ARTICLE INFO

Article Type

Original Research

Authors

Monadi Ziyarat   H. (1)
Fakharzadeh   L. (*)
Hojjat   S.K. (1)
Khazni   S. (2)
Akbari Nasaji   N. (2)
Latifi   M.H. (3)
Jesmi   A.A. (4)
Rezaei   M. (1)






(*) Nursing Department, Medicine Faculty, Abadan University of Medical Sciences, Abadan, Iran
(1) Addiction & Behavioral Sciences Research Center, Addiction & Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnord, Iran
(1) Addiction & Behavioral Sciences Research Center, Addiction & Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnord, Iran
(1) Addiction & Behavioral Sciences Research Center, Addiction & Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnord, Iran
(2) Nursing Department, Medicine Faculty, Abadan University of Medical Sciences, Abadan, Iran
(2) Nursing Department, Medicine Faculty, Abadan University of Medical Sciences, Abadan, Iran
(3) Biostatics & Epidemiology Department, Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
(4) Nursing Department, Nursing Faculty, North Khorasan University of Medical Sciences, Bojnord, Iran

Correspondence

Address: School of Nursing, University of Abadan, Fiyeh Street, Abadan, Iran
Phone: +985832230783
Fax: +985832230783
fakharzadehl@yahoo.com

Article History

Received:  April  4, 2015
Accepted:  June 1, 2015
ePublished:  June 6, 2015

BRIEF TEXT


… [1-10] Awareness of positive subsequent of work during learning positively affects the learner’s enhancement that motivates the learner [11]. … [12-14] Oral feedback is one of the feedback methods [15]. … [16] Oral feedback is an objective description of the learner’s performance that guides her/him in future activities [17]. … [18-26]

There are many studies about clinical environments and their problems. However, there is no extensive study about teaching methods and their components, including feedbacks, in the environments [15].

The aim of this study was to determine the effects of oral feedback on the learning consequences of the nursing students in Abadan Medical School.

This is a semi-experimental intervening study with simple and available sampling method.

All the 5th semester undergraduate nursing students of Abadan Medical School (n=38), who passed their 10-day training course in the children ward of Taleghani Hospital in Abadan City (Iran) and Valiasr Hospital in Khoramshahr City (Iran) during one semester of 2013-14, were studied.

33 students being present at the school during sampling were selected based on an inclusion criteria form. The students divided into two groups including intervention group (n=19) and control group (n=14).

The inclusion criteria were a 5th semester nursing student, willingness to participate in the study, first participation in children ward training, and no history of clinical work in the children ward. Data was collected, using an information form including the characteristics of the study units, a self-administrated questionnaire in the field of cognitive learning, and a learning checklist of the clinical skills. The questions of the cognitive learning questionnaire included all the 6 sub-sets of the cognitive domain, which included 18 questions about awareness domain, 10 questions about understanding domain, 6 questions about application domain, 9 questions about analysis domain, 3 questions about composition domain, and 7 questions about evaluating and judgment domain. False and true answers received zero and 1 scores, respectively. Clinical skills checklist was skills in vital symptoms control including temperature measurement (6 activities), measurement of the respiratory rate (9 activities), measurement of pulse (6 activities), skills in medication consumption for the patient (25 activities), skills in serum therapy (10 activities), and skills in the growth and evolution monitoring (18 activities). And “No skill”, “relatively skilled”, and “fully skilled” items were received zero, 1, and 2 scores, respectively. The validities of cognitive questionnaire and skills checklist were assessed through content validity and scientific articles with comments of 8 instructors of the nursing school. The reliability of the cognitive questionnaire was computed 77% through Test-Retest method. Pearson Correlation Coefficient was used to determine the reliability of the clinical skills checklist. This coefficient was computed 88%, 72%, 96%, and 94% for vital symptoms control, skills in serum therapy, skills in medication consumption for the patient, and skills in growth and evolution monitoring, respectively. The students of two groups were training in asynchronous. The learners completed the students’ demographic and cognitive assessment questionnaires as pretest. In different groups, the instructors used oral feedback to the students’ functions at least one time in a day and at the possible shortest length. In the last day, clinical skills learning checklists were completed by the instructors for each student. In the last day, the cognitive questionnaires were completed by the students as posttest. Data was analyzed, using SPSS 17 software and Chi-square, Mann-Whitney, Independent T, and Paired T tests.

