AARE-NZARE Conference 29 November-2 December 1999

To be academically successful in a university program a student may need to employ general learning strategies such as monitoring and to develop discipline and course-specific strategies. In the first year of a Bachelor of Nursing program, for example, in addition to discipline-specific strategies students may need to develop specific strategies for courses such as Science, Psychology and Nursing Practice. To assist students to be academically successful, educators may need an understanding of the general and specific strategies students need to acquire for the course they are teaching, if they are to assist students in the development of these strategies.

One way of identifying the strategies students need to develop for a course is by the examination of high achiever students, as they have been found to use more self-regulated strategies than low achievers (Risemberg & Zimmerman 1992; Archer 1998), and to use more general and course-specific strategies (Pressley et al 1987).

The next step is to determine the best way of teaching these strategies to students. This may be done through 'Learn to Learn Courses'. However a meta-analysis of learning skills interventions, undertaken to enhance academic success, found that whilst these types of courses were successful in changing students' attitudes, their effect on performance and subsequent use of the taught skills was marginal and that more success was obtained when the training was specific to a domain (Hattie, Biggs & Purdie 1996). Others also recommend teaching self-regulatory strategies as part of a course (Zimmerman & Paulsen 1995).

Whilst the difficulties students have with the Science courses of nursing programs have been the source of a number of studies (Trnobranski 1993; 1997; Caon & Treagust 1993), little is known about the strategies students employ when studying for their science courses which may explain why courses aimed at reducing students' difficulties have had limited success (Gillies & Soars 1992; Nicoll & Butler 1996). There is also a paucity of research about the nursing courses in Bachelor of Nursing programs, possibly because these courses cause students less difficulties. Nevertheless, not all students are successful in these nursing courses.

The purpose of this study was threefold: to determine whether students report using different learning strategies to study in their first year Science and Nursing courses; to examine these differences in relation to academic performance; and to explore the changes in students' strategy use, in the two courses, over the academic year. The study focused on first and second semester Science and Nursing Practice courses of first year Bachelor of Nursing programs.

Apart from extracting some data pertaining to students' background (see Table 1), the telephone interviews and analyses were conducted independently to the questionnaire. That is, students' responses to the questionnaire items were not consulted before the interviews, and therefore were not used to guide the interviews.

The study focused on two courses–Science and Nursing Practice–that students study in the first and second semester of Bachelor of Nursing programs. The Science courses covered chemistry and physics topics and human bioscience. The Nursing Practice course had a theoretical component and a practical–clinical skills (for example measuring a person's Blood Pressure) component. In both semesters the science courses were assessed by assignment and examination.

A major part of the Nursing Practice assessment for both semesters was the workbook which contained case studies, and questions appropriate to the students' level of nursing knowledge. There were also some additional assignments, and in second semester students had to do a clinical skills (practical) assessment.

It was not possible to interview all the students (80) who put their telephone number on the questionnaire. It was decided to interview 40 students in the first semester as there was no way of predicting how many students would be available for a second telephone interview at the end of the first year.

Nursing students may have widely varying backgrounds and experiences that may influence their approach to the study of their first year Science and Nursing Practice courses. To understand how and why students use certain study strategies, it was decided to employ purposeful sampling. This would ensure that variations in students' backgrounds as identified by the questionnaire and considered relevant to the present study, were represented in the telephone interview sample (Maxwell 1996). The 40 students who were interviewed were a purposeful sample of students from the 80 who had provided their telephone number. Students' questionnaires were scrutinised to determine their: method of entry to university (mature age/high school leaver), whether they were from Non-English speaking backgrounds (NESB) or had any previous nursing experience and whether they had studied biology or chemistry for their High School Certificate (HSC). This information was used to guide the selection of the telephone sample, who were chosen to reflect the heterogeneity of the questionnaire sample of students. If a student could not be contacted after 4 telephone calls the next student on the list was telephoned. A comparison of selected background details of the questionnaire and telephone interview sample of students are given in Table 1 and show that the samples are very similar.

