Impact of Formative Assessment on First-Year Nursing Student 'Anxiety, Performance, Self-Efficacy, and Self-Regulation in Palestine: A Mixed-Methods Study رسالة دكتوراة

Abstract

BACKGROUND: Improving education is crucial for enhancing student achievement. The Palestinian educational system faces challenges such as limited resources and political instability. The demanding nursing curriculum can lead to increased test anxiety, affecting academic performance, self-efficacy, and self-regulation. Formative assessment strategies in nursing education can help monitor student learning and provide feedback for both instructors and students, identifying strengths and weaknesses, and ensuring effective learning outcomes. While these assessments are used, understanding the impact of a combination of strategies on learning outcomes remains a challenge. There is a need for research to uncover the most effective strategies to maximize their benefits on educational outcomes. AIM: to examine the impact of formative assessment strategies on test anxiety, academic performance, self-efficacy, and self-regulation of first-year nursing students in Palestine. METHODS: A mixed-methods study with a quasi-experimental design with a pretest and posttest-non-equivalent groups at the Modern University College in Palestine during the second semester of 2022-2023. A convenience sample of undergraduate nursing students enrolled in the Anatomy II course were recruited. Students were divided into intervention and control groups; pre-and post-test evaluations assessed anxiety, performance, self-efficacy, and self-regulation. Qualitative individual interviews were conducted with seven students from the intervention group. This selection continued until data saturation was achieved with six students. Quantitative data were analyzed using t-tests and ANOVA. The qualitative data were analyzed using thematic content analysis which involved systematically identifying and coding meaningful themes, patterns, and segments within the data. VII RESULTS: Out of the 90 students who participated in the study, 46 were assigned to the intervention group and 44 to the control group. The intervention group exhibited a significant reduction in anxiety levels, with average scores decreasing from 17.2 to 10.4 (p < 0.001). Additionally, the intervention group outperformed the control group in the mean academic performance (29.7 vs. 32.0, p < 0.01). Self-efficacy and self-regulation also revealed substantial enhancements in the intervention group compared to the control group (mean self-efficacy: 32.2 vs. 39.6, p < 0.0001; mean self-regulation: 43.5 vs. 60.2, p < 0.001). The main theme that emerged from the content analysis was the strategies used in formative evaluation. These strategies included peer reviews, feedback, and open questions strategy. Academic performance is improved by addressing weaknesses, motivating, and stimulating critical thinking. Self-efficacy is improved by building confidence. Self-regulation is enhanced by goal setting, prioritizing, and time management. CONCLUSIONS: The study found that first-year nursing students who used integrative formative assessments had lower test anxiety, improved academic performance, improved self efficacy and self-regulation. This approach is very effective in cultivating competent and confident nursing students.