Self-regulated learning in physical therapy education: a non-randomized experimental study comparing self-directed and instruction-based learning

Self-directed learning and clinical competence: The mediating role of the clinical learning environment

Introduction

Recognizing the factors affecting clinical competence among internship nursing students is crucial. This study was aimed at determining the effects of self-directed learning on internship nursing students' clinical competence under the mediating role of the clinical learning environment.

Methods

This cross-sectional research was performed on 300 internship nursing students selected by convenience sampling with a structural equation modeling (SEM) approach. Data were collected in one stage with three tools: the Self-Directed Learning Readiness Scale for Nursing Education, Education Environment Measure, and Clinical Competence Questionnaire. Data analysis was performed in SPSS version 21 and Smart-PLS version 3 with partial least squares-SEM. Measurement and structural model data were assessed with a significance threshold of p < 0.05.

Results

A total of 20.5 % of the variance in clinical competence was explained by self-directed and clinical learning environments. Self-directed learning had a significant positive effect on clinical competence (path coefficient = 0.14, 95 % CI: 0.02, 0.26; p = 0.027), and on the clinical learning environment (path coefficient = 0.41, 95 % CI: 0.31, 0.52; p < 0.001). A relationship was observed between the clinical learning environment and clinical competence (path coefficient = 0.38, 95 % CI: 0.25, 0.50; p < 0.001). The indirect effect of self-directed learning on clinical competence was positive and significant (path coefficient = 0.11, 95 % CI: 0.07, 0.17; p < 0.001). Self-directed learning had a significant total effect on clinical competence (path coefficient = 0.30, 95 % CI: 0.19, 0.40; p < 0.001).

Conclusions

According to the results, we recommend that nursing education managers and instructors consider plans to enhance self-directed learning among nursing students and improve the clinical learning environment.

Implementation of a coaching training for enhancing empathy and emotional intelligence skills in health science students: a prospective study

BACKGROUND

Empathy and emotional intelligence are core competencies in the educational curriculum of health science students, both play a significant role in teamwork relationships and in attention patient's cares; so innovative strategies to enhance these emotional skills are required. We prospectively tested an academic coaching program for improving empathy and emotional intelligence in students of health sciences degrees.

METHODS

A prospectively single arm intervention study was performed in undergraduate students of nursing, physiotherapy and occupational therapy of the Faculty of Health Sciences from the University of Granada (Spain). The three groups of students participated in nine sessions of coaching, which included a training program to manage patient's priorities and communication, adherence to treatment, motivation and satisfaction. Survey data included the Cognitive and Affective Empathy Test (TECA), the Trait Meta-Mood Scale (TMMS-24) and the Interpersonal Reactivity Index (IRI) which were assessed at baseline and post-intervention.

RESULTS

A total of 93 students of 259 (mean age of 21.6 ± 3.2 years) participated in the study and completed the sessions of coaching/surveys. After the intervention, we observed an improvement in the cognitive dimension of empathy among nursing students (p = 0.035) and in the affective dimension of empathy in physiotherapy students (p = 0.044). In addition, an increase on perceived emotional intelligence among students was achieved only in nursing/physiotherapy groups (p ≤ 0.048). Finally, slight improvements were founded in the dimensions "Perspective-Taking" and "Personal Distress" of the occupational therapy group (p ≤ 0.031). No significant differences were found for the rest of variables of TECA (p ≥ 0.052), TMMS-24 (p ≥ 0.06) and IRI (p ≥ 0.12).

CONCLUSIONS

This study shows that an academic coaching intervention with students from health sciences degrees improves their empathy skills and self-perceived emotional intelligence. The current findings can be used to determine more effective approaches to implementing academic coaching interventions based in better designs as clinical trial studies.

Self-directed learning assessment practices in undergraduate health professions education: a systematic review

PURPOSE

The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.

METHODS

Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.

RESULTS

Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001).