The telephone interviews were semi-structured. In the first and second semester students were asked how they studied for their Science and Nursing Practice courses. In the second semester, if students mentioned using reading as a strategy for studying science, they were then prompted and asked if they tested themselves to see if they knew or understood what they were reading (monitored reading). In the second semester students were also asked if they had changed the way they now studied for these courses.

The telephone interviews were conducted by the first author, who had been responsible for the questionnaire distribution. This presented us with two advantages. Firstly, it avoided the need for interviewer training, and other standardisation procedures that are necessary when more than one interviewer is used in telephone interviewing (Frey 1983). Secondly, as the researcher had had contact with the students during the questionnaire phase, it seemed to help in the establishment of rapport, during the telephone interview, between the student and the researcher . Other researchers (Worth & Tierney 1993) have also found that pre-interview contact with participants has aided rapport. Rapport is important in interviewing, because it leads to 'more informed research' (Fontana & Frey 1994, p367).

The first telephone interviews were conducted over a period of two weeks which was approximately the middle of the first semester. Students were interviewed again in study recess at the end of the second semester. Telephone interviews were conducted on weekday and Sunday evenings, afternoons on the weekend and daytimes on Fridays. These times and days were selected after consulting the academic time-table and hypothesising about students' possible family, study and work commitments. When students were telephoned, the researcher introduced herself, reminded them that they had put their name on the questionnaire, established whether they were still willing to participate in the study and asked if they had time to answer some questions. Most students were willing to talk, only one declined to be interviewed. If the time was not convenient they were contacted again at a mutually suitable time. At the end of the interview, which ranged in time from 15-40 minutes (average 25 minutes) the researcher asked the student if she/he were willing to be interviewed again in the second semester.

The conduct of the second interview was similar to that of the first semester although the length of the interview was shorter–average 15 minutes. The researcher made certain that she thanked students for their participation in the research and informed them that this was their final telephone interview.

The researcher recorded students' comments by hand during the interview. Occasionally there were pauses while the researcher finished writing down a student's comment. It has been reported that some interviewers dislike pauses especially in telephone interviewing (Hertzog & Rogers 1988) whilst another who also hand-recorded telephone interviews, felt that the pauses may help the participants to relax (Carr 1999). The researcher (Andrew) felt that the pauses were beneficial as they allowed the students time to reflect on the topic being discussed and think about what they wanted to say. To ensure accuracy, the interviews were transcribed onto computer files as soon as possible, usually the same or the following day after the interview.

To understand students' strategies for studying science and nursing practice, the telephone interviews were analysed using the coding techniques described by Miles and Huberman (1994 p58-76) and derived from Strauss (1987), Strauss and Corbin (1990) and Lincoln and Guba (1985). Students' comments about their study strategies were coded by word and phrases or sentences where appropriate. Codes were revised frequently, and those that appeared to be related were then grouped into categories. Some of the categories were similar to those of the research instrument the Motivated Strategies for Learning Questionnaire (Pintrich et al 1991), and were named accordingly.

Students' academic results for their Science and Nursing Practice courses were used to divide students into Low or High Achiever categories according to their academic grades. Students who obtained a Fail or Pass grade were assigned to the Low Achiever category and those who obtained a Credit, Distinction or High Distinction were categorised as High Achievers. The frequency with which a strategy was mentioned by students was summed and divided by the total number of students in an achiever group to obtain a frequency measure (cf Zimmerman & Pons 1986) for each category of strategy for the two achiever groups for science and nursing practice (Table 3 & 5).

Students reported using a variety of strategies when studying for their first semester Science and Nursing Practice courses. Whilst there was some commonality in the strategies students employed to study these courses, there were also strategies that were course-specific. The study strategies used by students when studying for their Science and Nursing Practice courses are shown in Table 3 and 4 respectively.

For the Science course, eight categories of self-regulatory strategies were identified: organisation, reading, elaboration, rehearsal, metacognitive self-regulation, study environment and help-seeking. These strategies are comparable to those found on other self-regulatory measures, for example the Motivated Strategies for Learning Questionnaire (MSLQ) (Pintrich et al 1991) and the Self-Regulated Learning Interview Schedule (SRLIS) (Zimmerman & Pons 1986). Categories termed 'intention to study', 'lack or strategy awareness' and 'other' were identified and are included although they are not actually self-regulatory learning strategies.

