Criticisms of the Lecture Method in the Teaching of Nursing Students: The Case of Nurse Tutors in Bamenda, Cameroon

Transcription

1 British Journal of Medicine & Medical Research 6(4): , 2015, Article no.bjmmr ISSN: SCIENCEDOMAIN international Criticisms of the Lecture Method in the Teaching of Nursing Students: The Case of Nurse Tutors in Bamenda, Cameroon M. B. S. Atanga 1*, N. M. Abgor 2 and J. O. Ayangwo 3 1 Department of Nursing and Midwifery, FHS, University of Bamenda, Cameroon. 2 Department of Educational Psychology, Faculty of Education, University of Buea, Cameroon. 3 Institute of Health and Biomedical Sciences, St. Louis University, Bamenda, Cameroon. Authors contributions This work was carried out in collaboration between all authors. Author MBSA designed the study, wrote the protocol, and wrote the first draft of the manuscript. Author JOA managed the literature searches, analyses of the study, while author NMA read and made additions to all parts of the manuscript. All authors read and approved the final manuscript. Article Information DOI: /BJMMR/2015/13223 Editor(s): (1) Chan Shen, Department of Biostatistics, MD Anderson Cancer Center, University of Texas, USA. Reviewers: (1) Muhammad Zia-ur-Rehman, Leadership and Management Department, National University of Modern Languages, Pakistan. (2) Anonymous, Sweden. (3) Anonymous, South Africa. (4) Ndie Elkenah Chubike, Department of Nursing Science, Ebonyi State University, Abakaliki, Nigeria. Complete Peer review History: Original Research Article Received 8 th August 2014 Accepted 24 th September 2014 Published 26 th December 2014 ABSTRACT Introduction: The lecture method is used by most teachers in educational institutions such as the Nurse Training Schools in Bamenda. The lecture method of teaching remains the most common or dominating teaching method in adult education all over the world. There is heavy reliance on lecture where other methods could be used to achieve lower order and even higher order objectives during teaching/learning. Problem: This method of teaching predominates in Bamenda and in other parts of the country despite the fact that it has been criticized as being too teacher-centered and its effectiveness questioned. Its relative ineffectiveness as compared to other (active) teaching methods include inadequacies in instilling affective and psychomotor skills in nursing students and renders learners passive during the teaching-learning process, among others. *Corresponding author: mbisuh@yahoo.com;

2 Objectives: To assess nurse tutors knowledge on the criticisms of the lecture method and identify ways they use to overcome the criticism during teaching. In assessing the knowledge, attendance at seminars on teaching methods was also assessed. Research Methods and Materials: The explorative descriptive method was used whereby, nurse tutors were served with questionnaires reflecting the study objective. These were further used to elicit information on a cross sectional basis on the knowledge of criticisms of the lecture method, ways of overcoming the criticisms and possible sources of knowledge like attendance at seminars on teaching methods Results: Show that, majority of the nurse tutors both old and young were aware of the fact that the lecture method has been criticized a lot yet it is still being used. Conclusion: The conclusion is therefore that Nurse Educators plan their work and use a mixed method approach in teaching as much as possible so as to get student nurses actively involved in the teaching/learning process. Hence, the lecture method should be reduced. Keywords: Teaching methods; lecture; criticisms; solutions. 1. INTRODUCTION Though lecture is known to be effective in the transmission of information, it is thought that it fails in other aspects of teaching and learning. By the very nature of conventional lecturing (that renders students passive) acquisition of skills does not occur. In this case, the material does not sink in well because it is merely transmitted to the students without them doing critical examination and understanding [1]. In other words, as some scholars have stated, it is as if information delivered by this method from the lecturer s notes goes to the student s own notes without having been digested in the brain of either of them [2]. This means that in this situation the student may just do rote learning i.e. without active reflection or reasoning to have a good insight of the information. The shortcomings of the didactic nature of the traditional lecture, in which the lecturer has complete control of the learning situation, are: short attention span of learners, possible inaudibility of the lecturer, absence of social interaction or effective feedback, and almost limitless scope for boredom [3]. Furthermore, the lecture is apparently a one-way process that the learning society today seems to be rejecting in favor of active, learner-centered, self-directed and experiential learning. The view about teacher dominance during lecture is supported as a situation in which the teacher monopolizes control and gives little opportunity to the student [4]. It is worthwhile noting too that, scientific studies have shown little retention of material from lessons taught using lecture as the students assume a passive role [5,6,7]. More importantly, lecture would not suffice or would fail totally in the teaching/learning of affective and psychomotor skills in nursing students. Generally, information from literature seems to indicate an unforeseeable end to the battle over lecture and its effectiveness or ineffectiveness. Lecture is said to have originated from the medieval period about 1000AD and 1500AD. The term lecture stands for lectus or legere which means to read in Latin. According to a consortium of Professors, in the times of the medieval university (1350s) the instructor was seen to read from an original source, sitting on the lectus (reading desk) to a class of students who took notes on the lecture. Its subsequent meaning as a discourse on a given subject before an audience for purposes of instruction is seen from the 16th century and emerged in the middle ages and involved reading textbooks followed by a summarization of author s and lecturer s commentaries [4]. This method is therefore a very old one that has been used in teaching and it seems to have gained firm ground in educational systems. It continues to be used in schools and universities as it is the most common or dominating teaching method in adult education all over the world [8]. He adds that the method is not confined to educational institutions but is used in commerce and industry, trade conferences and professional associations, political meetings (where they are called speeches), and in churches (sermons) [9]. 1.1 Statement of Problem Teachers often use lecture as the main teaching/learning method in most Nurse Training institutions around the country since 1969 when 398

