Journal of Nursing Education

Syllabus Selections: Innovative Learning Activities Open Access

Using Cooperative Teams to Engage Students in a Stadium-Style Setting

Lenora A. McWilliams, PhD, RN; Sandra S. Lee, PhD, RN, CNE

  • Journal of Nursing Education. 2020;59(7):418
  • Posted June 29, 2020

Baccalaureate nursing students must apply health promotion, disease prevention, and epidemiology concepts to populations across the life span (American Association of Colleges of Nursing, 2008). Cooperative learning is an active learning strategy based on social interdependence (SI) theory (Johnson et al., 2007). The basic premise of SI theory and what makes this different from other types of group work relates to the structure of interdependence used within groups. If groups are structured using positive (cooperative) interdependence, then group members believe they can be successful only if the group is successful. Positive interdependence encourages promotive interactions, which in turn determines the outcome or success of the group (Johnson et. al., 2007).

Because cooperative learning typically occurs in small groups of students working side by side, it can be challenging to implement with large class sizes in a stadium-style setting. Four structured cooperative learning activities were implemented for second-degree community health nursing students using an author-designed cooperative learning template. Topics included school and community health settings, communicable diseases, and learning theories. Students were assigned to groups and worked together using elements of cooperative learning. Group structure was based on positive interdependence; team members were encouraged to use promotive interactions and were accountable to their classmates.

Five days prior to their community health class activity, students were given the cooperative learning plan via their course learning management system. The plan included the topic, schedule and objectives for the day, instructions for individual and group preparation, and information related to the assignment. Students were responsible for gathering resources and information from reputable websites and completing the reading assignment. Group preparation included what they were expected to do as a group, length of the planned activity, and presentation.

For each cooperative learning activity, students were randomly assigned into groups of six. Groups were subdivided again into smaller groups of three. Groups were instructed to sit together in the stadium classroom so they could interact during the working session. The smaller groups worked on specific content areas related to the larger topic but then they would compile the information together for inclusion in their presentation.

One example of a cooperative learning activity was epidemiology and the spread of infectious diseases. Groups were assigned to different infectious diseases, researched the diseases, and then presented information on modes of transmission, incidence, prevalence, clinical manifestations, and legal and ethical concerns.

Groups particularly enjoyed “What Would You Do?” case scenarios based on faculty experience. Groups randomly picked a scenario and were given 5 minutes to debate how they would address the issue. A slideshow randomly pulled up a scenario, and groups presented their solution. Discussion was facilitated through the use of a portable microphone, and students were allowed to ask questions that facilitated engagement, while faculty probes to the entire class promoted higher-order thinking.

Student feedback was positive; students enjoyed the cooperative learning exercises and felt better prepared for class as the plans were made available prior to class. Everly (2013) reported students felt they learned more from active learning exercises than from lectures, which was supported by higher performance scores. The use of a positive interdependence structure (SI theory) promotes group success. Using this active learning style with a carefully developed, preplanned template may improve students' ability to learn and apply community health concepts to a larger population despite large classes and challenging classroom environments.

Lenora A. McWilliams, PhD, RN
University of Houston

Sandra S. Lee, PhD, RN, CNE
Ranger College


  • American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice.
  • Everly, M.C. (2013). Are students' impressions of improved learning through active learning methods reflected by improved test scores?Nurse Education Today33(2), 148–151 doi:10.1016/j.nedt.2011.10.023 [CrossRef]
  • Johnson, D.W., Johnson, R.T. & Smith, K. (2007). The state of cooperative learning in postsecondary and professional settings. Educational Psychology Review, 19(1), 15–29 doi:10.1007/s10648-006-9038-8 [CrossRef]

Funding for publication was supported by a grant from the Office of the Provost, University of Houston.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International ( This license allows users to copy and distribute, to remix, transform, and build upon the article non-commercially, provided the author is attributed and the new work is non-commercial. Funding for publication was supported by a grant from the Office of the Provost, University of Houston.


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