Online teaching plans and instructional quality control plans were developed using the PDCA cycle (Fig. 1).
PDCA cycle implementation process
For implementation, gynecology and obstetrics nursing was taken as an example:
(1) Plan (P) – teaching planning
1) Teaching and learning analysis and determining deficiencies and challenges
To ensure the quality and effectiveness of online teaching, first, the teaching and research department relies on the school platform to facilitate teacher participation in various online teaching skill training programs before the commencement of classes and conduct trials to ensure that each teacher is proficient in at least two to three online teaching tools. Second, through trials of various online teaching tools and learning and exchange of typical experiences in online teaching, excluding various uncontrollable factors, such as network speed, the advantages and disadvantages of various online teaching tools are analyzed and summarized. Third, before the commencement of the course, the Wenjuanxing, a professional online questionnaire survey platform provided by Hunan Changsha Ranxing Information Technology Co., LTD, is used to conduct an “online teaching survey during the epidemic prevention and control period” and investigate the online learning tools mastered by nursing students, challenges of online learning, and expected teaching methods and suggestions.
Using the three above-mentioned methods, the following potential problems arising during the online teaching and learning of this course are addressed: (1) The online teaching tools selected by teachers are inconsistent, and they are frequently switched within the same class. (2) Live online teaching is more popular, but the focus is not adequately high, and the challenges are not clearly elucidated. (3) There is limited interaction between teachers and students online. (4) The interest in online teaching should be improved, as the interest among nursing students is not high. (5) There is a lack of objective and effective teaching and learning feedback. (6) The use of electronic teaching materials is inconvenient.
2) Discuss and determine the response plan with nursing students as the center
The suggested activities are as follows: unify online teaching tools, build a teaching model, and develop a teaching program; design teaching resources effectively for easy use and instant sharing, designed carefully to enrich the classroom and enhance the interest of nursing students in learning; carry out curriculum ideology and politics and aid the development of a scientific and objective teaching evaluation method.
(2) Do (D) – Teaching and learning implementation
1) Before the class, build an online teaching model, formulate an online teaching plan, and build an online learning flow chart.
Based on the premise of facilitating teaching in nursing students and taking into account the advantages and disadvantages, teachers of this course uniformly chose Tencent Classroom as the online live teaching tool; developed the online teaching mode of the “university massive open online courses (MOOC) platform/QQ group (publishing learning materials) independent learning + Tencent Classroom live broadcast + QQ group after-class assistance”; formulated the online teaching program of the course, specified the weekly learning tasks, key learning points, and difficulties; and used available teaching resources and methods. Moreover, an “online learning flow chart” was prepared to guide nursing students in familiarizing them with the online teaching process and ensure the smooth launch of the course.
2) During the class, elaborate the design, create “authentic, interesting, interactive, organized, expansive, nurturing” classroom, and practice the “three entire” nurtures the human pattern, that is, the whole staff nurtures the human, the entire process nurtures the human, omni-directional nurtures the human.
First, restore the “authenticity” of the classroom. Tencent Classroom was used to broadcast live and share teaching aids, videos, and pictures to visualize the teaching content. The whole teaching process was in the form of a “picture-in-picture” so that nursing students could hear clearly and clearly view the teacher’s face, thus realizing online face-to-face teacher–student interaction.
Second, make the classroom more interesting. The course introduction is linked to Internet phrases to bring teachers and students closer, such as “teasing from boyfriend” and “period.” The teaching modules are richly designed and named in a way that is popular with nursing students, such as “small sensations,” “questions and answers,” “talking,” “parent–child” interaction, and “small trials.” The teaching tools are flexible and varied, and hands-on teaching adds to the interest. Moreover, on the basis of the traditional teaching models, pictures, videos, and 3D animation is incorporated promptly to turn abstraction into intuition, which facilitates learning and mastery.
Third, increase the interactivity of the classroom. In the classroom, interactive activities are initiated through small videos or keywords, and nursing students leave comments or “raise their hands” in the “discussion forum.” For example, with “period,” nursing students left comments on the discussion forum to show that they had gained knowledge about premenstrual syndrome, common discomforts during menstruation, and how to take good care of themselves. The CCTV documentary “The Firsts in Life – The World at First Sight” was useful to promote emotional involvement in students. An increase in interactivity made the online classroom “vibrant” and allowed nursing students to easily manage their professional knowledge.
Fourth, knowledge is “organized” logically. Mind maps are used to link knowledge points, lay out the knowledge surface, increase the layering and logic of knowledge understanding, and help nursing students unlock effective thinking patterns. Moreover, to highlight the key points, the difficulties should be discussed to attract the attention of students. During the lecture, include more pictures and fewer words, e.g., when explaining “ovulatory disorders and abnormal uterine bleeding,” a diagram will clearly explain its causes and consequences.
Fifth, the “expandability” of knowledge was highlighted. For example, “get to know loop electrosurgical excision procedure (LEEP)” expands the clinical frontiers and introduces the common clinical treatment methods for cervicitis. The “no better how beautiful the spring is, you are a million times better-Doula delivery” extends learning in the form of group work and mutual evaluation of homework, which expands the scope of the online teaching content.
Sixth, include the “nurturing” aspect of the profession. In light of the COVID-19 pandemic, the course takes maternal and child health in the context of life as a guide, guiding nursing students to think about life, cherish life, inspire innovation, and promote an enterprising attitude.
3) Post-class, Tencent QQ helps students teach and learn to grow with each other.
Through the Tencent QQ group, we actively answer questions for nursing students and continue to build a bridge for knowledge internalization, so that “teaching” and “learning” are inseparable and mutually promotional.
(3) Check (C) – Teaching evaluation
The assessment model is a combination of learning assessment and teaching assessment, real-time process feedback and summative feedback, and quantitative and qualitative evaluations.
(4) Act (A)
According to the evaluation results, the experience gained will be used in the next cycle of teaching activities. The problems identified in this cycle and rectification measures will be focused on in the next cycle of teaching quality monitoring so that problems can be identified and solved and feedback provided promptly to ensure that they do not recur, which will promote the smooth development of teaching activities and provide a guarantee for the continuous improvement and enhancement of teaching quality.
Evaluation indicators
(1) Self-regulated learning ability
The Self-regulated Learning Ability Scale for Nursing Students [13] was used to evaluate learning; the scale comprises 28 items in three dimensions: self-management ability, information ability, and learning cooperation ability. The Cronbach alpha coefficient of the total scale was 0.86, and the split-half reliability was 0.77, which indicated good reliability and validity. The 5-point Likert scale was used, and the higher the total score, the stronger their self-regulated learning ability.
(2) Self-efficacy
The general self-efficacy scale [14] was used for evaluation, with an internal consistency coefficient of 0.87, test–retest reliability of 0.83, split-half reliability of 0.9, and correlation coefficients of 0.60–0.77 for the ten items and total scale score, with good reliability and validity. The higher the total score, the stronger the self-efficacy.
(3) Online teaching satisfaction survey
A self-made questionnaire was used, which included (I) general information (sex, age, and grade, among other items.), (ii) an online teaching survey (satisfaction with each aspect of the PDCA implementation process and its reasons), (iii) a survey on the use of each online teaching tool, among others.