Defense Date

11-3-2016

Availability

Worldwide Access

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Rebecca Kronk

Committee Member

Bonnie Dean

Committee Member

Connie Moss

Committee Member

Mary Ann Cantrell

Keywords

Competency, Education, Graduate Nurse, Nursing, Patient Care

Abstract

Background/Purpose

Catheter associated Urinary Tract Infections (CaUTI) are preventable, and hospitals receive no additional reimbursement for these infections. The purpose of this study was to evaluate the effect of mastery learning compared to traditional learning on new nurses’ skill acquisition and self-regulation practices for indwelling urinary catheter insertion.

Theoretical Framework

Mastery Learning posits that all learners have the potential to achieve mastery when given the time to learn along with deliberate practice and repetition. Traditional Learning, a more rote instructional approach, emphasizes memorization with a single summative assessment. Self-regulation signifies actions practiced by the learner to gain new knowledge which is promoted when given deliberate feedback, a hall mark of mastery learning.

Methods

This randomized controlled trial was conducted in an acute care health system and collected outcome data at two points (immediately after the intervention and one month later). Participants, who were new to practice nurses, were randomized into the experimental (mastery learning and the control groups (traditional learning). All received baseline education on indwelling urinary catheter insertion before completing the procedure in the simulation lab. The experimental group was offered multiple attempts for insertion with deliberate practice, repetition and feedback. The control group was offered one attempt for insertion with feedback at the end. Paired t-tests compared: 1) the mean change in initial and one-month skill acquisition scores within groups measured on the Performance Assessment Tool (PAT), and 2) self-regulation practices for both groups using the Survey of Academic Self-Regulation (SASR) questionnaire one month post-intervention. An independent t-test compared the mean change in skill acquisition scores measured on the PAT scores between groups at one-month.

Results

The mean change in the initial and one-month skill acquisition scores within groups was not significant for either group: control, p = .128 and experimental, p = .275. The mean change in the initial and one-month skill acquisition score between groups was not significant, p = .063. A comparison between groups exclusively on those procedural steps deemed critical (potential to cause harm) was significant: the experimental group scored significantly higher, p = .013. The mean SASR scores between groups was significant, p = .035.

Conclusion

Although the difference in PAT initial and one-month post intervention scores both within and between groups were not significant, we cannot forego the need to continue to test and explore teaching strategies that promote clinical competence. Of importance is the retention of the seventeen critical steps retained by the experimental group. The retention of these steps was significantly greater in the experimental group as compared to the control. This finding is important because, if performed incorrectly, these steps will cause harm to the patient. The mean SASR score for the experimental group was greater than the mean for the control group suggesting that nurses in the experimental group, who received corrective feedback repeatedly for those critical steps, have a greater propensity for applying study strategies to help maintain skills acquisition and competence. Findings serve as a new nursing pedagogy.

Format

PDF

Language

English

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