Experiential Learning Program to Strengthen Self-Reflection and Critical Thinking in Freshmen Nursing Students during COVID-19: A Quasi-Experimental Study

Relationship between learning styles and clinical competency in nursing students

BACKGROUND

The acquisition of clinical competence is considered the ultimate goal of nursing education programs. This study explored the relationship between learning styles and clinical competency in undergraduate nursing students.

METHODS

A descriptive-correlational study was conducted in 2023 with 276 nursing students from the second to sixth semesters at Abhar School of Nursing, Zanjan University of Medical Sciences, Iran. Data were collected using demographic questionnaires, Kolb's learning styles, and Meretoja's clinical competence assessments completed online by participants. Data were analyzed using SPSS version 16, employing descriptive statistics and inferential tests (independent T-test, ANOVA, Pearson correlation) at a significance level 0.05.

RESULTS

The predominant learning styles among nursing students were divergent (31.2%), and the least common was convergent (18.4%). The overall clinical competency score was 77.25 ± 12.65. Also, there was a significant relationship between learning styles and clinical competency, so the clinical competency of students with accommodative and converging learning styles was higher. (P < 0.05).

CONCLUSION

The results of this study showed the association between learning styles and clinical competence in nursing students. It is recommended that educational programs identify talented students and provide workshops tailored to strengthen various learning styles associated with enhanced clinical competence.

Development of higher-order thinking in health profession education: A comprehensive toolkit for medical educators

BACKGROUND

Higher-order thinking (HOT) is widely recognized as an essential objective of health profession education (HPE). Based on Lipman's three-dimensional model of thinking, we investigated strategies for the development of HOT including critical thinking (CT), creative thinking, and caring thinking in HPE in three consecutive studies. Fostering students' CT is regarded as an outcome of HPE. However, there is the limited level of consensus on educational interventions for CT development. In view of some of the controversies surrounding the development of CT skills and dispositions in HPE, the aim of this study was to determine educational interventions affecting CT development in HPE.

MATERIALS AND METHOD

This study employed the best-fit framework synthesis design. The frameworks recommended by Abrami et al. were used as a basis for the synthesis. The priori themes were extracted from the selected best-fit frameworks. Then, Google Scholar, PubMed, SID, and ProQuest databases were searched for the literature related to the development of CT skills and dispositions in HPE students. Derived data from the HPE literature were coded against the priori themes, extracted from the best-fit frameworks. Interpretation and restructuring of the new themes derived from HPE literature, and the preexisting priori themes resulted in the final framework of the interventions affecting CT development in HPE students.

RESULTS

The themes extracted from the HPE studies (including reflection, discussion, simulation, role-playing, questioning, and explicit expression of CT goals in curriculum) were similar to the a priori themes derived from the studies by Abrami et al. The new themes of experiential learning, art-based learning, argument mapping, concept mapping, and creating appropriate educational atmosphere were obtained by constant comparison of the data among the studies.

CONCLUSION

The comprehensive framework of CT development methods provides a toolkit for medical educators. According to the results of the current study, the mixed approach, where CT is taught as an independent track, along with the discipline-specific CT development, seems to be more effective, compared to the immersion approach. Creating learning moments in the context of practice through experiential learning is noteworthy in the development of CT skills and dispositions. Further research is needed to evaluate the efficacy of the newly developed strategies, such as art-based learning and concept mapping.

Nursing students' critical thinking and associated factors in Vietnam: A multicenter cross-sectional study

AIMS

This study aimed to evaluate the critical thinking abilities of senior nursing students in Vietnam and determine factors associated with their critical thinking disposition and skills.

BACKGROUND

Assessing critical thinking competence is crucial for determining senior nursing students' preparedness for entering the healthcare workforce and can be used to examine current nursing education's ability to cultivate nursing students' critical thinking. However, little research was found on critical thinking among Vietnamese nursing students.

DESIGN

A multicenter cross-sectional research design.

METHODS

A convenience sample of 533 senior nursing students from six universities in Vietnam participated in this study. All participants completed the online questionnaires, including basic information, a subscale of the Motivated Strategy for Learning Questionnaire (MSLQ), Critical Thinking Disposition Scale (CTDS), and Critical Thinking Self-Assessment Scale (CTSAS).

