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Teaching Strategies:

Activity-Based Teaching
Aimee Caliolio
Jaylyn Gamir
Activity-based Teaching
Points toward the learners active learning role.
Involves strategies as:
Cooperative learning
Simulations and Games
Case studies
Problem-based learning
Self-learning Modules (elements)
Makes the learner do more than just listening and studying.
Learners implicate creating and storing knowledge.
Greater knowledge retention and high level performance.

Cooperative Learning (CL)
(Lindauer & Petrie,
1997) based on the
principle that
learners work with
each other and are
responsible for not
only their own
knowledge but as
well as their group
Types of Cooperative learning
Formal Cooperative learning group
Are more useful in academic setting rather than in-service
or patient education situation (e.g., assigning groups of
students to develop a proposal for a clinical research
Informal Cooperative learning group
Can be used in any setting (e.g., teaching about the
childbirth experience to a group of parents-to-be).

Types of Cooperative learning
Base Cooperative
learning group
Could be applied
easily to new staff
orientation or
programs (e.g., new
registered nurses
being oriented to a
new HC facility).
Summary of types of CL groups.

Advantages of Cooperative
Group members learn to function as part of a
Working in a group for any length of time can
teach or enhance social skills.
Cooperative learning groups can help to address
individual learning needs and learning styles
(Huff, 1997).
Critical thinking is promoted (Zafuto, 1997).
* There is really no disadvantage to CL.
Research on Cooperative Learning
Cooperative learning produces higher
achievement levels than do individualistic or
competitive learning approaches.
Outcome measures of achievement are knowledge
gain, retention of knowledge, problem-solving,
reading, mathematics and procedural tasks, all of
which show increases with CL.
Other outcomes found are increased self-esteem,
improved attitude toward learning, social
competence, and decreased anxiety in learning.
Research on Cooperative Learning
Cooperative learning has been found to be a cost-
effective strategy.
Effectiveness of cooperative learning has been
found in all age groups and levels of education,
both sexes, all nationalities studied, and all
economic groups.
Effects have been equally good for learners at all
ability levels.
CL has a level of validity and generalizability
beyond that seen in most educational research.
Why is Cooperative Learning so
Natasi and Clements (1991) suggests 3 reasons:
To learn something is to try to teach it to someone
As learners listen to each other, they work to
make sense of what each is saying and then they
build on these ideas, thus adding to their cognitive
As learners within a group disagree with each
other, they seek to reduce cognitive dissonance
and, therefore, end up synthesizing divergent
Are controlled
representations of
Are exercises that
learners engage in
to learn about the
real world without
the risks of the real
4 types of simulations:
Simulation exercises
A controlled representation of a piece of reality that
learners manipulate to better understand the
corresponding real situation.
Simulation game
A game that represents real-life situations in which
learners compete according to a set of rules in order to
win or achieve an objective.

Role playing
A form of drama in wsly act out roles on an
interaction involving problems or challenges in
human relations.
Case studies
An analysis of an incident or situation in which
characters and relationships are described, factual
or hypothetical events transpire, and problems need
to be resolved or solved.

Simulation types
Facts about Simulations
Simulations have been
a teaching strategy for
War games were used
in ancient China and
India and more
recently in eighteenth-
century Germany.

Chess, a simulation
game, is thought to
have been developed
around 800 B.C.
Simulations more
recent use in
education began in the
1960s, when business,
law, educational
administration and
medicine all began to
use various simulation
Purpose and Uses of Simulations
techniques can be
used to achieve
Simulation is also
an avenue for
attitude change.

Decision-making can be
fostered by simulation.
Simulation strategies
can be applied to the
teaching of psychomotor
Simulations can be used
to evaluate learning and

Role of the Educator
3 facets:
Choosing or
developing an
appropriate simulation
that will meet learning
Role of the Educator
Should occur
following the
still fresh.

