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Utilizing constructivism learning theory in collaborative testing as a creative strategy to promote essential nursing skills
Nurse Education Today 34 (2014) 31–34
Contents lists available at ScienceDirect
Nurse Education Today journal homepage: www.elsevier.com/nedt
Utilizing constructivism learning theory in collaborative testing as a creative strategy to promote essential nursing skills Barbara T. Duane a,⁎, Maria E. Satre b, 1 a b
School of Natural Science, Nursing, and Health, Capital University, One College and Main, Columbus, OH 43209, USA School of Natural Science, Nursing, and Health, Capital University, One College and Main, Columbus, OH 43209, USA
a r t i c l e
i n f o
Article history: Accepted 15 March 2013 Keywords: Constructivism learning theory Collaborative testing Nursing critical thinking
s u m m a r y In nursing education, students participate in individual learner testing. This process follows the instructionist learning theory of a system model. However, in the practice of nursing, success depends upon collaboration with numerous people in different capacities, critical thinking, clinical reasoning, and the ability to communicate with others. Research has shown that collaborative testing, a constructivism learning activity and a form of collaborative learning, enhances students' abilities to master these areas. Collaborative testing is a clear, creative strategy which constructivists would say supports the socio-linguistic base of their learning theory. The test becomes an active implementation of peer-mediated learning where individual knowledge is enhanced through problem solving or defense of an individual position with the collaborative method. There is criticism for the testing method's potential of grade inflation and for students to receive grade benefits with little effort. After a review of various collaborative testing methods, this nursing faculty implemented a collaborative testing format that addresses both the positive and negative aspects of the process. © 2013 Elsevier Ltd. All rights reserved.
Introduction The 2010 Institute of Medicine report on the future of nursing called for a transformation from content-based nursing education to a program that emphasizes concept application across client settings, inter and intra professional collaboration, and leadership development (Institute of Medicine, 2010). Completion of this goal requires nursing students to develop collaboration and communication skills. The traditional summative testing methods utilized in nursing programs do not promote theses skills. Instead, individuality is promoted and collaboration is punished as a form of cheating when not specifically part of an assignment, for example testing. Furthermore, summative evaluation is designed to merely assess student knowledge, but does not enhance knowledge development, critical thinking, collaboration, or communication ability. To increase student success in the application of concepts in addition to the knowledge of concepts, faculty at a small, private Midwestern University developed and implemented collaborative testing in combination with traditional individual testing. The premise of this collaborative testing technique utilizes the theory of constructivism learning as an alternative to instructivism theory. Collaborative testing was introduced into the traditional as well as accelerated (second degree) pre-licensure baccalaureate programs. ⁎ Corresponding author. Tel.: +1 614 236 7225(office); fax: +1 614 236 6157. E-mail addresses: [email protected] (B.T. Duane), [email protected] (M.E. Satre). 1 Tel.: +1 614 236 6638(office); fax: +1 614 236 6157. 0260-6917/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.nedt.2013.03.005
Faculty interested in utilizing this method taught junior level pediatrics in the traditional program and introductory medical/surgical nursing in the accelerated program. Examinations in both of these programs account for 50 to 60% of the course grade and are administered in multiple-choice formats to prepare students for the type of question used in the National Council Licensure Examinations (NCLEX).
Background Instructivists state that using a systems model provides learning through a very organized and systematic method. According to constructivists there is nothing systematic about how we learn or construct knowledge. Rather, constructivists believe that knowledge is constructed socially using language (Vygotsky, 1962) and everyone has different social experiences resulting in multiple realities (Jonassen, 1997). Constructing knowledge, then, is a socio-linguistic process where there is gradual advancement of understandings built upon previous knowledge resulting in multiple dimensions of the truth (Spiro and Jehng, 1990; Spiro et al., 1991). Students add to their learning through a variety of different experiences constructing knowledge from social encounters using language. The constructivist learning method is particularly suited for scientific knowledge. In this domain collaboration is paramount in initiating convergent conceptual change. Conversational interaction provides a means for students to construct increasingly sophisticated approximations to scientific concepts collaboratively, through gradual refinement of ambiguous, figurative, and partial meanings (Roschelle, 1992). Face-
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B.T. Duane, M.E. Satre / Nurse Education Today 34 (2014) 31–34
to-face interaction enables participants to construct, monitor, and repair shared knowledge (Sacks et al., 1974). Collaborative testing, a constructivist learning method, is an assessment method where students work together to develop answers on course examinations. This method is contrary to traditional testing methods, an instructivist learning method, used in education where students are tested individually. Traditional examination methods are time consuming and train students to work toward getting answers correct rather than growing as a learner (Dweck, 1999). Additionally, individual exams create an environment where collaboration is viewed as cheating, students compete for rank, and anxiety is heightened (Dallmer, 2004; Lusk and Conklin, 2003). Furthermore, this method may not accurately measure student knowledge gained (Dallmer). Collaborative learning is a student-focused, active learning strategy (Dallmer) as well as an interpersonal form of critical thinking that is essential in nursing (Alfaro-LeFevre, 2010). With collaboration, students participate in a democratic process of data analysis to promote critical thinking skills and collaboration skills (Lusk and Conklin, 2003). Furthermore, the social interaction and mentoring that occurs between peers in collaborative learning activities promotes knowledge acquisition and motivation to continue learning (Vygotsky, 1978). The collaboration between students promotes opportunities where students can work together to solve a problem. Thus, students assume the role of instructor to model expert behavior, provide “just-in-time” scaffolding, and promote reflection (Collins et al., 1989). Research has shown that there are many benefits to utilizing collaborative testing as a constructivist learning method. Critical thinking ability (Kapitanoff, 2009; Lusk and Conklin, 2003; Shindler, 2004), student test taking skills (Lusk and Conklin, 2003), and collaboration skills (Lusk and Conklin, 2003; Dallmer, 2004; Kapitanoff, 2009; Shindler, 2004; Sandahl, 2010) are enhanced with student participation in collaborative testing. Furthermore, student learning is improved by interacting with others to solve a problem or defend an answer (Bloom, 2009; Kapitanoff, 2009; Sandahl, 2010; Shindler, 2004). Additionally, students express greater motivation for learning (Dallmer, 2004; Shindler, 2004) and express increased study efforts to prepare for exams since others are depending on their knowledge application (Lusk and Conklin, 2003; Sandahl, 2010). Student exam scores are higher when they take the exam collaboratively (Bloom, 2009; Lusk and Conklin, 2003; Haberyan and Barnett, 2010; Kapitanoff, 2009; Sandahl, 2010). Moreover, Bloom found that collaborative exam scores were higher than scores earned when students were allowed to take individual exams while using course texts and notes. Further benefits include decreased test anxiety (Lusk and Conklin, 2003; Kapitanoff, 2009; Sandahl, 2010) and higher course evaluations (Dallmer). Counter to these benefits is a concern of grade inflation and the potential for social loafing students to receive grade benefits without effort. Data related to these negative effects is mixed in the literature. Shindler found that approximately 20% of students were marginal contributors on collaborative exams where students submit one answer sheet per group. Conversely, Kapitanoff found that students put in the same amount of study effort whether they were preparing for individual or collaborative exams. Also, individual final exam scores were the same or higher for students who participate in courses using collaborative unit exams compared to students who took individual unit exams (Lusk and Conklin, 2003; Haberyan and Barnett, 2010; Sandahl, 2010). While collaboration is a component of nursing curricula, students are rarely challenged to develop these skills with individual examinations and limited ability to actively participate in delegation, care conferences, or interdisciplinary communication prior to the senior year. Faculty at a small, private Midwestern university reviewed various collaborative testing methods and learning theories. The result was a collaborative testing model that utilized the basis of constructive learning principles. Furthermore, the faculty implemented strategies to decrease grade inflation and the potential for decreased student effort while promoting active learning.
The Model The model used was introduced into junior level traditional pediatric and introductory level accelerated (second degree) medical/surgical nursing courses. The classes in pediatrics had 16–20 students per section and the accelerated classes had approximately 30 per section. The model was used with each test scheduled throughout the course, including the final exam. The examinations were in a multiple-choice format similar to the structure of the licensure exam that students take after graduation. Throughout the course, students were given 3–6 examinations consisting of approximately 50 questions applicable to the current course subject matter and a 100 question cumulative final examination. In the model that was developed, students took the examination individually to decrease the potential for social loafing and then they repeated the exam in randomly assigned groups of three to six students depending on class size. Students were given 1 h to complete each of the examinations during the term and 2 h to complete the individual final examination. The retesting occurred immediately after the individual examination so that information was current in the minds of the students. With this method, students could receive immediate feedback and review of the information included in the examination. Additionally, the time for retesting was limited to half the amount of time allowed for the original exam; 30 min for a term exams and one hour for a final exam. Students in the collaborative groups were given one answer sheet per group to complete in order to enhance communication and collaboration skills. Furthermore, students were permitted to use their course learning materials when taking the exam. The decision to allow the use of course materials was based on the results of student course evaluations which revealed that students reported difficulty with locating and using course resources for problem solving. The score earned by the group on the collaborative exam may entitle the individual student to a small amount of extra credit added to their individual exam score. The faculty believes that this approach enhances student motivation to participate in the collaborative exam to earn a higher score. In order to decrease the likelihood of grade inflation, students must participate in the collaborative exam and earn a passing score on their individual exam to be eligible for extra credit. The extra credit is awarded based on the score earned on the collaborative exam by the group. Students earn an additional 2% in extra credit for earning an A or an A− on the collaborative exam and 1% for earning a B or B + on the collaborative exam. If the group score is a B- or lower, the students in the group do not earn extra credit. With the initiation of this model, students in the accelerated program were not permitted to use course notes or textbooks for the collaborative exam. In this instance, the course faculty used a different scale for extra credit: 3% for an A, 2% for a B and 1% for a C. To successfully complete the course, students in both the traditional and accelerated pre-licensure programs must succeed in both the didactic and clinical sections of the course, which are weighted and combined for the final grade. Course examinations account for 50 to 60% of the final course grade. The collaborative testing is designed to decrease the problem with grade inflation by only granting extra credit to those students who have succeeded on an exam by their individual effort. This policy prevents borderline students from completing courses based on the efforts of their classmates and encourages students to work on developing their individual knowledge base. The distribution of extra credit points allows all students who succeed with the exam credit without inflating the grades unnecessarily. Effectiveness After approximately two years of utilizing collaborative examination the faculty feels that their efforts have successfully enhanced their pre-licensure programs’ examination effectiveness. As previously discussed, collaborative learning has the potential to improve student
B.T. Duane, M.E. Satre / Nurse Education Today 34 (2014) 31–34
learning, critical thinking, communication, and test-taking skills. The authors wondered if students perceive any benefits from participation in this collaborative learning method. In the spring of 2011, 67 prelicensure nursing students who have taken courses utilizing this method of collaborative testing completed a voluntary, informal, anonymous survey. The Institutional Review Board (IRB) of the University was consulted prior to the distribution of the survey titled Collaborative Testing Questionnaire (Table 1). After an in-depth discussion concerning the contents of the tool and the purpose of the survey, the IRB determined that it was not necessary to receive formal approval prior to initiating the survey. Due to the informality of this faculty developed survey no pre-test was utilized. When voluntarily completing the survey, students were asked to read statements about the collaborative testing model used in their class and to indicate the degree to which they agreed with the statements (Table 2). The results indicated that the majority of the students perceived learning and thought process benefits of this active learning strategy. More than 75% of the students agreed to a high or exceptional degree that collaborative testing increased retention of course material, gave feedback that