Finding a balance: Using a pre-post test to evaluate the effectiveness of scenario based learning using a blended approach among undergraduate nursing students

Abstract

Background: While undergraduate education aims to provide student nurses with a level of competence for independent practice, criticisms exist surrounding the ability of these programmes to adequately prepare graduates for the clinical skills required to optimise care. Adopting virtual simulations into nursing curricula may support greater clinical preparedness due to the student-driven nature of this approach. However, learning is also cited as a social experience requiring teacher-student interaction. Therefore, a challenge exists to develop teaching strategies that balance interactive learning while also ensuring students achieve relevant competencies.

Aim: Using scenario-based learning in a blended environment, this research evaluates the impact of different teaching modalities (in-person vs virtual patient case simulations) on undergraduate student nurses' perceived learning gains and self-efficacy.

Design: A pre and post-test design.

Participants: Eligible participants were Irish nursing students enrolled in a 5-credit European Credit Transfer System (ECTS) module (Autumn 2023 academic term) focusing on the care of persons with altered cardiovascular function at a large, urban university.

Methods: An online survey investigated the impact of these different teaching modalities on students' perceived learning and self-efficacy. Scales were adapted from previous research and non-parametric tests explored changes in perceptions over time. Thematic analysis of open-text responses provided greater insight into student experiences.

Results: The response rate was 57 % (n = 97) at baseline and 23 % (n = 39) at follow up. Students' perceptions of their learning gains and self-efficacy were scored positively for both in-person and virtual scenario-based teaching modalities. However, following participation with virtual simulation, meaningful, positive improvements to students' understanding, attitudes, and self-efficacy were identified. Three key themes were generated from participants' open-ended survey responses which revealed the core features of both teaching modalities and students' desire to further integrate more virtual activities into undergraduate curricula: 1) In-person accessibility and interactivity matters: 2) Virtual simulations: bringing content to life: 3) Online learning: the path forward.

Conclusion: By combining the advantages of in-person and online learning platforms, a blended approach can close the theory to practice gap and support diverse student cohorts to succeed within nursing education.

Keywords: Learning gains; Nursing students; Online learning; Patient simulation; Quantitative evaluation; Self-efficacy.