SACRED HEART COLLEGE OF LUCENA CITY, INC.

1 Merchan St., Lucena City

“THE PREFERRED TEACHING-LEARNING STRATEGIES OF FOURTH-YEAR

NURSING STUDENTS”

Presented to
Clinical Teaching

In Partial Fulfilment of the Requirements for the Graduate School

Master of Science in Nursing

Submitted to:

Professor Vivian L. Dedace, RN, MAN, Ed.D.,FPCHA, FPSQua, FANSAP

Submitted by:
Kirk Cyrus T. Nada, RN
 ABSTRACT

This paper examines the perception of selected fourth-year nursing students about their

preferred teaching-learning methods both in classroom and clinical settings. 15 respondents who

participated in the study all belonged to the fourth year level in their Bachelor of Science in

Nursing (BSN) program from different schools and universities all over Quezon Province who

participated in the survey and interview.

Based on the findings and conclusions, students can be engaged in a proactive process of

learning utilizing a combination of different teaching methodologies. Nursing students are more

inclined to engage and comprehend the material related to the course whenever nursing educators

make use of those strategies effectively. To provide an excellent instructional experience, nurse

educators must implement suitable teaching methodologies to be able to produce high-quality and

safe practicing Filipino nurses.

INTRODUCTION

Everyone needs to be educated. Without education, it is impossible to live a fulfilling life.

Education's key component is teaching and learning. To impart knowledge to students and

encourage active learning, the educator employs many different types of approaches. As time goes

on, novel strategies and approaches are introduced in the field of education, and educators

nowadays implement a variety of tools to facilitate effective educational experiences. To assist

learning and motivate students to acquire knowledge more successfully is the primary objective of

teaching. The manner in which an individual consistently perceives, processes, and retains newly

acquired information is referred to as their learning style. Learning styles, associated methods and

strategies of instruction, and unconventional teaching strategies have drawn the attention of
educational researchers in recent years. Being able to support students in becoming effective and

competent nursing students fuels this passion.

The term 'learning style' refers to a person's preferred manner of acquiring, processing,

analyzing, organizing, and evaluating information. To tackle the issue of educating across

generations, nursing education was delivered in a variety of ways. The fourth-year nursing students

are taught using a variety of educational techniques, including lectures, demo and return

demonstrations, simulations, tutorials, case studies, etc. In the past, several factors, including

technique familiarity, favorable results, and so forth, have been cited as the primary causes of the

student's choice of various teaching-learning methodologies. A notably marginalized strategy for

improving classroom and clinical instruction is having information about the learners' learning

preferences. Students can also gain from identifying their learning styles because this will aid them

in developing effective learning techniques that will improve their academic and clinical

performance.

Educators should be mindful that longstanding customs cannot be the primary factor that

governs classroom learning while developing curricula. Instead, the requirements of the learner

must be taken into account. In an instructional environment with a variety of learning styles, a

single instructional technique will not sufficiently address the learning demands of multiple

students. Adopting innovative instructional approaches without taking into consideration the

satisfaction of learners and performance, on the other hand, can be stressful for pupils as well as

educators.

The goal of this research endeavor is to determine the most desired instructional techniques

and compare them with the nursing students' preferred learning styles in order to create teaching-

learning strategies that would enhance the learning process.

 METHODOLOGY

The qualitative research design was used in this study. The results of this research's

qualitative data were gathered from fourth-year level students enrolled in a Bachelor of Science in

Nursing program from various colleges and universities in Quezon Province, ranging in age from

16 to 30 years old, utilizing an online survey questionnaire to collect relevant data about preferred

teaching-learning methods throughout the classroom as well as clinical settings.

The subjects consisted of 15 selected fourth-year BSN students who were granted

permission to be included in the study. The collected data will thereafter be gathered and evaluated.

It comprises two sections. The first section contains basic demographic information such as age

and gender. The second section consisted of questions that examined their particular preferred

teaching-learning approaches concerning classroom and clinical settings.

The collected data was coded, computed, and analyzed. After having the collected data,

descriptive statistical measurement was applied using a weighted average method and percentage.

