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 of Medical Nursing and the development of critical thinking among undergraduate nursing students.
Methods: A cluster randomized controlled study design was used, with assessments immediately before and one school year after the intervention. There were two classes for second-year undergraduate nursing students enrolled in the study. The two classes of Medical Nursing were randomly allocated to either the experimental class, which undertook blended case-centered learning, or the control class, which undertook offline case-centered learning. The primary outcomes were academic performance consisting of final exam and process assessment, as well as the critical thinking ability assessed with the Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV). The Mann-Whitney U test and the unpaired t test was subsequently used. ANCOVA analyses were also performed to examine the two teaching methods’ effect on critical thinking.
Results: The median score in the Medical Nursing course was slightly higher in the experimental class than in the control class after 1 academic year, although was no significant difference in statistics. In addition, compared with the control class, the pre-post difference in competency in critical thinking self-confidence in the experimental class was significantly greater. In the experimental class, there was significant improvement compared with baseline in dimension of critical thinking self-confidence (p<0.05). In the control class, there was significant improvement compared with baseline in the total score (p<0.05) and two of the seven dimensions: truth-seeking (p<0.05) and systematicity (p<0.05).
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 could be applied to other nursing subjects in future studies. Moreover, further efforts to improve teaching are warranted.Keywords: education, nursing, teaching methods, critical thinking