assisted with learning, and increased critical thinking ability. More than 50% indicated that participation in collaborative testing improved their social skills, increased productivity, and increased accountability. Examples include such things as increased ability to voice disagreement with another students answer in a thoughtful, polite manner; productivity increased with their increased ability to research answers in a more expeditious manner with practice; and peer pressure increased their accountability to be prepared to discuss their answers during the collaborative review. Simple averages were used for this evaluation due to the single distribution and small sample size. Despite literature findings that indicate that the use of collaborative testing reduces student anxiety (Lusk and Conklin, 2003; Kapitanoff, 2009; Sandahl, 2010) only 36% of the students surveyed experienced decreased anxiety with this model and 21% of the students felt that collaborative testing was ineffective or minimally effective in reducing their anxiety. The student perceptions are consistent with faculty perceived benefits of this model. It is clear that students desire the opportunity to earn the extra credit awarded. The authors have witnessed this desire through students asking questions to ensure that they have an opportunity to earn extra credit; students arriving at the examination with note cards, highlighted notes, and pages flagged in textbooks; and students actively engaging in discussion during the collaborative examination. In order to receive extra credit, students must apply themselves to studying to succeed on their individual exam and be eligible for the credit. Faculty perceives that student communication improves with the use of this collaborative learning method. This is consistent with basic principles of constructivism where knowledge is created socially through communication (Vygotsky, 1978), as well as Terenzini et al. (2001)
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findings that student communication skills were improved with the use of collaborative learning versus the use of lecture. With collaborative testing, student groups discuss each question and need to be able to defend their answers. The authors have noted that students remain engaged in the discussion of course topics and answer rationale during the collaborative exam, unlike collaborative classroom activities where some students need encouragement to stay on topic or persuaded to participate. Students must be able to communication their view since verbal altercations are not permitted and only one group answer per question is accepted. On multiple occasions, the authors have observed a great deal of interaction from students who rarely participate during other class sessions. When students collaborate on exams, the exam becomes an active implementation of peer-mediated learning where individual understanding is enhanced through problem solving or defense of an individual position. With additional guidance in the clinical area these skills can then be transferred to improve collaboration with patients, families and other health care workers. This development of interdisciplinary communication capability also goes to address another of the 2010 Institute of Medicine requirements. Additional student benefits perceived by faculty and documents in collaborative learning literature include increased knowledge and improved logical reasoning (Kapitanoff, 2009; Lusk and Conklin, 2003; Roschelle, 1992; Shindler, 2004). During the collaborative exam, faculty had the opportunity to overhear student discussions as they dissected the exam questions, answers, and distractors. Students modeled the thought process used to understand what was being asked, ruled out each distractor, and selected the correct answer. Through this process, students were observed to develop their knowledge base by discovering why their answers were not accurate, or why another answer was preferred. By observing how other students analyzed questions they also improved their critical thinking and test taking skills, especially for multiple-choice NCLEX style questions, and had the opportunity to improve their examination scores over time. The authors found that when leading test reviews during a subsequent class meeting, the reviews became more of an active learning experience as students discussed alternate answers and were able to defend their positions. During the collaborative exams, the authors heard students state that they “read into” the question or did not completely read the questions. Often, these students were guided by their peers to identify this problem and improve their test taking abilities. Students allowed to utilize texts were able to research the question to discover the preferred response. This was a far superior experience to the more traditional “test review” when faculty told students what the acceptable answer was for a question with limited time for an explanation or discussion. Utilization of this learning strategy has had serendipitous benefits for faculty teaching the course. During the collaborative exam, the
Table 1 Collaborative testing survey questionnaire. Collaborative testing questionnaire Please take a few minutes and give us an evaluation of the collaborative testing used in class. (Scale 1 = not at all, 5 = to an exceptional degree) I feel that the collaborative testing method used in class …. 1. Helps me with increased achievement and retention 1 2 3 4 2. Helps me with improved social skills 1 2 3 4 3. Helps me develop increased accountability 1 2 3 4 4. Gave me with feedback that helped me learn 1 2 3 4 5. Helps decrease my anxiety 1 2 3 4 6. Help increase my productivity 1 2 3 4 7. Helps increase my critical thinking 1 2 3 4 Comments _____________________________________________________________________________________________________________________________________________
5 5 5 5 5 5 5
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B.T. Duane, M.E. Satre / Nurse Education Today 34 (2014) 31–34
Table 2 Survey of student perceptions on the use of collaborative testing (n = 67). Question Participating in Participating in Participating in Participating in Participating in Participating in Participating in
collaborative collaborative collaborative collaborative collaborative collaborative collaborative
testing testing testing testing testing testing testing
helps me with increased achievement in knowledge retention helps me with improved social skills helps me develop increased accountability gives me the feedback that helps me learn helps decrease my anxiety helps increase my productivity helps increase my critical thinking ability
Minimally/not at all
Moderate
To an high/exceptional degree
2 (2.98%) 17 (25.37%) 6 (8.96%) 3 (4.48%) 14 (20.90%) 7 (10.45%) 4 (5.97%)
9 (13.43%) 16 (23.88%) 14 (20.90%) 3 (4.48%) 29 (43.28%) 23 (34.33%) 11 (16.41%)
56 (83.58%) 34 (50.75%) 47 (70.15%) 61 (91.04%) 24 (35.82%) 37 (55.22%) 52 (77.61%)
faculty is given the opportunity to observe as students explain their interpretation of exam questions as well as their reasoning for selecting a specific answer. When several students display a lack of understanding of an important class concept, faculty can provide just-in-time teaching during the subsequent class session. This concept can then be re-tested on a future examination. Additionally, while completing the collaborative exam, students may share an interpretation of a test item that differs from the concept that faculty intended to assess. With this feedback, the faculty is given the opportunity to edit specific test items for clarity and improve examination reliability with future courses.
