The mediating effect of advanced health assessment on the relationship between self-directed learning and clinical thinking among master of nursing specialist postgraduate students: A structural equation model

With the growing trend of preparing students for lifelong learning, the theory of self-directed learning (SDL) has been increasingly applied in the context of higher education. In order to foster lifelong learning, abilities among nursing students, faculties need to have an appropriate instrument to measure the SDL abilities of nursing students. The objectives of this study were to develop an instrument to measure the SDL abilities of nursing students and to test the validity and reliability of this instrument. This study was conducted in 4 phases. In Phase 1, based on a review of the literature, the researchers developed an instrument to measure SDL. In Phase 2, two rounds of the Delphi study were conducted, to determine the content validity of the instrument. In Phase 3, a convenience sample of 1072 nursing students from two representative schools across three different types of nursing programs were recruited to test the construct validity of the Self-Directed Learning Instrument (SDLI). Finally, in Phase 4, the internal consistency and reliability of the instrument were tested. The resulting SDLI consists of 20 items across the following four domains: learning motivation, planning and implementing, self-monitoring, and interpersonal, communication. The final model in confirmatory factor analysis revealed that this 20-item SDLI indicated a good fit of the model. The value of Cronbach's alpha for the total scale was .916 and for the four domains were .801, .861, .785, and .765, respectively. The SDLI is a valid and reliable instrument for identifying student SDL abilities. It is available to students in nursing and similar medical programs to evaluate their own SDL. This scale may also enable nursing faculty to assess students' SDL status, design better lesson plans and curricula, and, implement appropriate teaching strategies for nursing students in order to foster the growth of lifelong learning abilities. Copyright (c) 2010 Elsevier Ltd. All rights reserved. Show more

Self-directed learning (SDL) is encouraged in professional education because it nurtures students' self-motivation and promotes accountability to their own learning. SDL is crucial to fostering collaborative skills for multi-disciplinary practice in today's healthcare settings.

Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education. Show more