed that students with the longest exposure to PBL (Group 3) had higher self-evaluated scores for all core competencies than the other groups, except for the execution competency. The mean total competency score increased by 0.12 points between the pre-and-test. In addition, the mean score increased significantly more in Group 3 than in Groups 1 and 2. These trends were consistent for the information analysis, execution, and life-long learning competencies. In conclusion, the changes in the self-evaluated scores between groups indicate PBL strategies effectively improve nursing students' core competencies. The longest exposure group reported higher self-evaluated core competency scores than the other groups, especially for the information analysis, execution, and life-long learning competencies.

The effectiveness of problem based learning in improving critical thinking, problem-solving and self-directed learning in first-year medical students: A meta-analysis

BACKGROUND

The adaptation process for first-year medical students is an important problem because it significantly affects educational activities. The previous study showed that 63% of students had difficulties adapting to the learning process in their first year at medical school. Therefore, students need the most suitable learning style to support the educational process, such as Problem-based learning (PBL). This method can improve critical thinking skills, problem-solving and self-directed learning. Although PBL has been adopted in medical education, the effectiveness of PBL in first-year medical students is still not yet clear. The purpose of this meta-analysis is to verify whether the PBL approach has a positive effect in improving knowledge, problem-solving and self-directed learning in first-year medical students compared with the conventional method.

METHODS

We searched PubMed, ScienceDirect, Cochrane, and Google Scholar databases until June 5, 2021. Search terms included problem-based learning, effectiveness, effectivity, and medical student. We excluded studies with the final-year medical student populations. All analyses in our study were carried out using Review Manager version 5.3 (RevMan Cochrane, London, UK).

RESULT

Seven eligible studies (622 patients) were included. The pooled analysis demonstrated no significant difference between PBL with conventional learning method in critical thinking/knowledge assessment (p = 0.29), problem-solving aspect (p = 0.47), and self-directed learning aspect (p = 0.34).

CONCLUSION

The present study concluded that the PBL approach in first-year medical students appeared to be ineffective in improving critical thinking/knowledge, problem-solving, and self-directed compared with the conventional teaching method.

Effects of five teaching methods in clinical nursing teaching: A protocol for systematic review and network meta-analysis

Introduction

Several teaching methods have been used in clinical nursing teaching to increase quality and efficiency, but disagreements over their effects persist. This study will evaluate the effects of five teaching methods in clinical nursing on nursing students’ knowledge, skill scores, learning satisfaction, and patients’ satisfaction.

Methods

We will conduct searches in PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure Database (CNKI), China Biological literature database (CBM), Wanfang Database, and China Science and Technology Journal Database (CSTJ) up to April 2022. Relevant randomized controlled trials meeting the eligibility criteria will be included. And the study selection and data extraction will be independently screened for eligibility by two authors. The quality of evidence will be evaluated using the Cochrane risk of bias tool. Pairwise meta-analysis and network meta-analysis (NMA) will be conducted using Rev Man, Stata, and R software. Statistical analyses including homogeneity tests, sensitivity analysis, transitivity tests, consistency tests, and publication bias will be completed.

Ethics and dissemination

No formal research ethics approval is required. The results will be disseminated to a peer-reviewed journal for publication.

Protocol registration number

INPLASY2021120040.

A Simulation-Based Clinical Nursing Education Framework for a Low-Resource Setting: A Multimethod Study

Simulation-based clinical education is a useful strategy for teaching, learning, and assessing clinical competence in health professions education. However, the use of simulation-based clinical nursing education (SBCNE) in low-resource settings such as Ghana has been hampered by the lack of a context-specific framework to guide its design, implementation, and evaluation. This study sought to develop a context-specific framework to guide the design, implementation, and evaluation of SBCNE in a low-resource setting. The study employed a sequential multimethod design, comprising a scoping review; qualitative descriptive design (situational analysis) made up of two parts–focus group discussions (FGDs) with post-registration nurses and nursing students, and semi-structured interviews with nurse educators; and narrative synthesis of the scoping review and situational analysis data, used to develop a draft SBCNE framework for a low-resource setting. The draft SBCNE framework was evaluated by stakeholders of nursing education and practice using nominal group discussions. The framework is comprised of five constructs (context, planning, design, community of learning, and outcomes). The user-centric, comprehensive, context-specific SBCNE framework has the potential to enhance the implementation of simulation in nursing education and the development of clinical competence in a low-resource setting. As a result, we urge nursing leaders and nurse educator unions to take the lead in lobbying regulatory bodies, the central government, and their development partners to provide the necessary financial support and resources for the implementation of the framework and adoption of SBCNE in low-resource settings.

Effects of simulation problem-based learning based on Peplau's Interpersonal Relationship Model for cesarean section maternity nursing on communication skills, communication attitudes and team efficacy

BACKGROUND

In the coronavirus disease-impacted era, many medical institutions have not permitted clinical practice at hospitals or have operated their training on a restricted basis. The effective strategy for improving therapeutic communication and team cooperation as a nursing core competency is required.