• Use collaborative testing for extra credit instead of high stakes testing and keep the points awarded minimal to decrease the potential of grade inflation. • Award extra credit only to those students who individually succeed on the examination. This will decrease the potential of grade inflation as well as encourage student effort. • Assist students to apply the critical thinking, collaboration and problem solving skills they develop through collaborative testing in their clinical practice.
Conclusion
Alfaro-LeFevre, R., 2010. Critical thinking indicators. Retrieved from http://www. alfaroteachsmart.com/2009-2010%20CTI%20Jan2010.pdf. Bloom, D., 2009. Collaborative test taking: benefits for learning and retention. College Teaching 57 (4), 216–220. Collins, A., Brown, J.S., Newman, S.E., 1989. Cognitive apprenticeship: teaching the craft of reading, writing, and mathematics. In: Resnick, L.B. (Ed.), Knowing, Learning, and Instruction: Essays in Honor of Robert Glaser. Laurence Erlbaum Associates, Hillsdale, NJ, pp. 453–494. Cuseo, J., 1997. Cooperative learning vs. small-group discussion and group projects: the critical difference. Retrieved from http://eminfo.emc.maricopa.edu/innovation/ccl/ models/differences.html. Dallmer, D., 2004. Collaborative test taking with adult learners. Adult Education Across the Disciplines 15, 4–7. Dweck, C.S., 1999. Self-theories: Their Role in Motivation, Personality, and Development. Taylor and Francis, Lillington, NC. Haberyan, A., Barnett, J., 2010. Collaborative testing and achievement: are two heads really better than one? Journal of Instructional Psychology 37 (1), 32–41. Institute of Medicine, 2010. The Future of Nursing: Leading Change, Advancing Health. Institute of Medicine, Washington, DC. Jonassen, D.H., 1997. Instructional design models for well-structured and ill-structured problem-solving learning outcomes. Educational Technology Research & Development 45 (1), 65–94. Kapitanoff, S.H., 2009. Collaborative testing: cognitive and interpersonal processes related to enhanced test performance. Active Learning in Higher Education 10, 56–70. http://dx.doi.org/10.1177/1469787408100195. Lusk, M., Conklin, L., 2003. Collaborative design to promote learning. Journal of Nursing Education 42 (3), 121–124. Roschelle, J., 1992. Learning by collaborating: convergent conceptual change. The Journal of the Learning Sciences 2 (3), 235–276. Sacks, H., Schegloff, E.A., Jefferson, G.A., 1974. A simplest systematics for the organization of turn-taking in conversation. Language 50, 696–735. Sandahl, S.S., 2010. Collaborative testing as a learning strategy in nursing education. Nursing Education Perspectives 31 (3), 142–147. Shindler, J.V., 2004. Greater than the sum of parts? Examining the soundness of collaborative exams in teacher education courses. Innovative Higher Education 28 (4), 273–283. Spiro, R.J., Jehng, J.C., 1990. Cognitive flexibility and hypertext: theory and technology for the nonlinear and Multidimentional transversal of complex subject matter. In: Nix, D., Spiro, R.J. (Eds.), Cognition, Education, and Multimedia: Exploring Ideas in High Technology. Lawrence Erlbaum Assoc, Hillsdale, N.J. Spiro, R.J., Feltovich, P.J., Jacobson, M.J., Coulson, R.L., 1991. Cognitive flexibility, constructivism, and hypertext: random access instruction for advanced knowledge acquisition in ill-structured domains. In: Duffy, T., Jonassen, D. (Eds.), Constructivism and the Technology of Instruction. Lawrence Erlbaum Assoc. Publishers, Hillsdale, N.J. Terenzini, P.T., Cabrera, A.F., Colbeck, C.L., Parente, J.M., Bjorklund, S.A., 2001. Collaborative learning vs. lecture/discussion: student reported learning gains. Journal of Engineering Education 90 (1), 123–130 (Retrieved from http://barnard.edu/sites/default/files/ inline/collaborative_learning_vs_lecture-discussion_student_reported_learning_gains. pdf). Vygotsky, L., 1962. In: Hanfmann, E., Backer, G., Trans. (Eds.), Thought and Language. M.I.T. Press, Cambridge, MA. Vygotsky, L.S., 1978. Mind in Society. Harvard University Press, Cambridge, MA.
While the literature search reveals data that supports the use of cooperative learning and collaborative testing, no data was available on this particular design. The positive results identified by faculty on the initial use of this method appear to support the learning potential for utilizing this constructivism learning method as a creative strategy to promote essential nursing skills. At first blush, the faculty that have utilized this method of collaborative testing find that the definition of constructive learning theory that was described more than 30 years ago is a solid base for this form of assessment and instruction. Constructivism (or cooperative learning) is an instructional method that can provide opportunities for generative learning. It is a “learner-centered instructional process in which small, intentionally selected groups of 3–5 students work interdependently on a welldefined learning task, individual students are held accountable for their own performance and the instructor serves as a facilitator in the group learning process” (Cuseo, 1997). Cooperative learning creates an opportunity to form communities of inquiry that provide learning environments that encourage critical dialogue and understanding (Vygotsky, 1978; Cuseo, 1997). A large number of the students have indicated that collaborative testing feedback helped their learning, increased critical thinking, increased retention, and increased accountability. Most students also felt that this form of testing improved their social skills and productivity. On course evaluations students frequently cite collaborative testing as a positive part of their learning experience. Statements such as “I really enjoy the collaborative testing. I always learn something when we review” and “I like collaborative testing because it helps facilitate critical thinking and frequently provides the correct answer to questions you were unsure of” are frequently seen on course evaluation forms (Nursing 364 course evaluation 2011). Recommendations for Implementation Based upon the experience of utilizing this method of collaborative testing the following recommendations are made for those considering including this learning process in to their curriculum: • Randomly assign students to collaborative testing groups each time the process is utilized.
