tomlinson.ua.edu 8/Responses...Web viewThese numbers suggest two to three students out of every ten, will not successfully be retained in the professional nursing program, and will

Running Head: GENERATION EFFECT

Generation Effect in Undergraduate Nursing Education

Jamie McKinney, MS, RN

University of Alabama

Capstone College of Nursing

Spring 2017

Comprehensive Exam

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Introduction

The improvement and maintenance of retention and completion rates of students enrolled

in professional nursing programs continue to pose challenges for nursing educators and

administrators across the country today. Statistics from the National League of Nursing (2017)

note Bachelor of Science in Nursing (BSN) programs to have a retention status (defined as

students still enrolled or have graduated one year after enrollment) of approximately 88%.

Associate Degree Nursing (ADN) programs and Diploma programs were not as successful, with

rates of 80% and 77% respectively. Similar statistics have been demonstrated by the

Accreditation Commission for Education in Nursing. According to a report to the commission’s

constituents, accredited BSN programs held an average completion rate of 73.99%, while ADN

programs averaged 74.46%, and an average of 72.94% was noted for Diploma programs

(Accreditation Commission for Education in Nursing, 2015).

These numbers suggest two to three students out of every ten, will not successfully be

retained in the professional nursing program, and will not progress to completion. Some may

suggest these numbers are acceptable in comparison to other degrees or programs, but it is

important to remember a variety of reasons exist on why continued vigilance is needed on

monitoring completion and retention rates in nursing programs. One reason is due to the

looming nursing shortage present today and projected for the future, with an estimated 1.05

million job openings by 2022, and 525,000 of those jobs being replacements (American

Association of Colleges of Nursing, 2014). This data shows the need for graduates to fill the

vacancies, and if students are not being retained in the programs, poorer completion rates (and

thus less graduates) occur. Next, completion rates are an important component in the

accreditation process of nursing programs. For example, the Accreditation Commission for

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Nursing Education (2017) establishes a standard required for accreditation to include

demonstration of students’ achievement in completing the nursing program, and an ongoing

assessment of completion rate data. This data must also be available to the public in accordance

with standard three (Accreditation Commission for Nursing Education, 2017). With information

being mandated to be publicly accessible, poor completion and retention rates can create a

negative view of the nursing program in the public’s eye, thereby justifying another need for

improvement and/or maintenance of current completion and retention rates.

What is the cause of students failing to progress academically to completion of a nursing

degree? Some suggest the rigorous curriculum of a professional nursing program can be to blame

for poor retention and completion rates (Johnson, 2012). If this idea is true, and the demanding

curriculum is a possible root cause, then research and new ideas need to be geared towards

assisting students navigate through the structured and intense curriculum. Research has yielded

retention models and has examined strategies at the program level and in the classroom to assist

students in the successful completion of the nursing curriculum. However, when one considers

the rigor of a nursing curriculum and the importance of success in the classroom in conjunction

with student retention models, gaps remain in the literature and are in need of further

exploration.

Review of Literature

As a goal of this project is to provide nursing educators with information and add to the

body of knowledge regarding nursing student retention two major lines of inquiry have emerged

in how to assist students with the problem of conquering the curriculum. First, researchers have

examined efforts made by faculty and administration through the implementation of formal

programs providing support and assistance to enrolled students. Next, analyzing what educators

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are utilizing in the classroom and how students are learning, can provide insight into how best to

manage and succeed in a demanding curriculum of study.

Retention Programs and Strategies

At the program or administrative level two main categories have emerged: formal

retention programs and mentoring. Each of these categories have added to the body of literature

regarding student retention, providing options and ideas for educators and administrators. The

ideas detailed throughout these research projects can assist the general nursing student

population or a target population navigate through the difficult nursing curriculum.

Retention Programs. The implementation of a formal retention program is a popular

avenue nursing programs select when trying to assist students with retention, remediation, and

progression. The outcomes and details of such programs have been outlined in the work of many

research studies, including both qualitative and quantitative projects. In an article by Fontaine

(2014) a formal retention program was described as having implemented a variety of strategies

and interventions that included: learning communities, comprehensive orientation, counseling,

stipends, peer tutoring, academic planning, and community nurse mentoring. While results were

positive, the researchers experienced a difficult time determining which specific intervention was

successful. Another program introduced similar strategies and interventions in a BSN program

and was entitled Growth and Access Increase for Nursing Students (GAINS) (Valencia-Go,

2005). This program was unsuccessful in meeting a goal of 70% student retention, however,

many ideas were continued after the project’s completion due to the perceived benefits

(Valencia-Go, 2005).

