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The perceived benefits of a virtual community: effects of learning style, race, ethnicity, and frequency of use on nursing students.

Abstract

BACKGROUND It is important for nursing faculty to consider the variability in learning style among nursing students.

AIM The researchers sought to compare differences in perceived learning benefits among nursing students who had different learning styles and in frequency of use of a virtual community learning intervention.

METHOD Using a comparative approach, learning style was measured with the Kolb Learning Style Inventory. Frequency of use and benefit were measured with an exit survey.

RESULTS NO differences in perceived benefit were found according to learning style. Subjects with frequent use of the virtual community reported significantly greater learning benefits than those with infrequent use, regardless of learning style. Also found was a statistically significant relationship between Kolb learning-style scores and race or ethnicity.

CONCLUSION All nursing students may potentially benefit from virtual community use.

KEY WORDS

Learning Styles--Virtual Communities Nursing Students--Innovative Teaching

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It has long been known that people learn in their own ways, and this awareness of varying learning styles has shaped educational reform in nursing. Although there are many ways to engage a learner, teaching strategies are often based on students' learning preferences. Students attending nursing programs are increasingly racially and ethnically diverse. In response, nursing faculty may need to employ a variety of teaching strategies to address the wider range of learning styles in their classrooms.

The use of a virtual community is an emerging multicontextual teaching application in nursing. Virtual communities involve fictional characters, whose stories shed light on health-related events or issues (Curran, Elfrink, & Mays, 2009; Giddens, 2007). It is postulated that teaching with a virtual community enhances learning through the integration of clinical situations into the classroom. This is consistent with the integrative-teaching approach advocated by Benner, Sutphen, Leonard, and Day (2010).

The purpose of this study was to evaluate students' perceptions of the benefits of a virtual community known as The Neighborhood, based on their learning styles and their frequency of use of the virtual community. The Neighborhood uses the stories of 34 characters, representing people in the community with various health issues, and six nurse characters, who deal with clinical issues in contemporary nursing practice. Stories unfold each week over 45 weeks and are enhanced with photos, videos, and medical records. Instructors create activities to promote conceptual learning (Giddens, 2007).

REVIEW OF THE LITERATURE

Virtual communities represent a relatively new teaching application. To date, only six research studies have been published involving virtual communities in nursing education. In a qualitative study, with 40 undergraduate students from one nursing program who used a virtual community known as The Neighborhood, emotional connectedness and engagement were found to be the dominant themes reported by participants (Shuster, Giddens, & Roehrig, 2011). With a sample of 248 undergraduate baccalaureate nursing students, the same researchers (Giddens, Shuster, & Roehrig, 2010) found that underrepresented minority students and students who expected to receive a course grade below an "A" reported the greatest perceived benefit using The Neighborhood. The difference could be attributed to learning preferences among students, although this variable was not examined.

Giddens, Fogg, and Carlson-Sabelli (2010) reported a significant relationship between frequency of use and perceived benefits among nursing students who used The Neighborhood. In other words, greater perceived learning benefit among students was reported with greater faculty use. Among students who used The Neighborhood most frequently, underrepresented minority students reported greater engagement compared with white or Asian students. More recent research associated with The Neighborhood examined learner perceptions of benefits and challenges (Carlson-Sabelli, Giddens, Fogg, & Fiedler, 2011). Students reported finding the application of concepts to real-life situations engaging and eye-opening, helping them understand health care issues from a variety of perspectives. Giddens, North, Rogers, Carlson-Sabelli, and Fogg (2012) also reported a link between the use of a virtual community and cultural awareness.

Early studies involving virtual communities have shown positive relationships between use and perceived benefits and evidence that this learning approach is engaging. Early evidence also suggests greater reported benefits among underrepresented minority students (Giddens, Shuster, & Roehrig, 2010; Giddens, Hrabe, Carlson-Sabelli, & Fogg, 2012). An individual's learning style or preferences may also be linked to reported benefits. This variable, however, has not previously been reported.

Learning styles are individuals' preferences for how they learn most effectively and efficiently. The Kolb Learning Style Inventory (LSI) (Kolb & Kolb, 2005) is the instrument most often used in research involving nursing and allied heakh students. According to LSI scores, a learner is categorized as an Accommodator, a Diverger, an Assimilator, or a Converger.

* An Accommodator is a hands-on learner, using a combination of concrete experience and active experimentation.

* A Diverger looks at situations from different points of view, using a combination of concrete experience and reflective observation

* An Assimilator learns best by reasoning, through placing information into concise and logical form, using a combination of abstract conceptualization and reflective observation.