RESULTS

The mean score for the CTDS was 42.81 (standard deviation (SD) = 5.29), while the mean score for the CTSAS was 168.29 (SD = 44.43). Results of the multiple linear-regression analysis showed that an increase in self-study hours per day (B = 0.41, p = 0.007), higher self-efficacy in learning and performance (B = 0.26, p < 0.001), and a more-supportive environment (B = 0.97, p < 0.001) were predictors of critical thinking disposition. Moreover, an increase in self-study hours per day (B = 4.09, p = 0.001), higher self-efficacy in learning and performance (B = 2.65, p < 0.001), a more-supportive environment (B = 7.74, p < 0.001), and more experience with research (B = 7.03, p = 0.03) were predictors of critical thinking skills.

CONCLUSIONS

This study revealed that senior nursing students in Vietnam possess a moderate level of critical thinking abilities. Those students who dedicate more hours to self-study, demonstrate higher self-efficacy in learning and performance, experience a supportive environment, and engage in more research activities exhibit better critical thinking disposition and skills. The findings highlight the ongoing need to enhance critical thinking disposition and skills of nursing students in Vietnam. It is suggested that nursing faculty members should develop the appropriate strategies to improve nursing students' critical thinking disposition and skills.

Community-based nursing: a concept analysis with Walker and Avant's approach

BACKGROUND

Community-based nursing in recent years has received much attention from nursing schools in different countries as a suitable solution in response to existing and future problems and challenges, but there is yet no comprehensive and correct understanding of this concept and considering its importance, the present study was conducted to the aim of analyzing the concept of community-based nursing.

METHODS

Concept analysis was done using Walker and Avant's 8-step approach. Nursing dictionary, Persian dictionary, research articles, journals and conferences articles, dissertations, thesis, books, and other sources related to the concept of research were investigated through search engines and available databases using the keywords of nursing, community-based, concept analysis and Walker and Avant from 1990 to 2023. Finally, 54 articles related to the concept were reviewed and analyzed.

RESULTS

The results showed that community-based nursing has attributes such as individual-oriented/ family-oriented/ community-oriented, social partnership with the communities and stakeholders, social justice, and group and interprofessional cooperation, the community as the main activity setting, providing services based on cultural diversity, providing services according to the context, conditions and community needs, caring for individuals and families with health problems throughout life, responding to the community needs, community-based experiences and facing real-life issues in the context of community, using a problem-based and service-based approach, providing context-based care and considering factors affecting health. In this regard, borderline and related cases (community health nursing, community-oriented nursing, population-based nursing, and public health nursing) were also presented to clarify the concept. Antecedents of community-based nursing included: determining the position of community-based nursing, making infrastructure and structure, the partnership between university, hospital and community, identifying all settings, the presence of educators proficient in education, survey of community needs, having knowledge, communication and community-based skills, expanding the role of the nurse, stakeholders' attitude towards community-oriented nursing and management and financial support. Consequences of community-based nursing included: competence development in nurses, solving community-based nursing challenges, meeting the health needs of individuals, families and communities, social justice, and increasing access to health care services.

CONCLUSION

The results of this study can provide an objective and understandable image of the use of community-based nurses and their education in practice. Conducting more quantitative and qualitative studies about community-based nursing is also recommended.

Relationship between Nurses Reflection, Self-efficacy and Work Engagement: A Multicenter Study

Introduction

Reflection is considered an essential element in nurses' practice with different positive outcomes, we decided to determine the level of nurses' reflection and then assess the relationship between nurses' reflection with their self-efficacy and work engagement.

Methods

In this cross-sectional study, a total of 240 nurses were selected from seven educational hospitals affiliated with Tabriz University of medical sciences (Iran). The stratified random sampling method was used to select the participants from hospitals. Data were collected through three questionnaires including Groningen Reflection Ability Scale (GRAS), Sherer's General Self-Efficacy Scale (SGSES), and Utrecht Work Engagement Scale (UWES). Data were analyzed using SPSS version 13.

Results

According to the results, the mean (SD) score of nurses' reflection was calculated as 86.51 (8.17) out of 115. The mean (SD) score of nurses' self-efficacy was 60.89 (11.11) out of 85. Moreover, the mean (SD) total score of nurses' work engagement in a possible range of 0 to 6 was 3.39 (1.36). There was a positive and significant relationship between the total reflection score with work engagement and self-efficacy scores.

Conclusion

According to the results, nurses working in different units showed different scores of reflection. Moreover, the results of the present study showed that nurses' reflection is associated with nurses' work engagement and self-efficacy. Therefore, nurse managers and nurse educators should improve nurses' skills in reflection and they should support the reflective practice in clinical settings.

The effect of blended task-oriented flipped classroom on the core competencies of undergraduate nursing students: a quasi-experimental study

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.

