Journal Club on Effectiveness of a self-directed learning program using blended coaching among nursing students in clinical practice: a quasi-experimental research design

2. JOURNAL CLUB
PRESENTATION
Ms. PREETI BAGUL
DEPARTMENT OF CHILD HEALTH
NURSING

3. Statement Of Problem
Effectiveness of a self-directed learning
program using blended coaching among
nursing students in clinical practice: a
quasi-experimental research design
3

4. • Name of the journal – BMC (Biomedical Central )Journal
• Author - Gie-Ok Noh and Dong Hee Kim Bacca- laureate
College of Nursing, Konyang University, 158 Korea.
• Category – International
• Article- Article number: 225 (2019)
• Distribution : open Access
• Publication types : Scientific Journals
• Published Online: 2019-06-24
• Published Print: 2019-12
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5. Introduction
New educational approaches may be necessary to enhance
competency in the new generation ofstudents. Self-directed
learning and blended coaching have been effective strategies to
meet this challenge.
However, there has been little research on self-directed learning
programs using blended coaching (SDL_BC) in clinical practice.
This study aimed to evaluate the effectiveness of a self-directed
learning program using blendedcoaching among nursing students
in clinical practice.
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6. OBJECTIVES
❖ To Assess the effect of Self
directed learning using offline
teaching method among nursing
students
❖ To assess the effect of self directed
learning program using blended
coaching in clinical practice among
nursing students
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7. BACKGROUND
OF
THE STUDY
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8. • Self-directed learning has become a popular concept in nursing education.
The benefits of self-directed learning include independence, professional
autonomy, and increased choice and motivation . Many faculty members
are attracted to the self-directed learning approach because it enables
nursing students to develop independent learning skills as well as
accountability, responsibility, and assertiveness, which will be important
qualities throughout their careers, allowing them to adapt to the dynamic
clinical environment .
• Currently, technology-based teaching methods have become mainstream
in nursing education . Among them, blended teaching, which combines
the strengths of online and offline instruction, is growing rapidly .
• Therefore, researcher aimed to determine the effects of SDL_BC in order
to maximize the effectiveness of the clinical practice , emphasized as self-
directed learning competency, clinical competency, and clinical practice
satisfaction.
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9. HYPOTHESIS
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Students who participated in the
SDL_BC will score higher than
those in the control group on self-
directed learning competency,
clinical competency, and clinical
practice satisfaction

10. RESEARCH METHODOLOGY

11. CORE ROLE OF
MIDWIFE
Research
Approach
Quantitative
approach
Research Variable
Age, Self evaluation
of academic
Achievements ,
satisfaction in
Nursing
Sample Size
91
( Experiment 44;
Control Group 47
Sampling
Technique
Convenience
Sampling
Research Setting
Bacca- laureate
programs at a
university located
in South Korea.
Research Design
N
on-equivalent
control group design
with pre-post non-
synchronized
intervention.
Sample
Participants with
age more than 18
years
Sample
nursing Students
From Junior college
Duration
2 weeks

12. TOOLFOR DATACOLLECTION
1 (SDL-BC)
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Garrison’s self- directed learning model which
consist of 3 Dimensions:

13. TOOLFOR DATACOLLECTION
2 ( Coaching Strategies)
Strategy model of self-regulated learning by Zimmerman &
Martinez- Pones
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14. INTERVENTION
“
”
2 weeks

15. Intervention: Self-directed Learning Program using Blended Coaching (SDL_BC)
SELF DIRECTED
LEARNIN OBJECTIVES
CLINICAL PRACTICE
PHASE
CONTROL GROUP EXPERIMENTAL STUDY
Learning activity of
Students
Teaching activity :
offline teaching
Learning activity of
Students
Teaching activity :
offline teaching
Teaching activity :
online teaching
Motivation Pre- Clinical Perform preparation and
pre-study
Check preparation and
assignment
-Motivate practice
-Preparation and pre-study
-Understanding and
setting practice goals
and strategies
-Check clinical performance
withstructured questionnaire
-Establish daily goal-
setting during practice
and preparepractice
plan
-Check practice goals,
encouraging pre-study be-fore
practice
-Check preparation and
assignment
-Identify learning needs and
motivate students with
questions and discussions
Explanation of self-directed
learning strategies
Self -
Management
Clinical -Set daily goal
-Implementation of nursing
process regarding the
assigned case in pediatric
clinic
-Performance of
fundamental nursing skills
and health assessment in
children
-Prepare daily practice
report
Teaching case/nursing
processes in pediatric clinic
-Teaching nursing skills
and health assessment in
children
Implementation of nursing
process regarding the
assigned case in pediatric
clinic
-Performance of
fundamental nursing skills
and health assessment in
children
-Set daily goal
-Prepare and post daily
practice report and
reflection report
-Self-assessment and
reflection on modifying
daily goal setting and
achieving daily goals
Conduct Q/A frequently
-Provide references
-Encourage and provide
feedback on daily practice
and reflection reports
-Check practice goal
achievement
-Discuss weaknesses and
improvement points
Teaching case/nursing
processes in pediatric clinic
-Teaching nursing skills
and health assessment in
children
Self Monitoring
and Evaluation
Post Clinical Analysis of case study
-Self-report on practice
(structured questionnaire)
-Sharing practice
impressions
Analysis of case study
-Analysis of case study
-Self-report about
practice(structured
questionnaire)
-Self-reflection on overall
clinicalpractice
-Discuss practice-related
impressions and
improvements
-Feedback about analysis
of case study
-Discussion about clinical
practice experiences
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16. • Used the 45-item Self-Directed Learning
Competency Questionnaire
• Sub Scale : Planning, implementation,
Evaluation
• Likert Scale
Self-directed
learning
competency
• Questionnaire; Self reported instrument
• Sub scale: Nursing process, nursing Skill,
degree of cooperation, personal relations/
communication, professional development
Perceived
clinical
competency
• Numeric Rating Score (NRS) : Clinical practical
satisfaction
• Whole clinical practice, homework , content and self
reflection on scale 1-10
Clinical
practice
satisfaction

17. IMPLEMENTATION
Control group that was trained
using conventional self-directed
learning program based on
offline teaching
In the experimental group that
was trained using SDL_BC
Students were unaware whether
they belonged to the control or
experimental group
Data were gathered in two
phases, approximately 2 weeks
apart.