As the previous two research studies held a broad focus and targeted general populations,

others have focused on specific populations, such a minorities, at-risk students, or disadvantaged

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students. One program hired a retention specialist to assist a target population of minorities and

disadvantaged students, and other students with marginal grade point averages who were at risk

for attrition. (Murray, Pole, Ciarlo, & Holmes, 2016). Meetings were held between program

enrollees and the retention specialist, and focused on strategies involving mentoring, scholarship

support, standardized practice exams, and test-taking strategies, while also allowing for students

to collaborate and discuss the demands of the program (Murray, et al., 2016). Another similar

project targeting students from disadvantaged backgrounds, the Consortium to Advance Nursing

Diversity and Opportunity (CANDO) was funded by a nursing workforce initiative (Igbo,

Straker, Landson, Symes, Bernard, Hughes, & Carroll, 2011). The program involved 105

students and three nursing programs and focused on interventions that included: study skills,

lecture preparation, note taking, test-taking strategies, written and oral communication, medical

terminology, critical thinking, career coaching, and socialization activities (Igbo et al., 2011).

Mentoring. In many of these formal retention programs, a component commonly

included was mentoring. The idea of mentoring by faculty and/or peers as a sole intervention for

improving student retention has also been the subject of other research studies. Crooks (2013)

described the MENTOR program which provided support and resources to ethnically diverse

students. Another mentoring program for minorities is the At-Risk Minorities for Success

(ARMS) program (Sutherland, Hamilton, & Goodman, 2007). An article by Robinson & Niemer

(2010) took a different approach to mentoring and focused solely on peer mentoring and peer

tutoring. Students met weekly with peer volunteers for mentoring and tutoring, and there was an

improvement in exam grades, but no significant difference in overall grade point average.

However, of the students who withdrew from the nursing program, the students who were

mentored only made up 1% of the total withdrawals (Robinson & Niemer, 2010).

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Classroom Instruction

The next avenue to explore when considering the idea of nursing student retention as it

relates to success in the nursing curriculum are the pedagogical tools used by nursing faculty in

the classroom. It is felt this area needs exploration because if the demanding curriculum is cause

for student attrition and failure, then how students are learning and gaining knowledge deserves a

closer look. Some popular topics discovered when reviewing the literature pertained to flipping

the classroom, technology use, and active learning strategies such as case studies and concept

maps. While many of the studies are descriptive in nature, some have produced measurable

results as it pertains to outcomes by nursing students.

Flipping the Classroom. A flipped classroom has a prominent place in nursing

education today. With the premise behind a flipped classroom revolving around the idea that

standard lectures are replaced with interactive opportunities, the student is moved to the center of

learning (Harrington, Bosch, Schoofs, Beel-Bates, & Anderson, 2015). Results exhibited in

research studies pertaining to flipping the classroom in nursing education have been

encouraging. Positive quantitative outcomes noting a significant difference between a traditional

classroom versus a flipped classroom were seen on unit exams in a pharmacology course (Geist,

Larimore, Rawiszer, & Al Sager, 2015). Another quantitative study compared the traditional

classroom and flipped classroom and no significant differences were noted between groups

(Harrington et al., 2015). While this study does not show a flipped classroom to be superior, it

does validate it as a comparable strategy for student outcomes in comparison to traditional

lecture. Qualitative studies have displayed similar positivity with student perceptions of a

flipped classroom (Smith, 2017; Schwartz, 2014). These quantitative and qualitative results have

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been validated by an integrative literature review by Presti (2016) demonstrating a flipped

classroom pedagogical approach can yield positive student outcomes.

Technology in the Classroom. A variety of technological tools are available for nursing

educators to use and many of these have proven to be quite valuable in the classroom.

Technology can be a valuable asset in supplementing traditional lectures. In reviewing the

literature the most common uses of technology has been through the use of audience response

systems and games.

