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

Developing and Validating a Flipped Classroom Intervention to Improve CPR Competency

The onset of cardiac arrest is unpredictable, and it is crucial to administer cardiopulmonary resuscitation (CPR). The flipped classroom has generated considerable interest in medical education in the last decade. To optimize the effectiveness of a flipped classroom intervention, there is a need to understand which component, if any, of the intervention may be successful in improving CPR competency. This study aimed to use mixed-method intervention development techniques to develop and validate a flipped classroom intervention to improve CPR competency. The theoretical framework underpinning the intervention is Competency Outcomes and Performance Assessment (COPA). The content validity index (CVI) and the content validity ratio (CVR) were calculated and found to be satisfactory. The results provided a clear specification of the intervention protocol for researchers in the next phase of the study - a pilot RCT to preliminarily explore the effect of the developed intervention.

Graduate Nurses in Acute Mental Health Settings and Their Viewpoints of Nursing Education to Support Their Transition to Mental Health Nursing: A Q Methodology Study

Graduate nurses are now comprehensively prepared in Australia and have limited mental health knowledge and experiences to work in acute mental health settings. As such, graduate nurses would need the support that they can get from their respective mental health services to progress from novice to advanced beginner. Nursing education is an important support for graduate nurses to develop the knowledge and skills required for them to transition successfully into acute mental health settings. This study explored 12 graduate nurses' experiences with the nursing education of one mental health services in Western Australia. Q methodology was the approach chosen to conduct this study as it is a 'ready-to-use' mixed method research approach that can enable the researchers to obtain in-depth and accurate understanding of the researched topic. Data analysis generated four factors which revealed that nursing education needs to: (1) be tailored to the area of speciality for graduate nurses who experience challenges of being accepted by their nursing team; (2) provide advanced specialist mental health training for graduate nurses who have low self-confidence about their mental health nursing knowledge and skills to practice in acute mental health settings; (3) provide clinical supervision for graduate nurses who experience challenges to apply their mental health knowledge and skills to difficult clinical situations; and (4) change the way mental health education and training are delivered for graduate nurses who feel confident with their mental health knowledge and skills and accepted by their nursing team. The findings of this study highlighted the usefulness of Q methodology in nursing research. The findings of this study can be used by nurse educators to provide more individualised education and training for graduate nurses. Future research will be conducted to test the use of different teaching and learning approaches for the different categories of graduate nurses in acute mental health settings and develop evidence-based nursing education.

Comparative Effectiveness of Developed Serious Game Versus Standardized Patients' Simulation in Nursing Education

Background: Serious games provide a realistic environment in nursing education, a stimulating and experiential learning environment for developing skills necessary for learning, recognizing, analyzing, selecting, and applying information. Methods: This study aims to determine the impact of serious games and standard patient practices developed for nursing education on students' knowledge levels, satisfaction, self-confidence, critical thinking, and problem-solving skills. A serious game was designed using the educational principles of the diabetes course and developed using the 3D interactive content creation platform UNITY. One group played the game online, whereas another had a face-to-face experience. Both groups completed forms before, after, and 4 weeks later via Google Forms. Results: Quantitative analysis showed significant improvements in knowledge and increases in student satisfaction and confidence in learning in both the serious game and standardized patient groups. The groups had no significant differences in problem-solving and critical-thinking abilities (P > 0.005). Conclusion: Developing advanced clinical proficiencies in nursing students requires an engaging and reliable educational environment. Using serious games and standardized patient simulations in nursing instruction highlights the need for diverse digital teaching tools. Therefore, it is essential to support the professional development of nursing educators in these innovative modalities.

Stepping outside national borders: International active learning educational collaboration events

AIM

This paper discusses the benefits of international collaborations for advanced practice nursing education. It identifies new perspectives and innovative practices to enhance cultural competency.

BACKGROUND

Competent, well-trained advanced practice nurses (APNs) are necessary to provide high-quality and safe patient care, improve access to care, and address health disparities that are no longer geographically bound. In 2021, an international network of advanced practice educators established an active learning program to teach students their role in global citizenship and increase awareness of health disparities. APN students from Scotland, Wales, Minnesota, Houston, and Rotterdam participated in presentations, online discussions, and in-country scholarships.

SOURCES OF EVIDENCE

Growing health disparities have created the need for efficient international collaboration to develop new concepts, approaches, and bidirectional exchange of experiences, culture, and knowledge. Integrating global health into curricula engages students' curiosity and integrates education, research, practice, and leadership while improving cultural competency.

DISCUSSION

Forty-two students participated in the international presentations. The students strongly believed in the benefit of international collaboration and the need for a universal role for the advanced practice nurse. They responded positively to sharing cultural and clinical experiences.

CONCLUSION

The recent global health challenge supported the development of innovative methods to deliver education and created an opportunity for advanced practice students to develop cultural competence and critical thinking. Collaborative solutions are essential to education and healthcare as we move forward in the 21st century.

IMPLICATIONS FOR NURSING PRACTICE

Robust international collaborations have enabled the development of cultural competence and critical thinking. These are crucial elements for advanced practice roles.

Assessment of the psychometric properties of the Vietnamese version of the Critical Thinking Disposition Scale

BACKGROUND

The Critical Thinking Disposition Scale is a valid and reliable tool for assessing an individual's attitudes towards critical thinking. However, it is unclear if the scale can be used with Vietnamese nursing students.

OBJECTIVES

This study aimed to translate the scale into Vietnamese and examine the psychometric properties of the Vietnamese version of the Critical Thinking Disposition Scale (CTDS-V).

SETTINGS

Data were collected from senior nursing students at four universities in southern Vietnam in October and December 2022.

