The study investigates how well nursing students retain challenging new vocabulary presented in either audio-only or printed formats, assessing the modality effect and its relation to learning style preferences. Results indicated that students who received print instruction recalled significantly more words than those who experienced audio-only instruction, while no significant relationship was found between learning styles and vocabulary recall. The study suggests improvements in design for future research to better compare the efficacy of audio and print modalities.

1. LEARNING A TECHNICAL
LANGUAGE:
The modality effect in
nursing students’ retention
of new vocabulary
Presented by Patience Wieland

2. Purpose of this study
2
 How well will nursing students remember a
challenging new vocabulary, offered in either
an audio only or printed format?
 Will there be a significant difference in
vocabulary recall, based on modality, and
based on learning styles preferences?

3. What is technical language?
3
 Four types of vocabulary have been defined
(Nation, 2001):
high frequency –
 Common use words, as seen on the Fry Word list – “the,
you, and, food, paper, river, mountain”, etc.
low frequency –
 Archaic words – “contumelious”, “sanguinolent”, etc.
Academic
 Words commonly learned & used in higher ed, eg
“dichotomy”, “utopian,” “proletarian”, etc.
technical
 Highly field-specific – nursing terms include “proxemics”,
“trochanter roll”, etc.

4. Which technical language?
4
 Health science students and practitioners must
constantly learn new words
 Pharmacology: an especially challenging
‘language’ (Manias & Bullock, 2001; Meade,
Bowskill & Lymn, 2009, 2011)

5. What is modality?
5
 Cambridge dictionary of psychology (2009)
defines modality as “a channel of sensory
perception, such as vision or hearing”.
 In this study, modality relates to the format used
to communicate new information or instruction
 Audio-only
 Written text

6. What are learning styles
preferences?6
 Which format, or channel, learners prefer to use
to communicate or learn new information
(Fleming & Mills, 1992)
 VARK questionnaire developed by Fleming and
Mills
 Visual (visual graphics)
 Aural / Audio
 Read-Write (visual text)
 Kinesthetic (hands-on)

7. What modality effect?
7
 “Modality effect”
Refers to how well test subjects do on memory tasks,
after learning new information
1960s-80s – cognitive theory that audio-only modality
is superior to text-only modality
(Drewnowski & Murdock, 1980; Healy & McNamara, 1996; Murdock,
1966, 1967, 1968; Penney, 1975)
More recently – newer theory that multimedia modality
is superior to audio-only or text-only modality
(Crooks, Cheon, Inan, Ari, & Flores, 2012; Mayer & Sims, 1994; Moreno
& Mayer, 1999; Mousavi, Low, & Sweller, 1995; Thompson & Paivio,
1994)
 Countered by communications research showing varied
results (Byrne & Curtis, 2000; Chaiken & Eagly, 1976, 1983; Corston &
Colman, 1997; Green, 1981; Potter & Choi, 2006)

8. A modality effect on vocabulary?
8
 Type of vocabulary influences learning (Vidal,
2003, 2011)
Technical vocabulary is easier to learn while
listening
Academic vocabulary is easier to learn while
reading

9. Nursing students’ challenges
9
 Lack of a biological science background
among first-year students
(McKee, 2002; Glackin & Glackin, 1998; Lymn, Bath-Hextall, & Wharrad,
2008)
 More likely to be non-traditional students
(Blake, 2010; El Ansari, 2002; Kevern, Ricketts & Webb, 2001; Ofori, 2000)
Older at program entry
Prior work histories and family obligations

10. Nursing students’ challenges
10
 More likely to be L2 (second language)
learners (Kazlauskas & Robinson, 2012)
 Frequent users of podcasts & reusable
learning objects
(Blake, 2010; Kardong-Edgren & Emerson, 2010; McKinney & Page, 2009;
Meade, Bowskill, & Lymn, 2009; Meade, Bowskill, & Lymn, 2011;
Shantikumar, 2009; Stiffler, Stoten, & Cullen, 2011)
 More likely to use podcasts than medical
students, but less confident in their technical
knowledge (Blake, 2010)

11. Study participants
11
 A purposeful sample of first year vocational nursing
students
Graduates become “LVNs” (licensed vocational nurses)
Shorter pace of program
First year students are less likely to be exposed to
technical vocabulary
Few have prior post-secondary training, such as BS
degrees or allied health certification.
 Attending an urban community college campus
Cohort is ethnically diverse; spans ages 19-51 – 43% are
aged 24 to 34.
88% were female
47% are L2 (second language) learners
 N=51

12. Study
12
 Students first took the VARK questionnaire to
gauge their learning style preferences.
 Vocabulary study tested recall of thirty new
vocabulary words
 Half were drug terms
 Half were psychiatric nursing terms
 Students were given a written pre-test to check
prior knowledge

13. Study
13
 Subjects were then separated into two groups,
then given vocabulary instruction
One group read 30 written text definitions on a
screen
One group heard 30 verbal text definitions played
Each word was repeated a total of four times;
each full definition was repeated twice.
The amount of time to read or hear the words was
approximately the same: 15 minutes
 Students were then given a written post-test to
check recall of these new words

14. Analysis
14
 An independent t-test was used to analyze
students’ pre-test baseline data and post-test
vocabulary recall
 Students’ answers on the VARK questionnaire
were collapsed into four scores: each student
had a separate Visual, Audio, Read-Write and
Kinesthetic score, from 0-16.

15. Results
15
 R1 - Is there a mean difference in the short-
term recall of vocabulary words based on
audio-only or print modalities?
 Yes - There was a statistically significant
difference in vocabulary recall between the two
groups
Participants who received print instruction
recalled more words than those who received
audio-only instruction.

16. Results
16
 R2 - Is there a relationship between learning
styles preferences, and short term recall of
these vocabulary words?
 No - There was not a significant relationship
found.
Correlation coefficients showed a weak negative
correlation between post-test scores and the
number of Visual, Audio, or Read-Write
preference questions answered
There was a weak positive correlation between
post-test scores and the number of Kinesthetic
preference questions answered

17. Additional results
17
 Were there any demographic factors that
influenced post-test scores?
There was no statistically significant mean
difference between test subjects based on
gender, race/ethnicity, prior certification (CNA,
CMA), prior undergraduate education, or GPA at
program entry
There was a statistically significant mean
difference between test subjects, based on age.
 Four birth year groups – 1964-1969; 1970-1979; 1980-
1989; 1990-1994
 The older students performed better on vocabulary
recall.

18. Future research
18
 Improving study design
 Existing design favored reading students – all
students read the pre-test, read or heard the
definitions, then read the post-test
 This meant readers had three exposures to sample
words, while the audio group got only one set of
exposures in audio-only format.
 An improved design allowing for audio only
vocabulary instruction, and an audio-formatted pre
and post-test, would more clearly compare scores,
based on modality (audio vs. print).