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Forde C, O’Brien A, Croitoru O, Molloy N, Amisano C, Brennan I, McInerney A. Comparing Face-to-Face, Blended and Online Teaching Approaches for Practical Skill Acquisition: A Randomised Controlled Trial. MEDICAL SCIENCE EDUCATOR 2024; 34:627-637. [PMID: 38887423 PMCID: PMC11180044 DOI: 10.1007/s40670-024-02026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 06/20/2024]
Abstract
Introduction The efficacy of blended and online teaching methods for practical skill acquisition remains ambiguous, particularly for skills requiring haptic awareness and/or sensory training. This study aims to compare three teaching methods (face-to-face, blended, online) for the acquisition of skills requiring sensory learning and haptic awareness. A secondary aim was to explore student experience of each teaching approach. Design A post-test only randomised controlled trial. Methods Forty-seven participants chose between learning two skills: manual measurement of blood pressure during exercise (BPM) and/or skin fold measurement using callipers (SKM). Participants were randomised to one of three learning groups: face-to-face (n = 23), blended (n = 22) and online (n = 26). Assessors determined skill competency during an in-person skill demonstration session. A survey captured student experiences. Results For SKM, there was a statistically significant difference in skill competency between the online learning group (17% achieved competency) and both the face-to-face (75% achieved competency; p = 0.011) and blended (89% achieved competency; p = 0.001) learning groups. For BPM, the online group had the lowest percentage of participants achieve overall skill competency. Both knowledge-based and sensory-based sub-competencies were negatively affected by the online learning method. For both skills, students in the face-to-face and blended learning group were significantly more confident in their knowledge and their ability to perform the skill in a clinical setting, compared to the online learning group. Conclusion Both face-to-face and blended teaching methods were more effective at leading to skill acquisition and were preferred by students when compared to a fully online teaching method.
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Affiliation(s)
- Cuisle Forde
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Annie O’Brien
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Nadine Molloy
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Chiara Amisano
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Iain Brennan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Adam McInerney
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Chen SL, Liao IC. Effectiveness of Using a Self-Directed Learning Program to Teach Physical Examination and Health Assessment Skills: A Quasi-Experimental Study. J Nurs Res 2024; 32:e320. [PMID: 38526776 DOI: 10.1097/jnr.0000000000000603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Conducting health assessments and physical examinations are essential skills for independent practice. Exploring how to teach these skills effectively is essential. PURPOSE This study was designed to validate the effectiveness of a self-directed learning program in improving nursing student outcomes in terms of their learning health assessment and physical examination skills. METHOD A quasi-experimental design was used, and second-year nursing students enrolled in a health assessment and physical examination course at a university of science and technology in central Taiwan were recruited using purposive sampling. Both the control and experimental groups were taught using a traditional teaching method. The experimental group additionally participated in a self-directed learning program. Structured questionnaires, including the Chinese version of the Self-Directed Learning Readiness Scale, Scales of Motivation and Learning Strategies, Interpersonal Skills Assessment Tool, the Course Satisfaction Evaluation Scale, and the Perception of Health Assessment and Physical Examination Competence Scale, were used to collect data at three time points. RESULTS After controlling for the effects of pretest scores, after the intervention, the experimental group achieved significantly higher scores than the control group for self-directed learning (creative learning and love of learning), learning motivation (goal orientation, work value, expected success, and test anxiety), and cognitive strategies (total score, elaboration strategy, recitation strategy, and monitoring strategy). In addition, the health assessment exercise improved interpersonal and communication skills, and learning satisfaction was significantly higher in the experimental group than the control group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE A physical examination and health assessment course designed using the self-directed learning framework can effectively improve student competence in related skills to enhance their ability to assess patient health problems in clinical settings. This study presents an alternative approach to teaching health assessment and physical examination courses and validates the positive effect of this approach on student learning outcomes.