OBJECTIVES

The study aimed to verify the effects of simulation problem-based learning on nursing students' communication skills, communication attitudes, and team efficacy.

DESIGN

Non-equivalent control group pretest-posttest design.

SETTINGS

A university in South Korea.

PARTICIPANTS

Nursing students who were classified as advanced beginners were randomly allocated to the control group (n = 46) or the experimental group (n = 47).

METHODS

The experimental group's students participated in the simulation problem-based learning for cesarean section maternity nursing. The control group's students participated in a conventional type of maternity nursing clinical practice. The communication skills, communication attitudes, and team efficacy were measured by using a self-reported questionnaire.

RESULTS

As compared with the pretest, the communication attitudes increased significantly (t = 2.41, p = .020) in the posttest for the experimental group. The communication skills (t = 1.47, p = .150) and team efficacy (F = 3.30, p = .073) were not statistically significant.

CONCLUSIONS

The simulation problem-based learning in clinical practice is recommended to improve communication attitudes for nursing students and to apply the learned knowledge in simulated nursing situations through experiential learning. Future research is particularly needed the standardized educational program to identify the long-term effects in various cases and settings.

Development of a Framework for Problem Domain Transference in Health-Related Problem Based Learning and Assessment

ObjectiveInvestigate the capability of a knowledge-based framework and architecture, used in a specific health domain problem that can utilise transfer learning, to speed virtual patient development for problem-based training and assessment in other health domains.MethodsAnalysis of a case study, based on a virtual patient used in the training of pharmacy students, to discover the viability of using generic, ontological knowledge capable of transfer to virtual patients in other health domains.ResultsAreas of the virtual pharmacy patient knowledge-base were identified, along with corresponding expected student questions, that are generic to other health domains. Using the framework from the case study to develop a new virtual patient for problem-based learning and assessment in a new health domain, these generic target questions could be utilised to speed up the development of other learning stimuli in future projects involving different health domains, such as nurse training in pain management.ConclusionsWith some modification, the framework of the case-study virtual patient was found to be capable of supporting generic expected student questions capable of re-use in virtual patients with new clinical conditions.

The Effects of Using Socio-Scientific Issues and Technology in Problem-Based Learning: A Systematic Review

Currently, a growing number of learning institutions at all educational levels are including problem-based learning (PBL) in their curricula. PBL scenarios often utilise technology and socio-scientific Issues (SSI), which enables the simultaneous learning of content and creative thinking and working skills needed in generating new knowledge for the future. In this sense, using SSI and technological tools in PBL learning environments can be viewed as a starting point for acquiring and integrating new knowledge. However, there is no comprehensive knowledge regarding the possibilities of this approach. The objective of this systematic review is to produce this knowledge via the PRISMA method. The strategy is used to explore the effects of the described approach through implementations conducted at secondary and undergraduate levels. The data consisted of 33 research articles that were categorised via qualitative content analysis. According to the results, PBL scenarios exploit mainly local SSIs that link scientific knowledge with a meaningful context for students. Technology is principally used in offering technical support for teaching tasks. Lastly, these results are discussed from the technological pedagogical science knowledge (TPASK) framework perspective, which proposes guidelines for achieving the Sustainable Development Goals (SDG).

Effectiveness of an Interprofessional Education Model to Influence Students' Perceptions on Interdisciplinary Work

BACKGROUND

To prepare students adequately for the workplace, training on interprofessional practice should be included in the curricula of future health professionals. This study evaluated the effect of an interprofessional education session on undergraduate students' attitudes toward interprofessional collaboration.

METHODS

A total of 225 medicine, nursing, physiotherapy, and nutrition and dietetics students were randomized to either an intervention (working together interprofessionally, n = 111) or control group (working together with their own profession, n = 114). Pre- and posttest assessment was performed with an adapted version of the Interdisciplinary Education Perception Scale.

RESULTS

A statistically significant improvement in attitude for Perception of Competence Own Profession (0.82, p = .008) and Perception of Actual Cooperation (1.10, p = .004) was found for students in the intervention group compared with students in the control group.

CONCLUSION

Interprofessional education sessions were likely to be effective on undergraduate students' attitudes toward interprofessional collaboration. [J Nurs Educ. 2021;60(9):494-499.].

Does problem-based learning education improve knowledge, attitude, and perception toward patient safety among nursing students? A randomized controlled trial

Background

Patient safety is a top priority for any health care system. Most universities are looking for teaching methods through which they would be able to enhance students’ clinical decision-making capabilities and their self-centered learning to ensure safe and quality nursing care. Therefore, this study aimed to determine the effect of patient safety education through problem-based learning (PBL) on nursing students’ knowledge, attitude, and perceptions toward patient safety.