ACP-supported redeployment in response to the COVID-19 pandemic: a service evaluation of staff experience

BACKGROUND

During the COVID-19 pandemic, healthcare organisations around the world had to optimise resources and redeploy staff to meet unprecedented demands on services. This service evaluation aims to establish the experiences of nurses redeployed to a COVID-negative Nightingale ward during the first wave of the pandemic in the UK.

METHODS

Purposive sampling using a survey was used to capture nurses' experiences. Data were extrapolated to meet the aims of the thematic line of enquiry and descriptive statistics used to analyse the data set.

RESULTS

The response rate was 34.0% (n=30). The majority of redeployees (76.7%; n=23) strongly agreed or agreed the trust induction had been beneficial. Informal learning, including from colleagues, was said to be very helpful by 50.0% (n=15) and helpful by 36.7% (n=10) of participants. Most (90.0%; n=27) agreed they were able to maintain safety, with 93.3% (n=28) satisfied with the quality of their care. Regarding giving the care they aspired to, 46.7% (n=14) strongly agreed and 40.0% (n=12) agreed they had been able to do this.

CONCLUSION

The advanced clinical practitioner role was central to successful redeployment, in preparing redeployees through induction and education. These practitioners facilitated the acquisition of the knowledge and skills to deliver competent care, ensuring staff had the capacity and capability to undertake their job. Patient safety was not compromised by redeployment.

Primary care nurses' learning styles in the light of David Kolb

OBJECTIVES

to identify primary care nurses' learning styles in the light of David Kolb's Experiential Learning Theory.

METHODS

a descriptive and exploratory qualitative study. A semi-structured interview script was used for data collection and content analysis for data processing.

RESULTS

primary care nurses showed different learning styles: diverging, which combines active experimentation and reflective observation; assimilating, which combines reflective observation and abstract conceptualization; converging, which associates abstract conceptualization and concrete experience; and accommodating, which unites concrete experience and active experimentation.

FINAL CONSIDERATIONS

learning through experience requires that knowledge be understood and transformed. Nurses learn in different ways, as they have different learning styles. Therefore, recognizing nurses' learning styles is important to foster ongoing professional development and ensure safe nursing care.

Saudi nursing student satisfaction and evaluation of reflective practice: A cross-sectional study

BACKGROUND

Regardless of the fact that reflection has been documented in nursing literature for several years and is recognized in the nursing profession to improve learners' knowledge and mindfulness, this topic requires investigation in Gulf countries from a student perspective, as no studies have been published in the gulf regarding nursing students' perspectives on reflective practice.

METHODS

A total of 261 nursing students from the third and fourth academic years at one major educational institution were recruited using a quantitative cross-sectional study design.

RESULTS

The participating nursing students reported high scores on the level of all domains of reflective practice as well as on the level of student satisfaction, where 3rd year students scored higher on the level of reflection with others (p = .03), as well as the reflection on action domains (p < .01). A significant correlation was found between reflection and satisfaction (p < .01), where reflection explained 6.87% of the changes in variance of satisfaction.

CONCLUSION

Nursing students who took part in this study has demonstrated a positive regard towards reflective practice and indicated high correlated satisfaction with learning.

Reflection in Rural Family Medicine Education

Reflection in medical education is vital for students' development as professionals. The lack of medical educators in rural family medicine can impinge on the effective reflection of residents' learning. Hence, based on qualitative research, we proposed a framework regarding reflection in rural family medicine education, indicating when, where, and how reflection is performed and progresses. The contents of reflection include clinical issues regarding knowledge and skills, professionalism in clinical decisions, and work-life balance. The settings of reflection include conference rooms, clinical wards, residents' desks, and hospital hallways. The timing of educational reflection includes during and after patient examination and discussion with various professionals, before finishing work, and during "doorknob" times (right before going back home). Rural medical teachers need competence as clinicians and medical educators to promote learning in medical residents and sustain rural medical care. Furthermore, medical teachers must communicate and collaborate with medical residents and nurses for educational reflection to take place in rural family medicine education, especially regarding professionalism. In rural family medicine education, reflection can be performed in various clinical situations through collaboration with learners and various medical professionals, aiding the enrichment of residents' learning and sustainability of rural medical care.

