Learning styles and academic performance in nursing education programs

¶ … growing recognition of the changing educational needs of college students, particularly those attending community colleges. In response to this awareness, reform efforts have been implemented in order to meet the needs of students. As reform efforts have been considered, increasing attention has been directed toward assessing the influence of learning styles on academic performance. The term 'learning styles' has been used to refer to the ways in which individuals display preferences in receiving, processing and presenting information and ideas when engaged in learning activities. In ongoing efforts to further establish the knowledge base on learning styles, evidence suggests that a number of factors have been identified as influencing learning styles. Some have suggested that the individual's personality, life experiences and the purposes associated with specific learning situations strongly determines one's learning style (e.g., Briggs-Myers, 1989; Kolb, 1984). Others have indicated that learning styles are primarily associated with the learning environment, including expectations of teachers (Ballard & Clanchy, 1997). Further documentation has suggested that regardless of the factors that influence learning style, mismatches that exist between the learning environment and the student's learning style operate to impact academic performance, student achievement and ultimately, attrition (UWA, 1996; Felder, 1996).

Overall, evidence has suggested that one of the more promising means for determining effective teaching is research that which pays attention to the importance of learning styles (McCarthy, 1996). There has been a growing interest in examining the influence of and factors associated with learning styles of students enrolled in college programs in the health sciences, medicine and nursing (e.g., Blagg, 1985; Rahr, Schmalz, Blessing & Allen, 1991; Vittetoe, 1983; Sutcliffe, 1993; Cross & Tillson, 1997; Highfield, 1988; West, 1982; Fox, 1984; Piane, Rydman, & Rubens, 1996; Haislett, Hughes, Atkinson, & Williams, 1993; Lynch, Woelfl, Steele, & Hanssen, 1998; Joyce-Nagata, 1996; Rakoczy, & Money, 1995; Cavanagh, Hogan, & Ramgopal, 1995; Jambunathan, 1995). As the field of nursing represents a sector in which there is a critical shortage and imbalance between the needs of society for professionals to fill nursing roles and educated persons available to fill that role, it appears important for nursing educators to continue with efforts to more fully understand the learning needs of nursing students in order to attract and retain students to the field. During the last two decades, there has been a continuing decline in the choice of nursing as a career. Without efforts to reverse this trend, the Registered Nurse (RN) workforce will continue to age, decrease and eventually, will not meet the projected long-term workforce requirements (Buerhaus, Staiger & Auerbach, 2000). In order to further help meet the nursing supply problem, it remains critical to further understand and implement teaching and learning strategies that will aid in further building the RN workforce.

The proposed study will use the Kolb LSI to further examine the learning styles of nursing students in a baccalaureate and associate degree program. A comparison will be conducted of LSI scores with age, gender and academic performance in order to more fully understand factors that may influence nursing students in their classroom experiences in nursing education.

Statement of the Problem

As documented in the results of the annual survey by the American Association of Colleges of Nursing (AACN) (2000), RN to Baccalaureate enrollments reflects strong declines in every region of the nation. Such evidence has pointed to the need to implement strategies for retaining and encouraging nursing students from diverse backgrounds while implementing efforts to utilize teaching strategies appropriate for the requirements and needs of students. Prior research has also indicated that the highest percentage of nursing student course failures occur in the first year of the nursing major (Hudepohl & Reed, 1984). When examining the types of students who drop-out of nursing programs, some have argued that the more extroverted, adventurous individual tends to leave nursing for other fields while others have argued that it is the less emotionally mature student who exits (Skodol & Levy, 1978).

Even though a number of studies have examined some aspect of learning styles and profiles of nursing students, few have extensively examined learning styles in relation to academic performance in relation to nursing education programs. As recommended by the AACN (2000), in order to meet the demands of the current health care environment, further efforts need to insure that at least two-thirds of the nurses in the workforce need to hold a baccalaureate degree or higher. Consequently, undergraduate programs in nursing are faced with planning and implementing ways to further attract and retain students through the completion of their training (AACN, 2000). It appears critical to engage in research activities intended to strengthen the knowledge base on the learning styles and needs of nursing students.