Methods

This randomized, controlled trial was conducted from September 2019 to January 2020. A total of 78 fourth-year nursing students participated in this study. The participants were randomly assigned to either the intervention group or the control group. In the intervention group, the educational materials were presented to the students using the PBL method during eight sessions of 45–60 min. In each control group, nursing students received eight education sessions through lectures and discussing the same educational content. Data were gathered 1 month after the intervention using demographic information and knowledge, attitudes, and perception questionnaires. Data were analyzed in SPSS ver. 22.0 using descriptive (mean and standard deviation) and inferential (chi-square test, independent t-test, paired t-test, and analysis of covariance (ANCOVA)) statistics.

Results

The results indicated that the difference in the mean scores of knowledge, attitudes, and perceptions of the nursing students about patient safety was statistically significant between the two groups after the PBL education (p = 0.001). The mean scores of students’ knowledge, attitude, and perceptions of patient safety increased significantly in the intervention group.

Conclusions

Implementing patient safety education through PBL positively affects knowledge, attitudes, and perceptions of patient safety among nursing students. Thus, the research team recommended the PBL method to be used by nursing professors to improve nursing students’ clinical skills and cognitive abilities to ensure safe patient care.

Trial registration

IRCT20190925044881N1; October 17, 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00588-1.

Problem-based learning: A strategy to foster generation Z's critical thinking and perseverance

Educators are concerned about Generation Z's inexperience with higher order critical thinking and tendency to give up or move on when faced with challenges. While acknowledging that this generation brings technological skills and an inclusive mindset that will enhance our profession, educators are challenged to adapt teaching strategies to promote critical thinking and foster perseverance. This manuscript will recount the attributes of Generation Z and describe problem-based learning as a strategy to enhance critical thinking and perseverance.

Does problem-based learning in Nursing Education Empower Learning?

In this discussion paper, we explored our experiences with the integration of problem-based learning and use of evaluation tools in an undergraduate nursing research class. Six content areas in the course were adapted to problem-based learning. Understanding of concepts and being able to link concepts to the real world of practice can be achieved when nursing students actively engage to construct and reconstruct their knowledge. This journey has demonstrated to us the importance of reflecting on practice as faculty and student. We encourage discussion among nursing faculty to more deeply understand the significance of moving from traditional didactic towards learner-centered approaches that enhance critical thinking.

To evaluate the effect of challenge-based learning on the approaches to learning of Chinese nursing students: A quasi-experimental study

Challenge-based learning (CBL) is a learner-centred, experimental learning strategy that aims to prepare students to manage unforeseeable and complex global issues in the 21st century. It cultivates an active and authentic learning environment that requires students' creative input, collaboration and community involvement. Studies in the past decade have shown that CBL strengthens soft skills essential for future society, such as critical thinking and creativity. However, its effect on students' metacognitive abilities is scarcely mentioned. This study - a quasi-experimental study with non-equivalent groups conducted in a self-financing tertiary institution in Hong Kong - aims to evaluate the effect of CBL on approaches to learning among nursing students. First-year students in the nursing programme who attended a nursing course using CBL were recruited for the intervention group and senior year-one students were included in the control group. Their approach to learning was measured by the Revised Two-Factor Study Process Questionnaire administered at the beginning and at the end of the semester. Analysis of Covariance (ANCOVA) was used to compare the mean difference in scores of deep and surface approaches between the groups. A total of 209 participants were recruited, with 130 in the intervention group and 79 in the control group. The response rates were 65.3% (130/199) and 78.2% (79/101) for the intervention and control groups, respectively. In the intervention group, the mean post-test deep approach score was significantly higher than the pre-test score (F = 5.2, p = 0.023), even though it had only a small effect. There was no statistically significant difference in baseline post-test mean surface scores (F = 2.4, p = 0.125). The results of this study indicate that CBL may facilitate deep learning in nursing students.

A review to identify key perspectives in PBL meta-analyses and reviews: trends, gaps and future research directions

In the past 50 years, the original McMaster PBL model has been implemented, experimented, revised, and modified, and is still evolving. Yet, the development of PBL is not a series of success stories, but rather a journey of experiments, failures and lessons learned. In this paper, we analyzed the meta-analyses and systematic reviews on PBL from 1992 to present as they provide a focused lens on the PBL research in the past 5 decades. We identified three major waves in the PBL research development, analyzed their impact on PBL research and practice, and offered suggestions of research gaps and future directions for the field. The first wave of PBL research (polarization: 1990-mid 2000) focused on answering the question "Does PBL work?" and the outcomes. The results were conflicting. The researchers took polarizing positions and debated over the merits of PBL throughout this wave. However, the contradictory results and the debates in fact pushed the researchers to look harder for new directions to solve the puzzle. These efforts resulted in the second wave (from outcomes to process: mid 2000-mid 2010) that focused on the question "How does PBL work?" The second wave of PBL research targeted at investigating the effects of implementation constituents, such as assessment formats or single versus curriculum wide implementations. The third wave (specialization: mid 2010 and onward) of PBL research focused on "How does PBL work in different specific contexts?" These research widened our perspectives by expanding our understanding of how PBL manifests itself in different contexts. Given the diversification of PBL and more hybrid PBL models, we suggest "Why does PBL with particular implementation characteristics for specific outcomes work or not work in the condition where it is implemented?" to be the question to answer in the next wave of PBL research.