* A Converger finds practical uses for ideas and theories, using a combination of abstract conceptualization and active experimentation.

The LSI is based on John Dewey's belief that education should be grounded in concrete experience (Kolb 1985). Kolb postulated that careers were based on learning norms and students with certain learning styles would be drawn to the careers that fit their learning style.

DeCoux (1990) reviewed eight studies published between 1981 and 1988 in which the Kolb LSI was administered to nursing students (sample sizes ranged from 62 to 611) and found learning styles scattered across all four categories. No styles predominated, but nursing students were seldom Convergers. More recent studies indicate Diverger or Accommodator as the predominant styles among nursing students (Cavanagh, Hogan, & Ramgopal, 1995; Hauer, Straub, & Wolf, 2005; Rawaf, 2007; Suliman, 2010; Yoder, 1994). The inconsistency remains, and may be related to the Kolb LSI instrument (DeCoux, 1990) or to unknown variables in the study samples, such as ethnicity or race.

METHOD

The virtual community used in this study was The Neighborhood. Two research questions were posed. First, is there a difference in students' perceived benefits of the virtual community based on learning style? Second, does the frequency of use of a virtual community have a moderating effect on the perceived benefits?

The researchers obtained institutional review board approval prior to beginning the study. To minimize bias and address concerns associated with conflict of interest, the lead researcher, who developed the virtual community used in this study, collaborated with nurse researchers from other academic institutions to carry out this study in different nursing programs. The lead researcher was not involved in the collection or analysis of the data.

Research Design and Sample

A comparative approach was used to evaluate the two research questions. This multisite study involved a convenience sample of 350 first-semester baccalaureate nursing students enrolled in five nursing programs in five states (California, Georgia, New York, North Carolina, and Ohio) that agreed to beta test The Neighborhood for at least one semester, at no cost to the school or the students. Student participation was voluntary and confidential; students were provided information about the study and consented to participate by completing the surveys. Sessions were held at each school before the semester began to get faculty oriented to the application. In addition, all faculty were given a guide that provided information and teaching tips. Students were given a guide as well; it included an introduction to the characters to facilitate their use. A nurse consultant was assigned to each of the participating schools to provide support to any faculty willing to use The Neighborhood. Faculty at each school were asked to use The Neighborhood as a teaching application in their courses on a regular basis. Because of the wide variability in curricula across the schools, the researchers were unable to control the frequency or quality (dose and efficacy) of use across all programs.

Data Collection

All student participants completed a demographic survey and the Kolb LSI at the beginning of the semester and an exit survey about their use of The Neighborhood at the end of the semester. Surveys were collected by a researcher at each site and sent to the research team for data entry and analysis.

LEARNINC STYLE The Kolb LSI, a 12-item instrument, was used to identify predominant learning style. Learning style reflects a combination of four abilities: concrete experience (CE), reflective observation (RO), abstract conceptualization (AC), and active experimentation (AE). These abilities form the basis for the preferred learning style. The Accommodator has a preference for CE over AC and AE over RO. The Diverger has a preference for CE over AC and RO over AE. The Assimilator has a preference for AC over CE and RO over AE. Finally, the Converger has a preference for AC over CE and AE over RO. Internal consistency was demonstrated by Cronbach's alphas ranging from .77 to .84 (Kolb, 1985).

EXIT SURVEY An exit survey (developed by the research team) was used to determine two variables: students' frequency of use of the intervention and their perceived benefits of using it. The "frequency of use" variable was used to group students according to high and low dose so that a comparison could be made. On the exit survey students were asked to rate how often they attended a class where the instructor provided an activity or assignment based on The Neighborhood. This item was ranked on a five-point Likert scale (1 = never; 5 = very often). Students who rated the item 2 or 3 were considered low users, while students rating it 4 or 5 were considered high users. Students who rated this item 1 were dropped from the analysis.

The exit survey asked participants, "Considering your learning preferences, what is the strength of your personal benefit to using The Neighborhood in your nursing course?" This item was measured on a 10-point scale (1 = no benefit; 10 = high benefit). For the survey items, internal consistency was demonstrated by a Cronbach's alpha of .81, indicating good internal reliability.

