Reading as an Instructional Strategy in Nursing Education
Korean J Med Educ. 2020 Jun; 32(2): 103–117.
Strategies for sustaining and enhancing nursing students' appointment in academic and clinical settings: a narrative review
Mohammad Reza Ghasemi
1Nursing and Midwifery Care Research Center, Schoolhouse of Nursing and Midwifery, Mashhad Academy of Medical Sciences, Islamic republic of iran
Hossein Karimi Moonaghi
1Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Islamic republic of iran
2Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Islamic republic of iran
Abbas Heydari
1Nursing and Midwifery Care Research Heart, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Iran
Received 2020 February 27; Revised 2020 Apr 10; Accepted 2020 May 6.
Abstruse
Students' engagement in academic-related learning activities is i of the of import determinants of students' success. Identifying the best teaching strategies to sustain and promote nursing students' engagement in bookish and clinical settings has ever been a challenge for nurse educators. Hence, information technology is essential to provide a set of strategies for maintaining and enhancing the academic engagement of nursing students. The purpose of this review was to explore and summarize the strategies that nurse educators use to sustain and promote nursing students' engagement in academic and clinical settings. A narrative literature review was conducted. CINAHL (nursing content), ProQuest, Medline, the Cochrane, Google Scholar, and Scopus were searched. Of ane,185 retrieved articles, 32 educational activity strategies were identified and extracted from the nursing literature. We used thematic assay arroyo to organize these strategies into five main categories every bit follows: technology-based strategies (fifteen articles), collaborative strategies (10 manufactures), simulation-based strategies (2 articles), enquiry-based strategies (two articles), and miscellanea learning strategies (three manufactures). As a general comment, these strategies take the potential to promote nursing students' engagement. Among the strategies discussed in this review, the use of engineering, especially the response system and online learning, was more common among nursing educators, which is in line with today'south advances in smart technologies. The drove presented in this review tin be used as a starting point for hereafter research to evaluate the effectiveness of an educational intervention on the bookish engagement of nursing students. Nevertheless, due to the lack of experimental studies, the optimal strategies remain to be elucidated through future high-quality experimental written report.
Keywords: Nursing schools, Nursing students, Instruction, Instruction, Bookish success, Engagement
Introduction
One of the essential requirements of healthcare systems to see the broad needs of patients is the employment of well-qualified nurses [1]. In this respect, one of the of import responsibilities of nursing education systems is providing high-quality education to nursing students and preparing competent nurses so that they can provide patients with safe and high-quality care in the hereafter [ii-4]. As a step toward that end, nursing educators demand to apply new educational strategies to actively engage nursing students in learning activities in academic and clinical settings [5,6]. Previous studies have shown that increasing bookish engagement of students could increase their desirable academic performance and success [seven]. Recent evidence indicates that engagement in academic-related learning activities is one of the important determinants of students' success in university [viii-10]. As a event, identifying the best instruction strategies to sustain and promote nursing students' date in academic and clinical settings has always been a challenge for nursing educators. Hence, it is essential to provide a gear up of strategies for maintaining and enhancing the bookish engagement of nursing students.
In educational literature, the concepts of academic engagement, student appointment (SE), educational engagement, student involvement, and school engagement take oftentimes been used interchangeably [11]. In this study, the term 'SE' was used. The concept of SE has been extensively studied in educational literature equally an important determinant of quality in academic teaching. Several definitions of this concept have been proposed; however, one of the most widespread definitions of SE is provided by the prolific author, Kuh [12]. Kuh [12] defined SE every bit "the time and attempt students devote to activities that are empirically linked to desired outcomes of higher and what institutions do to induce students to participate in these activities." However, several authors argue that this concept is more than student involvement in school-related activities. It is rather a multidimensional concept, whose dimensions include behavioral, emotional, cerebral, and motivational [11, xiii,14]. SE, also, refers to the quality of the effort that learners spend on the targeted educational activities such every bit attention classrooms, studying, doing applied work, and engaging with professors or other students to reach the desired outcomes [15]. In the most recent definition of SE proposed past Kahu [13], the amount of time students spend on learning-related activities is considered equally one of the main components of SE. In clinical disciplines such equally nursing, many educational activities are accomplished in clinical settings. Hence, it is expected that the concept of SE in nursing education includes at least two concepts of "academic engagement" and "clinical engagement [xvi]." However, a search of the literature revealed pocket-sized number of studies regarding clinical engagement, and this concept has recently become an important issue in nursing students' education. In addition, most nursing researchers accept not provided a unique definition for the concept of SE [11,16]. Recently, Bernard [fourteen] using concept analysis, theoretically defined SE as "a dynamic process marked by a positive behavioral, cognitive, and melancholia state exhibited in the pursuit of deep learning." This definition included the previously discussed dimensions and focused on deep learning; however, this definition lacks practical and measurable characteristics of SE, peculiarly time spent to engage with educational activities. Given the lack of an operational definition of SE in nursing educational activity, based on the literature, we used the post-obit working definition for conducting the electric current review. SE is "the investment of fourth dimension, effort, and other relevant resource by both students and their institutions intended to optimize the student experience and enhance the learning outcomes and development of students, and the performance and reputation of the institution [11]."
