الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 92 |  |  |
| | | from | 92 | | |
Abstract
Collaborative learning activities, where students work together in small groups towards a common goal assist in developing team building skills that are essential in the health-care settings. Team-Based Learning (TBL) provides an excellent example of learner-centered approach that allows students to work together to solve professionally relevant problems. Within health professional education, the TBL strategy takes the advantages of small-group learning and building on students’ combined knowledge to engage in real-life clinical problems.
Team-Based Learning (TBL) is an active learning and a small group instructional strategy that provides students with opportunities to apply conceptual knowledge through a sequence of activities that includes individual work, teamwork and immediate feedback. TBL uses grading, peer evaluation and immediate feedback to ensure individual and team accountability in order to promote learning. TBL is designed to encourage team collaboration and promote the development of individual competencies. TBL also shifts the passivity of learning to a more active and constructive process. In addition, it promotes active participation in learning which assists students in becoming self-directed learners.
Key factors for effective TBL include appropriate allocation of students to small teams, out of class preparation, pre-class assessments, well-designed team activities, the presence of a well-trained educator during class and immediate feedback. These elements motivate students to learn, promote teamwork and enhance team discussions. When TBL is conducted correctly, there is a little question that academic outcomes are equivalent or improved in comparison to either lecture-based formats or more traditional small-group learning strategies.
The aim of this study
This study aims to determine the effect of Team-Based Learning strategy on the group engagement, knowledge and clinical performance among pediatric nursing students.
Research hypotheses
1. Pediatric nursing students who are taught by Team-Based Learning strategy exhibit more group engagement than those who are not.
2. Pediatric nursing students who are taught by Team-Based Learning strategy exhibit higher scores in knowledge test about colostomy care than those who are not.
3. Pediatric nursing students who are taught by Team-Based Learning strategy exhibit higher scores in performing colostomy care procedure than those who are not.
4. Pediatric nursing students who are taught by Team-Based Learning strategy exhibit more positive feedback about it than those who are not.
Research design
A quasi-experimental research design was used in this study.
Setting
This study was conducted at the two nursing skills laboratories of Pediatric Nursing Department at the Faculty of Nursing, Alexandria University where pediatric nursing students were trained for their clinical procedures.
Subjects
The subjects of this study comprised 72 nursing students who were selected using simple random sampling to represent 200 nursing students enrolled in Pediatric Nursing Course. This course includes six credit hours; three hours for theory and three hours for clinical practice during the first semester of the academic year 2017-2018. The total number of students was assigned randomly into two equal groups ”study and control” 36 students for each.
Tools of data collection
Four tools were used for data collection in this study.
Tool I: Nursing Students’ Knowledge Test
This test was developed by the researcher after thorough review of related literature. It was used to measure the pediatric nursing students’ knowledge level about colostomy care.
Tool II: Colostomy Care Observational Checklist
This observational checklist was developed by Pediatric Nursing Department staff. It was adopted by the researcher to measure the nursing students’ skills in performing colostomy care procedure.
Tool III: Nursing Students’ group Engagement Questionnaire
This questionnaire was developed by Schreiner and Louis (2006). It was modified and translated into Arabic by the researcher to be applicable for measuring nursing students’ group engagement during team-based learning sessions.
Tool IV: Team-Based Learning Feedback Questionnaire
This questionnaire was developed by Mennenga (2010). It was modified and translated into Arabic by the researcher to be applicable for measuring pediatric nursing students’ feedback about team-based learning strategy. Attached to the previously mentioned tools a sheet contains personal and academic data about nursing students such as; age, gender and their last GPA.
Method
• Tools were tested for their content validity by five experts in the related fields and their reliability was calculated.
• A pilot study was carried out on 10 % of nursing students enrolled in Pediatric Nursing Course to test the clarity and applicability of the tools. The tools were clear and applicable. Nursing students included in the pilot study were excluded from the study subjects.
• The study was conducted through three phases; preparation, implementation and evaluation phase.
I. Preparation phase
During this phase the researcher, the content and the students were prepared.
II. Implementation Phase
For the study group
In this phase colostomy care procedure was taught to students using team-based learning strategy through two parts; theoretical and clinical parts.
A. The theoretical part:
This part was conducted at the pediatric nursing skills laboratories following the steps of team-based learning strategy as follows:
1. Readiness assurance step: in this step, students were tested about the material they had read about colostomy care at the beginning of the clinical rotation using 15 multiple-choice questions (part 1 in tool I).
