Exploring the effect of problem-based facilitatory teaching approach on metacognition in nursing education: A quasi-experimental study of nurse students in Tanzania

Effectiveness of an Interactive Web-Based Clinical Practice Monitoring System on Enhancing Motivation in Clinical Learning Among Undergraduate Nursing Students: Longitudinal Quasi-Experimental Study in Tanzania

BACKGROUND

Nursing students' motivation in clinical learning is very important not only for their academic and professional achievement but also for making timely, informed, and appropriate decisions in providing quality and cost-effective care to people. However, the increased number of students and the scarcity of medical supplies, equipment, and patients, just to mention a few, have posed a challenge to educators in identifying and navigating the best approaches to motivate nursing students to learn during their clinical placements.

OBJECTIVE

This study primarily used descriptive and analytical methods to examine undergraduate nursing students' desire for clinical learning both before and after participating in the program.

METHODS

An uncontrolled longitudinal quasi-experimental study in a quantitative research approach was conducted from February to March 2021 among 589 undergraduate nursing students in Tanzania. Following a baseline evaluation, nursing students were enrolled in an interactive web-based clinical practice monitoring system by their program, institution, names, registration numbers, and emails via unique codes created by the lead investigator and trainers. The system recorded and generated feedback on attendance, clinical placement unit, selected or performed clinical nursing procedures, and in-between and end-of-shift feedback. The linear regression was used to assess the effect of the intervention (interactive web-based clinical practice monitoring system) controlled for other correlated factors on motivation in clinical learning (outcome) among nursing students. Nursing students' sociodemographic characteristics and levels of motivation in clinical learning were analyzed descriptively while a 2-tailed paired sample t test established a comparative mean difference in motivation in clinical learning between the pretest and the posttest. The association between variables was determined using regression analysis set at a 95% CI and 5% statistical significance.

RESULTS

The mean age of study participants (N=589) was 23 (SD 2.69) years of which 383 (65.0%) were male. The estimated effect (β) of a 3-week intervention to improve nursing students' motivation in clinical learning was 3.041 (P=.03, 95% CI 1.022-7.732) when controlled for other co-related factors. The mean score for motivation in clinical learning increased significantly from the baseline (mean 9.31, SD 2.315) to the postintervention (mean 20.87, SD 5.504), and this improvement presented a large effect size of 2.743 (P<.001, 95% CI 1.011-4.107).

CONCLUSIONS

Findings suggest that an interactive web-based clinical practice monitoring system is viable and has the potential to improve undergraduate nursing students' motivation for clinical learning. One alternative clinical pedagogy that educators in nursing education can use to facilitate clinical learning activities and develop motivated undergraduate nursing students is the integration of such technology throughout nursing curricula.

The mediating role of positive psychological capital in the relationship between metacognition and self-directed learning ability: A cross-sectional study

BACKGROUND

Self-directed learning is a fundamental skill and requirement for lifelong learning. It enables nursing students to enhance their learning ability, academic achievement, clinical performance, and adaptability to clinical situations. Metacognition (i.e., the process of reflecting on one's own cognitive activities) helps internalize learning strategies, construct self-concept, and solve problems. Positive psychological capital is a positive psychological state that stimulates the pursuit of individual development; it helps nursing students to cope effectively with various problems. However, it remains unclear if metacognition impacts self-directed learning ability (SDLA) through positive psychological capital; if confirmed, this would provide basic data for the development of effective teaching and learning methods.

OBJECTIVES

To examine the mediating effect of positive psychological capital in the relationship between metacognition and SDLA in nursing students.

DESIGN

A cross-sectional, descriptive survey study.

PARTICIPANTS

The participants were 172 nursing students from four nursing colleges.

METHODS

We measured metacognition, positive psychological capital, and SDLA using an online questionnaire; data were collected from September 7 to 23, 2023. We used Pearson's correlation coefficient to analyze correlations. To test the mediating effect of positive psychological capital, we used three-step regression analysis, Sobel's test, and Hayes's Process Macro - Model 4.