Mean ages of the intervention and control groups, without any significant difference, were 21.11±0.74years and 21.64±0.63years, respectively. 7 persons (36.8%) and 12 persons (63.2%) of intervention group were male and female, respectively. 4 persons (28.6%) and 10 persons (71.4%) of control group were male and female, respectively. Then, there was no significant difference in gender between groups. Mean GPA scores of intervention and control groups, without any significant difference, were 16.79±1.15 and 16.20±1.30, respectively. Two groups were homogenous in gender, age, and GPA. There was a significant difference between cognitive learning levels in all cognitive learning classes and total score in intervention group before and after the clinical training through oral feedback. There was a significant difference between cognitive learning levels in all cognitive learning classes and total score in control group before and after the clinical training through the usual method (Table 1). There was a significant difference between the mean differences between the scores in science, understanding, analysis, composition, and total score before and after the clinical training in the cognitive learning domain between intervention and control groups. Nevertheless, there was no significant difference between the groups in evaluation and application before and after the intervention (Table 2). There was a significant difference between the mean scores of clinical skills learning in all the related skills including vital symptoms control, medication consumption for the patient, serum therapy, and growth and evolution monitoring in intervention group compared to control group (Table 3). Two instructors participated in both training methods including oral feedback and the usual methods, and there was no significant difference between the instructors participating in each group in the scores of each learner in 4 skills.

There was a significant difference in cognitive learning levels in all classes of cognitive learning and total number in intervention group before and after the clinical training through oral feedback method. In addition, there was a significant difference between cognitive learning levels in all classes of cognitive learning domain and total score, except analysis and evaluation, in control group before and after the clinical training. In both intervention and control groups, the mean scores are significant than the scores before the training course [27], which is consistent with the present results. There is a significant difference between the mean scores in intervention group than the scores before the training, while there is no significant statistical difference in control group [28]. The results are consistent with the present results of intervention group, while they are inconsistent with the present results of control group. There was a significant difference between the groups in the mean score difference before and after the clinical training in the cognitive learning domain in science, understanding, analysis, composition, and total score. Nevertheless, there was no significant difference between the groups in evaluation and application before and after the intervention. The present results are consistent with other studies. There is a significant difference between the scores of feedback group compared to control group trained through the usual method [27]. There is no significant difference between two types of learning method, but the mean score of courses presented through feedback method is significantly higher than the mean scores of courses without any feedback for the learners [23]. The results are consistent with the present results. Educational progress in mathematics grade 3 of Guidance School is higher in the students receiving feedback than those who do not receive any feedback [29]. The effect of evolutionary evaluation and feedback on the students’ learning enhancement is positive [30]. The learners who receive feedback show far better educational performance than those who do not receive any feedback [31]. The results are consistent with the present results. In two internal medicine clinics, there is no significant difference between oral feedback group and written feedback group in the mean scores [24]. In clinical training of nursing students, there is no significant difference between oral feedback and written feedback groups [32]. There is a significant difference in mean clinical skills learning scores between feedback group and group received no feedback [28]. The results are consistent with the present results. There is an important, although insignificant, progress in the clinical performance of oral negative feedback group than oral positive feedback group. However, there is a significant difference in the clinical performance enhancement in two groups after oral feedback than before it. The results show that oral positive and negative feedbacks might act as powerful stimuli to enhance the learners’ performance [16], which is a result consistent with the present results. … [33, 34]

The training method should be used in learners’ clinical education.

No possibility for more study time and assessment of the long term effects of oral feedback were of the limitation for the present study.

Oral feedback highly increases cognitive learning and clinical skills of the learners. It should be noticed that the way to give feedback and its requirements should be enhanced to guide the learners. Therefore, it is necessary to empower the instructors in this respect.

The teachers of Ahwaz Jundishapur University and Abadan University of Medical Sciences, all the students who participated in the study, and the staff of Children Ward of Abadan Taleghani Hospital are appreciated.

Non-declared

Ethics Committee of Abadan Medical School confirmed the study.

This is derived from an MS thesis confirmed at Ahwaz Jundishapur University, No. B-9304.

TABLES and CHARTS

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