PARTICIPANTS

In total, 398 senior nursing students participated in this study.

METHODS

A cross-cultural adaptation of the CTDS-V was carried out with participants obtained through convenience sampling. Data were collected through an online survey. The study evaluated the validity of the CTDS-V by examining the content validity, concurrent validity, and construct validity, employing both Exploratory and Confirmatory Factor Analyses. The study also reported the internal consistency reliability using Cronbach's alpha and test-retest stability of the CTDS-V.

RESULTS

The CTDS-V had a good content validity index with a score of at least 0.85 for each item and an excellent overall content validity index of 0.96. Exploratory Factor Analysis identified two factors, critical openness, and reflective scepticism, with 11 items. Confirmatory Factor Analysis provided an acceptable fit model and supported the factor structure of the original scale. Cronbach's alpha coefficient of the scale was 0.88, and those of the two subscales were each 0.84. The test-retest stability of the CTDS-V was good with an intraclass correlation coefficient of 0.98 (95 % confidence interval = 0.96, 0.99).

CONCLUSIONS

This study indicated that the CTDS-V is a valid and reliable tool for assessing the critical thinking disposition of nursing students. The scale is short, rendering it feasible for regular use in education and research.

Assessing perceptions about critical thinking, motivation learning strategies in online psychiatric and mental health nursing education among Egyptian and Saudi undergraduate nursing students

BACKGROUND

The pandemic context prompts nursing students to be involved in online learning. Researchers indicated that critical thinking develops through the learning process, but the link between critical thinking and online learning in nursing does not have sufficient evidence.

AIM OF STUDY

This research examines student perceptions about critical thinking, motivation, and learning strategies in online psychiatric nursing education among nursing students at Imam Abdulrahman bin Faisal University in Saudi Arabia and Alexandria University in Egypt.

SUBJECT AND METHODS

An online survey was designed to collect data anonymously. A total of 75 Saudi undergraduates and 105 Egyptian nursing students who met the inclusion criteria participated. The online survey assessed three parts: socio-demographic data, critical thinking motivational, and cognitive processing strategy scales.

RESULTS

The current study found that using a motivating method for online learning inspired students to engage in critical thinking and cognitive processing strategies in a psychiatric and mental health nursing course, even in two different contexts.

CONCLUSION

This study demonstrates that using motivational methods for online learning encourages students to engage in critical thinking and cognitive processing strategies in psychiatry and mental health care courses, even in two different settings.

Understanding Learning Styles in Undergraduate Nursing Programs of the Kingdom of Saudi Arabia: An Integrative Literature Review

Background:

In Saudi Arabia, nursing education is developing fast due to high nursing demand. Alongside this development, nurse educators must identify and understand nursing students learning styles to ensure the multidimensional development of students learning experiences. Students' preferred learning style is an essential element in determining students' unique ways of processing new knowledge, information, and skills.

Objective:

This literature review aimed to identify the learning styles of undergraduate Saudi nursing students based on the premises of three learning style models: Kolb’s Model, Felder-Silverman Learning, and Visual, Aural, Read/Write, and Kinesthetic (VARK) Learning Styles Inventory.

Methods:

An integrative review of published studies on Saudi nursing students' learning styles was conducted while adhering to predefined eligibility measures. The research strategy for this study was based on online international databases, such as PubMed, Medline, CINAHL, EBSCO, Google Scholar, and Saudi health databases and journals. The keywords used were: “nursing education,” “learning style,” “learning preference,” “academic learning style,” “undergraduate nursing students,” and “nursing students in Saudi Arabia.”

Results:

Seven studies met the inclusion criteria. Most of the reviewed literature reported a prominent preference for kinesthetic, accommodating, converging, visual, and active learning styles in nursing students regardless of their age, gender, and level of education in various universities in Saudi Arabia.

Conclusion:

Students learning styles emphasize the importance of practical experience and students' hands-on practice as the best style that improves nursing students learning experience. The Saudi Arabian education system must adjust to fit students' preferred learning styles and focus on advanced state-of-the-science learning tools in nursing education.

Critical thinking abilities among newly graduated nurses: A cross-sectional survey study in China

AIM

The aim of this study is to describe critical thinking dispositions among newly graduated nurses with different educational background in China and to explore related factors.

DESIGN

A cross-sectional questionnaire survey.

METHODS

The data were collected using the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV). Overall, 588 newly graduated nurses finally completed the survey. Spearman and Pearson's correlation coefficients were used to examine the correlation between the CDTI-CV and nurses' general characteristics.

RESULTS

In terms of open-mindedness, analysis and inquisitiveness subscales, significant differences were found among nurses based on three educational level. When dichotomizing total CTDI scores into high and low, nearly 80% of the respondents fell into low score group. Pressure from workplace was high for 68.4% of them. Significant correlation was found among the new graduated nurses' critical thinking ability and their age, education level, reading habit and attitude towards nursing profession.

Simulation-Based Learning Supported by Technology to Enhance Critical Thinking in Nursing Students: Protocol for a Scoping Review

BACKGROUND

Critical thinking is a crucial skill in the nursing profession, so teaching strategies and methodology must be carefully considered when training and preparing nursing students to think critically. Studies on simulation-based learning supported by technology are increasing in nursing education, but no scoping reviews have mapped the literature on simulation-based learning supported by technology to enhance critical thinking in nursing students.

OBJECTIVE

The proposed scoping review aims to systematically map research on the use of simulation-based learning supported by technology to enhance critical thinking in nursing students.

METHODS

The proposed scoping review will use the framework established by Arksey and O'Malley and will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, EMBASE, PsycINFO, and Web of Science databases. Pairs of authors independently selected the articles by screening titles, abstracts, full-text papers, and extract data. The data will be analyzed and thematically categorized.

