CHAPTER # 1

Introduction

1.1 Statement of problem:

Learning is a Behavioral modification especially through experience or
conditioning. Learning is how you acquire new information about the world,
and memory is how you store that information over time. There is no
memory without learning, but there is learning without memory1.
"The task of the excellent teacher is to stimulate apparently ordinary people
to unusual effort. The tough problem is not in identifying winners: it is in
making winners out of ordinary people" (K. Patricia Cross).
This quotation shows a great significance of teaching and the true role of a
teacher. Teaching is not merely to reform students or to make them expert
technicians, it is to widen their horizon; inflame their intellects; and teach
them to be self directed. Therefore teaching in any discipline and
particularly in nursing, should always strive to move beyond simply
divulging of facts and knowledge or even training of certain skills. Instead,
teachers have the broad responsibility of serving as guide and mentor on an
intellectual journey, opening and broadening curious minds by exposing
students to creative thoughts and ideas. This manuscript was prepared after
observing a class of nursing students, conducted by one of the authors, as a
reflective process of faculty in order to portray learning experiences for
better teaching methods 5.
The concept of teaching is changing drastically in recent times. The
boundaries of knowledge are no longer restricted to textbooks and lectures.
The student of today has access to journals, Internet resources, educational
videos, online conferencing and much more. The basic concept of teaching

1
is shifting from uni-directional flow of knowledge as in lecturing to more
interactive Teaching Learning sessions. One to one approach, problem based
learning (small group learning), online learning are few of the popular
options 2.
Self directed learning has been described as “a process in which individuals
take the initiative, with or without the help of others”, to diagnose their
learning needs, formulate learning goals identify resources for learning,
select and implement learning strategies and evaluate learning outcomes.
An education design in which at their own pace, without the aid of an
instructor. It will work well for some educational needs and not well for
others and proved great opportunity for individual learning.
The death kneels for programmed instructions founded in the late 1960s with
push towards.
According to research students have no awareness about self directed
learning in Pakistan because in basic schools mostly traditional way of
teaching are used so in this setting the students can not express their
abilities. How to assess your need for self directed learning in educational
environment. The aim of study is to explore the meaning variation
perceptual experience of phenomenon of self directed learning from the
perspective of the student and investigate factors that facilitate or impede
self directed learning3.
Self directed learning is the descriptive model of the life long learning based
entirely on the focus of control for decision making about the objectives and
means of learning.
As a student, getting rapped on the knuckles on a wintry morning because
you did not form a letter correctly was a routine practice of the teachers at
the school which I attended. The teacher entered the room, expecting the

2
students to copy pages of notes from the chalkboard. The student who
reproduced these without missing a single punctuation mark, spelling
mistake and perfect handwriting got full marks.
In the past forty years not much has changed in the practices of teaching &
learning in Pakistan. The tendency to teach by the method of Repetition -
Conditioning - stimulus-response Pavlovian and operant conditioning &
shaping behavior Skinner - the leading proponents of the Behaviorist styles
of teaching continue.
Having no pedagogy which is the art (Art refers to a diverse range of human
activities and artifacts )or science an effort to discover, understand, or to
understand better, how the physical world work - Pedagogy generally refers
to strategies of instruction, or a style of instruction, also sometimes referred
to as the correct use of teaching strategies) along with lack of any serious
study of theories and practices in education around the world and virtual
absence of teacher professional development programs are some of the
causes of the decline in teaching & learning in the schools in Pakistan4.
There is more than one type of learning. A committee of colleges, led by
Benjamin Bloom, identified three domains of educational activities. The
three domains are cognitive, affective, and psychomotor. Since the work was
produced by higher education, the words tend to be a little bigger than we
are normally used to. Domains can be thought of as categories. Cognitive is
for mental skills (Knowledge), affective is for growth in feelings or
emotional areas (Attitude), while psychomotor is for manual or physical
skills (Skills). Trainers often refer to these as KAS, SKA, or KSA
(Knowledge, Attitude, and Skills). This taxonomy of learning behaviors can
be thought of as "the goals of the training process." That is, after the training
session, the learner should have acquires these new skills, knowledge, or

