Learning styles of baccalaureate nursing students and attitudes toward theory-based nursing

Learning styles and critical thinking relationship in baccalaureate nursing education: a systematic review

BACKGROUND

Critical thinking is a desirable competency for contemporary nurses although there are growing concerns supporting a disturbing paucity in its achievement. Learning styles reflect habitual behaviors which determine distinct preferences within learning situations. Evidence suggests that critical thinking could evolve through learning processes. Variances in critical thinking achievement by nursing students might therefore be influenced by individual learning preferences. The concepts "learning styles" and "critical thinking" have been independently examined in the nursing literature. No reviews were found however exploring their association in nursing education.

OBJECTIVES

To identify the potential relationships between learning styles and critical thinking in baccalaureate nursing students.

DESIGN

Systematic review.

DATA SOURCES

Eleven electronic databases were utilized without geographical and time publishing filters. Hand-searching journals and scanning references from retrieved studies were also performed.

METHODS

Databases were searched for descriptive correlational studies which considered the relationship between learning styles and critical thinking in baccalaureate nursing students. The authors independently progressed three stage screening. Retrieved articles were reviewed at title, abstract and full text levels according to predetermined criteria. All included studies were quality appraised using a rating tool for descriptive studies.

RESULTS

Six studies were finally included. Findings were grouped under four key themes: predominant learning styles, critical thinking scoring, critical thinking evolution across academic progress and learning styles-critical thinking correlations. Learning styles' diversities, weak critical thinking and inconsistent evolution through academic progress were revealed across studies. Critical thinking differed significantly between learning styles.

CONCLUSIONS

Commonly accepted models in nursing education were lacking in both learning styles and critical thinking. Within studies identical learning styles were found to be positively or negatively related to critical thinking. However comparative findings across studies revealed that all learning styles might be positive determinants toward critical thinking evolution, suggesting that there is a relationship between learning styles and critical thinking. Certain links between learning styles and critical thinking were supported in given settings and given nursing student populations. Further field exploration is required.

Leading Change and Advancing Health by Enhancing Nurses' and Midwives' Knowledge, Ability and Confidence to Conduct Research through a Clinical Scholar Program in Western Australia

This paper reports on an evaluation of a Clinical Scholar Program initiated at a hospital in Western Australia. The aim of the program was to build the capacity of nurses and midwives to conduct research and evidence-based practice within the hospital. The program was based on a previous program and consisted of six teaching days and four hours per month release for proposal preparation. At the end of the program participants were asked to complete a short anonymous questionnaire. The answers were analysed using standard processes of qualitative analysis. Themes emerging from the data included program strengths, individual gains, ability to conduct research, and areas for improvement. The findings highlighted that, while the participants considered that they were more knowledgeable and confident to conduct research, they still required support. The Clinical Scholar Program has provided a way to increase the capacity of clinicians to participate in research activities.

Development and testing of a Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students

Aim. This paper reports the development and testing of the psychometric properties of the Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students. Background. The quality of the clinical learning environment is an essential factor in determining the quality of nursing students' clinical experience. It is also well-recognized that the clinical setting can be a source of stress and anxiety for students. To design an optimal clinical learning environment for students, instruments based on the cognitive and socio-emotional aspects of the learning process are necessary. Method. The hypothetical construct of the clinical learning environment was derived from a comprehensive review of the literature, including experiential learning theory and the epistemology of practice. Developing the instrument involved the collection of items through semi-structured interviews, assessing content validity and determining the scaling. After a pilot study, the instrument was tested with 312 undergraduate students and 157 preceptors between September and December 2004. The factor structure was determined by exploratory factor analysis. Results. Exploratory factor analysis produced a five-factor solution that was similar to the hypothetical model. Cronbach's alpha internal consistency reliability coefficients ranged from 0.65 to 0.77 across the five factors. Three-week test-retest reliability coefficients ranged from 0.59 to 0.74. Criterion-related validity and construct validity were estimated by the correlation between the Clinical Learning Environment Diagnostic Inventory and appropriate other instruments and a set of comparison data obtained from the students and preceptors. Conclusion. The findings yielded acceptable estimates of reliability and validity of the Clinical Learning Environment Diagnostic Inventory. Therefore, this instrument is considered useful for assessing learning environments in clinical settings.

