The development and evaluation of a 'blended' enquiry based learning model for mental health nursing students: "making your experience count"

Exploring nursing students' learning experiences and attitudes toward older persons in a gerontological nursing course using self-regulated online enquiry-based learning during the COVID-19 pandemic: A mixed-methods study

BACKGROUND

During the COVID-19 pandemic, universities adopted online teaching as the primary teaching and learning method. Most of the online teaching, however, has been limited to the broadcasting of asynchronous lectures and sharing of teaching materials.

OBJECTIVES

To explore undergraduate nursing students' self-regulated learning experiences, satisfaction, and attitudes toward older persons in a gerontological nursing course using online self-regulated enquiry-based learning (EBL) during the COVID-19 pandemic.

DESIGN

A mixed-methods design was adopted.

SETTING

A university in Hong Kong providing pre-registration nursing programmes.

PARTICIPANTS

155 students studying in the fourth year in a five-year Bachelor of Nursing programme participated in the quantitative study in which 18 joined the focus groups (4 groups with group size of 4-5).

METHODS

Five video-based scenarios along with two interactive online workshops, a mind-map development exercise, gamified assessments, reading materials, group discussions, and presentations were adopted in a gerontological nursing course offered in 2019-2020 to enhance the students' learning, driven by a process of enquiry. Attitudes toward older people were measured at baseline and one week after the course (post-test). Information on self-regulated learning experiences, satisfaction, and confidence were collected at post-test only. Paired t-tests and descriptive statistics were used to analyse the data. Focus groups were conducted through semi-structured interviews and transcribed verbatim for inductive content analysis.

RESULTS

A significant improvement was demonstrated in the students' attitude toward older people. The students appreciated the opportunities provided by the online EBL to apply key concepts of gerontology in the teaching and learning activities and to enhance their critical thinking skills. Three major themes were revealed from the focus group: Perception of the teaching pedagogy, Improvement of cognitive skills, and Positive and negative aspects of the learning experience.

CONCLUSIONS

The online self-regulated EBL improved the students' online learning experience in a gerontological nursing course during the pandemic and improved their attitudes toward older people.

Preregistration adult nursing students' experiences of online learning: a qualitative study

BACKGROUND

Online learning (OL) is widely used in UK preregistration nursing programmes and the latest Nursing and Midwifery Council professional education standards state digital technology must be embedded in the curriculum. An exploration of preregistration adult nursing students' experiences of OL considers how technology supports learning theory and practice, and assists in designing and delivering effective OL in future programmes.

AIM

This study aimed to explore preregistration adult nursing students' OL experiences.

METHOD

Two focus groups with students were held and thematic analysis carried out.

FINDINGS

Three main themes emerged regarding OL: advantages, disadvantages and preferences. The main advantages included time, accessibility and convenience, being able to revisit learning and the variety of approaches. Disadvantages included inadequate communication, support and interaction. Students preferred an adequate balance of OL with traditional teaching, more communication, synchronous OL, preparation and support.

CONCLUSION

OL is valuable to adult nursing students, providing convenience and flexibility. While it has advantages, the disadvantages and preferences require addressing to ensure future programmes are effective and meet nursing students' requirements.

Development and evaluation of a technology-enhanced, enquiry-based learning program on managing neonatal extravasation injury: A pre-test/post-test mixed-methods study

BACKGROUND

Extravasation injury remains a significant preventable cause of morbidity and mortality in neonates. Equipping nursing students with the requisite knowledge and skills is essential for appropriate prevention, early detection, and management of extravasation injury.

OBJECTIVES

To develop a technology-enhanced, enquiry-based learning program for nursing students on the prevention and management of neonatal extravasation injury and examine its impact on their knowledge, approaches to studying and experience of learning.

DESIGN

A pre-test/post-test study with qualitative evaluation.

SETTINGS

Two university pre-registration nursing programs in Hong Kong.

PARTICIPANTS

A total of 192 senior-year nursing students.