A meta-analysis for comparing effective teaching in clinical education

Aim: Many factors affect learning outcomes, however studies comparing the effectiveness of different clinical teaching methods are limited. We utilize the list of influences on educational achievement compiled by John Hattie to inform a meta-analysis of learning effect sizes (ESs) associated with teaching-learning factors (TLFs) in clinical education. Methods: A literature search was conducted in PubMed to identify articles examining clinically relevant TLFs. Selection criteria were applied to identify learner-focused studies, with subsequent categorization by study design (pretest-posttest or controlled group). The Cohen's ES (d) for each TLF was extracted and a pooled ES determined. Results: From 3454 studies, 132 suitable articles enabled analysis of 16 TLFs' ESs. In general, ESs derived from pretest-posttest data were larger than those from controlled group designs, probably due to learner maturation effect. The TLFs of mastery learning, small group learning and goal settings possessed the largest ESs (d ≥ 0.8), while worked examples, play programs, questioning, concept mapping, meta-cognitive strategies, visual-perception programs and teaching strategies demonstrated ESs between 0.4 and 0.8. Conclusions: This is the first study to provide a rigorous and comprehensive overview of the effectiveness of TLFs in clinical education. We discuss the practical traits shared by effective TLFs which may assist teaching design.

Breaking with Tradition: A Scoping Meta-Analysis Analyzing the Effects of Student-Centered Learning and Computer-Aided Instruction on Student Performance in Anatomy

While prior meta-analyses in anatomy education have explored the effects of laboratory pedagogies and histology media on learner performance, the effects of student-centered learning (SCL) and computer-aided instruction (CAI) have not been broadly evaluated. This research sought to answer the question, "How effective are student-centered pedagogies and CAI at increasing student knowledge gains in anatomy compared to traditional didactic approaches?" Relevant studies published within the past 51 years were searched using five databases. Predetermined eligibility criteria were applied to the screening of titles and abstracts to discern their appropriateness for study inclusion. A summary effect size was estimated to determine the effects of SCL and CAI on anatomy performance outcomes. A moderator analysis of study features was also performed. Of the 3,035 records screened, 327 underwent full-text review. Seven studies, which comprised 1,564 participants, were included in the SCL analysis. An additional 19 studies analyzed the effects of CAI in the context of 2,570 participants. Upon comparing SCL to traditional instruction, a small positive effect on learner performance was detected (standardized mean difference (SMD = 0.24; [CI = 0.07, 0.42]; P = 0.006). Likewise, students with CAI exposure moderately outscored those with limited or no access to CAI (SMD = 0.59; [CI = 0.20, 0.98]; P = 0.003). Further analysis of CAI studies identified effects (P ≤ 0.001) for learner population, publication period, interventional approach, and intervention frequency. Overall, learners exposed to SCL and supplemental CAI outperformed their more classically-trained peers as evidenced by increases in short-term knowledge gains. Anat Sci Educ. © 2018 American Association of Anatomists.

Toolbox of teaching strategies

A teaching strategy is a method, which can help students to gain knowledge, deliver information, and improve their learning. Different learning environments, such as clinical teaching, online teaching, and face-to-face traditional learning environments, require different teaching strategies for students. Choosing teaching strategies for a course is very important for nurse educators because various factors should be taken into account to make students meet the learning outcomes. The use of modern technologies in teaching strategies can improve students’ competencies and confidences. The purpose of this article is to create a toolbox integrating ten teaching strategies that can be used in different teaching environments.

Effectiveness and experiences of team-based learning in nurse education programs: a mixed methods systematic review protocol

REVIEW OBJECTIVES/QUESTIONS

The objective of this mixed methods systematic review is to develop an integrated synthesis of quantitative and qualitative research evidence on team-based learning (TBL) in undergraduate nurse education programs to inform active learning strategies among students.More specifically, the objectives are.

Intellectual disability content within pre-registration nursing curriculum: How is it taught?

BACKGROUND

Despite experiencing higher rates of physical and mental health conditions compared with the general population, people with intellectual disability face inequitable access to healthcare services. Improving education of healthcare professionals is one way to reduce these inequalities.

OBJECTIVE

To determine how intellectual disability content is taught within Australian nursing schools.

DESIGN

A two-phase audit of Australian nursing curricula content was conducted using an interview and online survey.

SETTING

Nursing schools Australia-wide providing pre-registration courses.

PARTICIPANTS

For Phase 1, course coordinators from 31 nursing schools completed an interview on course structure. Teaching staff from 15 schools in which intellectual disability content was identified completed an online survey for Phase 2.

