Pure PBL, Hybrid PBL and Lecturing: which one is more effective in developing cognitive skills of undergraduate students in pediatric nursing course?

Background: Nursing education in Iran has conventionally focused on lecture-based strategies. Improvements in teaching and learning over the years have led to an expansion of the pedagogies available to educators. Likewise, there has been a suggestion for a move toward more learner-centered teaching strategies and pedagogies that can result in improvement in learning. This study was undertaken to investigate the effects of Problem-Based Learning in developing cognitive skills in learning Pediatric Nursing among university students.

Methods: In this quasi-experimental, posttest-only nonequivalent control group design, the subjects were undergraduate students who had enrolled in Pediatric Nursing II at Islamic Azad University in Iran. The experiment was conducted over a period of eight weeks, one two-hour session and two two-hour sessions. Two experimental groups, Pure Problem-Based Learning (PPBL) and the Hybrid Problem- Based Learning (HPBL), and one Lecturing or Conventional Teaching and Learning (COTL) group were involved. In the PPBL group, PBL method with guided questions and a tutor, and in the HPBL group, problem-based learning method, some guided questions, minimal lecturing and a tutor were used. The COTL group, however, underwent learning using conventional instruction utilizing full lecture. The three groups were compared on cognitive performances, namely, test performance, mental effort, and instructional efficiency. Two instruments, i.e., Pediatric Nursing Performance Test (PNPT) and Paas Mental Effort Rating Scale (PMER) were used. In addition, the two-Dimensional Instructional Efficiency Index (IEI) formula was utilized. The statistical analyses used were ANOVA, ANCOVA, and mixed between-within subjects ANOVA.

Results: Results showed that the PPBL and HPBL instructional methods, in comparison with COTL, enhanced the students' overall and higher-order performances in Pediatric Nursing, and induced higher level of instructional efficiency with less mental effort (p < 0.005). Although there was no significant difference in lower-order performance among the groups during the posttest (p = 0.92), the HPBL group outperformed the COTL group on the delayed posttest (p = 0.028).

Conclusions: It may be concluded that both forms of PBL were effective for learning Pediatric Nursing. Moreover, PBL appears to be useful where there are shortages of instructors for handling teaching purposes.