In the last decade, many nurse researchers accept investigated various educational strategies to explore and develop the best ways to increment nursing students' academic appointment. The result of these efforts has led to the creation of new pedagogy strategies or modification of the techniques used past other disciplines. However, the lack of a study that reviews these strategies and techniques as a drove is felt. Previously, Crookes et al. [17] explored the strategies and techniques that nurse educators take employed to help nursing students to contextualize theory learned in the classroom to their do. However, near of those techniques borrowed from other disciplines. Therefore, the ultimate purpose of this review was to explore and summarize the strategies that nursing educators utilize to sustain and promote nursing students' date so that nosotros can provide a ready of these educational strategies to nursing educators and researchers. This review has been carried out as office of a nursing doctorate dissertation attempting to appraise the lived experiences of nursing students on academic appointment activities.
Methods
The post-obit question was used to guide this non-systematic narrative literature review: What strategies or techniques take nursing educators used to sustain and promote nursing students' academic or clinical engagement? To reply this question, we reviewed the literature to identify the nigh pregnant studies and theoretical foundations regarding the bookish and clinical appointment strategies used by nursing educators.
1. Sources of data and search strategy
The following databases were searched for peer-reviewed scholarly manufactures: CINAHL (nursing content), ProQuest, Medline, the Cochrane, Google Scholar, and Scopus. Two authors (G.Chiliad.R. and K.Grand.H.) with the help of i librarian searched the databases using predefined search strategies. They individually screened the titles and abstracts of retrieved studies against the inclusion criteria for choosing relevant articles. We used several combinations of the post-obit search terms 'engagement, nurse, student' and their related concepts by using the Boolean operator, "AND", to obtain whatever link between them. The telescopic of the search was express to English-language written international articles and publication dates were express from Jan 2000 to June 2019. To find additional manufactures, we manually examined the reference sections of the retrieved studies and relevant review.
2. Selection criteria
To keep the focus straight on nursing students, the inclusion criteria for selecting articles were as follows: The sample should be nursing students and the used strategies must be done by nursing educators. Equally well, we included original articles, reviews, innovative papers, discussion papers, learning projects, and theoretical frameworks. Nosotros excluded the dissertations and articles related to the other professions. Duplicate articles were besides excluded. Given that we intended to provide a comprehensive ready of educational strategies for sustaining and promoting nursing students' date, we did not assess the quality of included studies and did not remove any studies due to the low quality.
Results
Of 1,185 retrieved articles, 32 articles accept met the selection criteria. Fig. 1 shows the procedure of study choice for inclusion in review.
PRISMA 2009 Menstruation Diagram for Study Choice
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Nursing researchers accept explored and applied several strategies/techniques for sustaining and promoting nursing students' engagement. Given the heterogeneity of the educational methods, we used a thematic assay approach to collate, summarize, and map the literature to identify themes across the retrieved studies based on the similarities of concepts and pedagogy techniques that educators had used. The second author reviewed each paper and data was coded to describe the master pedagogy methods. Similar codes were grouped together into categories to organize the main education strategies/techniques. New categories were developed or modified as analysis continued. At the end of analysis, nosotros organized these strategies into five main categories as follows: technology-based strategies (15 articles), collaborative strategies (10 articles), agile learning strategies (three articles), simulation-based strategies (two manufactures), and research-based strategies (ii articles). It should exist noted that there are some similarities between and within categories. Table 1 summarizes the students' appointment strategies. Regarding the methodology of retrieved studies, 5 were innovative, 10 were discussion paper, six were quasi- experimental, five were descriptive, and six were qualitative studies.
