Effects of unfolding case-based learning on academic achievement, critical thinking, and self-confidence in undergraduate nursing students learning health assessment skills

The impact of applying unfolding case-study learning on critical care nursing students' knowledge, critical thinking, and self-efficacy; a quasi-experimental study

BACKGROUND

The unfolding case-study learning approach is a growing modernized learning strategy implemented in different health disciplines. However, there is a lack of existing research that examines the effects of unfolding case studies in advanced nursing courses.

AIM

To examine the impact of applying an unfolding case-study learning approach on critical care nursing students' knowledge, critical thinking, and self-efficacy.

METHODS

This posttest-only, quasi-experimental study was conducted at XXX University in Palestine. A single-stage cluster sampling was used to assign nursing students enrolled in the critical care nursing course into experiment and conventional groups. The intervention group (n= 91) underwent unfolding case-study learning for selected cardiovascular topics, whereas the conventional group (n= 78) was taught using the traditional teaching methods. The posttest assessment was conducted using Knowledge Acquisition tests, Yoon`s Critical Thinking Disposition Instrument (YCTD), and the Self-Efficacy for Learning and Performance instruments. The Social Constructivist Theoretical Framework was integrated into the study.

RESULTS

Homogeneity was achieved between both groups concerning Age, Gender, and GPA. The experiment group scored significantly higher than the conventional group regarding the posttest knowledge acquisition tests (7.12 vs. 5.49, respectively, t=-12.7, P<0.001, CI: -1.89 to -1.38), critical thinking (4.32 vs. 3.63 respectively, t=17.390, p<0.001, CI: -77 to -61) and self-efficacy (6.12 vs. 4.4 respectively, t=-30.897, p<0.001, CI: -1.82 to -1.60). Multivariate analysis revealed that 69 % of the variations of posttest scores were influenced by critical thinking scores (Adjusted R Squared=0.690, F=3.47, P=0002, η2=0.969). Similarly, self-efficacy has been shown to contribute by 74 % to the variations of scores after conducting the study program (Adjusted R Squared=0.743, F=4.21, P=0001, η2=0.974). However, the variations of both critical thinking and self-efficacy scores were not significantly influenced by the contribution of knowledge acquisition (p=0.772 and 0.857, respectively) and students' GPA (p=0.305 and 0.956, respectively).

CONCLUSIONS

Irrespective of knowledge level and GPA, the unfolding case-study learning approach can enhance the critical thinking and self-efficacy of students enrolling in advanced nursing courses.

Effects of an unfolding case study on clinical reasoning, self-directed learning, and team collaboration of undergraduate nursing students: A mixed methods study

BACKGROUND

Clinical reasoning is an essential nursing competency that students must develop to provide safe patient care. Developing and utilizing unfolding case studies, which present constantly changing patient conditions to improve students' clinical reasoning and to foster communication and self-reflection, can help to achieve that imperative.

OBJECTIVES

To develop an unfolding case study and to test its effectiveness in improving clinical reasoning, team collaboration, and self-directed learning.

DESIGN

A mixed methods design.

SETTING

One university in Southern Taiwan.

PARTICIPANTS

Forty nursing students.

METHODS

An unfolding case study was developed based on the clinical reasoning model and unfolding cases model. The Nurses Clinical Reasoning Scale, Self-Directed Learning Instrument, and Questionnaire of Group Responsibility and Cooperation in Learning Teams were used. Forty nursing students completed questionnaires and nine of them participated in focus group discussions. Wilcoxon signed-rank, Spearman correlation, regression, and inductive content analysis were used to analyze data.

RESULTS

Students' abilities in clinical reasoning, self-directed learning, and team collaboration were statistically significantly improved after implementation of the unfolding case study. Emergent themes included "patient-centered communication," "group inspiration and learning," "thinking critically and reflecting on oneself," and "applying theoretical knowledge in care to meet patients' changing needs."

CONCLUSIONS

Unfolding case studies provide a safe environment in which nursing students may learn and apply knowledge to safe patient care.