RESULTS

SDLA was correlated with metacognition (r = 0.689, p < .001) and positive psychological capital (r = 0.605, p < .001). Metacognition influenced positive psychological capital (B = 0.324, p < .001) and SDLA (B = 0.614, p < .001). Positive psychological capital mediated the relationship between metacognition and SDLA (B = 0.297, p < .001; z = 3.214, p = .001 [Sobel test]).

CONCLUSION

Learning strategies aiming to enhance nursing students' SDLA require successful metacognition to boost positive psychological capital. This study's empirical evidence on the potential benefits of linking metacognition with positive psychological capital has practical implications in relation to helping nursing students attain core academic goals.

Effects of pecha kucha presentation pedagogy on nursing students' presentation skills: a quasi-experimental study in Tanzania

INTRODUCTION

Ineffective and non-interactive learning among nursing students limits opportunities for students' classroom presentation skills, creativity, and innovation upon completion of their classroom learning activities. Pecha Kucha presentation is the new promising pedagogy that engages students in learning and improves students' speaking skills and other survival skills. It involves the use of 20 slides, each covering 20 seconds of its presentation. The current study examined the effect of Pecha Kucha's presentation pedagogy on presentation skills among nursing students in Tanzania.

OBJECTIVES

The aim of this study was to establish comparative nursing student's presentation skills between exposure to the traditional PowerPoint presentations and Pecha Kucha presentations.

METHODS

The study employed an uncontrolled quasi-experimental design (pre-post) using a quantitative research approach among 230 randomly selected nursing students at the respective training institution. An interviewer-administered structured questionnaire adopted from previous studies to measure presentation skills between June and July 2023 was used. The study involved the training of research assistants, pre-assessment of presentation skills, training of participants, assigning topics to participants, classroom presentations, and post-intervention assessment. A linear regression analysis model was used to determine the effect of the intervention on nursing students' presentation skills using Statistical Package for Social Solution (SPSS) version 26, set at a 95% confidence interval and 5% significance level.

RESULTS

Findings revealed that 63 (70.87%) participants were aged ≤ 23 years, of which 151 (65.65%) and 189 (82.17%) of them were males and undergraduate students, respectively. Post-test findings showed a significant mean score change in participants' presentation skills between baseline (M = 4.07 ± SD = 0.56) and end-line (M = 4.54 ± SD = 0.59) that accounted for 0.4717 ± 0.7793; p < .0001(95%CI) presentation skills mean score change with a medium effect size of 0.78. An increase in participants' knowledge of Pecha Kucha presentation was associated with a 0.0239 (p < .0001) increase in presentation skills.

CONCLUSION

Pecha Kucha presentations have a significant effect on nursing students' presentation skills as they enhance inquiry and mastery of their learning content before classroom presentations. The pedagogical approach appeared to enhance nursing students' confidence during the classroom presentation. Therefore, there is a need to incorporate Pecha Kucha presentation pedagogy into nursing curricula and nursing education at large to promote student-centered teaching and learning activities and the development of survival skills.

TRIAL REGISTRATION

It was not applicable as it was a quasi-experimental study.

A Paradigm Shift for the Nursing Education Model: A Scoping Review

BACKGROUND

The Nursing Education Model (NEM) introduced a framework for education reform. This study examined the applications of NEM in education to determine whether modifications to NEM were warranted.

METHOD

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews process for scoping reviews was used. Online databases and searches identified peer-reviewed articles published from 2010-to June 2023, and 71 articles were identified that met the inclusion and exclusion criteria.

RESULTS

Six themes were derived from the findings: (1) learner-centered curricula; (2) instructional methods; (3) inclusive classrooms; (4) pedagogical creativity; (5) bridge theory-clinical divide; and (6) multiple units of analysis.

CONCLUSION

The findings support the application of the NEM to promote a paradigm shift in instructional content, methods, and evaluation of outcomes. Based on use of the model identified in the literature, future modifications to NEM may be indicated, based on continued evidence. [J Nurs Educ. 2024;63(3):141-147.].

