Case seminars open doors to deeper understanding - Nursing students' experiences of learning

Principles of oncology taught in a one-week course

BACKGROUND

Growing challenges in oncology require evolving educational methods and content. International efforts to reform oncology education are underway. Hands-on, interdisciplinary, and compact course formats have shown great effectiveness in the education of medical students. Our aim was to establish a new interdisciplinary one-week course on the principles of oncology using state-of-the-art teaching methods.

METHODS

In an initial survey, medical students of LMU Munich were questioned about their current level of knowledge on the principles of oncology. In a second two-stage survey, the increase in knowledge resulting from our recently established interdisciplinary one-week course was determined.

RESULTS

The medical students' knowledge of clinically important oncological topics, such as the diagnostic workup and interdisciplinary treatment options, showed a need for improvement. Knowledge of the major oncological entities was also in an expandable state. By attending the one-week course on the principles of oncology, students improved their expertise in all areas of the clinical workup in oncology and had the opportunity to close previous knowledge gaps. In addition, students were able to gain more in-depth clinical knowledge on the most common oncological entities.

CONCLUSION

The interdisciplinary one-week course on the principles of oncology proved to be an effective teaching method to expand the knowledge of the future physicians to an appropriate level. With its innovative and interdisciplinary approach, the one-week course could be used as a showcase project for the ongoing development of medical education in Germany.

Case-based learning interventions for undergraduate nursing students in a theoretical course: A review of design, implementation, and outcomes

BACKGROUND

Case-based learning (CBL) is a contextualized learning and teaching method that can facilitate active and reflective learning to develop critical thinking and problem-solving skills. However, nursing educators have some difficulty in creating a CBL environment that matches the diverse professional nursing curriculum and students' needs, including developing relevant cases and appropriate CBL implementation processes.

OBJECTIVE

To summarize the case design, implementation process, and their relationship with CBL effectiveness.

METHODS

Electronic databases of PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI) and Wanfang Data (a Chinese database) were searched from inception until January 2022. Study quality was assessed using the Mixed Methods Appraisal Tool. A qualitative synthesis was then conducted to summarize the study findings.

RESULTS

The systematic mixed studies review included twenty-one quantitative studies, five qualitative studies and two mixed methods studies. The case design and implementation process were indispensable parts of each study, but the application process of CBL in each study was slightly different, basically including case design, preparation, small-group interaction and exploration, collaborative efforts, teacher summary, assignment and teacher feedback. There were three themes in this review that indicate the effect of CBL on students, namely, knowledge, competence and attitude.

CONCLUSION

The present review analyzes the available literature and suggests that there is no common format for the case design and CBL implementation process, but demonstrates that they are an indispensable part of each study. This review provides conceptual procedures for nurse educators to design and implement CBL in nursing theoretical courses to improve the effectiveness of CBL.

The Meaning and Application of Student-Centered Learning in Nursing Education: An Integrative Review of the Literature

AIM

The aim of this study was to review empirical articles to explore the meaning and the application of student-centered learning in nursing education.

BACKGROUND

Teachers in higher education are encouraged to adopt student-centered learning principles, but research shows that many still apply teacher-centered methods. There is therefore a need to clarify the meaning of student-centered learning, including how it is performed and the reasons to apply it in nursing education.

DESIGN

This study employed an integrative review method, following Whittemore and Knafl's framework.

METHODS

The databases CINAHL, Education Database and Education Research Complete were searched for related literature published from 2010 to 2020. The initial search located 308 articles. After screening and checking for eligibility, 25 articles were critically appraised. Data were extracted from the articles and displayed in matrices to be categorized and compared.

RESULTS

Three themes with attendant sub-themes emerged through the analysis: foundation, using core concepts to define and explain student-centered learning, eligibility, enhancing student knowledge, developing student abilities and supporting student self-reliance and realization, learning in interaction with peers, learning individually and learning in interaction with the teacher.

CONCLUSION

Student-centered learning in nursing education is an approach where the teacher is a facilitator of student learning and students are empowered to take control of their own studies. Students study together in groups; they are listened to by the teacher and their needs are taken into consideration. The main reasons to apply student-centered learning are to enhance students' theoretical and practical learning; to improve their generic competencies, such as problem-solving and critical-thinking abilities; and to strengthen students' self-reliance.

