Effects of Blended Learning on Nursing Students’ Clinical Competence, Clinical Judgment, and Skill Performance Ability

April 30, 2022  |  Vol.8, No.4  |  PP. 57-67  | PDF

AUTHORS:

Hye Kyung Oh, Department of Nursing, Daegu University, South Korea

KEYWORDS:

Blended Learning, Clinical Competence, Clinical Judgment, Skill Performance Ability

Abstract

This study applied blending learning that combined online theoretical learning and offline practical education and examined its effects on the clinical competence, clinical judgment, and skill performance ability of nursing students in dealing with patients having complex nursing issues. A one-group pre- and post-test quasi-experimental research design was used. The participants comprised 87 fourth-year nursing students enrolled in a simulation practice course: 22 men and 75 women. Data were analyzed using SAS 9.2. The general characteristics, clinical competence, clinical judgment, and skill performance ability were analyzed using real numbers, percentages, mean, and standard deviation. The differences in scores for clinical competence, clinical judgment, and skill performance ability before and after the blended learning course were analyzed by conducting t-test. The integrated course was conducted for eight weeks for fourth-year nursing students, with the e-learning module delivered over five weeks and offline practical education conducted for three weeks. Clinical competence (t=4.63, p=<0.0001) appeared improvement after the blended learning course, with the difference being statistically significant. Clinical judgment and skill performance ability also improved after the blended learning course, with the differences being statistically significant (t=17.99, p=<0.0001; t=11.03, p=<0.0001). According to the results of this study, a blended learning approach that combines online and offline education is deemed an appropriate teaching-learning mode in improving the clinical competence, clinical judgment and skill performance ability of nursing students.

References:

[1] E. A. Karam, S. R. Clyner, C. Elias, C. Calahan, Together face-to-face or alone at your own pace: Comparing traditional vs. blended learning formats in couple & family relationship coursework, Journal of Instructional Psychology, (2014), Vol.41, No.1-4, pp.85-93.
Available from: https://web.s.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl =00941956&AN=102742808&h=Uy6XG64jQqc6SfIEfO9G77XHLamr%2fPE9%2fNp4%2fhUlWcULK0XJ0EMajh8fYT%2f1tw826JTM5V4cLzWNh2JWzLQcjA%3d%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d00941956%26AN%3d102742808
[2] N. S. Seo, S. J. Woo, Y. J. Ha, The effect of self-directed learning ability and motivation on learning satisfaction of nursing students in convergence blended learning environment, Journal of Digital Convergence, (2015), Vol.13, No.9, pp.11-19.
DOI: http://dx.doi.org/10.14400/JDC.2015.13.9.11
[3] K. S. Jang, S. J. Park, Effects of action learning approaches on learning outcomes in nursing management courses, Journal of Korean Academy of Nursing Administration, (2012), Vol.18, No.4, pp.442-451.
DOI: https://doi.org/10.11111/jkana.2012.18.4.442
[4] E. Doucette, D. Brandys, B. K. Canapi, A. Davis, J. Dinardo, I. Imamedjian, The intensive care unit as an untapped learning resource: A student perspective, Dynamics, (2011), Vol.22, No.1, pp.19-23.
[5] S. H. Choi, H. S. So, J. Y. Choi, S. H. Yoo, S. Y. Yun, M. H. Kim, M. O. Song, Comparison of blended practicum combined e-learning between cooperative and individual learning on learning outcomes, Journal of Korean Academic Society of Nursing Education, (2014), Vol.20, No.2, pp.341-349.
DOI: https://doi.org/10.5977/jkasne.2014.20.2.341
[6] L. L. Hsu, S. I. Hsieh, Factors associated with learning outcome of BSN in a blended learning environment, Contemporary Nurse, (2011), Vol.38, No.1-2, pp.24-34.
DOI: https://doi.org/10.5172/conu.2011.38.1-2.24
[7] S. M. Kim, The effect of blended learning approach on academic achivement and self directed learning skills of nursing undergraduate students, The Journal of Korean Contents Association, (2017), Vol.17, No.12, pp.330-338.
DOI: https://doi.org/10.5392/JKCA.2017.17.12.330
[8] M. Y. Cho, Effects of writing reflective journal on meta-cognition and problem solving ability in nursing students taking a fundamental nursing skills course applying blended learning, Journal of Korean Academy of Fundamentals of Nursing, (2016), Vol.23, No.4, pp.430-439.
DOI: https://doi.org/10.7739/jkafn.2016.23.4.430
[9] M. S. Lee, S. W. Hahn, Effect of simulation-based practice on clinical performance and problem solving process for nursing students, The Journal of Korean Academic Society of Nursing Education, (2011), Vol.17, No.2, pp.226-234.
DOI: https://doi.org/10.5977/jkasne.2011.17.2.226
[10] J. H. Park, S. K. Chung, The relationship among self-esteem, empathy, communication skill and clinical competency of nursing students, Journal of the Korea Academia-Industiral Cooperation Society, (2015), Vol.16, No.11, pp.7698-7707.
DOI: https://doi.org/10.5762/KAIS.2015.16.11.7698
[11] J. H. Lee, M. N. Choi, Evaluation of effects of a clinical reasoning course among undergraduate nursing students, Korean Journal of Adult Nursing, (2011), Vol.23, No.1, pp.1-9.
[12] J. Victor-Chmil, Critical thinking versus clinical reasoning versus clinical judgment: differential diagnosis, Nurse Educator, (2013), Vol.38, No.1, pp.34-36.
DOI: https://doi.org/10.1097/NNE.0b013e318276dfbe
[13] E. J. Kim, Nursing students' clinical judgment skills in simulation: using Tanner's clinical judgment model, Journal of Korean Academic Society of Nursing Education, (2014), Vol.20, No.2, pp.212-222.
DOI: https://doi.org/10.5977/jkasne.2014.20.2.212
[14] M. Street, P. Eustace, P. M. Livingston, M. J. Craike, B. Kent, D. Patterson, Communication at the bedside to enhance patient care: A survey of nurses' experience and perspective of handover, International Journal of Nursing Practice, (2011), Vol.17, No.2, pp.133-140.
DOI: https://doi.org/10.1111/j.1440-172X.2011.01918.x
[15] M. S. Choi, A study on the relationship between teaching effectiveness of clinical nursing education and clinical competency in nursing students, Ewha Womans University, Unpublished Master Thesis, pp.55-57, (2005)
[16] P. M. Schwirian, Evaluating the performance of nurses: a multidimensional approach, Nursing Research, (1978), Vol.27, No.6, pp.347-351.
[17] K. Lasater, Clinical judgment development: using simulation to create an assessment rubric, Journal of Nursing Education, (2007), Vol.46, No.11, pp.496-503.