Purpose of the Study

The overall intent of the study is to further exam the learning styles of nursing students at in undergraduate programs at the baccalaureate and associate level. Student age, gender and academic performance in nursing courses will also be investigated to further determine the way in which these factors may be associated with and influence student learning styles in order to assess the degree to which such factors represent important variables for nursing educators to consider in developing and implementing plans for retaining nursing students. As it has been suggested that a major factor responsible for student success or failure is the effectiveness of the teaching-learning process, it is hoped that the findings of the study will be useful in aiding nursing education programs in more fully responding to the learning needs of student nurses.

Research Questions

The research questions underlying the study are as follows:

To what degree, if any, does the learning style of student nurses influence academic performance as denoted by course grades?

To what degree, if any, does age and gender influence learning style?

To what degree, if any, does the relationship between learning style, age, and gender influence the academic performance of student nurses?

To what degree, if any, does academic performance vary on the basis of enrollment in nursing courses within in a four-year program as compared to enrollment in a two-year program?

To what degree, if any, does the learning style of student nurses in four-year educational programs as compared to student nurses in a two-year program vary?

Theoretical Framework

The theoretical framework providing a foundation for the study is based on conceptualizations of experiential learning and the emergence of theory concerning the learning styles of individuals engaged in the learning process. Experiential learning theory originated on the basis of work conducted initially by Carl Jung from which a model of the learning process related to how individuals think, grow and develop emerged (Smith & Kolb, 1986). The pioneering work in experiential learning theory was conducted by Dewey, Lewin and Piaget (Kolb, 1984). According to Kolb, Dewey, Lewin and Piaget helped to develop a model of learning in which learning comes to be understood as the process whereby concepts are derived from and are continuously modified by experience. Kolb further explained that learning based on experience occurs in three primary ways: by assimilation of knowing what the experience is like, using the senses, and by dealing primarily with concepts and the symbolic representation of experience. As was delineated by Kolb, the use of the senses is a more concrete way of perceiving experience whereas symbolic representation deals more with abstract concepts.

On the basis experiential theory, some individuals display a preference for sensing and/or feeling their way through new situations, relying heavily on intuition (Smith & Kolb, 1986). Such individuals perceive new information on the basis of prior concrete experience while others prefer to think through aspects of the situation more analytically (Smith & Kolb, 1986). According to Smith and Kolb, these two preferences represent a continuum with individual preferences of perceiving information lying somewhere between the two, and at a different place for each individual. As well, during any one learning experience, both modes of processing information may be used; however, the degree to which either is used may differ (Smith & Kolb, 1986). Via preferences for understanding one's experiences, the individual works at understanding and processing the information being presented. As further explained by Smith and Kolb (1986), some individuals prefer to process information immediately by actively engaging in the learning situation while others prefer to watch and reflect on what happens. The manner in which information is processed also exists on a continuum, from active experimentation to reflective observation (Smith & Kolb, 1986). The combination of individual preferences of grasping and transforming experience leads to a pattern which is termed learning style (Kolb, 1984).

Kolb (1984) suggested that there are four basic learning styles. These styles are as follows:

Concrete Experience (CE): Needs time to digest information. Needs tangible, "hands on" approaches. Will probably not volunteer to ask or answer questions spontaneously. Works well in individual tutorials and one-on-one situations. Should do a lot of reading to build the background knowledge that can facilitate understanding.

Reflective Observation (RO): Takes learning personally. It is important for this type to like a course and to find a personal link with it. Usually, needs to know on how to understand material without feeling compelled to agree with it.

Abstract Conceptualization (AC): Connects information with prior learning. Learns through linking new knowledge with previous knowledge and experiences. Sees the big picture. May have difficulty with organizing information, finding focus, or attending to details. In writing essays, may appear to be "all over the place."

Active Experimentation (AE): Has a need for immediate feedback. Learns best by asking questions. May jump ahead of the instructor and interrupt with questions. Is often an academic rebel, i.e. likes to "buck the system" or look for exceptions to the rules. Works well with group tutorials and group study.

As explained by Kolb and Smith (1986), in order for learning to be effective, it is critical that the learner be able to use the four different styles within a learning situation. An individual's preferred method of perceiving and processing experience may, in part, be related to self programming and be conditioned by experience (Kolb, 1984; Smith & Kolb, 1986). As well, as explained by Kolb (1984), the learning situation itself may also lead to emphasis being placed on utilization of one or more the learning styles.