RESULTS

The development of a comprehensive and systematic search strategy was completed in June 2021. The database searches were performed in July 2021, and the screening of titles and abstracts was completed in September 2021. Charting the data began in February 2022. Analysis and synthesis will be performed sequentially, and the scoping review is expected to be complete by May 2023.

CONCLUSIONS

The results of this proposed scoping review may identify gaps in the literature and provide an overview of research on the topic of simulation-based learning supported by technology to enhance critical thinking in nursing students. The research may identify nursing students' reported barriers and enablers for learning critical thinking skills through simulation-based learning supported by technology, and the results may help educators enhance their educational approach through knowledge of students' firsthand experiences and further development of successful teaching strategies in nursing education.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/36725.

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: A Mixed Methods Systematic Review (Preprint)

Background

Objective

Methods

Results

Conclusions

International Registered Report Identifier (IRRID)

Critical thinking among clinical nurses and related factors: A survey study in public hospitals

AIMS AND OBJECTIVES

The study investigated clinical nurses' critical thinking levels in public hospitals and related factors.

BACKGROUND

Since health care environments have become more complex, the critical thinking skills of clinical nurses are more important in daily problem-solving and decision-making processes. However, little research was conducted on this topic among clinical nurses.

METHODS

It was a cross-sectional study at five public hospitals between December 2018 and January 2019. The study followed the STROBE guideline. Data were collected from 559 nurses by a survey consisted of a data form and the Turkish version of the Nursing Critical Thinking in Clinical Practice Questionnaire.

RESULTS

Nurses' mean critical thinking scores were moderate level. Total critical thinking scores of the clinical nurses significantly differed according to education, hospital type, shift work, professional category and role. There was a significant effect on the total critical thinking scores of the clinical nurses according to variables.

CONCLUSION

This study found that critical thinking levels of nurses' working in clinical settings in public hospitals were moderate level. Hospital type, shift work, professional and educational level and role were significantly associated with clinical nurses' critical thinking levels.

RELEVANCE TO CLINICAL PRACTICE

This study provides evidence related to the levels of critical thinking of clinical nurses working in public hospitals. Since the critical thinking scores of the manager nurses, daytime working nurses' and nurses with bachelor's and master's degree education are higher, hospital managers may benefit from the study to implement effective strategies to improve the competence of critical thinking levels of nurses.

Development of critical thinking skills of undergraduate students throughout the 4 years of nursing degree at a public university in Spain: a descriptive study

OBJECTIVE

To analyse the critical thinking skills of students enrolled in the four academic years of the nursing degree at a public university belonging to the European Higher Education Area.

DESIGN

Cross-sectional, quantitative, descriptive study. Using the Critical Thinking Questionnaire to analyse the critical thinking skills in their substantive and dialogic dimension.

SETTING

Faculty of Nursing, Valladolid Public University in Spain, belonging to the European Higher Education Area.

PARTICIPANTS

The sample consisted of 215 first-year, second-year, third-year and fourth-year undergraduate nursing students.

MAIN OUTCOMES

The students of the four academic years were positively disposed towards critical thinking. The students of the final courses obtained higher average scores.

RESULTS

The study sample was 215 students, 19.1% men/80.9% women. The average score in the substantive dimension (3.81±0.53 points) was higher than that in the dialogic dimension (3.48±0.51 points) (p<0.001). They had a greater ability in listening and speaking (3.77±0.61 points) with respect to writing (3.65±0.61 points) and reading (3.52±0.43 points) (p<0.001). There are significant differences in the critical thinking average scores across academic years.

CONCLUSIONS

Nursing students displayed a greater critical thinking ability in its substantive dimension compared with the dialogic one. This reflects a greater ability in actions related to provide reasons and evidence that support their point of view. Identifying critical thinking skills in nursing students will help establish specific teaching methodologies focused on improving these skills.

Examining predictive factors of nursing students' self-confidence in multiple simulation sessions: A randomized controlled study

AIM

The aim of this study was to examine and describe predictors of self-confidence among nursing students attending multiple simulation-based education sessions during a bachelor program.

DESIGN

This was a randomized controlled longitudinal study.

METHODS

Participants (n = 146) were randomly assigned to a single or double set of acute care scenarios in each session. Participants attended 4 days of simulation sessions throughout a 3-year bachelor program. At four separate time points, both groups answered a survey including the Self-confidence scale and The Kolb Learning Style Inventory version 3.1. Descriptive statistics, cross-tabulations and linear models were employed to analyze the data.

RESULTS

No significant interaction effects were found between the students' self-confidence at the end of the educational program and predictive factors favoring a double set of simulation scenarios. Most third-year students (n = 52, 85%) preferred a concrete learning mode at baseline.

CONCLUSIONS

No significant predictive factors increasing self-confidence in favor of a double set of simulation scenarios could be demonstrated in this study. Hence, the continuous search for how to effectively implement SBE is of major importance for the development of SBE as a pedagogical method and remains a challenge.

A multi-centre study of learning styles of new nursing students

AIMS

To describe beginning nursing student learning styles and to determine whether there are relationships between learning style and sociodemographic or educational background. We also aim to compare these data with the normative values of the 3.1 version of the Kolb learning style inventory and verify its reliability.

BACKGROUND/LITERATURE

Learning style is related to the way in which an individual interacts with learning conditions, involving cognitive, affective, physical and environmental aspects. In nursing education, few studies have focused on knowing the learning styles of beginning nursing students, despite the need for students to develop critical thinking skills required of nurses.

DESIGN

Descriptive, cross-sectional, correlational, multi-site study.