DOI: https://doi.org/10.3928/01484834-20071101-04
[18] G. G. Shim, The reliability of validity of the Lasater Clinical Judgment Rubric in Korean nursing students, Kyunghee University, Unpublished Master Thesis, pp.57-62, (2012)
[19] Korean Accreditation Board of Nursing Education, A handbook of nursing education accreditation evaluation for nursing school, Korean Accreditation Board of Nursing Education, Seoul, (2014) pp.20-22, Retrieved Feb. 15, 2015, from http://www.kabone.or.kr/reference/refRoom.do
[20] M. Y. Cho, M. O. Chae, Impact of self-directed learning ability and metacognition on clinical competence among nursing students, The Journal of Korean Academic Society of Nursing Education, (2014), Vol.20, No.4, pp.513-522.
DOI: https://doi.org/ 10.5977/jkasne.2014.20.4.514
[21] O. S. Lee, M. O. Gu, The Relationship between Emotional intelligence and Communication skill, Clinical competence & Clinical practice stress in Nursing Students, Journal of the Korea Academia-Industrial Cooperation Society, (2013), Vol.14, No.6, pp.2749-2759.
DOI: https://doi.org/ 10.5762/KAIS.2013.14.6.2749
[22] E. K. Lee, J. A. Park, Ego-resilience and the clinical competence of nursing students, Journal of Korean Public Health Nursing, (2013), Vol.27, No.2, pp.293-303.
DOI: https://doi.org/10.5932/JKPHN.2013.27.2.293
[23] E. J. Lee, Y. J. Yi, Y. S. Kim, H. S.Jo, H. S. Kim, Y. M. Kim, K. H. Park, J. S. Kim, Comparison of Factors affecting Clinical Competence between Associate and Bachelor Nursing Students Completed Nursing Courses, The Journal of Korean Academic Society of Nurisng Education, (2011), Vol.17, No.2, pp.218-225.
DOI: https://doi.org/10.5977/kasne.2011.17.2.218
[24] S. H. Park, H. S. Choi, Effects of blended learning method for reinforcing self-practice on nursing students achievements and confidence: Focusing on blood transfusion therapy, Journal of Korean Society for Simulation in Nursing, (2021), Vol.9, No.2, pp.33-45.
DOI: https://doi.org/10.17333/JKSSN.2021.9.2.33
[25] Y. J. Oh, H. Y. Kang, Metacognition, learning flow and problem solving ability in nursing simulation learning, Journal of Korean Academy of Fundamentals of Nurisng, (2013), Vol.20, No.3, pp.239-247.
DOI: https://doi.org/10.7739/jkafn.2013.20.3.239
[26] M. P. Gagnon, J. Gagnon, M. Desmartis, M. Njoya, The impact of blended teaching on knowledge, satisfaction, and self-directed learning in nursing undergraduates: A randomized, controlled trial, Nursing Education Perspectives, (2013), Vol.34, No.6, pp.377-382.
DOI: https://doi.org/10.5480/10-459
[27] J. Y. Han, The effects of intrinsic motivation, and e-learning strategies on learning satisfaction of nursing students in blended e-learning environment, The Journal of Korean Academic Society of Nursing Education, (2013), Vol.19, No.1, pp.16-23.
DOI: https://doi.org/10.5977/kasne.2013.19.1.16
[28] S. D. Kim, Effects of a blended learning program on ethical values in undergraduate nursing students, Journal of Korean Academy of Nursing Administration, (2014), Vol.20, No.5, pp.567-575.
DOI: https://doi.org/10.11111/jkana.2014.20.5.567
[29] S. H. Lee, Effectiveness of web based learning program on self efficacy, knowledge, and competence in measurement of blood pressure, Journal of Korean Academy of Fundamentals of Nursing, (2012), Vol.19, No.1, pp.66-73.
DOI: https://doi.org/10.7739/jkafn.2012.19.1.66
[30] K. McCutcheon, M. Lohan, M. Traynor, D. Martin, A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education, Journal of Advanced Nurisng, (2015), Vol.71, No.2, pp.255-270.
DOI: https://doi.org/10.1111/jan.12509

Citations:

APA:
Oh, H. K. (2022). Effects of Blended Learning on Nursing Students’ Clinical Competence, Clinical Judgment, and Skill Performance Ability. Asia-pacific Journal of Convergent Research Interchange (APJCRI), ISSN: 2508-9080 (Print); 2671-5325 (Online), FuCoS, 8(4), 57-67. doi: 10.47116/apjcri.2022.04.06

MLA:
Oh, Hye Kyung, “Effects of Blended Learning on Nursing Students’ Clinical Competence, Clinical Judgment, and Skill Performance Ability.” Asia-pacific Journal of Convergent Research Interchange, ISSN: 2508-9080 (Print); 2671-5325 (Online), FuCoS, vol. 8, no. 4, 2022, pp. 57-67. APJCRI, http://fucos.or.kr/journal/APJCRI/Articles/v8n4/6.html.

IEEE:
[1] H. K. Oh, “Effects of Blended Learning on Nursing Students’ Clinical Competence, Clinical Judgment, and Skill Performance Ability.” Asia-pacific Journal of Convergent Research Interchange (APJCRI), ISSN: 2508-9080 (Print); 2671-5325 (Online), FuCoS, vol. 8, no. 4, pp. 57-67, April 2022.