Prevalence, medication adherence, and determinants of type 2 diabetes mellitus during Coronavirus Disease 2019 pandemic among adults in Tanzania

Introduction

Excessive consumption of comfort foods, which are mostly high in carbs, and limitations on outdoor and gym-based physical activities, for instance, are associated with foods high in the glycemic index and raise the risk of obesity and type 2 diabetes. In pandemic and or epidemic situations, peoples' lifestyles may change significantly to lead them to non-communicable diseases. However, lifestyle changes and the occurrence of type 2 diabetes mellitus during the Coronavirus Disease 2019 pandemic among adults have not been well established in Tanzania. This study assessed the prevalence, medication adherence, and determinants of type 2 diabetes mellitus among adults in the country.

Methods

A community-based analytical cross-sectional study was conducted in Dodoma region, Tanzania between September and October 2020 of which 107 adults aged above 18 years were studied regardless of whether they were newly diagnosed with type 2 diabetes mellitus or not using a quantitative research approach. Interviewer-administered lifestyle habits and medication adherence structured questionnaires benchmarked from previous studies served as the main tools of data collection. The statistical package for social sciences computer program was used to analyze the data descriptively for frequencies and percentages and by regression analysis model to determine the association between variables with a 95% confidence interval and 5% significance level.

Results

With a mean age of 31 ± 2.527 years, 59.8% of the respondents were female. 60.7% and 11.7% of the respondents had unhealthy and moderate lifestyle choices respectively. The prevalence of type 2 diabetes mellitus accounted for 63.9% of the respondents of which 44.6% were diagnostically confirmed during the Coronavirus Disease 2019 pandemic against 19.3% of respondents who were diagnosed before the pandemic. Medication adherence among the type 2 diabetes mellitus respondents accounted for 77.9% of the study respondents. Type 2 diabetes mellitus was significantly associated with being in the 36-55 age group (AOR = 1.054; 95% CI: 0.292, 3.162; p < 0.05); being female (AOR = 1.398; 95% CI: 0.205, 3.048; p < 0.05); having a job (AOR = 2.597; 95% CI: 1.243, 4.402, p < 0.05); and having unhealthy lifestyle habits (AOR = 3.301; 95% CI: 1.199, 6.52; p < 0.05).

Conclusion

The majority of adults had type 2 diabetes mellitus of which most of them were confirmed to have the disease during the Coronavirus Disease 2019 pandemic. Few type 2 diabetes mellitus adults did not adhere to their medications as recommended. Their sociodemographic characteristics profiles and unhealthy lifestyles significantly led them to have the problem. The treatment of the disease above and health promotion activities may need to take unhealthy lifestyle choices and certain sociodemographic profiles of adults into consideration to assist in preventing the problem.

Adolescents’ World: Know One Tell One against Unsafe Sexual Behaviours, Teenage Pregnancies and Sexually Transmitted Infections Including Chlamydia

Addressing adolescents’ sexual and reproductive health (SRH) matters using multidisciplinary pedagogical innovations may assure the proper development and well-being of adolescents so that they reach the adulthood stage healthy and strong enough to produce for their future investment. This is in response to sustainable development goal number 3, target 3.7, and SDG4, target 4.7 in particular emphasizes the universal availability and accessibility of sexual information and education among people and knowledge and skills for gender equality, human rights and sustainable lifestyles by 2030, respectively. Yet, the innovative strategies may respond to a call stated by SGD5 (gender equality), target 5.3 which advocates the elimination of child, early, and forced marriages, and target 5.6 which focuses on ensuring universal access to SRH and rights to all by 2030.