Development and implementation of a high-fidelity simulation training course for medical and nursing collaboration based on the Fink integrated course design model

Aim

The purpose of this study is to examine the design and implementation of a high-fidelity simulation training course for medical and nursing collaboration, based on the Fink integrated course design model. Additionally, the study aims to validate the teaching effectiveness of the course.

Background

Previous empirical studies have highlighted the effectiveness of collaborative healthcare education in institutional teaching and hospital training. However, the development of healthcare collaborative education in China has been slow to develop in China. In recent years, Chinese nursing educators and researchers have shown interest in utilizing high-fidelity simulators for healthcare collaborative education. These simulators help address the limitations of traditional nursing teaching and healthcare separation simulation. Nevertheless, a standardized simulation interprofessional education curriculum is still lacking. Therefore, nursing educators need to develop a standardized high-fidelity simulation training curriculum for healthcare collaboration, guided by established science curriculum development theories.

Methods

A high-fidelity simulation training course on healthcare collaboration was designed based on the Fink integrated curriculum design model. The course was taught to 14 nursing students and 8 clinical medicine students from March to July 2022. To comprehensively evaluate the effectiveness of the healthcare collaboration high-fidelity simulation training course, several assessment tools were used. These included course grades, satisfaction and self-confidence scales, simulation teaching practice scales, healthcare collaboration attitude scales, critical thinking skills scales, and semi-structured interviews.

Results

After the course was implemented, students demonstrated high overall scores (79.19 ± 5.12) and reported high satisfaction ratings (4.44 ± 0.37). They also exhibited increased self-confidence (4.16 ± 0.33). Additionally, students evaluated all four dimensions of the course teaching practice scale positively. Furthermore, the study demonstrated significant improvements in various aspects, such as attitudes toward medical and nursing collaboration (t = -7.135, P < 0.01), shared education and teamwork (t = -3.247, P = 0.002), job autonomy for nurses (t = -1.782, P = 0.000), and reduced physician dominance (t = -6.768, P = 0.000). The critical thinking skills of the students showed significant improvement, with higher scores in truth-seeking (t = -3.052, P = 0.004), analytical ability (t = -2.561, P = 0.014), systematic ability (t = -3.491, P = 0.001), self-confidence in critical thinking (t = -4.024, P = 0.000), and curiosity (t = -5.318, P = 0.000) compared to their scores before the course (all P < 0.05). The interviews showed that the course's student-centered approach enabled active learning. Students suggested enhancing teaching cases and allocating more time for reflection and summarization.

Conclusion

The study successfully designed a high-fidelity simulation training course for healthcare collaboration by utilizing the Fink integrated curriculum design model. The findings provide valuable insights for the development of standardized curricula and healthcare collaboration education in China. Moreover, the course adheres to best practice principles, fostering improved attitudes toward healthcare collaboration and enhancing students' healthcare collaboration and clinical thinking skills.

The impact of an educational program based on the reproductive health of LGBT individuals developed for nursing students to improve the knowledge, skills and attitudes of students: A quasi-experimental study

AIM

This study aimed to investigate the impact of an educational program developed for nursing students to evaluate their knowledge of the lesbian, gay, bisexual and transgender (LGBT) community, their reproductive health and recording their reproductive history. The program aimed to assess the effective communication skills and attitudes of nursing students toward LGBT individuals after completion of the program.

BACKGROUND

Issues related to the reproductive health of LGBT individuals are not adequately addressed in the nursing curriculum. Innovative approaches using active learning methods will increase the knowledge and skills of the students regarding LGBT reproductive health and help them gain positive attitudes toward LGBT individuals.

DESIGN

A quasi-experimental (single group pretest-posttest) design.

METHODS

This study was conducted with 48 students in the 4th year in the Spring semester of the Academic year 2020-2021 at the Faculty of Nursing in a university. The eight-week education program included a discussion of modules developed for the reproductive health of LGBT individuals, film display and analysis, sample video display and analysis, role-play activities and standardized patient interviews. The research data were collected using a semi-structured questionnaire, Information Evaluation Test for LGBT Individuals, Attitude Scale Toward LGBTI Individuals, Reproductive Health History Taking Skills Checklist, Effective Communication Skills Evaluation Form and Student Satisfaction Evaluation Form. The data were analyzed using the mean, standard deviation, frequency, percentage distributions and Wilcoxon signed-rank test.