Formula: % = (f / n) x 100

Formula:

Where: W = weighted average

n = number of terms to be averaged

wi = weights applied to x values

Xi = data values to be averaged

 REVIEW OF RELATED LITERATURE

The word teaching method relates to the broad concepts, pedagogy, and management

approaches that are applied in the classroom. Today's health profession educators strive to advance

students' abilities to more advanced levels of Bloom's taxonomy. This necessitates the

development of more complex cognitive processes such as critical thinking, analytical, and

evaluative abilities. Learning can occur as a result of newly acquired abilities, principles,

perceptions, knowledge, facts, and new information. Clinical educators have a significant deal of

responsibility when it comes to teaching students, and this training frequently takes place in a fast-

paced, high-workload setting. Burns et al. (2006) published an excellent study arguing that the

clinical learning experience should aim to develop students' knowledge and abilities, improve

practice efficiency and effectiveness, encourage increasing clinical independence, prepare students

for optimal patient health outcomes, and prepare students to become competent, compassionate,

autonomous, and collaborative clinicians.

Teaching methods, encompassing many sorts of instructional strategies, are the tactics and

approaches that instructors employ in the classroom to enhance the process of learning and

instruction. These strategies are specially developed to assist students in engaging with the subject,

developing critical thinking abilities, and eventually retaining and applying the information

students receive. Traditional lecture-style presentations, interactive conversations, practical

exercises, and technological instruments are a few examples of teaching approaches. To ensure

that students are prepared to learn and utilize innovative ideas and abilities, effective teaching

techniques, involving a variety of teaching techniques, are crucial. Teachers can incorporate

various approaches to learning and meet the various requirements and aptitudes of their students

by employing a number of strategies. For example, although some students can acquire knowledge
better by means of visual aids, others might find that participating in hands-on exercises or

collaborative endeavors proves to be more beneficial. According to Sunder (2010), instructional

materials increase teaching effectiveness, engagement, and student attention, while also

contributing to a more participatory and knowledge-focused teaching-learning process. There is

an urgent need for and importance of instructional technologies to make the teaching-learning

process more outcome-oriented, clear, successful, and engaging for both educators and students.

When it comes to teaching a sophisticated or difficult idea that may be difficult for novices to

grasp, audio-visual aids are essential. Educators might use audiovisual aids when explaining

subject matter to students would be extremely difficult without them. Utilizing two or more senses

to gather information improves retention and memory, according to Udomon, Xiong, Berns, Best,

and Vike (2013). When information is presented in both aural and visual formats, it is more likely

to be recalled clearly. In general, these improvements enable learners to connect more effectively

with knowledge, motivate students toward academic performance, and foster more in-depth and

precise expression of understanding. Teachers may provide their students with a thorough learning

environment by combining different approaches to learning.

The quality of teaching is reflected in effective learning. A constructivist approach to

learning refers to the construction of an environment in which the learner is an active participant

who learns experience and participates in reflection, resulting in problem-based, transformative

learning (Levin, 2010). Crookes et al. (2013) found a variety of relevant and engaging instructional

modalities used by nurse educators, including online education, gaming, and simulation

techniques. However, these authors found that more active lecture approaches in nursing education

are needed to increase the relationship between course material and clinical practice (Crookes et

al., 2013). Clinical practicum projects, lectures, small group work, post-clinical conferences,
online courses, and simulations have all been used as teaching and learning methodologies (Philips

and Cullen, 2014). Diverse activities help to strengthen the learner's understanding. Furthermore,

comprehending the complex process of clinical reasoning must begin early, using a range of

modalities such as clinical case-based learning and clinical skill practice (Khin-Htun & Kushairi,

2019). Students are stated to have learning technique preferences, and a large number of them

prefer a combination of learning modalities (Lujan & DiCarlo, 2006). Student motivation and

performance improve when education is matched to students' learning preferences and styles

(Miller, 2001). As a result, because students have such a wide range of learning styles, it is the

instructor's responsibility to address this variety and construct appropriate learning approaches

(Tanner & Allen, 2017). It serves as a realistic setting for students to gain insight into the critical

role in the integration of nursing theory and practice, progressively shaping the views of nursing

students regarding learning, practice, and advancement in knowledge, skills, attitudes, and values

that lead to registered nurses in the future. The choice of teaching tactics is a critical component

of instructional design. The purpose is to assist students in digesting information more thoroughly,

allowing them to connect new material to previously held beliefs or experiences (Kemp, et al.,

1994).