METHODS

A novel learning program was developed comprising 25 scenario-based video vignettes supplemented with critical-thinking exercises, discussion guides, interactive games, reading materials and a 3-hour in-class interactive workshop. Students received unlimited online access to the program. Data were collected at baseline and one-month post-workshop. Outcomes were students' level of knowledge of prevention and management of extravasation injuries and related care, approaches to studying, and experience of learning. Paired t-tests were performed on pre- post-test outcome data and individual semi-structured interviews were conducted at one-month post-workshop, transcribed verbatim and analyzed thematically.

RESULTS

There were statistically significant improvements in students' level of knowledge and use of a deep approach to learning at one month compared with baseline. Students were highly satisfied with the program, appreciating the video vignettes and interactive small group discussions with academics and clinicians. Suggestions for enhancing the program included more time for the workshop, interaction with clinicians, and details on the administration of neonatal medications and dosages.

CONCLUSIONS

This study showed that a novel technology-enhanced, enquiry-based learning program was effective in enhancing nursing students' knowledge of the prevention and management of neonatal extravasation injury, approaches to studying and experience of learning.

Blended learning versus face-to-face learning in an undergraduate nursing health assessment course: A quasi-experimental study

BACKGROUND

Blended learning, which integrates face-to-face and online instruction, is increasingly being adopted. A gap remains in the literature related to blended learning, self-efficacy, knowledge and perceptions in undergraduate nursing.

OBJECTIVES

To investigate outcomes of self-efficacy, knowledge and perceptions related to the implementation of a newly blended course.

DESIGN

This was a quasi-experimental pre-post test design.

SETTING

This study was conducted at an undergraduate university in Alberta, Canada.

PARTICIPANTS

A total of 217 second-year undergraduate nursing students participated and 187 participants completed all study components.

METHODS

A convenience sampling method was used. Data were collected at the start and end of the semesters. Data were analyzed using descriptive and inferential statistics using R(3.4.3) and R-Studio(1.1.423).

RESULTS

There were no significant differences in self-efficacy scores between groups or in the pre-post surveys (p > 0.100) over time. There was no significant difference in knowledge between the blended online and face-to-face groups (p > 0.100). For students in the blended course, perceptions of the online learning environment were positive.

CONCLUSION

Blended learning has the potential to foster innovative and flexible learning opportunities. This study supports continued use and evaluation of blended learning as a pedagogical approach.

The mPOWERED Electronic Learning System for Intimate Partner Violence Education: Mixed Methods Usability Study

Background

Nurse practitioners are a common resource for victims of intimate partner violence (IPV) presenting to health care settings. However, they often have inadequate knowledge about IPV and lack self-efficacy and confidence to be able to screen for IPV and communicate effectively with patients.

Objective

The aim of this study was to develop and test the usability of a blended learning system aimed at educating nurse practitioner students on topics related to IPV (ie, the mPOWERED system [Health Equity Institute]).

Methods

Development of the mPOWERED system involved usability testing with 7 nurse educators (NEs) and 18 nurse practitioner students. Users were asked to complete usability testing using a speak-aloud procedure and then complete a satisfaction and usability questionnaire.

Results

Overall, the mPOWERED system was deemed to have high usability and was positively evaluated by both NEs and nurse practitioner students. Respondents provided critical feedback that will be used to improve the system.

Conclusions

By including target end users in the design and evaluation of the mPOWERED system, we have developed a blended IPV learning system that can easily be integrated into health care education. Larger-scale evaluation of the pedagogical impact of this system is underway.

Perceptions toward a pilot project on blended learning in Malaysian family medicine postgraduate training: a qualitative study

BACKGROUND

Blended learning (BL) is a learning innovation that applies the concept of face-to-face learning and online learning. However, examples of these innovations are still limited in the teaching of postgraduate education within the field of family medicine. Malaysian postgraduate clinical training, is an in-service training experience and face-to-face teaching with the faculty members can be challenging. Given this, we took the opportunity to apply BL in their training. This study provides an exploration of the perceptions of the educators and students toward the implementation of BL.

