Nursing students studying physiology within a flipped classroom, self-regulation and off-campus activities

Perspectives on self-directed learning in bioscience in nurse education - An integrative review

OBJECTIVES

There is a lack of synthesized knowledge on nursing students self-directed learning in bioscience and how to best support students' learning in this subject. The purpose of this integrative review is to synthesize current literature on perspectives on self-directed learning among nursing students studying bioscience to guide further research aiming to support students' learning more effectively.

METHODS

An integrative review in line with Whittemore & Knafl's modified framework containing five stages: problem identification, literature search, data evaluation, data analysis and presentation. A structured literature search was undertaken in the Web of Science, ERIC, Medline and CINAHL databases from November 2022 to January 2023. The inclusion criteria were nursing students enrolled in a bachelor programme, research addressing activities intended for learning bioscience, in addition to formal taught lectures and perspectives on self-directed learning in natural science subjects within nurse education such as views, actions, activities, habits and attitudes. Exclusion criteria were students in other education programs, research in formal learning contexts, and self-directed learning in other subjects than natural science subjects. Rigour of each included source was assessed using Whittemore & Knafl's suggested 2-point scale (high or low). A constant comparison method was used to synthesize results.

RESULTS

Of the initial 1143 sources, 12 articles were included after abstract and full-text screening: one pilot study for randomized controlled trial, one qualitative study, two mixed methods studies and eight quantitative studies. The sample size was from 23 to 563 participants.

DISCUSSION

This review identifies self-directed learning in bioscience understood as a continuum of teacher-directedness and self-directedness rather than as distinguished orientations. There seem to be no consistent definition of self-directed learning in bioscience, yet descriptions commonly imply metacognitive learning approaches. Nursing students value digital learning resources, yet technology might be secondary to the skill of self-directed learning.

Nursing students' experiences of flipped classroom teaching method in higher education: a systematic review

BACKGROUND

During the COVID-19 pandemic face-to-face activities were suspended, boosting the delivery of online teaching. As students returned to campuses, the delivery of active learning teaching methods followed a blended learning style. The flipped classroom, which is a student-centred approach, appears to be an effective teaching method, generating improved learning outcomes. No systematic review has so far explored students' experiences of this teaching method - a knowledge gap that this review aims to address.

METHODS

Studies published between 2012 and 2023 were identified from seven databases. The JBI critical appraisal tool was adopted to select high-quality studies and add credibility. Following extraction of qualitative data, meta-aggregation was used to identify synthesised findings.

RESULTS

The findings were aggregated into seven categories. Based on meaning similarity, three synthesised findings were identified to answer the research question on how nursing students experience the flipped classroom method.

CONCLUSION

Several factors affect the student experience. Although variables are interrelated and complex to analyse, this approach is a valuable teaching method, positively experienced by students with the potential to improve engagement and learning outcomes. The group activities used as a feature of the flipped classroom can be seen as an instrument to deliver a safer and high quality of care.

Impact of COIL: Learning From Student Nurses in Norway Who Collaborated With U.S. Students

AIM

The aim of this study was to describe the experience of Norwegian nursing students with internationalization through participation in a Collaborative Online International Learning (COIL) course.

BACKGROUND

Educators in Norway and the United States collaborated to incorporate internationalization and population health concepts into virtual courses during the pandemic. Literature gaps exist in post-implementation assessment data that ascertain internationalization through the COIL experience.

DESIGN

This was a qualitative study with a descriptive design. Data were collected from focus group interviews and analyzed conventional content-analysis approaches.

METHODS

Fifteen Norwegian undergraduate nursing students who participated in the COIL opportunity completed focus group interviews.

FINDINGS

The themes identified included, "virtual conversation builds collaborations and enhances learning," and "this opened my eyes."

CONCLUSIONS

Norwegian students acknowledged they had learned transferable lessons from their global partners that could be applied to patient care of the marginalized population in Norway.

Designing and delivering digital learning (e-Learning) interventions in nursing and midwifery education: A systematic review of theories

AIMS /OBJECTIVES

To identify and synthesise theories that support the design and delivery of digital learning interventions in nursing and midwifery education.

