Impact of Metacognitive Ability on Learning Achievement and Skill Performance in Nursing Simulation Learning

Transcription

1 Vol.128 (Healthcare and Nursing 2016), pp Impact of Metacognitive Ability on Learning Achievement and Skill Performance in Nursing Simulation Learning Hye-Kyung Oh,1 1 Dept. of Nursing, Division of Health-Nursing, Daegu University 33 Seongdang-ro 50-gil, Namgu, Daegu, , Republic of Korea kyungoh@daegu.ac.kr Abstract. This was a descriptive study investigating the potential positive effect of metacognitive ability on learning achievement and skill performance. The participants average metacognitive ability score was 3.40, with 24 participants having high ability (29.6%), 25 moderate ability (30.9%), and 32 low ability (39.5%). At posttest, no significant differences in learning achievement by metacognitive ability group were observed (F = 0.96, p = ). In contrast, at posttest for skill performance, I found significant differences by metacognitive ability group (F = 3.69, p = 0.029). Post-hoc analysis demonstrated that the high metacognition group had higher skill performance scores than did the moderate group. Keywords: Metacognition, Nursing, Simulation, Skill, Learning 1 Introduction Traditional education is centered on lectures and repetitive training, which cultivates a passive learning environment and thereby fails to provide sufficient training for nursing students to be able to respond appropriately to various real-life situations. In other words, it is limited in its ability to help competent nurses achieve the skills required for actual nursing practice. To resolve these problems, the use of simulation training is increasing, as it can supplement the limitations of real practice while conveying knowledge, techniques, and appropriate attitudes to students during the course of their study [1]. Many preceding studies have confirmed that simulation learning for nursing students improves their problem-solving skills. In simulation learning, metacognition is the fundamental driving force behind the cognitive activities governing the learner s problem-solving processes [2]. 1 Dept. of Nursing, Division of Health-Nursing, Daegu University 33 Seongdang-ro 50-gil, Namgu, Daegu, , Republic of Korea kyungoh@daegu.ac.kr. ISSN: ASTL Copyright 2016 SERSC

2 Learners require self-motivation and initiative to accurately perform simulation learning, where in they must share opinions and establish new knowledge [3]. In this way, simulation learning requires metacognitive ability. Metacognitive ability can be an important precursor of problem-solving skills, as it helps individuals apprehend and control their own thought processes [4]. Thus, metacognition has a positive correlation with problem-solving skills, and therefore serves as a promotion strategy for improving critical thinking and problemsolving skills. So far, the vast majority of research on metacognition has focused on critical thinking, problem solving, self-directed learning ability, and learning flow; currently, research on how metacognition influences academic achievement and skill performance in nursing simulation learning remains inadequate. The present study aimed to clarify whether metacognitive ability, which has been demonstrated to improve the problem-solving skills of nurses in a simulated clinical situation, positively influences these nurses learning achievement and skill performance. In doing so, I intended to determine the effect of nursing simulation learning on skill performance, and thereby provide basic research data for the development of learning methods for improving metacognition in simulation learning. 2 Method 2.1 Design This was a descriptive study in which I analyzed the effect of metacognition on nurses learning achievement and skill performance in nursing simulation learning. 2.2 Participants The participants of the study were 81 nursing students in their 4th year of college in city A. The students were all enrolled in the simulation common curriculum, understood the purpose of the study, and agreed to participate. 2.3 Study Tools metacognition Metacognition is a strategy for applying appropriate knowledge in problem solving, which is achieved by recognizing (metacognitive knowledge) and controlling (metacognitive control) one s own thought processes [5]. The survey in this study utilized Yi s version [7] of Printrich et al. s Motivation Strategies for Learning 84 Copyright 2016 SERSC

3 Questionnaire (MSLQ) [6], which was modified and supplemented to ensure its adaptation to Korean culture. The questionnaire comprises a total of 31 items, including 4 rehearsal items, 6 elaboration items, 5 critical thinking items, and 12 selfregulation items. Each item was rated on a 5-point Likert scale, with total scores ranging from Higher scores indicated greater metacognitive ability. In Yi s study [7], the Cronbach s α was.74, whereas in this study, it was learning achievement Learning achievement refers to the evaluation of what and how much a learner has learned after a series of educational activities [8]. In this study, the participants learning achievement was evaluated using a written examination comprising 10 shortanswer questions. These questions assessed the knowledge regarding nursing abdominal pain and hip arthroplasty. One evaluator gave each participant a score ranging from 0 to 20 based on the evaluation criteria. The validity of the examination s contents was confirmed by a professor of adult nursing skill performance This study assessed participants blood transfusion skill under a simulated scenario using the evaluation criteria of the Core Basic Nursing Skills developed by the Korean Accreditation Board of Nursing Education [9]. There was a total of 28 performance items to be assessed for the blood transfusion skill, and each was scored from 0 to 2. The range of the total score was 0 100, with higher scores indicating higher skill performance. 2.4 Data Collection Prior to the study, the participants signed a consent form indicating their consent to participate. The form thoroughly outlined the purpose and procedure of the study, as well as its adherence to confidentiality. A research assistant distributed the questionnaire before and after the simulation practice, after giving out verbal instructions. The participants were informed in advance that their participation was voluntary and that they had the right to withdraw at any time without penalty. The study ethical considerations included obtaining participants consent and explaining their rights to anonymity and confidentiality. Data collection involved a pretest and a posttest given before and after the high-efficiency simulation learning, respectively. Data were collected from April to June Data Analysis All data were analyzed using SAS 9.2. The sample characteristics, metacognitive ability, learning achievement, and performance skill were analyzed using real Copyright 2016 SERSC 85

