Nursing students' perceptions of online learning and its impact on knowledge level

Facilitators and barriers to online group work in higher education within health sciences - a scoping review

INTRODUCTION

In health education, group work is essential to prepare students for working in health care and medical teams. Following the widespread adoption of online teaching, group work increasingly takes place in online environments. Although successful group work can provide good learning outcomes, it is unclear what facilitates or hinders online group work in health science education, and to what extent this topic has been addressed. Thus, this scoping review aimed to identify the facilitators and barriers to online group work in higher health education, provide an overview of the scientific literature related to the topic, and identify knowledge gaps in the research.

METHODS

This scoping review was guided by the methodological framework described by Arksey and O'Malley, and reporting is in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Eight online databases were searched for scientific articles published between 2012 and 2022. At least two researchers independently screened records and full-text articles and charted data including article characteristics and key information related to the research question. Findings were categorized and summarized based on the Community of Inquiry Framework.

RESULTS

After screening 3671 records and 466 full-text articles, 39 articles met the inclusion criteria. The review revealed smaller group size, consistency in group composition and joint responsibility to be facilitators. Challenges with group communication, scheduling synchronous meetings and technical issues were identified as barriers. Our findings supported the importance of all three elements of the Community of Inquiry Framework: social, cognitive, and teaching presence.

CONCLUSION

This review provides an overview of facilitators and barriers to online group work in health science education. However, there is a need for further investigation of these factors and studies addressing this topic from the teachers' perspective.

The impact of digital learning on Saudi nursing students' engagement: A qualitative study

AIM

This study aimed to explore the perception of nursing students regarding their engagement in digital learning environments.

DESIGN

At one of universities in Saudi Arabia, a qualitative descriptive study design was used among nursing students from various academic levels.

METHODS

Data were collected using focus group discussions among a sample of 23 participants. Data were analysed using thematic analysis. The COREQ Standards for Reporting Qualitative Research were used to report this study.

RESULTS

While sharing their perceptions the nursing students reflected on the behavioural and cognitive aspects of engagement, yet they did not include emotional aspects of engagement in their conceptualization. However, the results showed that, while they reflected on their experiences they tended to reflect on emotional aspects of engagement. According to the study's results, self-paced studying, reflective exercises, and interaction with audiovisual and dynamic content all encourage the activation of past knowledge in online learning. The learning modality also was found to be a safe and convenient approach among the participating students. Digital learning presents as a promising educational approach that extends beyond the pandemic yet, efforts should be put in place to facilitate the optimal student engagement to meet learning outcomes. Further research is needed to measure its impact on engagement and other pertinent indicators objectively.

Evaluating the online Resilience Skills Enhancement programme among undergraduate students: A double-blind parallel randomized controlled trial

Resilience training has beneficial effects on the ability of undergraduate students to withstand adversity and stress. However, there are inconsistencies in the content and delivery approaches for resilience training. Given the increasing shifts towards computer-assisted instruction, there is a need to develop and evaluate innovative approaches for resilience training. This study aimed to examine the efficacy of two versions of the Resilience Skills Enhancement (RISE) programme. A randomized controlled trial was used to evaluate the effects of blended learning (BL) and a self-guided RISE programme on the resilience, social support, and learning outcomes of undergraduate students. One hundred and fourteen students were recruited and randomly allocated to receive either BL or the self-guided RISE programme. The within-group analyses indicated significant improvements in resilience scores for the BL (F = 37.74, p < 0.001) and self-guided groups (F = 10.16, p < 0.001) with moderate (d = 0.62, 95% CI: 0.25, 1.00) to large effect sizes (d = 1.11, 95% CI: 0.71, 1.50) respectively. There were also significant differences across the three time points for social support scores for the BL (F = 4.50, p < 0.05) and self-guided groups (F = 4.59, p < 0.05). Students in the BL group had considerable improvements in self-efficacy of learning and performance (F = 5.42, p < 0.01) and meta-cognitive self-regulation scores (F = 5.91, p < 0.01). In the between-group analyses, both BL and self-guided RISE were comparable for resilience, social support, and learning scores (p > 0.05). The study provided preliminary evidence that both modes, BL and self-guided RISE programme lead to positive effects on the resilience, social support, and learning scores of students.