Learning Styles of Students and Faculty in Selected Health Care Professions

The purposes of this study were to determine if students and faculty in nursing and allied health demonstrate a predominant learning style, if there is an association between a specific learning style (converger, diverger, accommodator, or assimilator) and self-directed learning readiness for these groups, if these learning characteristics can predict academic success, and if a discipline-specific learning style can be identified. Marshall and Merritt's (1986) Learning Style Questionnaire and Guglielmino's (1978) Self-Directed Learning Readiness Scale (SDLRS) were administered to 301 generic BSN students, 188 RN-BSN students, 110 allied health students, and 30 nursing faculty from one southwestern university. There were no significant differences in learning style between students and faculty; the converger style was the predominant learning style for all subjects. Faculty were more self-directed than students; although, overall, students scored high on the SDLRS. Self-directed learning readiness appears to affect learning style. Convergers were significantly more self-directed than either the accommodators, assimilators, or divergers. Academic success, as determined by program completion, could not be predicted on the basis of learning style or self-direction.

The effect of a senior preceptorship on the adaptive competencies of community college nursing students

A pre-post design was used to examine the effect of a senior preceptorship experience on the adaptive competencies, environmental press perceptions and learning styles of 55 third-year community college nursing students. Kolb's experiential learning theory provided the framework for the study. Subjects rated their concrete and abstract competencies and the importance of divergent and convergent competencies significantly higher following the preceptorship. They also felt that the preceptorship experience contributed significantly more to their competency development than their weekly clinical experiences during the year. Contrary to expectations, administration of the Learning Style Inventory LSI-1976 and LSI-1985 produced inconsistent classifications of subjects' learning styles. Implications for nursing are described.

The assessment of student nurse learning styles using the Kolb Learning Styles Inventory

The learning styles of 192 Registered General Nursing/DipHE students was determined using the Kolb Learning Styles Inventory prior to the students having any formal contact with lecturing staff. The percentage of students having a predominantly concrete learning style was 53.7%, while 46.3% were predominantly reflective. This finding is in keeping with those of Laschinger & Boss (1984), who suggest that they are supportive of Kolb's theoretical tenet that concrete learners tend to choose people-oriented professions. Chi-squared tests were used to determine if the respondent's learning styles varied with either age, sex or having been in employment prior to becoming a nursing student; no statistically significant associations were found. A further chi-squared analysis was performed to see if there was a relationship between learning style and those students who possessed: 1) only the DC test, 2) O-levels as highest qualifications, and 3) A-levels as highest qualifications--no statistically significant associations were found. There remain measurement problems with the Kolb inventory, and a discussion of some of these issues are presented. The findings have reinforced the need for using a variety of delivery styles with students, with an emphasis on participation and experiential learning. This need for variety is essential given the distribution of learning styles found with the students. Nurse educators are urged to re-examine perceptions and assumptions about student learning needs.

Learning styles of nursing students: a 3-year cohort longitudinal study

The theoretical framework of this study was based on Kolb's model of experiential learning which proposes four phases: concrete experience, reflective observation, abstract conceptualization, and active experimentation. Kolb's Learning Style Inventory was used to assess preferences for these four learning modes. A freshman questionnaire developed by Peter Dietsche was used to determine basic demographic and background information, education goals, goal of obtaining a diploma, and goals in attending college. This study was conducted over a 3-year period (1990-1992). One hundred seventy-six female nursing students were tested in year 1. In the second year 138 of the original cohort were tested and in the third year 144 were tested. First year nursing students on the average selected as their cycle of learning: active experimentation "doing," reflective observation "watching," abstract conceptualization "thinking," and concrete experience "feeling." Little difference was noted in the learning style selected in year 2 and 3. In years 1, 2, and 3 nursing students' dominant learning style was that of Assimilator which combines the learning steps of abstract conceptualization (thinking) and reflective observation (watching).

The teaching/learning preferences of student nurses in the Republic of Ireland; background issues and a study

Teaching and learning in all forms of education is being increasingly reviewed in a climate of educational accountability. The literature generally displays a certain irrationality about nurse education; on the one hand teachers are espousing student-centred ideologies while on the other hand, students are expressing preferences for teacher-structured approaches. The research on nurse education generally concludes that the roles of teacher and student operate around a mechanistic view of man with the teacher being viewed as the front of all knowledge and the students the passive recipients of that which was given. This paper reports on related background issues, and a study of the teaching/learning preferences of student nurses from general, psychiatric, sick children's and mental handicap nursing. Whilst students reflected preferences for more teacher-structured strategies, significant differences were identified between the preferences of the four groups of student nurses. It is concluded that any insistence on a doctrinaire approach to teaching and learning would be unnecessarily restrictive to the whole process of nurse education. Nurse tutors therefore need to reflect on what they do, particularly that which influences the relationship between the students and what they learn. It is then the responsibility of nurse tutors to act on what they have learned about that relationship and their part in it.