3 the first of the schools in Bamenda was opened. Because of its prevalence and long duration of use over the years, there is a tendency for Nurse Educators to regard it as a good teaching method and thus continue to use it without questioning. Unfortunately, this method has been severely criticized as being ineffective. The method is described as a negation of teaching because of its autocratic nature which ipso facto minimizes the interaction expected in the learning process; and more, because the intellectual passivity and weariness of listeners and lack of discussion contradict the free flow and exchange of ideas demanded of the learning process. Moreover, research evidence points to its comparative ineffectiveness in relation to other methods that may be active [10]. Evidence has shown uncertainty in opinion concerning the magnitude of criticism against lecture so; it continues to be a predominant teaching method. 1.2 Research Questions 1. Are nurse tutors in Bamenda aware of the criticisms of the lecture method of teaching? 2. What methods are used by Nurse Educators to overcome the criticisms of lecture as being an ineffective method? 1.3 Specific Objectives To assess nurse tutors knowledge of the criticisms of lecture as a teaching method in Bamenda. To find out methods used by the Nurse Educators to overcome criticisms of lecture as a teaching method in Bamenda. 1.4 Assumption The lecture method has a lot of criticisms, yet it is used by Nurse Educators in training institutions in Bamenda. 1.4 Significance This investigation creates or raises awareness of Nurse Educators about the polemics involving lecture which is apparently used as the main teaching method. As a consequence it motivates them to look for ways to apply it more appropriately and improve its effectiveness for the benefit of student nurses, or use other teaching / learning methods and strategies as the case may be. 2. Research Methods and Materials A descriptive survey design was used for the investigation. By that approach the research was able to gain information that gives a picture of the real situation which is whether nurse tutors are aware of the criticisms of the lecture method and can work out ways of overcoming the criticism. Authorization to conduct the survey was obtained from the Regional delegation of public health, permission to use the said institutions were obtained from the head of the institutions and informed consent forms were given to the specific nurse tutors to obtain their consent. There no direct issues of harm to be caused. The research was carried out in Bamenda, the Administrative capital of the North West Region of Cameroon. It is divided into three council areas (Bamenda I, II and Bamenda III). There are ten authorized Nurse Educational Institutions in the city (2 Government, 2 denominational and 6 private) that were involved in the study namely; Training school for Nursing Assistants, Bamenda University of Science and Technology (BUST), Cameroon Christian University (CCU), St. Louis University Institute of Health and Biomedical Sciences, Florence Nightingale Higher Institute of Health and Biomedical Sciences, Full Gospel Training School for Health Personnel, Capitol Higher Institute of Health Science and Beauty, St. Jude s Higher Institute of Health and Biomedical Sciences and The National Polytechnic. The population under study was made up of all Nurse Educators in the Nurse Training Institutions or Faculties in Bamenda as listed above. The statistical formula N=4(Z crit ) 2 P(1-P)/ D 2 for calculating sample size in descriptive studies was used [11]. The instrument used to collect data from respondents concerning the use of lecture method was a questionnaire. It had 24 items developed following the objectives and research questions, and vetted, checked and cross checked by other superior /senior colleagues. Some questions were structured while others 399

