Effects of Blended Learning on Nursing Students’
Learning Outcomes
Hye-Kyung Oh1
1
Dept. of Nursing, Division of Health-Nursing, Daegu University 33 Seongdang-ro 50-gil, Namgu, Daegu, 705-714, Republic of Korea
Abstract. The present study was performed to understand the effects of
curriculum alteration on learning outcomes of nursing students, through application of blended learning, in Fundamentals of Nursing classes. This was undertaken to provide basic data necessary to preparation of various applications and uses of blended learning in nursing education. Participants were 67 sophomore students in a nursing faculty. Curriculum management with application of blended learning in Fundamentals of Nursing improved learning outcomes more than that without application (F = 7.80, p = .006).
Keywords: Blended Learning, Learning Outcomes
1
Introduction
Blended learning has been vigorously introduced to workforce education, and is partially used in elementary and middle schools. It also requires active consideration as a teaching and learning strategy in university education, to enhance learners’ autonomy and to improve academic achievement. Specifically, since university classes are given on a weekly basis, classes’ impact may be maximized across a semester by an appropriate combination of online and off line classes from week to week. Blended learning’s application to university may result in the following educational effects: increased communication between professors and students, and among students, increased variety of channels of knowledge expression, improved self-regulated learning ability via self-directed online activity, and provision of the opportunity to consider the online-offline connection [1].
On provision of blended learning in classes, it was found that students actively undertook learning activities that were related to the goal of the class; that is, they engaged in self-directed learning. For example, students assisted one another in grasping educational content, and then applied, reviewed and practiced content in face-to-face class and using content provided on the internet homepage [2].
The present study therefore aimed to illuminate the effects of curriculum alteration through the application of blended learning to Fundamentals of Nursing, by examining nursing students’ learning outcomes, and in order to provide basic data requisite to preparation of measures facilitating various applications of blended learning in nursing education.
2
Study Methods
2.1 Study Design
The present study uses a non-equivalent control group pre-post test design to understand the effect of curriculum management, via application of blended learning to Fundamentals of Nursing, on nursing students’ learning outcomes.
2.2 Participants
Participants were 34 students attending A university, and 33 students attending B university. A and B universities’ curricula are similar. All participants were attending blended-learning Fundamentals of Nursing classes, understood the study’s goal, and participated voluntarily.
2.3 Data Collection
A structured questionnaire was distributed and collected before and after curriculum alteration with blended learning. Prior to the questionnaire’s distribution, participants were notified of confidentiality, voluntariness of participation, the study’s goal, and estimated time to answer. Data were collected from September 2013 to December 2013.
2.4 Study Tool
2.4.1 Learning outcome
Learning outcomes are abilities acquired through the curriculum both in and outside class [3], which are measured by the regular curriculum [4]. In the present study, the Nursing Department Learning Outcomes Committee in A university analyzed two learning outcomes related to curriculum management of Fundamentals of Nursing. Analysis was facilitated by workshops and expert counseling, which addressed the subject’s learning goals and outcomes, achievement levels, and performance criteria. These items reflected the learning outcomes of nursing programs proposed by the Korea Accreditation Board of Nursing Education.
In the present study, learning outcomes were measured via the necessity and current achievement of two learning outcomes (A and B) in the Fundamentals of Nursing class. Measurements used a five-point scale; a higher score indicated a greater necessity and a higher achievement level of the learning outcome.
Learning outcome A: Nursing skills based on broad cultural and domain knowledge that are systematically applied to working practice.
Learning outcome B: Essential nursing skills that are selected and practiced depending on the nursing situation.
2.5 Data Analysis
Collected data were analyzed using SPSS 12.0. Participant characteristics were analyzed in absolute and percentage terms. Differences in participants’ learning outcomes before and after implementation of blended learning were examined using t-tests and a one-way ANOVA.
3 Results
3.1 Participant Characteristics
Participants’ general characteristics are presented in Table 1.
