INTRODUCTION:

Nursing education in India has been looked upon as one of the areas that needs improvement to attract students towards the profession. Many reports have brought to limelight the key issues and problems emphasizing the improvement of quality, issues related to nursing education are over cluttered curriculum and relying only on didactic teaching methods.¹ A research study analyzed the source of stress among the nursing students and one of them was academic overload and poor performances in examination². A survey of reasons for increased attrition rates in nursing schools found academic failure on the top of the list.³ The professional college administration and faculties have expressed increased concern over the student disengagement and lack of interest during the sessions. Research studies have revealed that collegiate students who are adult learners expect challenges and more active involving sessions but often dismayed and feel detached with the regular monotonous lectures.⁴

Nursing Faculty needs to plan their class teachings with more active teaching methods ensuring thorough participation of students which would trigger the interest in the student to be more attentive. The more attentive the student is the more concepts are learnt which improves their academic performances. The need for interactive class teaching especially in the professional courses are on demand student nurses in India. Hence the authors used Jigsaw technique as an intervention to keep the class more engaging and tracked the students’ academic performances in the tests conducted.

Jigsaw techniques is one of the integrated learning technique that instigates students to get involved with their course materials, prepare for themselves, lead and present among their peer group and encourage each other to learn. The technique is done with the aid of the teacher and performed under her supervision thus helping to activate students learning instincts by involving directly. It also helps the students to create peer support, expand deep thinking and perception with their group members. It provides equal opportunities to engage in thinking and problem solving.^5-7

The main objective of midwifery is to learn the concepts of normal labor, and to help the nursing students to differentiate between normal and abnormal labor to put in to their practice and to become best midwives in their career.^VIThe concepts of normal labor include stages, criteria, and physiological changes during each stage of labor, drug administration, and nursing management.The normal labour and its course is the major portion to study in the sylabbus and totally a new concept for the students. Hence making the learning process interesting in order to retain the learnt concepts is essential. Jigsaw technique creates interest in students motivating them to do self-reading and take up roles to make sure that all teamed up learn the concepts under the facilitation of the teacher.

MATERIALS AND METHODS:

Research Objectives.

• To assess the existing level of knowledge on normal labour and its management among nursing students.

• To plan and implement the Jigsaw Technique as a learning methodology

• To determine the effectiveness of Jigsaw learning technique on learning the concepts of normal labor by post-test among nursing students.

Research Design.

The research design used in the study is Pre-Experimental Design. One group pretest – posttest method was used. Here the chosen samples for the Pretest were given the questionnaire to assess the knowledge on the concepts of normal labor and its management after attending a regular non-interactive lecture and the same group was offered the same questionnaire after they participated in the Jigsaw technique to learn the same topic.

Setting: The study was conducted at the College of Nursing, St. Luke’s Hospital, Shrirampur, Maharastra.

Sample Size and Sampling technique.

The sample size chosen for the study was 40. Those who met the inclusion criteria were admitted in to the study using simple random sampling.

Jigsaw Technique.

Step 1: The Samples were divided into 5 “Expert Groups” with 8 samples in it..

Step 2: One sample in each group who has sound academic performance was appointed as the group leader to lead the group.

Step 3: The concepts on normal labour were divided into 8 different segments like Factors and Theories triggering onset of labour, First Stage Physiology and Management, Second stage Physiology, Labor Preparation, Mechanism of labour, Vaginal Delivery and Management, Third Stage and Management, Recovery period or fourth stage.⁸

Step 4: Assigned each student in the expert group to learn about different topics related to the concepts of normal labour. The groups were instructed to prepare the topic well, read them well, do extra reading than textual notes but at the same time to prepare simple enough to teach as well as make other students learn faster. The assigned students were expected to shoulder the responsibility of preparing that topic well.

Step 5: Ample time was given for students to familiarize the concepts. Students were instructed not to memorize instead prepare with understanding. A day was fixed to organize the Jigsaw classroom. Students initially discussed their topics in their parent groups. Each student explained and presented their prepared topic.

Step6: Then the students with similar topics made a group and discussed their topics. Each student shared their acquired knowledge on their topics. The others noted down additional points.

Step 7: Students then returned to their expert groups and once again shared their topics having new points. The investigator who was the teacher floated between groups and facilitated the whole process. As the concepts were too much to cover, the Jigsaw class room ran for three days. After a week, the students were tested with the tool.

Tool description.

The tool used was a structured questionnaire. It consisted of sixty questions related to the concepts of normal labour.⁹ Each item in the tool was checked for its quality by performing item analysis. The item difficulty and discrimination was scored and those which seemed too easy were changed. The distractors were four in number in which one of the response was the right answer. The tool was later sent to identified five experts for their opinion and content validity. The reliability of the tool was tested during the pilot study using split half method and the Karl Pearson’s formula was used. The reliability score was 0.71.

Inclusion criteria:

· Nursing students who are undergoing training.

· The students who attended the lecture on normal labor.

· The students who are available during data collection.

Exclusion criteria:

· The students who did not attend the lecture on normal labor.

· The students who are not available during data collection.

RESULTS AND DISCUSSION:

Table 1: Frequency and percentage distribution of demographic variables

Demographic variables	Frequency	Percentage
Age	Frequency	Percentage
19-21 years	27	67.5
21-23 years	09	22.5
23-25 years	04	10
Sex
Male	0	00
Female	40	100
Education
Diploma nursing	40	100
Graduate in nursing	00	00
Post graduate in nursing	00	00
Religion
Hindu	11	27.5
Muslim	00	00
Christian	29	72.5
Others	00	00

In this study total majority of the 27 (67.5%) students were between the age of 19-21 years and 9 (22.5%) students between 21-23 years and 4 (10%) students between 23-25 years. The participants were 40(100%) female students as the institution is girls only and no other male participants have been included in the study. The maximum number of the students 40 (100%) were diploma and none of the graduate and postgraduate students have participated. 29 (72.5%) Christian, 11 (27.5%) Hindu and none of the students belong to Muslim and other religion.

