Elsevier

Nurse Education Today

Volume 119, December 2022, 105596
Nurse Education Today

Review
Authentic learning in healthcare education: A systematic review

https://doi.org/10.1016/j.nedt.2022.105596Get rights and content

Highlights

  • Simulation is the best effective educational method in authentic learning.

  • Authentic learning promotes learners' cognitive, psychomotor affective competency.

  • The technology combined learning provided a more realistic learning environment.

Abstract

Background

The increasing complexity of the clinical environment demands a higher level of clinical performance competency. New pedagogical authentic learning methods have been developed to meet this need by bridging the gap between knowledge and practice.

Objective

This systematic review aimed to examine authentic learning methods and their effects in healthcare education.

Design

Systematic review.

Data sources

Data were obtained from a literature search of Embase, PubMed, MEDLINE, CINAHL, PsycINFO, and Korean databases (e.g., KoreaMed) for studies published until May 2021. This review selected research papers documenting RCTs or quasi-experimental studies targeting undergraduate students training to become healthcare professionals.

Review methods

This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The risk of bias assessment utilized the Joanna Briggs Institute (JBI) critical checklist.

Results

Of 20 selected studies, 12 studies were randomized controlled trials, while 8 had quasi-experimental designs with a control group. Simulation was identified as an effective educational method for authentic learning. Through authentic learning, undergraduate students cultivated their knowledge and learning motivation. However, divergent conclusions were shown for performance skills.

Conclusions

Authentic pedagogical methodologies effectively enhanced learners' competencies in the cognitive, psychomotor, and affective domains. Integrating technological applications, e.g., e-learning or web-based approaches, facilitated education across academic boundaries. Further studies on combining technology with authentic learning approaches should be conducted to construct realistic educational environments for learners.

Trial registration

CRD42021229350.

Introduction

Authentic learning, which is defined as “learning knowledge and skills in contexts that reflect the way the knowledge will be useful in real life,” focuses on the integration of knowledge in realistic contexts (Herrington and Oliver, 2000). In authentic learning, students regard the learning environment as reflective of practical circumstances between structured learning activities and the context in which they are performed (Petraglia, 1998). Educational pedagogy researchers have attempted to develop authentic learning over the last three decades (Nachtigall et al., 2022). Authentic learning is an effective educational approach that enhances learners' higher-order thinking strategies to solve patients' chronic and complex health problems (Chabeli et al., 2021). Authentic learning environments are needed to construct to develop educational curricula. Authentic learning encompasses context-based learning that uses technology to reinforce educational outcomes, as exemplified by high-fidelity simulations (HFS), virtual simulation, and game-based educational intervention (Hwang et al., 2022; Xu et al., 2021).

Learning can refer to knowledge when performed in a practical context (Bednar et al., 1992). An authentic context means an environment where similar cognitive competencies are required with analogous complexity; therefore, the knowledge acquired has contextual complexity (Park, 1996; Spiro et al., 1991).

Contextual learning makes knowledge easier to understand for students. Through authentic education, undergraduate students experience actual situations as they link the content of learning to their personal experiences (Choi, 1996). Students who learn new concepts through authentic learning are able to integrate their knowledge, skills, and attitudes. Chabeli and colleagues (2021) represented the attributes of authentic learning in nursing education as competent, important, proactive, lifelong-learning graduates suitable for the 21st-century global healthcare system. The previous concept analysis study suggested that authentic learning is a form of cyclic learning that constructs a cognitive and affective thinking ladder in real or virtual educational environments (Chabeli et al., 2021).

Previous authentic learning studies in nursing education attempted to apply case-based learning for person-centered care. Furthermore, coronavirus disease 2019 (COVID-19) has had an enormous effect on healthcare education. Healthcare faculty members face challenges in delivering virtual, non-in-person interactions to strengthen clinical knowledge and practical skills. In the field of pedagogy, the curriculum built within an authentic learning environment is aimed to overcome these problems and to enhance students' competencies (Herrington and Oliver, 2000). The educational environment has been undergoing a paradigm shift (Oducado and Soriano, 2021). Radical developments have taken place in online campuses and technology-combined learning in healthcare education (Sharpe et al., 2021). Social media or video lecturing using platforms such as Zoom or WebEx have been implemented with the goal of improving communication, knowledge exchange, and collaboration among healthcare providers and students (Assinger et al., 2021; Awan et al., 2018). Healthcare education faculty have prepared innovative methods to achieve learning outcomes and promote students' motivation (Sharpe et al., 2021).

In spite of the importance of authentic learning, the comprehensive effects of authentic learning methods, content, and learning outcomes remain unclear. Therefore, this study aimed to identify the effectiveness of authentic educational methods. This study provides evidence-based data for effective authentic learning methods that can maximize learning outcomes in healthcare education.

Section snippets

Methods

This systematic review was conducted to identify authentic learning methods and the effects of authentic learning in healthcare education. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline (Moher et al., 2015). The key words and research questions were constructed according to the PICOS (population, intervention, comparison, outcomes, and study design) framework, as follows:

P: Undergraduate students in programs

The search findings

The initial database search retrieved 2312 studies by searching the databases. The selection process of this study is summarized in Fig. 1. A total of 20 studies were included in the systematic review.

Study characteristics

Table 1 summarizes the characteristics of the studies included in the systematic review. Of the 20 selected studies, 10 studies (50 %) were in the field of nursing education, 10 (50 %) were in medical education. The year of publication was distributed as follows: one study in 2002, two studies in

Discussion

From 20 studies, we extracted data on the effectiveness of authentic learning methods and learning outcomes in healthcare education. The selected studies were conducted in 11 countries, e.g., the USA, Korea, and Canada. The publication years were from 2002 to 2021.

In the overall methodological assessment of the selected studies, none of the RCT studies concealed the experimental groups. In addition, only one study (Durning et al., 2012) blinded the assessor and the treatment assignment.

Conclusions

This systematic review summarized 20 selected studies that examined the effectiveness of authentic learning methods and learning outcomes. The present systematic review found that authentic pedagogical methods especially simulation, effectively enhanced learners' competencies in the cognitive, psychomotor, and affective domains. The educational methods involving technological integration, such as web-based or e-learning were more constructive for achieving learning outcomes. We recommend

Fundings

This work was supported by Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing (Grant number: 6-2016-0143).

Ethical approval

This study was approved for a review exemption from the Human Research Ethics Committee at the Yonsei University (approval number Y-2018-0114).

Declaration of competing interest

The authors declare that they have no competing interests.

Acknowledgements

Not applicable.

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