Impact of Educational Activity Formats, Online or In-Person, on the Intention of Medical Specialists to Adopt a Clinical Behaviour: A Comparative Study

COVID-19 accelerated continuing professional development (CPD) delivered online. We aimed to compare the impact of in-person versus online CPD courses on medical specialists' behavioural intentions and subsequent behaviour. In this comparative before-and-after study, medical specialists attended in-person courses on nine clinical topics. A second group attended an adapted online version of these courses. Behavioural intention and its psychosocial determinants were measured before and immediately after the courses. Behaviour change was measured six months later. Generalised estimating equation (GEE) models were used to compare the impact of course formats. A total of 82/206 in-person registrants (mean age: 52±10 years; 50% men) and 318/506 on-line registrants (mean age: 49±12 years; men: 63%) participated. Mean intention before in-person courses was 5.99±1.31 and 6.43±0.80 afterwards (average intention gain 0.44, CI: 0.16-0.74; p=0.003); mean intention before online courses was 5.53±1.62 and 5.98±1.40 afterwards (average intention gain of 0.45, CI: 0.30-0.58; p<0.0001). Difference in intention gain between groups was not statistically significant. Behaviour reported six months later was not significantly associated with post-course intention in either group. However, the intention difference increased significantly among those who said they had adopted the targeted behaviour (paired wilcoxon test: n = 40 and p-value=0.002) while it did not increase significantly in the group of those who had not adopted a targeted behaviour (paired wilcoxon test: n = 16 and p-value=0.223). In conclusion, the increase in intention of specialists after CPD courses was similar whether the course was in-person or online. Also, an increase in intention in both groups signalled more likelihood of adoption.

Is better readiness the key to deeper learning in distance education? A cross-sectional online study

Background

The COVID-19 pandemic has required teachers and students to suddenly transition from face-to-face formats to distance education (DE). The uniqueness of nursing discipline is that it requires both theoretical and skills-based learning. Therefore, it is necessary to explore the influencing factors and effectiveness of DE in nursing education. This exploration can guide teaching practice and provide a basis for the future application of DE in nursing education.

Aims

To describe the current distance education readiness and depth of learning among undergraduate nursing students and explore possible influencing factors. To determine the relationship between students' distance education readiness and the depth of learning.

Design

This is a descriptive and cross-sectional online study.

Settings

School of Nursing in a traditional Chinese medicine university, Beijing, China.

Participants

A total of 222 undergraduate nursing students from a traditional Chinese medicine university were recruited.

Methods

A questionnaire, which is composed of information form, the Online Learning Readiness Scale, and the Scale of Students Making Deep Learning, was used for data collection. Frequency, percentage, arithmetic mean, standard deviation, t-test, one-way ANOVA, and Pearson correlations were used in the analysis of the data.

Result

Undergraduate nursing students have lower averages in distance education readiness and higher averages in the depth of learning. Significant differences in distance education readiness and depth of learning between different grade groups. A positive correlation was found between distance education readiness and depth of learning (r = 0.894, p < 0.001).

Conclusion

Distance education is a feasible approach to learning today. Undergraduate nursing students have exhibited poor readiness for distance education but demonstrated deeper learning conditions. Upper grades may lead to better learning outcomes. Better distance education readiness can lead to deeper learning. These conclusions prompt teachers and students to be prepared before participating in distance education to obtain better academic performance.

Nursing Students' Views on an e-Learning Activity About Health Promotion for Older Adults: A Cross-Sectional Study

PURPOSE

Nurses are graduating ill-prepared to work with older adults across care contexts. The education nursing students receive about older adults often focuses on managing illnesses rather than promoting health. To expand the education that nursing students receive regarding health promotion and older adults, we examined nursing students' perceptions of an e-learning activity on health promotion with older adults.

