Comparison of technology-based cooperative learning with technology-based individual learning in enhancing fundamental nursing proficiency
Introduction
Due to high demand for qualified nurses, mass education has become the norm (Platt, 2002). The majority of nurse teachers use passive learning techniques with little student involvement. Students, therefore, have insufficient opportunity and limited capability to develop and demonstrate critical thinking, as well as to master nursing skills. Critical thinking encompasses the ability to analyze, apply standards, discriminate, information seek, reason logically, predict and transform knowledge (Scheffer and Rubenfeld, 2000). Scholars believe that critical thinking cannot be independently developed. McPeck (1990) asserted that critical thinking mastery is improved if developed and assessed within the context of a discipline. Nursing faculty generally agree that students who know how to think, make better clinical judgments and master skills, than those who have merely memorized facts. In this regard, nursing educators should utilize the most effective way to train students. Cooperative learning has been suggested as one useful method to nurture students' cognition, metacognition ability and skill acquisition.
Cooperative learning encourages groups of heterogeneous students to work on a common problem. Through a process of negotiation, conflict resolution, and active listening, they move to discussing issues and developing a consensus (Johnson and Johnson, 2003). Cooperative learning echoes the notion of constructivism, which stresses an individual's mind creates his or her own reality based on experiences and interaction with the environment. Cooperative learning teaches and enables the students to apply course content to situations they will experience as a nurse (Baumberger-Henry, 2005).
Twenty-first century communication channels disseminate information through both traditional (i.e. newspaper, TV) and modern media (i.e. telecommunication). Computer technology has been utilized to educate or life-long learning for decades. However, it has flourished with the advent of the Web. Web-based learning is a popular means to enhance face-to-face classroom learning and is at the center of most collaborative, multimedia educational environments (Chen et al., 2009). In recent years, the rapid growth of mobile technology promises to be comparable to the Web (Trifonova and Ronchetti, 2003). Integrating multiple forms of technology is gaining greater acceptance.
The use of technology-based cooperative learning became apparent after teaching the fundamental skills for ten years and seeing the same mistakes and hearing the same questions from students. After a decade teaching this course, it was clear that the materials were too difficult for entry level students to absorb within such a short amount of time (2–4 h/week depending on the topics) and class size (50 students). The students' learning difficulties are increased when their instructors are away teaching for clinical practicum. Nursing instructors need to fulfill both academic and clinical teaching responsibilities. Currently, the length of leave ranges from three weeks to nine weeks. A technology-based cooperative learning platform is expected to provide a more prompt, flexible, and accessible learning atmosphere.
Section snippets
Purpose
The purpose of this study was to investigate the effect of technology-based cooperative learning in nursing students' critical thinking, knowledge gain, error discover, skills acquisition, and overall scores.
Needs for Critical Thinker in Nursing Discipline
The speed of change in the healthcare context and the emphasis of best practice make it difficult to cultivate capable nurses with traditional teacher-centered lecturing. In an era of mass education the focus is on what is being taught, but not how. It promotes acquisition of the rules, but it does not necessarily lead to an exploration of how and when these might apply. In this climate, students may find it difficult to appreciate the relevance of the lessons and have little incentive to do so
Design
Research was conducted using an experimental method. Teaching instruction was applied as an independent variable. Knowledge of long-term indwelling catheterization, problem identification of long-term indwelling catheterization, and long-term indwelling catheterization skill were used as dependent variables. A pretest–posttest design was used. Data was collected at baseline and immediately after three weeks of intervention.
Participants
The participants for this study comprised 98 nursing students who were
Results
A total of 98 participants completed the intervention and questionnaires, for a 98% response rate. There were no statistically significant differences (p > .05) in the demographics of the two groups, indicating that randomization processes were effective and no confounding factors that would potentially interact with the effect of interventions for participants. Table 1 presents demographics characteristics of the participants.
The TBCL earned a higher mean post-intervention score (M = 92.86, SD =
Discussion
Cooperative learning with technology integration supports positive improvement in the participants' critical thinking and knowledge enhancement. Findings were consistent with previous studies (Cheng and Cheng, 2009, Khosravani et al., 2005, Lai and Wu, 2006). The success of TBCL is because it echoes the essence of knowledge, which is discovered by students through active participation and dialogue among students rather than passive acceptance of information. Additionally, at the beginning of
Limitation of the Study
Although this study showed promising results, two limitations must be emphasized. First, all participants were recruited from one school in eastern Taiwan, which limits the study's generalizability. Second, the number of MP5 players was inadequate, which didn't truly reflect the accessibility of mobile device.
Applications of Nursing Education
There is considerable agreement among nursing researchers that critical thinking is a vital component of successful nursing practice. Existing literature have noted the lack of discipline-specific teaching and assessment mechanisms to increase and evaluate critical-thinking competency in nursing students. Most vocational and baccalaureate nursing courses encompass lectures and hands-on laboratory practice. Technology-enhanced cooperative learning helps the nursing students to better discuss and
Recommendations of Future Research
This study used a cross-sectional design, longitudinal research can report the outcomes by comparing various timing between two groups. In addition, it would be more valuable to have learning modules besides videos, discussion platform, and mobile device. This approach might generate more influential learning outcomes. Moreover, it would be beneficial to compare the results with different mobile devices, which are popular in the market.
Conclusions
This study compared the efficacy of a technology-based cooperative learning with an individual learning for improving nursing students' critical thinking in catheterization-related subject. As predicted, the technology-based cooperative learning resulted in greater knowledge of subjects and overall domain, although skill acquisition was quite the same. Limitations of this study and recommendations for future research were suggested to provide more evidence-based results.
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Acknowledgment
This study was funded by National Science Council (NSC 98-2314-B-277-002), Taiwan. The author thanks the participants who participated in the study.
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