METHODS

A qualitative approach was employed using focus group discussions (FGD) and in-depth interviews (IDI) at an academic centre that trains family physicians. Twelve trainees, all of whom were in their hospital specialty's rotations and five faculty members were purposively selected. Three FGDs among the trainees, one FGD and two IDIs among the faculty members were conducted using a semi-structured topic guide. Data were collected through audio-recorded interviews, transcribed verbatim and checked for accuracy. A thematic approach was used to analyse the data.

RESULTS

There were four main themes that emerged from the analysis. Both educators and trainees bill the perspective that BL encouraged continuity in learning. They agreed that BL bridges the gap in student-teacher interactions. Although educators perceived that BL is in concordance with trainees learning style, trainees felt differently about this. Some educators and trainees perceived BL to be an extra burden in teaching and learning.

CONCLUSION

This study highlights a mix positive and negative perceptions of BL by educators and trainees. BL were perceived positively for continuity in learning and student-teacher interaction. However, educator and learner have mismatched perception of learning style. BL was also perceived to cause extra burden to both educators and learners. Integrating BL to a traditional learning curriculum is still a challenge. By knowing the strengths of BL in this setting, family medicine trainees in Malaysia can use it to enhance their current learning experience. Future study can investigate different pedagogical designs that suit family medicine trainees and educators in promoting independent learning in postgraduate training.

Communication in mental health nursing - Bachelor Students' appraisal of a blended learning training programme - an exploratory study

Background

It is important that mental health nursing students at Bachelor level obtain effective communication skills. Many students dread the fact that in the mental health field they will encounter patients and relatives with various backgrounds and personalities. Large classes and limited teaching resources in nursing education are challenging. To prepare students for mental health nursing practice, a communication skills course based on the blended learning method was developed and carried out at two different campuses.

The aim of the study is to explore Bachelor nursing students’ appraisal of blended learning methods for enhancing communication skills in mental health nursing.

Methods

This study employed an exploratory design. Teaching and information materials were available on the learning management system (LMS). Videotaped role play training was carried out in the Simulation Department. Data were collected after the course by means of a questionnaire with closed and open-ended questions. The response rate was 59.2%. Quantitative data were analysed using the Statistical package for the Social Sciences (SPSS) and the Kruskal Wallis test, while qualitative data were analysed by content analysis based on Graneheim and Lundman’s approach.

Results

No impact of background variables was observed. Students appreciated teachers’ participation in role play and immediate feedback was considered especially important for learning outcomes. The students perceived that their communication skills and knowledge had improved after completing the blended learning programme.

Conclusions

According to the nursing students, blended learning is an appropriate method for improving communication skills in preparation for mental health nursing. Blended learning makes it possible to build flexible courses with limited resources.

Electronic supplementary material

The online version of this article (10.1186/s12912-018-0288-9) contains supplementary material, which is available to authorized users.

Assessment in clinical education: A comparison between a generic instrument and a course-specific criterion-based instrument

Assessment of students’ clinical performance and reasoning raises critical questions of whether learning outcomes have been reached and whether the aims of a course/education programme have been fulfilled. The aim of this study was to compare two assessment instruments in clinical education. A cross-sectional, comparative design was used. Nursing students and supervisors from five universities and university colleges in Sweden were included in the study. A sample of 435 students was used. Data were collected with study-specific questionnaires targeted for the two groups, nursing students and supervisors, and were analysed using cross-tabulation, chi-square with WinSTAT. Students perceived supervisors using the instrument Assessment of Clinical Education (AClEd) to be more aware of what to assess and they experienced more support from the ‘AClEd supervisors’ as compared to the supervisors using the second instrument, the Assessment form for Clinical education (AssCe). Furthermore, the AClEd assessment was perceived to be fairer compared to the AssCe assessment. The criterion-referenced assessment instrument AClEd was perceived, by both nursing students and supervisors, to give a clearer view of the learning outcome and the possibility of a fair and comprehensive assessment.

Investigation of blended learning video resources to teach health students clinical skills: An integrative review

OBJECTIVES

The aim of this review is to inform future educational strategies by synthesising research related to blended learning resources using simulation videos to teach clinical skills for health students.