BACKGROUND

A range of educational and other theories are used to support nursing and midwifery education, including when e-learning interventions are being designed and delivered. However, there is a limited understanding of how theory is applied across the wide range of digital learning interventions to inform pedagogical research and practice.

DESIGN

A systematic review.

METHODS

CINAHL, ERIC, MEDLINE and PubMed were searched using key terms. Studies were screened by independent reviewers checking the title, abstract and full text against eligibility criteria. Due to the theoretical focus of the review, critical appraisal was not undertaken. Data were extracted and synthesised using a descriptive approach.

RESULTS

Thirty-four studies were included. Twenty theories were identified from a range of scientific disciplines, with the Technology Acceptance Model and Theory of Self-Efficacy employed most often. Theoretical frameworks were used to inform and explain how the digital learning interventions were designed or implemented in nursing and midwifery education. The sample were mainly undergraduate nursing students and the digital learning interventions encompassed animation, blended approaches, general technologies, mobile, online, virtual simulation and virtual reality applications which were used mainly in university settings.

CONCLUSIONS

This systematic review found a range of theories that support the design and delivery on digital learning interventions in nursing and midwifery education. While a single theory, the Technology Acceptance Model, tended to dominate the literature, the evidence base is peppered with numerous theoretical models that need to be examined more rigorously to ascertain their utility in improving the design or implementation of digital forms of learning to improve pedagogical research and practice in nursing and midwifery.

The Meaning and Application of Student-Centered Learning in Nursing Education: An Integrative Review of the Literature

AIM

The aim of this study was to review empirical articles to explore the meaning and the application of student-centered learning in nursing education.

BACKGROUND

Teachers in higher education are encouraged to adopt student-centered learning principles, but research shows that many still apply teacher-centered methods. There is therefore a need to clarify the meaning of student-centered learning, including how it is performed and the reasons to apply it in nursing education.

DESIGN

This study employed an integrative review method, following Whittemore and Knafl's framework.

METHODS

The databases CINAHL, Education Database and Education Research Complete were searched for related literature published from 2010 to 2020. The initial search located 308 articles. After screening and checking for eligibility, 25 articles were critically appraised. Data were extracted from the articles and displayed in matrices to be categorized and compared.

RESULTS

Three themes with attendant sub-themes emerged through the analysis: foundation, using core concepts to define and explain student-centered learning, eligibility, enhancing student knowledge, developing student abilities and supporting student self-reliance and realization, learning in interaction with peers, learning individually and learning in interaction with the teacher.

CONCLUSION

Student-centered learning in nursing education is an approach where the teacher is a facilitator of student learning and students are empowered to take control of their own studies. Students study together in groups; they are listened to by the teacher and their needs are taken into consideration. The main reasons to apply student-centered learning are to enhance students' theoretical and practical learning; to improve their generic competencies, such as problem-solving and critical-thinking abilities; and to strengthen students' self-reliance.

Student engagement in flipped classroom in nursing education: An integrative review

AIM

To summarize the effect of the flipped classroom method (FCM) on student engagement in nursing education and provide the implications for future practice.

BACKGROUND

Technological advancement of learning approaches including flipped classroom has become increasingly popular in nursing education. However, no integrative review has been published that specially explore the behaviour engagement, cognitive engagement and emotional engagement of flipped classroom use in nursing education.

METHODS

Population, Intervention, Comparison, Outcomes and Study (PICOS) strategies were implemented to investigate the literature from published peer-reviewed papers from 2013 to 2021 in CINAHL, MEDLINE and Web of Science.

RESULTS

The initial search identified 280 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 16 articles were considered for the final review. Most of articles targeted on undergraduate nursing students and were conducted in the USA and Australia. The review primarily identified positive learning outcomes among nursing students in term of student engagement. However, a few studies reported contrasting findings, possibly due to students are still dependent on traditional lecture-based classroom.

CONCLUSION

This review suggests that use of the FCM in nursing education could promote students' behavioral engagement and cognitive engagement but yield a mixed outcome in emotional engagement. This review contributed to our understanding of the effect of the flipped classroom method on student engagement in nursing education, the strategies for promoting student engagement in future flipped classroom practice and recommendation for future research on flipped classroom.

