الفهرس 
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Abstract
Nowadays, in the 21st century the aim of nursing education is to prepare nursing students to be able to meet rapid changes in health care environment. Students should be active participant, independent, reflective learner and have higher cognitive skills and creativity. So, the need for innovative interventions that achieve these goals has been the main responsibility of the nursing faculty. One of these interventions that have gained popularity is the use of student portfolio. It can be used as a learning and assessment tool.
Portfolio considered a very important tool not only for the students, but also for the teachers as it provides the teachers with clear view of their students’ development and growth in multiple dimensions not commonly seen in the traditional methods of evaluation. It helps them to determine to what extent their students are benefiting from the learning instructions in order to modify their teaching strategies. Despite these benefits, there are many challenges that may face the student if portfolio is not implemented effectively. So, the guidance provided by the clinical instructor in all phases of portfolio development application is very important.
The shifting done in nursing education from teacher centered approach to learner centered approach considers the students as the main element in the educational environment, respecting their opinion, perspectives and needs. So, the present study aims to determine the nursing students’ perspective toward the use of paper- based portfolio as an educational tool to identify problems that face the students and try to overcome them.
Aim of the study
The present study aimed to determine the nursing students’ perspective toward the use of paper- based portfolio as an educational tool.
Research question
What is the nursing students’ perspective toward the use of paper- based portfolio as an educational tool?
Materials
Setting: The study was carried out at the Faculty of Nursing, Alexandria University in seven academic departments that use portfolio in their clinical areas which include: Medical Surgical Nursing Department, Pediatric Nursing Department, Obstetric and Gynecological Nursing Department, Critical Care and Emergency Nursing Department, Nursing Administration Department, Gerontological Nursing Department and Community Health Nursing Department. Psychiatric Nursing and Mental Health Department was excluded because it does not use paper based portfolio in the students’ clinical training. Also Nursing Education Department was excluded because it does not include clinical training for the students in its educational plan. So, paper based portfolio is not used in this department.
Subjects: The total number of students was 320 nursing students who enrolled in three academic levels namely second, third and fourth level within the academic year 2019-2020, students at the first academic level were excluded because they did not be exposed enough to the portfolio experience and have no enough contact with the clinical areas.
Data of this study was obtained by using the following tools;
Tool 1: Nursing students’ personal and academic data questionnaire:
This tool was developed by the researcher to assess thepersonal and academic data of the study subjects such as age, sex, academic semester, past experience of using portfolio in their previous educational levels, and their academic achievement.
Tool 2: Nursing students’ perspective toward using portfolio as an educational tool questionnaire:
This questionnaire was developed by the researcher after reviewing the related literature to assess the nursing students’ perspective toward using paper -based portfolio as an educational tool in their clinical education. It consists of two parts as follows;
Part 1: Nursing students’ perspective about portfolio:
This part assesses the nursing students’ general perspective about portfolio. It consists of 64 items covering 4 dimensions of positive and negative perspectives toward portfolio as follows;
1) Beneficialness:which concerns with the issues relating to nursing students’ perspective toward benefits and gains from using portfolio.
2) Challenges:which indicates nursing students’ perspective toward difficulties facing the students during use of portfolio.
3) Guidance: that includes students’ perspective toward the received guidance from the teacher about effective use of portfolio through all phases of portfolio development.
4) Preferences: this dimension concerns with the nursing students’ perspective toward the value of using portfolio in comparison to other educational tools.
The higher mean percent score for each dimension indicated higher support to this specific perspective.
Part 2: Personal experience of portfolio:
This part consisted of seven items that described the nursing students’ evaluation of their own actual experience of using portfolio from their own perspective.
Method
- The necessary approvals to conduct the present study were obtained.
- The tools were tested for its content validity by seven experts in the related field such as Nursing Education and Gerontological Nursing in order to put the tool in its final form.
- The tool II was tested for its reliability using chronbach’s Alpha test,r = 0.969.
- A pilot study was carried out on 10% of the sample size, 32, nursing students from the study setting to test the clarity, feasibility and applicability of the study tools. These students were excluded from the study sample.
