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Skill demonstration for nursing students

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DOI: 10.22259/2639-1783.0602002

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 Open Access Journal of Nursing
SRYAHWA ISSN: 2639-1783 | Volume 6, Issue 2, 2023
PUBLICATIONS https://doi.org/10.22259/2639-1783.0602002

Research ARTICLE

Effectiveness of Different Skill Demonstration Methods in Serving

Oral Medication Among Student Nurses in a Private Healthcare
College, Johor Bahru
Anuramalar S.1, Aini A.2, Annamma K. 3, Nurul Fariza4, Puziah Y5
1
Undergraduate student, School of Nursing, KPJ Healthcare University, Negeri Sembilan, Malaysia.
Associate Professor, Senior Lecturer, School of Nursing, KPJ Healthcare University, Negeri Sembilan, Malaysia.
2,3,5

4
Dean, School of Nursing, KPJ Healthcare University, Negeri Sembilan, Malaysia.
Received: 21 July 2023 Accepted: 02 August 2023 Published: 08 August 2023
Corresponding Author: Annamma K, Associate Professor, Senior Lecturer, School of Nursing, KPJ Healthcare University, Negeri
Sembilan, Malaysia.

Abstract
Background: The nursing skill laboratory is a learning ground for all clinical skills where it enables nursing
students to learn nursing procedures and practice. However, during pandemics, shifts from the traditional
nursing procedural display to video demonstration take place as protection. During the conversion from
pandemic to endemic, nursing students started college and practised in Nursing Skill Laboratory. Therefore,
this research aims to determine the effectiveness of traditional skill laboratory demonstration versus video
demonstration on skill performance in serving oral medication among student nurses in a private healthcare
college, Johor Bahru. The independent variable used in this research is the traditional skill laboratory method
and video demonstration method and the dependent variable is skill performance of undergraduate nursing
students during serving oral medication.
Methods: Quasi experimental study with post-test 1 and post-test 2 was conducted among undergraduate
nursing students in KPJ International College Johor Bahru who came for skill lab practice, total sample size
was (n-90). The study duration was within 2 months, from January 2023 to February 2023.
Results: When comparing the paired differences, there were statistically significant differences between the
Post-Test 1 and Post-Test 2 traditional demonstration group (m = 2.29, SD = 1.74) and the Post-Test 1 and
Post-Test 2 video demonstration group (m = 2.09, SD = 1.81), as indicated by the values of t (44), p = < 0.000
(p < 0.05) is significantly different. A two-way repeated measures ANOVA indicate, there is no significant
difference between the two methods when they are combined. According to the attitude scale, the Traditional
Demonstration method states the highest percentage of 95.9 % as compared to the Video Demonstration
method states 91.6 %.
Conclusion: This study found that both methods were equally effective on student’s skill performance on
serving oral medication and recommended that combination of both demonstration method shall be adopted
to improve the skill performance among student nurses.
Keywords: Skill Laboratory Demonstration, Video Demonstration, Teaching Method, Skill Performance,
Student Nurses.

1. Introduction education’s theoretical and practice components

include cognitive, emotional, and psychomotor
The nursing Skill Laboratory is where skills are taught
learning sectors (Uysal, 2016). However, a serious
to the students on a specific nursing procedure. Nursing

Citation: Anuramalar S., Aini A., Annamma K., et al. Effectiveness of Different Skill Demonstration Methods in Serving Oral Medication
Among Student Nurses in a Private Healthcare College, Johor Bahru. Open Access Journal of Nursing. 2023;6(2): 09-14.

©The Author(s) 2023. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the original work is properly cited.