4 numbers, percentages, means, and standard deviations. Learning achievement and skill performance were compared among metacognitive ability groups before and after the nursing simulation learning using ANOVAs. Scheffé s method was used for post-hoc analysis. 3 Results 3.1 Participant Characteristics and Metacognitive Ability Table 1 shows participants characteristics by their metacognitive ability. The average age of the participants was Most (69.1%) responded that they were good at adapting to situations, and the majority (97.5%) took classes associated with critical thinking. The average score for participants metacognitive ability was Based on this average, participants with scores of 3.40 or above were classified as having high metacognitive ability; those with scores of had moderate metacognitive ability; and those with scores below 3.1 had low metacognitive ability. In this study, 24 participants (29.6%) had high, 25 participants (30.9%) moderate, and 32 participants (39.5%) low metacognitive ability. Table 1. Participant Characteristics by Metacognitive Ability Metacognitive ability Low (n = 32) Moderate (n = 25) High (n =24) (56.3) 15 (60.0) 15 (62.5) Age (years) 22 9 (28.1) 4 (16.0) 6 (25.0) 23 4 (12.5) 3 (12.0) 1 ( 4.2) 24 1 (3.1) 2 ( 8.0) 2 ( 8.4) 46 1 ( 4.0) Adaptation to situations Taking classes associated with critical thinking Very good 1 (3.1) 2 ( 8.0) 1 ( 4.2) Good 16 (50.0) 16 (64.0) 20 (83.3) Moderate 13 (40.6) 7 (28.0) 3 (12.5) Not 2 (6.3) Never Yes 31 (96.9) 24 (96.0) 24 (100.0) No 1 (3.1) 1 (4.0) 86 Copyright 2016 SERSC

5 3.2 Differences in Learning Achievement by Metacognitive Ability Table 2 shows the differences in learning achievement scores by participants metacognitive ability. At pretest, there were no significant differences in metacognitive ability between the groups (F = 1.56, p = ). Similarly, there were no such differences at posttest (F = 0.96, p = ). Table 2. Differences in Learning Achievement by Metacognitive Ability Metacognitive Ability Low 11.9 ± 2.5 Pretest Posttest M ± SD F p Scheffé s M ± SD F p Scheffé s 16.0 ± 3.1 Moderate 11.6 ± ± High 13.0 ± ± Differences in Skill Performance by Metacognitive Ability Table 3 shows the differences in skill performance by participants metacognitive ability. At pretest, there were no significant differences in skill performance scores according to metacognitive ability group (F = 0.08, p = 0.923). However, at posttest, the analysis of the skill performance differences by metacognitive ability group revealed significant differences (F = 3.69, p = 0.029). Post-hoc testing indicated that the high metacognitive ability group had higher skill performance scores than did the moderate group. Table 3. Differences in Skill Performance by Metacognitive Ability Metacognitive Ability Pretest Posttest M ± SD F p Scheffé s M ± SD F p Scheffé s Low 70.7 ± ± 8.7 Moderate 70.0 ± ± 7.5 High 69.6 ± ± * Moderat High > e Copyright 2016 SERSC 87

6 References 1. Lee, W.S., Cho, K.C., Yang, S.H., Roh, Y.S., Lee G.Y.: Effects of problem-based learning combined with simulation on the basic nursing competency of nursing students, Journal of Korean Academy of Fundamental Nursing, Vol.16, No.1, pp (2009) 2. Schoenfeld, A.H.: Cognitive science and mathematics education, Hillsdale, NJ: Lawrence Erlbaum, pp (1987) 3. Jeffries, P.A.: A framework for designing, implementing, and evaluation simulations used as teaching strategies in nursing, Nursing Education Perspectives, Vol.26, No.2, pp (2005) 4. Almeida, M.A.: Meta-cognitive strategies: a possibility in nursing education, Revista Brasileira de Enfermagem, Vol.55, No.4, pp (2002) 5. Flavell, J.H.: Metacognition and cognitive monitoring: A cognitive development inquiry, American Psychologist, Vol.34, pp , (1979) 6. Pintrich, P.R., Smith, D.A.F, Garcia, T, McKrachie, W.J.: A Manual for the use of the Motivated Strategies for Learning Questionnaire (MSLQ), Washington, D.C.: Office of Educational Research and Improvement (1991) 7. Yi, W.M.: Effects of Metacognition and flow level in learning through educational computer game on problem solving ability, Unpublished master s thesis, Korea National University of Education, Cheongju (2004) 8. The Korean Society of Educational Psychology: Educational psychology dictionary, Seoul: Hakgisa (2000) 9. Korean Accreditation Board of Nursing Education: A Handbook of Nursing Education Accreditation Evaluation for Nursing School, Korean Accreditation Board of Nursing Education, Seoul, (2014) 88 Copyright 2016 SERSC