- Data was collected at the end of the first academic semester 2019-2020.
The main findings of the study were as follows;
- The majority of the study nursing students, 85.3%, aged 20 years old and more, with a mean age of 21.23 ± 1.78. Females constituted 64.4% of the study sample. 47.5%, 47.8% of them obtained very good grade at the previous semester GPA and total GPA respectively.
- Regarding past experience of using the paper based portfolio, 36.6%, 38%, 54.9% of the students reported having past experience of using it either at primary, preparatory, and secondary school respectively.
Nursing students’ perspective about portfolio:
- Regarding their perspectives toward the benefits of using paper based portfolio, they perceive low benefits of using paper based portfolio in general with total mean percent score 26.81 ± 21.89.
- Regarding challenges of using the portfolio, they have greater endorsement and support to the presence of multiple challenges facing them in general with total mean percent score 77.2 ± 22.2. These challenges include mainly psychosocial challenges 78.9 ± 23.7 followed by financial challenges 76.8 ± 24.5 and then physical challenges 75.0± 27.9.
- Concerning clinical instructor guidance about application of paper based portfolio, they perceive low mean percent score 32.47 ± 22.81 toward clinical instructor guidance in general during all phases of portfolio development application.
- Concerning preferences of using paper based portfolio in comparison to other educational tools, They perceive minimum preferences of using paper based portfolio in comparison to other educational toolswith total mean percent score 22.78 ± 23.51.
- Regarding their actual personal experience of using paper based portfolio, students generally perceive it very negativelywith total mean percent score 18.14 ± 17.37.
- A statistical significant relation was observed between the nursing student’s gender and personal experience of portfolio (t = 2.348, P = 0.019) that females show more negative perspective than male 16.46 ± 16.82, 21.18 ± 18.0 respectively.Nursing students who located in early academic level (2nd level) reported higher mean percent scores of positive perspective about portfolio such as benefits (34.25 ± 20.06), guidance (37.72 ± 20.66), preferences (29.74 ± 21.51) and personal experience (24.04 ± 18.40) in comparison to the nursing students in advanced academic levels. At the same time, they perceive lesser endorsement to negative perspectives toward challenges(71.98 ± 20.28) in comparison to other nursing students.The differences were statistically significant p ≤ 0.05.
- Nursing student who have past experience of using portfolio in the previous educational levelsreported higher mean percent score of positive perspectives toward portfolio such as benefits (39.80 ± 25.91), received guidance (37.77 ± 22.42), preferences (27.78 ± 23.49) and also better perspective toward personal experience of using portfolio (25.56 ± 19.41) in comparison to other students.The differences were statistically significant p ≤ 0.05.
Based on the results of the present study, it can be concluded that:
The nursing students reported lower support and endorsement to the benefits of paper based portfolio or the preferences of its use in comparison to other tools. While, the students perceive greater challenges of using portfolio, they also perceive minimum instructions and guidance received from the clinical instructors during all phases of portfolio development application. Moreover, they reported greater negative perspective toward their actual personal experience of using portfolio in general.
Based on the present study finding, the following recommendations are suggested:
- Training workshops should be conducted by nursing education department staff to all nursing educators to enhance their abilities and competencies in the use of portfolio.
- Training sessions should be conducted to all nursing students about the purpose, content, application and evaluation of portfolio in order to understand its importance now and then. These sessions should be done at the beginning of college entry and reconducted at the beginning of every semester by nursing education staff
- Portfolio should be applied in all courses in the theoretical and clinical setting and allocation of suitable grades from the total score that suited to its importance at the Faculty of Nursing, Alexandria University.
- Connection between the different departments through the student portfolio from the first year until graduation should be assured.
- Standardized criteria and rubric must be provided to and followed by all clinical instructors and students about the evaluation of paper based portfolio.
Recommendations for further studies:
- A study to determine the effect of using paper based portfolio on academic achievement, critical thinking, and self-esteem of the nursing students.