Randomized comparison between objective-based lectures and outcome-based concept mapping for teaching neurological care to nursing students

The effect of outcome-based education on clinical performance and perception of pediatric care of the third-year nursing students in Mongolia

BACKGROUND

Mongolian government has set improvement of clinical proficiency of nursing students as one of its priorities. Nursing professionals have the sentinel role in providing healthcare services in rural areas. Outcome-based education (OBE) offers a promising pedagogical approach to actively mentally engage students to strengthen their clinical proficiencies. We implemented a pilot project with the objective of comparing students' clinical performance under OBE with our traditional didactic techniques.

METHODS

The researchers implemented a non-equivalent two-armed quasi-experimental post-test-only' design approach study. The intervention arm (n = 34) received OBE pediatric training, while the control arm (n = 32) received the traditional pedagogical pediatric nursing training. Each arm of the study completed 16 hours of theory, 32 hours of clinical skills practice and 32 hours of seminars in pediatric nursing care. Data were collected using a five-section instrument, Demographic, Competency Inventory, Nursing Students' Satisfaction, Course Experience, and Objective Structured Clinical Examination. Performance and knowledge proficiencies were evaluated by applying the two-sided independent T-test. The distributions of categorical variables were assessed by Fisher's exact test or chi-squared test of significance.

RESULTS

The intervention arm had higher mean score value in the competency inventory ([Formula: see text] = 238.70, SD = ± 23.07) compared to the control arm ([Formula: see text] = 222.11, SD = ± 39.94) (P = 0.04); similarly, the mean value for nursing students' satisfaction was higher for the intervention arm ([Formula: see text] = 117.87, SD = ± 15.94) compared to the control group ([Formula: see text] = 109.76, SD = ± 16.94) (P = 0.049). Additionally, the difference in the mean value for course experience questionnaire between the intervention arm ([Formula: see text] = 125.33, SD = ± 19.30) and the control arm ([Formula: see text] = 110.41, SD = ± 11.28) was statistically significant (P = 0.0001). Finally, the intervention arm had a higher mean value ([Formula: see text] = 85.40, SD = ± 6.11) for objective structural clinical examination compared to the control arm ([Formula: see text] = 81.56, SD = ± 7.01) (P = 0.023).

CONCLUSION

OBE pedagogical approach offers promising benefits to improving nursing students' clinical competencies; additionally, the OBE approach seems to increase students' satisfactions with their clinical curriculum.

Comparison lecture and concept map methods on the level of learning and satisfaction in puerperal sepsis education of midwifery students: a quasi-experimental study

BACKGROUND

Education and training about emergency cases are necessary for different medical groups such as midwives. Teaching puerperal sepsis is important for midwives. The teaching method is one of the challenges of the educational system in universities. This study was conducted to compare lecture and concept map methods on the level of learning and satisfaction in puerperal sepsis education of midwifery students.

METHOD

This semi-experimental study was conducted in 2022 at Ardabil Nursing and Midwifery School on 50 midwifery students. Students randomly were placed in lecture and concept map teaching groups. To collect data, a 23-question satisfaction questionnaire and a 15-question test taken from the WHO books on the management of puerperal sepsis were used to check students' knowledge and learning. The data were analyzed by using descriptive statistics and independent and paired t-test SPSS software.

FINDINGS

The average learning score of the students after teaching in the concept map group was 10.28 ± 1.90 and the lecture group 9.20 ± 1.70, the difference was statistically significant (p = 0.04). The average satisfaction score in the concept map group was 107.92 ± 4.46 and in the lecture group 105.68 ± 6.84, this difference was statistically significant (p = 0.03).

CONCLUSION

The teaching of puerperal sepsis with the concept map method had a greater effect on the learning and satisfaction of midwifery students. Therefore, it is recommended to use this educational method.

Effectiveness of the use of concept maps and simulated cases as a teaching-learning strategy in enhancing the learning confidence of baccalaureate nursing students: A qualitative approach

BACKGROUND

Didactic lectures and exam-oriented learning can lead to students becoming passive learners who rely on rote memory. This learning style negatively impacts their ability to cultivate the core nursing values and critical thinking.

OBJECTIVES

This study aimed to investigate the impact of a concept mapping teaching-learning strategy on undergraduate nursing students' ability to integrate theoretical biosciences knowledge into care practice and on their skills in critical thinking and teamwork.

