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Abstract SUMMARY The success of a learning process is strongly influenced by the learning methods applied. The use of learning methods has a goal to create and shape professional human beings. The ultimate goal of nursing education programs is to graduate a greater number of competent, accountable, and reliable professionals capable of cooperating with one another and other members of the health care team. Nursing education studies have often focused on traditional teaching methods such as classroom lecture learning. More effective student-centric learning methods are now being utilized to encourage active student participation and creative thinking. In general, education authorities believe that teachers should teach students how to learn content and increase the depth of their learning and motivate them to learn by involving them in the learning process and providing educational materials and contents. One of these methods is peer learning, in which peers learn from one another, involving active student participation. It is the acquisition of information and skills through active assistance and support among stated equals or matched peers. Having both formal and informal peer learning opportunities are beneficial to students since they are able to communicate and practice with someone who is in a similar learning position. This reduces stress and anxiety and other challenges of clinical practice are mitigated by peer support. Furthermore, it enhances the development of learning outcomes, teamwork, critical enquiry and reflection, and learning meaningfully. Also peer learning can increase confidence and ability to perform some skills, including team working skills, which prepares them even more for the transition work as qualified staff. Summary 83 Aim of the study The aim of this study to assess of Damnhour technical institute of nursing Students’ knowledge, skills and attitudes after application of peer learning strategy. A quasi-experimental design (post- test only) was used to conduct this study. Setting The study was conducted at Obstetrics and Gynecology skill lab at Damanhour Technical Institute of Nursing, which affiliated to General Organization for Teaching Hospitals and Institutes. The subjects The subjects of this study were included the last academic year nursing students (N=60), registered in the Obstetrics and Gynecology nursing department (first semester of the last year of Damanhour Technical Institute of Nursing) throughout the academic year (2022- 2023), they were divided into two groups. Control group (n=30), while, the study group (n=30). Tools: Three tools were used by the researcher in order to collect the required data from the study subject. Tool (I): Student’s Knowledge Assessment: it consist of 2 parts; Part (I): Socio- demographic data. This part included the data such as student’s age, sex, pervious academic achievement grade. Part (II): Abdominal Examination Knowledge Assessment Questionnaire. This tool was developed by the researcher after thoroughly Summary 84 review of literature (135-136) to assess nursing students’ knowledge in relation to abdominal examination during pregnancy. It consisted of 30 questions. 15 statements answered with true or false and the other 15 questions were multiple choice. Each correct answer was given one score and a zero for incorrect one with a total score of 30. Its distribution was as the follow, Excellent (≥27), Very Good (25 – <27), Good (22– <25), Satisfactory (20 – <22) and Poor (<20). Tool (II): Student’s Clinical Evaluation Checklist. This tool was developed by Obstetrics and Gynecology nursing department in Damanhoure Technical Institute of Nursing after thoroughly review of literature(135-137) .It is used to assess the nursing student’s performance toward applying steps of abdominal examination during pregnancy taught in the practical part of Obstetrics and Gynecology nursing course and applied in the laboratory setting. It contain 24 steps, each step checked as ”done” and ”not done”. The pre-procedure steps include 8 steps takes score 0.25, the procedures steps include 12 steps take score 0.5, post procedure steps include 4 steps take scores 0.25 and 1 for preparing equipment. The step which not done will be take score zero. The score of total performance will be 10.The point grade system of performance in the Damanhour Technical Institute of Nursing was applied to the total score was 10 distributed as follows: Excellent (≥9), Very Good (7 – <9) ), Good (5 – <7), Satisfactory (3– <5), and Poor (<3). Tool (III): Nursing Student’s Attitude toward Peer Learning Questionnaire. This tool was developed by the researcher based on the related literature.