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Affiliation(s)
- Shiah-Lian Chen
- PhD, RN, Professor, Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - I-Chen Liao
- PhD, RN, Assistant Professor, Department of Nursing, College of Nursing, Hungkuang University, Taichung, Taiwan
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Henderson B, Chipchase L, Golder F, Lewis LK. Developing student nurses' evaluative judgement in clinical practice tertiary education: A systematic scoping review of teaching and assessment methods. Nurse Educ Pract 2023; 73:103818. [PMID: 37925834 DOI: 10.1016/j.nepr.2023.103818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/05/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES This review aimed to systematically scope undergraduate or postgraduate tertiary higher education nursing students' clinical practice teaching and assessment methods to identify features that align with promoting students' evaluative judgement. INTRODUCTION Evaluative judgement is a new concept to nursing tertiary education. Currently, there are no published reviews of evaluative judgement in nursing clinical practice education. This review aims to assist nursing educators to operationalise the concept of evaluative judgement in clinical practice education. As such the starting point was to determine features of evaluative judgement in current clinical teaching and assessment designs. INCLUSION CRITERIA Peer reviewed qualitative or quantitative studies that have evaluated teaching and/or assessment of tertiary (university/higher education) pre-registration (undergraduate) or post-registration (postgraduate) nursing students' clinical practice. METHODS The systematic scoping review was prospectively registered systematic review (OSF DOI 10.17605/OSF.IO/PYWZ6) reported using PRISMA guidelines. A systematic search of five databases (Medline, Scopus, Web of Science, ProQuest, CINAHL) was conducted, limited from 1989 onwards and in English. Two reviewers independently screened titles and abstracts, then full text, with disagreements resolved with a third independent author. Data were extracted, including the frequency and methods of developing students' evaluative judgement across the categories of discerning quality, judgement process, calibration and feedback. A narrative synthesis was performed. RESULTS Seventy-one studies were included (n=53 teaching, n=18 assessment). Most of the included studies, included some, but not all, of the features to develop nursing students' evaluative judgment. For teaching methods, the most identified evaluative judgement features in the included studies were discerning quality (n=47), feedback (n=41) and judgement process (n=21). Only three studies included a method of calibration. For the assessment methods, feedback (n=16), discerning quality (n=15), judgement process (n=9) and calibration (n=4) were included. Many clinical practice teaching and assessment methods in nursing included features that develop students' evaluative judgement, with methods relating to discerning quality and feedback well embedded. Further adjustments are required to include methods to assist students to judge and calibrate their own performance. CONCLUSION This systematic scoping review identified that evaluative judgement in current nursing clinical teaching and assessment is not an overt aim. With minor adjustment to teaching and assessment design, nursing students could be better supported to develop their ability to judge the value of their own work.
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Affiliation(s)
- Bridget Henderson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, 5042, GPO Box 2100, Adelaide, SA 5100, Australia.
| | - Lucy Chipchase
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, 5042, GPO Box 2100, Adelaide, SA 5100, Australia
| | - Fleur Golder
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, 5042, GPO Box 2100, Adelaide, SA 5100, Australia
| | - Lucy K Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, 5042, GPO Box 2100, Adelaide, SA 5100, Australia
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Mohallem AGDC, Cunha MLR, Pancieri APL, Franco FAL, Dutra LA, Moraes MW, Dellê H. Quality of podcasts recorded by nursing lecturers as pre-class learning material for students: An observational study. Nurse Educ Pract 2023; 71:103721. [PMID: 37499536 DOI: 10.1016/j.nepr.2023.103721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/19/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Abstract
AIM To evaluate the quality of podcasts produced by lecturers as pre-class learning material; to verify lecturers' buy-in, after a specific workshop, regarding the practice of producing and using podcasts. BACKGROUND The teaching-learning process has undergone significant changes in recent years with the proposal of the flipped classroom strategy, which places the student at the center of the learning process and uses technology that requires adaptation of lecturers, both inside and outside the classroom. Pre-class learning material is one of the features of the flipped classroom model. It provides basic concepts for problem solving in small group discussion in classroom. Podcasts for this educational purpose are a recent technology and their innovative characteristics require deeper understanding in terms of their influence and usability. DESIGN Prospective, descriptive and quantitative study. SETTING AND POPULATION A workshop on the production of educational podcasts was offered to 23 lecturers on the Nursing course. METHODS Data were collected in the second semester of 2021 and the quality analysis was based on criteria available in the literature. RESULTS Eighteen professors (78 %) participated in the study and 46 podcasts were produced. Most professors being nurses (61 %), followed by biologists (28 %). Most have a doctorate degree (72 %). These podcasts were available for a mean of five days before the classes and their mean access rate by students was 58 %. There was no correlation between the access rate and the period of availability before the relative class. Most podcasts were informative (100 %) and monologues (98 %). The average duration was 6.2 min, which is within the ideal duration recommended in the literature. All of the podcasts included a description of the learning objectives at the beginning and most of them also included a closing message at the end. CONCLUSION The nursing lecturers were able to produce their podcasts, which met quality criteria and reached the standards suggested by experts in the field.