"I really liked the chance to talk about it": Students' Reflections on the Process of Completing Paper Puzzles, a Novel Active Learning Activity

INTRODUCTION

Research shows active learning is an effective teaching method. However, few qualitative studies explore medical student perceptions of the active learning process. The present study explored what students thought about while completing paper puzzles, an active learning tool used at the University of Utah School of Medicine, to understand what and how medical students think while engaged in active learning.

MATERIALS AND METHODS

To investigate second-year medical students' attitudes toward these active learning exercises, three Zoom-based focused groups were held and recorded throughout the course. Recordings were transcribed and coded using thematic analysis.

RESULTS

Students reported that peer interactions were of high value, and that while some interactions and thought processes were action-oriented, others were more metacognitive. Other benefits of the activity included promotion of learning, provision of structure, and designation of high-yield concepts. Challenges included feelings of confusion, problems with timing or difficulty of the tasks, and low utility without adequate preparation.

DISCUSSION

These findings reflect student-acknowledged pros and cons of active learning described in education literature and add further insight into the thoughts and conversations students have during active learning activities. These include practicing metacognitive skills, triaging information, and learning from peers.

CONCLUSIONS

These data further elucidate student perceptions of active learning activities in medical education. Though focused on a specific activity, the data can help medical educators understand what students appreciate about active learning and what they think about while engaged in such activities.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01682-y.

Twelve tips to center social accountability in undergraduate medical education

As the intersections of social identities and health become increasingly evident, the need for medical schools to center their education on social accountability becomes critical. Medical schools have a responsibility to direct their curriculum to ensure graduates become competent physicians in identifying and intervening for their community's needs. These topics have historically been taught in a didactic fashion, but there lacks adequate translation of this teaching style to clinical and community health advocacy. Active learning strategies must be used to engage students to critically think and act on the inter-relationships of social issues and health. We provide 12 recommendations to optimize medical education to effectively immerse students in social accountability through the use of experiential learning within a spiral curriculum. These recommendations are based on reviews of the literature and an environmental scan of curricular activities across Canadian medical schools.

Case-based Virtual Seminars on Masticatory Muscle Disorders during the COVID-19 Pandemic

Due to the significant influence of COVID-19 pandemic on dental education in the recent past, interactive educational strategies were explored to engage students. Case-based seminars (CBS) were proposed on masticatory muscle disorders (MMDs) for post-graduate dental students through integration of pathophysiology with its etiology, diagnosis, and management. Effectiveness of CBS was done at Kirkpatrick's level 1 and level 2 hierarchy with a pre-test and a post-test. CBS enhanced learning outcomes of post-graduate students in understanding MMDs. Thus, this report could serve as a useful model for other dental schools in prosthodontic post-graduate curriculum.

The experiences of nursing master's students with dialogic case-based learning in an evidence-based nursing course: A qualitative study

BACKGROUND

Evidence-based nursing (EBN) is a complex subject for teachers and students due to the abstract concepts involved. It requires combining theory with practice and is included in the major courses required for a master's education in many countries. Case-based learning (CBL), which is a student-centred teaching method, has been widely used in numerous disciplines because it can bridge the gap between theory and practice and foster critical thinking and communication skills. However, to adapt CBL to EBN coursework for a Master of Nursing degree, improve evidence-based practice (EBP) and enhance core competencies, the case design and operational procedures of CBL need to be further examined.

OBJECTIVES

To explore nursing master's students' experiences of dialogic CBL and case design and operational procedures regarding dialogic CBL.

DESIGN

A descriptive-qualitative study design was used.

SETTING AND PARTICIPANTS

The study was carried out in the nursing master's programme at a university in China. Twenty first-year nursing master's students who completed a 10-week EBN course were recruited using purposive sampling.

METHODS

Data were collected between September and December 2020 via in-depth semistructured interviews. The data were analysed using thematic analysis.

RESULTS

Four themes were identified: (1) 'learning theoretical EBN knowledge'; (2) 'improving clinical nursing ability'; (3) 'enhancing core competencies'; and (4) 'barriers to implementing dialogic CBL'.