METHODS

A qualitative research design was adopted. A course entitled Evaluation and Analysis of Adult Nursing Cases was developed based on a concept mapping strategy involving 24 simulated cases relevant to medical and surgical nursing. The participants were students from the two-year undergraduate nursing programme at a university in Taiwan. Data were collected from September 2020 to February 2021. Qualitative data were collected from semi-structured face-to-face interviews with 20 students and from 100 reflective reports on students' learning journeys. The data were analysed using qualitative content analysis.

RESULTS

Two major themes were identified: (1) changes in learning style and thinking and (2) rewards from learning. The participants reported that their learning style had changed from reliance on rote learning to image memory, and their thinking process from linear (cause-effect) to multifaceted thinking at different levels. The teaching and learning strategies contributed to feelings of ability advancement and psychological safety, which led to learning achievement and confidence.

CONCLUSION

The use of a concept mapping strategy and simulated cases enhanced students' learning by enabling them to integrate theoretical knowledge and improve their thinking abilities. The teaching and learning strategies helped participants in learning about psychological safety and increased their learning confidence.

Effects of a multifaceted neurological assessment educational program in nursing students: A randomized crossover study

AIM

This study aimed to verify the effects of a multifaceted neurological assessment educational program on neurological assessment-related knowledge, skills, communication ability and self-efficacy in nursing students.

BACKGROUND

Nurses should be equipped with optimal neurological assessment competency to ensure quality care for patients with neurological symptoms.

DESIGN

This study involved a waitlist control group with a randomized crossover design.

METHODS

Fourth-year nursing students were randomly assigned to an intervention group (n = 28) or a waitlist control group (n = 27). Pre- and post-intervention differences in neurological assessment knowledge, skills, communication ability and self-efficacy between the intervention and the waitlist control group were analyzed using generalized estimated equations.

RESULTS

The nursing students in the intervention group showed significantly improved knowledge, skills, communication ability and self-efficacy scores compared with those in the waitlist control group. Scores related to knowledge, skills and communication ability were maintained and self-efficacy scores had further increased at 2 weeks after the educational program in the intervention group.

CONCLUSIONS

Our multifaceted neurological assessment educational program is useful for improving nursing students' knowledge, skills, communication ability and self-efficacy.

The effect of competency-based education on clinical performance of health care providers: A systematic review and meta-analysis

AIM

This study aimed to investigate the effects of competency-based education on the clinical performance of health care providers.

BACKGROUND

Having in mind the importance of developing an intervention to enhance the clinical performance of health care providers, the researchers carried out the present study to investigate the effect of competency-based education on the clinical performance of health care providers.

METHODS

This was a systematic review and meta-analysis carried out by searching six international electronic databases including PubMed, Ovid, Cochrane Library, Web of Science, ProQuest, Scopus and Google Scholar, as well as two national electronic databases including IranMedex and SID. The studies relevant to the research aims were included in the study. To assess the quality of the studies, the Cochrane Collaboration's Risk of Bias Tool was used.

RESULTS

Based on the random effects model, competency-based education could enhance the clinical performance of the health care providers in the intervention group compared with that of the control group (standardized mean difference [SMD] = -2.717, 95% CI: -3.722 to -1.712). However, more recent studies have shown that competency-based education has little effect on clinical performance (β = -.255, 95% CI: -0.319 to -0.192, P < .001).

CONCLUSION

Competency-based education can enhance the clinical performance of health care providers. However, there is increasing concern over the attenuation of the positive effect of competency-based education on the clinical performance of health care providers, which deserves further studies.

Health management students' self-regulation and digital concept mapping in online learning environments

BACKGROUND

Self-regulation of learning is considered one of the key capabilities deemed essential for the healthcare system and its workers to cope successfully with the current challenges they are facing. Therefore, healthcare curricula are increasingly called upon to support self-regulation as a central learning outcome. With scant relevant publications describing how students of medicine and other healthcare professions regulate their learning, this study set out to design and assess a problem-based learning using digital concept mapping in an online course and to evaluate the set of connections between this intervention and Health Management students' self-regulation of learning.