Difficulties and innovations in teaching anatomy and physiology in nursing

AIM

This study aimed to clarify the difficulties and innovations in anatomy and physiology education from the perspective of faculty members in charge of anatomy and physiology education in Japanese nursing universities.

BACKGROUND

Many nursing students have difficulty acquiring anatomy and physiology knowledge and applying it in clinical situations; therefore, effective teaching and learning methods for anatomy and physiology must be provided in nursing education.

DESIGN

This study followed a cross-sectional observational design using a web-based self-administered questionnaire.

METHODS

A web-based self-administered open-ended survey regarding the difficulties and innovations in teaching anatomy and physiology in nursing was conducted involving nursing faculty members at universities in Japan. After inviting 280 nursing universities to participate in the survey, 37 completed questionnaires were collected and descriptively analyzed.

RESULTS

In approximately 30% of the universities, multiple professions were involved in collaboratively teaching anatomy and physiology. Furthermore, 59.5% of the universities offered a combination of didactic lectures and laboratory learning. Difficulties in teaching anatomy and physiology included the limitations of the physical teaching environment, the difficulty of teaching the importance of anatomy and physiology in nursing practice, the difficulty of adjusting educational content to learner readiness, and the difficulty of terminology and concepts specific to anatomy and physiology. Innovations used in teaching anatomy and physiology from a nursing perspective included integrating anatomy and physiology with related disciplines, encouraging students to visualize human anatomy in three dimensions, and linking anatomy and physiology to clinical nursing practice.

CONCLUSION

Despite some difficulties in teaching the subjects, faculty members have implemented effective educational methods on their own. Due to the various constraints of the learning environment, it is difficult for students to learn anatomy and physiology on campus in depth and acquire a deep understanding of its significance in clinical practice. Therefore, educational involvement that fosters students' self-directed learning skills and encourages flexible learning is expected. In addition, by collaborating with multiple disciplines to provide anatomy and physiology education, the participants of this study innovated pedagogies for teaching nursing students about the usefulness of anatomy and physiology and motivated their students. Moving forward, teachers need to relate their knowledge of anatomy and physiology to actual nursing care and clinical cases and convey the importance of deeply understanding anatomy and physiology in nursing practice to support their students' active learning.

Flipped versus traditional classroom and student achievement and cognitive engagement in an associate degree nursing fundamental course

BACKGROUND

There is a call for instructional transformation in nursing education to include an innovative approach. This study aimed to investigate the effects of the flipped classroom method on student achievement and engagement in an associate degree nursing course. This study investigated associate degree nursing studies students' achievement and cognitive engagement under traditional learning (n = 141) and flipped learning (n = 130). This study was conducted in two first-year cohorts enrolled in their nursing fundamental course, before and during the COVID-19 pandemic respectively at a Hong Kong community college.

METHOD

A mixed methods approach was used with quantitative (examination scores) and qualitative (semi-structured focus group interview) measures applied.

RESULTS

There was a significant increase in final exam scores for the flipped classroom, all p < 0.01, with a medium-to-large (d = 0.60) effect size. Students commented flipped classroom method promoted their cognitive engagement and the benefits that contributed to such a positive student achievement included more peer interaction and more opportunity to apply their knowledge.

CONCLUSION

This study contributed to our understanding of the effect of the flipped classroom method on student engagement in nursing education.

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.

Clinical Efficacy Analysis of Fast Rehabilitation Nursing on Pain Mitigation after Lumbar Discectomy and Bone Graft Fusion and Internal Fixation

Objective

To investigate clinical efficacy analysis of fast rehabilitation nursing on pain mitigation after lumbar discectomy and bone graft fusion and internal fixation.

Methods

A total of 60 patients with lumbar disc herniation who underwent lumbar discectomy and bone graft fusion and internal fixation in our hospital from January 2021 to December 2021 were randomized either into routine group (n = 30) or rehabilitation group (n = 30) via the random number table method. The patients in the routine group were intervened with the routine postoperative nursing mode, and the patients in the rehabilitation group were intervened with the fast rehabilitation nursing mode on the basis of the nursing of the patients in the routine group. The rehabilitation effect, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores, postoperative pain improvement, and nursing satisfaction were compared between the two groups.

