الفهرس 
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Abstract
SUMMARY
The success of a learning process is strongly influenced by the learning
methods applied. The use of learning methods has a goal to create and shape
professional human beings. The ultimate goal of nursing education programs
is to graduate a greater number of competent, accountable, and reliable
professionals capable of cooperating with one another and other members of
the health care team.
Nursing education studies have often focused on traditional teaching
methods such as classroom lecture learning. More effective student-centric
learning methods are now being utilized to encourage active student
participation and creative thinking. In general, education authorities believe
that teachers should teach students how to learn content and increase the
depth of their learning and motivate them to learn by involving them in the
learning process and providing educational materials and contents.
One of these methods is peer learning, in which peers learn from one
another, involving active student participation. It is the acquisition of
information and skills through active assistance and support among stated
equals or matched peers. Having both formal and informal peer learning
opportunities are beneficial to students since they are able to communicate
and practice with someone who is in a similar learning position. This reduces
stress and anxiety and other challenges of clinical practice are mitigated by
peer support. Furthermore, it enhances the development of learning outcomes,
teamwork, critical enquiry and reflection, and learning meaningfully. Also
peer learning can increase confidence and ability to perform some skills,
including team working skills, which prepares them even more for the
transition work as qualified staff.
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83
Aim of the study
The aim of this study to assess of Damnhour technical institute of
nursing Students’ knowledge, skills and attitudes after application of peer
learning strategy. A quasi-experimental design (post- test only) was used to
conduct this study.
Setting
The study was conducted at Obstetrics and Gynecology skill lab at
Damanhour Technical Institute of Nursing, which affiliated to General
Organization for Teaching Hospitals and Institutes.
The subjects
The subjects of this study were included the last academic year nursing
students (N=60), registered in the Obstetrics and Gynecology nursing
department (first semester of the last year of Damanhour Technical Institute
of Nursing) throughout the academic year (2022- 2023), they were divided
into two groups. Control group (n=30), while, the study group (n=30).
Tools:
Three tools were used by the researcher in order to collect the required
data from the study subject.
Tool (I): Student’s Knowledge Assessment: it consist of 2 parts;
Part (I): Socio- demographic data. This part included the data such as
student’s age, sex, pervious academic achievement grade.
Part
(II):
Abdominal
Examination
Knowledge
Assessment
Questionnaire. This tool was developed by the researcher after thoroughly
Summary
84
review of literature (135-136) to assess nursing students’ knowledge in relation to
abdominal examination during pregnancy. It consisted of 30 questions. 15
statements answered with true or false and the other 15 questions were
multiple choice. Each correct answer was given one score and a zero for
incorrect one with a total score of 30. Its distribution was as the follow,
Excellent (≥27), Very Good (25 – <27), Good (22– <25), Satisfactory (20 –
<22) and Poor (<20).
Tool (II): Student’s Clinical Evaluation Checklist. This tool was
developed by Obstetrics and Gynecology nursing department in Damanhoure
Technical Institute of Nursing after thoroughly review of literature(135-137) .It is
used to assess the nursing student’s performance toward applying steps of
abdominal examination during pregnancy taught in the practical part of
Obstetrics and Gynecology nursing course and applied in the laboratory
setting. It contain 24 steps, each step checked as ”done” and ”not done”. The
pre-procedure steps include 8 steps takes score 0.25, the procedures steps
include 12 steps take score 0.5, post procedure steps include 4 steps take
scores 0.25 and 1 for preparing equipment. The step which not done will be
take score zero. The score of total performance will be 10.The point grade
system of performance in the Damanhour Technical Institute of Nursing was
applied to the total score was 10 distributed as follows: Excellent (≥9), Very
Good (7 – <9) ), Good (5 – <7), Satisfactory (3– <5), and Poor (<3).
Tool (III): Nursing Student’s Attitude toward Peer Learning
Questionnaire. This tool was developed by the researcher based on the
related literature.(138,139) This tool was used to determine students’ attitude
toward peer learning strategy, peer tutors and organizational support. It
consist of 31 item, which are entitled under two parts presented as follow:
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85
Part I: Students’ Attitude toward Peer Learning Strategy
Questionnaire. This part consist of 18 statements, it included items related
to effective method of teaching, ability to ask questions easily, willing to
engage in educational sessions, confidentiality in learning from peers and
collaboration between peers.