METHOD

The study took place at five universities in Brazil and one university in the United States. Data were collected from a sample of beginning nursing students (n = 176) in 2019, using the Portuguese and English 3.1 versions of Kolb's learning style inventory.

RESULTS

Most students' learning styles were classified as divergers (34.10%), while 28.41% were assimilators, 23.86% were accommodators and 13.63% were convergers. Kolb describes learning as a four-stage cyclical process grounded in experience. The mean score of one learning stage, the concrete experience, showed those who attended public high schools compared with private high schools was higher (mean = 26.22; p = .0019), and there were different results between Brazilian state universities, Brazilian federal universities and the American university (p = .0149).

CONCLUSION

The diverger style was the most common among beginning nursing students in Brazil and the United States. There was a significant relationship between learning style, the educational background of students, the type of institution they attend and their previous experience with some active learning methodologies.

RELEVANCE TO CLINICAL PRACTICE

Aligned with Kolb's experiential learning theory, nurse educators must be aware of student learning styles so they may use teaching strategies to meet their students' needs.

Validation of information-seeking behaviour of nursing students confirms most profiles but also indicates desirable changes for information literacy support

Purpose

The study aims were: (1) to replicate a previous study by the first author to confirm previous findings (internal validity) and to check construct validity of previously proposed information-behaviour profiles, (2) to compare the information processes used by students in parallel with requirements of early professional practice.

Design/methodology/approach

A replication study used the same questionnaire, delivered online to all 175 students across three years of a BSc adult nursing degree programme on one UK university campus. The survey included questions on information seeking processes, personality, approaches to learning and self-efficacy with information literacy. The literature review examined evidence around the transition from nursing student to practitioner and the Association for College and Research Libraries (ACRL) standards for nursing information literacy.

Findings

The response rate was 86/175 (49%). The result verified findings on the most frequent information processes and association between approach to learning and information literacy self-efficacy. The personality findings differed. Combining results for both studies helped confirm most of the information-behaviour profiles. Mapping the frequent information processes against requirements of practice indicated gaps, particularly around professional networking.

Research limitations/implications

As both studies were carried out at one higher education campus, further research to assess external validity is required.

Practical implications

Information-behaviour profiles, plus the mapping, help librarians and tutors develop tailored information literacy support that is clinically relevant and support transition to practice.

Originality/value

Validated a set of information behaviour profiles for nursing students and linked these to the requirements of professional practice.

Descriptive Study of Nursing Students' Learning Styles. Case Study of the Professional Bachelor's Degree Cycle in Nursing of the Higher Institute of Nursing Professions and Health Techniques of Casablanca, Morocco

Background:

Learning difficulties experienced by learners are among the most recurring problems in education and, without doubt, the most worrying. Thus, at the beginning of each year, we at the Higher Institute of Nursing Professions and Health Techniques of Casablanca, Morocco (ISPITSC) note the diversity of intrinsic characteristics in our students in the initial training of the Professional Bachelor's (PB) degree cycle in initial nursing training. We believe these characteristics are related to the varied difficulties of adaptation and learning encountered in the first year. However, a lack of knowledge of the learning styles adopted by our students prevents the teaching staff from detecting the difficulties encountered by the learners in assimilating new knowledge during the 3 years of their training course. The identification of these learning styles and subsequent readjustments in training would help improve the quality of training and guarantee an effective mobilisation of knowledge during various care activities, while allowing the acquisition of necessary skills in the context of quality care that meets the needs of patients.

Objective:

The objective of this study is to identify the learning styles of nursing students in the BP nursing cycle at ISPITS Casablanca in Morocco and to classify their origin and nature according to the typology described by Honey and Mumford.

Methods:

Our research used a diagnostic and screening instrument for learning styles developed by Honey and Mumford, the “Learning Style Questionnaire” (LSQ), an abbreviated French version of which (LSQ-Fa) has been translated by Fortin et al. A sample of 49 students received the data collection instrument.

Results:

The study obtained a response rate of 87.75% (43 students). The results are similar to the research that shows that reflector style is the preferred learning style of learners in PB nursing education. However, the study also identified an important category of students who have dual learning styles.

Conclusion:

Given the gap between learners' teaching style and learning style and its consequences for the assimilation of the knowledge provided, nursing educators should adapt their educational strategies to the particularities of their students in order to reduce learning difficulties and promote the effective mobilisation of knowledge in various complex learning situations.

Effects of high-fidelity simulation on the critical thinking skills of baccalaureate nursing students: A causal-comparative research study

BACKGROUND

Critical thinking has been identified as one of the standards for nursing school accreditation and a long-standing outcome of nursing education and nursing practice. High-fidelity simulation is one method currently used by nursing programs to increase critical thinking in nursing students. Despite these expectations, there is limited empirical evidence which compares the effects of simulation to other teaching strategies.

OBJECTIVES

The purpose of this study was to examine whether statistically significant differences existed in mean critical thinking skill scores within groups (pretest to posttest) and between groups (simulation versus written case studies).

DESIGN

A quantitative causal-comparative methodology with a pretest/posttest design.

SETTING

A private university in the midwestern United States which offers a four-year Bachelor of Science Nursing program.

PARTICIPANTS

Baccalaureate junior nursing students (N = 69) were recruited from a convenience sample and divided into two groups which consisted of a simulation group (n = 36) and a written case studies comparison group (n = 33).

METHODS

This research study consisted of a pretest, three weeks of being in either the simulation group or the written case studies group, and a posttest. The Health Science Reasoning Test (HSRT) was the instrument used for the pretest and posttest to measure critical thinking skills of all participants.