Results

The postoperative rehabilitation effect of the rehabilitation group was significantly better than that of the routine group (P < 0.05). The fast rehabilitation nursing resulted in a notably lower postoperative SAS and SDS scores versus the routine nursing (P < 0.001). The postoperative pain was significantly mitigated in the rehabilitation group when compared with the routine group (P < 0.001). The fast rehabilitation nursing implemented in the rehabilitation group led to a remarkably higher nursing satisfaction of the patients (P < 0.001).

Conclusion

The fast rehabilitation nursing mode intervention for lumbar disc herniation patients undergoing lumbar discectomy and bone graft fusion and internal fixation is a promising approach to improve the postoperative rehabilitation, mitigate postoperative pain, and relieve anxiety, depression, and other negative emotions, with higher clinical nursing satisfaction.

Examining effects of the flipped classroom approach on motivation, learning strategies, urinary system knowledge, and urinary catheterization skills of first-year nursing students

AIM

In nursing education, innovative approaches are crucial to enhancing students' competence and preparing them to respond to the complex healthcare needs of society. The aim of the current study was to compare the efficacy of the flipped classroom and traditional educational approaches on the acquisition of urinary system knowledge and skill level, and on the motivation and learning strategies of first-year nursing students.

METHODS

This study was implemented with a single blind and randomized controlled design in the nursing department of a university's faculty of health sciences between December 2018 and December 2019, with 94 first-year undergraduate nursing students (47 in the experimental group adopting a flipped classroom approach, 47 students in the traditional approach control group). The study was conducted over pre-test and posttest phases for both groups.

RESULTS

The experimental group had higher mean scores than the controls in intrinsic goal orientation, task value, self-efficacy, rehearsal, elaboration, and organization and effort regulation, but lower scores in test anxiety (p < 0.001). The theoretical and skill exam scores of the experimental group were higher than those of the control group (p < 0.001).

CONCLUSION

The flipped classroom approach was effective for improving urinary system knowledge and skill level, and for the motivation and learning strategies of nursing students. This innovative education approach can be recommended as a student-centered method in nursing education for teaching theoretical knowledge and evidence-based practices.

Postgraduate Students' Experience of Using a Learning Management System to Support Their Learning: A Qualitative Descriptive Study

Introduction

Educational institutions worldwide have implemented learning management systems (LMSs) to centralise and manage learning resources, educational services, learning activities and institutional information. LMS has mainly been used by teachers as storage and transfer of course material. To effectively utilise digital technologies in education, there is a need for more knowledge of student experiences with digital technology, such as LMSs and especially regarding how LMSs can contribute to student engagement and learning.

Objective

This study aimed to gain knowledge about postgraduate nursing students’ experiences with the use of LMS in a subject in an advanced practice nursing master's programme.

Methods

A qualitative method with a descriptive design was employed. Two focus group interviews were performed with eight postgraduate nursing students from an advanced practice nursing programme at a university college in Norway. Data were analysed using qualitative content analysis.

Results

Three themes emerged from the data material: 1) A course structure that supports learning; 2) LMS tools facilitate preparation, repetition and flexibility; and 3) own responsibility for using the LMS for preparation before on-campus activities.

Conclusion

The course structure within the LMS seemed to be important to enhance postgraduate students’ ability to prepare before on-campus activities. Implementation and use of LMS tools can facilitate preparation, repetition and flexibility, especially when postgraduate students study difficult topics. Postgraduate students seem to have different views regarding their own responsibility for using the LMS to prepare before on-campus activities.

