Comparison of independent and traditional registered nurse learners in a physical assessment course.

Abstract: The purpose of this study was to determine if there was a significant difference in the time used to complete a neurological assessment by students who studied physical assessment and practiced independently when compared to students who used the traditional lecture method of instruction and practiced with the instructor. The research methodology utilized a descriptive comparative design. The convenience sample consisted of 20 Registered Nurses (RNs) randomly selected from a class of 34 RN students in one section of an undergraduate Physical Assessment course. A watch was used to measure the time the student used to complete the neurological assessment. A one-tailed independent samples t-test was used to compare the difference in time used as indicated by the means of the two groups. The level of significance was 0.05. The result of the study is that there was no significant difference found between the two groups on the amount of time used to complete a neurological assessment p > .05, t= 1.151, p = .303. The conclusion of this study was that RN students are able to learn physical assessment independently and successfully complete a neurological assessment in a similar amount of time as RN students who use the traditional classroom method. Recommendations include replicating the study with a larger sample and with students in a Graduate Health Assessment course to determine if similar results will occur. Key Words: Critical Elements, Independent Method, Neurological System, Physical Assessment, Traditional Classroom Method Nursing is an art and a science, and as such, educational experience in the laboratory is an essential component of the teaching-learning process. The simulated laboratory serves as a center of learning for students. Nurse educators consider physical assessment skills an essential component of nursing curricula (Solomon, 1990). The purpose of this study was to compare students who studied physical assessment independently to students who used the traditional classroom method to determine if there was a difference in the amount of time required to successfully complete a neurological assessment. BACKGROUND Learning is a change in a human's disposition that persists over a period of time. Learning is represented by a change in behavior (Kozier, Erb & Blaise, 1997). Understanding the principles and concepts of adult learning is necessary when teaching registered nurses. Benner (1984) describes the proficient nurse as one who learns from experience what typical events to expect in a given situation. Registered nurses (RNs) who have returned back to school can be classified as being at the proficient level of practice. Malcolm Knowles (1980) defines andragogy as "the art and science of helping adults learn" (p. 43). He also writes in his classic work that: (1) as people mature, they move from dependence to independence, and (2) an adult's previous learning experiences can be used as a resource for learning. Knowles (1990) describes the andragogical model as one that is based on several assumptions about adult learners: (1) the need to know. Adults will invest considerable energy in probing into the benefits when they undertake to learn something on their own (p. 57); (2) the learner's self-- concept. "Adults have a self-concept of being responsible for their own decisions, for their own lives." They have the need to be recognized as being capable of self-direction (p. 58; and (3) the role of the learner's experience. Adults enter into an educational experience with a greater quantity and a different quality of experience. Thus, their resources of learning are in themselves (p. 59). Knowles (1985) described a self-directed learning project for physicians conducted at the University of Southern California. The project, based on the andragogical model, rested on the assumption that physicians can best determine and satisfy their own educational needs. …