Table 2: Frequency and percentage distribution of Pre test and Post test knowledge scores

Level of knowledge	Score range		Frequency	Percentage
Pre test	Good	25-15	19	47.5%
	Average	14-10	17	42.5%
	Poor	10-1	04	10.0%
Post test	Good	25-15	36	90%
	Average	14-10	03	7.5%
	Poor	10-1	01	2.5%

Fig (1): Frequency and percentage distribution of Pre test score and Post test scores of jigsaw technique effectiveness on normal labor among nursing students

The above figure (1) and table (2) represents that, in pre test, 19 (47.5%) students gained good knowledge score and 17 (42.5%) students gained average (14-10) knowledge score and 4 (10%) students gained poor knowledge.

In post test, 36 (90%) students gained good knowledge (25-15) score, 3 (7.5%) students gained average knowledge (14-10) score, 1 (2.5%) student gained poor knowledge (10-1) score.

Table (3):Mean Standard Deviation, Standard Error of Difference, Degree of Freedom and t value of Pre test and Post test knowledge scores

Mean

Paired t test

Value

p value

Pre test

285.5

4.54

0.72

6.975

0.05

Post test

388

SD= Standard deviation; SE= Standard error

The above table depicts that effectiveness of jigsaw technique on nursing students determined by mean of pre test score 288.5 and post test score 388,standard deviation 4.54,standard error 0.72 and the significance is tested by paired ‘t’ test the value is 6.97 at p value 0.05 level.

SUMMARY AND CONCLUSION:

A student’s motivation to learn depends on many factors like interesting classroom sessions, active learning in the classroom, passion for the subject learnt , approachable teachers who can simplify complexities using teaching strategies. Researchers claim that “teacher led classrooms” result in the traditional methods like non-interactive lectures and blackboard teaching are the reasons for creating passive students. Teaching methodology slowly moved from the “Chalk and Board” system to the Microsoft slide presentation program – The PowerPoints. Two researchers found that students rated high the lectures those had PowerPoints but contradictory to this most studies found students reported having learnt more from the traditional lectures than sometimes boring, densely packed slides resulting in content overload and coverage in short span of time.^11,12

Technology has taken its dominance in the classroom with arrival of the virtual classrooms and smartboards but yet nothing like the student direct involvement would improve the attention focus of the students. Active learning or Cooperative learning techniques have changed the scenario in the classroom teaching and have encouraged student participation in learning topics.¹² A meta-analysis of 225 studies on student’s failure rates in STEM (Science, Technology, Engineering and Mathematics) classes was done. The results showed that active learning had a big impact on the increase in pass rates though an average increase in exam scores.¹³

There is saying- “Every accomplishment starts with the decision to try”. This study was also an attempt to promote cooperative learning among nursing students which is not a usual trend. Students found the technique as beneficial in helping them learn better. It gave them a sense of leadership and accomplishment apart from gaining and refining their knowledge on the concepts in normal labour. Thus the study concluded that jigsaw learning technique is effective educational learning tool for the nursing students and it can be implemented in daily teaching- learning activities. The only limitation being the time constraint to implement the activity in the routine class sessions.

REFERENCES:

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2. Shukla A, Kalra G, Pakhare A.(2013). “Understanding stress and coping mechanisms in Indian student nurses .Sri Lanka Journal of Psychiatry Vol 4(2) .

3. Last, L., and Fulbrook, P. (2003). Why do student nurses leave? Suggestions from a Delphi Study. Nurse Education Today, 23, 449-458.

4. Kuh, G., and Hu, S. (2001). Learning productivity at research universities. Journal of Higher Education, 72(1).

5. Aronson, E. (1997). The jigsaw classroom: Building cooperation in the classroom. Scott Foresman and Company.

6. Aronson, E. (2000-2008). Jigsaw Classroom: overview of the technique. Retrieved 2008, February 15, from http://www.jigsaw.org/overview.htm

7. Çağatay, G., and Demircioğlu, G. (2013). The effect of jigsaw-i cooperative learning technique on students’ understanding about basic organic chemistry concepts. International Journal of Educational Researchers, 4(2), 30-37.

8. Annamma Jacob (2007).Comprehensive Text Book of Midwifery.2nd edition.

9. Silvestri, L. A. (2016). Saunders comprehensive review for the NCLEX-RN® examination. Elsevier Health Sciences.

10. Drouin, M., Hile, R. E., Vartanian, L. R., and Webb, J. (2013). “ Student Preferences for Online Lecture Formats.” Quarterly Review of Distance Education, 14(3), 151-162.

11. Hill, A., Arford, T., Lubitow, A., and Smollin, L. (2012). “’I’m Ambivalent about It: The Dilemmas of PowerPoint.” Teaching Sociology, 40(3), 242-256.

12. Faust, J. L., and Paulson, D. R. (1998). Active learning in the college classroom. Journal on Excellence in College Teaching, 9(2), 3-24.

13. Freeman, S., Eddy, S., McDonough, M., Smith, M., Okoroafor, N., Jordt, H., Wenderoth, M.P. (2014) “Active Learning Increases Student Performance in Science, Engineering, and Mathematics.” Proceedings of the National Academy of Sciences USA (PNAS), 111 (23) 8410-8415. http://www.pnas.org/content/111/23/8410.full.

Received on 12.05.2016 Modified on 18.05.2016

Asian J. Nur. Edu. and Research.2017; 7(2): 181-184.

DOI: 10.5958/2349-2996.2017.00037.4