CONCLUSIONS

The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

A comparison between problem-based conventional learning and creative problem-based learning on self-regulation skills: Experimental study

Currently, the problem-based learning (PBL) method is a research trend used to improve students' self-regulation skills. This study highlights two methods derived from the PBL method, which applies the PBCL method (problem-based conventional learning) and the CPBL method (creative problem-based learning). Previous research stated that applying the PBCL and CPBL methods is often used to increase students' self-regulation skills; however, no study has compared the two methods to identify a more effective method for maximizing students' self-regulation skills. This study aims to compare students' self-regulation skills between applying PBCL and CPBL. Quasi-experimental methods were used in this experimental research. The research design was a posttest-only control group design. The population was 79 secondary school students in Probolinggo, Indonesia. A mathematics post-test and self-regulation skills questionnaire were the techniques used during data collection. An independent T-test and determination test were used during the data analysis. The results showed a significant difference between students' self-regulation skills in applying the CPBL and PBCL methods (Sig. = 0.000 < 0.05). The CPBL method is more effective than the PBCL method in improving students' self-regulation skills. Educators can use the implications of the results of this study to apply the CPBL method in their lesson plans to maximize students' self-regulation skills.

Cross-Cultural Adaptation, Reliability, and Validity of a Hebrew Version of the Physiotherapist Self-Efficacy Questionnaire Adjusted to Low Back Pain Treatment

BACKGROUND

Clinician self-efficacy may be an important factor in the success of treatment for low back pain (LBP), which has unique clinical features and a high prevalence rate. Therefore, it is important to assess clinicians' self-efficacy in this particular condition. The Physiotherapist Self-Efficacy (PSE) questionnaire was designed to measure self-efficacy of physiotherapy students.

OBJECTIVES

To translate and trans-culturally adapt the PSE into Hebrew, to adjust the questionnaire to assess clinicians' self-efficacy in the treatment of LBP, and to assess the construct validity and reliability of the PSE in the Hebrew version.

METHODS

After adjustment for LBP and cross-cultural adaptation, test-retest reliability was assessed with 140 physiotherapists. The analyses used included exploratory factor analysis for structural validity, Cronbach's alpha for internal consistency, and intraclass correlation coefficients (ICC) for test-retest reliability.

RESULTS

Factor analysis revealed a unidimensional structure with an acceptable model fit. The PSE translated into Hebrew exhibited a very high internal consistency (α = 0.93) and excellent test-retest reliability (ICC = 0.94). The standard error of measurement (SEM) and minimal detectable change (MDC) were 1.75 and 4.85, respectively.

CONCLUSIONS

The Hebrew-translated PSE showed adequate validity and excellent reliability, indicating its suitability to measure clinician self-efficacy in treating patients with LBP.

The association of loneliness, mindfulness, and optimism with self-directed learning among nursing students in China: A cross-sectional study

BACKGROUND

Successful adaption to the increasing demands of the healthcare system involves self-directed learning (SDL) approach, which contributes to professional values and academic and clinical performance. Although many factors are related to SDL, research examining the association between internal factors such as loneliness, mindfulness and optimism with self-directed learning is limited.

OBJECTIVE

This study aims to examine the association between loneliness, mindfulness, and optimism with self-directed learning.

METHODS

A cross-sectional design was conducted, and study participants included 568 nursing students from higher education institutes in North, East and South China from May 2020 to October 2020. Data collection instruments included socio-demographics, the self-directed learning scale, the loneliness scale, the Five Facet Mindfulness Questionnaire, and the Life Orientation Test. Hierarchical multiple regression and moderation analyses were used to analyze the data.

RESULTS

Findings indicated that loneliness was negatively related to SDL, whereas mindfulness and optimism showed a positive relationship to SDL. Optimism did not significantly moderate the relationship between loneliness and SDL, and between optimism and self-directed learning.

CONCLUSIONS

The findings suggest that incorporating training programs for reducing loneliness and improving mindfulness and optimism into curricular and extracurricular activities on campuses may help increase SDL.

The impact of facilitation in a problem-based pedagogy on self-directed learning readiness among nursing students: a quasi-experimental study in Tanzania

Background

Self-directed learning is important in nursing as it is associated with improved clinical and moral competencies in providing quality and cost-effective care among people. However, unethical professional conduct demonstrated by some graduate nurses is linked with the way they are developed in schools alongside the content and pedagogies prescribed in nursing curricula. Pedagogical transformations appear to be inevitable to develop enthusiastic nursing students who can work independently in delivering quality and cost-effective nursing services to people. This study intended to examine the impact of facilitation in a problem-based pedagogy on self-directed learning readiness among undergraduate nursing students in Tanzania.