In referring to games available to educators, Second Life and virtual reality games allow

for experiential learning and are increasing in quantity and relevance (Skiba, 2009). Popular

game shows have also found a way into nursing classroom. One example is “Who Wants to be a

Millionaire: The Classroom Edition” which was used to help maintain momentum, student

engagement, and reinforcement of specific topics (Hahn & Bartel, 2014). In a literature review

of gaming in nursing education, researchers found games can improve motivation, help with

knowledge retention, and demonstrate positive effects on learning outcomes (Royse & Newton,

2007).

Quantitative and qualitative studies have shown audience response systems or clickers to

be effective in the classroom. In one study, when clickers were used by students, higher exam

scores were seen on one of the unit exams and in final course grades (Berry, 2009). Positive

student satisfaction and perception of value with the use of clickers have been seen in multiple

studies (Berry, 2009; Filer, 2010; Meedzan & Fisher, 2009; Sternberger, 2012).

Active Learning. Two active learning strategies for nursing education commonly seen

in the literature are case studies and concept mapping. Case studies can assist learners to analyze

data, identify problems, and determine solutions (McMahon & Christopher, 2011) and can be a

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stand-alone case study, an unfolding case study, or a reverse case study. Unfolding case studies

are similar to problem-based learning and are used like traditional case studies but follow the

patient through stages so students can process data, respond, integrate knowledge, and reflect

about the situation presented before moving to the next stage (Azzarello & Wood, 2006).

Reverse case studies are an innovative active learning strategy that combines case studies and

concept maps in an attempt to improve critical thinking and problem solving (Beyer, 2011). In

general, case studies can stimulate knowledge retention, recall, and critical thinking while

assisting students to associate the practical with the theoretical (Rowles, 2012).

Concept mapping is an active teaching strategy for nursing education that can be

beneficial for development of critical thinking and decision-making skills (Noonan, 2011). A

few research articles associated with concept mapping are strictly descriptive in nature, merely

explaining the method in which concept mapping was used in the classroom (All & Huycke,

2007; Conceição & Taylor, 2007; Taylor & Wros, 2007). However, Harrison & Gibbons (2013)

note multiple studies demonstrating quantitative support for the use of concept maps, and

through qualitative research show students view concept mapping as a positive learning

experience with proper training. In nursing education, concept mapping is advantageous because

it can assist in understanding complex phenomena and stimulate long-term recall, along with

linking new information with previously learned information (Rowles, 2012).

Identified Gap

The review of literature review has produced a variety of results at the program level and

in the classroom to help students be successful in the nursing curriculum. Much of the literature

is descriptive in nature, describing specific programs and how ideas can be used in the

classroom, creating a need for more qualitative and quantitative research examining how these

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strategies are directly affecting student outcomes. If the solution for improving and maintaining

completion and retention rates are directly associated with curriculum, then future research needs

to continue to build upon some of the ideas explored here and examine other ideas related to

retention, teaching, and learning that has previously been under-utilized in nursing education.

One obvious gap was noted in the ways in which students construct or build knowledge,

and the quantitative implications of how using these ideas in the classroom could help with

retention and progression. One proven tool associated with students construction knowledge that

can promote stronger learning is the generation effect (Brown, Roediger, & McDaniel, 2014).

The foundational idea behind generation effect is when a student attempts to answer a question

or solve a problem (construct an answer) instead of selecting an answer from a list of options

stronger learning can occur, even if the constructed answer is incorrect (Brown, Roediger, &

McDaniel, 2014). Research has validated this tool and its use could prove beneficial if used in

nursing classrooms. However, the utilization of generation effect in nursing education has been

absent.

The work and research on nursing student retention should not be undermined. Valuable

insight from these retention programs have been available to educators and administrators and

have very likely made an impact on the success of many students and programs. However, while

great work has been done, gaps still exist and the library of research and literature in this field

needs additional resources.

Conceptual Framework

As the primary problem identified in this work involves retention and progression of

nursing students to degree completion, it is important to incorporate ideas from models and/or

theories involving retention and success. A model central to development of this study is the

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Nursing Undergraduate Retention and Success (NURS) model, which will closely examine

concepts associated with nursing student retention. Next, an examination of how students are

building and acquiring nursing knowledge as it pertains to meeting the demands of a nursing

education curriculum will viewed through the lens of cognitive constructivism. Through the

convergence of components of the NURS model and principles of cognitive constructivism, the

conceptual framework for this study is built.