3
attitudes. The committee then produced an elaborate compilation for the
cognitive and affective domains, but none for the psychomotor domain.
Their explanation for this oversight was that they have little experience in
teaching manual skills within the college level (I guess they never thought to
check with their sports or drama department). This compilation divides the
three domains into subdivisions, starting from the simplest behavior to the
most complex. The divisions outlined are not absolutes and there are other
systems or hierarchies that have been devised in the educational and training
world. However, Bloom's taxonomy is easily understood and is probably the
most widely applied one in use today. Cognitive: The cognitive domain
involves knowledge and the development of intellectual skills. This includes
the recall or recognition of specific facts, procedural patterns, and concepts
that serve in the development of intellectual abilities and skills. There are six
major categories, which are listed in order below, starting from the simplest
behavior to the most complex. The categories can be thought of as degrees
of difficulties. That is, the first one must be mastered before the next one can
take place. Knowledge: Recall data or information. Comprehension:
Understand the meaning, translation, interpolation, and interpretation of
instructions and problems. State a problem in one's own words. Application:
Use a concept in a new situation or unprompted use of an abstraction.
Applies what was learned in the classroom into novel situations in the work
place. Analysis: Separates material or concepts into component parts so that
its organizational structure may be understood. Distinguishes between facts
and inferences. Synthesis: Builds a structure or pattern from diverse
elements. Put parts together to form a whole, with emphasis on creating a
new meaning or structure. Evaluation: Make judgments about the value of
ideas or materials3.

4
Affective Domain: The affective domain (Krathwohl, Bloom, Masia, 1973)
includes the manner in which we deal with things emotionally, such as
feelings, values, appreciation, enthusiasms, motivations, and attitudes. The
five major categories are listed from the simplest behavior to the most
complex: Receiving Phenomena: Awareness, willingness to hear, selected
attention. Responding to Phenomena: Active participation on the part of the
learners. Attends and reacts to a particular phenomenon. Learning outcomes
may emphasize compliance in responding, willingness to respond, or
satisfaction in responding (motivation). Valuing: The worth or value a
person attaches to a particular object, phenomenon, or behavior. This ranges
from simple acceptance to the more complex state of commitment. Valuing
is based on the internalization of a set of specified values, while clues to
these values are expressed in the learner's overt behavior and are often
identifiable. Organization: Organizes values into priorities by contrasting
different values, resolving conflicts between them, and creating a unique
value system. The emphasis is on comparing, relating, and synthesizing
values. Internalizing values (characterization): Has a value system that
controls their behavior. The behavior is pervasive, consistent, predictable,
and most importantly, characteristic of the learner. Instructional objectives
are concerned with the student's general patterns of adjustment (personal,
social, emotional). Psychomotor Domain: The psychomotor domain
(Simpson, 1972) includes physical movement, coordination, and use of the
motor-skill areas. Development of these skills requires practice and is
measured in terms of speed, precision, distance, procedures, or techniques in
execution. The seven major categories are listed from the simplest behavior
to the most complex: Perception: The ability to use sensory cues to guide
motor activity. This ranges from sensory stimulation, through cue selection,

5
to translation. Set: Readiness to act. It includes mental, physical, and
emotional sets. These three sets are dispositions that predetermine a person's
response to different situations (sometimes called mindsets).Guided
Response: The early stages in learning a complex skill that includes
imitation and trial and error. Adequacy of performance is achieved by
practicing. Mechanism: This is the intermediate stage in learning a complex
skill. Learned responses have become habitual and the movements can be
performed with some confidence and proficiency. Complex Overt Response:
The skillful performance of motor acts that involve complex movement
patterns. Proficiency is indicated by a quick, accurate, and highly
coordinated performance, requiring a minimum of energy. This category
includes performing without hesitation, and automatic performance. For
example, players are often utter sounds of satisfaction or expletives as soon
as they hit a tennis ball or throw a football, because they can tell by the feel
of the act what the result will produce. Adaptation: Skills are well developed
and the individual can modify movement patterns to fit special requirements.
Origination: Creating new movement patterns to fit a particular situation or
specific problem. Learning outcomes emphasize creativity based upon
highly developed skills3.

