Student nurse attitudes towards different teaching/learning methods

‘VurrPEdurotlon roday (1990) 10,1x1-185 0 Longman Group CK Ltd 1990

Student nurse attitudes towards different teaching/learning methods

Trevor J Harvey and James Vaughan

Student nurse attitudes towards ten different teaching/learning methods were measured using the Osgood semantic differential scale. A variety of variables such as gender, age, and type of training being undertaken were considered. Analysis of variance showed that no difference in attitudes existed when including these

variables, which suggested that the nurses could be considered as a single

homogeneous group. Since the nurses could be considered as a single homogeneous group, it was then

possible to compare the ten teaching methods for this single group. These teaching methods were found to fall into four distinct groups, with student centred activities generating more favourable attitudes from the student nurses than teacher centred

activities. The least favoured teaching method being the lecture.

INTRODUCTION

The relationship between teaching and learning is something that has been the subject of con- siderable debate for many years. Involvement and participation are necessary for learning and

there are many schools of thought on the use of different methodologies. Nurse education,

whilst exhibiting many of the principles upon which the education and training of other professions are based, remains different in that it involves an apprenticeship system.

Bregg (1958) was one of the first to consider this difference when he said that it was imperative that students of service-orientated

Trevor J Harvey BSc MEd PhD Lecturer in Education, School of Education, University of Bath, Claverton Down, Bath BA2 7AY James Vaughan BEd MPhil Director of Nurse Education, Cheadle Royal Hospital (Requests for offprints to TH) Manuscript accepted 30 August 1989

professions must be able to do more than simply absorb content and pass examinations. Wiser

(1974) continued the theme when he discussed what he referred to as a shift from the technical aspects of nurses’ education to the teaching of principles. He felt that students were in danger of becoming super passers of examinations at the expense of being able to give skilled care to

patients.

Kolb (1976) seemed to be supporting this apprenticeship by suggesting that learning is a life-long process between the person and

environmental interaction. He further believed

that there is a strong relationship between how

people learn and how they respond to life

situations. Wong (1978), however, highlighted

the inability of nurses to transfer classroom knowledge to clinical practice. She sees learning

as a self-active process, where students need to be committed to the belief that particular facts

generated in the classroom are relevant in other

situations. Alderton ( 1983) extended this

181

182 NURSE EDUCATION TODAF

further and sees nurse education as not just a training to carry out technical tasks safely, but as a process that should cultivate the desire, moti-

vation and skills to continue learning in the future.

In addition to work by these researchers, there hav,e been a series of reports during the 1970s and 198Os, culminating with UKCC Project 2000

(1986), all related to nurse education and its attendant problems. Project 2000 suggested, amongst other things, that nurses should have a

common foundation programme for up to 2 years and that there should be closer links with further and higher education. Clearly, if Project 2000 is implemented, it will mean that the

present system of teaching theory and practice will need to change. What form this will take is uncertain but it is likely that students will have a prolonged theoretical input at the beginning of their training, and experience in the clinical areas will become much more closely supervised

by the nurse teachers than it is at present. The effect of this must surely be that one needs to

look very carefully at learning/teaching methodologies and one would hope that approaches will become much more learner centred than at present.

If the teaching approaches do not change, the findings of Kreigh and Perko (1983) in which

they conclude that the problems of bridging the gap between theory and practice are extensive, will continue. An additional factor which ought to cause nurse teachers to re-consider teaching styles is the large wastage rate of student nurses. According to the Institute of Manpower Studies, only 65% of student nurses in any given cohort finally become registered. Obviously this 35% fall out cannot be due in total to inappropriate teaching styles, but the two could well be related.

THE AIMS OF THE RESEARCH

The researchers were interested in teaching/ learning methods, and three aspects were ini- tially considered, namely:

a) the actual teaching styles of nurse teachers; b) the performance of students related to the

teaching styles;

c) the attitudes of the student nurses to the different teaching styles.

Previous work by Harvey (1985) and Meyer and Penfold (1961) have shown that there is a

relationship between attitude and performance. It thus seemed reasonable to restrict the investigation to the third aspect, namely student nurse

attitudes towards different teaching styles. Con- sequently it was hoped that this would give an indication of which teaching methods the students felt happiest and most secure with.