Steps to debriefing:
Briefly summarize
what has taken place.
Have the learners
explain what they did
and why.
Point out how
principles and
concepts have been
applied and how the
experience ties into
the learning
Four Types of Simulation
1. Simulation Exercise
2. Simulation Games
3. Role-playing
4. Case studies
Four Types of Simulation
Simulation Exercise (SE)
Focuses on process learning.
Partakers of the simulation exercise learns how to make decisions or solve
problem or apply theory.
Examples of SE:
Babic and Crangle (1987)
Undergraduate students simulated the aging process in themselves by
choosing a decrement associated with aging and simulating the resulting
lifestyle for 24 hrs.
Helmuth (1994)
developed mock convention, a simulation which is very involved and
lengthy one in which students simulate a portion of a professional
nursing organization convention, to aid NS to apply leadership skills.
Four Types of Simulation
Simulation Exercise (SE)
Examples of SE:
Lev (1998)
Conducted an exercise in which nursing students, acting as if they
were from a variety of community agencies, competed for
community grant monies designed to assist chronically ill people
across their lifespan (learned resource allocation).
Wildman and Reeves (1997)
Used a simulation technique to teach nursing students how to
apply management theory to organizing the work of a hospital
clinical unit.
Four Types of Simulation
Simulation Exercise (SE)
Examples of SE designed to help learners apply and master
psychomotor and clinical skills:
Aronson and colleagues (1997)
Arranged a lab simulation in dressing, IV lines, and the
like that simulated emergencies, complications and
urgent scenarios that the students had to assess and to
which they had to respond.
Johnson and colleagues (1999)
Described the use of live simulated patients as an
adjunct to clinical teaching.
Four Types of Simulation
Simulation Exercise (SE)
Examples of SE designed to help learners apply and master
psychomotor and clinical skills:
Eaves and Flagg (2001)
U.S. Air Force members who developed an entire
simulated hospital unit in which new graduates spent 4
hours providing care to 9 mannequins and 2 live actor
patients (learning about delegation, decision making,
and 15 psychomotor skills).
Four Types of Simulation
Simulation Games (SG)
Focuses on either content or process learning.
Content games
focus on teaching or reinforcing factual information
(e.g., crossword puzzles that aim to teach terminology or
bingo games that reinforce previously learned facts).
Process games
are those that emphasize problem solving or application
of information (e.g., SimCity).
Four Types of Simulation
Simulation Games (SG)
Frame games
Games that follow the format of
established board games, television
games, and word games (Bloom and
Trice, 1994) because they provide a frame
on which you can build new game
Advantages of Simulation Games
It is fun!
Disadvantages of Simulation Games
Games considered by others not to be
simulations are things like word games;
thus, some educators feel those games are a
waste of time.
Games are unprofessional
Disliking competition that games promote
Time consuming to play
Very labour intensive to develop

Factors to Consider in making a
Simulation Games
Validity of the
games (Peter and
colleagues, 1998)
Careful planning
(Greunding, Fenty
& Hogan, 1991)
Four Types of Simulation
Role-Playing (RP)
A form of drama in which learners
spontaneously act out roles in an
interaction involving problems or
challenges in human relations.
Helpful to gain skill in
interpersonal therapeutic
Develop the quality of empathy.

