Scholarly article on topic 'Investigation of nursing students' knowledge of and attitudes about problem-based learning'

Investigation of nursing students' knowledge of and attitudes about problem-based learning Academic research paper on "Educational sciences"

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Abstract of research paper on Educational sciences, author of scientific article — Yang Luo, Dan-dan Zhou, Ying Luo, Yan Song, Dan Liu

Abstract Purpose To investigate nursing students' knowledge of and attitudes about problem-based learning (PBL). Methods A total of 1200 students were surveyed at eight nursing colleges in Hunan Province. Results In all, 1037 valid questionnaires were returned, for an effective return rate of 86.4%. Some 54.4% of the students learned that PBL was a pedagogical method from teachers, and 27.8% of the students had participated in PBL courses. Almost all of students (97.6%) were interested in PBL, and 66.7% of survey participants believed that students who were not good at solving problems would have difficulty in PBL courses. Conclusion Nursing educators should guide students to adapt to new learning approaches, and encourage students to participate in the teaching reform to promote students' autonomous learning ability, innovation ability, and comprehensive ability.

Academic research paper on topic "Investigation of nursing students' knowledge of and attitudes about problem-based learning"

INTERNATIONAL JOURNAL OF NURSING SCIENCES XXX (2014) 1 —4

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Original Article

Investigation of nursing students' knowledge of and attitudes about problem-based learning

Yang Luoa'*, Dan-dan Zhoua, Ying Luob, Y an S onga, Dan Liua

a School of Nursing, Central South University, Changsha, China b Xiangya Hospital, Central South University, Changsha, China

ARTICLE INFO

ABSTRACT

Article history: Received 2 October 2013 Accepted 23 January 2014

Keywords: Cognition Education nursing Problem-based learning

Purpose: To investigate nursing students' knowledge of and attitudes about problem-based learning (PBL).

Methods: A total of 1200 students were surveyed at eight nursing colleges in Hunan Province.

Results: In all, 1037 valid questionnaires were returned, for an effective return rate of 86.4%. Some 54.4% of the students learned that PBL was a pedagogical method from teachers, and 27.8% of the students had participated in PBL courses. Almost all of students (97.6%) were interested in PBL, and 66.7% of survey participants believed that students who were not good at solving problems would have difficulty in PBL courses.

Conclusion: Nursing educators should guide students to adapt to new learning approaches, and encourage students to participate in the teaching reform to promote students' autonomous learning ability, innovation ability, and comprehensive ability.

Copyright © 2014, Chinese Nursing Association. Production and hosting by Elsevier

(Singapore) Pte Ltd. All rights reserved.

1. Introduction

Problem-based learning (PBL) is a teacher-guided, student-centered, pedagogical method that is based on independent learning and problem solving by students. PBL stresses mobilizing the motivation of students to find their own solutions to problems [1]. Higher education of nursing shoulders a

great historical mission to foster high-quality nursing personnel with an innovative spirit and practical ability. Yet, current nursing education is based on a traditional, textbook-centered and teacher-centered model that ignores the central role of the students in learning activities. This model easily leads to mechanical modes of teaching and rote modes of learning by students, which restrict the ability of nursing students to engage in two-way intellectual discourse with

* Corresponding author.

E-mail address: ly603202@sina.com (Y. Luo). Peer review under responsibility of Chinese Nursing Association

http://dx.doi.org/10.1016/jijnss.2014.02.009

2352-0132/Copyright © 2014, Chinese Nursing Association. Production and hosting by Elsevier (Singapore) Pte Ltd. All rights reserved.

2 INTERNATIONAL JOURNAL OF NURSING SCIENCES XXX (2014) 1 —4

nursing faculty. This approach impedes the cultivation of high-quality, modern-thinking nursing personnel. Therefore, many nursing schools have introduced PBL to cultivate students' learning skills and comprehension.

This aim of this study was twofold. The first aim was to examine nursing students' knowledge of and attitudes about PBL. The second aim was to identify existing problems with PBL in nursing colleges, to provide a reference point from which to expand and improve PBL in nursing.

2. Materials and methods

2.1. Participants

The study was conducted between October 2012 and December 2012. The researchers distributed a questionnaire survey to 1200 students in eight nursing colleges in Hunan Province, including four 3-year vocational nursing schools, three 4-year bachelor degree nursing schools, and one 5-year bachelor degree nursing school.

Inclusion criteria for participation in the study were: © the students who are enrolled in clinical professional courses; and © Students who volunteered to participate in this survey.

2.2. Data collection instruments

The investigators designed a pre-survey questionnaire based on the relevant literature and the expert opinions of four professors, who have been in nursing education for 10 years. We pilot tested the pre-survey questionnaire with 20 students to test its feasibility and readability. Based on the results of the pre-survey, we modified individual questions and answers to create the formal questionnaire. Demographic data included gender, age, schooling, education, grades and other general information on knowledge about PBL, attitudes about participation in PBL classes, and other related topics. The survey items were in question form, with each question having at least four alternative answers. Generally, participants could choose only one answer to multiple-choice questions. Some items were open-ended questions, for example, "What do you want from your teacher in PBL courses besides nursing expertise?"