4 were open-ended to enable the respondents express their views. The first section of the instrument was designed to collect data on identification and qualifications in which age, woman, or man were not considered necessary. The sections that follow served to collect information on criticisms of the lecture method, whether or not they had attended any seminars on teaching methods and methods to overcome criticisms. A pre-test was carried out in the schools for State Registered Nurses and Nursing Assistants in Limbe in the south west region of Cameroon, where few copies were printed and administered to nurse tutors. This was to test the answerability of the questions or any forms of ambiguity considered to be a check of validity and reliability of the questionnaire. Each randomly selected Nurse Educator was given a copy of the questionnaire to answer and return, and in order to facilitate progress of the study a maximum period of three days was given to return the questionnaire or call investigator to collect. Twenty four-item filled in questionnaires was collected from 69 respondents out of 75 representing a response rate of 92%. The statistical package for social sciences (SPSS, version 16) was used for analysis. Descriptive statistics was used to summarize the data. Proportions and percentages were compared using x 2 -test and mean number of seminars attended by Nurse Educators were compared using student s T-test. Differences between proportions and means were declared at 1 and 5% probabilities. The data is presented on tables and diagrams. The technique of thematic analysis was used for qualitative data collected using open-ended questions. By this approach responses were examined to identify inbuilt themes in them. Essential features in the themes were then identified and any interrelationships among them determined so as to make meaning in relation to the objectives and research questions. 3. FINDINGS This was a quantitative study with question directed at criticisms and whether the nurse tutors had had the opportunity to attend seminars on teaching methods in order to be aware that the lecture method of teaching was being criticized. It was also aimed at finding out how the criticisms are being overcome as the method is continuous used by the nurse educators. 3.1 Awareness of Criticisms of the Method There is significant awareness of Nurse Educators about existing criticisms of the lecture method at 5% probability (Table 1). 3.2 Ways of Overcoming Criticisms of the Lecture Method Respondents were asked on what could be done to overcome for example the teachercenteredness in the lecture method of teaching and other areas of the lecture method being criticized and findings were as on Table 2 below. Teaching/learning aids, demonstrations, assignments (classroom and take-home) among others were used during lecture to overcome the criticism of inactivity of students in class when the lecture method of teaching was used. Out of the 69 respondents, 9(13.04%) said they use teaching-learning aids to overcome criticisms of the lecture method; 8(11.59%) mentioned demonstrations; 7(10.14%) mentioned assignments; 5(07.25%) mentioned combination of methods; 4(05.78%) said they use student presentations; 3(04.35%) mentioned group work; and 2(02.90%) said they use group discussions. 3.3 Attendance at Training Seminars to Combat Some Criticisms This was found to be relevant to the study because nursing education seminars in Cameroon have also addressed the issue of good teaching method particularly studentcentered teaching and learning. Among the 69 respondents, 65(94%) had attended a maximum of 10 seminars with a mean of 1.52 seminars and an SD of from the mean. Within the group of young Nurse Educators, 42(98%) had attended a maximum of 5 seminars with a mean of 0.74 seminars and an SD of Among the experienced Nurse Educators, 23(88%) had attended a maximum of 10 seminars with a mean of 3 seminars and an SD of (Table 3). The difference between the mean number of workshops attended by young and experienced Nurse Educators was significant at 1% probability (P<0.01). 400

5 Table 1. Classification of nurse educators according to category and awareness about criticisms of the lecture method Aware Not aware X 2 Significance All nurse educators combined * Young nurse educators ns Experience nurse educator ns *Significance, ns: Not significant Table 2. Methods or techniques used by nurse educators to overcome criticisms of the lecture method Techniques Frequency Percentage Use of teaching/learning aids Demonstrations Assignments Association of lecture with other methods Student presentations Group work Group discussions Table 3. Classification of Nurse Educators by category, seminars or Workshops attended and the significance Number of seminars attended Category of nurse educator N Minimum Maximum Mean Standard deviation All nurse educators combined Young nurse educators Experienced nurse educators DISCUSSION 4.1 Awareness/ Non-awareness of Criticisms and Methods to Overcome Them A larger proportion of Nurse Educators agreed that they were aware of criticisms of the lecture method (64.2%) and the level of awareness tested significant at 5% probability. One intention of this study was to check the awareness in the Nurse Educators, some of who were still unaware, and/or raise the level of awareness in those already aware but doing nothing to improve on the use of lecture. The main issue then does not end at being aware, but extends to using strategies and techniques that circumvent the object of criticisms particularly passivity of student nurses. Here is where suggestions of ways by which teachers can make lecture more effective [8] was considered as ways of overcoming criticisms of the lecture method. The author [He] emphasizes the multi-method or mixed method approach where teachers should use lecture together with other methods so as to make it participative, more learner-friendly and more beneficial to the students. The methods or techniques that should be used to overcome criticisms of lecture [have been] are clear and found to exist in literature. These were options given on the questionnaires for nurse educators to select those methods, ways and techniques that are used to overcome the criticisms of the lecture method of teaching. From the responses, it was clear that very few Nurse Educators gave some methods used to improve on the use of lecture as a way of overcoming the criticisms. These were: demonstrations (11.59%), assignments (05.78%), and group discussions (02.90%). This low percentage of response of ways of overcoming criticisms of the lecture as a teaching method relative to other techniques and methods means that the Nurse Educators do not know other methods of overcoming the criticisms. The investigation has revealed the urgent need for training of Nurse Educators in other teaching methods as the method used in overcoming criticisms of the lecture method were limited. By 401