METHODS

Methods used to teach intellectual disability content and who taught the content were audited using an online survey.

RESULTS

Across the 15 schools offering intellectual disability content, lectures were the most common teaching method (82% of units), followed by tutorials (59%), workshops (26%), then other methods (e.g. e-learning; 12%). Approximately three-quarters of intellectual disability teaching used some problem-and/or enquiry-based learning. Only one nursing school involved a person with intellectual disability in delivering teaching content. Six (19%) participating schools identified staff who specialise in intellectual disability, and seven (23%) identified staff with a declared interest in the area.

CONCLUSION

While some nursing schools are using diverse methods to teach intellectual disability content, many are not; as a result, nursing students may miss out on acquiring the attributes which enable them to address the significant health inequalities faced by this group. A specific deficit was identified relating to inclusive teaching and clinical contact with people with intellectual disability.

Pure PBL, Hybrid PBL and Lecturing: which one is more effective in developing cognitive skills of undergraduate students in pediatric nursing course?

BACKGROUND

Nursing education in Iran has conventionally focused on lecture-based strategies. Improvements in teaching and learning over the years have led to an expansion of the pedagogies available to educators. Likewise, there has been a suggestion for a move toward more learner-centered teaching strategies and pedagogies that can result in improvement in learning. This study was undertaken to investigate the effects of Problem-Based Learning in developing cognitive skills in learning Pediatric Nursing among university students.

METHODS

In this quasi-experimental, posttest-only nonequivalent control group design, the subjects were undergraduate students who had enrolled in Pediatric Nursing II at Islamic Azad University in Iran. The experiment was conducted over a period of eight weeks, one two-hour session and two two-hour sessions. Two experimental groups, Pure Problem-Based Learning (PPBL) and the Hybrid Problem- Based Learning (HPBL), and one Lecturing or Conventional Teaching and Learning (COTL) group were involved. In the PPBL group, PBL method with guided questions and a tutor, and in the HPBL group, problem-based learning method, some guided questions, minimal lecturing and a tutor were used. The COTL group, however, underwent learning using conventional instruction utilizing full lecture. The three groups were compared on cognitive performances, namely, test performance, mental effort, and instructional efficiency. Two instruments, i.e., Pediatric Nursing Performance Test (PNPT) and Paas Mental Effort Rating Scale (PMER) were used. In addition, the two-Dimensional Instructional Efficiency Index (IEI) formula was utilized. The statistical analyses used were ANOVA, ANCOVA, and mixed between-within subjects ANOVA.

RESULTS

Results showed that the PPBL and HPBL instructional methods, in comparison with COTL, enhanced the students' overall and higher-order performances in Pediatric Nursing, and induced higher level of instructional efficiency with less mental effort (p < 0.005). Although there was no significant difference in lower-order performance among the groups during the posttest (p = 0.92), the HPBL group outperformed the COTL group on the delayed posttest (p = 0.028).

CONCLUSIONS

It may be concluded that both forms of PBL were effective for learning Pediatric Nursing. Moreover, PBL appears to be useful where there are shortages of instructors for handling teaching purposes.

Nursing curriculum and bullying: An integrative literature review

OBJECTIVES

The purpose of this integrative review was to identify and synthesize key concepts that inform curriculum which increase nursing students' competence, skills and strategies when addressing bullying. Specifically, the authors sought to examine the concepts informing educational interventions, skills, and strategies, which addressed the bullying of nursing students.

DESIGN

Integrative literature review.

DATA SOURCES

A search of the electronic databases CINAHL, MEDLINE, ERIC, PsycINFO, Proquest, and PubMed was conducted in January 2016 using search terms such as 'bully' 'nursing student' 'education' and 'curriculum'.

REVIEW METHODS

Articles were screened for relevance and eligibility and extracted onto a table. Critical appraisal was conducted using multiple tools. Papers were analysed using constant comparison and concept mapping.

RESULTS

61 articles were included in the synthesis. Concepts identified included: empowerment, socialization, support, self-awareness, awareness about bullying, collaboration, communication, and self-efficacy. All concepts linked to empowerment. Social Cognitive Theory was used by many studies. Active teaching methods which gave students opportunities to practice skills were the most effective.

CONCLUSIONS

Empowered nursing students have the potential to address bullying more effectively and competently. Empowerment of nursing students is a powerful concept that educators must consider when developing curriculum and educational interventions to address bullying.

Actions and interactions in clinical nursing practice in Primary Health Care

OBJECTIVE

Understanding the actions and interactions required for developing clinical nursing practice in Primary Health Care.

METHOD

A qualitative study anchored in the Grounded Theory. Data was collected between April and October 2016 with nurses divided into two sample groups.