RESULTS

The study identified a significant increase in the median students' knowledge about LGBT individuals (p < 0.001), a substantial positive development in their attitudes toward LGBT individuals (p < 0.001) and a significant increase in the median scores of effective communication with LGBT individuals and recording the reproductive health history (p < 0.001) at the end of the education program.

CONCLUSION

The education program resulted in positive knowledge, attitude and skill changes in the nursing students supporting the reproductive health of LGBT individuals. Education programs based on LGBT reproductive health using active learning methods should be integrated into undergraduate nursing curricula to combat disparities toward LGBT individuals.

Scaffolding as active learning in nursing education

Recent changes, such as COVID-19 restrictions and advances in technology, have led to unique effects on nursing education, requiring new pedagogical thinking and strategies. Studies have shown that a more active approach to learning leads to positive gains for students. In this conceptual paper, we argue that scaffolding specifically allows instructors to break down assignments into meaningful chunks with instructional support that fall within reach of a student's ability, making the assignment both more manageable and actively engaging. This paper outlines six principles (Van Lier, 1996) to the scaffolding approach and discusses two example assignments that utilize scaffolding in nursing education to increase active engagement and improve learning outcomes. Examples include a research critique paper and an unfolding case study.

Effects of reflective learning based on visual mind mapping in the fundamentals of nursing course: A quasi-experimental study

BACKGROUND

Previous studies have shown that reflective learning and mind mapping have many advantages in nursing education, but the relevant researches on the joint application of the two strategies are very limited.

OBJECTIVES

To confirm the efficacy of reflective learning based on visual mind mapping for educational purposes to support the critical thinking, academic self-efficacy, and professional self-concept of nursing students.

DESIGN

A quasi-experimental design with pretest and posttest model.

SETTINGS

A nursing college in Chengdu, Sichuan Province, China.

PARTICIPANTS

Eighty 2nd year baccalaureate nursing students in two parallel classes were assigned to an intervention group (n = 40) and a control group (n = 40) with one class for each group.

METHODS

This study was carried out from September 15 to November 30, 2021. The Chinese version of Critical Thinking Disposition Inventory (CTDI-CV), the Chinese version of Academic Self-Efficacy Scale (ASE-CV), and the Chinese version of Professional Self-Concept of Nurses Instrument (PSCNI-CV) were used to evaluate the effects of the study intervention on nursing students. Firstly, the pretest data were collected from students in the two groups. Then, the intervention group students made regular reflective entries based on mind mapping and the control group students conducted traditional reflective journal, while attending routine educational and clinical activities, about their experiences of the Fundamentals of Nursing course learning process. After the intervention, both groups completed the three scale tests again, and an open-ended question was set for intervention group to explore the difficulties or challenges encountered by students. Descriptive statistics, Chi-square, Mann-Whitney U test, and content analysis were performed.

RESULTS

There were no significant baseline demographic variables differences between the two groups. The intervention group showed significant improvement in critical thinking (P = 0.000), including truth-seeking, open-mindedness, analyticity, systematization, and inquisitiveness sub-dimensions (P = 0.000-0.014), and professional self-concept (P = 0.015), including flexibility and satisfaction sub-dimensions (P = 0.015-0.039), as compared to the baseline. There was no significant difference in students' academic self-efficacy level between pretest and posttest of the two groups. Compared to the total level of critical thinking between the intervention and the control group, the difference median values (posttest score-pretest score) were 14.0 and 1.5 respectively; and for professional self-concept, were 4.5 and 0.5 respectively, which were statistically significant at P < 0.05 level (P = 0.001-0.020). According to open-ended question survey, difficulties or challenges faced by the intervention group students were mainly problem of charting mind mapping, unfamiliar with tools, problem of mentors' guidance, and time-consuming.

CONCLUSIONS

This study found that it is appropriate for students to adopt reflective learning based on visual mind mapping. Although there were no significant differences in the improvement level of students' academic self-efficacy, students' critical thinking and professional self-concept were greatly improved by the intervention. This approach may be used as a complementary learning method for baccalaureate nursing education.

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.