6 so doing, the heavy reliance on the lecture amidst criticisms of the method will be reduced. 4.2 Attendance at Seminars to Improve on Ways of Overcoming Criticisms Results of this research show that more than 50% of Nurse Educators in the training institutions in Bamenda have not attended any further training activity in teaching methods as this is main way of educating nurse tutors on better ways of teaching and amelioration of teaching. This only reinforces the need for training and refreshment already suggested above. This training becomes more important and necessary considering the following: - A higher number of Nurse Educators (43) are young in the teaching career and therefore need to gain skills and experience. - Other items indicate the inability of many Nurse Educators to use other methods so as to overcome criticisms of the lecture method. These results should therefore cause the authorities and policy makers to think about making provision for refresher courses after training to keep abreast with current issues in teaching and learning. 5. CONCLUSION The use of lecture as a teaching method is not without difficulties. In a previous research, respondents expressed the fact that it is tiring to lecture to large number of students, and that much time is spent to search for material and prepare lessons, yet the lecture method of teaching still dominates teaching and learning in nursing. Results of the study [also] point to the fact that more than half of the Nurse Educators have never attended any training concerning teaching methods where they could have been informed on the difficulties and shortcomings of the lecture method of teaching and ways of overcoming them when teaching. The few ways or techniques indicated: use of teaching/learning aids (13.04%); demonstrations (11.59%), assignments (10.14%) among others are not very specific as being able to combat criticisms of the lecture method. However, it is visible that the lecture method of teaching is used and that the passive nature of learner during the lecture can be handled by the use of teaching /learning aids, demonstrations, assignments and others. 6. RECOMMENDATION 1. In order to reduce criticisms of the lecture method, Nurse Educators should plan their work, prepare lessons and use a mixed method approach in teaching as much as possible in a way that makes students actively involved in the teaching learning process. 2. Nurse educators should also endeavour to undergo continuing education as a matter of personal development to be updated on current issues and better ways of teaching nursing students. ETHICAL APPROVAL An authorization was obtained from the Faculty of Health Sciences, University of Buea. The Institutional Review Board (IRB) of the Faculty also reviewed, approved and gave letter of ethical clearance before the research was undertaken. Permission was also obtained from the various Nursing Institutions before the commencement. Informed consent process was fulfilled and the consent forms signed by all the various nurse educators. COMPETING INTERESTS Authors have declared that no competing interests exist. REFERENCES 1. Uhl JJ. How Technology influenced me to stop lecturing and start teaching, University of Illinois; Available: papers/uh/htm/ [Accessed: 04/04/12]. 2. Quinn FM. Principles and Practice of Nurse Education, 4 th ed; London: Stanley Thornes Ltd. 2001;91-92, Jarvis P. The Theory and Practice of Teaching, USA: Stylus Publishing Inc. 2002;22-30, Tchombe TM. Psychological Parameters in Teaching, Yaounde: Presses Universities d Afrique. 2009;46-47, 63-69, Mckeachie WJ. Active Learning, The cone of learning. Strategies, research and theory for college and University teachers;

7 6. Dale E. Dale s cone; the Abilene Christian University Adams Center for Teaching Excellence; Abilene; Maine B. The learning pyramid. National Training Laboratory Institute for Applied Behavioral Science; Available: pyramid.com 8. Bligh DA. What s the use of Lectures? San Francisco: Jossy-Bass Publishers. 2000; Gibbs G. Twenty terrible reasons for lecturing, Birmingham: SCED Occasional Paper. 1981;8. Available: s/ocsld/resrouces/20 reasons.html [Accessed: ]. 10. Kim MJ, Hwang SY. A comparison of problem-based learning and lecture-based learning in adult health nursing course. Nurse Education Today. 2006, 26, Available: ordan/active learning.html [Accessed: ]. 11. Eng J. Statistical concept series. John Hopkins, USA; Atanga et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Peer-review history: The peer review history for this paper can be accessed here: 403