RESULTS

A repeated measures mixed analysis of variance (ANOVA) indicated there was no statistically significant difference in participants' mean critical thinking scores within groups (pretest to posttest) or between groups (simulation versus written case studies).

CONCLUSIONS

The use of high-fidelity simulation as a teaching strategy versus written case studies to increase critical thinking skills of nursing students was not supported.

Nursing students' experiences and perceptions of learner-centred education in a disaster nursing course: A qualitative study

Learner-centred education has been shown to be an effective teaching method in the healthcare disciplines that integrate practical skills and theoretical knowledge. However, the elements of learner-centred education that influence students' motivation and engagement in learning remain unclear. In this descriptive qualitative research study, 43 nursing students in a baccalaureate nursing programme in Hong Kong who enrolled in a disaster and trauma nursing course were recruited through purposive sampling. Data were collected through semi-structured, face-to-face, focus group interviews. The transcribed interviews were interpreted through the use of qualitative analysis. This study revealed that adopting learner-centred education techniques in a disaster nursing course could cater to the hedonic nature and practical nature of learning disaster nursing, which consequently strengthens student's motivation and engagement in learning. The findings also suggested that learner-centred education could improve nursing students' learning experience and promote their transformation from passive and receptive students into proactive learners. The present study provides a greater and more focused understanding of the elements of learner-centred education that promote motivation and engagement in learning among nursing students. This study could offer insights into the development and evaluation of disaster nursing courses and other subjects in the undergraduate nursing curriculum.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.

Contextualizing Instructional Technology to the Demands of Nursing Education

This article reviews current technologies in nursing education and the impact of technology on learning. The integration of technology into nursing curricula is thought to improve efficiency and enhance student experiences through active learning and interactive learning designs. The following focused questions are explored: (1) What are the current technologies used by university students and faculty in nursing programs? (2) How does that technology influence student learning? The primary themes were student-centered technology, with five subthemes, and faculty-centered technology. Consumers of healthcare (patients) demand quality care and expect highly skilled, compassionate, ethical practitioners; to this end, training and education of future nurses by skilled, qualified nurse educators who are comfortable with technological demands of all aspects of healthcare are fundamental. While it is essential that nurses and nurse educators continue to publish as a mechanism for open discussion and transparency in our teaching and learning approaches, we need higher levels of evidence to strengthen the argument that technology improves the learning environment and student outcomes and has a positive impact on clinical settings and patient care.

Implicaciones de los estilos de aprendizaje en el uso de didácticas en la práctica docente

Objetivo: analizar los estilos de aprendizaje de los estudiantes de enfermería y discutir sus implicaciones en el uso de didácticas en la práctica docente.Metodología: a través de un muestreo consecutivo se reclutaron estudiantes de primero, segundo, tercero y cuarto año de enfermería. Se aplicó el Cuestionario Honey-Alonso de Estilos de Aprendizaje y un cuestionario demográfico. Se efectuó análisis descriptivo y test de normalidad en todas las variables. Se emplearon las pruebas Mann-Whitney y Kruskal-Wallis para el análisis entre los estilos de aprendizaje y las variables demográficas. Se examinaron correlaciones interestilo mediante el coeficiente de Pearson. Finalmente, se discutió la influencia de los estilos de aprendizaje en el uso de didácticas en la práctica docente. El error tipo I fue fijado en < 0,05 % en todos los test. Resultados: participaron 169 estudiantes con edad media de 24,5 años y predominancia de sexo femenino (81,7 %). El estilo de aprendizaje predominante fue reflexivo (53,8 %). Se identificó que la edad influye en la preferencia de los estilos de aprendizaje (p = 0,03) y que los estilos activo y pragmático; reflexivo, teórico y mixto se correlacionan positivamente (p < 0,05).Conclusiones: el estilo de aprendizaje reflexivo fue el más utilizado, sin embargo, existen múltiples preferencias de estilos de aprendizaje entre los estudiantes de enfermería. El docentetiene el desafío de hacer uso de diversas estrategias didácticas para facilitar el aprendizaje individual y grupal.

General Self-Efficacy Mediates the Effect of Family Socioeconomic Status on Critical Thinking in Chinese Medical Students

Background: Critical thinking (CT) is an essential competence for medical students. Family socioeconomic status (family SES) and general self-efficacy (GSE) play crucial roles in the development of CT. However, the association among family SES, GSE, and CT in Chinese medical students has yet to be fully investigated. Objectives: To investigate the role of family SES and GSE in the development of CT in Chinese medical students. Methods: 1,338 medical students were recruited using multistage stratified cluster sampling from three institutions in China. The Chinese critical thinking disposition inventory (CTDI-CV), General Self-Efficacy Scale (GSES), and a self-made inventory assessing family SES were administered to collect data. The relationship between CT and family SES as well as GSE was evaluated by structural equation modeling. Results: Students of higher family SES obtained higher CTDI-CV and GSES scores. A positive correlation was found between family SES and CT (r = 0.101-0.141, p < 0.05 or p < 0.01), as well as between family SES and GSE (r = 0.111-0.129, p < 0.01). Moreover, GSE was moderately correlated with CT (r = 0.418, p < 0.01). The model of partial mediate effect of GSE showed the best fit index with X 2 = 29.698, df = 9 and X2/df = 3.300, NFI = 0.990, IFI = 0.993, TLI = 0.984, CFI = 0.993, RMSEA = 0.041. Conclusion: Family SES has a positive albeit limited influence on GSE and CT in Chinese medical students. GSE mediates the effect of family SES on CT and plays a larger role. Enhancing medical student' GSE maybe an efficacious way to improve medical students' CT.

