Original researchDialogic oral exam in nursing education: A qualitative study of nursing students' perceptions
Introduction
There has been a shift in the focus of education programs in health care. Curricula have moved away from being process-based towards being competence-based. Whereas students used to be required to demonstrate that they have completed a specific learning course they now have to demonstrate mastery of a variety of competences. The continuously changing nature of work requires graduates to have new skills and competences, such as shared expertise, collaborative and team working skills. Assessments cover not only specific course content but also more general competences such as problem solving and decision making skills (Virtanen et al., 2015). It is important that educational courses promote the development of these competences and assessment methods should take into account the learning approach. The term constructive alignment is used to describe situations in which the whole learning process is logically and coherently organised: planning, learning outcomes, teaching and learning methods, assessment methods and learning atmosphere. This requires a broad perspective on learning and the learning process. The constructive alignment perspective implies than when learning outcomes are changed new methods of assessment should be developed (Biggs and Tang, 2009).
The purpose of this study is to start a debate about the assessment methods used in nurse education. A small-group dialogue exam facilitated by an educator is discussed.
A review of the literature on assessment suggested that small-group, dialogue-based assessment is very rarely used (Habron et al., 2012) or at least that there has been little research on the method. There have been studies of written group exams (Hodges, 2004, Lin and Brookes, 2012) and individual oral exams (especially in relation to medical doctors’ education) (Carter, 2012, Davis and Karunathilake, 2005, Lunz and Bashook, 2008, Tibbo and Templeman, 2004); however there is scant published research on oral group assessment (Dressel, 1991, Drouin, 2010). There were a few studies published in the 1990s, but hardly any in the 2000s. There is need for research on assessment using small-group oral exams.
In this study a dialogue exam is defined as one in which a small group of students (four or five) take part in an educator-facilitated discussion of a particular case. The participants try to find solutions to the problems the patient's care poses based on documented cases. The goal is to create a learning situation in which the learning objectives are to understand the key issues of the topic on which the case centres and achieve a comprehensive perspective on patient care, rather than learning by rote in preparation for an exam. The setting of a dialogue exam has a resemblance to clinical conferences or case studies (see e.g. Rossignol, 2000, Yehle and Royal, 2010) that have traditionally widely used in nursing education, however, in a dialogue exam a setting of the exam is carefully structured according to the framework of dialogue pedagogy as well as the students' assessment adheres to the evaluation criteria.
Section snippets
Literature
An electronic literature search was conducted of three international databases published between 2007 and 2017: Academic Search Elite, Science Direct and ERIC. The English search phrases were in Academic Search Elite: “dialogue exam*" or “oral group exam*" or “collaborative group exam*" or (“collaborative learning”) AND (“oral assessment” or exams or examination*). In Science Direct search phrases were: “dialogue exam*" OR “oral group exam*" OR “collaborative group exam*" OR (“collaborative
Aim
The aim of this study was to explore nursing students' experiences of dialogic group oral exams used in the assessment of a medical nursing course. The study contributes to the knowledge related to assessment methods in health care professionals’ education.
The research question was: what are nursing students’ experiences of dialogic group oral exams?
Study design
The study was conducted in a Unit of Health Care, University of Applied Sciences, in Finland. The participants were students on a medical nursing
Results
The following four themes emerged from the data describing the students’ experiences of the dialogic group oral exam: (1) context bound dynamics; (2) new shared understanding; (3) verified competences and (4) holistic nursing care. (see Table 1).
Study limitations
Limitations of this study consisted of two reasons that should also be taken into account. First, our findings do not necessarily represent the views of all nursing students in Finland, and this should be taken into consideration. Second, the researchers were doing research on their own work environment and one researcher had a pre-existing pedagogic relationship with the participating nursing students. According to Burns and Growe (2009) this can be decrease the reliability of a study if it
Conclusions
This study explored nursing students’ experiences of assessment by means of a dialogic group oral exam facilitated by a lecturer. The results indicate that the students valued the way in which the format embodies the principle of continuous learning and highlighted the importance of the context to creating an appropriate dynamic. The success of the dialogue exam depends on creating an atmosphere in which students feel safe and able to participate freely and openly in the discussions and this
Contributions
Study design: RT, M-AH, IM, E-RY.
Data Collection and Analysis: RT, M-AH, IM, E-RY.
Writing of the Manuscript: RT, M-AH, IM, E-RY.
Acknowledgements
None.
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