RESULTS

A total of 350 students from five nursing programs were eligible to participate in the study; reported use of the virtual community was the only eligibility criterion. The final sample included 281 participants who reported having used the intervention and completed all surveys. The mean age was 24.5 (SD = 6.53) years, with a range of 19 to 56 years; typical of nursing students, most (87.5 percent) were women. The racial breakdown was white, 55.8 percent (n = 150); African American, 20.4 percent (n = 55); Asian, 14.1 percent (n = 38); Pacific Islander, 3 percent (n = 8); and mixed race or other, 5.6 percent (n = 15). Only one student reported being Native American, and 14 did not identify race or ethnicity. Because of federal data collection guidelines that differentiate race from ethnicity, participants were asked to identify affiliation with Hispanic/Latino ethnicity; 24 participants (8.9 percent) indicated affiliation.

Learning Styles

The learning styles were represented as follows: Converger (46.2 percent, n = 129), followed by Assimilator (31.9 percent, n = 89), Accommodator (17.6 percent, n = 49), and Diverger (8.6 percent, n = 24). Ten participants scored evenly in two learning-style categories and were counted twice, accounting for the difference in the total number of study participants and the number reported by learning style.

Perceived Benefits

The mean benefit scores for each of the four Kolb styles were as follows: Diverger (M = 3.67; SD = 2.93), Assimilator (M = 3.19; SD -2.44), Converger M = 3.46; SD = 2.44), and Accommodator (M = 3.10; SD = 2.13). A series of four t-tests were applied to determine whether differences in perceived benefits existed among the four Kolb learning style groups, in which Assimilators were compared with non-Assimilators, Accommodators compared with non-Accommodators, and so on. The t-tests were calculated rather than an analysis of variance for this application, because some participants were represented in more than one group. No statistically significant difference between perceived benefits of using the virtual community was found among the four groups.

Frequency of Use, Benefits, and Kolb Learning Styles

Study participants reported considerable variability in the use of the virtual community. For this reason, we sought to determine whether differences in reported benefits existed based on frequency of use. Frequency of use was calculated by dividing the 281 students who used The Neighborhood into subgroups of low users (use score = 2 or 3, n = 77) and high users (use score = 3 or 4, n = 202).

The mean benefit was measured on a 10-point scale. Among low users it was 2.88 (SD = 2.27); among high users it was 4.57 (SD = 2.40). Results of a t-test comparing mean benefits between these two groups were significant (t = 5.59, df = 279, p < .001). These findings show that in this sample, the frequency of use significantly affected perceived benefits, mirroring previous findings (Giddens, Shuster, & Roehrig, 2010).

Next, we examined the self-reported benefits of using the virtual community with respect to each of the four learning styles in relation to the level of reported use (high or low). A two-way analysis of variance comparing the benefit scores of high and low users with each of the learning styles revealed no significant differences.

Learning Styles and Race and Ethnicity

Of the 350 subjects in our original sample, 349 completed the Kolb inventory and the exit survey. We included all of these subjects for the secondary analysis. Racial breakdown was white (n = 176), African American (n = 59), Asian (n = 56), Hispanic/Latino (n = 30), and mixed race (n = 28).

Four cross-tabulations with associated chi-square tests and odds ratios were calculated for each of the learning-style and race-and-ethnicity categories. The results are shown in the Table, where we see that each of the four learning styles maps to a different race or ethnicity.

The odds ratio (also in Table) is a relative measure of the likelihood for a particular outcome if a certain factor is present. In this study, it represents whether the odds are in favor of a nursing student with a particular learning style belonging to a particular ethnicity or race. The odds ratio is calculated by multiplying two ratios. For example, the first odds ratio in the Table is calculated as the ratio of African American Assimilators (n = 29) to African American non-Assimilators (n = 30) multiplied by the ratio of non-African American non-Assimilators (n = 210) to the number of Assimilators who are not African American (n = 80). The formula is 29/30 x 210/80 = 2.54. When an odds ratio is greater than 1, there is significant potential for the condition to occur. In our sample, there is a good likelihood that an Assimilator is African American, that a Diverger is Asian American, that a Converger is white, and that an Accommodator is Hispanic or Latino.

DISCUSSION

Our two primary findings are that when it comes to the use of a virtual community in nursing education, frequency of use matters and learning style does not. The latter finding holds true regardless of the frequency of use.