Table one.
Summary of Students' Engagement Strategies
| Category | Author (year) | Paper type | Strategy/technique |
|---|---|---|---|
| Technology based strategies | |||
| Online | Barnes [20] (2017) | Innovative | Kahoot in the classroom |
| Broussard et al. [23] (2018) | Discussion | Online pedagogy | |
| Daroszewski et al. [24] (2004) | Discussion | Online tiered discussion | |
| Dickson [26] (2016) | Innovative | Asynchronous discussion boards | |
| Johnston et al. [27] (2018) | Quasi-experimental | Posting videos on YouTube | |
| Turner et al. [22] (2018) | Give-and-take | Online computer games | |
| Giddens et al. [28] (2010) | Quasi-experimental | Virtual community | |
| Shuster et al. [30] (2011) | Discussion | Virtual community | |
| Offline | Fifer [33] (2012) | Quasi-experimental | Clickers |
| Berry [32] (2009) | Quasi-experimental | Clickers | |
| Filer [35] (2010) | Quasi-experimental | Audience response system | |
| Moredich et al. [31] (2007) | Clarification | Classroom response system | |
| Mordhorst [34] (2010) | Description | Student response arrangement | |
| Revell et al. [36] (2010) | Quasi-experimental | Personal response arrangement | |
| Aul et al. [37] (2018) | Qualitative | Barcode scanning | |
| Collaborative strategies | |||
| Team-based | Dearnley et al. [40] (2018) | Word | Squad-based learning |
| Oldland et al. [41] (2017) | Description | Team-based learning | |
| Bramble et al. [42] (2018) | Qualitative | Interdisciplinary partnership | |
| Burgess et al. [43] (2015) | Qualitative | Collaborative testing | |
| D'Souza et al. [44] (2013) | Discussion | Faculty-student interaction | |
| Raines [45] (2010) | Innovative | Crossword puzzles | |
| Service-based | Hart [46] (2015) | Discussion | Service-based learning |
| Taylor et al. [47] (2017) | Innovative | Service-based learning | |
| Peer-based | Casey et al. [49] (2011) | Qualitative | Peer assessment |
| Welsh [50] (2007) | Discussion | Peer assessment | |
| Simulation based strategies | Power et al. [51] (2016) | Qualitative | Simulation with manikins |
| Levett-Jones et al. [52] (2015) | Innovative | Tag team simulation | |
| Enquiry based strategies | Judge et al. [54] (2018) | Qualitative | Q methodology |
| Hensel [53] (2016) | Discussion | Q methodology | |
| Miscellanea learning strategies | Popkess et al. [nine] (2011) | Descriptive | Agile learning |
| Waltz et al. [55] (2014) | Discussion | Agile learning | |
| Salamonson et al. [56] (2009) | Descriptive | Homework completion |
1. Engineering science-based strategies
In that location is growing prove that shows the value of engineering science for engaging students in academic learning activities [18]. We found 15 articles discussing the importance of using online and offline technologies in promoting nursing students' engagement.
one) Online technologies
a. Kahoot in the classroom: Kahoot is a free web-based technology that incorporates a quizzing plan to increase the participation of learners during the lecture. Every bit well, information technology tin can be used as a mean for formative cess of students. It is believed that the learners' attention is reduced in the first minutes afterward the offset of the lecture and educators need to alter the situation and engage the learners to regain their attention [19]. The underlying assumption of Kahoot method is that an interesting program could increment students' participation during the lecture. Barnes [20] introduced this technique every bit an innovative tool for nurse educators for engaging students during the lecture. Withal, the effectiveness of Kahoot to increase the engagement of nurse students is nether inquiry and currently, there is no experimental inquiry that examined the effectiveness of this method.