METHOD

We used a cross-sectional survey design. We included first-year baccalaureate nursing students (N = 260) at a Canadian university. Students were required to complete the module, but only those who wanted to participate in the study completed the survey (n = 167; response rate = 64.2%). We used a feedback survey to assess students' perceptions of the e-learning activity using four 5-point, Likert-type items. We also asked one open-ended question to solicit participants' feedback and suggestions for improving the e-learning activity. Descriptive statistics (frequency, mean [SD]) were used to summarize participants' perceptions and demographic characteristics. Content analysis was used to explore responses to the open-ended question.

RESULTS

Participants reported that the module increased their knowledge about health promotion, as well as their perceptions and confidence in working with older adults. Participants also found the method of instruction interactive and enjoyable.

CONCLUSION

Our e-learning activity on health promotion was perceived by nursing students as helpful in sensitizing them to their role in promoting health among older adults. [Journal of Gerontological Nursing, 50(3), 19-24.].

Virtual Active Learning to Maximize Knowledge Acquisition in Nursing Students: A Comparative Study

BACKGROUND

Nursing students need to acquire knowledge through active methods that promote critical thinking and decision making. The purpose of this study is to analyze whether there are differences in the acquisition of knowledge by nursing students between active face-to-face or virtual teaching methods.

METHODS

In this comparative study, nursing students enrolled in the psychology course were divided into two groups: a face-to-face group that received active teaching methods and a virtual group. The virtual group was exposed to the Effective Learning Strategy (ELS), which included seminars based on video content through the Virtual Campus and answering questions using the H5P tool. In addition, participants engaged in reflection tasks on the content. Covariate data were collected, and knowledge tests were administered to both groups before and after the course. After three months, subjects were re-evaluated with a final exam to assess content retention.

RESULTS

A total of 280 students were randomized. No differences were found in students' scores at the end of the knowledge test or in their final grades in the subject. Having study habits (b = 0.12, p = 0.03) and social support from relevant people (b = 0.09; p = 0.03) were associated with better post-intervention scores, and inversely with social support from friends (b = -0.12, p < 0.01). Final grades were inversely associated with digital safety literacy (b = -0.101, p = 0.01). No factors were associated with the scores of each group separately.

CONCLUSIONS

The ELS virtual active learning model is as effective as face-to-face active learning methods for teaching psychology to first-year nursing students. This study was not registered.

Cognitive engagement of nursing undergraduates in blended learning: A parallel mixed method study

BACKGROUND

Blended learning is being integrated into undergraduate nursing education at all levels and from all directions. Cognitive engagement is not only an embodiment and guarantee of students' engagement into the curriculum from a cognitive level, deep engagement and high-level thinking, but also an important indicator of whether students are effectively engaged in the blended learning curricula. However, no studies have been seen to investigate the cognitive engagement of nursing undergraduates in the blended learning curricula and its influential factors.

OBJECTIVES

To explore nursing undergraduates' cognitive engagement during the blended learning curricula and its influential factors.

DESIGN

A convergent parallel mixed-methods was used. Data were collected between November 2021 and May 2022, inclusive.

SETTINGS AND PARTICIPANTS

The study was carried out in the nursing school at a university in China. Participants including students undertaking entry to the blended learning curricula.

METHODS

In the quantitative component (n = 142), participants' cognitive engagement was investigated and factors associated with it were examined using univariate analysis, correlation analysis and multiple regression analysis. During this period, personal, semi-structured interviews were conducted with a subset of these participants (n = 15) to understand participants' cognitive engagement experiences.