References
Contents lists available at ScienceDirect
Nurse Education Today journal homepage: www.elsevier.com/nedt
Utilizing constructivism learning theory in collaborative testing as a creative strategy to promote essential nursing skills Barbara T. Duane a,⁎, Maria E. Satre b, 1 a b
School of Natural Science, Nursing, and Health, Capital University, One College and Main, Columbus, OH 43209, USA School of Natural Science, Nursing, and Health, Capital University, One College and Main, Columbus, OH 43209, USA
a r t i c l e
i n f o
Article history: Accepted 15 March 2013 Keywords: Constructivism learning theory Collaborative testing Nursing critical thinking
s u m m a r y In nursing education, students participate in individual learner testing. This process follows the instructionist learning theory of a system model. However, in the practice of nursing, success depends upon collaboration with numerous people in different capacities, critical thinking, clinical reasoning, and the ability to communicate with others. Research has shown that collaborative testing, a constructivism learning activity and a form of collaborative learning, enhances students' abilities to master these areas. Collaborative testing is a clear, creative strategy which constructivists would say supports the socio-linguistic base of their learning theory. The test becomes an active implementation of peer-mediated learning where individual knowledge is enhanced through problem solving or defense of an individual position with the collaborative method. There is criticism for the testing method's potential of grade inflation and for students to receive grade benefits with little effort. After a review of various collaborative testing methods, this nursing faculty implemented a collaborative testing format that addresses both the positive and negative aspects of the process. © 2013 Elsevier Ltd. All rights reserved.
Introduction The 2010 Institute of Medicine report on the future of nursing called for a transformation from content-based nursing education to a program that emphasizes concept application across client settings, inter and intra professional collaboration, and leadership development (Institute of Medicine, 2010). Completion of this goal requires nursing students to develop collaboration and communication skills. The traditional summative testing methods utilized in nursing programs do not promote theses skills. Instead, individuality is promoted and collaboration is punished as a form of cheating when not specifically part of an assignment, for example testing. Furthermore, summative evaluation is designed to merely assess student knowledge, but does not enhance knowledge development, critical thinking, collaboration, or communication ability. To increase student success in the application of concepts in addition to the knowledge of concepts, faculty at a small, private Midwestern University developed and implemented collaborative testing in combination with traditional individual testing. The premise of this collaborative testing technique utilizes the theory of constructivism learning as an alternative to instructivism theory. Collaborative testing was introduced into the traditional as well as accelerated (second degree) pre-licensure baccalaureate programs. ⁎ Corresponding author. Tel.: +1 614 236 7225(office); fax: +1 614 236 6157. E-mail addresses: [email protected] (B.T. Duane), [email protected] (M.E. Satre). 1 Tel.: +1 614 236 6638(office); fax: +1 614 236 6157. 0260-6917/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.nedt.2013.03.005
Faculty interested in utilizing this method taught junior level pediatrics in the traditional program and introductory medical/surgical nursing in the accelerated program. Examinations in both of these programs account for 50 to 60% of the course grade and are administered in multiple-choice formats to prepare students for the type of question used in the National Council Licensure Examinations (NCLEX).
Background Instructivists state that using a systems model provides learning through a very organized and systematic method. According to constructivists there is nothing systematic about how we learn or construct knowledge. Rather, constructivists believe that knowledge is constructed socially using language (Vygotsky, 1962) and everyone has different social experiences resulting in multiple realities (Jonassen, 1997). Constructing knowledge, then, is a socio-linguistic process where there is gradual advancement of understandings built upon previous knowledge resulting in multiple dimensions of the truth (Spiro and Jehng, 1990; Spiro et al., 1991). Students add to their learning through a variety of different experiences constructing knowledge from social encounters using language. The constructivist learning method is particularly suited for scientific knowledge. In this domain collaboration is paramount in initiating convergent conceptual change. Conversational interaction provides a means for students to construct increasingly sophisticated approximations to scientific concepts collaboratively, through gradual refinement of ambiguous, figurative, and partial meanings (Roschelle, 1992). Face-
32
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to-face interaction enables participants to construct, monitor, and repair shared knowledge (Sacks et al., 1974). Collaborative testing, a constructivist learning method, is an assessment method where students work together to develop answers on course examinations. This method is contrary to traditional testing methods, an instructivist learning method, used in education where students are tested individually. Traditional examination methods are time consuming and train students to work toward getting answers correct rather than growing as a learner (Dweck, 1999). Additionally, individual exams create an environment where collaboration is viewed as cheating, students compete for rank, and anxiety is heightened (Dallmer, 2004; Lusk and Conklin, 2003). Furthermore, this method may not accurately measure student knowledge gained (Dallmer). Collaborative learning is a student-focused, active learning strategy (Dallmer) as well as an interpersonal form of critical thinking that is essential in nursing (Alfaro-LeFevre, 2010). With collaboration, students participate in a democratic process of data analysis to promote critical thinking skills and collaboration skills (Lusk and Conklin, 2003). Furthermore, the social interaction and mentoring that occurs between peers in collaborative learning activities promotes knowledge acquisition and motivation to continue learning (Vygotsky, 1978). The collaboration between students promotes opportunities where students can work together to solve a problem. Thus, students assume the role of instructor to model expert behavior, provide “just-in-time” scaffolding, and promote reflection (Collins et al., 1989). Research has shown that there are many benefits to utilizing collaborative testing as a constructivist learning method. Critical thinking ability (Kapitanoff, 2009; Lusk and Conklin, 2003; Shindler, 2004), student test taking skills (Lusk and Conklin, 2003), and collaboration skills (Lusk and Conklin, 2003; Dallmer, 2004; Kapitanoff, 2009; Shindler, 2004; Sandahl, 2010) are enhanced with student participation in collaborative testing. Furthermore, student learning is improved by interacting with others to solve a problem or defend an answer (Bloom, 2009; Kapitanoff, 2009; Sandahl, 2010; Shindler, 2004). Additionally, students express greater motivation for learning (Dallmer, 2004; Shindler, 