Noticing that we had an ethnically and racially rich mix in our sample, we decided to undertake a secondary analysis to determine whether differences existed in learning preferences (as measured by the LSI) based on self-identified racial or ethnic group. We were able to test such differences only because our sample was more heterogeneous than that of earlier studies. Our findings surprised us: Convergers and Assimilators were the preferred learning styles of a majority of the nursing students, while several earlier studies reported a predominance of Divergers and Accommodators. The one study where Convergers were found to be predominant among nursing students was done in Saudi Arabia (Suliman, 2006). Keane (1993) reported learning style differences between students who had English as their primary language and those who did not. Pewewardy (2002) reported that learning style differences were influenced by language, culture, and heritage. Sizemore and Schultz (2005) found no statistically significant difference in learning styles between Hispanic and non-Hispanic students. Molsbee (2011) reported no significance differences in Kolb learning styles among nursing students of differing ethnicity or race until they collapsed the sample into two groups, whites and nonwhites.

In light of the underrepresentation of minority students in nursing education, this finding suggests the need for further exploration of the relationships among ethnicity, race, learning style, and learning outcomes.

Limitations

We used a convenience sample from beta-testing schools and it is therefore not representative of the United States population or of undergraduate baccalaureate nursing students.

The variability in Kolb LSI scores reported in the literature may indicate a limitation of this instrument, that is, it may not be the most effective measure of learning preference. Therefore, the use of the LSI may be a limitation of this study. Variability in faculty support for the Neighborhood may have influenced the quality of faculty use and student outcomes.

IMPLICATIONS FOR NURSING EDUCATION

Students perceived no differences in benefits, according to the Kolb LSI category, possibly indicating that the use of a virtual community may be appropriate, regardless of students' learning styles. This is important given the diversity of learners in nursing today. The differences according to race and ethnicity suggest that as student populations increase in diversity, multimodal methods of learning may help students, regardless of learning style, to flourish. It also calls nurses to research more fully the relationship of ethnicity, race, and learning style and to reevaluate how we measure learning styles.

Originally, Kolb (1984) conceived of learning as a four-stage process, whereby immediate concrete experience (CE mode) serves as a basis for reflection and observation (RO mode) that leads to the formation of abstract concepts (AC mode) and theories of how things are. By testing these theories through active experiments (AE mode), problems are solved and learning occurs (Hawk & Shah, 2007). All four stages are needed, with learners moving through them as learning takes place, suggesting that the predominant mode of learning should change over time and cannot be considered a trait variable to predict learning outcomes. Measures other than the Kolb analysis for determining learning styles include interviews and observation, which may be more accurate. However, it may not be the predominant style that is of interest, but rather the range of styles with which the student learns. This would support the need for developing multimodal learning activities, such as a virtual community. Forced to operate in other modes, students might increase the number of styles they use.

It is critical that nurse educators continue the pursuit of innovative teaching applications, particularly those that integrate clinical context and classroom learning (Benner et al., 2010). Such applications are known to enhance learning and are likely to benefit a majority of learners.

doi 10.5480/11-526.1

REFERENCES

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Giddens J. F., Fogg, L., & Carlson-Sabelli L. (2010). Learning and engagement with a virtual community by undergraduate nursing students. Nursing Outlook, 58(5), 261-267.

Giddens, D., Hrabe, D., Carlson-Sabelli, L., Fogg, L., & North, S. (2012). The impact of a virtual community on student engagement and academic performance among baccalaureate nursing students. Journal of Professional Nursing, 28(5), 284-290.

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Shuster, G., Giddens, J. E, & Roehrig, N. (2011). Emotional connection and integration: Dominant themes among undergraduate nursing students using a virtual community. Journal of Nursing Education, 50(4), 222-224.

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Louis Fogg, PhD, is an associate professor at Rush University College of Nursing, Chicago, Illinois. Linnea Carlson-Sabelli, PhD, RN, is a professor (retired) at Rush University College of Nursing. Karen Carlson, PhD, RN, is a professor (retired) at University of New Mexico, Albuquerque. Jean Giddens, PhD, RN, FAAN, is dean and professor at Virginia Commonwealth University School of Nursing, Richmond, Virginia. For more information, contact Dr. Giddens at jgiddens@vcu.edu.
Table: Kolb Learning Style, Race, and Ethnicity

Kolb Learning
Style Race or Ethnicity Odds Ratio

Assimilator African American 2.54

Diverger Asian American 5.41

Converger White 2.06

Accommodator Hispanic/Latino 2.66

Kolb Learning
Style Chi-Square Statistic

Assimilator 20.09 (df = 4); p = .001

Diverger 23.82 (df = 4); p = .000

Converger 15.60 (df = 4); p = .004

Accommodator 14.51 (df = 4); p = .006
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Author:Fogg, Louis; Carlson-Sabelli, Linnea; Carlson, Karen; Giddens, Jean
Publication:Nursing Education Perspectives
Date:Nov 1, 2013
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