“The Impact of Applying Unfolding Case-Study Learning on Critical Care Nursing Students` Knowledge, Critical Thinking and Self-Efficacy; A Quasi-Experimental Study” رسالة دكتوراة

Abstract

BACKGROUND: The growing awareness of utilizing modernized learning strategies in nursing education is emphasized. The unfolding case studies learning approach has a concrete contribution to nursing education. The unfolding case studies can enhance students' acquisition of diverse learning experiences through interactive case scenario discussions. There is a lack of existing research that examined the effects of unfolding case studies on knowledge acquisition, critical thinking, and self-efficacy among undergraduate nursing students. AIM: To examine the impact of applying unfolding case-study learning on critical care nursing students` knowledge, critical thinking, and self-efficacy in comparison to conventional teaching methods. METHODS: This posttest-only, quasi-experimental study was conducted at the Arab American University in Jenin, Palestine in the period between February and June 2023. Undergraduate nursing students enrolled in the critical care nursing course were recruited using a single-stage cluster sampling. Students assigned to the intervention group (n= 91) underwent unfolding case-based learning, whereas those in the conventional group (n= 78) were subjected to conventional teaching methods. Unfolding case study learning methods were implemented through interactive group discussions of unfolding case scenarios that were moderated and guided by teachers to ensure exhaustive coverage of the course materials. Study outcomes included the posttests evaluation of students' knowledge, critical thinking, and self-efficacy using validated vi instruments. The collected data were analyzed statistically using SPSS software version 27. The Social Constructivist Theoretical Framework which emphasizes social interaction and collaboration in the learning process was integrated into the study. RESULTS: Participating students were distributed roughly equal across genders, their mean age was 22.3 years, and the mean of their GPA was 2.76. After implementing the study intervention, students in the experimental group showed higher scores in knowledge compared to the conventional group (7.12 vs. 5.49 respectively, t = -12.7, df = 167, p < .001, 95% CI [-1.89 to -1.38]). Similarly, these score differences were also found when assessing students’ critical thinking (4.32 vs. 3.63 respectively, t = -17.390, df = 167, p < .001, 95% CI [-0.77 to -0.61]), and self-efficacy (6.12 vs. 4.4 respectively, t = -30.897, df = 167, p < .001, 95% CI [-1.82 to -1.60]). The correlation coefficient indicated a strong positive correlation between critical thinking and self-efficacy in the experimental groups (r = 0.69, p < 0.001). CONCLUSIONS: The unfolding case-based learning approach was found to be an effective method that enhanced critical care nursing students` knowledge acquisition, critical thinking, and self-efficacy. Nursing instructors should advocate for policies that encourage the incorporation of unfolding case studies as a learning strategy in nursing curricula across various subjects and cohorts.