Four Types of Simulation
Role-Playing (RP)
Examples of RP:
Land of Suria
By Dahl (1984) simulation designed to
give learners experience in
communicating with people from
culture previously unknown to them.
Halloran and Dean (1994)
Developed a role-playing simulation
combined with a game format.
Johnson (1997)
Used role-playing to teach home care
nurses to assess patients, communicate
with families and professionals, and to
fill out paperwork accurately.
Four Types of Simulation
Case Studies (CS)
An analysis of an incident or situation in
which characters and relationships are
described, factual or hypothetical events,
transpire, and problems need to be resolved
or solved.
Harvard Law School in the 1870s (Wade,
100 years before enjoyment.
Four Types of Simulation
Case Studies (CS)
Steps to make a Case Study for a group of
Develop objectives.
Select a situation.
Develop the characters.
Develop the discussion questions.
Lead the group discussion.
Problem-Based Learning (PBL)
An approach to learning that involves confronting students with real-life
problems that provide a stimulus for critical thinking and self-taught
Based on a principle that students, working together in small groups, will
analyze a case, identify their own needs for information, and then solve
problems like those that occur in everyday life.
Differences between PBL and Case
PBL, conducted with small groups /case studies may be used by individuals or
Students using PBL have little background of what theyre going to do/
students doing CM have every detail they need.
PBL cases are usually brief and the presenting problems are ill structures/CM
cases are often long and detailed, and their problems are fairly well defined.
Problem-Based Learning (PBL)
Began over 30 yrs ago at McMaster University School of
Medicine in CA spread to medical schools in US-the world.
Medical schools other disciplines, 1
nursing application
started in AU (Heliker, 1994).
Cause for a new approach to medical education:
Emphasis on memorization of more & more content.
Lack of correlation between the basic sciences and
clinical content.
Identification of the need to prepare professionals with
skills for lifelong learning (Bloud & Feletti, 1997).
Why use PBL in Nursing?
Glen & Wilkie (2000, p.13) suggests 2 rationale:
It helps students to see the relevance of subjects they learn.
It sets the learning in a context in which it will be used
Heliker (1994)
claims that learning in context enables learners to structure their long-term
memory for easy retrieval of the information.
Advantages of PBL
Help students to think critically.
Sharing of new information.

Disadvantages of PBL
Takes a lot of time (Mathews-smith, Oberski, GrayCrater & Smith, 2001).
Students may feel unhappy and that of the teacher.
Teachers have difficulty adjusting to their role.
Students feel frustrated as they learn to direct their own learning (Lunky-
Child et al., 2001).
Problem-Based Learning
Is PBL worth using?
Does it have very large effects on student learning?
Does the students enjoy learning using PBL?
Self-Learning Modules (SLM)
Also called self-directed learning elements, self-paced modules, self learning
packets, and individualized learning activity packages.
Defined as a self-contained unit or package of study materials for use by an
1960s in academic setting moved to staff development surpassed used in
school of nursing.
Self-Learning Modules
Are based on some principle of adult learning such as:
Adults are self-motivated to learn material for which they see relevance
Adults prior experience is a resource for further learning.
Adults are problem focused and readily learn material they can use to solve
problems (Herrick, Jenkins, & Calrson, 1998; Mast & VanAtta, 1986).
Self-Learning Modules
There are few topics or settings in which self-learning modules would not be
Used to teach entire courses or sections of courses in academic settings at both
undergraduate and graduate levels (Fullerton & Graveley, 1998; Holtzman, 1999;
Spickerman, Lee & Eason, 1988).
Used for bridging courses for LPNs or RNs returning to school for a higher degree.
Applied to staff development for purposes of orientation, mandatory in-service
topics and just about every specialty area imaginable and for every level of nursing
Components of Self-Learning Modules
Introduction and instructions
Topic for a module is single concept
Behavioural objectives
Are no different from those you have already learned
about and written.
Expresses what the learner will be able to do on
completion of the module.
Usually not included in a module.
Include a pre-test for staff development and academic setting.
Components of Self-Learning Modules
Learning activities
Make the most creative portion of the self-learning module.
Will help the learner achieve the objectives.
Activities might include:
Reading textbook chapters, articles or pamphlets
Reviewing handouts, charts, pictures or diagrams
Attending short lectures, speeches or demonstrations
Answering study questions and getting feedback
Watching a video or slide presentation
Using a computer program
Practicing a psychomotor skill in a lab
Participating in a discussion group

Components of Self-Learning Modules
To see whether they are achieving the objectives that were listed at the beginning
of the unit.
Some form of quiz, either multiple choice questions or short-answer questions.
Used to determine whether learners have mastered module objectives.
Maybe an objective-item test, a case study, a written assignment such as care
plan, or a demonstration of a psychomotor skill.