Learning Style Preferences of Practicing Nurses

Nursing professional development practitioners are encouraged to consider incorporating preferred learning styles into professional development programs. However, conclusive evidence about preferred learning styles does not exist. This study describes the preferred learning styles of nursing staff. Results showed that learning style preferences existed and were correlated with satisfaction, years of experience, and gender. The results can be used to plan and deliver professional development opportunities that are engaging and promote retention of learning.

Effectiveness of teaching strategies to improve critical thinking in nurses in clinical practice: a systematic review protocol

OBJECTIVES

The aim of this review is to identify and synthesize the best available evidence on the effectiveness of teaching strategies aimed at improving critical thinking (CT) in registered nurses who provide direct patient care. Specifically, the research question is: What are the best teaching strategies to improve CT skills in registered nurses who provide direct patient care?

Perceptions of nursing students after performing an individual activity designed to develop their critical thinking: The "critical card" tool

Critical thinking in Health Sciences is among the transversal competences in the Nursing Degree. The critical card is a tool of individual learning, designed to develop critical thinking, and set in the process of environmental health learning. Every student must perform the activity to obtain the highest qualification in Community Health Nursing subject. The aim of this project was to evaluate this learning tool using the students' perceptions after its performance. The evaluation was based on the answers to a questionnaire obtained from the third course students of Nursing Degree at the University of Zaragoza. The questionnaire was made up of 14 Likert-type questions, grouped in four dimensions. The student participation rate was higher than 50%. The analysis of the questionnaire obtained 67,8% positive answers. The variability between dimensions ranged between 49% of positive answers for application in other subjects and 87% of positive answers for the improvements applicable to the instrument. The students coincided in indicating that the critical card is a useful learning tool and could be applicable in other subjects. However, the weight it is given in the global evaluation of the subject is considered to be too low, considering the time used to complete the activity.

Theory of communicative action: a basis for the development of critical thinking

Reflections on some assumptions of the theory of Communicative Action and the development of Critical Thinking in the context of training students in undergraduate nursing courses. The perspective is based on concepts of Jürgen Habermas, as a possibility for the development of critical thinking among the students of these courses. Communication is therefore understood as inherent in the training of nurses in a continuous, dynamic, dialogical process, with interventions that are related to the context of the students and that have meaning for them, in order to contribute to the promotion of Critical Thinking.

Strategies used for the promotion of critical thinking in nursing undergraduate education: A systematic review

OBJECTIVE

Identifying the strategies used to promote critical thinking (CT) during undergraduate education in nursing courses.

DESIGN

Systematic review.

SOURCE OF DATA

Five electronic databases were searched without language, publication time or geographic filters.

METHOD

A systematic review of the literature. Including experimental studies that considered at least one teaching strategy to promote critical thinking of undergraduate students in Nursing courses. The search for studies occurred in three phases: title and summary review, complete text and implementation of a clinical form of selection according to predetermined criteria. All included studies were assessed for quality through a classification tool for experimental studies.

RESULTS

Six studies were selected. The results were grouped into three key themes: an evaluation of the quality of the selected studies, characterization of the studies and the strategies used to promote critical thinking. All selected studies were in English, with significant conceptual similarity of Critical Thinking and dominance in choosing the approached theme during strategies in clinical nursing education with an emphasis on the nursing process.

CONCLUSIONS

The most widely used teaching intervention was Problem-Based Learning. Nursing education mediated by strategies that stimulate CT is considered a positive difference in undergraduate curriculums.

An integrated review of the correlation between critical thinking ability and clinical decision-making in nursing

AIMS AND OBJECTIVES

To explore whether there is a correlation between critical thinking ability and clinical decision-making among nurses.

BACKGROUND

Critical thinking is currently considered as an essential component of nurses' professional judgement and clinical decision-making. If confirmed, nursing curricula may be revised emphasising on critical thinking with the expectation to improve clinical decision-making and thus better health care.

DESIGN

Integrated literature review.

METHODS

The integrative review was carried out after a comprehensive literature search using electronic databases Ovid, EBESCO MEDLINE, EBESCO CINAHL, PROQuest and Internet search engine Google Scholar. Two hundred and 22 articles from January 1980 to end of 2015 were retrieved. All studies evaluating the relationship between critical thinking and clinical decision-making, published in English language with nurses or nursing students as the study population, were included. No qualitative studies were found investigating the relationship between critical thinking and clinical decision-making, while 10 quantitative studies met the inclusion criteria and were further evaluated using the Quality Assessment and Validity Tool. As a result, one study was excluded due to a low-quality score, with the remaining nine accepted for this review.

RESULTS

Four of nine studies established a positive relationship between critical thinking and clinical decision-making. Another five studies did not demonstrate a significant correlation. The lack of refinement in studies' design and instrumentation were arguably the main reasons for the inconsistent results.

CONCLUSIONS

Research studies yielded contradictory results as regard to the relationship between critical thinking and clinical decision-making; therefore, the evidence is not convincing. Future quantitative studies should have representative sample size, use critical thinking measurement tools related to the healthcare sector and evaluate the predisposition of test takers towards their willingness and ability to think. There is also a need for qualitative studies to provide a fresh approach in exploring the relationship between these variables uncovering currently unknown contributing factors.

RELEVANCE TO CLINICAL PRACTICE

This review confirmed that evidence to support the existence of relationships between critical thinking and clinical decision-making is still unsubstantiated. Therefore, it serves as a call for nurse leaders and nursing academics to produce quality studies in order to firmly support or reject the hypothesis that there is a statistically significant correlation between critical thinking and clinical decision-making.

A study of the relationship between the study process, motivation resources, and motivation problems of nursing students in different educational systems

BACKGROUND

The study process is related to students' learning approaches and styles. Motivation resources and problems determine students' internal, external, and negative motivation. Analyzing the study process and motivation of students yields important indications about the nature of educational systems in higher education.