Open Access Journal of Nursing V6. I2. 2023 9

Effectiveness of Different Skill Demonstration Methods in Serving Oral Medication Among Student Nurses in a Private Healthcare
College, Johor Bahru

threat to public health surfaced in 2020, the SARS- willing to participate in the study and agreed to
CoV-2 epidemic outbreak (Ramos-Morcillo et al., informed consent. A total cohort sampling method
2020). Nursing training institutions switched to was used in this study and included 90 students.
virtual remote learning to protect the students from The study respondents returned to college after post-
the pandemic, and clinical encounters were put on theory for skill laboratory practice sessions.
hold. As a result, undergraduate nursing students
faced challenges in learning nursing procedures, so 2.3 Data Collection Tool
they used online video demonstrations (Agu et al., 2021). The structured questionnaire consisted of two parts.
1.1 Background of the Study Part I: Demographic profile of the respondents. Part II:
A pre-validated questionnaire was used in this research
The nursing skill laboratory is an important setting using the Likert scale. Descriptive analysis was done
where nursing students learn nursing procedures and, using frequency and percentage. The researcher
at the same time, practice what they have learned got approval to use this attitude scale from Madam
without worrying about harming the patient (Toriente Sugathapala (Sugathapala & Chandrika, 2021).
Relloso et al., 2021). The skills lab is a facility that Strongly agree and agree are categorised as positive
enables nursing students to practice their clinical attitudes, whereas disagree and strongly disagree are
abilities before their clinical placement. It should be categorised as negative attitudes (Ama,2016). The
well-established and improved (Hayat, 2021). This
original study reported the test–retest reliability was
research is essential because the researcher identifies
assessed, and the Pearson correlation was significant
effective methods for teaching nursing skills. This
(p = 0.001), showing high internal consistency
approach has been embraced by nursing schools in
reliability. However, as part of the data analysis, the
the Caribbean and other nations, both developed and
developing. The content delivery primarily occurs total items pool Cronbach alpha’s computed value
online, although teachers receive training to conduct was 0.924. The test confirmed the scale’s reliability
virtual classroom sessions when necessary. However, in this study (Zhang et al., 2020).
the traditional nursing curriculum’s standard method, 2.3 Data Collection Procedure
which heavily relied on face-to-face instruction,
The respondents were divided into two equal groups,
limited student skill development and clinical practice
placement (Agu et al., 2021). traditional skill laboratory demonstration (n=45) and
video demonstration (n=45), using simple random
1.2 Purpose of the Study sampling (Noor et al., 2022). Each group was further
This study determined the effectiveness of different divided into five subgroups of 9 students each (n=9).
skill demonstration methods in serving oral medication The students participated in a two-hour session on
among student nurses (1) skill performance on serving oral medication, with the control group
serving oral medication using traditional skill lab, (2) using traditional skill laboratory demonstration and
skill performance on serving oral medication using the experimental group using video demonstration.
video demonstration method among student nurses, Immediate assessments were conducted by five
(3) compare the skill performance on serving oral Nursing Instructors using a validated checklist
medication using both methods and (4) attitude related form on the same day (post-test 1). The control
to the skill laboratory procedure demonstration methods. group received an assessment checklist, while the
2. Methodology experimental group was given a video assessment
link (Bayram & Caliskan, 2019). Both groups were
2.1 Research Design provided with an application manual and practised
The design used in this descriptive study was a Quasi- nursing skills using the application repeatedly for one
experimental design with Post-test 1 and post-test 2 week. After this week, the Nursing Instructors re-
(Sheikhaboumasoudi et al., 2018). Two groups were assessed the subgroups (post-test 2). A pre-validated
tested in Post-Test 1 and Post-Test 2 to compare the questionnaire consisting of 5 questions on a 4-point
intervention group with the control, which compares the Likert scale was used to determine their attitude to
participant’s Post-Test 1 and Post-Test 2 scores to evaluate different types of skill laboratory demonstration
students’ skill performance (Malik & Alam, 2019). techniques. The blinding technique was implemented
to reduce bias, ensuring participants were unaware of
2.2 Participants their assignment group or the type of demonstration
The respondents were undergraduate nursing students used (Kim & Suh, 2018).

