Journal of Nursing Education

Success in Baccalaureate Nursing Programs: A Matter of Accommodation?

Judith Haislett, PhD; Robbie B Hughes, EdD, RN; George Atkinson, Jr, PhD; Calvin L Williams, PhD

Abstract

ABSTRACT

This article explores student learning styles as an important variable in four-year baccalaureate nursing programs. Student learning styles were assessed by Kolb's Learning Style Inventory-1985 (LSI-1985), which identifies the accommodator, diverger, assiinilator, and converger learning styles. The authors examined the relationship between learning style and academic performance as measured by grade-point ratio (GPR) and studied behaviors and attitudes as measured by Brown and Holtzman's (1964) Survey of Study Habits and Attitudes. Analysis indicated that this sample (N = 100) included mainly assimilators and divergere, making reflective observation the most common mode of learning. Compared to the accommodator/converger group, the assimilator/diverger group earned a significantly higher GPR, significantly better scores on the study habits variable of Work Methods (WM), and moderately better scores on the study attitude variable of Educational Acceptance (EA). Accommodators were identified as the most at-risk learning style group, and specific interventions were suggested to assist accommodators in adapting to the academic rigors of a nursing curriculum.

Abstract

ABSTRACT

This article explores student learning styles as an important variable in four-year baccalaureate nursing programs. Student learning styles were assessed by Kolb's Learning Style Inventory-1985 (LSI-1985), which identifies the accommodator, diverger, assiinilator, and converger learning styles. The authors examined the relationship between learning style and academic performance as measured by grade-point ratio (GPR) and studied behaviors and attitudes as measured by Brown and Holtzman's (1964) Survey of Study Habits and Attitudes. Analysis indicated that this sample (N = 100) included mainly assimilators and divergere, making reflective observation the most common mode of learning. Compared to the accommodator/converger group, the assimilator/diverger group earned a significantly higher GPR, significantly better scores on the study habits variable of Work Methods (WM), and moderately better scores on the study attitude variable of Educational Acceptance (EA). Accommodators were identified as the most at-risk learning style group, and specific interventions were suggested to assist accommodators in adapting to the academic rigors of a nursing curriculum.

Introduction

In recent years, nurse educators have investigated learning styles as an important variable in the preparation and development of nursing students. They, along with others in medical education (e.g., Leonard & Harris, 1979; Wunderlick & Gjerde, 1978), have examined learning style from a number of different perspectives using Kolb's (1984) theory of experiential learning. For example, Laschinger and Boss (1984) and Dougan (1982) explored the influence of learning style on preferred nursing specialty; Merrit (1983) examined the learning style preferences of traditional and nontraditional nursing students; and Christensen, Lee, and Bugg (1979) probed the relationship of learning style, job performance, motivational needs, and locus of control.

Several important findings in the research literature have at least two implications for the present study. First, in the studies using Kolb's model, the most commonly reported learning styles for nurses are accommodator and diverger (Christensen et al., 1979; Hodges, 1988; Laschinger, 1986; Laschinger & Boss, 1984). Second, while the relationship of several different variables has been investigated with learning style, little systematic research has examined the relationship between learning style and academic performance as measured by grade point ratio (GPR), and study behaviors and beliefs. Research has focused on such variables as locus of control (Linares, 1989), and stage of adult development (King, 1986). A variety of nursing samples have been used in these studies including such groups as nontraditional nursing students (Merrit, 1983), baccalaureate nursing (BSN) students (Lassan, 1984), and RNs (King, 1986). Only one investigation (Hughes, 1989) appeared to address the performance issues in a program for academically at-risk nursing students, but no statistical analysis was reported.

The purposes of this study are threefold: to identify the predominant learning style of freshmen BSN students; to determine the relationship between learning styles and academic performance in freshmen BSN students at the conclusion of their first semester; and to determine the relationship between student learning styles and study skills and attitudes in freshmen BSN students.

Experiential Learning Theory

Learning cycle

The core of Kolb's (1984) scheme describes how experience is transformed into ideas that learners can use to select and integrate new experiences. Learning is a four-step process based on the relationship of two dimensions of cognitive growth and learning: the concreteabstract dimension and the active-reflective dimension (Figure). Learners take in information from the environment either concretely or abstractly; they process that information either actively or reflectively. Each step or mode emphasizes different preferences. Using concrete experience, individuals immerse themselves affectively in the immediacy of the learning experience. Those preferring abstract conceptualization take a logical and rational approach. With reflective-observation preferences, a person impartially views a situation from many different perspectives. Those using active experimentation risk active participation in learning with a "hands-on" approach.

A learner moves through the cycle by first having an immediate experience (CE), which becomes the basis for observations and reflections (RO). The learner next assimilates and distills these observations and reflections into a concept or theory (AC) - even if highly informal - that can be actively tried and tested (AE). Actively testing the theory creates a fresh concrete experience and begins the cycle anew.

Learning styles

Learning style may be broadly conceived as the modus operandi that a student employs to master the content of a subject or task. Keefe (1979, p. 4) defines learning style more comprehensively as the "characteristic cognitive, affective, and physiological behaviors that serve as relatively stable indicators of how learners perceive, interact with, and respond to the learning environment." KoIb (1984) believes learning style is shaped by heredity, experiences of the past, and the everyday demands of the present (environmental press).

An individual's learning style category depends upon how he or she combines a preferred mode from each of the two dimensions (Figure). Divergere, combining concrete experience and reflective observation, are interested in people and are feeling-oriented. They like viewing situations from several perspectives in order to discover and identify potential problems or opportunities. Linking reflective observation and abstract conceptualization, assimiiators prefer working with concepts and abstract ideas rather than people, and organizing disparate observations into coherent and integrated explanations. Convergers join abstract conceptualization with active experimentation. They are more technically oriented, like to make decisions and apply their problem-solving skills in practical ways. Accommodators blend active experimentation and concrete experience. They are considered risktaking, action-oriented, and pragmatic. Accommodators solve problems in an intuitively trial-and-error manner.

Figure. Relationship of learning dimensions, modes, styles, and the learning cycle. Adapted from Experiential Learning: Experience as the Source of Learning and Development (p. 42) by David KoIb, 1984, Englewood Cliffs, NJ: Prentice-Hall, Inc. Adapted by permission.

Figure. Relationship of learning dimensions, modes, styles, and the learning cycle. Adapted from Experiential Learning: Experience as the Source of Learning and Development (p. 42) by David KoIb, 1984, Englewood Cliffs, NJ: Prentice-Hall, Inc. Adapted by permission.

Methodology

Sample

One hundred volunteers from an introductory nursing course at a mid-sized southeastern university participated in the research; 92% of the students were enrolled in the first semester of their freshman year. The remainder of the students were previously enrolled students who had recently changed their major to nursing. All students were in the first semester of the nursing curriculum. The average age of the student nurses was 19.1 years; 95% were female and 5% male. The data were collected over a two-year period. Forty-eight students were surveyed during 1989-1990, while 52 were assessed during 19901991.

Instruments

The Learning Style Inventory- 1985 (LSI-1985) (Smith & KoIb, 1986) was used to appraise the variable of learning style, and Brown and Holtzman's (1964) Survey of Study Habits and Attitudes (SSHA) was used to assess the variable of study skills and attitudes. They were both administered during the first week of classes. The LSI-1985 is a 12-item questionnaire. A phrase such as "When I learn . . ."or "I learn best from . . .* begins each item and the students have a choice of four sentence completions describing how they learn. Each sentence completion represents one of the learning modes. The students are requested to rank the sentences from 1 to 4, with the highest numbers given to sentences best describing how they learn. For example, to complete the phrase "When I learn . . . ," the student must choose between "I get involved" (CE), "I like to observe" (RO), "I evaluate things" (AC), and "I like to be active" (AE).

Table

TABLE 1Means and Standard Deviations for GPR and SSHA Subscales by Learning Styles and Style Pairs

TABLE 1

Means and Standard Deviations for GPR and SSHA Subscales by Learning Styles and Style Pairs

Scores are totaled on the four scales to ascertain a student's relative emphasis on each mode: concrete experience (CE), reflective observation (RO), abstract conceptualization (AC), and active experimentation (AE). Additionally, combination scores are computed (AC-CE and AE-RO) to determine an individual's learning style. Psychometrically, the original LSI received mixed reviews (Atkinson, 1991). The LSI-1985 is the revised version intended to satisfy concerns about validity and stability. Smith and KoIb (1986) report internal consistency coefficients (Cronbach's a) ranging from .73 to .88 (M= .81) for the revised LSI. Stability coefficients for the LSI-1985 have been reported in two studies with college freshmen (Atkinson, 1988, 1989): the first related coefficients for the six scales ranging from .24 to .69 (M = .51); the second study produced coefficients ranging from .49 to .72 (M= .64). None was reported in the User's Guide (Smith & KoIb, 1986).

The SSHA is a self-report measure that estimates the relative strength of four study skills and attitudes deemed necessary for successful performance. Scores are ranked in percentile format, comparing each student to successful four-year college and university students. Study skills are measured by two subscales: Delay Avoidance (DA), the student's ability to plan time and begin work accordingly; and Work Methods (WM), the use of appropriate methodologies to input and process new information.

Study attitudes are measured by the subscales of Teacher Approval (TA) and Education Acceptance (EA). Those scoring in the mid-range on the percentile scale for TA report comfort with teacher authority in the classrooms yet are able to initiate learning independently of teacher direction. Mid-range scores on EA indicate the student sees the value in the process of higher education and its relevance to their future. The SSHA has reliabilities ranging between .83 and .87 and is judged to be an effective measure of study skills and attitudes (Brown & Holtzman, 1964).

Finally, the variable of successful performance was measured by the student's earned GPR during the first semester of their BSN program.

Results

Assimilators and divergere made up 74% of the sample with the remaining 26% falling in the accommodator and converger quadrants (Table 1). Reflective observation, the learning preference shared by the assimilators and divergere, was the primary learning strategy characterizing nearly three fourths of the sample.

Successful performance was measured by earned GPR during the first semester in the BSN program. An analysis of variance comparing all four learning styles established significant differences in GPR (^=4.57, ¿/"3,96; p = 0.005). To localize the differences, Tukeyfc HSD was conducted because it is especially robust when applied to samples of unequal cell sizes and controls for Type I error. Scheffé's F test was also conducted with similar results. It should be noted that these a posteriori tests control for Type I experimentwise error rates. Scheffé's would be the more conservative of the two in that fewer significant differences would be found. The comparisons identified significant differences at the .05 level between assimilators and accommodators and between divergere and accommodators. This outcome suggested the reflective styles were more successful than the active.

To test this assumption, accommodators and convergers were combined, consolidating the more active learning preferences, and assimilators and divergere were combined, consolidating the more reflective learning preferences. Under this scheme (Table 2), a two-sample t test indicated that more reflective learning styles (M= 2.65) earned a significantly better GPR than the active learning styles (M-2.19), (t=-2.94, p = 0.004).

Similarly, accommodators and divergere, the concrete styles, were grouped as were the abstract styles, assimilators and convergers, to ascertain any possible significant differences between the concrete and the abstract styles. Analysis by a two-sampled t test indicated that the abstract preferences (M = 2.69) earned significantly better GPRs than the more concrete preferences (M = 2. 39), (t = 2.13,p = 0.04).

Another analysis of variance was conducted to determine whether there were any differences in the four learning styles on the study habit and attitude variables. However, results revealed no significant differences on these variables.

After defining the successful students on the performance variable as those who prefer the learning modes of reflective observation and abstract conceptualization, and the less successful as those who prefer concrete experience and active experimentation, the combined learning modes were examined on the study habits and attitudes variables. Using the subscales of the SSHA, group means were established for the two groups on the study habit variables of DA and WM and the study attitude variables of TA and EA (Table 3).

Table

TABLE 3Comparisons of Learning Style Pairs on SSHA Subscales by t Tests

TABLE 3

Comparisons of Learning Style Pairs on SSHA Subscales by t Tests

Table

TABLE 2Comparisons of Learning Style Pairs on GPR by (Tests

TABLE 2

Comparisons of Learning Style Pairs on GPR by (Tests

Application of a i test procedure revealed no significant differences between groups on the study habit variable of DA (p<17) thus both groups reported equal ability in controlling and utilizing time. However, a significant difference (Table 3) in means was exposed on the study habit variable of WM (p<.05). The more reflective styles showed more facility with varied study methodologies than the active styles. No significant differences were indicated by i tests comparing means on the two attitudinal variables of TA and EA. The reflective styles (M= 38.27) seemed to have a stronger understanding and acceptance of the role of higher education (p<.08 on EA) in their lives than those on the active styles (M- 30.17).

Discussion

Assimilators (Af = 2.70) and divergere (Af = 2.59) were labeled the most successful academically because their GPRs were significantly different from those of the accommodators (Af = 2.03). Actually, convergers (M=2.64) had the second highest GPR. However, their GPRs did not differ significantly from the accommodators1. This is probably an artifact of the underrepresentation of convergers (n = 7). In any event, convergers, with a preference for the abstract learning style, did significantly better than those students favoring the more concrete styles. Therefore, the most successful students were divergere and assimilators, who relied on reflective observation; or convergers, who relied on abstract conceptualization. In other words, students who relied on such reflectiveobservation preferences as understanding the meaning and implications of ideas and situations, appreciating what is presented to them from different points of view, and relying on their own thoughts and feelings to form opinions achieved higher GPRs. Those students who employed abstract conceptualization preferences such as focusing on logic, concepts, and ideas; taking a scientific approach to problem-solving; manipulating symbols and quantitative analysis; and valuing systematic planning and precision also did well. Those who counted mainly on concrete experience and active experimentation had more difficulty in the first year of the nursing curriculum as measured by GPR.

These findings regarding the learning style of entering nursing students are not consistent with some previous studies nor with the environmental press of the profession. Dominated by accommodators and divergere, the learning preference of concrete experience characterizes both the profession and the majority of its students (Laschinger, 1986). An explanation of the discrepancy between the current research and previous efforts may be due, in part, to the composition of the populations sampled. In the research establishing concrete experience as the key factor defining the environmental press of the nursing profession (Laschinger), the four-year baccalaureate students sampled were third-year students. The assumption is that these students had experienced at least some of the applied curricula of the nursing program and had completed the more theory-based science course work and general university requirements typical of the first semester of a nursing program. Thus, their third-year learning style could be influenced not only by their naturally occurring preference for concrete experience, but also by the lack of demand for the strategies required to master course work more compatible with abstract conceptualization and reflective observation.

The students assessed in this study were first-semester nursing students beginning the initial week of classes. Unseasoned in the more applied aspects of the nursing curricula at this early stage, the students reported learning preferences more typical of the university climate (i.e., abstract conceptualization), rather than preferences more prevalent (i.e., active experimentation) in the climate of their chosen profession. Additionally, previous studies examined the learning styles of nurses and nursing students from varied learning environments. Some were enrolled in two-year programs (Hodges, 1988) while others were employed nurses returning for added ? credentials (Hodges; King, 1986). Among this group, concrete experience was the primary learning preference, which meant that most were either accommodators or divergere. As previously stated, the sample selected for this research came from a population restricted to firstyear nursing students enrolled in a four-year baccalaureate program of study. Because we know a four-year institution lends itself to reflective observation as a learning modality (Claxton & Murrell, 1987), it makes sense that a sample drawn exclusively from this population would mirror reflective observation as a primary learning preference.

Based on the results of this investigation, accommodators are left in a rather awkward position. They rely on active experimentation and concrete experience rather than reflective observation or abstract conceptualization. Accommodators prefer more trial-and-error and "handson" approaches to learning, unlike their more abstractly and reflectively oriented counterparts. Accommodators appear to be, according to this study, the nursing students most at risk in the first year of their program.

Convergers, while sharing active experimentation with accommodators, also have abstract conceptualization to rely on. Convergers would feel at home in a curricula emphasizing science and technology. Valuing precision, they want to hone in on the single correct answer to problems. Subsequently, they negotiate well the multiplechoice testing format used by many large basic science and nursing course instructors, not to mention the national licensure examination. Divergere, who share concrete experience with accommodators, also have reflective observation to rely on. Their ability to take different perspectives, generate alternatives, and pinpoint potential problems and opportunities may enable them to adapt to the large classes and science courses that would otherwise seem very impersonal to the feeling-oriented divergere.

Accommodators probably face another block as well. Their instructors at the university are not likely to share their learning style preferences. The more advanced the level of instruction, the more likely the instructor is to be an abstract learner and teacher (Claxton & Murrell, 1987). Thus, the most likely learning/teaching styles for them would be assimilator and converger.

It also should not be surprising that accommodators rank low on the WM subscale, Accommodators want to use information, not gather it. Developing their own informationacquisition skills is seen as waste of time and resources when data can be gleaned from others more efficiently. Accommodators focus on practical application of knowledge for immediate and observable outcomes - they want results! Because they rely on concrete experience, accommodators prefer work methods that increase personal involvement with instructors. This is potentially very frustrating to accommodators because access to professors is limited for the first-semester nursing student. Large lecture-format basic science courses taught impersonally in spacious auditoriums present formidable barriers to anything resembling satisfactory personal contact for the accommodator. More compatible work methods such as modeling, tutorials, group study, behavioral rehearsal, and trial applications of information are of little use or profit in such courses.

Accommodators also rate lower on the EA subscale, a measure of comfort with the length and process of a BSN program. Accommodators are more apt to approach education as a means to a superordinate goal rather than as an end in itself. University training, then, is what must be endured to reach the desired goal of being a practicing nurse. The accommodators are at risk for perceiving the large, introductory, lecture-format, theory-based courses taught outside of nursing as alien to their interests, abilities, and future. True to their trial-and-error, wait-andsee approach to learning, accommodating nursing students are likely to find their academic performance below standard at mid-semester with little time to recoup their losses.

Recommendations

Based on these results, it seems reasonable to conclude that students with accommodator learning styles are the most at risk in the first semester of a BSN program. While the accommodators may not be in danger of failing to graduate, they are clearly in jeopardy of experiencing difficulty in adjusting to the basic science course work and the large lecture hall format. The concern of nurse educators for the accommodators predicament should not only be a humanistic and educational interest in the welfare of the student, but for practical reasons as well. Do BSN programs want approximately 19% (the percentage in this study) of their students frustrated and struggling during the semester in which they are solidifying their decision to enter nursing as a career? Logic suggests that a planned early intervention program would be a reasonable alternative to encourage academic achievement and retention. Following are some recommendations for early intervention.

First, an assessment of learning style using an instrument such as the LSI- 1985 should be done early in all students' academic experience. They could then be sensitized to the attendant strengths and weaknesses of their particular style through pre-matriculation workshops or post-matriculation university orientation courses. In these forums, special attention could be given to accommodators by informing them of the potential hazards in their curricula and acquainting them with available resources for learning the reflective and abstract study strategies necessary for academic survival in the university environment.

Second, special sections of existing introductory nursing seminars could be offered to enhance abstract conceptualization and reflective observation skills. College students normally move from a reliance on concrete experience to abstract conceptualization as they progress academically from the freshman to the senior year (Mentkowski & Strait, 1983). However, the first-semester nursing student will already be immersed in large, impersonal, lecture format courses - particularly those in the physical and life sciences taught outside the nursing program. Accommodators will probably need assistance in learning how to take and organize lecture notes in theoretically based courses, how to coordinate notes from lecture with reading material, how to use Bloom's taxonomy of learning as a guide to choosing the appropriate study strategy, and how to conduct goal-directed and task-oriented study groups. Study groups would be especially helpful to accommodators because they could use their natural preferences for explaining concepts to each other until mutual understanding is reached. They would also gain the opportunity to apply abstract constructs and formulas while receiving immediate feedback and individual attention. Particular heed should be given to teaching objective test-taking skills to accommodators. Because they are usually impatient with details, they may require practice in identifying the more subtle elements embedded within a multiplechoice question that cue the most correct response.

Third, accommodators must use their inherent strengths in theory-based courses as well as applied course work. As mentioned, they enjoy teamwork. They also need concrete stimulation and the opportunity to actively experiment in the learning process. Effective group study and/or a tutoring relationship are excellent outlets for accommodator preferences. Tutor-mentor programs for the large science classes could provide the individual attention, feedback, and role models that accommodators appreciate in the learning environment. Because they profit from immediate feedback on their trial-and-error approach to self-correction, accommodators would discover that they can become more complete and flexible learners without having to abandon their natural preferences.

Summary

This article has demonstrated how learning styles in general, and Kolb's typology in particular, can be used to identify nursing students at risk for academic difficulty and discouragement in the first year of their program. It also identifies incoming student nurses as primarily assimilators/divergers in a profession the literature suggests is dominated by accommodators. The learning preferences of the former group (along with convergers) places them in favorable position to negotiate the scholarly demands of that first year's curriculum. However, entering accommodators are clearly in the least favorable position even though their learning preferences "fit" the professional environment in which they will eventually practice.

Interventions aimed at improving the abstract and reflective skills of accommodators, at least in the first year, could improve student academic performance and increase retention. Further research could focus on learning how the other three learning styles adapt to the changing environmental press that moves in the nursing profession from the theoretical to the applied. It may be beneficial to students with more abstract and reflective styles for nurse educators to design interventions directed at facilitating the development of concrete and active skills necessary in the more applied aspects of nursing. Finally, attending to how nursing students learn - not just to what they learn - will help them develop skills in each of the four learning modes and become the complete and flexible learners as KoIb (1984) suggests. It will be the complete and flexible learners who will be able to handle the increasing demands of the nursing profession with confidence.

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TABLE 1

Means and Standard Deviations for GPR and SSHA Subscales by Learning Styles and Style Pairs

TABLE 3

Comparisons of Learning Style Pairs on SSHA Subscales by t Tests

TABLE 2

Comparisons of Learning Style Pairs on GPR by (Tests

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