Organization of the Thesis

The thesis is organized and presented within five chapters. The first chapter has served to provide an introduction to the study. In Chapter Two, a review of the literature of relevance to learning styles will be presented. This will be followed by a discussion of the research methodology to be applied in the study in Chapter Three. Within Chapter Four, the findings of the study will be presented. Chapter Five will offer conclusions and recommendations based on the primary findings of the study.

CHAPTER TWO

Literature Review

Within this section of the thesis, a literature review will be provided of both seminal and current literature of relevance to the study. Initially, as a consequence of the their relevance to learning styles of students enrolled in higher education, an overview will be provided in which a contrast is offered of the andragogical and pedagogical model as associated with teaching adult learners. This will be followed by a discussion of learner-centered and teacher-centered learning environments. After this, further information will be provided on learning styles.

The Question of Learner Centered or Teacher Directed Adult Learning Environments

Within the literature, there has also been extensive discussion of learner centeredness as another distinguishing characteristic of adult education. Cervero and Wilson (1999) offer a strong indication of this thread of thinking in the following statement: "At the heart of practice is the adult learner....The highest professional and moral principle for adult educators is to involve learners in identifying their needs" (p. 29). In traditional teacher-directed education as practiced in elementary, secondary, and postsecondary settings, passive learners receive knowledge transmitted by teachers (Tice 1997). Formal curricula reflect what powerful groups think students should learn and what kinds of knowledge are considered important (Sheared & Sissel, 2001; Titmus, 1999). In contrast, learners are at the center of policy and practice in adult learner-centered institutions, which are characterized by flexibility and individuation for self-directed, empowered adults. According to Tice, this philosophy carries with it the idea that traditional teaching practices, not considered appropriate for adults, are more appropriate and suited to the needs of children and adolescents. However, there are others that do not believe that the traditional model is appropriate in meeting the needs of either children or adults. As suggested by Titmus (1999), education and learning as a whole are shifting from transmission of a fixed body of knowledge to a focus on lifelong learning, the essential habits of mind with which adults will be ill prepared if initial schooling continues to use traditional teacher-directed methods. Andragogical methods, which purport to provide "a relaxed, trusting, mutually respectful, informal, warm, collaborative and supportive learning environment" (Sipe 2001, p. 89), are more conducive to learning at all ages (Sipe 2001).

The question thus has emerged as to what extent are learner-centered practices actually used by adult educators. In Kember, Kwan, and Ledesma's (2001) study, instructors viewed adult students as being at the andragogical end of the continuum, but teaching methods stemmed from their conception of good teaching: as transmission of knowledge or facilitation of learning. They also varied the use of teacher-directed and learner-centered approaches depending on which better served learner needs (e.g., designing teaching to be congruent with the relative strengths and weaknesses of students).

In Beder's (2001) research, teachers expressed learner-centered intentions and orientations. Yet "observations portrayed a type of instruction that was the near antithesis of learner-centered" (p. 46): predominant use of teacher-prepared lessons, elementary-school-style elicitations, and virtually no substantive learner input. Beder concluded that, although instruction itself was teacher directed, teachers were learner centered in their affective relationships with learners. Learner centeredness was thus an expression of values, not a teaching method.

As well, the literature reflects that efforts have been made to determine the degree to which adult learners prefer learner-centered approaches. Beitler (1997) found midcareer adult students more concerned with teacher characteristics and appropriate teaching methods; for example, they preferred teacher direction in courses with a clearly defined body of knowledge to master, such as accounting. In Donaldson et al.'s (1993) study, adult students' conceptions of good teaching included a mix of teacher-directed and learner-centered characteristics.

As well, some researchers have attempted to address the degree to which learners or teachers experience autonomy within formal educational institutions. As findings have suggested, driven by a current climate of accountability and quality assurance, learner experience may be valued in class discussions, but not in assessment (Leach, 2001). Additionally, as reported by Leach, learning contracts are a typical learner-centered approach, but postsecondary institutions control what credit will be given. Adult educators with a transformative and/or emancipatory philosophy may find institutional limits on their ability to challenge inequities (Leach, 2001; Sissel et al., 2001). At the same time, their focus on raising learner awareness can be disorienting and painful for adults, rather than nurturing and supportive (Leach, 2001). The educator's role as facilitator in learner-centered approaches does not account for intersecting power dynamics that "privilege some, silence some, and deny the existence of others" (Johnson-Bailey & Cervero, 1997, p. 240).