CONCLUSIONS

The study provided a standardised CBL procedure based on students' experiences, which included preparation, group discussions, presentations, and teachers' feedback following the presentations, and these operational procedures were shown to be indispensable. The student experiences in this study should be referenced by nursing educators who apply this teaching method in other graduate and undergraduate nursing courses such as surgical nursing and nursing research.

Teaching LGBT+ Health and Gender Education to Future Doctors: Implementation of Case-Based Teaching

Improving the education of medical students and physicians can address the disparities in LGBT+ (lesbian, gay, bisexual, transgender, and others) health care. This study explored how teachers used case-based teaching to teach medical students about gender and LGBT+ health care and discussed the implementation and effectiveness of case-based teaching from the perspective of the teachers and students. This study employed the case study method and collected data through semi-structured interviews. This study used two gender courses in clinical psychiatric education as case studies. Two teachers and 19 medical students were recruited as participants. The findings of this study were as follows: (1) effective cases links theory to clinical practice and competency learning; (2) experience sharing by LGBT+ is highly effective; (3) discussions promote the effectiveness of case-based teaching; and (4) the challenges of case-based teaching included time limitations, the multiplexity of the cases, and multilevel learning. This study also found that using narrative cases is a form of narrative pedagogy, which can help students to integrate medicine, gender, and LGBT+ competency education. A successful narrative case–based teaching strategy involves teachers integrating knowledge related to gender, guiding students through the cases to understand the importance of these cases, and reflecting on the medical profession to make improvements. However, teachers face challenges in this approach, such as changes in the school’s teaching culture and a lack of institutional support.

Effects of blended versus offline case-centred learning on the academic performance and critical thinking ability of undergraduate nursing students: A cluster randomised controlled trial

OBJECTIVE

This study aimed to compare the effect of blended and offline case-centred learning on medical nursing education for undergraduate nursing students.

BACKGROUND

Technological advancements are rapidly changing nursing education in higher educational settings. Educational reform, especially regarding methods of teaching, has been the focus of nursing educators in recent years.

DESIGN

The research was conducted between September 2018 and July 2019 in China.

METHODS

Second-year undergraduate nursing students in two classes were enrolled for this study by cluster sampling. The study outcomes were academic performance and critical thinking ability, measured using the Critical Thinking Disposition Inventory-Chinese Version.

RESULTS

Students in the experimental class showed significantly higher improvements in academic performance than those in the control class. Compared with the control class, the pre-post difference in competency in critical thinking self-confidence in the experimental class was significantly greater (p = 0.037). In the experimental class, there was a significant improvement over the baseline in the dimension of critical thinking self-confidence (p = 0.022). In the control class, there was a significant improvement over the baseline in the total score (p = 0.029) and two of the seven dimensions: truth-seeking (p = 0.016) and systematicity (p = 0.005).

CONCLUSIONS

The use of blended case-centred learning showed promising results in improving students' academic performance. Both blended and offline case-centred learning were indicated to be effective educational approaches to improve the critical thinking ability of undergraduate nursing students and could be implemented for other nursing subjects in the future.

Online dental teaching practices during the COVID-19 pandemic: a cross-sectional online survey from China

Background

Coronavirus disease 2019 (COVID-19) emerged in China in December 2019. The COVID-19 pandemic hindered dental education, as school buildings were closed. Online dental teaching provided an alternative teaching tool for dental education. However, the efficiency of online dental teaching and student preferences for online dental teaching are unclear.

Aim

To investigate the satisfaction with online dental teaching practices among undergraduate dental students and standardized resident physician training students during the COVID-19 pandemic in China.

Methods

A total of 104 undergraduate dental students and 57 standardized resident physician training students from Zhejiang University participated in the study. A 12-item survey was conducted. This investigation included the teaching methods received, frequency of classes, degree of satisfaction, preferred teaching method, whether to participate in a course regarding COVID-19 prevention, and the effects of teaching. The percentages were then calculated and evaluated for each item.

Results

A total of 161 students (104 undergraduate dental students and 57 standardized resident physician training students) participated in this survey. All students had online dental classes during the COVID-19 pandemic. Lecture-based learning (LBL), case-based learning (CBL), problem-based learning (PBL), team-based learning (TBL), and research-based learning (RBL) were selected as teaching methods. Students were more satisfied with LBL and CBL than PBL, RBL, and TBL. The majority of students had more than four classes per week. The most selected protective measures were hand washing, wearing masks, and wearing gloves. A total of 46.6% of students participated in courses on COVID-19. After training, the students consciously chose to wear face shields and protective clothing.