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Affiliation(s)
| | - Mariana Lucas Rocha Cunha
- Faculdade Israelita de Ciências da Saúde Albert Einstein at Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Ana Paula Loreto Pancieri
- Faculdade Israelita de Ciências da Saúde Albert Einstein at Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Fernando Alves Lima Franco
- Faculdade Israelita de Ciências da Saúde Albert Einstein at Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Livia Almeida Dutra
- Faculdade Israelita de Ciências da Saúde Albert Einstein at Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Marcia Wanderley Moraes
- Faculdade Israelita de Ciências da Saúde Albert Einstein at Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Humberto Dellê
- Faculdade Israelita de Ciências da Saúde Albert Einstein at Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; Postgraduate Program in Medicine, Universidade Nove de Julho (Uninove), São Paulo, SP, Brazil.
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Ruzafa-Martínez M, Molina-Rodríguez A, Pérez-Muñoz V, Leal-Costa C, Ramos-Morcillo AJ. Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design. NURSE EDUCATION TODAY 2023; 128:105878. [PMID: 37352765 DOI: 10.1016/j.nedt.2023.105878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/24/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom. OBJECTIVE To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology. DESIGN Quasi-experimental study of non-equivalent groups. SETTING The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit. PARTICIPANTS The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022. METHODS Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year. RESULTS A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η2 = 0.022), skills (p = 0.019, η2 = 0.018), and global competence in EBP (p = 0.003, η2 = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206). CONCLUSIONS The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.
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Affiliation(s)
| | | | - Verónica Pérez-Muñoz
- University of Murcia, Department of Sociosanitary Care, Faculty of Social and Health Sciences, Spain.
| | - César Leal-Costa
- Department of Nursing, Faculty of Nursing, University of Murcia, Spain.
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Sultan AS, Ali R, Zahid N, Akbar R, Ali M, Fatima S, Ghias K, Martins R, Tariq M, Ajani K. Experiences of Undergraduate Medical, Nursing Students and Faculty regarding Flipped Classroom: A Mixed Method Study at Private Medical University in Pakistan. BMJ Open 2023; 13:e070276. [PMID: 37076143 PMCID: PMC10124245 DOI: 10.1136/bmjopen-2022-070276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
The 'flipped classroom (FCR)' is a teaching pedagogy where students are actively involved in the learning process. It reduces passivity, enables students to become active learners through reasoning and concept application and facilitates student interaction with their peers and instructors. This instructional approach enhances retention and decreases distraction by engaging students. OBJECTIVES The purpose of this study was to train the faculty of the medical college and school of nursing in developing FCRs as an innovative teaching and learning strategy, to facilitate them in conducting flipped sessions for their students and to explore the experiences of medical, nursing students along with faculty members regarding the FCR they had attended and conducted. SETTING Private medical college. PARTICIPANTS A total of 442 students from medical college and school of nursing and midwifery participated in the evaluation survey with a female to male ratio of 339:103. Students who attended the flipped class sessions were included in the study sample. Students who did not complete the forms were excluded from the study. Nine faculty members who attended the workshop, agreed to facilitate the FCR session were invited to participate in the focus group discussion. RESULTS Both medical and nursing students found FCR format stimulating. A significantly higher proportion of medical students (73%) found the FCR more engaging and interesting than a traditional lecture as compared with nursing students (59%) (p=0.009). Similarly, 73% of medical students believed the learning objectives of both the non-face-to-face and face-to-face sessions were shared with them as compared with the 62% of nursing students who believed the same (p=0.002). A significantly higher proportion of medical (76%) versus nursing (61%) students found the FCR format more useful for application of their theoretical knowledge into clinical practice (p=0.030). CONCLUSION Students found the FCR more engaging and interesting in terms of applying theoretical knowledge into practice. Similarly, faculty found this strategy as effective but challenging in terms of involving and engaging students in the learning process. It is recommended to conduct more FCR sessions for an interactive and student-centred learning, but proper planning of the session and using variety of technological tools to engage learners is a key to success.