RESULTS

Eighteen (18) nurses participated in the study. The category "Recognizing the Systematization of Nursing Care as an essential element for clinical nursing practice" supports the "actions-interactions" component and it is composed of two subcategories: "Accomplishing clinical practice in nursing consultations", which presents the challenges encountered in performing clinical practice; and "Highlighting management tools for evidence-based clinical practice", which operates through strategies in response to the studied phenomenon.

CONCLUSION

Care actions developed in clinical nursing practice are highlighted by the systematization of care in nursing consultations, a moment of direct interaction with the individual, thus contributing to improvement in the quality of care provided.

Embedding fundamental care in the pre-registration nursing curriculum: Results from a pilot study

International evidence suggests nursing is not providing fundamental care consistently or adequately, resulting in poor outcomes for patients and healthcare systems. One possible reason for this inadequate care delivery is nursing education, with fundamental care often implicit or invisible in nursing curricula. To understand how best to teach fundamental care to pre-registration (pre-licensure) students, we developed and piloted a six-week intervention that incorporated into the first-year curriculum a more explicit focus on fundamental care. A conceptual fundamental care framework was used to guide students' learning, and clinical skills sessions were structured to reinforce the framework's conceptual understanding and enable students to practice delivering fundamental care in an integrated manner. The intervention's impact was explored via a pre-post survey and focus groups. The survey demonstrated that the intervention did not affect students' ability to identify patients' fundamental care needs; however, focus groups showed the intervention assisted students in understanding the complexity of fundamental care and its importance to patients' experiences. The pilot provides preliminary evidence on the importance of embedding fundamental care into nursing curricula early and explicitly, and emphasising the integrated nature of such care, particularly through structured debriefs, consistent terminology, and opportunities for students to experience care as a patient.

Effectiveness of various innovative learning methods in health science classrooms: a meta-analysis

This study reports the results of a meta-analysis of the available literature on the effectiveness of various forms of innovative small-group learning methods on student achievement in undergraduate college health science classrooms. The results of the analysis revealed that most of the primary studies supported the effectiveness of the small-group learning methods in improving students' academic achievement with an overall weighted average effect-size of 0.59 in standard deviation units favoring small-group learning methods. The subgroup analysis showed that the various forms of innovative and reform-based small-group learning interventions appeared to be significantly more effective for students in higher levels of college classes (sophomore, junior, and senior levels), students in other countries (non-U.S.) worldwide, students in groups of four or less, and students who choose their own group. The random-effects meta-regression results revealed that the effect sizes were influenced significantly by the instructional duration of the primary studies. This means that studies with longer hours of instruction yielded higher effect sizes and on average every 1 h increase in instruction, the predicted increase in effect size was 0.009 standard deviation units, which is considered as a small effect. These results may help health science and nursing educators by providing guidance in identifying the conditions under which various forms of innovative small-group learning pedagogies are collectively more effective than the traditional lecture-based teaching instruction.

A model of collaboration for the implementation of problem-based learning in nursing education in South Africa

Background

The idea of collaboration between key stakeholders in nursing education for the implementation of problem-based learning (PBL) may have far-reaching implications for the institutions and students.

Main objective

To develop a model of collaboration to facilitate the implementation of PBL in nursing education.

Methodology

An exploratory sequential design was used. Qualitative data were collected from purposively recruited nurse educators from three universities in South Africa offering PBL and nurse managers from all the three hospitals in North West Province where PBL students are placed for clinical learning. A questionnaire was used to obtain data from respondents who were conveniently recruited. Model development, concept analysis, construction of relationships, description and evaluation were followed.

Results

This model has six elements: higher education and nursing education (context), institutions initiating PBL, clinical services, colleges affiliated to PBL universities, students and healthcare users (recipients), champions in PBL (agents), effective implementation of PBL (terminus), collaboration (process) and commitment, communication, trust and respect (dynamics).

Conclusion

Collaboration in implementing PBL can be a functional reality in the delivery of quality educational experiences and has far-reaching implications for the institutions and students. The implementation of the model in South African nursing education institutions may be necessary in the light of the revision of the preregistration qualifications.

Recommendations

Managerial commitment, training of collaborators on PBL and collaboration skills, memorandum of agreement, monitoring and evaluation are critical. More research is required to pilot the model and evaluate collaboration in implementing PBL at different levels of operations.

Supporting and Empowering Nurses Undergoing Critical Care Certification

PURPOSE

Nurses working in critical care settings face multiple sources of stress, such as complex clinical situations and the use of new advanced technologies, which can affect their psychological health. Literature suggests that the promotion of educational activities, such as a certification process within a specialty, can contribute to nurses' empowerment, professional growth, and personal satisfaction. However, it is of utmost importance that the institutional organizations support nurses undergoing the certification process to optimize positive impacts of this educational activity on the nurses, on the patients, and within the institutions.

DESCRIPTION OF THE PROJECT

In the course of a graduate studies stage, an educational program aiming at supporting and creating an empowering environment for nurses undergoing a critical care certification process was developed and implemented, in a Canadian intensive care unit, over a 7-month period. The Humanist model was used as a theoretical framework and was complemented by the problem-based learning pedagogical approach.