METHOD

Students of a Management of Health Service Organizations program (100) were presented with an ill-structured problem, relevant to their course content (accreditation process within hospitals) and were asked to argue for or against the implementation of the accreditation process. The participants were asked to detail five arguments to establish their decision by using Mindomo, a popular digital platform for designing concept maps. The students were given predefined criteria that allowed them to self-assess their maps. Data for the analysis were gathered by two measurements: Concept mapping for problem-based learning scale and the Online self-regulated learning scale and were analyzed by using Partial Least Squares - Structural Equation Modeling.

RESULTS

The analyses showed that at the beginning of the process, students' online self-regulation was found lower than at the end of the intervention, and only two self-regulation sub-factors: Goal setting and Task strategies, were positively linked to students' perceptions of the intervention. After the intervention, the analyses showed that it increased the levels of four Online self-regulation sub-factors: Goal setting, Task strategies, Environment structuring, and Time management.

CONCLUSIONS

Teachers need to recognize and account for different types of learners and encourage and scaffold students' effective use of self-regulation strategies. Low self-regulated learners might fail to see the advantages of concept mapping in problem-solving activities. Combining these teaching and learning tools together with the use of advanced technology in an online course that encourages active learning enables the development and acquisition of abilities of self-directed learning among students in the medical and health management professions.

Comparison of the Conceptual Map and Traditional Lecture Methods on Students' Learning Based on the VARK Learning Style Model: A Randomized Controlled Trial

Developing skills and knowledge in nursing education remains a considerable challenge. Nurse instructors need to be aware of students’ learning styles so as to meet students’ individual learning preferences and optimize knowledge and understanding. The aim of this study was to compare the effects of the conceptual map and the traditional lecture methods on students’ learning based on the VARK learning styles model. In this randomized controlled trial, 160 students from nursing, nurse anesthetics, and midwifery disciplines with four different learning styles of visual, auditory, reading/writing, and kinesthetic were selected using the convenience sampling method. Participants were randomly assigned to the intervention (conceptual map method) or control (traditional lecture method) groups. A medical-surgical nursing course was taught to the students in both groups over 6 weeks. Data collection tools consisted of the VARK questionnaire and pre- and postassessments. Data were analyzed using descriptive and inferential statistics via the SPSS software. Teaching using the conceptual map method had different effects on the students’ learning outcomes based on their learning styles. The conceptual map method had a statistically significant impact on the students’ learning in the intervention group compared with the control group in the students with a visual learning style (p = .036). No statistically significant differences were reported between the groups in other three learning styles. Nurse instructors should assess students’ learning styles based on the VARK model before the application of a particular teaching method to improve the quality of nursing education and facilitate deeper learning.

Effects of web-based concept mapping education on students' concept mapping and critical thinking skills: A double blind, randomized, controlled study

BACKGROUND

Using concept maps in nurse education improves students' critical thinking skills. Offering web-based concept mapping education can increase motivation for learning in students actively using the Internet.

OBJECTIVES

To examine the effects of web-based concept mapping education on nursing students' concept mapping and critical thinking skills.

DESIGN

This is a double-blind, randomized, controlled, experimental study.

SETTINGS

A nursing faculty at a state university in Turkey.

PARTICIPANTS

Second-year nursing students taking the course surgical nursing in the spring term of the academic year of 2018/2019.

METHODS

The experimental group (n = 201) was offered web-based concept mapping education before starting practicums. Data were collected using a students' information form, concept map evaluation keys, and the Critical Thinking Motivational Scale at the end of the practicums. A structured questionnaire was used to reveal opinions of the students about concept mapping.

RESULTS

There was a significant difference in concept mapping scores between the students offered web-based concept mapping education (16.45 ± 10.91) and those not receiving this education (12.70 ± 9.31) (p= .000). Also, there was a significant difference in students' scores for the subscales of Critical Thinking Motivational Scale expectancy, attainment and utility between the groups. The students reported that concept maps facilitated their learning and management of nursing processes but that they occasionally experienced difficulty.

CONCLUSION

It can be concluded that web-based concept mapping education improves concept mapping skills and motivation for critical thinking skills. Web-based education could be utilized as a tool to enhance nursing students' concept mapping and critical thinking skills.

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.