Ten different teaching methods were finally

chosen. They, with their definitions which were

used in the investigation with the nurse students,

are;

a)

b)

c)

d)

e)

I)

g)

h)

i)

j)

Seminar - a structured group discussion which may or may not follow a formal

lecture; Games - an activity making use of mater- ials such as card and board games. They are in general structured and can involve

any numbers of students; Role Play - the learners are briefed to act out a variety of roles. The participants

must play according to their briefs; Discovery learning - where the content of what is to be learned is obtained by the learner investigating the literature;

Lecture - a formal exposition. It is a

one-way communication, and the recipient can only act as the receiver

Case-Study - is the examination, analysis and diagnosis of a real or simulated problem; Discussion - is where a free flow of argu- ments is used by the group. It is to be regarded as student led; Teaching Aids - use of such things as filmstrips, video etc. These would be essen- tially for student use, not to be seen as accessories to a lecture;

Experiential learning - learning achieved by the learner gaining insight by sorting things out from his/her own experience; Projects - an investigation carried out by the individual student nurse, which would then be presented for assessment.

NURSE EDUCATION TODAY 183

These teaching methods clearly fall on a

spectrum ranging from totally teacher-centred,

i.e. lectures, through to totally student-centred

with discussions. The remaining eight falling somewhere between these two. It is not easy to place them exactly on this spectrum and no attempt will be made to do so.

The aims of the research were thus two-fold,

namely:

a) to find out whether there was an associa- tion between the expressed attitudes of students for each teaching method, and such variables as gender, age, type of

training undertaken, date students started training, initial academic qualifications

and parental occupation; b) a comparison of the attitudes expressed to

the ten teaching methods.

A’ITITUDE MEASUREMENT

There are several accepted methods of measuring attitudes, as for example the Likert scale or the Thurstone scale, but in this case it was decided to use the Osgood semantic differential scafe. The major reason for this choice is

because it is believed to be the most suitable method when measuring the effective

component of attitudes, particularly in terms of the evaluative dimensions of meaning.

For the Osgood scale, a number of adjective pairs of opposite meaning are used. These adjective pairs are then listed down the page and each pair is separated by a seven point rating scale. For each of the ten teaching methods, the same 18 pairs of adjectives were used. To illustrate the scale, consider one pair of adjectives, namely, ‘valuable and worthless’. A student would then have to rate a teaching method, as

for example, seminars on the seven point scale separating the two adjectives. A score seven would indicate that the student perceived the teaching method as ‘valuable’, and as the score decreases to one, so it would indicate the relative decrease in value the student perceives until at one, it would be perceived as ‘worthless’. The scoring for the test is so arranged that for all

adjective pairs, high scores indicate favourable disposition and low scores unfavourable dispo-

sition for that particular teaching method. Each

teaching method is thus described by 18 adjective pairs, each pair generating a score between

one and seven. For any teaching method, a student can have a maximum score of 18 x 7 through to a minimum score of 18 X 1, i.e. for

each teaching method the responses to the 18 adjective pairs is totalled. Each student would thus generate 10 total scores for the 10 different

teaching methods. The instrument was trialled on 50 student nurses to establish its suitability.

RESEARCH METHOD

Nine schools of nursing agreed to participate in the research and since all nine offered both genera1 and psychiatric nurse training, it seemed

appropriate to use these two groupings as those for part (a) of the aims of the research i.e. ‘type of training undertaken’. In all responses were

received from 134 general student nurses and 69 psychiatric student nurses. This was slightly disappointing because not all schools returned questionnaires from their psychiatric student nurses, but the numbers were sufficient to make

comparisons between the two types of training. Rather more disappointing, but probably inevitable, was that the responses came from 176 females and only 27 males, which made the gender analysis somewhat less reliable.

ANALYSIS OF DATA

The first part of the analysis was to see if there were any differences for each teaching style for each of the variables listed earlier. Gender differences (p < 0.05) were evident for discovery

learning and teaching aids when, in both cases, females exhibited more favourable attitudes towards them than males. No significant differences in attitudes to any of the teaching styles were present when considering; age of the students, the year in which they started training, initial academic qualification or in parental occupation. There was, however, one difference

B

184 NURSE EDUCATION TODAY

exhibited and that was between general and psychiatric student nurses with regard to discussions in which the psychiatric students showed a more positive attitude than the general students. Overall, however, out of 60 possible differences, only these three identified above were significant, and this leads one to assume that the student nurses could be treated as a homogeneous group and this is what was done for the second part of the analysis.

The mean attitude scores and standard deviations for each of the 10 teaching methods for all the student nurses are given in the table.