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Affiliation(s)
- Amber Shamim Sultan
- Department for Educational Development & Surgery, The Aga Khan University, Karachi, Pakistan
| | - Rahila Ali
- Department for Educational Development, The Aga Khan University, Karachi, Pakistan
| | - Nida Zahid
- Department of Surgery, The Aga Khan University, Karachi, Pakistan
| | - Rozmeen Akbar
- Department of Biological and Biomedical science, The Aga Khan University, Karachi, Pakistan
| | - Mehdia Ali
- Research Department, The Aga Khan University, Karachi, Pakistan
| | - Sadia Fatima
- Department of Biological and Biomedical science, The Aga Khan University, Karachi, Pakistan
| | - Kulsoom Ghias
- Department of Biological and Biomedical science, The Aga Khan University, Karachi, Pakistan
| | - Russell Martins
- Research Department, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Tariq
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Khairulnissa Ajani
- School of Nursing and Midwifery, The Aga Khan University, Karachi, Pakistan
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Torbergsen H, Utvær BK, Haugan G. Nursing students' perceived autonomy-support by teachers affects their intrinsic motivation, study effort, and perceived learning outcomes. LEARNING AND MOTIVATION 2023. [DOI: 10.1016/j.lmot.2022.101856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ng EKL. Flipped versus traditional classroom and student achievement and cognitive engagement in an associate degree nursing fundamental course. Nurse Educ Pract 2023; 68:103567. [PMID: 36758445 DOI: 10.1016/j.nepr.2023.103567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/16/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is a call for instructional transformation in nursing education to include an innovative approach. This study aimed to investigate the effects of the flipped classroom method on student achievement and engagement in an associate degree nursing course. This study investigated associate degree nursing studies students' achievement and cognitive engagement under traditional learning (n = 141) and flipped learning (n = 130). This study was conducted in two first-year cohorts enrolled in their nursing fundamental course, before and during the COVID-19 pandemic respectively at a Hong Kong community college. METHOD A mixed methods approach was used with quantitative (examination scores) and qualitative (semi-structured focus group interview) measures applied. RESULTS There was a significant increase in final exam scores for the flipped classroom, all p < 0.01, with a medium-to-large (d = 0.60) effect size. Students commented flipped classroom method promoted their cognitive engagement and the benefits that contributed to such a positive student achievement included more peer interaction and more opportunity to apply their knowledge. CONCLUSION This study contributed to our understanding of the effect of the flipped classroom method on student engagement in nursing education.
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Affiliation(s)
- Emily Ka Lai Ng
- The Hong Kong University School of Professional and Continuing Education Community College, 28, Wang Hoi Road, Kowloon Bay, Kowloon, Hong Kong, SAR China.
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Ke L, Xu L, Sun L, Xiao J, Tao L, Luo Y, Cao Q, Li Y. The effect of blended task-oriented flipped classroom on the core competencies of undergraduate nursing students: a quasi-experimental study. BMC Nurs 2023; 22:1. [PMID: 36624445 PMCID: PMC9830926 DOI: 10.1186/s12912-022-01080-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The flipped classroom (FC) method is becoming increasingly popular in China's nursing education. It is an important breakthrough improvement in the quality of learning in nursing education reforms. PURPOSE This study aimed to determine the effects of blended task-oriented flipped classroom (TFC) on nursing students undertaking the Fundamentals of Nursing course. METHODS A pre-and post-test quasi-experimental design was adopted. This study was conducted in the Autumn semester, 2021 academic year in a Chinese university. Using cluster sampling technique, this study enrolled second-year undergraduate nursing students from six classess who were studying Fundamentals of Nursing course. A blended TFC was developed and implemented with three classes (experimental group: n = 152). In-class traditional lectures were applied to the other three classes (control group: n = 151). The Self-Directed Learning Instrument, Problem-Solving Inventory, and California Critical Thinking Disposition Inventory were used to evaluate students' learning outcomes, and final examinations were conducted at the end of after course. In addition, students in the flipped classroom group were required to answer five open-ended questions concerning their flipped classroom learning experiences. RESULTS Students in the experimental group showed significant improvement in academic performance compared to those in the control group (p = 0.001). Considering total scale and factors, students in the experimental grouped recorded significantly higher scores in self-directed learning ability, problem-solving skills, and critical thinking ability compared to those in the control group (p < 0.05). Furthermore, improved abilities and skills such as team cooperation, communication, presentation, identifying /solving clinical problems, and accountability were reported. CONCLUSION A blended TFC teaching approach positively impacted students' core competencies and improved learning outcomes in the Fundamentals of Nursing course.
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Affiliation(s)
- Li Ke
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Lanlan Xu
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Li Sun
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Juan Xiao
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Lingxuan Tao
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Yixue Luo
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Qiongya Cao
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
| | - Yan Li
- grid.443573.20000 0004 1799 2448School of Nursing, Hubei University of Medicine, Shiyan, Hubei China
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Kaplan A, Özdemir C, Kaplan Ö. The Effect of the Flipped Classroom Model on Teaching Clinical Practice Skills. J Emerg Nurs 2023; 49:124-133. [PMID: 36400573 DOI: 10.1016/j.jen.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION No evidence was found in the literature for the use of the flipped classroom model in teaching clinical practice skills in paramedics. The study aimed to determine the effect of the flipped classroom model in teaching clinical practice skills to paramedic program students. METHODS The study was a single-center, randomized controlled, single-blind parallel-group study. The research was carried out with a university's first-year paramedic program students in the 2021 to 2022 academic year. The students were divided into groups by stratified sampling (intervention group = 21, control group = 21). Five clinical skills practices at various times were explained to the intervention group with the flipped classroom model and to the control group with the traditional lecture method. The research data were collected with the Introductory Characteristics Information Form, Checklists, Time Tracking Form, and Students' Questionnaire for Evaluating the flipped classroom model. RESULTS Although the students in the intervention group received a higher total score from all 5 clinical practice skills than the students in the control group, this difference was not statistically significant (P > .05). However, although the time allocated for applications in the intervention group was 40 to 75 minutes longer than in the control group, most students stated that this model successfully taught skills and theory, increased their motivation during the application, and reduced application and exam anxiety. DISCUSSION The flipped classroom model can be used as an alternative method to the traditional system in teaching clinical practice skills. This innovative educational approach can be recommended as a student-centered method in clinical skills teaching.
