Running head: TEACHING STYLES

Teaching Styles in the Classroom and Their Effect on Student Grades

Jennifer Fernandez
University of Saint Mary

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Abstract

A study was conducted that focused on nursing education and the use of active learning as a
teaching intervention. Approximately 200 students were involved in the study. There were four
teams of instructors and the students are divided between the four teams. Two of the teams were
instructed using teaching interventions focused on active learning. Power Point slides, YouTube
videos, life experiences, and question periods were utilized. A data analysis was then conducted
comparing the mean, median, standard deviation, reliability coefficient, biserial and P value/ D
value scores. The test data statistics were not statistically significant and does not support the
hypothesis that active learning would provide stronger content comprehension.

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Background

Nursing education should be taught using the same strategies around the world to create
equality in the learning field. The main focus in recent years has been on active learning (Iwasiw,
& Goldenberg, 2015, p. 27). Research has shown that students learn best when being actively
taught and using a more kinesthetic approach when possible (Iwasiw, & Goldenberg, 2015, p.
22). These methods can also be introduced in the classroom by encouraging students to engage
with the instructors during lectures. There is a mixed array of instructors; the ones who just talk
without any direction or program to their method, the ones who read straight off of the Power
Points, and then the ones who ask questions and involve the students in their learning process.
The belief in active learning is that teachers are putting the power of the material taught into the
students hands ((Iwasiw, & Goldenberg, 2015, p. 19). Active learning enables the students to
have control and be responsible for their own learning and grades. Research shows that activelearning strategies can increase student learning and satisfaction (Boctor, 2013, p. 96). This
study is an effort to evaluate various teaching methods at an Associate Degree Nursing (ADN)
program with an approximate enrollment of 200 students per semester. This large volume of
nursing students is distributed among four different teams of instructors and they have those
same instructors for the entire semester. However, all four teams of students take the same tests
across the level. It has been noted during test reviews, that some of the teams are achieving
higher grades and correct answers than the other teams, using the overall scores and point biserial numbers to compare. After visiting in on all of the instructors teaching lectures, some
significant teaching differences have been noted as well. The students in the class with the
novice instructors who are using active learning teaching styles are making higher grades across
the board than the students in the expert teachers classes who are using Power Points and

TEACHING STYLES

straight lecture without any questions and answers time being offered. In this particular learning
environment Patricia Benners theory of Novice to Expert is working backwards. The novice
instructors using active learning are providing a better education, according to grades, than the
experts. The hypothesis of this informal study, therefore, is to demonstrate that a classroom using
active learning will achieve statistically higher scores and the grades will represent a higher
understanding of the content.
Curriculum Mission and Philosophy
Billings and Halstead (2012) describes mission statements as unique purpose for which
an institution exists (p. 108). Billings and Halstead (2012) also looks into the purpose of
institutional philosophies (p.108). The philosophy is a narrative statement as to what the values
and beliefs of the institution are. Mission statement for the ADN school in southern Louisiana
guide various backgrounds of students in a learning focused environment and have them
graduate as fully competent and caring nurses in any entry level position (DCC.edu). According
to DCC (2016) the school in southern Louisianas philosophy:
The philosophy is that the faculty of the ADN school in southern Louisiana
upholds the mission in supporting the educational and lifelong learning needs of a
diverse multicultural community. The school strives to prepare competent,
technically-skilled graduates invested in a lifelong pursuit of knowledge, the
achievement of personal excellence, and a commitment to service to humankind
by providing compassionate, culturally-relevant nursing care. Throughout nursing
it is believed that nursing is an applied discipline that works with diverse persons
as patients across diverse environments to promote, maintain, and/or restore
health. Nurses, applying both art and science, must provide holistic patient-

TEACHING STYLES

centered care. Incorporating the qualities of compassion, cultural sensitivity, and

competence, the nurse functions as a caregiver, change agent, leader, and role
model who possesses the ability to anticipate needs and synthesize knowledge in
diverse environments. The faculty affirms that nursing is a profession that exists
in dynamic diverse environments which requires lifelong learning, internalization
of professional standards, and promotion of clinical competency through
experience. Nurses must safely, legally, and ethically practice in an
interdisciplinary atmosphere amidst mutual trust and respect. Open
communication, collaboration, and teamwork are integral to safe care, as well as
to the emotional, intellectual, spiritual, and social development of persons. A
strong sense of caring and community enables the nurse to adapt, manage conflict,
and commit to the professions. The faculty knows that nurses serve persons as
patients and their communities. Persons are unique multi-dimensional individuals
and deserving of dignity, respect, and care regardless of any other consideration.
Persons are also members of families or other aggregates that share mutual
supports and beliefs, especially in relation to health. The faculty recognizes that
the educational process empowers persons to be self-directed and to expand
knowledge. The learner must assume an active role in a learning-centered
environment that promotes interaction, reflection, mutual respect, and intellectual
curiosity. Nurses, supported by evidence-based knowledge, combine experiential
learning with life experiences to enhance clinical reasoning. As the dynamic
environments are constantly changing and evolving, the nurse must stay informed,
committed to continued education and lifelong learning, and use informatics to