DESIGN

An integrative review methodology was used to allow for the combination of diverse research methods to better understand the research topic. This review was guided by the framework described by Whittemore and Knafl (2005), DATA SOURCES: Systematic search of the following databases was conducted in consultation with a librarian using the following databases: SCOPUS, MEDLINE, COCHRANE, PsycINFO databases. Keywords and MeSH terms: clinical skills, nursing, health, student, blended learning, video, simulation and teaching.

REVIEW METHODS

Data extracted from the studies included author, year, aims, design, sample, skill taught, outcome measures and findings. After screening the articles, extracting project data and completing summary tables, critical appraisal of the projects was completed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Ten articles met all the inclusion criteria and were included in this review. The MMAT scores varied from 50% to 100%. Thematic analysis was undertaken and we identified the following three themes: linking theory to practice, autonomy of learning and challenges of developing a blended learning model. Blended learning allowed for different student learning styles, repeated viewing, and enabled links between theory and practice. The video presentation needed to be realistic and culturally appropriate and this required both time and resources to create.

CONCLUSIONS

A blended learning model, which incorporates video-assisted online resources, may be a useful tool to teach clinical skills to students of health including nursing. Blended learning not only increases students' knowledge and skills, but is often preferred by students due to its flexibility.

Reflective Practice: A Comparative Dimensional Analysis of the Concept in Nursing and Education Studies

AIM

This paper reports on an analysis of the concept of reflective practice.

BACKGROUND

Reflective practice, a concept borrowed from the field of education, is widely used in nursing. However, to date, no study has explored whether this appropriation has resulted in a definition of the concept specific to the nursing discipline.

DATA SOURCES

A sample comprised of 42 articles in the field of nursing drawn from the CINAHL database and 35 articles in education from the ERIC database (1989-2013) was analyzed.

REVIEW METHOD

A concept analysis using the method proposed by Bowers and Schatzman was conducted to explore the differing meanings of reflective practice in nursing and education.

RESULTS

In nursing, the dimensions of the concept differ depending on context. In the clinical context, the dimensions may be summarized as theory-practice gap, development, and caring; in training, as learning, guided process, and development; and in research, as knowledge, method, and social change. In education, the concept is also used in the contexts of training (the dimensions being development, deliberate review, emotions, and evaluation) and research (knowledge, temporal distance, and method). The humanist dimension in nursing thus reflects a use of the concept more specific to the discipline.

CONCLUSION

The concept analysis helped clarify the meaning of reflective practice in nursing and its specific use in the discipline. This observation leads to a consideration of how the concept has developed since its appropriation by nursing; the adoption of a terminology particular to nursing may well be worth contemplating.

Mental Health Education and Virtual Learning Environments (VLEs) in Pre-registration Nursing Degrees: Follow the Leaders?

Virtual learning environments (VLEs) are now commonly used, worldwide, as teaching and learning platforms for pre-registration nursing education. However, there is only limited evidence in the research literature to suggest that VLEs are employed to support the education of student nurses about mental health and illness. This article describes the work of mental health nurse educators who have taken the lead by providing case-based simulations on VLEs, thereby enabling students to acquire knowledge and develop the clinical skills required for practice in mental health settings. Benefits of VLEs include their flexibility and accessibility, and also the opportunity they provide for students to engage with Web 2.0 technologies. Leadership in education must include the utilization of the most current pedagogical tools and strategies, as well as staying abreast of contemporary evidence-based practices in clinical settings, to support the knowledge acquisition and practice-based learning of the registered nurses (RNs) of the future.

Academic reflective writing: a study to examine its usefulness

Reflection is widely regarded as important for learning from practice in Nursing. Academic reflective writing (ARW) is increasingly being used to assess reflective practice. However, there is currently scant literature on ARW, which is extremely complex, requiring students to link their own experiences to published literature. There are also concerns in the literature about the validity of ARW as a medium of assessment. In this paper, an exploratory discussion on ARW is illustrated with reference to the views of 8 self-selected students on a course for post-registered nurses. These students found ARW extremely challenging, and highlighted a range of difficulties associated with it. In conclusion, it is argued that the student experience of ARW warrants further investigation. In addition, it is suggested that either scaffolding should be put in place to facilitate the production of successful ARW, or alternatives should be explored.