Nursing Undergraduate Retention and Success Model

Marianne Jeffreys developed a model aiming to explain and assist in the complicated,

multi-dimensional phenomenon that is nursing student retention (Jeffreys, 2004). The NURS

model works to identify the variety of variables, the interactions of those variables, and how each

can impact a nursing students’ success (Jeffreys, 2004). While some may consider the work

dated, as the model was conceived over 10 years ago, it is felt to be a vital reference and merits

inclusion in this study and the work derived from this model is still relevant today.

The NURS model differs from many retention models as it examines the question of why

students stay as opposed to why students leave (Jeffreys, 2015). Educators and administrators

can utilize this model due to its design focusing on identifying at-risk students, guiding

innovations in teaching, developing strategies to facilitate success, and ways to effectively

evaluate those strategies (Jeffreys, 2004). In the composition of the model, Jeffreys identifies the

following factors as being associated with success and retention in nursing school: student

profile characteristics, student affective factors, environmental factors, academic factors,

academic outcomes, professional integration factors, psychological outcomes, and outside

surrounding factors. As these factors interact, a determination will be made on whether the

nursing student will become a victim of attrition or be retained in the program (Jeffreys, 2004).

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In regards to this research study, special attention is being paid to two variables

mentioned in the model, academic factors and academic outcomes. According to the NURS

model, academic factors include: attendance, study skills, general academic services, class

schedule, and study hours. Based on the model, one can argue, the items labeled as academic

factors play an important role in influencing academic outcomes, which are defined as course

grades, cumulative nursing grade point average, and overall grade point average (Jeffreys, 2004).

What makes the NURS model significant for this study and for nursing is the focus

Jeffreys pays to academic outcomes, more specifically to course grades. Many retention models

may examine grade point average in relationship to student retention, however, the structured

nursing curriculum makes these ideas from other models insufficient (Jeffreys, 2004). As a

nursing curriculum demands successful completion of one or a combination of concurrently

enrolled courses to be completed before progressing to the next course(s), individual course

grades are an important consideration for retention of nursing students, due to the risk of attrition

a student obtains when failing a course (Jeffreys, 2004).

Success in individual nursing courses are vital for a nursing student’s progression and

retention. According to Jeffreys (2007), during, and at the conclusion of each nursing course a

decision will be made to either voluntary or involuntarily remain, persist, stopout, dropout,

return, graduate, take the licensing exam, and/or enter the nursing workforce. Due to this

important decision and subsequent consequences, supporting interventions should be in place to

assist with academic factors and outcomes. Such interventions can include: workshops (focusing

on stress management, time management, study skills, and test-taking), mentoring (faculty and

peer), tutoring, and/or computer assisted programs (Jeffreys, 2007).

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The NURS model is a valuable and strategic tool that nursing educators can use to help

examine and improve retention rates. However, with the importance on academic outcomes

(especially course grades) as it relates to the nursing curriculum and the identified gap noted in

the literature, other theories and ideas are needed to accompany the NURS model. To address

the gap identified in the literature, attention needs to be turned to ways in which students acquire

and build knowledge, and the ideas associated with cognitive constructivism and its relationship

to nursing education can positively fill this void.

Cognitive Constructivism

Cognitive constructivism is a theory grounded in the work of Jean Piaget focusing on the

concept of ideas being constructed in individuals through personal processes and experiences,

creating a personal meaning for the individual (Powell & Kalina, 2009). To have effective

learning with cognitive constructivism, learners needs to be comfortable, open, and challenged.

Teaching methods employing this theory will promote ideas based on the premise that to have

meaningful or real knowledge an individual needs the ability to reason, acquire, and accept

information, and then retrieve information suggesting the said information has been constructed

in memory (Powell & Kalina, 2009).

The presence of cognitive constructivism is present in nursing education today in a

variety of ways and has a tremendous importance (Handwerker, 2012). In fact, many suggest a

shift to a constructivist paradigm in relation to contemporary practice needing reflection,

adaptation, action, and critical thinking to deliver care (Peters, 2000). In an article by Brandon

and All (2010), the authors suggest cognitive constructivism can help in improving critical

thinking skills and encourage adaptation to changes in practice. Use of constructivism will work

to make opportunities that encourage and support understanding, and if students have a better

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understanding and know how to think, then decision-making skills can be improved (Kala,

Isaramalai, & Pohthong, 2010).