Innovation in Digital Education: Lessons Learned from the Multiple Sclerosis Management Master's Program

Since 2020, the master’s program “Multiple Sclerosis Management” has been running at Dresden International University, offering structured training to become a multiple sclerosis specialist. Due to the COVID-19 pandemic, many planned teaching formats had to be changed to online teaching. The subject of this paper was the investigation of a cloud-based digital hub and student evaluation of the program. Authors analyzed use cases of computer-supported collaborative learning and student evaluation of courses and modules using the Gioia method and descriptive statistics. The use of a cloud-based digital hub as a central data platform proved to be highly successful for learning and teaching, as well as for close interaction between lecturers and students. Students rated the courses very positively in terms of content, knowledge transfer and interaction. The implementation of the master’s program was successful despite the challenges of the COVID-19 pandemic. The resulting extensive use of digital tools demonstrates the “new normal” of future learning, with even more emphasis on successful online formats that also increase interaction between lecturers and students in particular. At the same time, there will continue to be tailored face-to-face events to specifically increase learning success.

Effectiveness of flipped classroom teaching models in nursing education: A systematic review

OBJECTIVES

The purpose of this systematic review was to reveal the evidence of how the method of flipped classroom was applied in nursing education and examine the results associated with this teaching method.

DATA SOURCES

Peer-reviewed studies published from 2013 to 2020 were selected from the PubMed, Web of Science, and Science Direct databases.

REVIEW METHODS

A systematic review was conducted according to the PRISMA Statement Guidelines. Electronic databases were searched using a range of keywords, and the findings were integrated into a narrative synthesis. Quality appraisal was undertaken.

RESULTS

In total, 7470 articles were retrieved including the 24 paper those were finally selected for the systematic reviews. The themes identified were: academic performance outcomes, student perceptions, activities, and structures.

CONCLUSIONS

It was determined that the flipped classroom method supported learning effectively and increased the quality of teaching. Nursing courses are suggested to be structured as flipped classrooms.

Effects of flipped learning on nursing students: A mixed methods study

AIM

Improving the learning capability of nursing students is imperative to their development as healthcare professionals. This study aimed to verify the effects of flipped learning on class participation, academic self-regulation, co-regulation, and academic performance, and to offer suggestions regarding educational strategies related to flipped learning.

METHOD

In the Community Health Nursing I course, 32 junior-year students (the experimental group) were provided with flipped learning, and 30 other junior-year students (the control group) received traditional instructor-led education. Flipped learning consisted of pre-learning, readiness assessment, a mini-lecture, group activities, and formative assessment. The pretest-posttest quasi-experimental and convergent parallel study designs were used in this study.

RESULTS

After participating in flipped learning, the experimental group exhibited a significant improvement in class participation, academic self-regulation, and co-regulation compared to the control group, but academic performance exhibited an insignificant improvement. The participants experienced a "change in attitude toward academic participation," "improved academic competence," and "pressure from learning" related to flipped learning.

CONCLUSION

Flipped learning can positively change students' approach to learning. We propose that flipped learning be applied more widely to the education of nursing students.

A blended learning teaching strategy strengthens the nursing students' performance and self-reported learning outcome achievement in an anatomy, physiology and biochemistry course - A quasi-experimental study

In nursing, bioscience is regarded as one of the cornerstones of nursing practice. However, bioscience disciplines as anatomy, physiology and biochemistry are considered challenging for students and the failure rate is high. In this study we explore a blended learning teaching strategy in an anatomy, physiology and biochemistry course for first year Bachelor nursing students. In the blended learning teaching strategy, short narrated online digital resources of bioscientific terms and concepts were integrated into the teaching design along with digital metacognitive evaluations of learning outcomes. Results show that compared to students receiving traditional face-to-face teaching, the students with a blended learning approach performed better on their national exam with a small to medium effect size (Cohen's d=0.23). Student course evaluations supported the blended learning delivery with small to medium effect sizes. The students reported that the digital resources supported their learning outcome achievement, that they better understood the teacher's expectations and that they were more satisfied with their virtual learning environment. This study adds to the growing literature of blended learning effectiveness in higher education, and suggests the use of digital resources as an enrichment of teaching and enhancement of students' study experience.