Conclusions

Dental students accepted online dental learning during the COVID-19 pandemic. Students preferred LBL and CBL and were satisfied with the classes. Courses on COVID-19 helped students understand how to prevent COVID-19 transmission in the dental clinic.

Trainee doctors in medicine prefer case-based learning compared to didactic teaching

BACKGROUND

Sustaining interest and promoting deep learning is a challenge in any teaching method. The purpose of the study is to find the perception of trainee doctors in Internal Medicine and teaching faculty on the usefulness of case-based learning (CBL) and to compare assessment knowledge outcome with didactic seminars.

METHODS AND MATERIALS

We developed and conducted a CBL teaching program on eight topics in infectious diseases. First group had CBL and second group had didactic seminars. In step 1, a clinical case was introduced in stages. Learning objectives were formulated and topics were divided among the trainees. At step 2, trainees shared what they had learnt from self-directed learning. Faculty summarized the case and learning points. In the seminar group, trainees made presentations on the given topics. Trainees who had CBL underwent a questionnaire survey. Multiple choice questions-based test was administered for both the groups.

RESULTS

The trainee doctors and staff overwhelmingly found CBL to be more interesting, stimulating, and useful compared to didactic seminars. There was no statistical difference in the test scores.

CONCLUSIONS

CBL is a useful and interesting method of learning and should be employed more often in teaching for trainee doctors.

Application of problem-based learning and case-based learning integrated method in the teaching of maxillary sinus floor augmentation in implant dentistry

Background

Teaching of maxillary sinus floor augmentation (MSFA) is challenging for dental educators due to the varied sinus anatomy and high rate of complications. The method integrating problem-based learning and case-based learning (PBL-CBL method) may be more effective than the traditional teacher-centered method. The aim is to evaluate the efficacy of the PBL-CBL method in teaching MSFA.

Materials & Methods

Ninety-two students who received training between 2015 and 2017 at the Department of Implant Dentistry were divided randomly into an experimental group and a control group. Students in the experimental group were trained using the PBL-CBL method, while those in the control group were trained using the traditional teacher-centered method. After three months of training, a survey of the students’ opinions about the corresponding teaching method was carried out through a feedback questionnaire. A theory test was used to investigate the level of MSFA knowledge among the students. A case analysis was designed to test whether the students can apply the knowledge in solving new problems.

Results

Compared with the control method, the PBL-CBL method resulted in higher scores in both the theory test and the case analysis, and obtained a higher rate of satisfaction among the students. The difference in scores between the two methods were statistically significant (P < 0.01),

Conclusion

The PBL-CBL method resulted in better results regarding acquisition of academic knowledge, ability in case analysis and student satisfaction compared with the teacher-centered method. It may be a promising mode for teaching complex surgical techniques in implant dentistry and other dental fields.

Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology

Purpose: Case-based learning (CBL) is now used as a teaching strategy to promote clinical problem-solving ability. The purpose of this study was to determine whether CBL is superior to the traditional teaching method in teaching lung cancer curriculum to oncology students. Methods: This study was a randomized controlled trial, enrolled 80 first-year oncology postgraduates from Bengbu medical college in the past 3 years. They were randomized to divide into 2 groups, had courses with the same lung cancer contents and timing. The experimental group (n = 40) utilized the CBL method while the control group (n = 40) used the traditional lecture-based teaching method. A questionnaire was used to attain the students' learning satisfaction and self-efficacy of the course, and a post-study examination was used to assess end-of-course performance. Results: Complete data were obtained from participating students (n = 40 in CBL; n = 40 in traditional teaching). The CBL group performed significantly better in questionnaire and examination compared to traditional teaching groups. Students showed high levels of satisfaction and problem-solving ability in the CBL group. Conclusion: Compared with the traditional teaching method. The case teaching method is a more effective teaching method to improve the ability of problem-solving for graduate students in medical oncology.