18. DATA ANALYSIS
Statistical Package for the Social Sciences (SPSS), version 20
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The pre-intervention test of homogeneity
Independent t- test and Fisher’s exact test
Pre-intervention test of homogeneity for
self-directed learning and clinical
competency between the experimental
group and the control group
Independent t-test. ANCOVA ( Analysis of
Covariance )
The significance level is based on P < .05.

19. 19

20. Homogeneity Test of General Characteristics and Pretest Competency
Score (n = 91)
VARIABLE
Control Group
(n=44)
Experimental
Group
(n=47)
T Value P Value
Age 21.48 21.45 -0.09 0.930
Academic
Achievement
High
Middle
Low
4
33
7
6
32
9
0.06 0.797
Satisfaction in
Nursing
Very Satisfied
Satisfied
Average
Dissatisfied
4
16
15
4
6
20
14
7
2.81 0.423
Self Directed
Learning
Competency
61
63 0.56 0.575
Perceived
Clinical
Competency
56 62 1.41 0.162 20

21. 21
0
0
0
0
0
0
0
21.48
4
33
7
4
16
15
4
61
56
21.45
6
32
9
6
20
14
7
63
62
0 20 40 60 80 100 120 140
Age
Academic Achievement
Satisfaction in Nursing
Self Directed Learning Competency
Perceived Clinical Competency
Homogeneity Test of General Characteristics and Pretest
Competency Score
VARIABLE Control Group (n=44) Experimental Group (n=47)

22. INFERENCE
• No significant differences in general characteristics were
found between the control and experimental groups.
• Therefore, the two groups were considered homogenous.
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23. Differences in Self-directed Learning and Perceived Clinical Competency Scores between
Experimental and Control Groups (n = 91)
INDEPENDENT VARIABLE AND
COVARIATE
CONTROL GROUP - SD EXPERIMENTAL GROUP- SD P VALUE
Self directed learning competency
Pre test 161.14 163.09
0.249
Post test 163.34 167.94
Planning
0.632
Pre test 66.89 70.66
Post test 70.30 73.51
Implementation
Pre test 57.32 55.85
0.039
Post test 56.41 57.38
Evaluation
Pre test 36.93 36.57
0.390
Post test 36.64 37.04
Perceived Clinical Competency
Pre test 156.43 162.70
0.768
Post test 162.77 168.87

24. INFERENCE
• The differences in self-directed learning competency and
perceived clinical competency scores between the experimental
and control groups.
• There were no statistically significant differences in other
variables related to self-directed learning competency.
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25. Differences in Clinical Practice Satisfaction Scores between Experimental
and Control Groups
(n = 91)
Variable Control
SD
Experimental
SD
Independent
t-Test
P value
Whole clinical practice 7.10 8.13 3.10 0.003
Homework 7.34 7.28 −0.17 0.862
Content 6.98 8.34 3.88 < 0.001
Self-reflection 7.23 8.40 3.36 0.001

26. INFERENCE
• In the case of perceived clinicalcompetency, there were no statistically significant
differences between the two groups (t (89) = − 0.06, p = 0.956).
• Clinical practice satisfaction, there were significant differences in overall
clinical practice
(t (89) = 3.10, p = 0.003), practice content (t (89) = 3.88, p <0.001), and self-
reflection (t (89) = 3.36, p = 0.001) .
• No significant difference was found for homework.
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27. DISCUSSION
▪ Students in the experimental group showed a significantly higher improvement in
competency in theimplementation of self-directed learning (F (1,89) = 4.27, p =
0.039) and higher satisfaction with clinical practice (t (89) = 3.10, p = 0.003)
compared with those in the control group.
▪ The blended coaching provided to the experimental group in this study increased
the online interaction relative to the control group, who received offline
teaching.
▪ In fact, blended learning is less monotonous than face-to-face teaching and can
enrich learning by providing various supplementarymaterials, as shown in this
study
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28. LIMITATION
The participants were recruited from a single university
The sample size was smaller
The time between observations was 2 weeks,
Clinical competency was assessed by student themselves
only
Some variables were not measured, such as personality and
learning style, which might affect the learning outcomes.
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29. CONCLUSION
• As per the research the present SDL_BC, involving
blended learning (combining with online and
offline methods) and coaching for clinical practice,
was appropriately applied to self-directed learning
among nursing students. The SDL_BC developed
in this study was a suitable educational approach to
improve the implementation of self-directed
learning competency and clinical practice
satisfaction. This seems to be a useful method for
educators as they face the challenge of applying a
variety of learning methods to enhance the
competency of a new generation of students.
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30. RECOMENDATION
Further research is required to investigate
whether other variables are associated with
clinical competency, competency in planning
and evaluation of self-directed learning, and
their long-term effects.
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31. WEBLIOGRAPHY
https://bmcmededuc.biomedcentral.com/articles/10.1
186/s12909-019-1672-1
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