RESULTS

The qualitative findings of this study are presented in the tables as discussed below. Figure

1 shows the demographics of the respondent's gender. There is a total of 15 fourth-year students

participated in the study. Among the 15 students, there were 9 female nursing students which

encompassed 60% which is the majority of contributors to this study. The remaining 6 students

(40%) were male.

Figure 1

MALE PERCENTILE FEMALE PERCENTILE

6 40% 9 60%

Figure 2 shows that the studied cases ranged from 21 to 25 years of age. This illustrates

that these respondents belong primarily to the age 21 to 25 years old which encompasses 100%.

Figure 2

AGE PERCENTAGE
16-20 years old 0%
21-25 years old 100%
25-30 years old 0%

Figure 3 displays the most preferred instructional method among respondents, which was

demonstration and return demonstration with a WAM score of 4.00. Distance learning, with a

WAM score of 1.80, was the least preferred of the specified instructional methods.

Figure 3

Instructional Strongly Non- Strongly

non-
Methods preferred Preferred preferred preferred WAM Interpretation
(4) (3) (2) (1)
Lecture 13 2 0 0 3.87 Strongly
preferred
Group Discussion 4 11 0 0 3.27 Strongly
preferred
One-on-one 7 6 2 0 3.33 Strongly
discussion preferred
Demo and Return 15 0 0 0 4.00 Strongly
Demonstration preferred
Simulation 11 4 0 0 3.73 Strongly
preferred
Role-Playing 2 8 5 0 2.80 Preferred
 Role-Modeling 6 8 1 0 3.40 Strongly
preferred
Computer-Assisted 0 10 4 1 2.60 Preferred
Instruction
Distance Learning 0 1 10 4 1.80 Non-preferred
Case Method 4 11 0 0 3.27 Strongly
preferred
Ward Class 9 5 1 0 3.53 Strongly
preferred
Nursing Rounds 12 3 0 0 3.80 Strongly
preferred
Nursing 8 7 0 0 3.53 Strongly
Conference preferred
Case Presentation 13 2 0 0 3.87 Strongly
preferred

Conclusion

Furthermore, multiple methods of instruction might be employed to attain different

learning objectives. Certain approaches are probably ideal for presenting innovative ideas or

establishing core knowledge, whilst others might be more effective for encouraging creativity,

problem-solving, and teamwork. As a result, nursing educators must be versed in the variety of

instructional techniques accessible and available as well as the manner in which they may be

utilized to support and supplement certain learning goals and objectives. Teaching methodologies,

which includes different types of instructional strategies, are critical in fostering a healthy learning

environment and promoting that student realize their full academic potential. Nurse educators can

develop captivating and effective educational programs to ensure students obtain the competencies

and knowledge they require for academic achievement by recognizing the positive and negative

aspects of each approach and the manner in which they can be effectively utilized to promote

learning.
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Appropriate Classroom Teaching Methods and Strategies

Educational systems must be continuously developed and modernized all around the

world. It employs all new procedures to stay up with cutting-edge technology and the requirements

it imposes. It is of the utmost importance that students are kept up to stay up-to-date with current

developments in order to improve their capacity for creativity. As a result, it is also fundamental

to establish instructional strategies and practices that support the cultivation of students'

Knowledge and competencies. Instructors can employ a range of teaching methodologies to boost

student learning. It is critical to use proper teaching tactics in nurse education to contribute to

classroom instruction more interesting and productive.

The concepts of methodologies for instruction and techniques for instruction are

intrinsically connected. Following the continual development of the concept of teaching strategies,

the concept of teaching techniques evolved as well. We may describe teaching techniques as the

methods, instruments, and devices that must be available to assess, are applicable, prepare, and

impart knowledge to students in addition to achieving academic objectives. It also reflects the

cognitive endeavors and the method that determines how the learning process develops. Teaching

strategies could be beneficial to students broaden their areas of expertise, enhance their degree of

comprehension, and conserve work and time, along with increasing the efficiency of the instructor.