RESULTS

The cognitive engagement of nursing undergraduates was at a moderate level and the cognitive engagement experiences were reflected in the four themes of Reconstitution, Connection, Elaboration and Retention. The influential factors of cognitive engagement were learning activities (β = 0.226, p = 0.004), autonomy (β = 0.158, p = 0.047), academic self-efficacy (β = 0.311, p < 0.001, β = 0.271, p < 0.001) and social interaction (β = 0.358, p < 0.001).

CONCLUSIONS

The cognitive engagement of nursing undergraduates in the blended learning curricula needs to be improved. To maximize promote cognitive engagement of nursing undergraduates in the blended learning curricula, educators should design diverse learning activities, engage in high quality social interactions with students, and maximize students' autonomy and self-efficacy.

Technology: A metaparadigm concept of nursing

Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.

Mediating effects of future time perspective on the relationship between mindfulness and learning burnout in college students: A cross-sectional descriptive study

With the rise of positive psychology, educators gradually pay attention to the construction of psychological capital of college students. Mindfulness is linked to learning burnout; however, little research has examined how mindfulness is associated with learning burnout via future time perspective. The aims of this study were to investigate the relationship between mindfulness state, future time perspective and learning burnout of college students, and explore the mediating effect of future time perspective on mindfulness and learning burnout. A cross-sectional design was used. A total of 358 college students were enrolled from Harbin Medical university. General information questionnaire, the Five Facet Mindfulness Questionnaire (FFMQ), the learning burnout scale and The Future Time Perspective Scale were used for investigation. Calculations were performed using SPSS Statistics, version 25. There was negative correlation between positive mindfulness and learning burnout (r = -0.41, P < .01), and positive correlation between future time perspective and mindfulness (r = 0.38, P < .01), and negative correlation with learning burnout (r = -0.37, P < .01). Furthermore, future time perspective (β = -0.40, P < .01) had a significant mediating effect on the relationship between mindfulness and learning burnout. Educators should improve the mindfulness of college students by developing and implementing future time perspective, in order to improve their learning burnout.

Distance Education in Nutrition and Dietetics Education over the Past 30 Years: A Narrative Review

The coronavirus disease 2019 pandemic necessitated the use of distance education, which sparked a technological transformation that was long overdue in higher education. The purpose of this narrative review is two-fold: to summarize the state of knowledge regarding distance education in nutrition and dietetics education over the past 30 years to inform recommendations for future education/research and implications for practice and to determine the influence that distance education has had on the knowledge, skills, and attitudes of both nutrition and dietetics educators and their students. A narrative review of 822 publications yielded 25 that met the search criteria. In the scope of 30 years, the literature shows that attitudes and perceptions of distance education have changed as barriers to online access have diminished and the availability of online nutrition and dietetics courses and Accreditation Council for Education in Nutrition and Dietetics-accredited distance education programs has expanded. However, whereas the limited results are promising, the paucity of large-sample research about the use of distance education in nutrition and dietetics education restricts educators' knowledge of and ability to evaluate the learning outcomes of distance programs and courses. Moreover, differences in how accreditors, government agencies, and institutions define distance education could have significant influence on funding and financial aid benefits for students and research. Recommendations for future research and implications for practice are provided given the relevance and importance of distance education to nutrition and dietetics education.

The impact of distance education on nursing students course performance in a sino-foreign cooperative program during the onset of COVID-19: a quasi-experimental study

BACKGROUND

The outbreak of COVID-19 changed many studies' teaching mode in higher education profoundly, including nursing. This study evaluated the impact of distance education on the course performance of nursing students in a nursing fundamentals course during the epidemic of COVID-19.

METHODS

This is a comparative prospective and retrospective quasi-experimental study. Nursing students in a Sino-foreign cooperative program were allocated to either an intervention group (distance education, n = 48) or control group (face-to-face teaching, n = 36). A self-efficacy questionnaire, an academic engagement scale and grades of the final written examination were used to evaluate the students' self-efficacy, academic engagement and academic performance, respectively. The data in this study were analyzed by two independent sample t-tests and the Chi-square test. Students experiencing distance teaching had worse academic performance (p = 0.001) and lower levels of learning behavior self-efficacy (p<0.05). The total score of academic engagement (p = 0.04) for students experiencing distance teaching were significantly lower than the scores of those students in the control group.