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Yoosoof F, Liyanage I, de Silva R, Samaraweera S. Videos of demonstration versus text and image-based material for pre-skill conceptualisation in flipped newborn resuscitation training for medical students: a pilot study. BMC MEDICAL EDUCATION 2022; 22:839. [PMID: 36471390 PMCID: PMC9721000 DOI: 10.1186/s12909-022-03926-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The flipped skills lab is a student-centred approach which incorporates pre-class preparation (pre-skill conceptualization) followed by repeated, hands-on practice for practical skills training. Objective measures of skills acquisition in the flipped literature are few and conflicting. The importance of pre-skill conceptualization in flipped skills training suggests that pedagogically informed pre-skill conceptualization can enhance outcomes. METHODS A mixed quasi-experimental study was conducted on 41 final year medical students who followed a flipped newborn resuscitation skills lab. Pre-class preparatory material covered conceptual and procedural knowledge. Students in the traditional group (n = 19) and those in the interventionalmental group (n = 22) received identical reading material covering conceptual knowledge. Procedural knowledge was shared with the interventional group as demonstration videos, while the traditional group received a PowerPoint presentation with text and images covering the same material. Knowledge acquisition was assessed by 20 single best answer questions before and after hands-on practice in the skills lab and skill performance was tested post-intervention with a simulated scenario. Students' perceptions were collected by survey. Quantitative data was analysed using Wilcoxon Signed Ranks test and Mann-Whitney U test as appropriate. Qualitative data was analysed by thematic analysis. RESULTS Overall student rating of the intervention was positive with ratings of 4.54 and 4.46 out of 5 by the traditional group and the experimental group respectively. Post-intervention skill performance in the experimental group was significantly better (p < .05) in the interventional group (M = 87.86%, SD = 5.89) than in the traditional group (M = 83.44, SD = 5.30) with a medium effect size (r = .40). While both groups showed significant knowledge gains, only students in the experimental group showed a statistically significant gain in procedural knowledge (p < .05) following the flipped skills lab. Finally, while both groups self-reported feeling more knowledgeable and confident following the intervention, the level of confidence was superior in the experimental group. CONCLUSIONS Flipping the skills lab with pre-skill conceptualisation combining text-based conceptual knowledge and video-based procedural knowledge followed by simulation-based hands-on practice improves procedural knowledge and skills acquisition in newborn resuscitation training for medical students. This study shows that in addition to temporal benefits, pedagogically informed pre-skill conceptualization can confer procedure-specific cognitive and emotional benefits supporting skills acquisition.
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Affiliation(s)
- Farah Yoosoof
- Department of Paediatrics, General Sir John Kotelawala Defence University, Rathmalana, 10390 Sri Lanka
| | - Indika Liyanage
- Department of Paediatrics, General Sir John Kotelawala Defence University, Rathmalana, 10390 Sri Lanka
| | - Ranjith de Silva
- Sri Lanka College of Obstetricians and Gynaecologists, No.112 Model Farm Rd, Colombo, Sri Lanka
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Zhou H, Wang Y, Cheng L. The mediating effect of self-directed learning in the relationship between caring and resilience among Chinese nursing students: A multi-center cross-sectional study. NURSE EDUCATION TODAY 2022; 119:105598. [PMID: 36272323 DOI: 10.1016/j.nedt.2022.105598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite the proliferation of literature focusing on resilience, a paucity of research has attempted a thorough and accurate examination of factors that contribute to resilience among nursing students. OBJECTIVES To examine the mediating effect of self-directed learning in the relationship between caring and resilience in Chinese nursing students. DESIGN A cross-sectional design. SETTINGS Five universities in China. PARTICIPANTS Undergraduate nursing students (N = 511). METHODS The Caring Ability Inventory, Self-Rating Scale of Self-Directed Learning, and Connor-Davidson Resilience Scale (CD-RISC) were administered. Socio-demographic and academic data were collected from nursing students after obtaining their informed consent. A multiple linear regression analysis was performed to assess factors associated with resilience. A structural equation model with bootstrapping estimation was conducted to further explore the potential mediating role of self-directed learning in the relationship between caring and resilience. RESULTS The average score of CD-RISC for nursing students was 92.96 ± 14.85. Multiple linear regression analyses indicated that caring and self-directed learning were significantly positively associated with resilience. Self-directed learning (β = 0.327, 95% Confidence Interval [CI]: 0.049-6.667, p < 0.001) had a significant mediating effect on the relationship between caring and resilience in nursing students, explaining 67.1% of the total effect of caring on resilience. CONCLUSIONS Interventions that enhance students' self-directed learning have the potential to enhance resilience level. Innovative pedagogical approaches, strategic reinforcement, and nursing curriculum transformation are recommended to promote self-directed learning awareness and internalize self-directed learning skills.