The Effect of Graphic Organizers on Learning Outcomes, Study Efficiency, and Student Satisfaction in an Elective Veterinary Cardiology Course

Graphic organizers (GOs) are visual and spatial displays, such as tables or charts, which facilitate learning by making conceptual relationships between content more apparent. We hypothesized that study aids in the form of GOs would lead to improved learning outcomes, study efficiency, and student satisfaction compared to traditional outline (OUT) format. A mixed-methods prospective randomized crossover trial was undertaken with veterinary students (n = 31) in an elective cardiology course. All students received identical content presented via weekly in-class lectures. Following 8 pre-designated lectures, students were given instructor-prepared study aids in either GO or OUT format. Students completed quizzes of content knowledge for each lesson and indicated amount of time spent studying. Crossover occurred such that groups of students alternated between receiving GO and OUT. Quantitative and qualitative data were collected in the form of in-depth pre- and post-course surveys. Quiz scores did not differ (p = .42) based on type of study aid provided (GO vs. OUT). Students spent an average of 17% less time studying per lesson when using GO compared to OUT (p = .05). Student satisfaction with both study aid formats was high, but students preferred GO over OUT in terms of study efficiency (p = .002), visual appeal (p < .001), ease of use (p < .004), and likelihood of referencing in the future (p < .001). In an elective veterinary cardiology course, use of GO compared to OUT format study aids resulted in higher study efficiency and student satisfaction with equivalent short-term learning outcomes.

The effectiveness of outcome based education on the competencies of nursing students: A systematic review

BACKGROUND

Outcome Based Education (OBE) is a student-centered approach of curriculum design and teaching that emphasize on what learners should know, understand, demonstrate and how to adapt to life beyond formal education. However, no systematic review has been seen to explore the effectiveness of OBE in improving the competencies of nursing students.

OBJECTIVE

To appraise and synthesize the best available evidence that examines the effectiveness of OBE approaches towards the competencies of nursing students.

DESIGN

A systematic review of interventional experimental studies.

DATA SOURCES

Eight online databases namely CINAHL, EBSCO, Science Direct, ProQuest, Web of Science, PubMed, EMBASE and SCOPUS were searched.

REVIEW METHODS

Relevant studies were identified using combined approaches of electronic database search without geographical or language filters but were limited to articles published from 2006 to 2016, handsearching journals and visually scanning references from retrieved studies. Two reviewers independently conducted the quality appraisal of selected studies and data were extracted.

RESULTS

Six interventional studies met the inclusion criteria. Two of the studies were rated as high methodological quality and four were rated as moderate. Studies were published between 2009 and 2016 and were mostly from Asian and Middle Eastern countries. Results showed that OBE approaches improves competency in knowledge acquisition in terms of higher final course grades and cognitive skills, improve clinical skills and nursing core competencies and higher behavioural skills score while performing clinical skills. Learners' satisfaction was also encouraging as reported in one of the studies. Only one study reported on the negative effect.

CONCLUSIONS

Although OBE approaches does show encouraging effects towards improving competencies of nursing students, more robust experimental study design with larger sample sizes, evaluating other outcome measures such as other areas of competencies, students' satisfaction, and patient outcomes are needed.

Aplicação do mapa conceitual: resultados com diferentes métodos de ensino-aprendizagem

Objetivo: analizar el resultado de una intervención de enseñanza aliada a un método tradicional para el desarrollo del concepto de complicaciones de la herida quirúrgica postoperatoria para uso en el pregrado en enfermería. Método: estudio de análisis cualitativocasi-experimental, aplicado por medio de una intervención de enseñanza en los estudiantes de enfermería de pregrado. La recolección de datos se dio en dos etapas, y los estudiantes fueron divididos al azar en los subgrupos I y II. Para facilitar la recopilación de datos, los estudiantes desarrollaron mapas conceptuales con la ayuda de las herramientas de software Cmap Tools®. Los datos fueron analizados mediante la técnica de análisis de contenido, identificando 12 categorías. Resultados: el subgrupo II mostró resultados positivos en relación con el subgrupo I, ya que la asociación de los dos métodos de enseñanza que utilizan la técnica de MC podría promover la capacidad de articular los conceptos desarrollados con conocimientos previos. Conclusión: se encontró que la asociación de la intervención docente con base teórica en la Teoría del Aprendizaje Significativo, más el método tradicional y el uso de la técnica de MC estimulan un buen desempeño de los estudiantes en el proceso de enseñanza-aprendizaje.