10 Archives of Hematology and Blood Diseases V6. I2. 2023

Effectiveness of Different Skill Demonstration Methods in Serving Oral Medication Among Student Nurses in a Private Healthcare
College, Johor Bahru

2.4 Ethical Clearance and Protection of Human alpha value was identified (Kim & Suh, 2018). The
Rights level of skill performance in serving oral medication
Research Management Centre approved the study using both methods was analysed with descriptive
on 25 November 2022 (Ethical form reference No: analysis and paired sample t-test (Moon & Hyun,
KPJUC/RMC/SON/EC/2022/437). Respondents had 2019). Both methods were compared with Two-
the option to participate in the study by providing Way ANOVA Repeated measures (Tamaki et al.,
informed consent. Confidentiality and anonymity 2019) and Independent Sample T-Test (Tamaki et
were ensured, with data stored securely on a password- al., 2019). The students’ attitudes were analysed with
protected personal computer (Mothiba et al., 2020). Likert Scale, Descriptive Analysis using frequency,
percentage and Independent Sample T-Test.
2.5 Data Analysis
The data was analysed in version 27 of the Statistical
Package for the Social Sciences (SPSS). Cronbach’s
3. Results
Table 1. Demographic profile of the respondents

Characteristics Frequency (f) Per Cent %

Gender
Male 10 11
Female 80 89
Age
19 - 20 1 1
21 - 22 89 99
Race
Malay 78 87
Indian 9 10
Chinese 1 1
Others 2 2

Table 1 shows the demographic profile characteristics 3.1 Skill Performance in Serving Oral Medication
of the respondents. Among the responders, 89% were The Post-Test 1 scores of both groups were compared
female (n=80), and 11% were male. Most participants with the Post-Test 2 scores, and the results are shown
(99%, n=89) were between 21 and 22, while only 1% in Table 2. Based on the paired t-test result, there was
(n=1) were between 19 and 20. In terms of ethnicity, a statistically significant difference between the Post-
the majority of respondents were Malay (92%, n=83), Test 1 and Post-Test 2 scores of both traditional skill
followed by Indians (4%, n=4), Chinese (1%, n=1), laboratory demonstration and video demonstration, p
and others (2%, n=2). < 0.001.
Table 2. Skill Performance on oral medication administration

Skill Performance Score Mean Mean SD Sig.

Difference (d) (2-tailed)
Traditional Skill Laboratory Demonstration < .001
Post-test 1 12.33 2.29 1.91
Post-test 2 14.62 2.70
Video Demonstration
Post-test 1 13.93 1.76 2.38 < .001

Post-test 2 15.69 2.43

Open Access Journal of Nursing V6. I2. 2023 11

Effectiveness of Different Skill Demonstration Methods in Serving Oral Medication Among Student Nurses in a Private Healthcare
College, Johor Bahru

Furthermore, two-way repeated measures ANOVA 2 scores of both methods (Table 3). The Post-Test
was performed to determine the interaction between 2 Score in Traditional Demonstration groups shows
traditional skill laboratory and video demonstration a slightly lower mean (mean = 14.62; S.D. = 2.70)
methods. As for the Traditional Demonstration than the Video Demonstration group (mean = 15.69;
method, ‘s p-value is 0.819, > 0.05, which is not S.D. = 2.43), with a mean difference of 1.07. The
significant. For the Video Demonstration method, Std. Error Mean shows students in the Traditional
a p-value is 0.000, < 0.05, which is significant. The Demonstration groups are slightly higher than in the
interaction effect between the two methods, the Video Demonstration group. The p > 0.05 indicate
p-value is 0.615, > 0.05, which is insignificant. There that the variability in the two methods is about the
is no significant difference between the two methods same. The Sig (2-tailed) value is 0.05, indicating a
when they are combined. Besides, an independent statistically significant difference between the means
sample t-test was performed to compare the Post-Test of the two groups being compared.
Table 3. Independent Sample t-test of Post-Test 2