Effectiveness of a venous thromboembolism course using flipped classroom with nursing students: A randomized controlled trial

BACKGROUND

Modern innovative education approaches are crucial for nursing education, which leads to improving evidence-based teaching strategies and preparing nursing students for their future workplaces. The primary aim of the study was a comparison of the effectiveness of the flipped classroom and traditional educational methods on the attainment of knowledge regarding venous thromboembolism (VTE) prevention among nursing students. In addition, investigation of the opinions of the nursing students regarding the advantages and disadvantages flipped classroom educational method was the secondary aim of the study.

METHODS

This study was implemented with a randomized controlled design in the Faculty of Nursing in September and October 2019, with 118 first- and second-semester undergraduate nursing students (58 students in the flipped classroom, 60 students in the traditional lecture) who had not taken the Adult Health Nursing course. Implementation of the study was conducted in three phases: pretest, educational intervention, and posttest for both groups.

RESULTS

The study findings demonstrated no statistically significant difference in any of the mean scores of VTE domains between the two groups in the pretest. However, the flipped classroom group had higher mean scores of all VTE domains compared with the traditional lecture group in the posttest. Mostly, students highlighted four advantages of the flipped classroom, including "Deep motive," "Engagement," "Cost-effectiveness," and "Self-confidence."

CONCLUSIONS

The flipped classroom method proved to have positive effects in VTE domains in terms of knowledge, risk assessment, and prophylaxis among nursing students. This method can be recommended as an innovative and student-centered method in the teaching of evidence-based nursing practices.

Exploring the pedagogical design features of the flipped classroom in undergraduate nursing education: a systematic review

Background

In recent years, technological advancement has enabled the use of blended learning approaches, including flipped classrooms. Flipped classrooms promote higher-order knowledge application – a key component of nursing education. This systematic review aims to evaluate the empirical evidence and refereed literature pertaining to the development, application and effectiveness of flipped classrooms in reference to undergraduate nursing education.

Methods

A PRISMA systematic review protocol was implemented to investigate the literature pertaining to the development, implementation and effectiveness of flipped classroom pedagogy in undergraduate nursing education. Seven databases (Scopus, PsycINFO, CINAHL, ERIC, MEDLINE, Cochrane, Web of Science) were utilised to survey the salient literature. Articles were appraised with respect to their level of evidence, the origin of study, study design, the aims/s of the study, and the key outcomes of the study. A qualitative synthesis was then conducted to summarise the study findings.

Results

The initial search identified 1263 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 27 articles were considered for the final review, most of which were conducted in the USA and South Korea. A range of research designs were applied to measure or discuss the outcomes and design features of the flipped classroom pedagogy when applied to undergraduate nursing education. The review indicated that a common operational flipped classroom model involves three key components, namely pre-classroom activities, in-classroom activities and post-classroom activities, guided by two instructional system design principles. The review predominantly identified positive learning outcomes among undergraduate nursing students, after experiencing the flipped classroom, in terms of skills, knowledge and attitudes. However, a few studies reported contrasting findings, possibly due to the incompatibility of the flipped classroom pedagogy with the traditional learning culture.

Conclusions

Current evidence in this systematic review suggests that incorporating the flipped classroom pedagogy could yield positive educational outcomes in undergraduate nursing education. There are promising pedagogical models available for adapting or developing the flipped classroom pedagogy in undergraduate nursing education.

The development and evaluation of an integrated virtual patient case study and related online resources for person-centred nursing practice

Ensuring students develop person-centred practice for diverse groups of people across health care settings is an important outcome of undergraduate nursing education. This paper presents the development and evaluation of a learning innovation, an integrated virtual patient case study and complementary online resources for person-centred nursing practice. The virtual patient case study of an Australian Aboriginal woman diagnosed with breast cancer was integrated within four core subjects of a Bachelor of Nursing program, for a total of 600 second-year students. The evaluation of this learning strategy was encouraging. Students reported that the online learning activities were engaging, particularly due to the level of realism, their understanding of Aboriginal Peoples' healthcare needs increased, and they developed therapeutic communication skills, applicable in a variety of healthcare contexts. Staff concerns about student wellbeing when learning sensitive content online were unfounded. When carefully planned, a virtual patient case study and online learning resources can support students to enhance their person-centred nursing practice. Further evaluation, including student outcomes through assessment, is an important next step.