Peters (2000) suggests cognitive constructivism can take into account what students

already know and have learned and will build new knowledge upon the previously learned

information. With this idea, one can argue that use of cognitive constructivism can be beneficial

for students progressing through a structured and rigorous nursing program. However, in order

to be effective, faculty need to incorporate these ideas in the classroom. Examples of using

cognitive constructivism in the classroom can include: concept maps, class discussions, problem-

based learning, case studies, and collaboration (Handwerker, 2012).

With a central focus of cognitive constructivism calling for learners to be active creators

of knowledge, faculty should encourage active-learning processes in the skills laboratory,

classroom, and clinical environment to assist learners in creating and building knowledge. The

role of nursing educators needs to be that of a facilitator, developing creative education strategies

to produce strong nursing students (Brandon & All, 2010). The literature review and research

discussed earlier in this narrative outlined some strategies being used in nursing classrooms

today. However, one classroom strategy and study skill (generation effect) which calls on the

ideas of cognitive constructivism, has yet to be fully explored in nursing education.

Generation effect. The generation effect can be defined by a student attempting to

answer a question or solve a problem instead of having the information presented (Brown,

Roediger, & McDaniel, 2014). The idea behind this is when a person has to generate (or

construct) a solution on a familiar or unfamiliar topic then that person has to retrieve knowledge

from memory, and a map is routed in the mind to fill in gaps and make connections to related

material. It is believed this cognitive and learning strategy can lead to stronger learning (Brown,

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Roediger, & McDaniel, 2014). This construction of a solution embodies the principles of

cognitive constructivism focusing on previously learned information (Peters, 2000) through the

retrieval map and connections in the mind.

The effectiveness of generation on knowledge retention and retrieval has been proved

from two historical pieces of research. Slamecka and Graf (1978) conducted five experiments

which demonstrated words are better retained and recalled if that word(s) is generated as

opposed to simply being read. The work of Crutcher and Healy (1989) confirmed this idea of a

word generated is better retained and recalled as opposed to simply being read. These authors

believed that by generating a word an individual has to search through one’s memory for related

words and symbols, thereby creating a path for later retrieval of the word or symbol generated

(Crutcher & Healy, 1989).

In the construction of an answer with generation effect research has shown that students

do not need to answer the supplied questions or prompts correctly. A deeper processing and

learning can occur if an attempt is incorrect, especially after the correct answer is later supplied,

because the result will be encoded in an individual’s mind (Brown, Roediger, & McDaniel,

2014). This idea was proven in a study involving students being tested over material prior to

reading related content, and results producing stronger learning and knowledge retention

(Richland, Kornell, & Kao, 2009).

Generation effect can be used in a variety of educational settings and classrooms,

including nursing education. One example is having students answer fill-in-the-blank questions

instead of multiple-choice questions (Brown, Roediger, & McDaniel, 2014). These questions

could be provided by the instructors as a classroom exercise or encouraged as a study habit.

Through this simple activity the relationship to cognitive constructivism is observed. By filling

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in the blanks to a question, the learner is constructing an answer by relying on prior knowledge

and related pathways in the brain, thereby developing new knowledge and retrieval maps in the

mind, as opposed to selecting an answer from a list of choices.

Research has shown generation to be effective in regards to better knowledge retention

and retrieval. While some sources are slightly dated, the relevance to classrooms today cannot

be underestimated. By generation effect being grounded in cognitive constructivist thought, and

a need for a cognitive constructivist paradigm in nursing education, it would be wise to take a

closer examination of this phenomenon at work in nursing education classrooms.

Resulting Conceptual Framework

In order to address the needs and gaps in the literature as it pertains to nursing student

retention, the resulting conceptual framework for this study will be calling upon the merging of

ideas from the NURS model and cognitive constructivism. In accordance with the NURS model,

if one area of academic factors (i.e. study skills/habits) can influence academic outcomes, then

student retention can be affected. Cognitive constructivism and generation effect can influence

these study skills/habits, thereby affecting course grades and outcomes, and in turn retention.

Figure 1 demonstrates this conceptual framework.