(138,139) This tool was used to determine students’ attitude toward peer learning strategy, peer tutors and organizational support. It consist of 31 item, which are entitled under two parts presented as follow: Summary 85 Part I: Students’ Attitude toward Peer Learning Strategy Questionnaire. This part consist of 18 statements, it included items related to effective method of teaching, ability to ask questions easily, willing to engage in educational sessions, confidentiality in learning from peers and collaboration between peers. Part II: Students’ attitude toward peer tutors and Organizational Support questionnaire. This part consist of 13 statements related to: tutor’s communication manner, the tutors’ knowledge, learning environment, The seminar rooms and equipment, time allowed for each session. The items had to be rated on three points likert scale where (1) denoting “agree” , (2) denoting “ natural” and (3) denoting “ disagree”. Reversed score was taken into consideration. The scoring system was as follows; negative attitude to peer learning score <50%. Neutral attitude to peer learning score 50% - <75 % positive attitude to peer learning score; ≥75%. Results: In the light of data analysis, the results could be summarized as follows: Concerning age, it was observed that nearly two thirds of the control group were aged 19 to less than 20 years while, a half of Study group (50.0%) were aged 19 to less than 20 years, and (50.0%) were aged 20- 21 years. Regarding academic achievement it was noticed that less than half of students in control group and one-third of study group respectively achieved excellent score. Moreover, the results indicate that there was a statistical significant difference in the level of total knowledge score related to abdominal examination during pregnancy between study and control groups after Summary 86 implementing peer and traditional learning. The peer learning group had better knowledge than the traditional group in almost items related to abdominal examination during pregnancy. As regards the mean scores of total knowledge , it was observed that there was a statistical significant differences between the mean scores of control group and the mean scores of the study group in the favor of the study group. It was observed that the mean score for control group after implementing traditional learning was (18.06 ± 4.87), while it was (21.53 ± 4.27) for study group after implementing peer learning. Also there was a statistical significant differences in the level of practice score related to abdominal examination during pregnancy between study and control groups after implementing peer and traditional learning. The majority of study group performed the items of abdominal examination more correctly than traditional group. Concerning the mean scores of total practice , it was observed that there was a statistical significant differences between the mean scores of control group and the mean scores of the study group in the favor of the study group. It was observed that the mean score for control group after implementing traditional learning was (21.83 ± 3.94). While, it was (25.70 ± 4.30) for the study group after implementing peer learning strategy. Concerning the overall and total attitude toward peer learning strategy , the results reveal that less than three quarters of study group had a positive attitude regarding the peer learning strategy and one third of study group students had a natural attitude toward peer learning strategy. Summary 87 In addition, it was noticed that there was positive correlation between student’s clinical practice, abdominal examination knowledge assessment and nursing student’s positive attitude toward peer learning. Conclusion and Recommendations from the present study, it can be concluded that: Peer learning strategy is a more effective strategy in the improvement of nursing students’ knowledge and practice than traditional learning method and it can explained by the following: -The hypotheses of the study were achieved. -There was a statistically significant difference in the level of knowledge and practice scores related to abdominal examination during pregnancy procedure between study and control group after implementing of peer learning and traditional learning. - The peer learning group had better knowledge and skills than the traditional learning group in almost all items related to abdominal examination during pregnancy. - The majority of the study group nursing students had positive attitude regarding peer learning. -Moreover, There was significant positive correlations between student’s knowledge, clinical practice regarding abdominal examination and nursing student’s attitude toward peer learning. Summary 88 Based on the findings of the present study, the following recommendations are suggested: (1) Implement of peer learning strategies in both classrooms and clinical settings to increase students’ knowledge level and clinical performance. (2) Conduct more training workshops for nurse educators to increase their competencies in applying peer learning (3) Allotted enough time allotted for all students to practice the procedure until they reaches competency level. (4) Involve ministries of education and school authorities to attend conferences, seminars and workshops to update their knowledge on current pedagogies in science classrooms. Recommendation for further studies: (1) Replication study with other groups of students in different locations and branches of nursing to further validate the results. (2) Conduct peer leaning strategy in other clinical teaching situations and using other peer learning models. (3) Comparative study to determine the effect of traditional learning versus peer learning on students’ social interactions, leadership ability and academic outcome. |