Elsevier

Nurse Education Today

Volume 61, February 2018, Pages 101-105
Nurse Education Today

Influence of undergraduate nursing student teaching methods on learning standard precautions and transmission-based precautions: Experimental research

https://doi.org/10.1016/j.nedt.2017.11.007Get rights and content

Highlights

  • Standard and transmission-based precautions prevent nosocomial infections.

  • We determine the best method to teach standard and transmission-based precautions.

  • We compare two methods: traditional teaching and using a self-instructional module.

  • Group 2 achieved significant differences (p < 0.05) in the knowledge post-test.

  • Learning should be improved through strategies that students prefer.

Abstract

Objectives

An experimental study was performed with undergraduate nursing students in order to determine, between two methodologies, which is the best for learning standard precautions and precautions based on disease transmission mechanisms.

Methods

Students in the sample are stratified by performance, with the experimental group (49 students) being exposed to self-instruction and clinical simulation on the topic of standard precautions and special precautions according to disease transmission mechanisms. Conventional classes on the same topics were provided to the control group (49 students).

Results

The experimental group showed the best performance in the multiple-choice post-test of knowledge (p = 0.002) and in the assessment of essay questions (p = 0.043), as well as in the evaluation of a simulated scenario, in relation to the control group.

Conclusions

This study demonstrates that it is possible to transfer some teaching subjects on the prevention of Healthcare Associated Infections (HAIs) to self-learning by means of virtual teaching strategies with good results. This allows greater efficiency in the allocation of teachers to clinical simulation or learning situations in the laboratory, where students can apply what they have learned in the self-instruction module.

Introduction

Healthcare Associated Infections (HAIs) are the most prevalent adverse events in the world according to the World Health Organization (WHO) (Barrios Araya et al., 2011).

Millions of dollars are spent on direct costs (Abdraboh et al., 2016) that have a great impact on public health, not counting indirect HAI costs and associated morbimortality for patients, families, and communities. For this reason, prevention is a central issue for nursing (Chalmers and Straub, 2006).

Within HAI, the key concepts in terms of prevention are the correct management of standard precautions and precautions based on disease transmission mechanisms (CDC, 2007, Tavolecci et al., 2008). Standard precautions and precautions based on disease transmission mechanisms were strategies developed by the World Health Organization in order to reduce the risk of transmission from pathogens by blood or other sources (CDC, 2004).

There is no consensus about the best way to teach these concepts to nursing students or other health care students (Lam, 2014, Barikani and Afaghi, 2012, D'Alessandro et al., 2014, Hinkin and Cutter, 2014). Nursing education has traditionally been based on behavioral models and conventional learning methodologies (Acevedo-Gamboa, 2009); nonetheless, the importance of developing critical thinking in students is also considered key, which is not achieved by this type of learning (Stanley and Dougherty, 2010).

Constructivism has been indicated as one of the learning theories that contributes to teaching through knowledge transformation, which occurs due to the learner's active thinking. Furthermore, this learning is best in circumstances that are of interest to the student, stimulating his or her autonomy (Kahn and Friedman, 1993).

Due to the relevance of HAI and its complexity, it is necessary to have a transversally instilled teaching method in nursing which stimulates reading and critical thinking (De Oliveira Giroti and Garanhani, 2016, Sax et al., 2005) and the correct application of standard precautions, especially hand hygiene and aseptic techniques (Megeus et al., 2015, Seibert et al., 2014, Van de Mortel et al., 2010).

Thus, the development of interactive support for nursing education seems to be a natural scenario (Ainsley, 2009). Moreover, it is well evaluated by students, who see it as a fast and easily accessible tool for learning (Ryan and Davies, 2016). Interactive computer modules allow the use of all available technology, including videos, to be incorporated as teaching tools (Blazeck et al., 2016, Bloomfield et al., 2010, Gerdprasert et al., 2010). Based on this background, an experimental study was conducted with nursing students to determine which method is best to teach standard precautions and precautions based on disease transmission mechanisms. The methodologies of lectures vs. computational modules and clinical simulations were analyzed.

This study contributes to nursing and its undergraduate education due to the lack of agreement about the best methodologies to teach key HAI concepts, which lead to a better understanding and subsequent management and prevention of this important adverse event.

Section snippets

Method

An experimental study was performed with second-year nursing students at San Sebastián University, Puerto Montt, Chile. Students did not receive theoretical content of standard precautions or precautions based on disease transmission mechanisms prior to the study.

As a student's prior academic performance may influence his or her acquisition of knowledge that will be evaluated later, second-year students were previously stratified according to academic performance and then randomized to be

Results

Both groups were compared statistically to verify sample normality in terms of previous academic performance. Normality was tested with the Kolmogorov-Smirnov & Lilliefors test (95% confidence level). Data presented was normal (p > 0.05); therefore, a parametric analysis was performed. A student analysis test with a reliability level of 95% (p > 0.05) was carried out for dependent samples. Results showed that the two groups were homogeneous in relation to their grades (p > 0.05) (Table 1).

Survey

Discussion

This study shows that, by comparing two teaching methodologies for standard precautions and precautions based on disease transmission mechanisms, student learning is significantly higher with the methodology that provided a self-instruction and clinical simulation module in comparison with the methodology of conventional classes and a clinical case study.

It is also important that the better evaluated methodology is preferred by students, which is consistent with other research (Desai et al.,

Conclusions

The present research establishes that teaching methods influence student learning; thus, it is also possible to improve learning through strategies that are preferred by students.

We are able to conclude that the methodology of intervention as a teaching method achieves better learning outcomes than the traditional methodology. It can then be demonstrated that for teaching standard precautions and precautions based on disease transmission mechanisms, self-learning computer programs should be

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