2.3. Procedures

After permission was obtained from the leading institutions and teachers, the researchers delivered the questionnaires to the sites of presiding teachers. Study participants answered the questionnaires on-site, and gave them to the investigators. The investigators examined whether there were any omissions and had them corrected immediately. Of the 1200 questionnaires that were distributed, 1037 were returned with valid responses, for an effective return rate of 86.4%.

2.4. Statistical analysis

The responses were entered into a SPSS database and analyzed by, SPSS 13.0 statistic software. The results are presented as frequencies, and other descriptive statistics.

3. Results

3.1. Basic information

A total of 1037 nursing students completed and returned the questionnaires for the study. The sample consisted of three groups of students: 50.0% (n = 519) were 3-year vocational nursing school sophomores; 42.0% (n = 436) were 4-year bachelor degree juniors; and 8.0% (n = 82) were 5-year bachelor degree seniors. The vast majority of the students were female (98.7%, n = 1024), with males accounting for 1.3% (n = 13) of the sample. Student perceptions of teacher-student roles are shown in Table 1.

3.2. Knowledge of the PBL model

Of the 1037 participants, 41.2% (n = 427) had not heard of PBL and 58.8% (n = 610) had heard of it. Of the 610 students who had heard of PBL, 54.4% (n = 332) knew it was a teaching method, but they did not know its specific content. Roughly three out of 10 students (30.3%, n = 185) knew the meaning of PBL, and 15.2% (n = 93) of the students who had heard of PBL (9.0% of all students in the sample) were familiar with its format and concepts. More than eight of 10 students (82.0%, n = 500) who knew of PBL said the main way they learned about it was from teachers who introduced BPL in their courses, while 16.3% (n = 98) of students gained knowledge of PBL through communicating with classmates. A small number of students (2.0%, n = 12) learned about PBL through books, other literature, or the internet.

Over a quarter (27.8%, n = 288) of all the students who were surveyed (N = 1037) had participated in PBL courses. Roughly comparable numbers of students said they had a "Single course of individual chapters" (14.8%, n = 153) and "Many courses of individual chapters" (13.0%, n = 135).

3.3. Attitudes about the PBL model and the traditional teaching model

Students' attitudes toward the traditional teaching model are described in Table 2. Of the 1037 students surveyed, 47.2% (n = 489) were unsure or did not know whether PBL could change learning styles, and 34.8% (n = 361) students said it was

Table 1 — Students' perceptions of teacher-student roles (N = 1037).

Item Traditional teaching method PBL method

Number % Number %

Teacher role

Authority 199 19.2 83 8.0

Initiator 706 68.1 0 0.0

Mentor 132 12.7 879 84.8

Counselor 0 0.0 75 7.2

Student role

Knowledge recipient 774 74.6 0 0.0

Knowledge seeker 263 25.4 977 94.2

Knowledge builder 0 0.0 45 4.3

Knowledge creator 0 0.00 15 1.5

International journal of nursing sciences xxx (2014) 1—4 3

Table 2 — Students' attitudes towards traditional teaching

methods.

Item Person- %

Not close relationship of basic knowledge of 784 75.6

nursing and clinical case

Pay attention to knowledge, but ignore the 542 52.3

inspiration thinking

More teaching content repeat, less comprehensive 659 63.5

little interdisciplinary knowledge involved 0 0.0

Less interaction between teachers and students, 0 0.0

teaching form is inflexible

Learning effect cannot be judged by theory or skill 321 31.0

examination

certain to change them. Only 18.0% (n = 187) of students thought that PBL could lead to major changes in learning styles. A total of 1012 (97.6%) students were interested in PBL. Students expected a number of things from PBL courses besides nursing expertise, as described in Table 3.

3.4. Perceived problems with PBL

The survey also asked the question: "If PBL teaching was introduced, what is the greatest difficulty you would face?" Two thirds of the students (66.7%, n = 692) argued that their most difficult problem was that they were not good at finding learning problems, and more than half (56.6%, n = 56.6%) of the students thought the "motivation to learn was not strong." More than three in 10 students (31.9%, n = 331) agreed that they did not know "how to use the tools to search the literature", and two in 10 students (21.0%, n = 218) argued that "they were not accustomed to group discussions to solve problems".

4. Discussion

PBL is a problem-based teaching method which can stimulate students' motivation and guide students to grasp the learning content. It was initiated by Professor Barrows, an American neurology professor at McMaster University in Canada [2]. The core of PBL is student-centered, self-learning, and its main purpose is to improve students' problem-solving skills and self-learning ability [3]. In PBL, teachers are not the knowledge authorities, they are learning facilitators [4]. PBL was first introduced to medical schools in the late 20th century, and it

was introduced into nursing education by nursing educators with their own specific expertise.

