The Effectiveness Of Self-Directed Learning On The Professional Development Of Pre-Registration Nursing Students: A Systematic Review Of The Literature

Abstract

Background: The nature of the nursing profession requires professionals who are confident, responsible, motivated and able to work and respond independently in a changing health care environment (Garrison 1992) 5. Hence, the trend in nursing education has moved towards an adult approach to teaching in which students must be self-directed to be able to meet the new challenges. Self directed learning (SDL) approach is one of the programmes which has been established based on adult teaching approach. SDL does not only provide a means for effective learning of knowledge and skills but also serves as a vehicle for enabling nursing students to acquire and develop independent learning skills; as well as develop a sense of accountability and responsibility that equips them with the essential attributes they require for their future nursing career.Aim: The overall aim of this review is to evaluate the effectiveness of self directed learning on the professional development of pre-registration nursing students.Methodology: Systematic review of the literature was conducted. A search for published and unpublished studies between 1985 and 2009 was done using all major electronic databases. A four step search strategy was devised which consisted of using different terminology and keywords to ensure that all material relevant to the review was captured. The review included randomised controlled trial and quasi-experimental studies that compared between SDL and the traditional method of teaching published between 1985 and 2009. The year 1985 was deemed appropriate because SDL has been utilised in nursing education in early 1980(s) and 1990(s) in some countries. The review included studies that addressed pre-registration nursing students. The review focused on studies that addressed SDL approach as an intervention and compared it to traditional method of teaching. Nevertheless, some Canadian studies addressed traditional method of teaching as an intervention and compared it to SDL as the predominant approach in Canada is SDL and students’ were dissatisfied with this approach. Therefore, these studies were also considered as it is still compare between SDL and traditional method of teaching. A variety of outcomes measures was used to evaluate the effectiveness of SDL. These include, improvement in knowledge, psychomotor skills acquisition, students’ satisfaction with SDL and problem solving skills. A total of eight papers were considered applicable to the review based on the information provided in the title and the abstract. These studies then processed to the critical appraisal process. Two independent reviewers assessed the methodological quality of the retrieved papers using Joanna Briggs Institute (JBI) checklist for experimental studies and agreed for the papers for inclusion. After critical appraisal, a total of seven papers were included in this review of which six are RCTs and one is quasi-experimental design. Data were extracted using a modified data extraction instrument of JBI. The data extracted were crosschecked by another examiner. The heterogeneous nature of the included studies prevented meta-analysis; therefore, the results of these studies presented in a narrative summary. The studies’ results were grouped by themes that were pulled out from the outcomes of those studies. Results: Most of the studies reached to a conclusion that SDL is an effective approach for learning but not more than the traditional method of teaching. SDL found to facilitate the acquisition of skills, knowledge and problem solving skills effectively. Also, it is a satisfying approach and meets students’ needs. Recommendation: The nature of nursing profession indicates that, nursing is beyond the level of knowledge and skills acquisition. It requires a mixture of different capabilities which include the confidence, responsibility, decision making and life long learning so it is not just limited to skills and knowledge. Therefore, since nursing programs must be congruent with today’s world changes and meet the demands of adult learners, nursing schools which still incorporate traditional method of teaching, should think of introducing SDL programs for long term outcomes.