b. Online education techniques: Forth with advances in technology and the Internet, many traditional instruction methods have been transformed into interactive web-based educational methods [21]. In contempo years, web-based courses provide many opportunities for actively engaging nursing students in learning activities [22-24]. Nursing pedagogy experts believe that online forum courses can span the gap between theory and practice in nursing discipline besides as it can facilitate the process of nursing students' engagement [17].
c. Asynchronous discussion boards: These boards enable multiple learners to appoint in discussion with each other. All discussions of the learners are nerveless on a board and the members contribute their comments past responding to the initial word question or past responding to each other. Information technology is believed that asynchronous word boards, by use of the Spider web and other Internet technologies, encourage deeper learning and assist students to be more than engaged in learning activities related to assay, synthesis, decision-making, and the utilize of knowledge [25]. In nursing education, Dickson [26], proposed the bones structure of asynchronous discussion boards for enhancing the engagement of nurse students. The foundation of the technology is that educators can enhance students' engagement by posting a serial of questions on the discussion lath and then encourage those students to reflect and respond actively to those questions. At present, no experimental enquiry has evaluated the effectiveness of this technology in terms of SE.
d. Posting videos on YouTube: Johnston et al. [27] incorporated a collection of YouTube videos into the bioscience course to support nursing students' date. The full number of views, comments, and subscriptions from students were nerveless directly from the Biological Sciences YouTube channel over four semesters. The videos are highly successful; with more than than 300,000 views, one.5 million minutes of viewing and more than five,000 international subscribers during the report. More than 90% agreed that watching videos increased their engagement time in learning. Authors concluded that posting educational videos on YouTube tin can significantly appoint students in learning activities and enrich the educatee experience and operation [27].
eastward. Virtual Community: Giddens et al. [28] designed and implemented an intervention called "the neighborhood virtual customs (VC)" to assist offset-semester baccalaureate nursing students (n=350 participants) in learning circuitous, health-related content. They described VC as an online teaching application presenting an imaginary community with multiple interconnecting character stories. VC included households' and health care nurses' characters. Students should follow the character stories each week during the semester by logging on to the Website. Using a 2-group quasi-experimental study, they plant that appointment in learning activities were significantly higher in the experimental grouping than those of the control grouping (analysis of variance, F=ii.40, p<0.05). In addition, a significantly positive relationship (r=0.416, p<0.001) between the frequency of VC apply and perceived benefits amidst students was found [29]. In another study, using VC in nursing education leading to the improvement of students learning through emotional connectedness to families and date of characters into learning activities [30].
two) Offline technologies
a. Response systems (clickers): Response systems are a set of software and hardware that educators take used to attract learners' attention and increase their engagement during the form lecture. By asking questions in the classroom, the educator encourages the students to respond to these questions through a technology-based response pad called "clickers". Using this system, students can get instant feedback from the educator regarding the asked questions. In this way, clickers actively engage students during the lecture. Recently, several nursing schools across the world used this technology [31-34]. Filer [35] in a pilot quasi-experimental study with 90 nursing students assessed the impact of an audience response organisation (clickers) on students' date and participation in the classroom. The control grouping responded verbally, while the intervention group responded anonymously using the clickers to questions posed during the lecture. The author found that students in the intervention group reported a greater level of motivation (p<0.001); were more comfy in the classroom (p=0.00); and expressed a higher level of participation (p<0.001) than students in the control grouping. In addition, almost all students indicated the clickers were easy to use and they would like to use it in time to come classes [35]. In another quasi-experimental written report, Revell and McCurry [36] compared the effectiveness of a personal response system with didactic presentations. These interventions were incorporated within two undergraduate courses, nursing research (n=33) and junior medical-surgical nursing (north=116). The efficacy of each intervention was evaluated by multiple-pick, truthful-simulated, and quiz questions. Authors constitute that using a personal response system could significantly increase faculty-student participation and enhance active learning (p<0.001) compared with the lecture [36]. In a report with 47 offset-twelvemonth nursing students, Fifer [33] evaluated the perceptions of showtime-year nursing students regarding the apply of pupil response organisation technology. A 14-particular Likert scale survey was used to collect students' perceptions. More fourscore% of the student had a positive perception regarding the strengths of this applied science for increasing SE. Many students expressed that this method maintained their focus during the lecture [33]. Berry [32] incorporated clickers to enhance pupil interaction and learning in a didactic pediatric nursing course. Test grades and level of participation were monitored and examination scores and final scores were compared between 2 groups of 'with clickers' (north=65) and 'without clickers' (n=61). Student t-tests demonstrated that i of the 3-grade exams and final form grades were significantly higher for the students who used clickers (mean±standard deviation, 93.33±1.99 versus 95.03±1.64; p<0.001). Satisfaction feedback besides supported the apply of clickers as a tool to engage students and enhance learning outcomes [32].