Knowledge transfer from an e-learning course to clinical practice

BACKGROUND

Continuing education is essential in improving practical psychiatric nursing skills. However, little is known about how knowledge gained in continuing education is transferred to nurses' daily work.

OBJECTIVES

To describe the transfer of knowledge gained from an e-learning course to daily practice.

DESIGN

Qualitative study design.

SETTINGS

One hospital district in Southern Finland with three specialized psychiatric wards (acute, rehabilitation, geriatric wards).

PARTICIPANTS

Nursing staff (N=53) were recruited and 35 participated voluntarily in the e-learning continuing education course in spring 2009.

METHODS

The data comprised nurses' reflective writing during the e-learning course and course evaluation forms completed after the course. We used qualitative design with inductive content analysis to analyze nurses' writings.

RESULTS

The nurses were willing and able to transfer what they learned to their daily practice including the course themes, communication and co-operation among staff members, understanding of preventive and alternative treatment methods and critical thinking regarding one's own work. After the e-learning course the nurses were able to identify development areas such as issues related to staff members' daily work, the patient's role on the ward, alternative methods to avoid coercion, issues pertaining to the care environment on the ward, psychiatric nurses' education, and making an action plan for aggressive situations. All nurses would recommend the course to other nurses.

CONCLUSIONS

New knowledge is easily adopted and transferred to daily practice.

Quality and substance of educational strategies for mental health in undergraduate nursing curricula

In Australia, there is a workforce shortage of nurses in the mental health sector, and it is essential that universities play a part in the recruitment of nurses to work in this area. In this article, we present a literature review of educational strategies for mental health in undergraduate nursing curricula and how these align with the recommendations of the Mental Health Nurse Education Task Force. We reviewed quantitative and qualitative research from 2005 to 2012. Twelve studies from Australia and elsewhere of different types of educational courses and strategies were included for this review. The key topics identified were in relation to a general overview of programmes outlining the content and outcomes, clinical placement strategies, involvement of consumers and mental health nurses in curriculum delivery and oversight, e-learning strategies, and implementation of mental health majors. Finally, limitations with considering the literature as a whole were highlighted, and recommendations made for future changes and research.

Planning an objective and need based curriculum: the logistics with reference to the undergraduate medical education in biochemistry

PURPOSE

The medical education is recently being transformed into several domains in order to adapt to the need and the value based academics which is required for the quality doctors who serve the community. Presently, the biochemistry curricula for the graduate students of medicine have been questioned by as many experts, because of their multiple lacunae. In this review, we would like to highlight the scenario which is related to the existing biochemistry curricula for graduate medical students, which have been followed in several medical schools and universities and we also hope to share our ideas for implementing objective and pragmatic curricula. Evidence based research, wherein the articles which are related to innovative teaching-learning tools are collected and the pros and cons which are related to the different methods analyzed in biochemistry point of view.

CONCLUSION

Rapid changes in the content of the curriculum may not be required, but a gradual introduction of the novel approach and the methods of teaching biochemistry can be adopted into the curriculum.

Developing an assessment tool for intended learning outcomes in clinical practice for nursing students

This report describes the development of a new criterion based reference tool to assess nursing knowledge and competence in clinical practice. Nursing education has changed from educating a profession, based on tested experience, to being based on a scientific approach and research based knowledge. Assessment should be capable of measuring whether intended learning outcomes have been reached or not, and if the aims of a course have been fulfilled in order to ensure safe and competent nursing care. The intended learning outcomes from a first year course syllabus were integrated and formed into a three-graded criterion-referenced assessment tool, Assessment of Clinical Education, (AClEd). The AClEd is to be seen as a template, and may be tailor-made in accordance to the objectives, level and criteria of a specific course. The tool showed validity in assessing nursing skills not only the nursing student's ability to perform a task but also, most importantly, the quality of nursing care.