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BACKGROUND: Standards contribute to comprehensive and programmatic implementation of educational strategies, such as scaffolding. Although the development of educational standards follows a rigorous consensus approach, they are socially constructed and could result in varied interpretations by users. Reports of varied implementation of standards in health professions education underscore the need to test the developed standards for scaffolding in health sciences programmes. Usability entails determining whether a product like standards works as intended under the expected conditions and contexts. This study aimed to describe the usability of standards for scaffolding in a health sciences programme through a pilot study. METHODS: A multi-method design employing user and expert-based usability evaluation techniques sought to describe the usability of the standards for scaffolding in a three-year pre-registration nursing programme. The user sample of nurse educators drawn from the programme, conducted a self-assessment on scaffolding practices in the programme using a developed standards checklist. For the expert sample, three-panel members with an understanding of the discipline and programme context were purposively sampled. These panelists studied the users' self-assessment reports before completing an author-generated heuristics checklist to support or refute any of the standards. Descriptive statistics, comparative and content analysis were applied to analyse data from users' interviews and expert's completed heuristics checklist, determining the standards' usability, and identifying the usability flaws or strengths. RESULTS: The users had three or more years of teaching experience in the competency-based curriculum for nursing. The experts shared an average of 16 years of experience in teaching in higher education, and seven years of experience in quality assurance and programme accreditation. The four standards had a usability score of above average (68%). Seven usability strengths and four usability flaws were identified. Usability flaws related to misinterpretation of some criteria statements and terminologies, multiple meanings, and users' challenges in generating evidence for some criteria. CONCLUSIONS: The pilot study revealed the context-based 'truth' regarding the fidelity of a health sciences programme evaluation on scaffolding, as well as identifying the ideal contextual conditions in which the standards for scaffolding health sciences programmes would work best. The identified usability flaws highlighted the need for further revisions of the standards. Future research on the feasibility of the standards in other health sciences programmes and contexts is recommended.
RESUMEN
Introduction: Health sciences programmes operate in complex, unpredictable contexts, underscoring the need for comprehensive scaffolding of the learning processes. Yet, the scaffolding approaches remain fragmented, and lack a shared approach to how programmes could integrate scaffolding across the curricula. The literature argues that standards result in the comprehensive implementation of educational practices. There are no reported standards related to scaffolding practices in these programmes. OBJECTIVES: To develop standards for scaffolding in health sciences programmes utilising a consensus approach through a modified Delphi Technique. METHODS: Following the recommendations on Conducting and REporting of DElphi Studies (CREDES), an online modified Delphi technique was applied. Evidence on the application of scaffolding in health sciences programmes, obtained through an integrative review, was synthesised to draft standards. Using purposive and snowball sampling, an international panel from diverse geographical and professional backgrounds refined and validated the standards. Descriptive statistics was utilised to analyse demographic data and consensus agreements to include standards and criteria. Qualitative analysis of textual comments ensured the synthesis and inclusion of critical divergent views and additions. RESULTS: A total of 22 experts from around the globe agreed to participate in the study and one did not complete Delphi surveys. Most experts (n = 18) held a PhD; and an average of 19 years of teaching in health sciences programmes. Four standards and 27 criteria were included after achieving consensus during the two Delphi surveys rounds. The included standards focused on four areas: structuring and sequencing educational activities, resources/tools for scaffolding, structuring the programme and instructional strategies to support learning. CONCLUSION: The principle-based standards developed in this study could direct and support scaffolding practices in health sciences programmes. The standards' emphases on macro-, meso- and micro-scaffolding present numerous opportunities for designing and applying contextually sensitive scaffolding strategies at every level of curriculum implementation.
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The complexity of health sciences programmes justifies scaffolding to support students in becoming competent health professionals. This article reports on an integrative review that aimed to describe the application of scaffolding in health sciences programmes. Twenty-nine sources, inclusive of theoretical and empirical studies, were reviewed. The sequencing of educational activities, the application of scaffolding tools or resources, frameworks for applying scaffolding, modelling, and fading represented the application of scaffolding in health sciences programmes. Awareness of the application of scaffolding in health sciences programmes could contribute to enhancing competence development among students when applied across all learning platforms.
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AIM: The study describes the fidelity of implementing a competency-based nursing education (CBNE) programme during the COVID-19 pandemic in a low-resource setting. DESIGN: A descriptive case study research design integrating mixed methods underpinned by the fidelity of implementation framework was applied to assess teaching, learning and assessment during the COVID-19 pandemic. METHODS: A survey, focus group and document analysis were applied to collect data from 16 educators, 128 students and eight administrators of a nursing education institution and accessing institutional documents. Data were analysed through descriptive statistics and deductive content analysis and packaging the outcome of the study according to the five elements related to the fidelity of implementation framework. RESULTS: The fidelity of implementing the CBNE programme was satisfactorily maintained as described in the fidelity of implementation framework. However, sequenced progression and programmatic assessments were not aligned with a CBNE programme within the context of the COVID-19 pandemic. PATIENT OR PUBLIC CONTRIBUTION: This paper proposes strategies to enhance the fidelity of implementing competency-based education during educational disruptions.