As suggested by Cervero and Wilson (1999), learner centeredness is a politically naive and ethically blind position, because there are always multiple interests at stake in adult education activities and no generic adult learners. They assert that meeting learner needs is not a viable guiding principle; at the heart of practice should be the question of who benefits and who should benefit from adult education.

Learning Styles and the Learner-Centered Approach

As found within the literature, an array of concepts has been utilized in discussions on learning styles. One of the clearest classifications of terms is presented by Curry (1991) and Riding and Cheema, (1991). Definitions of these terms are as follows:

Learning Preference: favoring one method of teaching over another.

Learning Strategy: adopting a plan of action in the acquisition of knowledge skills or attitudes.

Cognitive Strategy: a systematic and habitual mode of organizing and processing information.

Cognitive Style: a systematic and habitual mode of organizing and processing information.

The learning centered approach, according to Riding and Rayner (1998), has been motivated by educators who have recognized the importance of addressing the diversity of the environment in which learning takes place, and driven by process-based concerns relating to meeting individual differences and learning needs. The focus has shifted from concentrating on the constructs of intelligence and processing of information to an increased interest in learners' active response to the learning task and to the learning environment. The learning centered tradition has grown out of process-based models of learning, including:

the learning process as a form of experiential learning (Kolb, 1984) learners' orientations to learning (Entwistle 1981; Biggs, 1979) cognitive skills and strategy development (Keefe & Monk, 1986).

The research that has been conducted on learning style has documented that learners are dynamic and open to adaptation according to the particular context of learning (Riding & Rayner, 1998). However, as noted by Riding and Rayner, criticism has also been directed towards the learning-centered tradition of research on learning styles, on the basis that it represents an uncertain relationship between learning style and cognition and that concepts are poorly defined and used loosely. In spite of this concern, as noted by Riding and Rayner, the strength of the learning-centered tradition is that it attempts to contextualize and operationalize the construct of 'learning styles' and to apply the insights gained to improving pedagogical practice.

Stated simply, the context is not just an external context imposed by somebody else.

In a comprehensive review of literature, Richardson (1994) concluded that higher education requires students to comprehend, and not merely to reproduce ideas and that acknowledging different approaches to learning enables authentic tasks to be created which are responsive to learner needs. As explained by Richardson, in designing a learning task there is also an increased emphasis on productive as opposed to reproductive learning activities. For example, learners are required to solve problems, produce arguments and evaluate their own work and that of others. With a growing focus on these productive and creative activities, a shift in emphasis in higher education from reproductive to higher order learning activities and an emphasis on meaning-directed and investigative styles of learning has occurred (Trigwell & Prosser, 1999). Such an approach necessitates taking into account differences in prior knowledge and a greater understanding of learning processes in which learners are participants in knowledge creation, not mere receptors of inert knowledge.

According to Dearing (1997), implementation of a learner-centered approach places greater importance on aiding learners in developing an understanding of their own learning styles. For learning tasks, Dearing indicated that: an effective strategy is to guide and enable learners to be effective learners to understand their own learning styles and to manage their own learning. (Dearing, 1997: 24). As explained by Jonassen and Wang (1993), merely providing content and information and showing learners structural relationships is not sufficient for higher cognitive performance. They conclude that "what matters most is the construction of personally relevant knowledge structures" (p. 7). This means that learners must be able to engage with the learning materials at varying levels and depths and be capable of accessing resources, which match or accommodate their learning preferences.

The findings of prior research have suggested that learning improves when learning styles are taken into account (e.g., Riding & Rayner, 1995; Riding & Douglas, 1993). Claxton and Murrell (1987) concluded that consideration of styles provides a means for faculty and administrators to think more deeply about their roles and the organizational culture in which they carry out their work. Others have suggested that it is also important to extend or change learners' cognitive systems or approaches to learning through adaptive, intelligent use of computer courseware and learning materials (Jonassen, 1988).

