Study groups among nursing students have received little attention in the nursing literature. Literature in the field of education abounds with evidence that study groups increase learning, social support, and student retention, yet nursing faculty have not been very involved in encouraging or structuring study groups. In light of the fact that faculty are continually looking for ways to increase student learning and to help students at risk of academic failure or of leaving school, it would seem that study groups would be a beneficial avenue to take - a logical adjunct to traditional teaching.
Review of Literature
A search of the literature revealed relatively little about study groups in professional schools, even though they have been well established in medical and law schools for years. It did give a sense of the history of research into group learning and formal and informal study groups.
There is a fairly large body of evidence that suggests that group learning enhances academic achievement in students of all ages and sexes and across settings (Frierson, 1983; Frierson, Isom, & Webster, 1984; Hall et al., 1988; Hartwell & Hartwell, 1990; Johnson, 1984; Johnson & Johnson, 1982; Laschinger, Locke, & Stutsky, 1993; Wright, 1985). These reports reveal that study groups, both in class and out of class, those structured by the teacher and those informally organized by students, can be very effective in increasing learning. Students of all ability levels benefit from group study, regardless of the ability levels in any one group.
As reported by Seaver and Belli (1989), students involved in informal, out-of-class study groups for a statistics course benefited from having time to discuss and compare ideas and interpretations in an informal setting, to clarify misconceptions, to explain a concept to others, and to share real life experiences related to classroom material.
Nastaei and Clements (1991) mention the following cognitive benefits: more active involvement in learning; oral rehearsal of material, which promotes retention; higher level reasoning; avoidance of error in reasoning; and questioning and tutoring behaviors.
Social support is another advantage of study groups. Researchers have found that group learning leads to positive interactions, increase in self-esteem in some cases, assistance with coping, an increased acceptance of students who are different (i.e., minorities, handicapped), and a decrease in alienation (Johnson & Johnson, 1982; Magid, 1988; Nastasi & Clements, 1991; Slavin, 1983). These interpersonal effects have been shown to be a factor in student retention. Starks ( 1987) found that adult women who remained enrolled in a community college were often involved in study groups, while those who left the college were more likely to study alone.
Study Groups in One Associate Degree Program
In most of the research that has been done, teachers and researchers purposefully structured the study groups for either in-class or out-of-class study; but in some cases, especially at undergraduate and graduate levels, students formed their own study groups in response to a felt need. In an associate degree program in which one of the authors teaches, nursing students spontaneously formed their own study groups. A brief questionnaire was created and distributed in each of the four nursing courses that comprise the program to ascertain information regarding study group participants and their activities.
At the time that this small scale study was done, 85 participants (29% of the student body) completed a questionnaire indicating that they were involved in study groups. Students ranged in age from 19 to 47; the median age was 29.
Thirty percent of the students had been *| a member of a study group for only one semester, 43% for two semesters, and the remainder for more than three semesters. Seventy-four percent responded that they had been a member of the same group for the whole time. The majority of students (68%) were not involved in a study group prior to starting a nursing course.
Students were asked to describe how their group became organized. Most met either in theory courses or in campus or clinical laboratories. Some were friends, some met other students while studying in the library or by word of mouth, and some were invited to join an already existing group. Others made an announcement in class or wrote a note on the blackboard soliciting those interested in forming a study group.
Study groups were formed because of math anxiety; the belief that studying alone was inadequate; the need to study more efficiently or the desire for better grades; and because of panic before exams, or as one student put it, "desperation!" One student said she became part of a study group after recognizing the value of "study-buddies." Some students met to discuss reading assignments and this expanded into studying for exams on a regular basis. The overwhelming majority (86%) did not study for courses other than nursing. The study groups varied in size from 2 to 7 members, with 37% (32 students) r having 4 members in their group.
When asked how often they met, more than half (56%) of the students said they met only before exams. Forty-eight percent studied off campus, 20% on campus, and 32% studied both on and off campus. All students said that being part of a study fc group had improved their learning either very much (67%) or somewhat (33%).
Encouragement of Study Groups in a BSN Program
Based on the perceived benefits of study groups, the author who teaches in a baccalaureate program encouraged the formation of study groups among the new freshman class of nursing students. The value of group study and the usual composition of study groups were briefly explained to students who attended freshman orientation. Faculty who taught freshman science courses were asked to encourage students to become involved in study groups. Freshman who sought tutoring in science courses were also encouraged to join a group.
To determine the effectiveness of this encouragement after one semester, a brief questionnaire was given to 93 freshman nursing majors and was completed by 30. Nine students (30%) were involved in study groups. All said they got started in a study group because they thought it would help their grades. Only two students said they joined a study group because it was suggested by a faculty member.
The same class of nursing students was surveyed at the end of their third semester. Seventy-nine questionnaires were completed at the end of a nursing class, which revealed that 33 students (42%) were involved in study groups. Between the first and third semesters, faculty had continued to recommend study groups; faculty had not, however, provided any other suggestions or structure for the groups.
The students' ages ranged from 19 to 29 with the majority being 20 and 21 years old. Most students had been in a group for only one semester (59%), with 42% having been involved in a study group prior to the first nursing course, and 58% getting involved only after they had started nursing courses. Eighty-seven percent of the respondents said their groups study only nursing content.
Most students said they formed a study group because a group of friends had recognized the need to help each other (37%). Twenty-seven percent said they were students in the same nursing or science laboratory section. One group was organized by the science department, one was a group who lived close to each other, and one was formed by a student's announcement in class. The motivation for involvement was overwhelmingly to improve their learning and their grades.
The locations where the groups met were on campus (58%), off campus (18%), and in both places (24%). Forty-nine percent met only before exams, while 27% met once a week and 21% met every 2 weeks.
The median group size was 4, but there were many groups of 2 and at least one group of 11. Forty-four percent of the respondents had been in their same group the whole time, but 56% had switched groups. Reasons given for changing groups were that they had changed lab sections, their group was not serious enough, or they had transportation problems.
Students were asked to report to what degree being in a study group had improved their learning. Forty-nine percent reported "very much," 42% said "somewhat," and 9% "very little."
Helpful Hints for Starting Study Groups
If study groups are beneficial to students, what practical steps can faculty take to foster participation by students? The following approaches and considerations might be helpful:
1. Include information about study groups during freshman orientation.
2. If possible, provide training sessions in how to study effectively in a group.
3. When encouraging group formation, keep in mind that a group with 2 to 5 students of mixed scholastic ability as well as mixed races and sexes is beneficial (Maskit & Hertz-Lazarowitz, 1986; Radebaugh & Kazemek, 1989).
4. Stress that this is not a competitive effort, but a cooperative one where students can build on each other's ideas and where everyone can succeed.
5. Explain that an effective way of learning something is to teach it to someone else and that this can readily be accomplished in a study group.
6. Review principles of group dynamics to prepare students for the challenges of working in groups.
7. Review the behavior expected in groups: being courteous, accountable, and responsible, and learning to resolve conflicts in a socially acceptable manner.
8. Stimulate group formation by structuring in-class discussion groups to help students get acquainted.
9. Assign group projects for out-of-class work and ask the groups to report back to the class.
10. Assign case studies to be completed by groups out of class.
11. Set aside time for a representative of each study group to meet with the instructor to clarify any difficulties the group may be having.
With continued support of faculty and interest generated by the success of existing study groups, the formation of study groups may become part of the campus culture, which will serve to improve the learning of many students.
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