Nursing students' experiences of a pedagogical transition from campus learning to distance learning using digital tools

Background

The use of distance education using digital tools in higher education has increased over the last decade, particularly during the COVID-19 pandemic. Therefore, this study aimed to describe and evaluate nursing students’ experiences of the pedagogical transition from traditional campus based learning to distance learning using digital tools.

Methods

The nursing course Symptom and signs of illness underwent a transition from campus based education to distance learning using digital tools because of the COVID-19 pandemic. This pedagogical transition in teaching was evaluated using both quantitative and qualitative data analysis. Focus group interviews (n = 9) were analysed using qualitative content analysis to explore students’ experiences of the pedagogical transition and to construct a web-based questionnaire. The questionnaire comprised 14 items, including two open-ended questions. The questionnaire was delivered to all course participants and responses were obtained from 96 of 132 students (73%). Questionnaire data were analyzed using descriptive statistics and comments from the open-ended questions were used as quotes to highlight the quantitative data.

Results

The analysis of the focus group interviews extracted three main dimensions: didactic aspects of digital teaching, study environment, and students’ own resources. Social interaction was an overall theme included in all three dimensions. Data from the questionnaire showed that a majority of students preferred campus based education and experienced deterioration in all investigated dimensions after the pedagogical transition. However, approximately one-third of the students appeared to prefer distance learning using digital tools.

Conclusions

The main finding was that the pedagogical transition to distance education reduced the possibility for students’ social interactions in their learning process. This negatively affected several aspects of their experience of distance learning using digital tools, such as reduced motivation. However, the heterogeneity in the responses suggested that a blended learning approach may offer pedagogical benefits while maintaining an advantageous level of social interaction.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00542-1.

Desenvolvendo o pensamento crítico no ensino de Enfermagem: um desafio em tempos de pandemia de Covid-19

Resumo Objetivo Refletir sobre o desenvolvimento do pensamento crítico no ensino de enfermagem em tempos de pandemia de Covid-19. Método Estudo teórico-reflexivo baseado nas experiencias dos pesquisadores do Programa de Pós Graduação em Enfermagem da Universidade Federal de Santa Catarina em parceria com os pesquisadores do Programa de Graduação em Enfermagem da Faculdade diaconisa Lovisenberg (Lovisenberg Diakonale Høgskole), Noruega e com a Faculdade de Enfermagem do Hospital Israelita Albert Einstein. Resultados e Discussão Essa discussão categorizou dois pontos teóricos reflexivos: A importância do pensamento crítico na educação de enfermagem e Inovação para estimular o pensamento crítico. O atual momento de calamidade assume caráter pedagógico porque ensina sobre a necessidade de mudanças nos modos de fazer atenção, gestão e pesquisa, bem como sinaliza para o campo da educação em saúde a necessidade de adaptação dos processos de ensino e aprendizagem à realidade das condições de vida dos estudantes. Conclusão e implicação para a prática Espera-se despertar nos formadores a reflexão em torno do compromisso com o ato de ensinar em tempos de mudanças, adaptando suas práticas pedagógicas com criatividade, inovação tecnológica e desenvolvimento do pensamento crítico nos estudantes.

Differential Effects of Self- vs. External-Regulation on Learning Approaches, Academic Achievement, and Satisfaction in Undergraduate Students

The aim of this research was to determine the degree to which undergraduate students’ learning approach, academic achievement and satisfaction were determined by the combination of an intrapersonal factor (self-regulation) and a interpersonal factor (contextual or regulatory teaching). The hypothesis proposed that greater combined regulation (internal and external) would be accompanied by more of a deep approach to learning, more satisfaction and higher achievement, while a lower level of combined regulation would determine a surface approach, less satisfaction and lower achievement. Within an ex post facto design by selection, 1036 university students completed validated questionnaires using an online tool. Several multivariate analyses were conducted. Results showed that the combination of self-regulation and external regulation can be ordered as levels along a five-point scale or heuristic. These levels linearly determine type of learning approach, academic achievement and satisfaction. Implications are established for quality and improvement of the teaching and learning process at university.