The conceptual framework of teaching methods is a subset of the idea of methods of

instruction, which can be considered more expansive and all-inclusive. To better understand a

principle or alter an unclear idea to improve the status of the learning process, an instructor utilizes

a collection of teaching approaches, which may be characterized as a comprehensive arrangement

of resources, devices, tools, and educational attitudes. Additionally, it strives to enhance the

teaching strategies, the circumstances and skills of the educators, and the curricula. According to
Jie-hui Xu (2016), there are ten methodologies for instruction to assist instructors in acquiring the

knowledge to include the teaching approach in nursing school instruction. Students who utilize

these approaches well are better able to remember the material correlated with the course of study.

It is critical for nursing instructors to incorporate proper teaching methodologies to provide high-

quality education.

a. Lecture

When you need to cover a lot of content fast, lecturing has historically proven to be

one of the most successful ways to communicate knowledge to big groups of students.

Lectures do not have to be dull anymore, thanks to advances in technology.

Incorporating polling technologies, multimedia, and interactive software applications into

the lecture may make it more engaging and oppose the passive student role.

b. Simulation with High Fidelity

Simulation enables instructors and students to reproduce an actual clinical situation

in a simulated environment. These types of situations frequently simulate the patient care

setting and enable the practical use of theoretical information.

Simulations are frequently used to offer novel teaching experiences that assist

nurses in assessing and developing clinical competency. Furthermore, it boosts the nursing

student's self-esteem and self-confidence.

Debriefing sessions after every exercise are an additional opportunity to develop

critical thinking and clinical reasoning skills. It's critical to discuss the situation,
 constructive aspects to improvement, the rationale of the situations or procedures, and how

your nursing students reacted to the simulation.

c. Concept Mapping

This method encourages students to graphically depict concepts, which prompts

them to analyze, assess, and contemplate critically. By helping students to understand

interrelationships in clinical data and appreciate a patient holistically with a clinical picture,

concept mapping enables students to fill in missing information and explain current

findings.

d. Online Training

There are no planned on-campus class meetings for an online course. It is an

integrated learning application that can be accessed at any time and from any location using

a computer with an Internet connection. Student-centered education is commonly

acknowledged in online education. Instructors should establish a complete course plan,

which involves selecting course materials and discussion themes, as well as devising

activities, to enhance the success of the online learning environment (Karaman, 2014).

e. Games

The use of games as a teaching approach fosters participation and boosts the

student's motivation and interest. Learning may be made more pleasant by using games.

Several justifications for adopting games as a teaching approach are highlighted in the

nursing literature, notably the enhancement of active learning, the encouragement of

 critical thinking, the importance of fun and excitement in learning, and the reproduction of

real-life scenarios (Glendon and Ulrich, 2005).

f. Role Playing

Students represent and experience characters from everyday life in role-playing,

which teaches them how to interact and cope with conflict. Role-playing is a very effective

method for honing therapeutic communication skills and managing conflict (Shearer and

Davidhizar, 2003). To use this method, set the purpose of the role-playing session and

summarize afterward to offer constructive criticism to students.

g. Jigsaw Classroom

The Jigsaw Classroom is an excellent cooperative learning teaching approach (Lai

and Wu, 2006). Elliot Aronson devised this approach, which involves the development of

Home Groups to complete a job. The Home Groups assign one member to each Expert or

Research Group to collect data and report back to the Home Group.

This cooperative learning strategy lowers racial conflict among students, promotes

better learning, boosts student motivation, and makes learning more enjoyable El Miedany

and El Miedany, 2019). By providing each member of the group with an important role to

perform in the academic activity, the jigsaw approach develops listening, involvement, and

empathy (Kaufman, 1976).