TEACHING STYLES

achieve positive patient outcomes while constantly striving to improve the quality
of care (p. 5).
Framework
A framework serves as an organizing resource to guide a project; it should provide a
foundation for the project and establish its scope (Bonnel & Smith, 2014). For this study and
statistical analysis the framework being used is Patricia Benners theory of Novice to Expert.
Benner introduced the concept that expert nurses develop skills and understanding of patient care
over time through a sound educational base as well as a multitude of experiences, developing a
sound base of care from which a novice nurse can learn from (Smith & Parker, 2015, p. 109).
This all applies to nursing education as well, where the experienced educators are thought of as
the experts and the new graduate educators are thought of as the novice instructors. Few studies
address nurses perceptions of the transition from the role of staff nurse to the role of nurse
educator in an academic setting. Understanding how nurses make the transition from the role of
staff nurse to the role of nurse educator is an area that needs to be studied (Roth, 2015, p. 2).
Using Patricia Benners concept, the expert instructors teach novice instructors the paths to
follow. However, sometimes fresh minds can also bring new knowledge of teaching strategies to
the table. Various teaching methods are used, the most current trending method is active
learning. Boctor (2013) did a study to study the students satisfaction on an active learning
activity. The study showed Student survey results, using a five-point Likert scale showed that
they did find this learning method enjoyable and beneficial to learning. More research is
recommended regarding learning outcomes, when using active-learning strategies, such as
games (p. 100).

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Study Objectives

The final outcomes for this project are to conduct a statistical analysis of test results of
students who are taught by instructors who use different teaching styles. Statistics may show that
some methods work better for some students. The main objective is to identify the method of
teaching that best suits the largest amount of students and results in higher test scores, and to
present that information to the faculty.
The ultimate goal for the project is to be able to provide ample data from observation and
the test analysis to inform the instructors on teaching methods that have produced the most
positive results across the four teams. This can provide a way, whether it is a faculty meeting or
educational opportunity, to discuss factors affecting the mean scores on the students tests by
assessing the different teaching styles from all of the teachers to assure positive student outcomes
and allow discussion for content delivery and assessment of learning. The point is to use
strategies to ensure that all of the students are being taught the same information in a way the
student can understand and utilize. All instructors need to have enduring understandings of
different teaching styles and ways to help the students better understand and apply the material in
nursing.
Using data from a Pediatrics/ Med-Surg course, the plan was to foster increasing
understanding across the different teams of instructors to better align understanding of the
material as evidenced by tests results. By creating a nurturing environment, not accusatory,
where the instructors from each team can learn to work collegially towards the greater good and
a common goal, higher quality of understanding may be demonstrated in the students test
results. Thinking about assessment early in the planning process helps to clarify the intended
outcomes, which in turn helps to determine the most appropriate learning activities; this has been

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described as curriculum planning by reverse engineering (Whitehouse, 2014, p. 99). According

to Billings and Halstead (2012) Faculty in itself are considered to own the curriculum,
meaning the faculty are responsible for each step of the curriculum. Faculty assess, implement,
evaluate, and change the curriculum to assure the highest quality of education for their students.
Faculty is also responsible for offering ideas of change to better the curriculum (p. 76).
Implementation
This project consisted of a teaching intervention in two teams with active learning. Many
methods were implemented to keep the students engaged and interested. "Active Learning" is, in
short, anything that students do in a classroom other than merely passively listening to an
instructor's lecture. This includes everything from listening practices which help the students to
absorb what they hear, to short writing exercises in which students react to lecture material, to
complex group exercises in which students apply course material to "real life" situations and/or
to new problems (Tedesco-Schneck, 2013, p. 58). The hope with active learning is to get the
students to think critically.
Power Points, videos, and personal life experiences were used as a teaching intervention
to provide an active learning environment as the method of instruction, being examined. Students
were engaged with questions prior to lecture and throughout after each subject which included
cystic fibrosis, celiac disease, Phenylketonuria (PKU) Addisons disease, Cushings disease, etc.
YouTube videos were also used to give a realistic view. The use of online social networks in
medical education can remodel and enhance anatomy teaching and learning; one such network is
the video-sharing site YouTube. A study completed by Jaffar (2012) reports the popularity of
and awareness about using YouTube as a social network as well as in learning. Based on these
findings, YouTube can be considered as an effective tool to enhance anatomy instruction if the