Kolb's Learning Cycle

As discussed within Chapter One, the core of Kolb's (1984) theory on learning style is that learners progress through a learning cycle in which experience leads to observation and reflection, which then leads to concept formation. Figure 1 provides a visual display of this cycle.

Figure 1: Stages of the Learning Cycle (Kolb, 1984)

On the basis of Kolb's (1984) learning cycle, as learners are exposed to new learning materials, efforts to understand concepts in turn leads to new experiences and further experimentation, in cyclic fashion. Effective learners tend to proceed through all four stages but may develop dominance in one domain. Later research conducted by Honey and Mumford (1986, 1992) resulted in modifications to Kolb's cycle, with the inclusion of four learning styles corresponding to each of the stages:

activists: those who like new experiences and tackling new problems and quickly go on to new tasks to ensure novelty;

pragmatists: those who like to apply new ideas immediately;

reflectors: those who like consider all the aspects and angles before making a decision;

theorists: those who integrate their observations into conceptual models.

Thus, Kolb's model of the learning process, based on a four-phase model is associated with four modes of learning characterized by the terms activists, reflectors, theorists and pragmatists as depicted within Figure 2.

Figure 2: Learning Styles associated with the Learning Cycle

Kolb, Rubin and Osland (1995) designed a 'floor map' exercise that enabled learners to identify their own learning profile. It was found that many learners have attributes that characterize all stages in the learning cycle and can demonstrate eclecticism in their capacity for concrete experience, formation of abstract concepts, active experimentation, reflection and observation.

CHAPTER THREE

Research Methodology

Within Chapter Three, the research methodology to be implemented within the study will be described. The discussion will address the research design of the study as well as the research methods used including sampling, measures, and data collection. The data analysis methods selected and used for analyzing the data will be explained.

Research Design

As the overall purpose of the study is to explore the learning styles of nursing students, the research design selected for the study is an exploratory correlational design. While the use of an experimental or quasi-experimental research design is critical for the purposes of predicting and/or establishing causal relationships, as explained by Zechmeister, Zechmeister and Shaughnessy (1997), the implementation of a correlational research design permits the researcher to explore and discover relationships among a large number of variables within a study. In correlational research, according to Zechmeister et al., the main purpose is to establish whether two variables are related, and if so, establish the direction of the observed relationship.

Correlational research may be considered to be nonexperimental in that there is no manipulation of the independent variable and no attempt to establish causality. Instead, variables are simply measured to determine if a correlational relationship exists between them.

According to Zechmeister et. al, (1997), survey research represents a general approach to be used when the correlational research design is implemented. Survey research is the method of gathering data from respondents thought to be representative of some population, using an instrument composed of closed structure or open-ended items (questions). It is one of the most dominant forms of data collection in the social sciences, providing for efficient collection of data over broad populations, amenable to self-administration, administration in person, by telephone, via mail and over the Internet.

There are many advantages that have been identified in the use of the survey method. According to Babbie (2001), these advantages include:

One can collect a large amount of data in a fairly short time.

Surveys are easier and less expensive than other forms of data collection.

Questionnaires can be used to research almost any aspect of human perceptions regarding the variables under study.

They can be easily used in field settings.

Research Method

In this section of Chapter Three, the research method, which will be applied in the study, will be reviewed. Information will be provided as to the procedures planned for sampling, measures and instrumentation, and data collection.

Sample

The population of interest for the study is nursing students attending baccalaureate and associate level classes in nursing. **** YOU WILL NEED TO EXPLAIN IN THIS SECTION WHERE THE POPULATION IS LOCATED - WHAT SCHOOLS.

Sampling Procedure

For the purposes of the study, nonprobabilistic sampling will be utilized. Nursing students who are attending

****AGAIN YOU WILL NEED TO EXPLAIN HOW YOU ARE GOING TO GET NURSING STUDENTS TO PARTICIPATE IN YOUR STUDY - GAINING PERMISSION FROM THE INSTRUCTOR, EXPLANATION TO STUDENTS AS TO THE PURPOSE OF THE RESEARCH, AND APPROPROXIMATE NUMBER OF STUDENTS WHO ARE TO PARTICIPATE IN THE STUDY.

Measures and Instrumentation well-designed questionnaire is critical for achieving the purposes of correlational and survey research. Additionally, concerns with validity (i.e., the degree to which an instrument measures what it was intended to measure) and reliability (i.e., the degree to which an instrument provides measurements that are consistent and accurate) must always be at the forefront of the questionnaire selection/construction process.