OBJECTIVES

This study aims to analyze the relationship between the study process, and motivation resources and problems with regard to nursing students in different educational systems in Turkey and to reveal their effects according to a set of variables.

DESIGN

This is a descriptive, cross-sectional and correlational study.

SETTINGS

Traditional, integrated and problem-based learning (PBL) educational programs for nurses involving students from three nursing schools in Turkey.

PARTICIPANTS

Nursing students (n=330).

METHODS

The data were collected using the Study Process Questionnaire (R-SPQ-2F) and the Motivation Resources and Problems (MRP) Scale.

RESULTS

A statistically significant difference was found between the scores on the study process scale, and motivation resources and problems scale among the educational systems. This study determined that the mean scores of students in the PBL system on learning approaches, intrinsic motivation and negative motivation were higher. A positive significant correlation was found between the scales.

CONCLUSIONS

The study process, and motivation resources and problems were found to be affected by the educational system. This study determined that the PBL educational system more effectively increases students' intrinsic motivation and helps them to acquire learning skills.

Assessing Learning Styles of Graduate Entry Nursing Students as a Classroom Research Activity: A quantitative research study

BACKGROUND

A number of studies across different disciplines have investigated students' learning styles. Differences are known to exist between graduate and baccalaureate nursing students. However, few studies have investigated the learning styles of students in graduate entry nursing programs. .

OBJECTIVES

Study objective was to describe graduate entry nursing students' learning styles.

DESIGN/SETTING/PARTICIPANTS/METHODS

A descriptive design was used for this study. The Index of Learning Styles (ILS) was administered to 202 graduate entry nursing student volunteers at a southwestern university. Descriptive statistics, tests of association, reliability, and validity were performed. Graduate nursing students and faculty participated in data collection, analysis, and dissemination of the results.

RESULTS

Predominant learning styles were: sensing - 82.7%, visual - 78.7%, sequential - 65.8%, and active - 59.9%. Inter-item reliabilities for the postulated subscales were: sensing/intuitive (α=0.70), visual/verbal (α=0.694), sequential/global (α=0.599), and active/reflective (α=0.572). Confirmatory factor analysis for results of validity were: χ²(896)=1110.25, p<0.001, CFI=0.779, TLI=0.766, WRMR=1.14, and RMSEA =0.034.

CONCLUSIONS

Predominant learning styles described students as being concrete thinkers oriented toward facts (sensing); preferring pictures, diagrams, flow charts, demonstrations (visual); being linear thinkers (sequencing); and enjoying working in groups and trying things out (active),. The predominant learning styles suggest educators teach concepts through simulation, discussion, and application of knowledge. Multiple studies, including this one, provided similar psychometric results. Similar reliability and validity results for the ILS have been noted in previous studies and therefore provide sufficient evidence to use the ILS with graduate entry nursing students. This study provided faculty with numerous opportunities for actively engaging students in data collection, analysis, and dissemination of results.

The significance of personal learning environments (PLEs) in nursing education: Extending current conceptualizations

BACKGROUND

Personal learning environments (PLEs) have been shown to be a critical part of how students negotiate and manage their own learning. Understandings of PLEs appear to be constrained by narrow definitions that focus primarily on technological engagement with a range of web tools and associated applications. This paper addresses a gap in the literature around PLEs for students currently enrolled in undergraduate nursing degrees.

PURPOSE

To provide in-depth insights into how undergraduate students of nursing manage and experience their learning.

METHODS

This was an international multi-site qualitative study, utilizing focus groups. A schedule of 10 questions and nominal group techniques were used.

FINDINGS

Whilst the focus groups took place in very different geographical locations, there were strong similarities in student understandings of effective PLEs. These went well beyond current technological definitions. Findings were organized into three major themes; technologies, learning modalities and influencing factors.

DISCUSSION

We propose a broader understanding of PLEs that acknowledges individual personal and cultural contexts which we call the personally significant learning environment (PSLE). There is a need for greater investigation of how students understand and systematize their PSLE.

CONCLUSIONS

This paper and our findings will be of interest to educators, researchers and institutions for developing appropriate frameworks that may maximize learning outcomes, encourage cultural sensitivities and facilitate greater understandings of how to support students to create appropriate PSLEs.

Aplicação do mapa conceitual: resultados com diferentes métodos de ensino-aprendizagem

Objetivo: analizar el resultado de una intervención de enseñanza aliada a un método tradicional para el desarrollo del concepto de complicaciones de la herida quirúrgica postoperatoria para uso en el pregrado en enfermería. Método: estudio de análisis cualitativocasi-experimental, aplicado por medio de una intervención de enseñanza en los estudiantes de enfermería de pregrado. La recolección de datos se dio en dos etapas, y los estudiantes fueron divididos al azar en los subgrupos I y II. Para facilitar la recopilación de datos, los estudiantes desarrollaron mapas conceptuales con la ayuda de las herramientas de software Cmap Tools®. Los datos fueron analizados mediante la técnica de análisis de contenido, identificando 12 categorías. Resultados: el subgrupo II mostró resultados positivos en relación con el subgrupo I, ya que la asociación de los dos métodos de enseñanza que utilizan la técnica de MC podría promover la capacidad de articular los conceptos desarrollados con conocimientos previos. Conclusión: se encontró que la asociación de la intervención docente con base teórica en la Teoría del Aprendizaje Significativo, más el método tradicional y el uso de la técnica de MC estimulan un buen desempeño de los estudiantes en el proceso de enseñanza-aprendizaje.