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videos are scrutinized, diversified, and aimed toward course objectives. Faculty of average
computer literacy should be enabled to produce videos on their own YouTube channels to
support independent learning and integration in a PBL curriculum (p. 164). Personal life
experiences (also referred to as storytelling) was also used as a method of education intervention.
Hunters dissertation (2008) addresses the benefits of storytelling to nursing faculty. By creating
a safe space within their classrooms for students to share their personal experiences, teachers
begin to move beyond the more customary empirical focus traditionally found in nursing
education programs (p. ii).
The two teams that received the education intervention are team 1 and team 3 (see Table
1 &2). Specific data was collected on eight questions that covered the content taught using active
learning methods. This includes Power Points, YouTube videos, personal life experiences, and
opportunities for questions before and after each disease covered.
Data
The test was administered as a 50 question multiple choice test with each question worth
two points. Out of the 50 questions, eight were based on the material covered in the education
intervention.
Column1
Median Score
Mean
Score
Highest
Lowest
Standard
Deviation
Reliability
Coefficient

Team
Team
Team
Team
1
3
2
4
90.08
91.86
90.39
92.23
88.38
96
74

88.73
96
70

90.53
100
78

92.4
98
84

6.64

7.05

5.25

3.53

0.65

0.69

0.49

0.02

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Table 1. Relative data from all four teams on the test given. These scores are for the entire
test of 50 questions. The median and mean scores are very close from all four teams, indicating
the students achieved the same level of content understanding. The highest and lowest scores
from each team are also represented in the data table. The standard deviation is calculated for
each team as well. The standard deviation shows the level of variability on the exam. The
reliability coefficient data from each team shows some differentiation. The reliability coefficient
shows the difference in the scores if the exam were to be administered in a different form. Team
four has the lowest reliability since it is closest to zero and team three has the highest reliability.
The reliability coefficient is the most significant because it indicates that the two teams that
received the teaching interventions were more likely to score higher on the exam even if it were
administered in a different form, possibly indicating a higher understanding of the content
presented by team one and team three.

Point biserial

Team
Team
Team
Team
1
3
2
4
0.19
0.24
0
0.29
0.32
0
0.02
0.29
0.1
0.42
0
0
-0.12
0
0
0
0.06
0.36
0.26
0.18
0
0
0.26
0
0
0
0
0.11
0.27
0.64
0.48
0.16

Table 2. Point Biserial data from the questions related to the education intervention. Eight
questions on the exam were related to the education material presented using active teaching
learning methods. The point biserial values from each team for each question is provided above.
The closer to +1.0 the more reliable the question is, zero means no discrimination, and a negative
number means that students who performed well on the test as a whole tended to miss the

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question under review and students who didn't perform as well on the test as a whole got it right.
All four teams had several scores of zero and Team 1 had a negative result, this brings to
question the quality of the questions on the exam and further exploration.
Billings and Halstead describe using a P value/ D value table to describe the reliability of
the test. This allows an evaluation of the difficulty of the test question and the percentage of the
students who got the answer correct. Item discrimination (D value) establishes the difficulty level
of the test. (See Table 3).

Team
1/3
>.5
P value/ D
value
0-.5
.
51-.69
.7-.8
.811.0
Total # of
items

Team
2/4
>.5
P value/ D
value
0-0.5
.
51-.59
.7-.8
.811.0
Total # of
items

.4-.49

.3-.39

8
1

.4-.49

.2-.29

.1-.19

1,3,5

2,7
3

.3-.39

.2-.29

.
01-.09

.1-.19

5 1,2,4

Negati
ve

.01.09

Negati
ve

Total

Total

3,6
3

Table 3. P value/ D value from the questions related to the education intervention.

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The teams which received the teaching interventions scored slightly higher according to the
item difficulty (P value) over the item discrimination (D value). All of the test questions scored
poorly on as far as item difficulty, which is the percentage group of questions that the students
answered correctly (Billings & Halstead, 2012, p.480). The teams that received the teaching
intervention scored higher on the item discrimination inferring that those students had a better
understanding of the test material (Billing & Halstead, 2012, p. 480).
Results
The median score of a test is the middle score range that the students made on the test
overall. The test consisted of 50 multiple choice questions. The students averaged around the
same grade over all four teams. The basic advantage of the median over the mean in describing
data is that it is resilient to extremely large or small values, and may be a better descriptor of a
"typical" outcome.