NURS Model Cognitive

Constructivism

Generation EffectStudy Skills/Habits

Academic Factors

Academic Outcomes

Course Grades

Student Retention

Figure 1

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Research Questions and Purpose

In examination of the resulting framework and gaps present in the literature, two primary

research questions have evolved. First, is there a significant difference in course grades for ADN

students who use generation effect to construct an answer versus those students who select an

answer on practice questions? Second, is there a significant difference in academic progression

in an ADN program between students who use generation effect to construct an answer

compared to those who select an answer on practice questions?

The development of these two questions has accounted for the current problem at hand,

student retention and completion rates, and has offered a solution to be tested, the generation

effect. The questions have encompassed the ideas of cognitive constructivism, and a central

feature of the NURS model, academic factors and academic outcomes. With these questions and

ideas in mind, the purpose of this experimental study is to test the theory of generation effect

from the perspective of cognitive constructivism and the Nursing Undergraduate Retention and

Success model as it relates to course grades and academic progression for Associate Degree

Nursing students.

Methodology

A quantitative method will be utilized for this research study. A quantitative approach

should be used if the researcher is choosing to test theories by examining relationships among

variables which can be measured and numbered data used (Creswell, 2014). With the conceptual

framework for the study focusing on course grades and academic progression, the quantitative

approach is a logical option. The design will be experimental, as the aim is to test the impact of

an intervention on an outcome with randomly assigned groups (Creswell, 2014). A control

group and experimental group will be in place for data collection and comparison. Through

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statistical tests and software, analyses will be performed in reference to the proposed research

questions.

Research Design

The following definitions are being used in the design of this study and are offered for

clarity in this proposal. Student retention will be defined as nursing students that are

successfully retained in the program through academic progression. A student who has met the

requirements of one course to progress to the next course(s) in the curriculum as defined by the

academic institution will be labeled as meeting the definition for academic progression. Course

outcomes will be defined as course grades and academic progression or failure. The format of

practice questions is defined as either a multiple-choice questions or a fill-in-the-blank question.

There are four variables seen at this time. First, the independent variable will be for the

format of the practice questions (either multiple-choice or fill-in-the-blank). Course outcomes

will be the dependent variable. A control variable will be prior academic success, and will be

accounted for through the requirement of a specific grade point average for participation in the

study. To be transparent in this proposal, a confounding variable for the study is the student

effort in the practice questions.

Participants will be randomized into a control group or an experimental group. The

control group will answer practice questions provided the faculty of record by selecting an

answer from multiple-choice responses. The experimental group will construct an answer to

same question through fill-in-the blank responses. It will be important that all participants

receive practice questions for two reasons. First, it ensures no unfair advantage is given to those

students in the experimental group in regards to exam preparation. Second, it also controls for

the retrieval/testing effect helping to ensure results are based upon use of generation.

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A key piece for completion of this study is the cooperation of faculty at the institutional

setting. It is determined that practice questions developed by faculty members would be ideal

because of the principles of the NURS model as it relates to academic outcomes and academic

factors. With a main focus of this study centering on course grades, it is felt practice questions

developed by faculty can best align with the content on exams and preparation for exams.

Practice questions were chosen as a classroom strategy to test the generation effect based

upon known ideas and research. Practice questions and/or practice exams are a prime example

of formative evaluation and the use of formative evaluation can help ensure students are learning

and to improve instruction before the conclusion of a course (Caputi, 2010). While other forms

of formative evaluation are available, practice questions have an added benefit of being

associated with stronger learning through retrieval practice. A simple quiz after a lecture is an

example of retrieval practice and produces better learning and remembering as opposed to

merely rereading notes or text (Brown, Roediger, & McDaniel, 2014). This improved learning is

felt to be the result of strengthened retrieval routes in the mind. Retrieval testing also lets

learners know what is known and not known, and the recalling causes the brain to reconsolidate

memory and make connections to already known information and allow for easier recall in the

future (Brown, Roediger, & McDaniel, 2014). Practice questions can also be of multiple use,

whereby faculty can use practice questions in the classroom, and influence the study habits and

study skills of students at home in exam preparation.

The faculty-developed practice questions will be given at the conclusion of each lecture

over the course of one full semester. At the conclusion of the semester, final course grades will

be obtained for each participant and a determination made on whether or not the participant met

the institutional requirements for academic progression. Confidentiality of all participants’

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grades and determination of progression will be maintained and no grades, personal, or

identifying information will be included in the written narrative of the study.