Perception of nursing students about the implementation of GREENS© methodology in nursing studies

BACKGROUND

The Gymkhana Room for Education and Evaluation in Nursing Studies (GREENS©) is a pedagogical model that can be used as a learning and assessment method in nursing training workshops. This model combines the advantages of gamification, the flipped classroom and the use of low-fidelity clinical simulation, also including self-reflection and peer evaluation of the situations experienced.

OBJECTIVES

To evaluate the students' perception of the implementation of GREENS© as a learning and assessment tool in an academic course at the University of Almeria.

DESIGN

A cross-sectional descriptive study.

SETTINGS

Academic year 2018/2019, at the University of Almeria (UAL), Spain.

PARTICIPANTS

77 students enrolled in their 2nd year of the Nursing Degree who attended the "Health Promotion and Safety" class.

METHODS

After completing the GREENS© activity, the perception and anxiety of students were analyzed through an online ad hoc questionnaire composed of 17 questions. Data were collected in January 2019.

RESULTS

All of the questions scored above 4 out of a maximum of 5 on a Likert scale. For all the questions, >50% of the students were in total agreement with the questions answered, showing a high acceptance of the GREENS© methodology implementation. The students reported that their anxiety decreased significantly, with a score of 4.7 points on average (95% CI: 4.16 to 5.33, p < 0.001), after knowing that the assessment would be through a gamification tool, not an oral one. More than 60% of the students answered "agree" or "strongly agree" with the idea that GREENS© is useful for improving motivation, teamwork, learning, fun and knowledge assessment.

CONCLUSIONS

The use of GREENS© has generated a high satisfaction and motivation of the students in their learning process, and as an assessment tool, it created a lower degree of anxiety as compared to an oral examination.

Effects of Self-Regulation vs. External Regulation on the Factors and Symptoms of Academic Stress in Undergraduate Students

The SRL vs. ERL theory has shown that the combination of levels of student self-regulation and regulation from the teaching context produces linear effects on achievement emotions and coping strategies. However, a similar effect on stress factors and symptoms of university students has not yet been demonstrated. The aim of this study was to test this prediction. It was hypothesized that the level of student self-regulation (low/medium/high), in interaction with the level of external regulation from teaching (low/medium/high), would also produce a linear effect on stress factors and symptoms of university students. A total of 527 undergraduate students completed validated questionnaires about self-regulation, regulatory teaching, stress factors, and symptoms. Using an ex post facto design by selection, ANOVAs and MANOVAs (3 × 3; 5 × 1; 5 × 2) were carried out. The results confirmed that the level of self-regulation and the level of regulatory teaching jointly determined the level of stress factors and symptoms of university students. Once again, a five-level heuristic of possible combinations was configured to jointly determine university students’ level of academic stress. We concluded that the combination of different levels of student regulation and regulation from the teaching process jointly determines university students’ level of academic stress. The implications for university students’ emotional health, stress prevention, and well-being are established.

Effects of Levels of Self-Regulation and Regulatory Teaching on Strategies for Coping With Academic Stress in Undergraduate Students

The SRL vs. ERL TheoryTM predicts that regulation-related factors in the student and in the context combine to determine the student's levels in emotional variables, stress, and coping strategies. The objective of the present research was to test this prediction in the aspect of coping strategies. Our hypothesis posed that students' level of self-regulation (low-medium-high), in combination with the level of regulation promoted in teaching (low-medium-high), would determine the type of strategies students used to cope with academic stress; the interaction of these levels would focus coping strategies either toward emotions or toward the problem. A total of 944 university students completed validated questionnaires on self-regulation, regulatory teaching, and coping strategies, using an online tool. ANOVAs and MANOVAs (3 × 1; 3 × 3; 5 × 1) were carried out, in a quasi-experimental design by selection. Level of self-regulation and level of regulatory teaching both had a significant effect on the type of coping strategies used. The most important finding was that the combined level of self-regulation and external regulation, on a five-level scale or heuristic, predicted the type of coping strategies that were used. In conclusion, the fact that this combination can predict type of coping strategies used by the student lends empirical support to the initial theory. Implications for the teaching-learning process at university and for students' emotional health are discussed.