b. Barcode scanning: Quick response (QR) code is a specific two-dimensional code that are used to encode and decode information such as text, Compatible Resources Locator links, Short Message Service letters with a mobile device that is equipped with a camera and QR reader software. QR codes can exist integrated with learning activities such equally linking a specific topic to information on the Internet, reviewing data, or evaluating classroom assignments. Equally an interactive technology-based approach, many health care systems incorporate barcode scanning or QR codes into nursing students' clinical rotations to ensure patient safety. In improver, many educators incorporate this arroyo into the classroom activities to heighten students' engagement. In this regard, Aul and Johnston [37] explored the experiences of undergraduate nursing students during the oncology grade. The authors created barcodes consisted of one review question using a web-based, QR code generator tool. The authors printed the barcodes on an index card and and then the cards were strategically taped throughout the classroom and the hallways exterior of the classroom. Threescore-seven students were instructed to circulate around the room to scan the codes with their smartphones to notice a range of oncology review questions. Afterward, the students should present and hash out the answer to the scanned questions. The authors found that barcode scanning is an bonny method for increasing SE and performance of nursing students. At present, the efficacy of barcode scanning to increase the engagement of nurse students is under research and currently, there is no experimental research that examined the effectiveness of this method.
2. Collaborative strategies
Collaborative learning is divers as a set of instructional methods to encourage students to work together to achieve a common learning goal. It involves mutual intellectual works past students themselves or students and educators. In this approach, students themselves are responsible for grouping governance and education output [38]. Nosotros found 10 articles discussing the importance of using collaborative strategies in promoting nursing students' appointment.
1) Team-based strategies
a. Team-based learning: Squad-based learning (TBL) is a shared learning and education approach, which is frequently used by health sciences educators in their preclinical and clinical programs to foster self-directed learning [39]. In nursing education, Dearnley et al. [xl] reviewed the outcomes of TBL in nursing instruction programs to explore the experiences of nursing students regarding the TBL. They discussed that at that place is a smashing body of evidence, which supports TBL, as collaborative teaching and learning strategy, for sustaining and enhancing students' engagement [forty]. In an exploratory, descriptive written report, Oldland et al. [41] explored the perceptions of nursing students regarding the role of TBL in shaping their professional person clinical behaviors. Authors plant that TBL can maximize students' participation in the learning activities, develop active and deep learning, and raise teamwork performance, which in turn tin can raise the students' appointment in both bookish and clinical settings [41].
b. Interdisciplinary partnership: Many schools across the world have been implementing partnership projects between students and the school's staff in order to increase students' engagement in bookish learning activities. Bramble et al. [42] implemented a participatory activity research to develop a "3-month mentorship partnership intervention" between nursing students and a group of academics every bit a mentor. They found that interdisciplinary partnership could increase students' academic appointment and success; notwithstanding, the acquisition of common trust and security were the main bug for developing mentorship capacity [42].
c. Collaborative testing: Quizzing has get a popular method of assessing learning and retention of knowledge besides every bit a mean of engaging students. In collaborative testing, students work together in small groups to complete quizzes before they select their final respond. Therefore, an of import aspect of collaborative testing is the peer interaction, educational activity, and collaboration during discussing each question. In nursing, Burgess and Medina-Smuck [43] used a collaborative testing approach using quizzes during maternal-infant course in the undergraduate nursing program. During this course, 4 multiple-choice quizzes were electronically administered. The outcomes were perception and attitude of students regarding collaborative testing strategy. Seventy-viii percentage of students described this method as helpful and enjoyable in supporting their learning of the class textile. Authors concluded that this strategy provided a structured method to enhance students learning and retention of form contents [43]. At nowadays, no experimental research has evaluated the effectiveness of this technology in terms of SE.