Sample

Associate Degree Nursing students from a community college in Texas will comprise the

sample population in this study. Texas was chosen for logistics and due to the need observed in

the nursing workforce and education statistics. Texas will have a projected 20% deficit of

nursing by 2030 (Texas Center for Nursing Workforce Studies, “Nurse supply and demand

projections, 2015-2030,” 2016) and has had a 3.9% decline in graduates in 2014-2015 (Texas

Center for Nursing Workforce Studies, “Admission, enrollment, and graduation trends in

professional nursing programs,” 2016). For Texas, ADN programs comprise the greatest number

of nursing education programs available to students (Texas Center for Nursing Workforce

Studies, “Program characteristics in professional nursing programs report,” 2016). Therefore, to

meet the needs of the state in which the research will occur, ADN students are a logical choice.

The first requirement for participation is a minimum grade point average of 2.5 to control

for the variable of prior academic achievement. Next, all participants must be enrolled in a

Medical-Surgical nursing course. By ensuring participants are enrolled in the same type of

course can allow for continuity of course materials and content, and help to ensure no other

variables may be enacting on the results.

As both a control group and experimental group will be utilized, a total of 102

participants will be needed. Using G*Power analysis, conducted a priori, it was determined that

51 students were need for the experimental group and 51 students for the control group. This

number was developed so a power of at least .80 and a significance level of .05 could be reached

for the study.

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Data Analysis

The statistical software SPSS will be used to conduct the analysis for this study. Two

data points will be needed for each study participant. First, the participant’s course grade will be

recorded and an independent t-Test of two means will be performed to determine if any

significant difference exists between the control group and experimental group. Analysis of this

data will help to answer the first research question.

In order to answer the second research question, pertaining to academic progression, a

similar statistical test will be performed. A numeric value will be assigned for each participant

based upon academic progression or failure. For example, progression will be scored as a one

and failure will be scored as a two. Again, an independent t-Test will be conducted in SPSS to

examine for any statistical differences between the groups.

Methodology Summary

Participants from a community college ADN program in Texas will be randomized in

either, a control group or experimental group. Each participant will complete practice questions

in either the multiple-choice format or fill-in-the-blank format. After participants have practiced

questions using this strategy for one full semester, course outcomes will be analyzed for any

statistical differences.

Significance of Study

Professional and practical goals can be achieved through this study and many things can

be learned. By studying generation effect in nursing education a significant contribution can be

made to the body of literature regarding nursing student retention and classroom strategies. If

the results of this experimental study note a significant difference in course grades and academic

progression/retention for nursing students, then educators have now been armed with an

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additional strategy that can be used in classrooms and/or provided to students as a study skill or

habit. Quantitative results pertaining to classroom strategies, student grades, and academic

progression will be available for further review and possible replication studies. Qualitative

studies may also be developed from exploring generation effect in nursing education.

This study can highlight the learning sciences in the classroom and in the study habits of

students. It can also provide a glimpse into how use of constructivist learning ideas could

influence academic outcomes for nursing students faced with a rigorous nursing curriculum.

Lastly, it provides a framework of combining the learning sciences with retention models to

impact student grades and thereby, retention, progression, and completion.

Not only can many things be learned from this study and avenues of future research

opened up, but monetary and practical value for nursing programs can also be obtained with

positive results. Often retention programs have called for a retention coordinator or director, or

require faculty load hours to assist students with remediation. This experiment, if positive, can

allow educators to make a change in the classroom without the hiring of additional personnel or

faculty. The use of generation effect could supplement the program and assist students without

additional monies needed for the program.

Conclusion

In conclusion, this quantitative experimental study aims to explore the generation effect

in ADN students with a framework built upon the ideas of cognitive constructivism and the

NURS model. It can add to the growing body of literature regarding student retention and

instructional strategies educators can use in the classroom or provide to students as a study tool.

The data analysis can provide readers on whether or not generation effect is an appropriate

option to consider for use in nursing education classrooms.

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GENERATION EFFECT

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live

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tomlinson.ua.edu 8/Responses...Web viewThese numbers suggest two to three students out of every ten, will not successfully be retained in the professional nursing program, and will