Perceptions of Australian and Malaysian Educators in an Undergraduate Pharmacy Program on Case-based Learning

Objective. To determine the perceptions of lecturers toward case-based learning (CBL) and to elicit their feedback and opinions regarding the design of CBL sessions within the pharmacy curricula. Methods. One-on-one interviews were conducted with 10 academic staff members involved in teaching an undergraduate Bachelor of Pharmacy (BPharm) program. All sessions were audio-recorded and field notes were compiled. The recordings were transcribed, and thematic analysis of responses was performed. Results. Four key themes were identified: perceived benefits of CBL, challenges in implementing CBL within the curricula, characteristics of effective and engaging CBL, and relevance and implementation of CBL within the curriculum. Some of the specific benefits of CBL identified by participants included the applicability of knowledge learned to students' future role as pharmacists. Participants also identified challenges such as the design of CBL cases and course time constraints. Respondents also emphasized the need for more training for facilitators in how to design cases and facilitate sessions. Conclusion. While participants identified numerous benefits of CBL, they also identified challenges to implementing this learning method within the pharmacy school curriculum. Paying careful attention to selecting facilitators and providing appropriate facilitator training, in terms of facilitation and case design, is paramount in effectively implementing CBL sessions.

Promoting synergistic partnerships in low resource countries: a case study exemplar

OBJECTIVES/AIMS

The purpose of this discussion is to explore the dynamics of partnership and its impact on both nursing faculty at Hue University of Medicine and Pharmacy (HueUMP) and Health Volunteers Overseas (HVO) volunteers.

DESIGN

A case study approach was used to promote understanding of partnerships in global health.

DISCUSSION

Collaboration between HueUMP's nursing program and HVO is one of the most dynamic HVO nurse educator programs with five volunteer visits to Vietnam within a two-year period. Volunteer efforts include workshops to meet the diverse needs and interests of nursng faculty. We also emphasize the potential for ongoing strategic program planning integrating components from other nursing partnerships in the Southeast Asian region.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

If we are to continue meeting partnership goals, we must recognize that partnerships should evolve according to the goals of HueUMP nursing faculty and the context of nursing in Vietnam.

Effect of a PBL teaching method on learning about nursing care for patients with depression

BACKGROUND

Depression is a worldwide public health problem that requires the attention of qualified health professionals. The training of skilled nurses is a challenge for nursing instructors due to the complexity of this pathology.

OBJECTIVES

The aim was to analyse the declarative and argumentative knowledge acquired about depression by students receiving traditional expository instruction versus students receiving problem-based learning instruction.

METHODS

Quasi-experimental study with pre-test and post-test design in experimental and control group to measure differences in the improvement of declarative and argumentative knowledge. Non parametric tests were used to compare the scores between the experimental group and the control group, and between the pre-test and post-test in each group. 114 students participated in the study. Implementation of the study took place during the 2014-2015 academic year in the third year of the Nursing undergraduate degree courses in the University of the Basque Country (UPV/EHU) as part of the Mental Health Nursing subject.

RESULTS

The data indicated that there were no statistically significant differences between the two methodologies in regard to declarative knowledge in the care of patients with depression. Nevertheless, the argumentative capacity of the experimental group improved significantly with the problem-based learning methodology (p=0.000).

CONCLUSIONS

The results of the implementation indicated that problem-based learning was a satisfactory tool for the acquisition of argumentative capacity in depression nursing care. Still, working examples of teaching sequences that bridge the gap between general clinical practice and classroom practice remain an important goal for continuing research in nursing education.

Media Matter: The Effect of Medium of Presentation on Student's Recognition of Histopathology

INTRODUCTION

Pathology teaching has undergone transformation with the introduction of virtual microscopy as a teaching and learning tool.

AIM

To assess if dental students can identify histopathology irrespective of the media of presentation and if the media affect student's oral pathology case based learning scores. The perception of students towards "hybrid" approach in teaching and learning histopathology in oral pathology was also assessed.

MATERIALS AND METHODS

A controlled experiment was conduc-ted on year 4 and year 5 dental student groups using a perfor-mance test and a questionnaire survey.

RESULTS

A response rate of 81% was noted for the performance test as well as the questionnaire survey. Results show a significant effect of media on performance of students with virtual microscopy bringing out the best performance across all student groups in case based learning scenarios. The order of preference for media was found to be virtual microscopy followed by photomicrographs and light microscopy. However, 94% of students still prefer the present hybrid system for teaching and learning of oral pathology.