Table 1. Participant characteristics
(N = 67) Experimental group (N = 34) Control group (N = 33) Frequency (individuals) Percent Frequency (individuals) Percent Age 18 years 1 2.94 0 0.00 19 years 13 38.24 14 42.42 20 years 14 41.18 15 45.45 21 years 3 8.82 1 3.03 22 years 3 8.82 2 6.06 24 years 0 0.00 1 3.03 44 years 0 0.00 0 0.00 Personality Very positive 1 2.94 2 6.06 Positive 22 64.71 17 51.52 Neutral 11 32.35 13 39.39 Negative 0 0.00 1 3.03 Very negative 0 0.00 0 0.00
3.2 Effects of Blended Learning
Differences in learning outcomes between the experimental group, which experienced blended learning, and the control group, which did not, are presented in Table 2. In order to examine changes within the experimental and control groups, a paired t-test was performed. Results showed that post-measurement values were statistically significantly greater both in the experimental group (t = -7.99, p = .000) and the control group (t = -4.65, p = .000) compared to pre-measurement values.
Regarding subordinate concepts of learning outcomes, a significant difference was found in learning outcome B’s achievement, but not its necessity, between the two groups (F = 7.80, p = .006).
Table 2. Comparison of learning outcomes
Variable Group Mean SD t(p) F(p) F(p) F(p) Pre Post Total learning outcome Experimental group 3.57 0.38 4.17 0.37 -7.99 (.000) 2.89 (.091) 63.04 (.000) 3.45 (.066) Control group 3.58 0.30 3.95 0.37 -4.65 (.000) Necessity A Experimental group 4.65 0.54 4.76 0.55 -2.33 (.026) 2.32 (.131) 0.02 (.888) 1.72 (.192) Control group 4.88 0.33 4.78 0.42 1.50 (.143) Necessity B Experimental group 2.44 0.75 3.44 0.56 -2.39 (.023) 3.82 (.053) 76.10 (.000) 0.17 (.679) Control group 2.27 0.57 3.18 0.64 1.07 (.292) Achievement A Experimental group 4.74 0.51 4.88 0.41 -6.57 (.000) 0.07 (.798) 0.03 (.855) 2.71 (.102) Control group 4.85 0.44 4.73 0.52 -5.71 (.000) Achievement B Experimental group 2.44 0.66 3.59 0.61 -7.50 (.000) 7.80 (.006) 82.70 (.000) 2.30 (.132) Control group 2.30 0.64 3.12 0.60 5.13 (.000)
3.2 Learning Outcomes Depending on General Characteristics
To examine differences in learning outcomes depending on general characteristics, t-tests and a one-way ANOVA were performed; results are presented in Table 3.
The control group showed a statistically significant difference in outcomes depending on personality (F = 3.42, p < .05).
Mean learning outcome scores in the control group, separated by general characteristics, were 15.25 for “Very positive,” 15.38 for “Positive,” 14.58 for “Neutral,” 13.00 for “Negative,” and 0.00 for “Very negative.” A post-hoc test was performed to examine significant differences between groups; significant differences were found between “Positive” compared to “Neutral” and “Negative,” respectively.
Table 3. Learning outcomes depending on general characteristics
Experimental group (N = 34) Control group (N = 33)
M SD F(t) Post-hoc M SD F(t) Post -hoc Age 1 15.71 0.75 0.76 15.18 1.05 1.05 2 15.30 1.46 14.84 0.97 3 0.00 0.00 0.00 0.00 Personality
Very Positive (a) 14.50 0.00
0.71 15.25 1.06 3.42* c,d < b Positive (b) 15.66 1.18 15.38 0.74 Neutral (c) 15.18 1.33 14.58 0.81 Negative (d) 0.00 0.00 13.00 0.00
Very negative (e) 0.00 0.00 0.00 0.00 *p < .05
References
1. Lim, J. H. Strategy for qualitative improvement of college education: Blended Learning. Proceedings of the Third International e-Learning Workshop. Korean University Alliance for Cyber Education (2004)
2. Koo, Y. M. A study on self-directed learning in blended learning in higher education - Possibilities of existential and social self-directed learning. J. of Educ. Technology. 22(1), 161--193 (2006)
3. Peon, K. H., & Song, D. J. A case study on the continuous quality improvement for leadership outcomes education in Yeungnam university. Engineering Educ. Research. 12(1), 64--72 (2009)
4. Kim, C. S. A study of strategic approaches for course and program outcomes assessment. Engineering Educ. Research. 10(2), 73--86 (2007)
5. Korean Accreditation Board of Nursing Education. A manual of Korean accreditation board of nursing education in the second half of 2014, http://kabon.or.kr.
6. Oh, H. K., Jeon, E.Y. Effects of Simulation based Training using a Post-operating Rehabilitation Case on Learning Outcomes. Korean J. Rehabil. Nurs. 17(2), 90--96 (2014)