Estilos de aprendizagem de enfermeiros que atuam na atenção primária à luz de David Kolb

RESUMO Objetivos: identificar o estilo de aprendizagem dos enfermeiros de atenção primária à luz da Teoria da Aprendizagem Experiencial de David Kolb. Métodos: estudo qualitativo descritivo e exploratório. Utilizou-se um roteiro de entrevista semiestruturado para a coleta dos dados, e a análise de conteúdo, para o tratamento dos dados. Resultados: enfermeiras que atuam na atenção primária apresentaram diferentes estilos de aprendizagem: divergente, que combina experiência ativa e observação reflexiva; assimilador, que combina observação reflexiva e conceitualização abstrata; convergente, que associa conceitualização abstrata e experiência concreta; e acomodador, que une a experiência concreta e a experiência ativa. Considerações Finais: aprender pela experiência requer que o conhecimento seja compreendido e transformado. Enfermeiras aprendem de modos diferentes, pois apresentam diferentes estilos de aprendizagem. Portanto, reconhecer os estilos de aprendizagem dos enfermeiros é importante para fomentar o desenvolvimento profissional contínuo e garantir um cuidado de enfermagem seguro.

Effect of community-based education on undergraduate nursing students' skills: a systematic review

Background

Community-based education, as an effective approach to strengthen nurses’ skills in response to society’s problems and needs has increased in nursing education programs. The aim of this study was to review the effect of community-based education on nursing students’ skills.

Methods

For this systematic review, ProQuest, EMBASE, Scopus, PubMed/ MEDLINE, Cochran Library, Web of Science, CINAHL and Google Scholar were searched up to February 2021. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Seventeen studies were included in this systematic review. Inclusion criteria included articles published in English and were original articles.

Results

In all studies, undergraduate nursing students’ skills were improved by participation in a community-based education program. Community-based education enhances professional skills, communication skills, self-confidence, knowledge and awareness, and critical thinking skills and teamwork skills in undergraduate nursing students.

Conclusions

Community-based education should be used as an effective and practical method of training capable nurses to meet the changing needs of society, to improve nurses ‘skills and empower them to address problems in society.

Online argumentation-based learning aided by digital concept mapping during COVID-19: implications for health management teaching and learning

Purpose

The COVID-19 pandemic has affected educational systems worldwide, forcing them to abruptly shift from face-to-face to online teaching and learning. This case study illustrates how a traditional lecture-based activity for undergraduate students in a Management of Health Service Organizations program was transformed into an argumentation-based learning activity using the technique of digital concept mapping and was deployed in an online format during the COVID-19 lockdown.

Design/methodology/approach

The students were tasked with solving an ill-structured problem bearing significance for their future professional lives and connected to the contents of their course (entitled “Assimilation of service quality in health systems”). The activity was composed of two phases. In Phase 1, participants were asked to provide five arguments to establish their proposed solution to the problem by using a concept map on a digital platform (Mindomo). In Phase 2, they were asked to substantiate their arguments. Reflective journals were used to ascertain how the participants viewed the activity. Thematic analysis was used to analyze the qualitative data by searching for themes demonstrating different epistemological positions.

Findings

Six themes were inductively derived from the students' reflections: (1) transitioning from passive to active learning; (2) generating epistemic change; (3) social perspective-taking; (4) domain-based knowledge; (5) prior knowledge and experience; and (6) online collaboration with other students. Episodes, thoughts and feelings expressed by the students were reported so as to increase the reliability of the recurrent and common themes.

Originality/value

This study mainly shows that combining constructivist teaching and learning tools with advanced technology in an online course enables the development of lifelong learning capabilities among students in the health management professions.

The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis

Rural community-based medical education (CBME) enriches undergraduate and postgraduate students' learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.

Effects of S-PBL in Maternity Nursing Clinical Practicum on Learning Attitude, Metacognition, and Critical Thinking in Nursing Students: A Quasi-Experimental Design

Due to the coronavirus disease (COVID-19) pandemic, there are many restrictions in effect in clinical nursing practice. Since effective educational strategies are required to enhance nursing students' competency in clinical practice, this study sought to evaluate the effectiveness of simulation problem-based learning (S-PBL). A quasi-experimental control group pretest-post-test design was used. Nursing students were allocated randomly to the control group (n = 31) and the experimental group (n = 47). Students in the control group participated in a traditional maternity clinical practicum for a week, while students in the experimental group participated S-PBL for a week. The students in the experimental group were trained in small groups using a childbirth patient simulator (Gaumard^® Noelle^® S554.100, Miami, USA) based on a standardized scenario related to obstetric care. The students' learning attitude, metacognition, and critical thinking were then measured via a self-reported questionnaire. Compared with the control group, the pre-post difference in learning attitude and critical thinking increased significantly (p < 0.01) in the experimental group. S-PBL was found to be an effective strategy for improving nursing students' learning transfer. Thus, S-PBL that reflects various clinical situations is recommended to improve the training in maternal health nursing.