1.2 Significance of the Study:

Self directed learning strategies are helpful to restore & memorize
knowledge effectively. By this study students will be encouraged to achieve
more knowledge by using this method than lecture method of learning. This
method of study will make students more active than other teaching
methodologies. In addition to this above mentioned teaching strategy will
stimulate students own ideas and own thoughts for learning.

6
The activities used in the self directed learning method develops intrinsic
motivation to learn for learners. It also develops creativity, self efficacy,
helpful for examination, to achieve complex goals by critical thinking &
reasoning strategies.
By using this methodology learners become more knowledgeable material
for longer duration of the time.
It is also best for life long learning.

1.3 Hypothesis:
1. The self directed teaching learning method is more effective than
lecture method of learning.

1.4 Objectives:
• The purpose of this study is to investigate that the self directed
learning method is more effective than lecture method of learning.
• To determine the students get best results in the examinations by
using this method.

7
 CHAPTER # 2
Literature Review

2.1 Literature Review

Self directed learning has received much attention as there are numerous
articles. Knowles 1975 describe how various under graduate programs
educating health care professionals gave incorporated self directed learning.
Report on the extensive research conducted to identify student readiness for
self directed learning (crook, 1985). The literature is typically favorable and
there is much support self directed learning as a method of learning among
adults in under graduate, graduate and continuing education programs. The
literature several models that attempt to describe the phases of the self
directed learning process. While some of these models are anecdotal.
(Bound 1981, Entwistle and Ramsden1983) and based on inferences made
from observation7.
The purpose of Taylor’s study was to identify, form the learner’s
perspective, common pattern, in experience of learning namely
disorientation, exploration, reorientation and equilibrium with four phase
transition points. Taylor (1986) states that the learning process begins with
the collapse of the learners frame of references or assumptive world as an
adequate means of understanding his / her experience. This collapse marks
the beginning of the learner’s reorientation in their assumption and
expectations about teaching and learning6.
The Normative Model of Physical Therapist Professional Education,
Version13 (the Normative Model) states that the practice of physical therapy
involves complex cognitive processes. Several authors of educational texts
have argued that lecturing is inappropriate for the presentation of complex,

8
detailed, or abstract material and when that material must be understood at
higher cognitive levels. Research data supporting this contention, however,
are lacking. The Normative Model states that physical therapist professional
education curricula should be “designed to foster active, self-directed
learning,” but it does not specify a method to be used or an underlying
philosophy for clinicians8.
Active learning methods are supposed to leave students with a greater level
of knowledge and better learning skills compared with students exposed to
other forms of learning. Whether they do in all courses, however, awaits
further research. A commonly studied form of active learning is the small-
group discussion. Greater learning in small discussion groups has been
shown in engineering courses, physiological psychology courses, and
anatomy courses. Some investigators have reported that students working in
groups were more likely to be able to generalize from specific observations,
were superior at applying concepts to new situations, and had a greater
ability to critically analyze what they read and synthesize information from a
variety of sources. Students working in groups also appeared to have
increases in the attributes of self-directed learning and in obtaining relevant
help for facilitating learning when compared with students in lecture-only
courses. More recently, no difference has been reported in scores on
multiple-choice or essay examinations between courses with combined
active learning and lecture methods and those courses with only lectures.
Students who had taken the combined lecture and discussion courses,
however, were described by instructors in more advanced courses to be more
aggressive learners who would ask and answer more questions in class
discussion11.