Part II: Students’ attitude toward peer tutors and Organizational
Support questionnaire. This part consist of 13 statements related to: tutor’s
communication manner, the tutors’ knowledge, learning environment, The
seminar rooms and equipment, time allowed for each session.
The items had to be rated on three points likert scale where (1) denoting
“agree” , (2) denoting “ natural” and (3) denoting “ disagree”. Reversed score
was taken into consideration. The scoring system was as follows; negative
attitude to peer learning score <50%. Neutral attitude to peer learning score
50% - <75 % positive attitude to peer learning score; ≥75%.
Results:
In the light of data analysis, the results could be summarized as follows:
Concerning age, it was observed that nearly two thirds of the control group
were aged 19 to less than 20 years while, a half of Study group (50.0%)
were aged 19 to less than 20 years, and (50.0%) were aged 20- 21 years.
Regarding academic achievement it was noticed that less than half of
students in control group and one-third of study group respectively
achieved excellent score.
Moreover, the results indicate that there was a statistical significant
difference in the level of total knowledge score related to abdominal
examination during pregnancy between study and control groups after
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86
implementing peer and traditional learning. The peer learning group had
better knowledge than the traditional group in almost items related to
abdominal examination during pregnancy.
As regards the mean scores of total knowledge , it was observed that there
was a statistical significant differences between the mean scores of control
group and the mean scores of the study group in the favor of the study
group. It was observed that the mean score for control group after
implementing traditional learning was (18.06 ± 4.87), while it was (21.53 ±
4.27) for study group after implementing peer learning.
Also there was a statistical significant differences in the level of practice
score related to abdominal examination during pregnancy between study
and control groups after implementing peer and traditional learning. The
majority of study group performed the items of abdominal examination
more correctly than traditional group.
Concerning the mean scores of total practice , it was observed that there
was a statistical significant differences between the mean scores of control
group and the mean scores of the study group in the favor of the study
group. It was observed that the mean score for control group after
implementing traditional learning was (21.83 ± 3.94). While, it was (25.70
± 4.30) for the study group after implementing peer learning strategy.
Concerning the overall and total attitude toward peer learning strategy , the
results reveal that less than three quarters of study group had a positive
attitude regarding the peer learning strategy and one third of study group
students had a natural attitude toward peer learning strategy.
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In addition, it was noticed that there was positive correlation between
student’s clinical practice, abdominal examination knowledge assessment
and nursing student’s positive attitude toward peer learning.
Conclusion and Recommendations
from the present study, it can be concluded that:
Peer learning strategy is a more effective strategy in the improvement of
nursing students’ knowledge and practice than traditional learning method
and it can explained by the following:
-The hypotheses of the study were achieved.
-There was a statistically significant difference in the level of knowledge and
practice scores related to abdominal examination during pregnancy procedure
between study and control group after implementing of peer learning and
traditional learning.
- The peer learning group had better knowledge and skills than the traditional
learning group in almost all items related to abdominal examination during
pregnancy.
- The majority of the study group nursing students had positive attitude
regarding peer learning.
-Moreover, There was significant positive correlations between student’s
knowledge, clinical practice regarding abdominal examination and nursing
student’s attitude toward peer learning.
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Based on the findings of the present study, the following
recommendations are suggested:
(1) Implement of peer learning strategies in both classrooms and clinical
settings to increase students’ knowledge level and clinical performance.
(2) Conduct more training workshops for nurse educators to increase their
competencies in applying peer learning
(3) Allotted enough time allotted for all students to practice the procedure
until they reaches competency level.
(4) Involve ministries of education and school authorities to attend
conferences, seminars and workshops to update their knowledge on current
pedagogies in science classrooms.
Recommendation for further studies:
(1) Replication study with other groups of students in different locations and
branches of nursing to further validate the results.
(2) Conduct peer leaning strategy in other clinical teaching situations and
using other peer learning models.
(3) Comparative study to determine the effect of traditional learning versus
peer learning on students’ social interactions, leadership ability and academic
outcome.