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Affiliation(s)
- Hua Zhou
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
| | - Yarui Wang
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
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Forde C, OBrien A. A Literature Review of Barriers and Opportunities Presented by Digitally Enhanced Practical Skill Teaching and Learning in Health Science Education. MEDICAL EDUCATION ONLINE 2022; 27:2068210. [PMID: 35445632 PMCID: PMC9037199 DOI: 10.1080/10872981.2022.2068210] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/13/2022] [Accepted: 04/15/2022] [Indexed: 05/15/2023]
Abstract
INTRODUCTION An evidence gap exists identifying the challenges and opportunities presented by digitally enhanced practical skill teaching and learning in health science education. A literature review was carried out to address this gap and to provide recommendations for overcoming identified challenges. METHOD A systematic search strategy was carried out using PRISMA guidelines. The research databases PubMed, ERIC, Medline and CINHL, were searched using MeSH terms. Barriers and opportunities were identified through deductive thematic analysis of the included articles. RESULTS Of the 602 articles identified through the database screening, 29 were included in the current review. Potential challenges posed by technologically supported practical skill teaching identified were i) Inaccessibility and Inequity of Online Learning (ii) Digital illiteracy Among Staff (iii) Technological Challenges (iv) Lack of Engagement with Preparatory Material Hinders Practical Learning (v) Lack of Staff-Student Interaction (vi) Negative Attitudes Towards Online Learning and (vii) Skill Suitability. The opportunities presented by digital technologies identified were (i) Facilitates Higher Order Learning (ii) Ability to Practice in a Safe Environment (iii) Efficacious Use of Class Time (iv) Access to Education (v) Learning Brought to Life (vi) Diverse Range of Learning Materials (vii) Promotes Autonomous Learning. DISCUSSION This literature review demonstrates the acceptability and usability of digitally enhanced practical teaching in health science education among students and educators. CONCLUSION To consolidate the positive disturbances in higher education from the Covid-19 pandemic, potential barriers to online delivery and student engagement must be acknowledged and addressed by relevant stakeholders. Recommendations detailed as part of this paper suggest means of overcoming barriers and leveraging opportunities.
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Affiliation(s)
- Cuisle Forde
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland
| | - Annie OBrien
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland
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14
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Hassan EA, Elsaman SEA. The effect of simulation-based flipped classroom on acquisition of cardiopulmonary resuscitation skills: A simulation-based randomized trial. Nurs Crit Care 2022; 28:344-352. [PMID: 35801367 DOI: 10.1111/nicc.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) is an essential skill required by critical care nurses. Evidence has shown that the use of a novel method called simulation-based flipped classroom (SBFC) can save training time in nursing laboratories and, to some extent, enhance social distancing during the current COVID-19 pandemic. AIM To evaluate the effects of SBFC on nursing students' acquisition of CPR skills. STUDY DESIGN A two-parallel prospective, single-centre, simulation-based, randomized, controlled trial. METHODS The total sample size was 326 students. A CPR video was recorded and uploaded on Microsoft Teams channel for the SBFC group only. Thereafter, both groups demonstrated and redemonstrated the CPR procedure. Both groups were then compared according to the simulation experience satisfaction scale and CPR skills acquisition checklist. RESULTS Two equally randomly selected groups of 163 undergraduate nursing students completed the study. The SBFC group had a significantly better satisfaction with the simulation experience than the traditional simulation (TS) group (p = 0.03). As regards the mean score of the CPR checklist after simulation, the SBFC group had a significantly higher score than TS group (p = 0.01). CONCLUSIONS SBFC using a pre-recorded video can be an effective method that can reduce the time needed for CPR clinical simulation and can be used for the CPR simulation among critical care nurses. RELEVANCE TO CLINICAL PRACTICE This study provides critical care nursing educators with a deep understanding regarding the benefits and value of utilizing the SBFC method in the clinical training of CPR skills. SBFC can be used to increase critical care nurses' satisfaction and skill acquisition during CPR training.