d. Faculty-student interaction: D'Souza et al. [44] highlighted and summarized the important roles of nursing educators to promote nursing students' engagement in the clinical surround. The suggested that to increment students' academic date, nursing educators should: (i) involve students in teaching strategies, (ii) rest educatee's clinical activities with clinical assignments, (three) provide broad range of clinical activities, (iv) capeesh the private departure, (5) provide them with multidimensional resources, (6) group students for reflective activities, (7) create an atmosphere to enable students to learn, and (8) continuously supervise their activities. Authors found that when students and kinesthesia actively share learning opportunities with each other, students are motivated to be more engaged in the new clinical learning environment.
e. Crossword puzzles solving: Raines [45] incorporated 2 models of crossword puzzles, equally a cooperative learning action, into nursing courses to promote students' engagement and their critical thinking. Students worked in two phases of individually and in a small group. In the beginning model, which was designed for simple courses, students should solve the clues and in the 2nd one, they should construct the content for the crossword puzzle (advanced courses). This process forces the students to actively engage and share their thinking and reasoning process with each other. The writer found that these methods can actively engage students, promote their decision-making procedure, and assistance them to solve the issues [45].
ii) Service-based strategies
Service-based learning involves learning that takes place outside the classroom in a structured style between the learner and a service, and seeks to attain common goals. It is a kind of partnership that bridges academic and customs needs. This blazon of learning is mostly done in the community, just information technology tin also be used in clinical settings [46]. Information technology is believed that service-based learning is one of the well-nigh effective strategies for students' engagement considering it has the potential to positively engage learners into the existent-life situations and encourage the learner to be an agile learner [46,47]. In this regard, Hart [46] provided a three-step framework, called "ABCs of service-learning," that indicated the process of establishing and evaluating a service–learning project. The primary components of this project are taken from the nursing process. In this project, A stands for "cess and evaluation of customs and educational needs," B stands for "be flexible and engaging," and C stands for "collaboration and celebration." The authors claimed that service-learning projection has the distinctive potential for engaging students because it can capture the learners' attention, develop their partnerships and collaboration [46].
3) Peer-based strategies
Peer cess (PA) refers to a process whereby students evaluate the learning or job performance of their peers and conversely, their learning are evaluated by their peers [48]. Although a few studies have focused on PA as a strategy for enhancing students' date in academic learning, some nursing authors agree that PA can actively engage nursing students in their learning activities by enhancing the conviction of students in judging about their ain work/performance. In improver, PA tin can encourage them to reread their own assignment in light of their peers' feedback [49,fifty].
three. Simulation-based techniques
This category includes 2 strategies of "Simulation with Manikins and Tag" squad simulation.
1) Simulation with manikins
Manikins have been long used in nursing education since they can provide safe and repeatable weather for practicing. In this regard, Ability et al. [51] fake five separate example studies during ten education weeks. They aimed to explore student perspectives (n=9) of the use of vignettes to increment engagement with manikins. Authors through thematic analysis and group word establish that manikins are an constructive procedure for increasing SE. Authors believed that if the appropriate educational scenario is selected in this learning method, the instructors volition exist able to actively engage nursing students in the learning process and to promote their determination-making skills [51].
ii) Tag team simulation
The word "tag squad" refers to a combination of two or more than people who have formed a team to come across like goals. The tag squad is a pocket-size group, so the participation of the members in that team is maximal and active. In nursing programs, simulations are regularly led in big groups, with few students playing an active office and virtually observing. In contrast, tag team simulation (TTS) every bit an innovative educational strategy emphasizes the active engagement of both participants and observers in the simulation scenario. This method is inspired by the principles of theater and allows learners, as actors, to take responsibility for the actions and outcomes in a real context. Levett-Jones et al. [52] provided a TTS with hurting scenario for 444 2nd-yr nursing students. Satisfaction with Simulation Experience Scale was used to evaluate the agile appointment and satisfaction of observers and participants. The mean satisfaction score was not unlike between participants and observers (iv.63 versus four.56, p=0.16). This indicated that TTS is an effective approach for ensuring observers' and participants' agile involvement during group-based simulations. Authors showed that TTS could promote the active engagement of learners and enhance their satisfaction with the simulation experience [52].