Role perceptions of freshman and senior nursing and medical students and attitudes toward collaborative decision making

David Kolb's (1981) experiential learning theory was used to examine differences between first- and fourth-year nursing and medical students' perceptions of competencies important for nursing and medicine. A convenience sample of nursing (n = 109) and medical (n = 108) students from a large Canadian research university was surveyed. Respondents completed the Environmental Press Questionnaire, the Adaptive Competency Scale, and a 6-item measure of attitudes toward collaborative nurse-physician patient care decision making. Nursing students' perceptions of competencies important for medicine were found to be more congruent with medical students' perceptions of these competencies than were medical students' perceptions of competencies important for nursing as seen by nursing students. Gaps in perceptions of each others' roles were significantly negatively related to attitudes toward collaborative patient care decision making.

Changes in student learning styles and adaptive learning competencies following a senior preceptorship experience

The purpose of this pre-post comparison study was to examine the effect of the preceptorship experience on the learning styles (the manner in which individuals process information from the environment), adaptive competencies (the congruences between personal skills and task demands) and environmental press perceptions (the subjects' perceptions of the importance of each adaptive competency to effective functioning in a designated environment) of 37 fourth-year baccalaureate nursing students. Using Kolb's theory of experiential learning as the theoretical framework for the study, it was found that the students' learning styles were inconsistently categorized by two versions of Kolb's learning style inventory. The preceptorship experience was perceived by students to have significantly (P < 0.05) improved the development of their adaptive learning competencies. Students perceived the importance of divergent, accommodative and convergent learning competencies to be lower after the preceptorship experience, with the only significant difference (P < 0.05) being between pre- and post-convergent competencies. The preceptorship experience, however, was found to contribute significantly more (P < 0.001) to the students' development of most adaptive competencies than their weekly clinical experiences. The findings support the notion that a senior preceptorship programme is a valuable and worthwhile learning experience to include in baccalaureate nursing curricula.

Effect of Pregraduate Preceptorship Experience on Development of Adaptive Competencies of Baccalaureate Nursing Students

Kolb's (1984) theory of experiential learning was used as a framework to study 50 baccalaureate nursing students' perceptions of the contributions of a senior preceptorship experience to the development of adaptive competencies. Nursing learning environments were thought to contribute most to divergent and convergent competencies, reflecting the importance of both people-oriented and scientific skills in nursing. The preceptorship had a significant impact on most learning competencies. Significant increases occurred in competencies considered not important for nursing by students prior to the experience, e.g., assimilative competencies such as testing theories and ideas, and accommodative competencies such as leading and influencing others. These results support the notion of further research of nursing learning environments from the experiential learning perspective.

Impact of nursing learning environments on adaptive competency development in baccalaureate nursing students

Kolb's experiential learning theory (ELT) was used as a framework to study 179 generic baccalaureate students' perceptions of the contributions of different types of nursing learning environments to development of adaptive competencies described in the theory. In addition, students in each of the 4 years of the program were asked to describe their perceptions of the importance of Kolb's adaptive competencies for successful functioning in nursing settings as well as to rate their personal levels of skill on each competency. Nursing learning environments were thought to contribute most to divergent and convergent competencies, reflecting the importance of both people-oriented and scientific skills in nursing. Clinical experiences and the senior preceptorship experience contributed significantly more to the development of these competencies than typical nursing classes and nonnursing classes. Students considered assimilative competencies--such as testing theories--and ideas and accommodative competencies--such as leading and influencing others--relatively unimportant to successful functioning in nursing learning environments. Implications for nursing education are discussed.

Review of experimental learning theory research in the nursing profession

In this paper, Kolb's theory of experimental learning theory is briefly outlined. This overview is followed by a summary of research on the theory in nursing populations. Moderate support for various propositions of the theory suggests that further research is warranted and that Kolb's model may be useful as a basis for developing instructional activities in professional nursing education programmes.