Effects of blended versus offline case-centered learning on academic performance and the development of critical thinking among undergraduate nursing students
Abstract Background Educational reform, especially methods of teaching, has been a focus among nursing educators. This study explored the impact of blended versus offline case-centered learning on academic performance and the development of critical thinking among undergraduate nursing students.Methods A total of 269 undergraduate nursing students in two classes were taught Medical Nursing for 1 year. The two classes were randomly allocated to the experimental group (151 students), which undertook blended learning, or the control group (118 students), which undertook offline learning. The primary outcomes were academic performance and critical thinking ability. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was used.Results At baseline, the students in the control group exhibited superior performance to that observed in the experimental group regarding all seven Professional Basic courses. There was no significant difference in academic performance in the Medical Nursing course after applying the two teaching methods; however, the median score was slightly higher in the experimental group than in the control group. In addition, there was no significant difference in the development of critical thinking ability between the blended and offline learning groups. In the experimental group, there was significant improvement compared with baseline in one of the seven CTDI-CV dimensions: critical thinking self-confidence (p<0.05). In the control group, there was significant improvement compared with baseline in the total score (p<0.05) and two of the seven dimensions: truth-seeking (p=0.001) and systematicity (p=0.010).Conclusions Our study confirms the effectiveness of blended and offline learning (both based on case-centered learning) for academic performance and components of critical thinking among undergraduate nursing students. Blended and offline case-centered learning should be applied to other nursing subjects in future studies. Moreover, further efforts to improve teaching are warranted.