This paper is a report of a study to examine the influence of demographic, learning behavior and learning performance variables on learning outcomes of baccalaureate nursing students within a blended learning environment. A cross-sectional survey was conducted using the self-structured demographic questionnaire, case analysis attitude scale (CAAS), the case analysis self-evaluation scales (CASES), the metacognition scale (MS) and blended learning satisfaction scale (BLSS) to measure learning outcomes after the blended learning course. A total of 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were eligible to participate in the study in 2008. Data were analyzed by descriptive statistics and multiple linear regression. Univariate analysis showed significant associations between frequency of online dialogues, time spent on the internet, CAAS, and MS and scores on the ethical course. However, frequency of online dialogues, time spent on the internet, and the CAAS were significantly independent predictors for scores on the ethical course in the final model of multivariate analysis. The final model of the data analysis could account for 78% variances scores of ethical course (R(2) = 0.78 and adjusted R(2) = 0.77). It can be concluded from this study that frequency of online dialogue, time spent on internet, and the CAAS score are all useful predictors for learning outcome. In addition, blended learning was found to have contributed to learners' learning outcome by facilitating their metacognitive development and self-regulatory development. In blended learning courses, students have more responsibilities placed upon them than in traditional face-to-face learning environments. The first step of constructing a working blended learning model is to develop student-oriented teaching pedagogies that include face-to-face and online instruction, rather than just focusing on the provision of technical skills.
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