The results of this study found that most students recognized that teachers and students were both initiators and recipients in traditional nursing education, and 84.8% of the students recognized that teachers should facilitate knowledge as mentors in the PBL model. In contrast, some teachers in the traditional lecture-style of teaching tend to use scripted lectures, and students become passive recipients of knowledge.

The results found that 41.2% of students had never heard of the PBL model, and only 9% of all the students surveyed were familiar with its format and concepts, which indicates that the PBL philosophy has had little effect on students. The results also identify the sources of students' knowledge about PBL. A large number of students learned about PBL from their teachers, and most of them were from the university, probably because they heard about PBL from teachers who introduced PBL into the nursing education program. The results also show that it is necessary for teachers to guide students and to advertise PBL to help students accept its new learning concepts. In addition, to the fact that 67.8% of students did not know about PBL, only a small part of the students recognized that PBL could help improve the quality of their understanding, and that it could make them active learners. The conditions for expanding PBL are not ideal; only 288 (27.8%) students participated in the "single course of individual chapters" and "multi-course individual sections" of PBL.

Nursing education in our country pays more attention to students' professional knowledge and education, than it does to the students' independent thinking skills, critical thinking skills, innovation and comprehension ability that they will need for years to come. The current teaching mode continues to be a traditional, lecture-based form of education. The results showed that most students supported the PBL model, with 97.6% of students expressing interest in PBL, which may reflect the fact that students have realized the drawbacks of traditional teaching methods and hope for a reform in teaching methods. Just over three-quarters of the students (75.6%) argued that basic nursing knowledge and clinical practice is not closely linked, and 63.5% agreed that the teaching content of various courses repeated more but mastered less. Over half of the students (52.3%) thought the traditional teaching model focused on instilling knowledge and ignoring thought, which made students argue that the existing teaching method in nursing was in serious need of improvement.

In addition to obtaining nursing expertise in PBL, 75.6% of the students hoped to obtain the relevant interdisciplinary knowledge, and 52.3% hoped to improve self-learning and integrated capabilities. Moreover, 63.5% wanted to improve learning their methods and study skills, and 19.8% wanted to increase emotional communication between teachers and students. The results indicated that nursing students were hopeful about the changes encompassed in the PBL model and they had high expectations, which may be a challenge for faculty. Nursing faculty members have to improve teaching ability, constantly update their teaching philosophy, and explore new teaching methods. Educational administrators should formulate relevant policies to support and encourage faculty to reform teaching, and take steps like "out and in" to

Table 3 — Students' expectations of PBL teaching

methods.

Item Person- %

Get the interdisciplinary knowledge 784 75.6

Improve the ability of autonomous learning and 542 52.3

comprehensive

Improve learning methods and skills 659 63.5

Increase the emotional communication between 205 19.8

teachers and students

4 intEtnATiQNAi jouRnAi or NutsiNg sciENces xxx (2014) 1-4

train teachers. These effects will enable faculty to understand and effectively apply new teaching methods to cultivate high-quality, creative, self-learners to serve as senior nursing personnel.

Students basically accept the current orientation of education from primary school through the university, and the result of this long-term, examination-oriented education has been: © that students lack interest in learning professional knowledge; © they have no motivation to explore the power of knowledge; and © they lack cooperative learning ability. The survey results indicated that 66.7% of students thought the most difficult part of participating in PBL would be that they not good at discovering learning problems, and 56.6% of students agreed that their motivation to learn was not strong. Those results illustrate that the ability to enquire and innovate are poor, which can be strengthened by the PBL model. In PBL, students are active learners, so students may find it difficult to adapt to PBL after years of traditional teaching, which is one reason why the PBL model may not be used extensively for a long time.

In conclusion, we believe the PBL method can overcome the shortcomings of traditional education, and actively promote students' self-learning, which will have a positive effect on nursing educational reform. The survey results suggest that implementing educational reform is a complex process of

long-term engineering and nursing education in our country. In this critical period of reform, it is necessary to examine the content of nursing education to find a balance between lecture-style teaching and creating a transformational model of modern nursing education. Nursing educators should actively guide students to help them integrate new learning approaches, encourage students to participate in educational reform of teaching methods, cultivate students' abilities of self-learning and innovation, and promote their comprehension capabilities.

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[3] Koh GC, Khoo HE, Wong ML, et al. The effects of problem-based 1earning during medical school on physician competency: a systematic review. CMAJ 2008;178(1):134-41.

[4] Glens Wilkie K. Problem based learning in nursing: a new model for a new context?. Malaysia: MacMillan Press Ltd.; 2001. p. 5260.