The reading of a variety of course or course-related materials was the strategy most often described as being used by students when studying for their Science course, whilst help-seeking was the least reported strategy. Whilst students also report reading for their Nursing Practice course, the variety of materials they read was less than for the Science course. As for the Science course, help-seeking was also the least used strategy for the Nursing Practice course.

Elaboration was the strategy students were most likely to report using when studying for their Nursing Practice course. Whilst students 'make notes', an elaboration strategy also used in the study of science, they do not discuss summarising or paraphrasing study course materials for the Nursing Practice. This may be because students see Nursing Practice as practical and not theoretical and therefore do not employ their full range of strategies when studying for this course. Students made comments indicating that they make links between their Nursing Practice course and the Science course material or their clinical (hospital) experiences and these were included in this category.

Two course-specific categories of strategies–workbook and clinical skills practice were identified for their Nursing Practice course. It may be that the workbook and clinical skills practice incorporated other strategies, as to do extra clinical skills practice, for example, students needed to organise a place to practise (at home or university clinical skills laboratory and maybe with friends–peer learning) which therefore also incorporated time management strategies and possibly perform the skill more than once during the practice (rehearsal).

Therefore, organisation, rehearsal, peer learning or study environment strategies are more course-specific to science with reading–of textbooks and notes–and elaboration and help-seeking are more generic strategies.

Organisation and reading were the two main strategies used by both achiever groups to study science (Table 5). Unlike High Achievers however, Low Achievers tend not to monitor their reading or use other metacognitive self-regulatory strategies very frequently. Table 6 shows that except for reading, High Achievers use all of the other strategy groups more frequently than Low Achievers.

Low Achievers find their Nursing Practice course less difficult and put less time and effort into studying for it than their science course. Whilst this does applies to a certain extent to High Achievers they are more likely, however, than Low Achievers, to see the need for studying in the Nursing Practice course. They will also use similar study skills, in Nursing Practice, that they employ for science and engage in skills specific to the Nursing Practice course although they have difficulty in conceptualising engaging in clinical skills practice as a method of studying.

Low and High Achievers are most likely to use elaboration strategies when studying for their Nursing Practice course although High Achievers are equally likely to use metacognitive self-regulation strategies (Table 5).

Apart from elaboration and help-seeking–which is the strategy least used–Low Achievers are equally likely to mention using, albeit infrequently, workbook, reading, clinical skills practice or metacognitive self-regulation strategies.

Clinical skills practice and workbook are the strategies that are likely to be described by High Achievers as being used next after elaboration and metacognitive self-regulation strategies. Like Low Achievers, High Achievers are least likely to describe using help-seeking strategies to study for their Nursing Practice course.

* Includes strategies 9, 10 & 11 (see Table 2)

Most students remained in the same achievement group in the second semester. Low Achiever students did not seem to make any significant change to the way they study. Some students commented that they were approaching their study of science differently in this semester, however, their descriptions of the study strategies they used did not appear to support their assertions. For example, one student who indicated said that she was studying for the science differently in the second semester said :

In the first semester this student had also mentioned using diagrams, reading the textbook and taking key words from her notes, in other words, the student was still basically using the same study strategies in the second semester as she had in the first semester. Low Achiever students described using a limited repertoire of self-regulatory strategies and when questioned they admitted that they did not monitor their reading or test their knowledge. Reading was once again the strategy most frequently cited as a study strategy.

Low Achiever students continue to leave their study preparation for the final examination until the last minute. When interviewed in the final weeks of the second semester, one student who had failed science in the first semester said:

Some Low Achiever students (17%) improved their academic performance in science over the first year of their nursing program and therefore were classified as High Achievers for their second semester.

These students seem to have made changes to the way they study science and this may be a contributory factor in their improved academic achievement. For example, in the first semester one student indicated she studied for science by reading the textbook and notes. In second semester the student said:

This student had made several changes to her study of science. She had increased the number of strategies she used to study and included metacognitive self-regulatory strategies–namely self-testing–to assess her knowledge.