OUTCOMES

A postintervention qualitative questionnaire revealed that the program was tailored to nurses' learning needs and that participants felt supported by their institution throughout the process.

CONCLUSION

This program could help institutions support nurses in achieving higher professional and personal development levels through specialty certification.

Toward a mediation model for nurses' well-being and psychological distress effects of quality of leadership and social support at work

Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses' well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses' overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses' Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate = 51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses' well-being and psychological distress are partially mediated, that is, reduced, by nurses' overcommitment. Social work environment is highly important in relation to nurses' well-being and psychological distress.

Approaches to continuing professional development: putting theory into practice

This article provides an overview of approaches to and models of education to assist nurses involved in the delivery of education and continuing professional development. A number of models will be summarised to look at how learning, teaching and assessment can be integrated to benefit the learner, and the benefits this may have in nursing education and continuing professional development courses. The author also considers different domains of learning: cognitive, psychomotor and affective. This article presents the case for considering the constructive alignment of educational content as one means of increasing the likelihood of it being translated into practice.

Team learning, team performance and safe team climate in elder care nursing

Purpose

This study aims to determine whether elder care nurses engage in knowledge sharing and reflection within their teams and if these team-learning activities influence an elder care nursing team’s performance. Furthermore, the authors investigated the relation between elder care nurses' estimation of the team climate as being safe and team-learning activities.

Design/methodology/approach

For this research, a questionnaire survey of 30 elder care nursing teams (N = 30, n = 149) working in 17 different retirement homes was conducted.

Findings

Structural equation model showed significant positive relations between knowledge sharing and team performance, and between reflection and knowledge sharing. A safe team climate had a significantly positive influence on reflection.

Originality/value

Little is known about the performance of elder care nursing teams, how to measure team performance in this domain and how performance is influenced by learning activities. This study fills these gaps by providing an insight into the relationship between team-learning activities and team performance. Team performance was measured by the estimation of the team members and by using performance assessments from an independent institution.

Factors affecting integration of midwifery nursing science theory with clinical practice in Vhembe District, Limpopo Province as perceived by professional midwives

Background

Professional midwives have an important role to play in midwifery training to produce a competent midwife. According to the social learning theory, professional midwives act as role models for students. When allocated for clinical learning experiences in the training hospitals, students will have the opportunity to observe the well-trained, skilled, and experienced professional midwives. The whole process will enable students to integrate theory with practice and they will become competent.

Aim

The aim of this study was to determine the factors affecting integration of midwifery nursing science theory with clinical practice as perceived by midwives.

Setting

The study was conducted at the training hospitals in Vhembe district of the Limpopo Province, South Africa. These hospitals were: Donald Fraser, Siloam, and Tshidzini.

Methods

A qualitative explorative, descriptive and contextual design was used. A Non-probability, convenient sampling method was used to select 11 midwives from the following hospitals: Donald Fraser, Siloam, and Tshidzini, in Vhembe district. In-depth individual interviews were conducted. Data were analysed through open coding method.

Result

One theme and five sub-themes emerged from the analysed data, namely: shortage of midwives, attitudes towards student midwives, reluctance to perform teaching functions, language barriers, and declining midwifery practice standards.

Conclusion

Shortage of midwives in the clinical areas led to fewer numbers of mentors whom the students could observe and imitate to acquire clinical skills. Some of the midwives were reluctant to teach students. Recommendations were made for both training institutions and hospitals to employ preceptors for students in the clinical practical.

Effectiveness of simulation-based nursing education depending on fidelity: a meta-analysis

BACKGROUND

Simulation-based nursing education is an increasingly popular pedagogical approach. It provides students with opportunities to practice their clinical and decision-making skills through various real-life situational experiences. However, simulation approaches fall along a continuum ranging from low-fidelity to high-fidelity simulation. The purpose of this study was to determine the effect size of simulation-based educational interventions in nursing and compare effect sizes according to the fidelity level of the simulators through a meta-analysis.

METHOD

This study explores the quantitative evidence published in the electronic databases EBSCO, Medline, ScienceDirect, ERIC, RISS, and the National Assembly Library of Korea database. Using a search strategy including the search terms "nursing," "simulation," "human patient," and "simulator," we identified 2279 potentially relevant articles. Forty studies met the inclusion criteria and were retained in the analysis.

RESULTS

This meta-analysis showed that simulation-based nursing education was effective in various learning domains, with a pooled random-effects standardized mean difference of 0.70. Subgroup analysis revealed that effect sizes were larger for high-fidelity simulation (0.86), medium-fidelity simulation (1.03), and standardized patients (0.86) than they were for low-fidelity and hybrid simulations. In terms of cognitive outcomes, the effect size was the largest for high-fidelity simulation (0.50). Regarding affective outcome, high-fidelity simulation (0.80) and standardized patients (0.73) had the largest effect sizes.