Methods

A controlled quasi-experimental design was conducted in Tanzanian higher training institutions from January to April 2019. A 40-item Self-directed learning Readiness scale for nursing education adopted from previous studies measured self-directed learning and the Student A descriptive analysis via a Statistical Package for Social Sciences software program (version 23) was performed to establish nursing students’ socio-demographic characteristics profiles. Independent samples t-test determined mean scores difference of self-directed learning readiness among nursing students between groups while regression analysis was performed to discriminate the effect of an intervention controlled with other co-related factors.

Results

The post-test results of self-directed learning readiness showed that nursing students scored significantly higher [(M = 33.01 ± 13.17; t (399) = 2.335; 95%CI: 0.486,5.668)] in the intervention group than their counterparts in the control. Findings of SDL readiness subscales were significantly higher among students in the intervention including self-management [(M = 10.11 ± 4.09; t (399) = 1.354; 95%CI: 0.173,4.026)], interest learning [(M = 9.21 ± 2.39; t (399) = 1.189; 95%CI: 0.166,4.323)] and self-control [(M = 13.63 ± 5.05; t (399) = 2.335; 95%CI: 0.486,5.668)]. The probability of nursing students to demonstrate self-directed learning readiness was 1.291 more times higher when exposed to the intervention (AOR = 1.291, p < 0.05, 95%CI: 0.767, 2.173) than in the control.

Conclusion

Facilitation in a problem-based pedagogy promises to change the spectrum of nursing learning habits potentially to their academic and professional achievements. Nurse tutors need to be empowered with it to prepare nursing students to meet their academic and professional potentials.

Obesity bias and stigma, attitudes and beliefs among entry-level physiotherapy students in the Republic of Ireland: a cross sectional study

OBJECTIVE

To explore entry-level physiotherapy students' attitudes and beliefs relating to weight bias and stigmatisation in healthcare.

DESIGN

Cross sectional survey of physiotherapy students.

METHODS

All final year physiotherapy students (n = 215) enrolled in entry-level physiotherapy programmes in the Republic of Ireland were invited to participate. Each received a questionnaire, consisting of 72 questions, within four key sections. Descriptive statistics and frequencies were used to analyse the data.

RESULTS

A response rate of 83% (179/215) was achieved. Whilst physiotherapy students, overall, had a positive attitude towards people with obesity, 29% had a negative attitude towards people with obesity, 24% had a negative attitude towards managing this population and most (74%) believed obesity was caused by behavioural and individual factors. Over one third of students (35%) reported that they would not be confident in managing patients with obesity and more than half (54%) felt treating patients with obesity was not worthwhile.

CONCLUSION

This study provides preliminary findings to suggest that weight stigma-reduction efforts are warranted for physiotherapy students. Helping students to understand that obesity is a complex, chronic condition with multiple aspects requiring a multi-faceted approach to its management might be the first step towards dispelling these negative attitudes towards patients living with obesity. Inclusion of a formal obesity curriculum should perhaps now be part of the contemporary physiotherapy students' education.

The correlation of metacognitive ability, self-directed learning ability and critical thinking in nursing students: A cross-sectional study

AIM

To understand the status quo of metacognitive ability (MA), Self-directed learning (SDL) ability and critical thinking (CT) ability of five-year higher vocational nursing students as well as the correlation among them.

BACKGROUND

MA, SDL ability and CT are the core abilities that nursing students must have and they are the important factors to improve students' nursing service quality and lifelong learning ability.

DESIGN

A quantitative and cross-sectional descriptive study.

METHOD

The survey collected data from 3,047 five-year vocational nursing students with questionnaires April-May in 2020.

RESULTS

The total score of MA was 81.18 (SD 13.51), SDL ability score was 220.28 (SD 35.09), and CT ability score was 271.96 (SD 26.08). The positive correlations were found between those three (p < .01).

CONCLUSIONS

The overall metacognitive ability of nursing students was not high, SDL ability and CT ability were both at a medium level. Health educators need pay attention to cultivation and development of the core competencies.