Comparison of lecture and manipulative teaching methods on learning and application to practice.

IMPORTANCE: Manipulatives are hands-on or virtual displays that facilitate teaching and learning and are interactive and engaging to students during the learning activity. Manipulatives have been shown to be effective teaching tools for a wide range of students. OBJECTIVE: This study examined whether the use of manipulatives in nursing education improved Satisfaction, Learning/Knowledge Retention, Behavior/Transfer of Learning, and Intentions to Change Practice. Underpinning theoretical frameworks included Kirkpatrick's Four Levels of Evaluation Model and Theory of Planned Behavior. DESIGN, SETTING, AND PARTICIPANTS: A quasi-experimental design comparing lecture to manipulative training was used with a sample of nursing interns and students. The study manipulative was a hands-on tool that demonstrated physiologic changes that occur with fluid imbalances. Data were collected using three questionnaires (1) before training, which included demographics and questions on participants' level of comfort with fluid imbalances, (2) immediately following training, which evaluated Satisfaction, Learning, Behavior, and Intentions, and (3) 6-8 weeks after training, which evaluated Learning, Behavior, and Intentions. MEASURES: Independent sample t-test, Mann-Whitney U test, and repeated-measure analysis of variance were used to analyze the data. CONCLUSION: Findings revealed significant differences in Intentions to change practice (p = 0.014), indicating the manipulative had a greater potential effect on clinical practice compared to the lecture.

Nurses Preparation for Advanced Directives: An Integrative Review.

Although nurses have a legal and ethical responsibility to educate and help patients complete advance directives, few nurses have a clear understanding of their role. This review integrates 19 studies published between 1990 and 2018 of the knowledge or confidence of nurses and nursing students regarding advance directives or of education on advance directives in nursing curricula. Fewer than half of working nurses demonstrated knowledge, confidence, or both regarding advance directives, and nursing programs which cover advance directives at all typically devote only 1.5 h or less to this legal document which potentially has impact on patient care and outcomes. Nurses with greater confidence regarding advance directives did not always have accurate knowledge about them. Nursing programs need more education specifically about advance directives, and more research is needed to determine what education methods can successfully address nurses' knowledge and confidence deficits.