CONCLUSIONS

In the context of COVID-19, nursing students conducted using distance education had poor course performance.

Dialogues on nursing curriculum and pedagogy: a critical planning activity for global educational collaboration

PURPOSE

We describe the experience of a collaborative, dialogical process on nursing pedagogy to identify the best process for creating a mutually beneficial international nursing education exchange.

APPROACH

Faculty from two universities in Sucre, Bolivia and in Seattle, Washington, US engaged in planned virtual dialogues to share their nursing curricula, course content, teaching methodologies, and contextual challenges and strengths.

RESULTS

From the dialogues, a thematic analysis using a modified conventional content analysis approach was completed, and four themes emerged: 1) similarities in course content, pedagogy, and curricular challenges; 2) differences in teaching competencies; 3) teaching methodologies responsive to national trends; and 4) benefits from and alternatives to the use of educational technology. Early dialogues among participants allowed them to discern areas of need and interest for future planning.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Intentional academic dialogues should be the first step to enter in an exchange program to enable participants from different hemispheres to contribute equally as partners in the formation of nurses able to respond the current global health concerns.

Student and faculty perceptions of effectiveness of online teaching modalities

BACKGROUND

When the COVID-19 pandemic forced colleges and universities to rapidly transition from face-to-face teaching to online teaching/learning environments, different instructional methods were employed to deliver course content and help students remain engaged in learning. With the transition back to the on-campus environment, select online teaching modalities may be effective in the face-to-face environment as well. While online and distance learning have been extensively studied, little research is available to guide faculty in using technologies designed for distance learning in the face-to face environment.

PURPOSE

The purpose of this study was to determine pre-licensure baccalaureate nursing student and nursing faculty perceptions of the effectiveness of various online teaching modalities.

METHOD

A mixed-methods study using a convenience sample of students and faculty at two universities was conducted. Students and faculty completed a researcher-developed survey to rate a variety of online teaching methods and technologies from a scale of one (not effective at all) through six (extremely effective). Participants also provided comments within the survey and in focus groups of randomly selected students and faculty. Surveyed items included modes of asynchronous and synchronous instruction, instructional technology, and instructional activities.

RESULTS

There were significant differences as well as similarities in student and faculty perceptions of effectiveness. Students demonstrated a clear preference for pre-recorded lectures, while faculty perceived synchronous lectures and assigned readings to be equally as effective as pre-recorded lectures. Synchronous activities such as case studies and student presentations were rated as more effective by faculty than by students. Both groups perceived instructional games, especially quiz games, as very or extremely effective.

CONCLUSIONS

Students were more engaged with instructional activities that they perceived as effective for learning. The results of this study will assist faculty in developing effective online and in-person instruction which will optimize the teaching/learning experience.

Learning engagement; nursing students' experiences in an online environment at a university

AIM

The aim of this study was to understand students' engagement with learning in an online environment at a university in Namibia.

DESIGN

A qualitative descriptive design was applied.

METHODS

Data were collected using in-depth telephonic interviews among 12 purposively selected nursing students. Data were analysed thematically.

RESULTS

While the students did practice engagement, their understanding of learning engagement was not clear. The students considered online learning to be a safe space for engagement that enhanced active participation. They also noted that it forced them to reflect on their pre-existing knowledge before learning new information and ultimately enhanced their understanding of the learning material. The findings of this research suggest that online platforms and apps can support nursing students' learning engagement, in particular behavioural engagement, but they are less conducive to cognitive and affective engagement.

