NR-505: Advanced Research Methods: Evidence-Based Practice/ RESEARCH LITERATURE, DESIGN,, Study Guides, Projects, Research of Nursing

Download NR-505: Advanced Research Methods: Evidence-Based Practice/ RESEARCH LITERATURE, DESIGN, and more Study Guides, Projects, Research Nursing in PDF only on Docsity! NR-505: Advanced Research Methods: Evidence-Based Practice/ RESEARCH LITERATURE, DESIGN, SAMPLING AND IMPLEMENTATION Week 5: Research Literature, Design, Sampling and Implementation Terrance A. McClain Chamberlain College of Nursing NR-505: Advanced Research Methods: Evidence-Based Practice October 2018 2 Week 5: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Research Literature Support The selected nursing concern that I have chosen is the education of millennial learners in undergraduate nursing to best develop their critical thinking skills. It is well-documented that modern day students are vastly different from those of years past, having grown up with the proliferous use of technology, the Internet, and the ability to instantly access information to answer questions and solve problems (Battersby, 2017; Tai, 2014; Revell & McCurry, 2010). Battersby noted that because of the way in which millennial learners process information, they prefer the addition of certain interactive learning modules into a traditional curriculum to best effectuate their learning (Battersby, 2017, p. 122). The PICOT question associated with this proposal is as follows: In millennial nursing students (P), how does flipping the classroom (I) versus traditional teaching methods (C) affect the abilities of critical thinking (O) over the course of a nursing school semester (T)? There have been a number of studies examining the effectiveness of flipping the classroom in the overall educational experience of today’s learners. Missildine, Fountain, Summers & Gosselin (2013) studied the effects of various teaching methods in undergraduate nursing students in Adult Health Nursing classes, measured by exam scores and student satisfaction surveys. This quasi-experimental study used three different teaching methods: a traditional lecture-only approach, traditional lecture supplemented by lecture capture (lectures electronically recorded and made available to students) and a flipped classroom utilizing lecture capture as well as interactive learning opportunities presented during classroom time. 5 showed no statistically significant differences in the students’ performance on exams between the traditional classroom and the flipped classroom. It did, however, demonstrate that the flipped classroom was an effective means of learning in an undergraduate nursing program. A strength of this study was that it was a randomized experimental study that compared the effectiveness of the two pedagogies. A limitation was that it involved a small sample size and therefore has questionable generalization to a larger population (Harrington et al., 2015) In a study conducted in 2016, El-Banna, Whitlow & McNelis (2017) sought to evaluate the effectiveness of the flipped classroom in a pharmacology course offered to students in an Accelerated Bachelor of Science in Nursing (ABSN) program. This was a quantitative study utilizing the crossover repeated measure design and involved students in two pharmacology classes. Both started the course using traditional lecture methods for a period of six weeks, after which a baseline exam was given. Thereafter, while one class of students continued with traditional instruction, the other class utilized the flipped classroom approach for a period of three weeks, after which another exam (the first exam) was given. In the third section of the classes, the approaches were reversed for the two classes, and again, after a three-week period, another exam (the second exam) was given. Data collection was achieved by evaluating the scores on the three pharmacology exams, as well as through the use of questionnaires designed to measure student satisfaction based on a scale of one (never satisfied) to five (always satisfied). Finally, students were asked to voluntarily participate in focus groups after the flipped classroom experience. The results of the study indicated that both the traditional and the flipped classroom approaches prepared the students for success on the pharmacology exams. However, those students who were exposed to the flipped classroom first did perform better on the first exam as 6 opposed to those who continued with the traditional instructional approach. There was no appreciable difference in the scores on the second exam, after the approaches were switched. The student questionnaires indicated that the students were more satisfied with the traditional teaching method than the flipped classroom. The researchers concluded that the flipped classroom may be more effective in advanced classes where students possess a solid foundational knowledge coming into the course and should be utilized judiciously taking into consideration the other courses students may be taking at the same time. They also suggested that the flipped classroom approach should be introduced earlier in the classroom experience so that students were able to become accustomed to that technique and not be disrupted by alternating between different approaches. One strength of the El-Banna, Whitlow & McNelis (2017) study was that the two classes were demographically similar, and the researchers were able to limit the effects of any bias from previous learning experiences. A limitation of the study was the small sample size and the inability to control whether students shared information with each other during the course of the study. Therefore, the ability to generalize to a larger population was compromised. Additionally, as the two approaches were used while teaching different course material, some of which may have been more advanced, the comparison of the two could not be completely reliable (El-Banna, Whitlow & McNelis, 2017). Hanson (2016) conducted a two-year study of undergraduate nursing students enrolled in a pharmacology course. The aim of the study was to elicit participants’ responses to a flipped classroom approach in the pharmacology class and to evaluate the impact of the flipped classroom on their understanding of drug science and its application to clinical practice. The study was qualitative in nature, consisting of a descriptive research method that used questionnaires as the method of data collection. The study found that the students perceived that 7 the flipped classroom approach “increased their understanding of pharmacology concepts and their application to clinical practice (29%) and promoted deeper and wider thinking (14%)” (Hanson, 2016, p. 83). However, the study also indicated that a significant portion of the students voiced a preference for the traditional lecture teaching method. A strength of the study is that, despite a relatively small sample size, the analysis of the data revealed common themes that appeared throughout the data, perhaps adding to the reliability and credibility of the data. A limitation of the study was the low response rate (13%) despite the fact that the purpose of the study was explained to the students throughout the course. The author noted that this factor could potentially bias the results because those who were motivated to respond to the survey were likely also those who were motivated toward self-learning (Hanson, 2016). Greenwood and Mosca (2017) also studied the effects of flipped classroom instruction on nursing students in a quasi-experimental design study. The purpose of the study was to evaluate the relationship between a flipped classroom and exam scores in undergraduate baccalaureate nursing students in a medical-surgical class taken during the junior year. One class (spring 2013) received traditional lecture-based instruction, and two classes (fall 2013 and spring 2014) were instructed via the flipped classroom with the use of narrated PowerPoint. Data was collected by examination scores and satisfaction reports. The results of the study indicated that students in the flipped classroom courses tested significantly higher (an average of 8.04 points) than the students in the traditional classroom. However, like the results found in the Missildine, Fountain, Summers & Gosselin (2013) study, student satisfaction with the flipped classroom modality were lower than those in the traditional classroom. A strength of this study is found in the fact that all students were tested with the same examination and the instructors were all the same. A limitation was noted in that the researchers 10 students to use their knowledge in participatory activities. A strength of the study, according to the authors, was that the students were rotated through different collaborative groups throughout the study, so that they were better able to discuss concepts and work through problems as teams. A limitation noted by the authors was the need for advanced electronic technicians who could produce and monitor the flipped classroom component, as well as the large number of students in both classes (Dehghanzadeh & Jafaraghaee, 2018). Research Approach and Design The research approach of my proposed evidence-based practice project will be quantitative, and quasi-experimental in design. The quasi-experimental design is one in which the researchers cannot control for all variables and often, there is no randomization. Gliner and Morgan (2000) described the quasi-experimental research design that I would use as a pretest- posttest quasi-experimental research approach: “In these designs, for example, participants are already in intact groups, such as two different classrooms, prior to the study. Both groups are measured (pretest) prior to the introduction of the independent variable. One group receives the independent variable and the other group does not get the independent variable. At the end of the study, both groups are measured again (posttest)” (Gliner & Morgan, 2000, p. 67). I chose this research approach and design because I could certainly control for some, but not all variables that could affect the outcome of the research. Because I will be working with classrooms of individuals there will likely be no randomization in sampling, which is a feature of quasi- experimental design. According to Dutra and Reis (2016), an advantage to the quasi-experimental design is found in the ease of application, as the rigid control of all variables that is required of a true experiment is not necessary in the quasi-experimental design. Therefore, the quasi-experimental 11 design is more practical to implement. A disadvantage is that the validity of the results of the quasi-experimental design is somewhat limited, particularly because the researcher cannot control for potential bias. (Dutra & Reis, 2016, p. 2235). Sampling The target population for my proposed EBP project is millennial undergraduate nursing students. The sampling method that I would use would be probability sampling, as each student would have the same probability of being assigned to the control group (the traditional learning class) as the intervention group (the flipped classroom). (Aday & Cornelius, 2006, p. 131). The sample size would ideally be between 25 and 30 for each group. The criteria for inclusion in the study would be millennial learners (which I would identify for purposes of the study as being between the ages of 18 and 40) who were enrolled in an undergraduate nursing program, and who were scheduled to receive instruction in a Complete Adult Health course. Participants would be excluded if they had unsuccessfully taken the Complete Adult Health course in the past or if they fell outside the requisite age range. They would also be excluded if they had participated in a flipped classroom experience in the past. The type of probability sampling that I believe that I would use would be systematic sampling. An advantage of