Enhancing self-directed learning among Italian nursing students: A pre- and post-intervention study

Background: In accordance with Knowles's theory, self-directed learning (SDL) may be improved with tutorial strategies focused on guided reflection and critical analysis of the learning process. No evidence on effects on SDL abilities of different tutorial strategies offered to nursing students during the 1st clinical experience is available. Objectives: To evaluate the effect of different tutorial strategies offered to nursing students on their SDL abilities. Design: A pre-post intervention non-equivalent control group design was adopted in 2013. For the treatment group, structured and intensive tutorial interventions including different strategies such as briefing, debriefing, peer support, Socratic questioning, performed by university tutors were offered during the 1st clinical experience; for the control group, unstructured and non-intensive tutorial strategies were instead offered. Setting: Two Bachelor of Nursing Degree. Participants: Students awaiting their clinical experience (n. =. 238) were the target sample. Those students who have completed the pre- and the post-intervention evaluation (201; 84.4%) were included in the analysis. Methods: SDL abilities were measured with the SRSSDL_ITA (Self Rating Scale of Self Directed Learning-Italian Version). A multiple linear regression analysis was developed to explore the predictive effect of individual, contextual and intervention variables. Results: Three main factors explained the 36.8% of the adjusted variance in SDL scores have emerged: a) having received a lower clinical nurse-to-student supervision (B 9.086, β 2.874), b) having received higher level and structured tutorial intervention by university tutors (B 8.011, β 2.741), and c) having reported higher SDL scores at the baseline (B .550, β .556). Conclusions: A lower clinical nurse-to-student ratio (1:4), accompanied by unstructured and non-intensive tutorial intervention adopted by university tutors, seemed to be equivalent to an intensive clinical supervision (1:1) accompanied by higher level and structured tutorial strategies activated by the university tutors.