Online learning challenges in Thailand and strategies to overcome the challenges from the students' perspectives

Recently, at the end of 2019, the whole world was affected by the outbreak of COVID - 19 disease, which has caused massive disruption of the normal teaching and learning process worldwide, including Thailand's educational system. This sudden shift of the educational processes to online learning and teaching has caused many challenges as teachers, learners, and educational institutes are not well-prepared, especially in developing countries like Thailand. This research used a mixed-methods approach, quantitative and qualitative data, in which a google form survey questionnaire was designed in both English and Thai language to 1). investigate Thai students' perceptions of the online learning experience; 2). assess factors that cause challenges in online learning in Thailand; 3). find out strategies for improvement and overcome the challenges. For the sample of the study, 465 students were selected purposively from two public Universities in Thailand due to convenience for collecting data as two co-researchers were teaching in these universities. Results identified major challenges such as the temptation to see other sites, difficulty in understanding the lesson context, poor internet connectivity, difficulty in time management, difficulty in attending the online examination, poor quality of learning experience, low interest/motivation, difficulty in selecting the area at home, difficulty in doing work assignment/task, and distraction at home learning environment. Among the identified factors for these challenges were distraction due to noise and poor learning environment at home, teacher's incompetency due to technical, poor teaching skills, unstructured content or no follow-up, and technological constraint affecting the quality of audio/video uploaded connectivity, technical issue or data limit. Students also suggested strategies to overcome online learning challenges such as improvement in evaluation, connectivity, interactivity, content and accessing materials. The study concluded that all these factors and strategies should be considered for the effective implementation of the online education system in Thailand.

Re-thinking the online distance instruction based on students' feedback

During the covid-19 pandemic, schools at all levels were often closed and online distance instruction (ODI) was applied. The main objective of this research was to discover the main didactic features of online distance instruction; and based on the collected data to define didactic recommendations towards improving the quality of the process. Five hypotheses were set that evaluated students' opinions in the areas of teachers' support for learners within ODI, types of sources exploited within ODI, means used for practising and fixing new knowledge within ODI, assessment of learners' performance within ODI, and students' feedback on ODI. In total, 272 respondents from upper secondary and higher education institutions participated in the research. Each respondent described the process of online distance instruction in two courses they selected of 64: (1) in a course that they appreciated, liked, enjoyed, and considered efficient from the point of view of their learning; (2) in a course that caused them discomfort in learning, as it was conducted in a way that did not suit them, and their learning did not bring the expected learning outcomes. Data were collected via a questionnaire; Chí-square test, adjusted residuals, and t test for comparison of means were calculated. Before the research started, teachers were trained in online distance instruction. Therefore, we expected that they will be competent in designing online distance courses and the courses will follow didactic principles. The results discovered significant differences in the frequency of occurrence of observed features in courses that received positive feedback compared to those having negative evaluation. However, some exceptions were detected.

A Meta-synthesis on Technology-Based Learning Among Healthcare Students in Southeast Asia

Healthcare education providers are eager to apply technologies in teaching and learning activities; however, students are the consumers in higher education, and their opinion and experience should be considered. We performed a meta-synthesis of qualitative studies to help inform our understanding of Southeast Asian healthcare students' perceptions and experience of technology-based teaching and learning in their education. Our search strategy located 1599 articles from a dozen electronic research databases. Articles were analyzed for quality using the Hawker's Evidence Appraisal Tool, and 23 qualitative studies were included in the final meta-synthesis. Technologies investigated largely involved online or blended learning, with fewer exploring virtual reality, simulations, telehealth, game-based learning, and videos. Three overarching themes were synthesized: (i) culture does matter in the implementation of technology-based learning; (ii) the values and limitations of technology used for learning; and (iii) technology is part of daily life and creates new challenges in education. Technology is an asset to enhance the learning experience, but educators must be aware of its limitations. Pre-coronavirus disease 2019 (COVID-19) studies were more focused on technology and product, and were optimistically reported, whereas COVID-19-spanning studies focused on life experience and paid more attention to reporting on the inherent challenges. The educational approaches, theories, cultural aspects, and availability of facilities all play a vital role in steering successful technology use in learning.