systematic probability sampling is that it is highly precise and the data collected from the sample is generally easy to analyze. A disadvantage of this type of sampling is that it may not be efficient and may introduce bias into the data. (Aday & Cornelius, 2006, p. 135). Fouka & Mantzorou (2018) noted that informed consent is essential in research in order to protect individuals’ autonomy. Of equal importance is the need to protect the confidentiality and anonymity of the participants and ensure that no harm comes to the participants. (Fouka & Mantzorou, 2018). In my proposed EBP project, the identity of the participants would be known 12 to the instructors of the traditional and the flipped classroom, but the data collection would not identify the participants. The Complete Adult Health Course is certainly a required course in an undergraduate nursing program; however, I would ensure that each student participating in the study would be fully informed about the nature of the study and asked to sign a “noncoercive disclaimer” indicating that their participation in the study was completely voluntary. I would also work with the educational institution to ensure that any individual wishing to opt out of the study would be permitted to do so without penalty and permitted to participate in the Complete Adult Health course at a later date. This project would not involve any foreseeable risk of harm to any participants, but I would insist that full disclosure as to the nature of the study be conveyed to the participants prior to obtaining their informed consent to avoid any malfeasance. (Fouka & Mantzorou, 2018). Data collection in the form of exam scores would be done in such a way that would preserve the participants’ anonymity, particularly regarding the surveys at the conclusion of the class that would measure student satisfaction with the flipped classroom experience. Analysis of the data would be accomplished by assigning each student a numerical identifier so that names and other personal information would never be disclosed. Proposed Implementation with a Change Model The PDSA Change Model is a model for learning and change management. (Donnelly & Kirk, 2015). PDSA stands for “Plan, Do, Study Act,” a four-part model for arriving at solutions to problems. The PDSA Change Model is an instructive method for developing and implementing a plan of study or other research. In fact, Coury, Schneider, Rivelli, Petrick, Seibel, D’Agostini, … and Coronado (2017) noted that “the PDSA cycle may prove useful in adapting and implementing research-based interventions, particularly where its incorporation into every-day care is a central question.” (Coury et al., 2017, p. 2). Because the transition to the 15 on solid notions of evidence based practice, I would hope to help foster an environment which supports the need for evidence based practice in nurse education as well as clinical practice. 16 References Aday, L. & Cornelius, L. (2006). Designing and Conducting Health Surveys: A Comprehensive Guide (Vol. 3rd ed.) San Francisco: Jossey-Bass. Retrieved from: https://eds-a-ebscohost- com.chamberlainuniversity.idm.oclc.org/eds/ebookviewer/ebook/bmxlYmtfXzE1ODE3 MF9fQU41?sid=13739ca2-ddcc-47d9-8a47- a0f3e0bd5784@sessionmgr4009&vid=3&format=EB&rid=21 Battersby, L. (2017). Education strategies that best engage Generation Y students. Canadian Journal of Dental Hygiene, 51(3), 118-125. Retrieved from: http://eds.b.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer? vid=2&sid=7b87e5f4-fcfa-42bd-9c1c-964354c7a418%40sessionmgr101 Betihavas, V., Bridgman, H., Kornhaber, R., & Cross, M. (2016). Review: The evidence for “flipping out”: A systemic review of the flipped classroom in nursing education. Nurse Education Today, 38 15-21. doi: 10.1016/j.nedt.2015.12.010 Bernard, J. S. (2015). The flipped classroom: Fertile ground for nursing education research. International Journal of Nursing Education Scholarship, 12(1), 33-43. doi:http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.1515/ijnes-2015-0005 Burak, K., Raman, M., Paget, M., Busche, K. Coderre, S. & McLaughlin, K. (2017). A mixed methods study on the effect of flipping the undergraduate medical classroom. Education Sciences, 7(4). 83- https://doi- org.chamberlainuniversity.idm.oclc.org/10.3390/edusi7040083 Connor, B. (2014). Differentiating research, evidence-based practice, and quality improvement. American Nurse Today. 9(6). Retrieved from: 17 https://www.americannursetoday.com/differentiating-research-evidence-based-practice- and-quality-improvement/ Coury, J., Schneider, J. Rivelli, J., Petrick, A., Seibel, E., D’Agostini, B… Coronado, G. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC Health Services Research, 17(1) p. 1-10. Retrieved from: https://eds-b-ebscohost- com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=5eadff24- 621f-4f6c-8798-67682490bc27%40pdc-v-sessmgr02 Critz, C. & Knight, D. (2013). Using the flipped classroom in graduate nursing education. Nurse Educator, 38(5), 210-213. https://doi- org.chamberlainuniversity.idm.oclc.org/10.1097/NNE.0b013e3182a0e56a Dehghanzadeh, S. & Jafaraghaee, F. (2018). Comparing the effects of traditional lecture and flipped classroom on nursing students’ critical thinking disposition: A quasi-experimental study. Nurse Education Today, 71, 151-156. https://doi- org.chamberlainuniversity.idm.oclc.org/j.nedt.2018.09.027 Donnelly, P. & Kirk, P. (2015). Use the PDSA model for effective change management. Education for Primary Care: An Official Publication of the Association of Course Organisers, National Association of GP Tutors, World Organization of Family Doctors, 26(4), 279-281. Retrieved from: https://eds-b-ebscohost- com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=8&sid=c01ba4fd- 5290-47ea-9a54-4072d6ed8988%40sessionmgr104 Dutra, H & Reis, V. (2016). Experimental and quasi-experimental study designs: definitions and challenges in nursing research. J Nurs UFPE on line., Recife, 10(6), 2230-41. DOI: