Demographics
248 nursing students from Grade 2017 were enrolled as the traditional learning group, including 65 males and 183 females, with an average age of 20.42+0.84years, 276 students from the Grade 2019 were the blended learning group, including 53 males and 223 females, with an average age of 20.57+1.11 years. A total of 154 nursing students in the traditional study group were transferred to the nursing program by their majors, and 56 students were class officers and were able to actively participate in various activities. In the blended learning group, 183 students were transferred and 68 were class officers. The baseline data of the two groups were consistent and comparable (see Table 1 for details).
Table 1. Description and comparison of demographic characteristics, skill performance and learning engagement scores between two groups of nursing undergraduates
Skill Performance and Learning Engagement
The final course grades were obtained from the university’s educational administration management system and the classroom platform. Table 1 shows the overall score of the blended group (81.19+5.86) was better than traditional group (76.29+8.06), with a statistically significant difference (t= -8.723, p <0.001). By comparing the results of the bar charts (Figure 1), It can be seen that the integration of IT into traditional education has resulted in a decrease in the proportion of students in the lower band (skill performance < 70) and an increase in the proportion of students in the higher band (skill performance > 80). There is a tendency for students in almost every mark range to migrate to higher mark levels. This demonstrates that blended learning does not only help to improve overall scores by raising the performance of poor students, but also allows students in the higher bands to progress.
According to the data analysis results, the level of learning engagement of nursing students in blended (79.67+14.99) was higher than traditional (48.73+18.18), there were statistical differences in the overall score of learning engagement and scores of all dimensions between the two groups (t=-21.106, p<0.001) (see Table 1 for details). Figure 1. Score distribution map of surgical nursing skills
Data analysis of students’ cognition, attitude, and opinions
A purposive sampling was conducted among the 2019 Grade nursing undergraduates based on gender and skill performance with a total of 15 students. Among them, the male-to-female ratio was 3:2. The skill scores are representative in all score segments(see Appendix 3 for details).
Combined with the analysis of the interview data, three first-level nodes were determined: 1) Conforming to the development of the times, reflection and worry about the blended learning, 2) The positive and negative changes that blended learning brings to students, and 3) Students' comments and suggestions on blended learning. In addition, there were 8 secondary nodes: 1) cause of occurrence, 2) reflection and worry,
3) advantage and disadvantage, 4) benefits and obstacles,5) satisfaction,6) platform usage, 7) resource updates, and 8) faculty capacity enhancement. The original information in the literature is the three-level node, namely, the reference point, which is the encoded text content in the qualitative data.
Theme 1: Conforming to the development of the times, reflection and worry about the blended learning
students affirmed that the emergence and development of blended learning is a major trend. Moreover, they thought about and looked forward to the prospects of blended learning.
A: This is in line with our development, that is, the progress of consistent development of the nursing discipline, which is also why blended learning can emerge. …
K: Offline platforms have been unable to meet the learning requirements of contemporary college students, which is the reason for the emergence of online platforms. …I really look forward to it. Will the future be a fully digital era !
O: What about our model after the end of the pandemic? What is suitable for the development of a society? Will it always change according to the needs of students? ...
Theme 2: The positive and negative changes that blended learning brings to students
The students had a clear understanding of the advantages and disadvantages of blended learning. blended learning can meet the learning needs of students and make students have a sense of benefit and pleasure. While it also hinders their progress to a certain extent.
I: We can review knowledge repeatedly and learn the knowledge points more clearly and systematically. Videos and online materials are more convenient to review. Meanwhile, the online information is complete, mainly very authoritative, and sent by the teacher.
G: We have a little worry about online learning could to become a burden on students. E-learning requires high power consumption of electronic equipment and network fluency. when you watch the video, you will also be disturbed by some information from the outside world. A higher demand for autonomy may lead to a lower learning efficiency.
H: In traditional learning, the teacher sometimes speaks too fast to record or understand. the blended learning model can meet my learning needs in surgical nursing. I think that my study has made progress. My operations are more standardised, and my knowledge is more solid. ...
Theme 3: Students' comments and suggestions on blended learning
The students clearly expressed their love for blended learning with a high score of satisfaction and expressed hope that the next class of students will continue this mode. they put forward their own suggestions on blended learning from platform usage, resource updates, faculty capacity enhancement.
A: Here, I will take Sudan, one of our excellent teachers, as an example. I hope that other teachers can learn from her in the future, develop unique teaching styles, and improve their teaching ability.
B: The video materials still need to be constantly updated, and I still feel that there is still a gap between the requirements and some specific clinical operations. ...
F: I also feel that blended learning is very good, with a satisfaction rating of 98. I hope that the younger brothers and sisters of the next semester will continue this learning method.
O: As I mentioned earlier, how can we diversify resources? Not just by videos, such as bibliographic indices, but the entire resource platform. It lacks a unified guide for use. ... Our classmates may not use the electronic resources of e-learning platforms much as they are more accustomed to the original teaching methods sometimes.