Can Group Scenario Exercises in Fundamental Nursing Using Process Oriented Guided-Inquiry Learning (POGIL) Affect National Test Scores

Background

Measuring the effect of a Process-Oriented Guided-Inquiry Learning (POGIL) implementation in a fundamental nursing course is one way to determine its effectiveness. Utilizing the POGIL method may be beneficial in nursing courses. The purpose of the study was to measure the effects of participation in the POGIL process in Fundamental Nursing classes on the final grades and ATi grades (Assessment Technologies Institute®, LLC., national exam) of groups of students who participated in group scenario work compared to students who did not participate in group scenario work in class. A comparative quantitative design measured the relationship of grades in two fundamental nursing classes taught by the same professor.The results demonstrated a small sample of one participating class of 25 and a non-participant group of 25 subjects. Final exam data revealed no significance in grade performance between groups. Quantitative measures demonstrated effectiveness of the POGIL intervention on a national standardized exam.

Process-Oriented Guided-Inquiry Learning (POGIL) is a student-centered pedagogy that supports group activities. Students interact and are given the opportunity to construct knowledge. Learning is a shared responsibility of faculty and students. Educators developed POGIL in 1994 as a student centered general chemistry strategy. This pedagogical method encourages cooperative and collaborative classroom learning. Comparing the results of standardized exams has demonstrated improvement in grades in the POGIL classes’ verses the traditional lecture approach (Hanson & Moog, 2010). POGIL allows students to think about their learning, their performance and how to improve and develop problem-solving skills Students work in teams with group guided learning exercises to encourage active learning (Bransford, Brown, & Cocking, 2000).

The POGIL method uses activities to teach content and encourage analytical critical thinking and teamwork. POGIL activities are implemented in groups of 4 students. The instructor is a facilitator moving between the groups and listening to the student discussion and intervening when necessary with guiding questions. The roles include four different ones for each student in the group: Manager keeps everyone on task. Recorder keeps records of the names, roles and discussions of the group. Presenter or team leader presents an oral report to the class. Reflector observes and comments group behavior and dynamics in learning process (Moog, 2012).

The ability for nursing students to work effectively in a team through the POGIL process may help to prepare future nurses for a work environment that requires multidisciplinary teamwork. Health care future improvements will need to promote teamwork and excellent communication skills (Frankel, Leonard, & Denham, 2006). Safe patient care is an essential factor identified by the Joint Commission (TJC) (2014) trough teamwork in the work environment.  Providing students the opportunity to work as teams and communicate in a basic nursing course may better prepare them for transitioning to the work environment. It is imperative to continue to develop and test alternative methods in education that will lead to improved learning and will lead to improved test scores as well, there is a need to explore the POGIL approach in nursing education as a valuable tool for both. The author adopted the POGIL in a fundamental’s class and used a control group section in the same semester to evaluate the effect on course grades and a standardized test.

In nursing, due to the complex nature of its curricula, innovative pedagogy should be explored to present this complex material. Published reports on the POGIL method of delivering science courses have documented success of students. For example a study of 200 undergraduate students investigated whether POGIL use affected grades, retention, self-efficacy, attitude and learning environment in a first semester chemistry course. Grades had some positive results in the POGIL group verses the control (non-participant group). Retention rates varied, however emotional satisfaction and attitude toward chemistry was lower in the control population. Overall the POGIL approach had minimal impact on the results. No difference was revealed in self-efficacy between groups. The most positive result was the attitude toward learning environments of the POGIL students (Case, Pakhira & Stains, 2013). Undergraduate biomechanics courses traditionally were taught by lab and lecture method. Students reported that lectures were not engaging and learning was not enhanced. POGIL (N=64) and traditional instruction methods (N=52) were compared.  Quiz, tests and course grades were reported to be higher in the POGIL group (Simonson & Shadle, 2013). Many studies have documented the POGIL method in general chemistry.  One author compared the final exam scores on a national standardized exam of organic chemistry with a participant and control group to evaluate the effectiveness of POGIL pedagogy. Analysis indicated that 72% of the POGIL students scored higher than the control group (Hein, 2012). In summary, following a review of the literature POGIL has been documented as an effective approach in a variety of disciplines. Much of the research is centered on chemistry and other science courses. Studies have not included nursing courses utilizing the POGIL method. Although it is a useful strategy POGIL has not been effectively documented in  nursing courses. Therefore the aim of this study was to evaluate would POGIL group scenario exercises improve test scores in a fundamental nursing course.

Methods

The study used a comparative quantitative design. Two sections of undergraduate students in a fundamentals didactic nursing course with the same professor were given the opportunity to volunteer to participate in the research. One class participated in six group scenario exercises and the control non-participant group was given the scenarios on an individual basis. Purposive sampling of was used. Group one (experimental) was offered the opportunity to participate in POGIL exercises during class time. The professor assigned 4-5 students to each group in the participation class. After lecture the participants completed in 45 minutes intervals 6 group case scenario exercises. A team leader of each group presented the information to the class. The professor throughout the exercise encouraged critical thinking and communication skills. Roles of reflector, recorder, presenter and manager were chosen by the students and rotated each group exercise. Group two (control) of another Fundamentals class of nursing students was given the opportunity to complete the same 6 case scenario exercises individually on-line after the lecture. This group had the opportunity to individually submit the work to their professor.. The scenarios for both groups were the same non-credit assignment.

Results

Demographic variables were analyzed descriptively to determine the comparison of the two groups (POGIL and Non-POGIL) in the course using SPSS version 21. The participant experimental group age range of students was 19 – 40 years with a mean age of 23.4 years old. Included in the data were three males and 22 female subjects.  Non-participant control group in the study age range of student’s was 19-26 years with mean age was 20.6 years. Included in the data were two males and 23 female subjects.

The mean 3.6 GPAs of participant and non-participant groups mean 3.5 GPA prior to the study were compared for consistency and no significant differences were found. The mean final grade (B) of the participant POGIL group was higher than the mean (B-) of the non-participant group although not significant. The participant POGIL group mean (C+) national standardized test scores were higher than the (C) non-participant group. The 2-tailed t-test ATi standardized test equality of means revealed a significance of p= 0.032 with alpha=0.05. Distribution of the ATi was measured with a Mann-Whitney non-parametric test. The analysis was 0.28, which the data revealed reject the null hypothesis, which demonstrates significance at 0.05. There is a difference between ATi groups across the categories of treatment. The numerical final grade for the course between participant (B) and non-participant groups (B-) was not significant 2-tailed t- test=. 199.

Limitations

This study had some limitations.  Participants were not randomly assigned to the two groups. A small sample of 50 participated in the study. Students did not participate in the same number of scenarios; some participated in five and some in six.   Also, not all students participating in the online scenarios completed them. The study was conducted at one site with one professor and one course in one semester.

Conclusions

Although the final grade for the participating and non-participating group was not significant, the participating group had higher national test scores. The POGIL methodology enhances the use of teamwork, which may help prepare students to meet an essential competency for professional nursing. Exploring POGIL as a teaching strategy is in alignment with goals to promote evidence-based teaching. A priority in nursing education is to enhance the development of analytical critical thinking and teamwork, which is encouraged through use of POGIL methodology. Pedagogy, such as POGIL in nursing education has been shown to improve learning.