An analysis of variance between the teaching methods shows a significant difference (p < 0.01) which indicates that at least one of the methods differs significantly from the others. If one considers the least significant difference between the means, a difference of 2.8 between the mean scores indicates a significant difference (p < 0.05). Bearing this in mind, it is possible to group the teaching methods in which those within any given group can be considered to be not significantly different. An attempt has been made to do this, and the table gives probably the best grouping.

The larger the mean score the more positively predisposed are the students towards that teaching method, and hence those in group A are more favourably considered by the students than group B and so on through to group D.

Table Mean attitude scores and standard deviations

Groups Teaching Methods Mean S.D

A Games

Discussions

B

Teaching Aids Seminars Case Study Role-play Experiental Learning

C

D

Projects

Discovery Learning

Lectures

86.2 14.4

83.9 14.3

82.2 14.1 82.1 11.6 81.0 14.9 80.6 16.4 80.0 14.2

74.1 15.7

71.9 15.7

69.6 14.2

The middle value for any teaching style is 4 x 18. This arises because 4 is the mid-point value for an adjective pair and there are 18 adjective pairs. Thus it could be argued that any teaching method with a mean less than 72 is tending towards a negative attitude. This would imply

that discovery learning and lectures fall into the negative attitude category with projects only just on the positive side. On this criteria the remaining seven teaching methods would appear to be viewed positively by the student nurses.

CONCLUSIONS

The first part of the analysis showed that only three significant differences occurred out of a possible 60 when considering differences between groups for the different teaching methods. This suggests that student nurses can be considered as a homogeneous group with regard to their attitudes towards teaching methods. In some ways this is surprising when one considers that such variations as gender, initial academic qualifications and social background, as determined by parental occupation, were considered. This could possibly be explained by suggesting that candidates who apply for nurse training have particular personality character- istics. For example, they may well see the profession as a vehicle for allowing them the opportunity to satisfy their caring aspirations. Alternatively it may well be that the similarity of attitudes is a consequence of the selection proce- dure which looks for candidates who are inher- itantly similar. What ever the reasons, student nurses do appear to be a homogeneous group with regard to attitudes towards teaching methods.

When considering the student nurses as a single group, it is clear that they do not have a favourable attitude towards lectures. This may well be explained from the fact that nursing is a practical profession. Student nurses do learn from practical clinical activities, by observing role models and by interacting with people. When students find themselves in the lecture method, where rarefied concepts and theories are being expounded, they may well be unable to

KURSE EDUCATION TODAY 185

appreciate the relevance of them to the practical clinical area. We know that it is very easy for

concentration to lapse under these conditions

and not only do students exhibit a negative

attitude but it may well be a counter productive method of teaching.

It is interesting to see that discovery learning and projects do not attract particularly favourable attitudes. They are both student-centred activities, but they have a tendency to be restric-

ted to single students working on their own.

The teaching methods apparently most favoured by student nurses appear to be those that are student-centred and involve groups of

students. The interaction within the group appearing to be an important factor.

This research suggests that schools of nursing are likely to improve the education of their student nurse if they engage much more in student-centred learning activities. It may well be that the traditional form of communication,

i.e. the lecture, could be totally abandoned. The major problem in doing this is that it may require

the production of a wider range of teaching resources; for example, games, case-studies and teaching aids. This in itself is expensive and time

consuming, but in the end could well benefit the

nursing profession.

References

Alderton J S 1983 In training - but I want to be Educated. Nurse Education Today 3, 2:83, 29-3 1

Bregg E A 1958 How can we help students learn? American Journal of Nursing 58: 1120-l 122

Harvey T J 1985 Gender differences in attitudes to science and school for first year secondary school children in a variety of teaching groups. Educational Review 37.3: 281-288

Kolb D A 1976 Learning style inventory. Technical manual. McBer and Company, Boston

Kreigh H Z, Perko J E 1983 Psychiatric and mental health nursing - commitment to care and concern (2nd ed). Appleton. Century, Croft, Hemel Hempstead

Meyer G R, Penfold D H E 1961 Factors associated with interest in science. British Journal of Educ. Psychology 3 1: 33-37

UKCC 1986 Project 2000 A new preparation for practice. London

Wisser G H 1974 Those darned principles. Nursing Forum 13: 386-392

Wong I 1979 The inability to transfer classroom learning to clinical nur&ng practice. A learning problem and its remedial plan. Journal of Advanced Nursing 4: 161-168.

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Student nurse attitudes towards different teaching/learning methods