The effect of educational intervention on shaping safe sexual behavior based on problem-based pedagogy in the field of sex education and reproductive health: clinical trial among adolescents in Tanzania

BACKGROUND

The majority of adolescents are currently becoming sexually active before their 18th birthday having to battle with unsafe sexual behaviors, teenage pregnancies, sexually transmitted infections, and school dropouts. The study designed and tested the effect of integrated reproductive health lesson materials in a Problem-Based pedagogy (PBP) to enhance safe sexual behaviors among adolescents in Tanzania.

METHODS

Clustered Randomized Controlled Trial was adopted among 660 adolescents in Tanzania. The study consisted of three research arms including pure PBP, Hybrid PBP, and Lecture-Based Pedagogy (LBP). Sexual-risk Behavior Beliefs and Self-esteem Scale adopted from previous studies measured adolescents' sexual behaviors. A Statistical Analysis Software (SAS) version 9.4 was used to analyze data. Descriptive analysis established adolescents' socio-demographic profiles. Generalized Estimating Equation (GEE) determined the effect of interventions on adolescents' intentions to practice safe sexual behaviors at a 95% confidence interval and a significance level of 5%.

RESULTS

Adolescents' mean age was 15 ± 1.869 years. Sums of 57.5% (n = 380) were females. 39.5% of adolescents were sexually active whereas 44.8% of them initiated sexual intercourse by the age between 10 and 12 years. The end-line findings showed that 54.9% of adolescents in the LBP group demonstrated a significant intention to unsafe sexual behaviors against 26.3% and 30.9% of adolescents in the pure PBP and Hybrid PBP groups respectively. The Difference-In-Difference odds ratio for unsafe sexual behavior among adolescents in the Hybrid PBP and pure PBP was less (AOR = 0.30; p < 0.0001; 95%CI: 0.1398, 0.5559) and (AOR = 0.30, p < 0.0002; 95%CI: 0.1386, 0.5487) contrary to a control group respectively.

CONCLUSION

The integrated RH lesson materials in a PBP can change a spectrum of sexual behavior among adolescents in Tanzania. This study suggests school teachers and health workers work together to facilitate RH lessons using PBP to enhance safe sexual behaviors among adolescents for their healthy adulthood and future investment.Trial registration: Pan African Clinical Trial Registry identifier: PACTR202009656160779.

Effect of integrated reproductive health lesson materials in a problem-based pedagogy on soft skills for safe sexual behaviour among adolescents: A school-based randomized controlled trial in Tanzania

BACKGROUND

Adolescents are currently becoming sexually active before their 18th birthday during which they have to battle with unsafe sexual behaviours, teenage pregnancies, sexually transmitted infections (STIs), and school dropouts. The trend is linked with low soft skills (self-esteem and assertiveness skills) for them to make informed, reasoned, and responsible decisions over sexual activities. This study designed and tested the effect of integrated reproductive health (RH) lesson materials in a problem-based pedagogy (PBP) to enhance soft skills for safe sexual behaviour among adolescents in Tanzania.

METHODS

A double-blinded clustered randomized controlled trial was conducted between September 2019 and September 2020 among 660 randomly selected adolescents. A Sexual-risk Behaviour Beliefs and Self-esteem Scale adopted from previous studies measured soft skills for safe sexual behaviour. A descriptive statistical analysis was performed by using the statistical analysis software programme version 9.4. The effect of the intervention was determined using Linear Mixed Model set at α error probability = 5% significance level (95% confidence interval) and a β error probability = 0.80.

FINDINGS

Adolescents' mean age was 15±1.869 with 57.5% females. The end-line findings indicated that the coefficient of soft skills was significantly higher among adolescents in the hybrid PBP (β=9.0986, p<0.01; 95%CI: 4.7772, 14.2311) and pure PBP (β =8.7114, p<0.01; 95%CI: 3.9990, 10.1208) than in the control group. The retention rate of soft skills was still significantly higher at 3-months follow-up (β=2.0044; p<0.01; 95%CI: 1.0234, 4.1182) and at 6-months follow-up (β=1.9803; p<0.01; 95%CI: 0.8399, 3.1099) compared to the baseline and immediate post-intervention assessments.