four. Research-based strategies: Q methodology
Q methodology is a mixed-method approach for conducting enquiry that focuses on individuals' preferences and subjective attitudes. Participants can express and share their viewpoints within the group [53]. In nursing, Guess et al. [54] incorporated Q methodology into a nursing education course about "substance corruption in school." The basis for using this method was that if students' attitudes and preferences are recognized and fulfilled, their participation and appointment in educational activities will be enhanced. The authors aimed to promote students' date and heighten their learning of evidence-based practice. Nursing students (n=35) participated in a 2.5-hour session to create a mock Q report on their opinions about substance abuse education. The outcome was the overall opinions of students regarding the characteristic of Q methodology and the class format. At the end of the report, most students expressed favorable opinions. Authors found that Q methodology can provide a means to extract the participants' opinion around a given topic and thus provide a way to continue students as agile and engaged learners [54].
5. Miscellanea learning strategies
We found iii articles discussing uncategorized learning strategies in promoting nursing students' engagement.
i) Agile learning
Undoubtedly, active learning is i of the key strategies for enhancing students' engagement within the nursing educational programs. Active learning is a student-centered approach in which requires students to participate and cooperate in the teaching and learning process [55]. Many of the discussed educational strategies in the current review can be classified as an agile learning strategy. In full general, the available prove well-nigh the effectiveness of active learning in nursing didactics shows that this cooperative educational strategy has a potential to promote nursing students' date in the academic and clinical learning activities [9,55]. In contrast, some studies have shown that in the absenteeism of agile learning, bookish date is not created. Popkess and McDaniel [9] examined the relationship between pre-college students' inputs and academic engagement levels among baccalaureate students in nursing (n=1,000) and non-nursing professions (n=ii,000). The National Survey of Student Engagement instrument was used to measure engagement on five subscales with a full of 41 items. Their findings showed that nursing students scored significantly higher (hateful=58.71) on some aspects of academic engagement than other professions (mean=55.22 or 56.14). However, they were less engaged in active and collaborative learning than other majors [9].
two) Homework completion
Although many studies have shown that homework, as an active learning approach, can increment the academic functioning of students, this learning activities has received little attending in nursing education [56]. Salamonson et al. [56] described the relationship between bookish engagement (homework completion, lecture omnipresence) and academic functioning in nursing students (northward=126) who were enrolled in a pathophysiology subject. Students spent most six hours per calendar week studying. The mean percentages of lecture attendance and homework completion were 67.5% and 48.9%, respectively. Authors found that active learning activities such as homework completion are one of the all-time way to engage students. Besides, it is a strong positive predictor of academic performance and success for nursing students [56].
Discussion
Engaging nursing students in bookish environments and clinical settings is a challenging issue for nursing educators, worldwide. In recent years, many nurse researchers have investigated various educational strategies to explore and develop the best means to increase nursing students' academic appointment. Results of these efforts are the creation of new pedagogy strategies or modification of the techniques used by other disciplines. Accordingly, our main goal of this review study was to provide a set of useful tools for promoting nursing students' academic engagement. In this review, we summarized the didactics strategies that nursing educators used to sustain or enhance the academic and clinical engagement of nursing students and somewhen, we highlighted the gap for farther research. We organized the teaching strategies into five categories based on the similarities of concepts and instruction techniques that educators had used: the main categories were technology-based strategies, collaborative strategies, simulation based strategies, research based strategies, and miscellanea learning strategies. Many of the training strategies had been created innovatively or derived from other disciplines such as management, technology, art, and theater. Only the office of today technologies such as Internet in creating educational strategies was more than prominent than the other [57]. More often than not, in many of the strategies used, students' bookish engagement increased, just the main problem was that the tools used to measure the caste of engagement were more often than not self-reported or subjective. In other words, due to the lack of experimental educational studies in nursing regarding the SE (only 6 quasi-experimental studies), we could non judge the strengths and weaknesses of the extracted strategies. Therefore, regarding the optimal strategy to sustain and promote nursing SE, further experimental study is needed. Moreover, given that the effectiveness of these techniques has been evaluated in the small number of studies, more experimental inquiry is recommended.