The effectiveness of an e-learning course on medication calculation in nursing students: a clustered quasi-experimental study

AIM

To evaluate the effectiveness of an e-learning course compared with a face-to-face lecture on medication calculation.

BACKGROUND

The current knowledge on medication calculation of nursing students and nurses is insufficient to provide safe care.

DESIGN

A stratified-clustered quasi-experimental study.

METHODS

A random selection of nursing schools were allocated to the e-learning course (intervention group) (seven schools; 189 students) or face-to-face lecture (control group) (six schools, 222 students). Students in both groups completed a validated medication calculation test (maximum score: 16) prior to the course (T0), immediately after the course (T1) and 3 months later (T2). A linear mixed model was used for data analysis.

RESULTS

Medication calculation skills improved significantly more by the face-to-face lecture than e-learning course. Students in both groups significantly improved in medication calculation skills immediately after the course (T1) and 3 months later. The results flattened at T2 with a significant decline in the intervention group between T1 and T2 and a non-significant decline in the control group. Based on a subgroup analysis, improvement in medication calculation skills at T2 could only be observed in vocational-level (sub degree) nursing students receiving a face-to-face course.

CONCLUSIONS

Both medication calculation courses had a positive effect on medication calculation skills. Students receiving traditional face-to-face lecture improved significantly more than the students receiving the e-learning course.

Effectiveness of teaching strategies on the development of critical thinking in undergraduate nursing students: a meta-analysis

Abstract OBJECTIVE To evaluate the effectiveness of teaching strategies used for development of critical thinking (CT) in undergraduate nursing students. METHOD Systematic review with meta-analysis based on the recommendations of the Joanna Briggs Institute . Searches were conducted in the following databases: PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, LILACS, Cochrane CENTRAL, PsycINFO, ERIC, and a database of theses from four continents. The initial selection and evaluation of studies and assessment of methodological quality was performed by two reviewers independently. RESULTS Twelve randomized clinical trials were included in the study. In the meta-analysis of the four studies included that evaluated the strategy of problem-based learning (PBL), compared to lectures, the effectiveness of PBL was demonstrated with statistical significance (SMD = 0.21 and 95% CI = 0.01 to 0.42; p = 0.0434) for the development of CT in undergraduate nursing students, and the studies were homogeneous (chi-square = 6.10, p = 0.106). CONCLUSION The effectiveness of PBL was demonstrated in the increase of overall CT scores. Further studies need to be conducted in order to develop, implement and evaluate teaching strategies that are guided in high methodological rigor, and supported in theoretical models of teaching and learning.

Nurse teacher candidates learned to use social media during the international teacher training course

The purpose of this study was to describe the nurse teacher candidates' learning outcomes and experiences in social media during the international nurse teacher training course, Empowering learning environments in nursing education, Intensive Program (EleneIP). The pre-post research design was used. The data was collected before and after the course, with the questionnaire consisting of structured and open questions. Altogether, 24 nurse teacher candidates from four different European countries participated in the course and this study. The results showed that the knowledge of using social media applications increased during the course from 5.2 (range 1-9) to 8.1 (range 4-10), and their skills increased from 4.5 (range 1-8) to 7.6 (range 4-10).The main topics learnt during the course were divided in two categories: subjects of the course and teaching and learning methods. The students' experiences concerning the EleneIP course were positive in both categories. The international group created during EleneIP course also allowed the students to achieve another important aim, learning from a collaborative group the importance and possibilities of different learning environments, considering the cultural and social characteristics of each country participating in it.

Correlations Between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room

BACKGROUND

Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students' team achievements in clinical judgement and emotional, sociological and physiological learning style preferences.

METHODS

A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed.

RESULTS

Three significant correlations were found between the team achievements and the students' learning style preferences: significant negative correlation with 'Structure' and 'Kinesthetic' at the individual level, and positive correlation with the 'Tactile' variable. No significant correlations with students' 'Motivation', 'Persistence', 'Wish to learn alone' and 'Wish for an authoritative person present' were seen.

DISCUSSION & CONCLUSION

There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences, cognitive learning outcomes and group processes.

Implementation of Free Text Format Nursing Diagnoses at a University Hospital's Medical Department. Exploring Nurses' and Nursing Students' Experiences on Use and Usefulness. A Qualitative Study

Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses' and nursing students' experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses' use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis' appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process.

Evaluation of best practices in the design of online evidence-based practice instructional modules

OBJECTIVES

The research determined to what extent best practices are being followed by freely available online modules aimed at teaching critical thinking and evidence-based practices (EBPs) in health sciences fields.

METHODS

In phase I, an evaluation rubric was created after reviewing the literature. Individual rubric questions were assigned point values and grouped into sections, and the sections weighted. Phase II involved searching Internet platforms to locate online EBP modules, which were screened to determine if they met predetermined criteria for inclusion. Phase III comprised a first evaluation, in which two authors assessed each module, followed by a second evaluation of the top-scoring modules by five representatives from different health sciences units.

RESULTS

The rubric's 28 questions were categorized into 4 sections: content, design, interactivity, and usability. After retrieving 170 online modules and closely screening 91, 42 were in the first evaluation and 8 modules were in the second evaluation. Modules in the first evaluation earned, on average, 59% of available points; modules in the second earned an average of 68%. Both evaluations had a moderate level of inter-rater reliability.

CONCLUSIONS

The rubric was effective and reliable in evaluating the modules. Most modules followed best practices for content and usability but not for design and interactivity.

IMPLICATIONS

By systematically collecting and evaluating instructional modules, the authors found many potentially useful elements for module creation. Also, by reviewing the limitations of the evaluated modules, the authors were able to anticipate and plan ways to overcome potential issues in module design.