The jigsaw classroom technique may be utilized in nursing education to teach the

content of numerous issues both in the classroom and in the workplace. Following the
 course of study, the instructor must supervise the process and deliver a summary and

debriefing session.

h. Case Study

Case studies are commonly associated with workplace procedures, but they may

also serve as excellent learning devices. Case studies are realistic and complicated

experiences that assist in the integration of theory and practice, as well as the classroom

and the workplace. Case studies bridge the theoretical and practical divides, as well as the

classroom and the workplace (Barkley et al., 2014). Case studies can be used in nursing

education to educate about clinical illnesses, cultural competency, communication skills,

and other issues.

i. Debating

When teaching a contentious subject or debating a nursing education trend, debate

should be employed. It encourages students to take an active role in studying the subject

matter, boosts critical thinking abilities, and improves spoken communication

skills. Debaters must review pertinent literature, assess the evidence, come up with a theory

or an option, and then articulate and forcefully argue their points throughout the heated

discussion. The audience members engage in a post-debate discourse and critique the

debaters' performances. Every single one of the students is actively involved in their

learning, teamwork is enhanced, and analytical thinking is developed through this sort of

discussion with critique.

 j. Problem-based Learning

With this approach, instructors pose hypothetical patient situations, raise questions,

and urge students to look for all-encompassing solutions. Additionally, it promotes

integrating knowledge, collaboration, discipline, self-evaluation clinical capacity for

problem-solving, proactive and autonomous learning, and self-appraisal.

This may be utilized to educate subjects like heart failure or pneumonia that have a

broad link with fundamental science and clinical practice.

In everyday classroom instruction, teaching techniques are fundamental. Nurse

educators would be indiscriminately presenting informative material that fails to resonate with

students or engage them whenever they fail to implement a plan. Strategies foster engagement,

connection, and enthusiasm in the delivery of the material.

Appropriate Teaching Methods and Strategies in Clinical Areas

In the context of education, the value of teaching methodologies, specifically the wide

range of instructional techniques, cannot be sufficiently underrepresented. Effective approaches

to instruction have an important role in providing an engaging and active learning environment in

which students may acquire and implement innovative ideas and abilities. Nurse instructors and

educators may respond to the differing requirements and skills of their students and supply these

individuals with an optimal learning experience by using an assortment of teaching approaches.

Furthermore, different teaching strategies can be employed to attain various learning results.

Actual clinical activities and group projects, for example, can be very useful in fostering

collaborative effort, problem-solving skills, and analytical thinking abilities. Furthermore, the
employment of various teaching approaches may be beneficial in the creation of a pleasant and

equitable learning environment. Educators may assist with making certain that every student feels

valued and appreciated in the clinical learning environment by accommodating the students'

unique requirements and skills.

Clinical teaching is the major instructional method designed to train students from the

first day of nursing school until nursing students complete their related learning experiences in

various clinical settings. Although simulation is becoming more popular in nursing academic

education curricula, the long-standing practice of teaching with actual patients stays vital.

Teaching in clinical settings, such as bedside and outpatient clinics and even in a community set-

up, is paramount in nursing education and an essential component of clinical training. To learn

more about the patients, clinical teaching approaches have been adopted. Nurses including nurse

educators and instructors evaluate the patient's condition, status, observation, recommended

therapy, and nursing care processes using this technique.

Clinical approaches include case method, case presentation, bedside rounds and

conferences, nursing process recording, ward class, concept mapping, and nursing conferences.

These are the most effective strategies for teaching clinical skills. This strategy is used for patient

care and treatment. These types of methodologies are presented by clinical instructors, educators,

professional nurses, and others. The primary goal of these methods is to provide better care and

treatment. The healthcare professionals like the doctors and other specialists treat the patient, while

the nurses focus on taking care of the patients in a holistic manner.

Teachers encourage techniques that equip students with the ability to put forward and

then answer questions for themselves, in addition to supporting learners in acquiring knowledge.

Students are encouraged to proactively express their ideas about problems they encountered and
subject matter that are relevant to the practicum in their clinical areas. According to Schmidt

Bunkers (1999), nurse instructors need to be mindful of providing opportunities for listening,

reflecting, and not knowing.

Conclusion

There are continuously innovative tools and methods to investigate as teaching

strategies change over time. Nursing educators must provide nursing students access to a more

dynamic and engaging educational environment by remaining receptive to cutting-edge concepts

and methods. Clients, students, and educators all recognize that teaching in a clinical context,

especially when teaching at the point of care, is an efficient and effective instructional strategy.

Learning tasks within the boundaries of a clinical setting should be organized, structured, and in

compliance with the curriculum and evaluation to maximize learning and nursing student

engagement.

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