Students who were categorised as High Achievers for science appeared to recognise the success of their study strategies and talked about studying for science 'the same' in the second semester or not changing 'the way I study'. One student said:

These students were consistent in the descriptions of the study strategies they use. For example in the first semester one student said she studied for science by:

In the second semester this student said:

These comments indicate the consistent use of metacognitive self-regulatory strategies, and was reflective of other High Achiever students who also described using these strategies, particularly monitoring and self-testing.

Although the second semester was considered 'a lot of work' and 'not as easy' as the first semester, Low Achiever students were not likely to have changed their study strategies. Most Low Achiever students mentioned doing the workbook although they continue to be confused about its role as a study strategy:

Low Achiever students made comments regarding their academic performance and attributed it to 'lecturers for lack of supervision' or being 'bad at explaining things', and having 'three assignments due on one day'.

Some students improved grades and were moved from the Low to High Achiever category. One such student, said in the first semester that for the Nursing Practice course:

In the second semester this student had significantly improved her performance and her comments indicated that she had made some changes to her study strategies:

High Achiever students clearly recognise the theoretical and practical aspects of their Nursing Practice course. Some students mentioned the presence of more assessments for the Nursing Practice course in the second semester and adjusted their study accordingly:

In preparation for the clinical skills examination one student said :

This student's comment indicates the continued confusion students have in recognising that doing extra clinical practice is a strategy of studying for the Clinical Practice course.

This study found that students report using general and course-specific strategies when studying for their Science and Nursing Practice courses. Elaboration (making notes), reading textbooks and notes, metacognitive self-regulation (self-testing) and help-seeking were strategies common to both the Science and Nursing Practice courses. Strategies specific to Science included organisation, rehearsal, peer learning, the study environment and the reading of specific materials eg diagrams. The use of these strategies may reflect the heavy theoretical nature of the Science courses. The course-specific learning strategies for Nursing Practice included participation in extra clinical practice, the completion of the course workbook and making links between science knowledge, clinical and the course. It is possible that extra clinical skills practice and the workbook may require additional strategies from categories such as rehearsal.

Whilst students described doing extra clinical practice and completing the workbook as methods of studying for their Nursing Practice course, they had difficult conceptualising them as study strategies. This may be because this is the first time they have had to study a course that had a theoretical and practical component. Radloff et. al. (1999) recommend that lecturers spend time finding out about students' conceptions of study, and it would appear that this would help students in Nursing Practice, particularly as those who failed to come to terms with the dual nature of this course tended to be less successful in the course.

With regards to academic performance in the Science course in the first semester, Low Achiever students need to be taught a wider range of strategies if they are to improve academically. One strategy that these students particularly need to develop, is the monitoring of their reading and study generally, as it helps them to identify any faulty areas in their learning (Zimmerman & Paulsen 1995).

In the second semester students who were Low Achiever in their Nursing Practice courses were not likely to report changing their study strategies, and were most likely to use to workbook to study for their Nursing Practice course. The students who were persistently High Achiever students in Nursing Practice course made adjustments to their study in the second semester particularly in response to the clinical skills examination in this semester. They recognised that the Nursing Practice course had practical and theoretical aspects and managed to address both in their study. As for the Science course, the High Achiever student used metacognitive self-regulatory strategies.

Just as they did in the first semester, Low Achiever students describe using less strategies when studying for their Science course. Reading the textbook was the main strategy most frequently used by Low Achiever students who continued to use this strategy without monitoring their reading. Low Achiever students also continue to leave their study until the last minute. Some students reported making some changes to their strategies and this was reflected in their academic performance and hence change from the Low Achiever to the High Achiever category. They also reported increasing the number of strategies they employed and to have introduced, or increased, metacognitive self-regulatory strategies particularly monitoring of their reading and self-testing into their study practices. Persistent High Achiever students were consistent in their study strategy usage particularly, metacognitive self-regulatory ones, and seem to recognise the success of their academic approach to studying science.

To assist students to be academically successful in their Science and Nursing Practice courses they need to be taught to employ a wide range of general learning strategies in particular self-monitoring and those specific to the course they are studying.

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