The Impact of Blended Teaching on Knowledge, Satisfaction, and Self-Directed Learning in Nursing Undergraduates: A Randomized, Controlled Trial

Article excerpt


AIM This study aimed to assess the effectiveness of a blended-teaching intervention using Internet-based tutorials coupled with traditional lectures in an introduction to research undergraduate nursing course. Effects of the intervention were compared with conventional, face-to-face classroom teaching on three outcomes: knowledge, satisfaction, and self-learning readiness.

METHOD A two-group, randomized, controlled design was used, involving 112 participants. Descriptive statistics and analysis of covariance (ANCOVA) were performed.

RESULTS The teaching method was found to have no direct impact on knowledge acquisition, satisfaction, and self- learning readiness. However, motivation and teaching method had an interaction effect on knowledge acquisition by students. Among less motivated students, those in the intervention group performed better than those who received traditional training.

CONCLUSION These findings suggest that this blended-teaching method could better suit some students, depending on their degree of motivation and level of self-directed learning readiness.


Computer-Based Learning--Nursing Education--Randomized Controlled Design --Self-Directed Learning Readiness-- Satisfaction


Recent work in the educational sciences and advances in information and communications technology (ICT) have contributed to the transformation of learning environments. Although computer-based learning in nursing dates back to the 1960s (Lewis, Davies, Jenkins, & Tait, 2001), the advent of the Internet in the 1990s led to a greater use of online education for health professionals (Cook et al., 2008). The potential of the Internet as an instructional tool for the health professions was rapidly recognized (Curran, Lockyer, Sargeant, & Fleet, 2006; Friedman, 1996; Lam-Antoniades, Ratnapalan, & Tait, 2009; Wutoh, Boren, & Balas, 2004).

E-learning has many advantages, including increased accessibility to educational materials (at a time and place chosen by learners), personalized instruction (to tailor education to individual learners' needs), and standardization of content (Cook et al., 2008; Ruiz, Mintzer, & Leipzig, 2006). This study aimed to assess the effectiveness of a blended learning strategy in an introductory research course for nursing undergraduates. We sought to compare the effects of an intervention combining self-directed, Internet-based learning and conventional, face-to-face classroom teaching on three outcomes: students' knowledge, satisfaction, and self-directed learning.


As Internet-based learning (IBL) became increasingly popular in nursing education, concerns about its effectiveness stimulated a growing body of research. Thus, a number of nursing studies have compared the effects of computer-based learning and conventional teaching methods on knowledge acquisition (Lewis et al., 2001). A comprehensive review by Cook et al. (2008) summarized the evidence on the effectiveness of IBL in the health professions. In two systematic reviews (which included 201 studies), Cook and colleagues compared the effects of IBL to no intervention and to non-Internet interventions and found positive effects associated with IBL when compared with no intervention. Compared with non-Internet learning methods, effects were inconsistent across the studies and generally small, a finding that may be due to different learning contexts and objectives or to different methods of implementing an Internet-based course.

In a recent systematic review, Cook, Garside, Levinson, Dupras, and Montori (2010) portrayed instructional approaches used in IBL and found a wide range of approaches. The configuration of courses (e.g., tutorial, asynchronous discussion, live conferencing) and the instructional methods (e.g., practice exercises, cognitive interactivity) encompassed by this term varied considerably. …


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