Evaluation of problem-based learning in an undergraduate nursing education programme

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Date
1999-05
Authors
Becker, Susanna
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Publisher
University of the Free State
Abstract
English: The aim of this study was to evaluate problem-based learning in an undergraduate nursing education programme. The School of Nursing at the University of the Orange Free State implemented problem-based learning as a teaching and learning strategy in the undergraduate programme in 1997. The 1998 course was evaluated to determine the success of this innovative method of instruction. It was done by administration of an audit to determine whether the methodology and process of PBL were followed; all the variables (internal and external) were considered during programme development, and whether requirements for outcomes as required by the South African Qualifications Authority were met. Student satisfaction was determined by means of a perception questionnaire and changes that took place in learning styles were determined by means of a learning style inventory that was developed in Lancaster. The grades students obtained in problem-based learning subjects were compared to the grades they obtained in subjects that were instructed by means of traditional lectures, as well as their grade 12 results secondary schooling. The audit revealed that this course was carefully planned and implemented to be one of exceptional quality. An action research model was used to monitor the integrated curriculum model with an emphasis on the PBL philosophy. This curriculum was found to be successful in portraying the South African health context in a lifelike and comprehensive manner, as the design was community-based. This curriculum addressed the tendency to overload and divided curricula in the disciplines, which bears little resemblance to the reality of the South African health context. A deficiency found is the lack of a formal quality assurance programme, which will enhance the maintenance of the high standard. Students in the course were under a lot of stress as they had to leave the comfort zones of traditional learning and some reacted with anger and resentment. Learning did take place in spite of all the hurdles students were confronted with. Superiority in meaning orientation, intrinsic motivation, deep approaches and comprehension learning was detected by the LAS! when results were compared to the scores of similar studies done in first-world countries (see Appendix J). Unfortunately a decrease in student-centredness took place, which could be ascribed to group sizes that were too large, fear of failure (as bursaries would be forfeited if students did not perform up to certain standards) and a heavy workload. Assessment results of PBL subjects were very positive in spite of students' indications that they found the course difficult. Assessment scores were much higher for PBL subjects than for traditional lecturing subjects, as well as Anatomy, which was instructed by means of video-assisted instruction. Nearly half the students obtained better assessment results in PBL than in their matriculation examinations. The most positive aspect of the first-year nursing course was the fact that students became self-directed learners and that a pattern of lifelong learning was created to equip them for the challenges that lie ahead in the 21st century.
Afrikaans: Die doel van hierdie studie was om probleemgebasseerde leer in 'n voorgraadse opvoedkundige verpleegprogram te evalueer. Die Skool vir Verpleegkunde aan die Universiteit van die Oranje Vrystaat het probleemgebasseerde leer in 1997 as 'n onderwys- en leerstrategie geïmplementeer in die voorgraadse basiese program. Die 1998 kursus is geëvalueer om vas te stel hoe suksesvol hierdie innoverende strategie vir onderrig was. Evaluering is gedoen deur middel van 'n oudit om te bepaal of die metodologie en proses van probleemgebasseerde leer gevolg is; of al die veranderlikes (intern en ekstern) in aanmerking geneem is tydens programontwikkeling; en om vas te stelof daar voldoen is aan die vereistes vir leeruitkomste soos vereis deur die Nasionale Kwalifikasie Owerheid. Tevredenheid van studente is bepaal deur middel van 'n persepsie vraelys wat ontwikkel is in Lancaster. Punte wat studente behaal het 10 probleemgebasseerde vakke is vergelyk met punte wat behaal is in vakke wat onderrig is deur middel van tradisionele lesings, asook vergelyk met punte wat in graad 12 (sekondêre skool) behaal is. Volgens die oudit is hierdie kursus noukeurig beplan en geïmplementeer en is bewys gelewer dat dit oor uitstaande kwaliteit beskik. 'n Model van aksienavorsing is gebruik om implementering van die geïntegreerde kurrikuleringsmodel (met klem op die probleemgebasseerde leerfilosofie) te monitor. Daar is bevind dat die kurrikulum Suid- Afrika se gesondheidskonteks lewensgetrou en omvattend weerspieëlomdat die ontwerp gemeenskapsgebaseerd was. Die probleemgebasseerde kurrikulum het die neiging vir oorlaaide en afgebakende dissiplines, wat min ooreenkomste met die werklikheid van die Suid-Afrikaanse gesondheidskonteks het, aangespreek. 'n Tekortkoming wat in hierdie studie bevind is, is die gebrek aan 'n formele kwaliteitsversekeringsprogram wat defnitief sal kan bydra om hierdie hoë standaard te handhaaf Omdat studente die gemaksone van tradisionele leer moes verlaat, was hulle onder baie druk en sommige studente het gereageer met woede en gegriefdheid. Ten spyte van al die struikelblokke waarmee studente gekonfronteer is, het leer wel plaasgevind. Die LAS! bevindings het aangedui dat hierdie groep studente se benaderings tot leer (as dit vergelyk word met soortgelyke studies wat in eerstewêreld lande gedoen is) ander studies oortref het op die volgende gebiede: betekenis-oriëntasie, intrinsieke motivering, diep benadering tot leer, en omvattende leer (Sien Aanhangsel 1). Ongelukkig was daar 'n afname in studentgesentreerde leer en dit kan toegeskryf word aan die groepgroottes wat te groot was, vrees vir mislukking (omdat beurse verbeur sou word as studente nie 'n sekere standaard sou handhaafnie), en swaar werkladings. Ten spyte daarvan dat studente aangedui het dat die kurses moeilik was, was eksamenuitslae van die probleemgebasseerde vakke baie positief. Uitslae was heelwat beter in die probleemgebasseerde vakke as in die tradisionele vakke wat d.m.v. lesings aangebied IS, en Anatomie wat deur middel van video-ondersteunende onderrig aangebied IS. Ongeveer die helfde van die studente het beter uitslae in die probleemgebaseerde vakke gehad as wat behaal is aan die einde van matriek. Die mees positiewe aspek van die eerstejaarskursus is dat studente selfgerigte leerders geword het en dat 'n patroon van lewenslange leer gevestig is wat hulle sal toerus om die uitdagings van die 21ste eeu die hoof te bied.
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Keywords
Competency-based education, Nursing -- Study and teaching -- South Africa, Dissertation (M.Soc.Sc. (Nursing))--University of the Free State, 1999
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