2004) and express increased study efforts to prepare for exams since others are depending on their knowledge application (Lusk and Conklin, 2003; Sandahl, 2010). Student exam scores are higher when they take the exam collaboratively (Bloom, 2009; Lusk and Conklin, 2003; Haberyan and Barnett, 2010; Kapitanoff, 2009; Sandahl, 2010). Moreover, Bloom found that collaborative exam scores were higher than scores earned when students were allowed to take individual exams while using course texts and notes. Further benefits include decreased test anxiety (Lusk and Conklin, 2003; Kapitanoff, 2009; Sandahl, 2010) and higher course evaluations (Dallmer). Counter to these benefits is a concern of grade inflation and the potential for social loafing students to receive grade benefits without effort. Data related to these negative effects is mixed in the literature. Shindler found that approximately 20% of students were marginal contributors on collaborative exams where students submit one answer sheet per group. Conversely, Kapitanoff found that students put in the same amount of study effort whether they were preparing for individual or collaborative exams. Also, individual final exam scores were the same or higher for students who participate in courses using collaborative unit exams compared to students who took individual unit exams (Lusk and Conklin, 2003; Haberyan and Barnett, 2010; Sandahl, 2010). While collaboration is a component of nursing curricula, students are rarely challenged to develop these skills with individual examinations and limited ability to actively participate in delegation, care conferences, or interdisciplinary communication prior to the senior year. Faculty at a small, private Midwestern university reviewed various collaborative testing methods and learning theories. The result was a collaborative testing model that utilized the basis of constructive learning principles. Furthermore, the faculty implemented strategies to decrease grade inflation and the potential for decreased student effort while promoting active learning.
The Model The model used was introduced into junior level traditional pediatric and introductory level accelerated (second degree) medical/surgical nursing courses. The classes in pediatrics had 16–20 students per section and the accelerated classes had approximately 30 per section. The model was used with each test scheduled throughout the course, including the final exam. The examinations were in a multiple-choice format similar to the structure of the licensure exam that students take after graduation. Throughout the course, students were given 3–6 examinations consisting of approximately 50 questions applicable to the current course subject matter and a 100 question cumulative final examination. In the model that was developed, students took the examination individually to decrease the potential for social loafing and then they repeated the exam in randomly assigned groups of three to six students depending on class size. Students were given 1 h to complete each of the examinations during the term and 2 h to complete the individual final examination. The retesting occurred immediately after the individual examination so that information was current in the minds of the students. With this method, students could receive immediate feedback and review of the information included in the examination. Additionally, the time for retesting was limited to half the amount of time allowed for the original exam; 30 min for a term exams and one hour for a final exam. Students in the collaborative groups were given one answer sheet per group to complete in order to enhance communication and collaboration skills. Furthermore, students were permitted to use their course learning materials when taking the exam. The decision to allow the use of course materials was based on the results of student course evaluations which revealed that students reported difficulty with locating and using course resources for problem solving. The score earned by the group on the collaborative exam may entitle the individual student to a small amount of extra credit added to their individual exam score. The faculty believes that this approach enhances student motivation to participate in the collaborative exam to earn a higher score. In order to decrease the likelihood of grade inflation, students must participate in the collaborative exam and earn a passing score on their individual exam to be eligible for extra credit. The extra credit is awarded based on the score earned on the collaborative exam by the group. Students earn an additional 2% in extra credit for earning an A or an A− on the collaborative exam and 1% for earning a B or B + on the collaborative exam. If the group score is a B- or lower, the students in the group do not earn extra credit. With the initiation of this model, students in the accelerated program were not permitted to use course notes or textbooks for the collaborative exam. In this instance, the course faculty used a different scale for extra credit: 3% for an A, 2% for a B and 1% for a C. To successfully complete the course, students in both the traditional and accelerated pre-licensure programs must succeed in both the didactic and clinical sections of the course, which are weighted and combined for the final grade. Course examinations account for 50 to 60% of the final course grade. The collaborative testing is designed to decrease the problem with grade inflation by only granting extra credit to those students who have succeeded on an exam by their individual effort. This policy prevents borderline students from completing courses based on the efforts of their classmates and encourages students to work on developing their individual knowledge base. The distribution of extra credit points allows all students who succeed with the exam credit without inflating the grades unnecessarily. Effectiveness After approximately two years of utilizing collaborative examination the faculty feels that their efforts have successfully enhanced their pre-licensure programs’ examination effectiveness. As previously discussed, collaborative learning has the potential to improve student
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learning, critical thinking, communication, and test-taking skills. The authors wondered if students perceive any benefits from participation in this collaborative learning method. In the spring of 2011, 67 prelicensure nursing students who have taken courses utilizing this method of collaborative testing completed a voluntary, informal, anonymous survey. The Institutional Review Board (IRB) of the University was consulted prior to the distribution of the survey titled Collaborative Testing Questionnaire (Table 1). After an in-depth discussion concerning the contents of the tool and the purpose of the survey, the IRB determined that it was not necessary to receive formal approval prior to initiating the survey. Due to the informality of this faculty developed survey no pre-test was utilized. When voluntarily completing the survey, students were asked to read statements about the collaborative testing model used in their class and to indicate the degree to which they agreed with the statements (Table 2). The results indicated that the majority of the students perceived learning and thought process benefits of this active learning strategy. More than 75% of the students agreed to a high or exceptional degree that collaborative testing increased retention of course material, gave feedback that assisted with learning, and increased critical thinking