Developing a Module
Do plan in making a module months or weeks ahead since making a module is
a time-consuming process.
(Overy, 1999)10-15 hrs of development for every hour spent by learners in
completing the self-learning module.

Behavioural Objectives
step in the development process is writing the objective
for the module.
Example (basing on self-learning module on intestinal
Perform an assessment of intestinal elimination on alive
simulated patient (video-taped or performed during a
scheduled appointment with the instructor) correctly,
including all critical elements.
Explain the effect of infection and inflammation on the GI
Differentiate between any 4 infectious or inflammatory GI
disorder min terms of pathology, patient problems and
nursing intervention.
Behavioural Objectives
View a computer simulation of a patient with inflammatory bowel disease and list
the patients problems, your proposed interventions, and the rationale for those
Analyze why a given list of nursing intervention would be used for a patient with
an obstructed small bowel.
Write and implement (on video-tap or during a schedules appointment with the
instructor) a teaching plan for a patient (a friend or colleague with a selected
inflammatory disorder.
Decide what knowledge the learner would to have bring to the learning
experience in order to progress through the module.
(basing on the example intestinal elimination) part of the pre-test should
include questions about normal anatomy and physiology of intestinal

Learning Activities
Plan content and learning activities
Choose some learning activities that are visual, some auditory and some
Choose activities that stress abstractions and some that focus on concrete
Keep in mind about time.
(basing on the example intestinal elimination)
Unit I
Read pages 216 to 222 in the accompanying textbook in light of the study questions on
Handout I.
Learning Activities
Select one of the following activities:
View the videotape, Assessment of Intestinal Function
Listen to the audiotape, Step-by-step History Taking and Physical Assessment, Part 5.
Practice doing an assessment of intestinal elimination.

Guides should be developed to accompany each unit in a form of short
quizzes, based on the objectives, that enable learners to check their
Is usually, at least in part, a written examination.
Consists of multiple-choice and matching items, essay questions, or case
studies with questions.
Introduction and Instruction
Tells the learner how to work through the module, how to use the pre-test
and self-evaluation guides, where to locate resources, what procedures to
use for handing in assignments or scheduling skill tests, and what the roles of
the educator and learner.
Pilot Testing
Have 1 or 2 people work through the module.
Experience will tell if there are flaws in the module.
Advantages of Self-Learning Modules
The ability to learn independently and at ones own pace and in ones own
Faculty who are frustrated by not having the time to help students who are
struggling with course material in a traditional learning system have that
opportunity in the individualized approach.
Can reduce travel time for conferences and reduce the amount of time that
staff nurses have to be away from their units.
Reduce the cost of in-service education.
Disadvantages of Self-Learning Modules
Some learners may miss learning with other people and miss the interactions
that take place in a classroom.
Individualized learning may lead to further procrastination due to lack of
structure and deadlines.
Learners may be less than honest about their results and thus forgo needed
learning (Suggs et al., 1998).
Research on Effectiveness of SLM:
Comparison on the amount of knowledge gained by nurses using SLM to those
taught by lecture and found no significant differences (Coleman et al., 1991;
Scholmer, Anderson & Shaw, 1997; Suggs et al., 1998).
Nikolajski (1992) compared module use to classes with lecture/slide
presentations and found that both groups had significant learning gains, but
the gains were greater for the lecture group.
Research on Effectiveness of SLM:
Lamb and Henderson (1993)
found that in comparing groups
given lectures versus those
using modules, the module
group had significantly higher
post-test scores.
Grant (1993) found that nurses
preferred to use module rather
than attend lecture classes
Lipe and colleagues (1994)
reported 95 to 100 percent
favorable evalutaions among
nurses who learned from
Wong and Wong (1985)
measured patient
compliance behaviour
and postoperative
complications in two
groups of patients
undergoing hip surgery.