Live Versus DVD Mock Trial: Are Cognitive and Affective Changes Different?

Abstract

Educating nurses to provide safe, ethical patient care while being socialized into the professional role requires active learning Personal, affective growth and professional transformation occur over the course of the nursing program as a result of the synthesis of cognitive knowledge, psychomotor skills, and ethical standards into a professional identity (Benner, Sutphen, Leonard, & Day, 2010). The end result is a nurse who demonstrates ethical comportment by keeping the good of the patient at the forefront, and continually acting to protect patient safety and dignity (Benner et al.). All faculty are challenged to present didactic material while using best practices. Encouraging the internalization of content while being prudent regarding financial and faculty resources requires creativity. We decided to revisit one creative strategy for teaching ethical patient care to nursing students, that is, the mock trial and explore how viewing a live trial versus a DVD affected cognitive knowledge and changed affective learning. The purpose of this study was twofold: a) to explore how presenting didactic information, followed by experiential learning with a mock trial, enhanced the cognitive and affective domains of the learner, and b) to investigate the effectiveness of a live mock trial versus a DVD of the same trial in producing the desired changes. METHOD This mixed-methods, quasi-experimental study involved 192 generic baccalaureate nursing students at a public university in the United States. The students had completed all general education credits, including an ethics course. The mock trial took place during the first upper division semester in a professional concepts course. One cohort of 96 students experienced a live mock trial; the second cohort, also 96 students, experienced the DVD version of the same trial. Focus groups with each cohort provided insight into thoughts regarding the events of the trial and its perceived effectiveness as a teaching method. Sample Most student participants were female (89.5 percent). The race/ ethnicity membership of the total cohort was 92 percent Caucasian, 6.5 percent African American, and 1.5 percent other. All students attended focus groups. Three students did not complete both the pretest and the posttest, resulting in a final sample of 189 students. Data Collection and Analysis Cohorts completed identical learning modules covering ethical content and legal issues. After finishing the modules, students completed a pretest to determine baseline knowledge about legal concepts as discussed in The Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing, 2008) as well as current affective status. Identical pre-/posttests consisted of 17 questions, assessing three faculty-identified constructs: knowledge, responsibility, and accountability. Knowledge questions measured cognitive change. Responsibility and accountability questions assessed affective change. This level of assessment was appropriate for newly promoted undergraduate students who are just beginning to interact with patients, as they were likely to be in one of the first two steps of the affective taxonomy, receiving and responding (Kirkpatrick & DeWitt, 2012). The test was a course-specific exam, and face validity was confirmed by faculty experts. The live trial took place in a courtroom and was recorded for future use. The case was a scripted scenario developed by nursing faculty and a circuit court judge. It was loosely based on a real-life case and involved a nurse who gave a miscalculated overdose of digoxin and did not record the administration of the medication. Mock trial participants playing various roles included students and faculty from law, nursing, and the drama department (March, Ford, Adams, Cheshire, & Collins, 2011). Immediately following the intervention, students participated in focus groups to determine how the mock trial affected them and to assess the acceptability and effectiveness of the strategy. …