ability. More than 50% indicated that participation in collaborative testing improved their social skills, increased productivity, and increased accountability. Examples include such things as increased ability to voice disagreement with another students answer in a thoughtful, polite manner; productivity increased with their increased ability to research answers in a more expeditious manner with practice; and peer pressure increased their accountability to be prepared to discuss their answers during the collaborative review. Simple averages were used for this evaluation due to the single distribution and small sample size. Despite literature findings that indicate that the use of collaborative testing reduces student anxiety (Lusk and Conklin, 2003; Kapitanoff, 2009; Sandahl, 2010) only 36% of the students surveyed experienced decreased anxiety with this model and 21% of the students felt that collaborative testing was ineffective or minimally effective in reducing their anxiety. The student perceptions are consistent with faculty perceived benefits of this model. It is clear that students desire the opportunity to earn the extra credit awarded. The authors have witnessed this desire through students asking questions to ensure that they have an opportunity to earn extra credit; students arriving at the examination with note cards, highlighted notes, and pages flagged in textbooks; and students actively engaging in discussion during the collaborative examination. In order to receive extra credit, students must apply themselves to studying to succeed on their individual exam and be eligible for the credit. Faculty perceives that student communication improves with the use of this collaborative learning method. This is consistent with basic principles of constructivism where knowledge is created socially through communication (Vygotsky, 1978), as well as Terenzini et al. (2001)
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findings that student communication skills were improved with the use of collaborative learning versus the use of lecture. With collaborative testing, student groups discuss each question and need to be able to defend their answers. The authors have noted that students remain engaged in the discussion of course topics and answer rationale during the collaborative exam, unlike collaborative classroom activities where some students need encouragement to stay on topic or persuaded to participate. Students must be able to communication their view since verbal altercations are not permitted and only one group answer per question is accepted. On multiple occasions, the authors have observed a great deal of interaction from students who rarely participate during other class sessions. When students collaborate on exams, the exam becomes an active implementation of peer-mediated learning where individual understanding is enhanced through problem solving or defense of an individual position. With additional guidance in the clinical area these skills can then be transferred to improve collaboration with patients, families and other health care workers. This development of interdisciplinary communication capability also goes to address another of the 2010 Institute of Medicine requirements. Additional student benefits perceived by faculty and documents in collaborative learning literature include increased knowledge and improved logical reasoning (Kapitanoff, 2009; Lusk and Conklin, 2003; Roschelle, 1992; Shindler, 2004). During the collaborative exam, faculty had the opportunity to overhear student discussions as they dissected the exam questions, answers, and distractors. Students modeled the thought process used to understand what was being asked, ruled out each distractor, and selected the correct answer. Through this process, students were observed to develop their knowledge base by discovering why their answers were not accurate, or why another answer was preferred. By observing how other students analyzed questions they also improved their critical thinking and test taking skills, especially for multiple-choice NCLEX style questions, and had the opportunity to improve their examination scores over time. The authors found that when leading test reviews during a subsequent class meeting, the reviews became more of an active learning experience as students discussed alternate answers and were able to defend their positions. During the collaborative exams, the authors heard students state that they “read into” the question or did not completely read the questions. Often, these students were guided by their peers to identify this problem and improve their test taking abilities. Students allowed to utilize texts were able to research the question to discover the preferred response. This was a far superior experience to the more traditional “test review” when faculty told students what the acceptable answer was for a question with limited time for an explanation or discussion. Utilization of this learning strategy has had serendipitous benefits for faculty teaching the course. During the collaborative exam, the
Table 1 Collaborative testing survey questionnaire. Collaborative testing questionnaire Please take a few minutes and give us an evaluation of the collaborative testing used in class. (Scale 1 = not at all, 5 = to an exceptional degree) I feel that the collaborative testing method used in class …. 1. Helps me with increased achievement and retention 1 2 3 4 2. Helps me with improved social skills 1 2 3 4 3. Helps me develop increased accountability 1 2 3 4 4. Gave me with feedback that helped me learn 1 2 3 4 5. Helps decrease my anxiety 1 2 3 4 6. Help increase my productivity 1 2 3 4 7. Helps increase my critical thinking 1 2 3 4 Comments _____________________________________________________________________________________________________________________________________________
5 5 5 5 5 5 5
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Table 2 Survey of student perceptions on the use of collaborative testing (n = 67). Question Participating in Participating in Participating in Participating in Participating in Participating in Participating in
collaborative collaborative collaborative collaborative collaborative collaborative collaborative
testing testing testing testing testing testing testing
helps me with increased achievement in knowledge retention helps me with improved social skills helps me develop increased accountability gives me the feedback that helps me learn helps decrease my anxiety helps increase my productivity helps increase my critical thinking ability
Minimally/not at all
Moderate
To an high/exceptional degree
2 (2.98%) 17 (25.37%) 6 (8.96%) 3 (4.48%) 14 (20.90%) 7 (10.45%) 4 (5.97%)
9 (13.43%) 16 (23.88%) 14 (20.90%) 3 (4.48%) 29 (43.28%) 23 (34.33%) 11 (16.41%)
56 (83.58%) 34 (50.75%) 47 (70.15%) 61 (91.04%) 24 (35.82%) 37 (55.22%) 52 (77.61%)
faculty is given the opportunity to observe as students explain their interpretation of exam questions as well as their reasoning for selecting a specific answer. When several students display a lack of understanding of an important class concept, faculty can provide just-in-time teaching during the subsequent class session. This concept can then be re-tested on a future examination. Additionally, while completing the collaborative exam, students may share an interpretation of a test item that differs from the concept that faculty intended to assess. With this feedback, the faculty is given the opportunity to edit specific test items for clarity and improve examination reliability with future courses.