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Affiliation(s)
- Eman Arafa Hassan
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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15
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Choi J, Lee SE, Choi S, Kang B, Kim SH, Bae J, Tate JA, Son YJ. Integration of visual thinking strategies to undergraduate health assessment course: A mixed-method feasibility study. NURSE EDUCATION TODAY 2022; 113:105374. [PMID: 35462324 PMCID: PMC9014655 DOI: 10.1016/j.nedt.2022.105374] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/07/2022] [Accepted: 04/12/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic has accelerated demands for a shift from traditional face-to-face learning to online learning. Visual Thinking Strategies (VTS) is an inquiry-based teaching method using various visual artworks to improve critical thinking and interpersonal skills. VTS has been studied in health professional education mostly in art gallery settings. Implementing VTS during online learning in nursing education has not yet been investigated. OBJECTIVES This study evaluated the feasibility of incorporating VTS into an undergraduate nursing health assessment course and explored students' perceptions and experiences of VTS. DESIGN A single-group, posttest-only, concurrent mixed-methods design was used. SETTING This study was conducted in an urban nursing college in Seoul, Korea. PARTICIPANTS A convenience sample of 60 second-year undergraduate nursing students enrolled in a health assessment course. METHODS We integrated VTS into three skills lab sessions (assessment of older adults, skin assessment, and musculoskeletal system assessment) via on-site sessions or real-time online videoconferencing sessions. Through an online survey, we obtained sociodemographic information, previous VTS experience, measures of teaching orientation, perception of arts-based learning, and VTS evaluation. Additionally, participants were asked to comment on their VTS experiences through free-response questions. RESULTS Participants rated VTS as an interesting and easy-to-concentrate learning method compared with traditional classes during a COVID-19 pandemic. In participants' narratives, being able to learn diverse perspectives, expanding the scope of thoughts and observations, and sustainable learning were the most commonly positive experiences. A lack of familiarity and the open-ended nature of observations were reported as the most common challenges. CONCLUSION Applying VTS in undergraduate nursing education may help students develop critical thinking, communication, and collaboration skills. As an alternative to traditional teaching, implementing VTS via online may have potential to motivate students' engagement to active learning. Future randomized controlled trials are warranted to build evidence on the benefits of VTS.
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Affiliation(s)
- JiYeon Choi
- Yonsei University College of Nursing, Mo-Im Kim Nursing Research Institute, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Seung Eun Lee
- Yonsei University College of Nursing, Mo-Im Kim Nursing Research Institute, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Seongmi Choi
- Yonsei University College of Nursing and Brain Korea 21 FOUR Project, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Bada Kang
- Yonsei University College of Nursing, Mo-Im Kim Nursing Research Institute, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Soo Hyun Kim
- Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Juyeon Bae
- Department of Nursing, Yeoju Institute of Technology, 12652, Sejong-ro 338, Yeoju-si, Gyeonggi-do, Republic of Korea.
| | - Judith A Tate
- The Ohio State University College of Nursing, 386 Newton Hall, 1585 Neil Ave., Columbus, OH 43210, USA.
| | - Youn-Jung Son
- Chung-Ang University Red Cross College of Nursing, 84 Heukseok ro, Dongjak-gu, Seoul 06974, Republic of Korea.
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Hester L, Reed B, Bohannan W, Box M, Wells M, O'Neal B. Using an educational mobile application to teach students to take vital signs. NURSE EDUCATION TODAY 2021; 107:105154. [PMID: 34583238 DOI: 10.1016/j.nedt.2021.105154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/04/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The utilization of smartphone applications in educational settings, specifically in the field of nursing, has grown increasingly popular. To date, there have been few, if any, smartphone applications dedicated specifically to the teaching of vital signs. The Clinic Vitals app was designed to be an acceptable substitute for in-person vital signs instruction. OBJECTIVES The objective of this study was to show the utility of the Clinic Vitals app as a pedagogical tool in comparison to in-person nursing educational instruction. DESIGN A crossover design was employed within collegiate nursing educational sessions to determine if Clinic Vitals was an equivalent alternative to traditional vital sign teaching methods. PARTICIPANTS Participants were first-year nursing students from six different lab sessions within the same undergraduate university. METHODS Students with little to no vital sign experience were given instruction via the Clinic Vitals mobile application or traditional learning. After the learning session, students were given skills assessments. After one week, students were given the opposite method of instruction followed by skills assessments. RESULTS Results showed that no significant difference was found between the two groups based on skills assessments. Mobile application and in-person instruction teaching methods produced a similar level of competency in students learning to take vital signs. CONCLUSIONS The utility of being able to access the application's videos and instructional articles at any time and anywhere that there is an internet connection would make the app particularly useful. The present study provides evidence that the Clinic Vitals mobile application can be a reliable substitute for in-person vital signs instruction. Recent educational advances have demonstrated that online videos, simulations, and mobile applications can be effective resources for nursing educators. There is potential for further study of the uses of educational mobile applications, including Clinic Vitals, for nursing education.