CONCLUSION

The intervention substantially enhanced soft skills for safe sexual behaviour among adolescents of both sex. Despite the fact that scores for soft skills varied across the study timelines, adolescents demonstrated significant intentions to abstain from sexual intercourse, delay sexual relationships, negotiate condom use, and withstand sexual coercions. The PBP may need to be incorporated in ordinary level secondary school curricula as a formal guide to teachers and or health workers to optimally prepare adolescents for their healthy adulthood.

Metacognição em um jogo educativo orientado pelo processo de enfermagem sobre distúrbios eletrolíticos

Resumo Objetivos Descrever os eventos metacognitivos contidos nos relatos de alunos de enfermagem após participação em jogo educativo e identificar as operações metacognitivas presentes nos relatos de alunos de enfermagem após participação no jogo educativo. Método Estudo qualitativo para a compreensão de eventos e processos metacognitivos de vinte e seis estudantes engajados na solução de um caso de distúrbios eletrolíticos, orientados pelo processo de enfermagem. Dados coletados por entrevista semiestruturada. Análise de conteúdo com categorias teóricas da metacognição para procedimentos dedutivos e classificatórios. Resultados Foram identificadas quinze características do processo e do controle durante o jogo, com operações metacognitivas a partir de eventos metacognitivos presentes nas falas dos participantes do jogo. As fases de antecipação, de controle da performance e de autorregulação reflexiva foram utilizadas para classificar as quinze características emergentes da tarefa. Conclusão A participação em um jogo educacional orientado à aprendizagem do processo de enfermagem pode evidenciar descrições de eventos metacognitivos, clarificando processos mentais. Implicações para a prática Conhecer as características de um trajeto metacognitivo mais comum pode facilitar a atuação do professor como mediador e facilitador da aprendizagem em aspectos específicos.

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.

Exploring the effect of problem based facilitatory teaching approach on motivation to learn: a quasi-experimental study of nursing students in Tanzania

Background

Academic motivation is most important as a key determinant of competent and motivated nurses who are often considered as frontline healthcare providers who devote most of their time taking care of clients and patients. However, most of them demonstrate remarkable differences in their academic performances during their schooling that might be due to the differences in their academic motivation and achievement motivation. There appears a growing concern to rethink the approaches on how nurses are prepared, explore, and test novel approaches for delivering the nursing curricula. This study tested the effect of Problem Based Facilitatory Teaching pedagogy on academic motivation among nursing students in Tanzania, higher learning institutions.

Methods

A pre-post-test controlled quasi-experimental study of 401 purposively selected participants was conducted between February and June 2018. The study was not a clinical randomized controlled trial and thus it has not been identified in the title and no summary of trial design, its methods, results, and conclusion. The Auditing Inventory developed by the researcher measured the intervention and a Questionnaire titled “Academic Motivation Scale,” was adopted to measure academic motivation. Statistical Product for Service Solutions software program version 23 was used to perform descriptive analysis to establish participants’ sociodemographic profiles. Regression analysis was performed to determine the association between variables.

Results

Findings revealed that 65.8% of participants were males. Post-test findings showed 70.3% of participants demonstrated the motive to learn contrary to 34.9% at baseline. The odds of an intervention to influence academic motivation among participants was higher than the control (AOR = 1.720; p < 0.05; 95%CI: 1.122, 2.635). However, the intervention demonstrated little influence on the extrinsic motivation to learn (AOR = 0.676, p > 0.05, 95%CI: 0.405, 1.129) and Amotivation to learn (AOR = 0.538, p > 0.05; 95%CI: 0.283, 1.022) compared to the control.

Conclusion

The Problem Based Facilitatory Teaching pedagogy was a predictive factor to intrinsic academic motivation among nursing students. The approach demonstrated educational potentials to change the spectrum of nursing competency and quality of care to patients or clients. This study suggests problem-based facilitatory teaching pedagogy be integrated into the nursing curriculum in Tanzania as it is feasible.