CONCLUSIONS

These results suggest that simulation-based nursing educational interventions have strong educational effects, with particularly large effects in the psychomotor domain. Since the effect is not proportional to fidelity level, it is important to use a variety of educational interventions to meet all of the educational goals.

A Rapid Review of the Factors Affecting Healthcare Students' Satisfaction with Small-Group, Active Learning Methods

PHENOMENON: Problem-based learning (PBL) and other small-group, active learning methodologies have been widely adopted into undergraduate and postgraduate healthcare curricula across the world. Although much research has examined student perceptions of these innovative teaching pedagogies, there are still questions over which factors influence these views. This article aims to identify these key elements that affect healthcare student satisfaction with PBL and other small-group learning methods, including case-based and team-based learning.

APPROACH

A systematic rapid review method was used to identify high-quality original research papers from the healthcare education literature from between 2009 and 2014. All papers were critically appraised before inclusion in line with published guidelines. Narrative synthesis was achieved using an inductively developed, thematic framework approach.

FINDINGS

Fifty-four papers were included in the narrative synthesis. The evidence suggests that, despite an initial period of negative emotion and anxiety, the perspectives of healthcare students toward small-group, active learning methods are generally positive. The key factors influencing this satisfaction level include (a) the facilitator role, (b) tutorial structure, (c) individual student factors, (d) case authenticity, (e) increased feedback, (f) group harmony, and (g) resource availability. Insights: Student satisfaction is an important determinant of healthcare education quality, and the findings of this review may be of value in future curriculum design. The evidence described here suggests that an ideal curriculum may be based on an expert-led, hybrid PBL model.

Not just ticking all the boxes. Problem based learning and mental health nursing. A review

BACKGROUND

The practice and policy of mental health nursing are changing. Integration of health and social care, an increased emphasis on wellness and recovery and greater expectation of involvement from both service users and carers require competence in both group and interpersonal working. The active and dynamic processes of problem based learning provide the ideal environment to achieve proficiency in these skills.

OBJECTIVES

The aim of this review was to understand those programme elements that best support the delivery of a problem based learning module.

DATA SOURCES

This study utilised a standard module evaluation.

REVIEW METHODS

A systematic analysis of completed module evaluations allowed key themes to be established.

RESULTS

Problem based learning helps develop the skills and attributes that mental health nursing need in an increasing collaborative and wellness focused practice environment. Successful integration of PBL is more likely to occur when student centred approaches are already incorporated within a programme. Creating the right conditions for learning are key to successful facilitation of PBL groups.

CONCLUSIONS

Successful implementation of PBL requires identification of relevance to practice by students, a programme approach that is compatible with the aims and philosophy of PBL and a form of facilitation that encourages development of student autonomy.

Problem-Based Learning in Prenursing Courses

We conducted an observational study with 150 undergraduate nursing students to verify the usefulness of problem-based learning in the classroom and to ascertain whether this methodology facilitated the development of their knowledge acquisition skills. Problem-based learning fostered the development of integrated knowledge acquisition skills among nursing students.

Effects of an online problem-based learning program on sexual health care competencies among oncology nurses: a pilot study

PURPOSE

The purpose of this study was to test the effectiveness of an online problem-based learning (e-PBL) program that offers multimedia scenarios to develop sexual health care competencies.

METHOD

A pretest–posttest control group design was used with two randomized groups in one Korean tertiary hospital. The sample included 32 RNs who cared for oncology patients. The intervention group completed an e-PBL cycle consisting of eight tutorials.

RESULTS

Nurses in the intervention group scored significantly higher on knowledge than did those in the control group. The intervention group exhibited no significant differences in attitude and practices following the intervention.

CONCLUSION

The results show the potential of e-PBL to enhance traditional PBL by offering multimedia scenarios in an interactive and flexible learning environment.

Problem-based learning in pharmaceutical education: a systematic review and meta-analysis

OBJECTIVE

To assess the effects of problem-based learning (PBL) on the learning achievements of pharmacy students.

METHODS

We searched for controlled studies that compared PBL to traditional learning in pharmacy courses (graduate and undergraduate) in the major literature databases up to January 2014. Two independent researchers selected the studies, extracted the data, and assessed the quality of the studies. Meta-analyses of the outcomes were performed using a random effects model.

RESULTS

From 1,988 retrieved records, five were included in present review. The studies assessed students' impressions about the PBL method and compared student grades on the midterm and final examinations. PBL students performed better on midterm examinations (odds ratio [OR] = 1.46; confidence interval [IC] 95%: 1.16, 1.89) and final examinations (OR = 1.60; IC 95%: 1.06, 2.43) compared with students in the traditional learning groups. No difference was found between the groups in the subjective evaluations.

CONCLUSION

pharmacy students' knowledge was improved by the PBL method. Pharmaceutical education courses should consider implementing PBL.