Another of import point is that educational strategies were mostly used in the classroom, and few were able to be transferred to clinical settings. Therefore, because more than one-half of nursing didactics takes identify in clinical settings, the findings of these studies do not support the part of these strategies in increasing the academic date of nursing students in clinical educational activity. In contrast, previous studies have shown that nursing students have greater motivation, both internally and externally, to learn clinical activities; therefore, they are more engaged in these activities [44,58]. However, in that location are limited studies on the clinical date of nursing students and there is a need for further research in this surface area. It is necessary that nursing instructors sustain and enhance the academic and clinical engagement of nursing students using innovative educational strategies in order to increase the level of students' noesis and abilities and improve the quality of clinical services provided.
Based on the results of this review, amid the strategies discussed in this review, the use of applied science, particularly the response system and online learning, was more mutual amongst nursing educators, which is in line with today advances in smart technologies. Students of new technologies' era ('digital native' learners) are constantly engaged with the updated smart technologies [57]. In addition, online learning has witnessed a noticeable growth within healthcare education, nowadays [18,25,36,57]. Accordingly, if nursing educators want to maintain and heighten the students' academic and clinical engagement, they should equip themselves more with innovative technologically-driven learning techniques.
Active learning was the foundation of most educational strategies used to raise students' academic engagement. In this regard, several studies in different fields of study have shown that any educational activity method that tin actively engage the pupil in learning process, tin can promote academic engagement and ultimately academic achievement of students [55,59]. Among the educational strategies reviewed in this written report, strategies based on online technologies and simulation were more than attractive to students and fabricated their participation more agile in the learning process. Accordingly, as a practical point of this report, if nursing teachers desire to improve students' academic engagement, they need to use attractive teaching methods that are based on the latest technologies of today earth, such as smartphones and online discussion systems; however, at nowadays little is known about the methods of promoting academic appointment in clinical activities.
1. Limitations and strengths
Our chief limitation was that the number of experimental studies that accurately assessed the effectiveness of a detail teaching strategy on students' date was limited. Some educators evaluated an innovative method in a limited group of nursing students without using a particular enquiry programme and some others discussed the advantages and disadvantages of particular teaching strategies. These factors limited our determination nigh the effectiveness of a item technique. Notwithstanding, the collection presented in this review can be used as a starting bespeak for hereafter research that to evaluate the effectiveness of an educational intervention on the bookish engagement of nursing students. One of the strengths of our study is that we simply considered the studies that were conducted in the field of nursing.
ii. Conclusion and directions for time to come research
The master goal of this review study was to provide a set of useful tools for promoting nursing students' bookish engagement. In this review, we organized the teaching strategies into v categories based on the similarities of concepts and educational activity techniques that educators had used. The chief categories were engineering science-based strategies, collaborative strategies, simulation-based strategies, research-based strategies, and miscellanea learning strategies. Amongst these educational strategies, technologies- and simulation-based strategies were more bonny to students and made their participation more active in the learning process. At present, little is known virtually the methods of promoting academic engagement in clinical activities. Farther experimental research is needed to confirm or disprove the effectiveness of the methods discussed in this paper. We did not find a unique strategy to enhance academic date in clinical education activities. One of the possible reasons for this is that learning in clinical settings particularly requires maximum date in clinical learning activities. It is recommended that future researchers design and test unique strategies for improving bookish appointment in clinical settings.
Footnotes
Funding
This review was non funded by whatsoever companies, research grants, or funds.
Conflicts of involvement
No potential disharmonize of interest relevant to this article was reported.
Author contributions
Study conception and pattern: MGH, HKM; data assay and estimation: MGH, HKM, AH; drafting the article or revising it critically for important intellectual content revisions for important intellectual content: MGH, HKM, AH; and terminal approval of the version to exist published: MGH, HKM, AH.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272374/
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