CONCLUSION

The study shows that identification of histo-pathology by students is dependent on media and the type of media has a significant effect on the performance. Virtual microscopy is strongly perceived as a useful tool for learning which thus brings out the best performance, however; the hybrid approach still remains the most preferred approach for histopathology learning.

Iranian Nursing Students' Experiences of Case-Based Learning: A Qualitative Study

The purpose of this study was to explore the experiences of undergraduate nursing students of the implementation of case-based learning in an emergency nursing course. The present qualitative study was conducted using the qualitative content analysis method. Participants consisted of 18 third year undergraduate nursing students selected through purposive sampling, which continued until the saturation of the data. Data were collected using semistructured interviews and were analyzed concurrently with their collection through the constant comparison method. The process of data analysis led to the emergence of 4 main themes, including "the continuum of knowledge from production to transfer competence," "a positive atmosphere of interaction," "the process of stress relieving," "the sense of role-playing in professional life," and the emergence of 12 subthemes signifying participants' experiences and perceptions with regard to the implementation of case-based learning (CBL) in teaching the emergency nursing course. The results of the present study showed that CBL is a stressful but pleasant and empowering experience for Iranian nursing students that develops critical thinking and stress management skills, reinforces peers' potentials, improves diagnostic abilities, and helps acquire professional competencies for use in future practices through the creation of a positive environment.

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.

A method of developing and introducing case-based learning to a preclinical veterinary curriculum

Case-based learning (CBL) has been introduced as part of a major review of the veterinary curriculum at the University of Bristol. The initial aim was to improve integration between all first year subjects, i.e., basic science disciplines (anatomy, physiology, and biochemistry), animal management, and professional studies, while highlighting the relevance by providing clinical context. The CBL was delivered as whole class sessions in a lecture theatre, as small group teaching facilities were not readily available, co-facilitated by two to four basic scientists and clinicians. Active learning tasks were included by using an audience response system and encouraging discussion. A case template was developed in PowerPoint and then populated by basic science and clinical staff in an iterative design process. Comments from a student focus group informed the design of the case sessions. Feedback collected from students via a survey after the first three cases suggested that CBL was well received and assisted students in integrating material taught in the first year units and was used to further improve the ongoing case design. The project team developed eight cases for Year 1 and is implementing CBL in various formats throughout the curriculum. There was a considerable time commitment in developing each case; however, the use of readily available software and the large group format overcame limitations, including resourcing small group sessions. This article reports a model that could be successfully adapted by other institutions wishing to use CBL to provide clinical context and promote integration of the basic sciences.

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.

Biosciences within the pre-registration (pre-requisite) curriculum: an integrative literature review of curriculum interventions 1990-2012

BACKGROUND

The learning of biosciences is well-documented to be problematic as students find the subjects amongst the most difficult and anxiety-provoking of their pre-registration programme. Studies suggest that learning consequently is not at the level anticipated by the profession. Curriculum innovations might improve the situation but the effectiveness of applied interventions has not been evaluated.

OBJECTIVE

To undertake an integrative review and narrative synthesis of curriculum interventions and evaluate their effect on the learning of biosciences by pre-registration student nurses. Review methods A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar for empirical research studies was designed to evaluate the introduction of a curriculum intervention related to the biosciences, published in 1990-2012. Studies were evaluated for design, receptivity of the intervention and impact on bioscience learning.

RESULTS

The search generated fourteen papers that met inclusion criteria. Seven studies introduced on-line learning packages, five an active learning format into classroom teaching or practical sessions, and two applied Audience Response Technology as an exercise in self-testing and reflection. Almost all studies reported a high level of student satisfaction, though in some there were access/utilization issues for students using on-line learning. Self-reporting suggested positive experiences, but objective evaluation suggests that impacts on learning were variable and unconvincing even where an effect on course progress was identified. Adjunct on-line programmes also show promise for supporting basic science or language acquisition.

CONCLUSIONS

Published studies of curriculum interventions, including on-line support, have focused too heavily on the perceived benefit to students rather than objective measures of impact on actual learning. Future studies should include rigorous assessment evaluations within their design if interventions are to be adopted to reduce the 'bioscience problem'.

Concept mapping in a critical care orientation program: a pilot study to develop critical thinking and decision-making skills in novice nurses

BACKGROUND

Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities.