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Affiliation(s)
- Landon Hester
- University of Oklahoma College of Medicine, United States of America.
| | - Brandon Reed
- University of Oklahoma College of Medicine, United States of America
| | - Whitney Bohannan
- University of Oklahoma College of Medicine, United States of America
| | - McKenna Box
- University of Oklahoma College of Medicine, United States of America
| | - Monica Wells
- University of Oklahoma College of Medicine, United States of America
| | - Becky O'Neal
- Oklahoma Christian University, School of Nursing, United States of America
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Markwick L, Sacco TL. A Comparison of Teaching Methods for a Baccalaureate Nursing Health Assessment Course. Comput Inform Nurs 2021; 39:786-792. [PMID: 34050056 DOI: 10.1097/cin.0000000000000770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
New teaching methods are designed and implemented to ensure student success and application of knowledge. One of these designs is the flipped classroom. Nursing programs are also integrating technology, including simulation, into nursing education in order to enhance student engagement. Although several research studies support flipped classroom methodology, no studies have compared traditional and flipped classroom teaching methods, as well as the use of a technology-enhanced classroom, in a baccalaureate nursing health assessment course. The purpose of this study was to compare learning outcomes and student satisfaction in an undergraduate health assessment course across three teaching methods: traditional lecture, flipped classroom, and a technology-enhanced interactive flipped classroom. All three methods incorporated virtual patient simulation. Using a quasi-experimental design, formative and summative assignment grades were compared. Student course evaluations were compared to assess satisfaction with each teaching method. Significant differences in mean grades were found in 12 of the 23 assignments. The technology-enhanced interactive flipped classroom section outperformed the traditional and flipped classroom sections on most of these assessments. Only one difference was noted in student satisfaction. The results showed that a technology-enhanced interactive flipped classroom design supported student learning. A longitudinal analysis of student performance is recommended.
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Affiliation(s)
- Laura Markwick
- Author Affiliations: NP Family Care of Rochester, PLLC (Dr Markwick); and St John Fisher College and University of Rochester Medical Center (Dr Sacco), Rochester, NY
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Al-Mugheed K, Bayraktar N. Effectiveness of a venous thromboembolism course using flipped classroom with nursing students: A randomized controlled trial. Nurs Forum 2021; 56:623-629. [PMID: 33782992 DOI: 10.1111/nuf.12573] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Modern innovative education approaches are crucial for nursing education, which leads to improving evidence-based teaching strategies and preparing nursing students for their future workplaces. The primary aim of the study was a comparison of the effectiveness of the flipped classroom and traditional educational methods on the attainment of knowledge regarding venous thromboembolism (VTE) prevention among nursing students. In addition, investigation of the opinions of the nursing students regarding the advantages and disadvantages flipped classroom educational method was the secondary aim of the study. METHODS This study was implemented with a randomized controlled design in the Faculty of Nursing in September and October 2019, with 118 first- and second-semester undergraduate nursing students (58 students in the flipped classroom, 60 students in the traditional lecture) who had not taken the Adult Health Nursing course. Implementation of the study was conducted in three phases: pretest, educational intervention, and posttest for both groups. RESULTS The study findings demonstrated no statistically significant difference in any of the mean scores of VTE domains between the two groups in the pretest. However, the flipped classroom group had higher mean scores of all VTE domains compared with the traditional lecture group in the posttest. Mostly, students highlighted four advantages of the flipped classroom, including "Deep motive," "Engagement," "Cost-effectiveness," and "Self-confidence." CONCLUSIONS The flipped classroom method proved to have positive effects in VTE domains in terms of knowledge, risk assessment, and prophylaxis among nursing students. This method can be recommended as an innovative and student-centered method in the teaching of evidence-based nursing practices.
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Affiliation(s)
- Khalid Al-Mugheed
- Faculty of Nursing, Surgical Nursing Department, Near East University, Nicosia, Cyprus
| | - Nurhan Bayraktar
- Faculty of Nursing, Surgical Nursing Department, Near East University, Nicosia, Cyprus
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