For the purposes of the study, Kolb's LSI was selected for use in the investigation. The LSI consists of 12 simple sentence completion items, which require the respondent to rank order 4 sentence endings that correspond to the 4 learning modes: concrete experience (CE), reflective observation (RO), abstract conceptualization (AC), and active experimentation (AE). The highest number of choices relevant to a learning mode yields a raw score varying from 12 to 48. This score can be used to classify an individual into one of four learning style types: converger, diverger, assimilator, or accommodator. The LSI also yields two combination scores that indicate the extent to which the individual emphasizes abstractness over concreteness (AC-CE) and action over reflection (AE-RO). The combination raw scores vary from +36 to -36. The entire LSI comes in a self-scoring booklet containing the inventory, the Learning Style profile, and the Learning Style type grid.

The reliability data of the LSI for the four basic scores and two combination scores indicate good internal consistency as measured by Cronbach's Standardized Scale alpha (n=268). The combination scores indicate almost perfect additivity (1.0) as measured by Tukey's Additivity Test (Kolb, 1984).

External Validity.

Sampling bias is always a threat to the external validity associated with the findings of a study. Random sampling and the use of a truly representative sample in research is often a difficult challenge. In order to reduce the potential for sampling bias, as suggested by Borg (1983), an effort will be made to clearly describe the sample selection process in detail and the characteristics of the study participants.

The utilization of a representative design has also been suggested as a means of increasing the generalizability of research findings (Snow, 1974). A representative design is one that has been planned in such a way as to reflect environments characteristic of those associated with the population as well as the characteristics of the study participants. In order to plan for a representative design, Snow recommended the following:

Conduct research in an actual field setting/locality familiar to study participants;

Attempt to include within the design participants who vary on certain characteristics (e.g., level of experience);

Include observations of the participants during the study; and,

Observe the social context in which the study is conducted as certain events may influence the findings of the study. Recording the occurrence of such events can aid in increasing the degree to which the findings have greater interpretability.

In order to further increase the potential for generalizability of the study findings, following the Snow's (1974) guidelines, the research will be conducted within a setting that will be student-class-related and familiar to those who choose to participate in the study. Additionally, questions will be included on the questionnaire regarding age and gender, which provides a means of accounting for some variation amongst study participants.

Data Collection

As described earlier, the survey method will be used as the means by which data will be collected within the study. Prior to initiating the data collection phase of the study, permission to conduct the survey will be obtained from appropriate university officials regarding the involvement of human subjects if need be. Data collection will commence predicated approval of the proposal for the study. Questionnaires and the cover letter explaining the purpose of the survey and the anonymity associated with participation in the survey will be distributed to participants and will be picked up after the student's complete the questionnaire in class.

Data Analysis

Within this section of Chapter Three, the data coding and data analysis procedures implemented within the study will be reviewed. The general assumptions associated with statistical procedures selected will be addressed.

Data Coding.

In order to process and organize the data, a database will be created using a computer database software program (i.e.,SPSS). The scaled response format used in the construction of the questionnaire items will allow for a number to be assigned for each response given for each item. For each respondent, the numerical response provided for each item will be then entered into the database during the data-coding phase of the study.

Statistical Analyses.

Within the study, statistical analyses will be conducted through a progression or series of analyses using SPSS. During the initial phase, descriptive statistics will be used to describe and summarize the data obtained within the study. The second phase of analyses will focus on the use of multivariate analyses to determine the relationship between specific items. This will be conducted through the use of cross tabulations of nominal data between selected variables in the study. The Chi-square statistic will be used to examine the difference between the observed frequency and the expected frequency of nominal data. Statistical significance will be set at an alpha level of.05. The phi coefficient statistic will be used to measure the correlation between the specific variables when found to be significant.

During the third phase of statistical analyses, when the chi-square statistic is found to be significant, further analyses will be conducted on the variables that are found to be correlated using the independent t-test for independent samples. For analyses purposes, the t-test is used to determine whether two samples were drawn from populations with different means. Within the study, the t-test will be, therefore, used to determine whether the two groups under consideration in relation to the variables being studied were statistically different.