2. Application step: After the completion of Readiness Assurance Tests, the teams were given two real world problems about colostomy care (part 2 in tool I). These problems are called Team Application Problems (TAP).
B. The clinical part:
The researcher demonstrated the steps of colostomy care procedure on the simulator in front of the students while discussing with them the rational and the precaution for each step. At the end of the researcher’s demonstration, each student was allowed to re-demonstrate the procedure in front of the researcher and other students in each subgroup.
For the control group
• Students were instructed applying the routine of Pediatric Nursing Department in teaching colostomy care procedure ”demonstration” without any interference from the researcher.
III. Evaluation phase
• Students’ knowledge, clinical performance and group engagement of the study and the control groups were measured twice; immediately after and after four weeks of the clinical experience using tool I, tool II and tool III.
• Study group’s feedback about team-based learning strategy was measured using tool IV.
Results
The following are the main results yielded by the present study
• Almost all students in both groups had low group engagement before applying TBL strategy. In addition, almost all students in the study group and none of them in the control group had high group engagement immediately after applying TBL strategy. Moreover, the majority of students in the study group and none of them in the control group had high group engagement after 4 weeks of applying TBL strategy.
• There was no statistically significant difference between the study and control groups in relation to their group engagement before applying TBL strategy (p=0.493). While, there were highly statistically significant differences between both groups in relation to their group engagement immediately after and after 4 weeks of applying TBL strategy (p<0.001* and <0.001* respectively).
• More than half of the students in both groups had low knowledge about colostomy care before applying TBL strategy. While, all students in the study group compared to one quarter of them in the control group had high knowledge about colostomy care immediately after applying TBL strategy. Moreover, almost all students in the study group compared to only 19.4% of them in the control group had high knowledge about colostomy care after 4 weeks of applying TBL strategy.
• There was no statistically significant difference between the study and control groups in relation to their knowledge about colostomy care before applying TBL strategy (p=0.096). While, there were highly statistically significant differences between both groups in relation to their knowledge about colostomy care immediately after and after 4 weeks of applying TBL strategy (p<0.001* and <0.001* respectively).
• Almost all students in the study group compared to only 11.1% of them in the control group had high performance of colostomy care procedure immediately after applying TBL strategy. Moreover, the majority of students in the study group compared to only 8.3% of them in the control group had high performance of colostomy care procedure after 4 weeks of applying TBL strategy.
• There were highly statistically significant differences between both groups in relation to their performance of colostomy care procedure immediately after and after 4 weeks of applying TBL strategy (p<0.001* and <0.001* respectively).
• All students in the study group had positive feedback about the use of team-based learning strategy.
• The benefits mentioned by the students after using team-based learning strategy were as follows; it helped them in remembering the content easily and improved their grades in knowledge test, developed their problem-solving, decision-making and communication skills, developed the spirit of teamwork and enhanced teacher and students’ relationship and it was an interesting teaching method and motivated them to learn.
• The majority of the students reported that there were no drawbacks from applying the TBL strategy.
Conclusion
It can be concluded from the current study that TBL is a valuable teaching strategy. It played a crucial role in enhancing pediatric nursing students’ group engagement, knowledge and clinical performance of colostomy care procedure. TBL was perceived by pediatric nursing students as an interesting teaching method and motivated them to learn. Also, it developed their problem-solving, decision-making and communication skills. In addition, it improved the spirit of teamwork and enhanced teacher and students’ relationship. Moreover, all students in the study group had positive feedback about the TBL strategy.
Recommendations
Based on the findings of the current study, the following recommendations are suggested:
Recommendations related to nursing education
• Educational workshops should be conducted to all nurse educators to raise their awareness about the TBL strategy.
• Team-Based Learning (TBL) strategy should be used in combination with traditional clinical teaching methods.
• Team-Based Learning (TBL) strategy should be used in the pediatric nursing course and all other nursing courses at the Faculty of Nursing, Alexandria University.
Recommendations for further studies
• Replicate the current study with other and larger populations of nursing students for generalization of results.
• Replicate the current study on pediatric patients in hospital settings.
• Replicate the current study on the theoretical nursing courses.
• Study the effect of TBL strategy on nursing students’ anxiety, self-confidence and self-efficacy.
• Study the effect of TBL strategy on nursing students’ self-directed learning readiness.
• Study the effect of TBL strategy on nursing students’ learning styles.