• Use collaborative testing for extra credit instead of high stakes testing and keep the points awarded minimal to decrease the potential of grade inflation. • Award extra credit only to those students who individually succeed on the examination. This will decrease the potential of grade inflation as well as encourage student effort. • Assist students to apply the critical thinking, collaboration and problem solving skills they develop through collaborative testing in their clinical practice.
Conclusion
Alfaro-LeFevre, R., 2010. Critical thinking indicators. Retrieved from http://www. alfaroteachsmart.com/2009-2010%20CTI%20Jan2010.pdf. Bloom, D., 2009. Collaborative test taking: benefits for learning and retention. College Teaching 57 (4), 216–220. Collins, A., Brown, J.S., Newman, S.E., 1989. Cognitive apprenticeship: teaching the craft of reading, writing, and mathematics. In: Resnick, L.B. (Ed.), Knowing, Learning, and Instruction: Essays in Honor of Robert Glaser. Laurence Erlbaum Associates, Hillsdale, NJ, pp. 453–494. Cuseo, J., 1997. Cooperative learning vs. small-group discussion and group projects: the critical difference. Retrieved from http://eminfo.emc.maricopa.edu/innovation/ccl/ models/differences.html. Dallmer, D., 2004. Collaborative test taking with adult learners. Adult Education Across the Disciplines 15, 4–7. Dweck, C.S., 1999. Self-theories: Their Role in Motivation, Personality, and Development. Taylor and Francis, Lillington, NC. Haberyan, A., Barnett, J., 2010. Collaborative testing and achievement: are two heads really better than one? Journal of Instructional Psychology 37 (1), 32–41. Institute of Medicine, 2010. The Future of Nursing: Leading Change, Advancing Health. Institute of Medicine, Washington, DC. Jonassen, D.H., 1997. Instructional design models for well-structured and ill-structured problem-solving learning outcomes. Educational Technology Research & Development 45 (1), 65–94. Kapitanoff, S.H., 2009. Collaborative testing: cognitive and interpersonal processes related to enhanced test performance. Active Learning in Higher Education 10, 56–70. http://dx.doi.org/10.1177/1469787408100195. Lusk, M., Conklin, L., 2003. Collaborative design to promote learning. Journal of Nursing Education 42 (3), 121–124. Roschelle, J., 1992. Learning by collaborating: convergent conceptual change. The Journal of the Learning Sciences 2 (3), 235–276. Sacks, H., Schegloff, E.A., Jefferson, G.A., 1974. A simplest systematics for the organization of turn-taking in conversation. Language 50, 696–735. Sandahl, S.S., 2010. Collaborative testing as a learning strategy in nursing education. Nursing Education Perspectives 31 (3), 142–147. Shindler, J.V., 2004. Greater than the sum of parts? Examining the soundness of collaborative exams in teacher education courses. Innovative Higher Education 28 (4), 273–283. Spiro, R.J., Jehng, J.C., 1990. Cognitive flexibility and hypertext: theory and technology for the nonlinear and Multidimentional transversal of complex subject matter. In: Nix, D., Spiro, R.J. (Eds.), Cognition, Education, and Multimedia: Exploring Ideas in High Technology. Lawrence Erlbaum Assoc, Hillsdale, N.J. Spiro, R.J., Feltovich, P.J., Jacobson, M.J., Coulson, R.L., 1991. Cognitive flexibility, constructivism, and hypertext: random access instruction for advanced knowledge acquisition in ill-structured domains. In: Duffy, T., Jonassen, D. (Eds.), Constructivism and the Technology of Instruction. Lawrence Erlbaum Assoc. Publishers, Hillsdale, N.J. Terenzini, P.T., Cabrera, A.F., Colbeck, C.L., Parente, J.M., Bjorklund, S.A., 2001. Collaborative learning vs. lecture/discussion: student reported learning gains. Journal of Engineering Education 90 (1), 123–130 (Retrieved from http://barnard.edu/sites/default/files/ inline/collaborative_learning_vs_lecture-discussion_student_reported_learning_gains. pdf). Vygotsky, L., 1962. In: Hanfmann, E., Backer, G., Trans. (Eds.), Thought and Language. M.I.T. Press, Cambridge, MA. Vygotsky, L.S., 1978. Mind in Society. Harvard University Press, Cambridge, MA.
While the literature search reveals data that supports the use of cooperative learning and collaborative testing, no data was available on this particular design. The positive results identified by faculty on the initial use of this method appear to support the learning potential for utilizing this constructivism learning method as a creative strategy to promote essential nursing skills. At first blush, the faculty that have utilized this method of collaborative testing find that the definition of constructive learning theory that was described more than 30 years ago is a solid base for this form of assessment and instruction. Constructivism (or cooperative learning) is an instructional method that can provide opportunities for generative learning. It is a “learner-centered instructional process in which small, intentionally selected groups of 3–5 students work interdependently on a welldefined learning task, individual students are held accountable for their own performance and the instructor serves as a facilitator in the group learning process” (Cuseo, 1997). Cooperative learning creates an opportunity to form communities of inquiry that provide learning environments that encourage critical dialogue and understanding (Vygotsky, 1978; Cuseo, 1997). A large number of the students have indicated that collaborative testing feedback helped their learning, increased critical thinking, increased retention, and increased accountability. Most students also felt that this form of testing improved their social skills and productivity. On course evaluations students frequently cite collaborative testing as a positive part of their learning experience. Statements such as “I really enjoy the collaborative testing. I always learn something when we review” and “I like collaborative testing because it helps facilitate critical thinking and frequently provides the correct answer to questions you were unsure of” are frequently seen on course evaluation forms (Nursing 364 course evaluation 2011). Recommendations for Implementation Based upon the experience of utilizing this method of collaborative testing the following recommendations are made for those considering including this learning process in to their curriculum: • Randomly assign students to collaborative testing groups each time the process is utilized.
References