Kill Performance Score Traditional Skill Laboratory

Video Demonstration
POST TEST 2 Demonstration
Mean 14.62 15.69
Std. Deviation 2.70 2.43
Sig. (2-tailed) 0.05 < .001

3.2 Student’s Responses to the Attitude

The point of strongly agree and agree is categorised
Questionnaire under a positive attitude, whereas the point of disagree
Table 4 shows Descriptive Statistics comparing and strongly disagree is categorised under a negative
the Attitude Scale using Likert Scale between the attitude (Ama,2016). For both demonstrations,
Traditional Demonstration Method and Video the frequency of positive attitudes states a higher
Demonstration Method. The total score for each item percentage than negative attitudes. The Traditional
in the 4-point Likert scale was 4. An Independent Demonstration method states the highest percentage
sample t-test was performed for each scale to identify of 95.9 % compared to the Video Demonstration
the p-value. method, which states 91.6 %.
Table 4. Descriptive Statistics of Attitude Scale

Report
Traditional Video
Demonstration Demonstration
Std. Sig.
Mean Std. Deviation Mean Deviation (2-tailed)
Enjoyed learning skills 3.62 0.54 3.44 0.66 0.16
Prepared for assessment 3.49 0.63 3.36 0.68 0.34
Motivated to perform 3.58 0.62 3.49 0.66 0.51
Learnt required nursing skill 3.58 0.54 3.47 0.66 0.39
Learnt skills effectively 3.51 0.55 3.27 0.78 0.09

4. Discussion recorded nursing procedures and utilised online video

In 2020, the SARS-CoV-2 outbreak prompted a demonstrations for teaching. Video-assisted online
movement control order, requiring everyone to stay tools effectively teach clinical skills, enabling learners
home. This measure aimed to curb the disease’s spread to connect theory to practice and fostering learner
while vaccines were being developed. Undergraduate autonomy (Hasan & Khan, 2020). In Post-test 1, the
nursing students encountered difficulties in learning majority of students grading was satisfactory, 44 %;
nursing procedures due to these circumstances. however, in Post-test 2 majority of students’ grading
To address this, nursing instructors and Lecturers was good, 62 %. These conclusions are supported by

12 Archives of Hematology and Blood Diseases V6. I2. 2023

Effectiveness of Different Skill Demonstration Methods in Serving Oral Medication Among Student Nurses in a Private Healthcare
College, Johor Bahru

Dash, who conducted a randomised clinical trial with implemented instructional strategy that could improve
Post-Test 1 and Post-Test 2 designs to evaluate the clinical skills education under current circumstances,
effectiveness of the video-assisted teaching module on even if there is a need for more research in the field.
suggested that there was a significant improvement in Limitations
post-test knowledge, attitude, and practice compared
with Post-Test 1 and demonstrated the effectiveness The limited sample size (the students of year 1
of the video-assisted teaching programme (Du et al., semester 2) was one of the research limitations.
2022). When comparing the paired differences, there Recommendations
were statistically significant differences between the
Post-Test 1 and Post-Test 2 traditional demonstration It is recommended that future studies use larger sample
group (m = 2.29, SD = 1.74) and the Post-Test 1 and sizes and in a wider context. It is also recommended
that in further studies, both methods, one group that
Post-Test 2 video demonstration group (m = 2.09, SD
received the traditional skill laboratory method and
= 1.81), as indicated by the values of t (44), p = <
another group that received both the traditional skill
0.000 (p < 0.05) is significantly different. According to
laboratory method and video demonstration method,
another study, the persistence of learning experience
can be used together. They should be carried out using
skills may be improved by using auditory, visual, and
these demonstration methods in different student
other abilities.
groups. It is also recommended to analyse more than
Consequently, it is crucial to practice the skills several one procedure in future studies.
times before using them in a real-world setting (Arslan,
Conflict of interest
2018). A two-way repeated measures ANOVA
indicates no significant difference between the two This study has no conflict of interest.
methods when combined. In terms of clinical skills,
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College, Johor Bahru

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