METHODS

This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention.

RESULTS

The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators.

CONCLUSION

Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills.

Students' well-being in nursing undergraduate education

BACKGROUND

Although previously the Job-Demand-Control-Support model has been successfully applied in many studies in the field of health care and education, the model was never used for the evaluation of the nursing students' well-being.

OBJECTIVES

The aim of this study was to promote nursing students' well-being. The objective was to verify whether the Job-Demand-Control-Support model is appropriate for the evaluation of their well-being.

DESIGN

The Job-Demand-Control-Support model was implemented and investigated in a multiple-case study, which consisted of two phases. In phase I the students' well-being along with the perceived levels of control, support, and demand for each individual student during their study were identified. These results were used in phase II, where the usefulness of the presented model was evaluated.

SETTINGS

The study was performed at the end of the academic year 2009/2010 in two institutions: Tampere University of Applied Sciences, School of Health Care, Finland (institution 1); and the University of Primorska, Faculty of Health Sciences, Slovenia (institution 2).

PARTICIPANTS

Participants of the study were nursing graduates who finished their studies in 2009/2010 and the Vice-Deans for education of both institutions. The final sample included 83 students in institution 1 and 79 students in institution 2.

METHODS

The case study was combined with a survey (phase I) and an interview (phase II).

RESULTS

Although the students' well-being in these two institutions was different, most students of both institutions perceived their studies as low strain, placid, and only some of the students in both institutions had a high risk of malaise. The Vice-Deans for education of both institutions confirmed that the application of the Job-Demand-Control-Support model provided relevant information on the nursing students' well-being, which helped in planning improved nursing study programmes.

CONCLUSIONS

This study demonstrated that the Job-Demand-Control-Support model is appropriate for estimating undergraduate nursing students' well-being.

A systematic review of critical thinking in nursing education

OBJECTIVES

This review aimed to explore how critical thinking is perceived in previous studies of nursing education, and analyse the obstacles and strategies in teaching and learning critical thinking mentioned in these studies.

DESIGN

Systematic review.

DATA SOURCES

This review was based on the following five databases: The British Nursing Index, Ovid Medline, CINAHL, PsycINFO and Scopus.

REVIEW METHODS

After the screening process and evaluation through using the Critical Appraisal Skills Programme tool, 17 studies were identified that met the inclusion and quality criteria. The studies were read through several times and analysed through thematic synthesis.

RESULTS

A total of three themes were developed. The first theme, components for critical thinkers, suggests the abilities and attitudes that critical thinkers should have. The other two themes, influential factors of critical thinking in nursing education, and strategies to promote critical thinking, describe the obstacles and strategies in teaching and learning critical thinking.

CONCLUSIONS

The 17 studies illustrated that the definition and concept of critical thinking may change from time to time, and hence there is a need to clarify educators' perspective towards critical thinking. There is also a need to evaluate the efficacy of the new strategies mentioned in several selected studies, such as art-based, questioning, cross-cultural nursing experience, and preceptorship. With a better understanding of critical thinking in nursing education, educators and nursing faculty are able to develop better strategies in enhancing critical thinking development in nursing students, in turn preparing them for future clinical practice.

Global teaching and training initiatives for emerging cohort studies

A striking disparity exists across the globe, with essentially no large-scale longitudinal studies ongoing in regions that will be significantly affected by the oncoming non-communicable disease epidemic. The successful implementation of cohort studies in most low-resource research environments presents unique challenges that may be aided by coordinated training programs. Leaders of emerging cohort studies attending the First World Cohort Integration Workshop were surveyed about training priorities, unmet needs and potential cross-cohort solutions to these barriers through an electronic pre-workshop questionnaire and focus groups. Cohort studies representing India, Mexico, Nigeria, South Africa, Sweden, Tanzania and Uganda described similar training needs, including on-the-job training, data analysis software instruction, and database and bio-bank management. A lack of funding and protected time for training activities were commonly identified constraints. Proposed solutions include a collaborative cross-cohort teaching platform with web-based content and interactive teaching methods for a range of research personnel. An international network for research mentorship and idea exchange, and modifying the graduate thesis structure were also identified as key initiatives. Cross-cohort integrated educational initiatives will efficiently meet shared needs, catalyze the development of emerging cohorts, speed closure of the global disparity in cohort research, and may fortify scientific capacity development in low-resource settings.

