Knowledge Surveys in Nursing Education: Pre-licensure Nursing Students’ Perceptions of their Knowledge and Clinical Skill Abilities
2016-08
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Knowledge Surveys in Nursing Education: Pre-licensure Nursing Students’ Perceptions of their Knowledge and Clinical Skill Abilities
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2016-08
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Knowledge surveys (KS) have been used for educational assessment to measure cognitive knowledge; assess student confidence and perceptions of knowledge; identify content areas that need further development; and, provide students a guide for study. The purpose of this study is to discover and examine pre-licensure nursing students’ perceptions of their own knowledge (and expectations) regarding their clinical abilities and, to evaluate the effectiveness of knowledge surveys as an educational tool for increasing students’ knowledge and clinical skill(s). The conceptual framework selected for this research study is derived from Lave and Wegner’s (1991) seminal work, which contributed to the understanding of situated learning through a focus upon the act of learning and its relationship with the social and cultural contexts where such learning occurs. Using an experimental, randomized pre-test, post-test design, several instruments, including a demographic survey; pre- and post-knowledge surveys; evaluation items; and a clinical simulation performance evaluation, were developed for use with professional, pre-licensure nursing students. In this study, students received didactic learning materials and participated in a high fidelity simulation specifically focused upon End-of-Life care. Using non-parametric tests using chi square (with Phi or Cramer’s V) as well as the t-test for paired samples, I evaluated whether or not the use of a KS increased knowledge and clinical skill/ability. The participants demonstrated a perception of improvement in their knowledge and clinical skill/abilities; they overwhelmingly overestimated their knowledge; they over/under estimated their abilities to perform clinical skills; and their perceptions did not reflect actual ability to safely demonstrate clinical skills/abilities. These findings may be consistent with the Dunning-Kruger effect. This effect is found when low performing students over-estimate their ability and high performing students’ under-estimate or have an accurate perception of their ability. I also used non-parametric tests, including chi square test (with the McNemar test and Phi correlational coefficient) to evaluate whether there was a relationship between student perceptions and their cognitive knowledge and clinical skills/abilities. It was difficult to illustrate that student’s perceptions of their knowledge and clinical skill/ability are strongly or directly related to their actual ability and, student’s perceptions of their knowledge and clinical skill/ability ae more strongly and positively related to their actual clinical ability during a simulation. There are several strengths and limitations of this study. The strengths include: there are no published studies in nursing regarding the use of KS; the literature does not reveal any discipline that has assessed behavioral components in a KS and this study introduces a behavioral component; this study examined only one module in a semester-long course, there is the potential to expand these surveys into an entire semester of a nursing course; and, the incorporation of the QSEN competencies illustrates how profession-specific competencies can be incorporated into a KS. The limitations include: the fact that this is a pilot study; there is a small sample size; the use of on-line surveys may limit student accuracy; the lack of debriefing items in the surveys; the lack of diversity of participants, the use of non-parametric statistics; and the difficulty of ensuring that participants did not talk with one another and influence the findings of the study. There are a number of directions for future research and nursing education practice. The directions for research include: planning ahead when creating KS in order to evaluate validity/reliability of items; plan to control bias by using participants not known to the researcher; exposing students to KS prior to conducting a research study; providing a thorough description of KS with students prior to recruitment; administering the KS in class rather than on-line; consider offering extra credit for students to participate in KS research; collect data from KS administered over several semesters; differentiate the skill level of participants. There are several ways in which the use of KS can impact nursing education practice. For instance, it may be helpful to explain to students the goal of KS and how the use of such surveys can improve metacognition. In addition, educators should be mindful of the possibility of the Dunning-Kruger effect; closely monitor student activities in the clinical setting; provide timely and accurate feedback to improve metacognition; recognize students may not accurately self and/or peer evaluations for simulations; and finally encourage the practice of reflective judgement.
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University of Minnesota D.Ed. dissertation. September 2016. Major: Organizational Leadership, Policy, and Development. Advisors: Rosemarie Park, Catherine Twohig. 1 computer file (PDF); xii, 217 pages.
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Goering, Mary. (2016). Knowledge Surveys in Nursing Education: Pre-licensure Nursing Students’ Perceptions of their Knowledge and Clinical Skill Abilities. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/201044.
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