Table 4. Calculated mean and median scores from the exam.

The overall median across the teams is 91.13%. The mean score is the average score across
the teams on all the questions. The mean is calculated by adding up all of the scores and dividing
them by the number of scores added. The mean for this data is 90.01%. The highest and lowest
scores on the overall test are also provided in Table 1. The standard deviation is also calculated
and provided for all four teams. The standard deviation is the best measurement of variability
according to Billings and Halstead (2012, p. 479) and is the average distance of scores from the
mean score. Variability is defined as referring to how spread out a group of data is. The common
measures of variability are the range, IQR, variance, and standard deviation. Measures of

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variability are descriptive statistics, which means they can only be used to describe the study
data. Reliability is defined as the degree to which an assessment tool produces stable and
consistent results.
The reliability coefficient is provided to show the amount of difference the students
would make if the test was given in a different form. The closer the reliability coefficient is to
zero, the lower the reliability is. Whereas, the closer the reliability coefficient is to one, the
higher the reliability is on the exam. One of the outcomes of interest are the point biserials for
the eight exam questions covered using active learning. The point biserial correlation measures
item reliability. It correlates student scores on one particular question with their scores on the test
as a whole. According to Demirtas and Hedeker (2014)
The point biserial correlation ranges from a low of -1.0 to a high of +1.0. The
closer the point biserial correlation is to +1.0 the more reliable the question is
considered because it discriminates well among students who mastered the test
material and those who did not. A point biserial correlation of 0.0 means the
question didn't discriminate at all. Imagine a test where all 20 students answered
Question 1 correctly. Since Question 1 doesn't discriminate among any of the
students relative to how they performed on the rest of the test, its point biserial
correlation of 0.0 makes perfect sense. A negative point biserial correlation means
that students who performed well on the test as a whole tended to miss the
question under review and students who didn't perform as well on the test as a
whole got it right. It's a red flag, and there are a number of possible things to
check. Is the answer key correct? Is the question clearly worded? If it's multiple
choice, are the choices too similar? (p. 7).

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There were 13 0.0 point biserials, meaning there wasnt any measurable discrimination at
all. Only one point biserial was a negative number, indicating the material presented on that
question needs to be further reviewed. The lowest positive point biserial number received was a
0.02 and the highest was a 0.64. The differences noted between the point biserials are not
significant enough to prove the hypothesis correct regarding active learning. However, these
point biserials demonstrate a need to look at the questions themselves to analyze the level of
difficulty and what level of competency is planned to be learned from the material presented.
Evidence of a good test normally has these following criteria for the scales: a higher
reliability coefficient, higher point biserial, and the P value/ D value higher scores. The reliability
coefficients were low, the point biserials were low, and the P value/ D values were low as well.
The P value/ D values are calculated for both the teams of students who received the teaching
intervention and then the teams of students who did not. These values show a slightly improved
P value/ D value on the teams the received the teaching interventions as opposed to the teams of
students who did not. Overall, the test statistics display low values indicating the questions
themselves should be looked at for item discrimination and level of difficulty.
Feedback
It was observed that the students who were instructed using active learning methods were
more engaged. Personal correspondence and feedback from two students after the exam included
thanks and said that they appreciated the way the material was taught in lecture because it made
them think and be involved and they felt it helped them better understand the material. Other
instructors observed the teaching interventions and filled out correspondence which received
great recognition and feedback, including to keep up the good work and great way to get the
students involved.

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Summary

In summary, there is not enough significant data to prove the hypothesis that a classroom
using active learning will achieve statistically higher scores and the grades will represent a
higher understanding of the content, and at this time the data suggests a rejected hypothesis. The
students in the two teams taught by other instructors did almost equally as well across the board
of statistics as the two teams who received the teaching interventions. Overall, the students
across all four teams did very well on this test creating very similar data across all four teams. If
other tests are examined and tracked, significance may be found but the data sample was too
small to differentiate. According to a study by Everly (2013) active learning activities were
very acceptable to students. The majority of students reported learning more from having activelearning activities in the classroom rather than lecture-only and this belief was supported by
improved test scores. Students who had active learning activities in the classroom scored
significantly higher on a standardized assessment test than students who received lecture only
(p.151). This study was confirmed with student reports of satisfaction with intervention teaching
methods and feedback from other instructors. The P value/ D value scores report a slightly better
outcomes from the students who received the teaching intervention. More study needs to be
focused on the test questions themselves for assessment of the competency tested by the
questions and a study using more questions and more students. Significant conclusions could not
be drawn from the data from this study.

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