Developing a service user facilitated, interactive case study--a reflective and evaluative account of a teaching method

This article describes the development and ongoing evaluation of a method of service user facilitated case study in health and social care education in a U.K. University. An action research approach (Norton 2009) has been used in which the aim of the work is to improve personal practice with the aim of enhancing the student experience. The paper is written from the perspective of the service user with support from an academic colleague. The paper describes how a narrative monologue, over time is developed into an interactive case study. In draws upon literature from service user involvement, case study and pedagogic action research. The research group are health and social care students both under and post-graduates. Analysis is via a session evaluation form. Thematic analysis draws out key themes. Firstly that first person accounts have a reasonance and interest with students. Secondly that the built in thinking time helps students to develop their reflection and critical thinking skills. Furthermore a theme emerges on how the technique supports students with their future careers. Finally the author reflects on how the approach enables the development of teaching practice and enhanced student learning.

The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23

BACKGROUND

Case-based learning (CBL) is a long established pedagogical method, which is defined in a number of ways depending on the discipline and type of 'case' employed. In health professional education, learning activities are commonly based on patient cases. Basic, social and clinical sciences are studied in relation to the case, are integrated with clinical presentations and conditions (including health and ill-health) and student learning is, therefore, associated with real-life situations. Although many claims are made for CBL as an effective learning and teaching method, very little evidence is quoted or generated to support these claims. We frame this review from the perspective of CBL as a type of inquiry-based learning.

AIM

To explore, analyse and synthesise the evidence relating to the effectiveness of CBL as a means of achieving defined learning outcomes in health professional prequalification training programmes.

SELECTION CRITERIA

We focused the review on CBL for prequalification health professional programmes including medicine, dentistry, veterinary science, nursing and midwifery, social care and the allied health professions (physiotherapy, occupational therapy, etc.). Papers were required to have outcome data on effectiveness.

SEARCH STRATEGIES

The search covered the period from 1965 to week 4 September 2010 and the following databases: ASSIA, CINAHL, EMBASE, Education Research, Medline and Web of Knowledge (WoK). Two members of the topic review group (TRG) independently reviewed the 173 abstracts retrieved from Medline and compared findings. As there was good agreement on inclusion, one went onto review the WoK and ASSIA EndNote databases and the other the Embase, CINAHL and Education Research databases to decide on papers to submit for coding. Coding and data analysis: The TRG modified the standard best evidence medical education coding sheet to fit our research questions and assessed each paper for quality. After a preliminary reliability exercise, each full paper was read and graded by one reviewer with the papers scoring 3-5 (of 5) for strength of findings being read by a second reviewer. A summary of each completed coding form was entered into an Excel spread sheet. The type of data in the papers was not amenable to traditional meta-analysis because of the variability in interventions, information given, student numbers (and lack of) and timings. We, therefore, adopted a narrative synthesis method to compare, contrast, synthesise and interpret the data, working within a framework of inquiry-based learning.

RESULTS

The final number of coded papers for inclusion was 104. The TRG agreed that 23 papers would be classified as of higher quality and significance (22%). There was a wide diversity in the type, timing, number and length of exposure to cases and how cases were defined. Medicine was the most commonly included profession. Numbers of students taking part in CBL varied from below 50 to over 1000. The shortest interventions were two hours, and one case, whereas the longest was CBL through a whole year. Group sizes ranged from students working alone to over 30, with the majority between 2 and 15 students per group. The majority of studies involved single cohorts of students (61%), with 29% comparing multiple groups, 8% involving different year groups and 2% with historical controls. The outcomes evaluation was either carried out postintervention only (78 papers; 75%), preintervention and postintervention (23 papers; 22%) or during and postintervention (3 papers; <3%). Our analysis provided the basis for discussion of definitions of CBL, methods used and advocated, topics and learning outcomes and whether CBL is effective based on the evaluation data.

CONCLUSION

Overwhelmingly, students enjoy CBL and think that it enhances their learning. The empirical data taken as a whole are inconclusive as to the effects on learning compared with other types of activity. Teachers enjoy CBL, partly because it engages, and is perceived to motivate, students. CBL seems to foster learning in small groups though whether this is the case delivery or the group learning effect is unclear.