9
According to Farrah (1990) the lecture format is one of the most frequently
used instructional methods in adult education. Broad well admits that the
lecture format assumes the educator to be the expert; but describes the
lecture as "an efficient way of imparting information in a scheduled way
without interruption, and with less planning than in most other teaching
methods" (1980,). Cox suggests that, ideally, "Lectures are only there to lay
foundations, show the way, and ease the passage, as the student works
through the subject" (1994). Knowles proposes that a good lecturer is one
who gets to know his/her students and develops the lecture according to the
student (B needs (1950). The lecture appears to be most effective in
accomplishing its specific purposes when used in combination with other
instructional strategies9.
Online lectures can be presented in a variety of ways. Lecture notes can be
placed on a web page for the learner to review. Notes can be put together in
a packet for the learner to refer to and either downloaded in file form using
File Transfer Protocol (FTP) or sent via regular postal mail. Lectures can
also be presented via audio or video over the Internet. Since online lectures
must, of necessity, be carefully prepared in advance, they are likely to be
shorter and more to the point than many lectures in live classroom which, all
too often, can extend far beyond the attention span of even adult learners. A
short lecture which can be read or listened to in ten to twenty minutes will
be likely to give the learner enough information to serve as a basis for
further reading, research, or other learning activities. Another obvious
advantage of online lectures is that they are readily available for students to
reread or listen to again and again as needed10.
Self-directed learning can include self-paced learning, independent learning,
individualized learning and self-instruction. Self-directed learning is defined

10
by Conner, Wright, DeVries, Curry, Zeider and Wilmsmeyer as "Learning
initiated and directed by the learner" (1995). Knowles describes self-directed
learning as usually taking place "in association with various kinds of helpers,
such as teachers, tutors, mentors, resource people, and peers" (1975).
Whatever terminology is used, self-directed learning places the
responsibility for learning directly on the learner15.
Knowles believes there is convincing evidence that "people who take the
initiative in learning (proactive learners) learn more things, and learn better,
than do people who sit at the feet of teachers passively waiting to be taught
(reactive learners)" (1975). He goes on to say, "They enter into learning
more purposefully and with greater motivation. They also tend to retain and
make use of what they learn better and longer than do the reactive learners".
According to Kemp, Morrison and Ross (1994), "a "true" individualized
learning or learner-controlled program would require the design of separate
objectives and learning activities for each learner according to that
individual's own characteristics, preparation, needs, and interests”. Kemp, et
al suggest that in many learning situations "learners participating in self-
paced learning programs work harder, learn more, and retain more of what is
learned" . These and other advocates seem to agree that the independent
learner is one who is more involved and active within the learning process13.
Computer-mediated learning via the Internet, by its very nature, supports the
self-directed learner in pursuing individualized, self-paced learning
activities. The learner, working at a computer at a convenient time and pace,
is able to search and utilize the vast archive and database resources of the
Internet and numerous online library catalogs and document delivery
systems to research nearly any topic imaginable. He/she can visit libraries,
museums and various institutes world wide, talk to professionals, access the

11
latest research, and read electronic newspapers and peer reviewed scholarly
electronic journals. He/she can write collaboratively with peers and even
publish written and multimedia products on web pages. The self-directed
learning possibilities of computer mediated online communication would
seem limited only by the learner him/herself14.
The literature pertinent to the study includes an overview of research studies,
as well as anecdotal writings, related to the field of SDL. A review of
current research literature regarding PBL in higher education and curriculum
outcomes are also included16.
The majority of SDL literature supports the need for empirical testing of a
theory and extensive theory development (Wilcox, 1996; Garrison, 1997;
Ramsey & Couch, 1994). Much of the SDL literature has been directed
toward identifying personal characteristics of the self directed learner
(Taylor & Burgess, 1995; Kreber, 1998; Pedley & Arbor, 1997). The results
have been inconclusive regarding specific personal character traits that
enhance SDL17.
In one study, Kreber (1998) analysed the relationships between self directed
learning, critical thinking, and psychological type. Three instruments were
used in the study. The first tool, the Self Directed Learning Readiness Scale
(SDLRS) developed by Lucy. M. Guglielmino (1977), which is the same
instrument used in the current study, was administered. The second tool was
the Watson-Glaser Critical Thinking Appraisal instrument that tested
students' abilities to enhance critical thinking. The third instrument used was
the Psychological Types and the PET Type Check that is based on
theoretical applications by Jung and measures people's preferences regarding
intuition and psychological typing (Kreber, 1998)18.

12
One hundred forty-two undergraduate students from a Canadian university
were the subjects for the study and they were to complete all three
questionnaires. Limitations for the study were cited as controversy over the
content and construct validity of all three instruments used and the fact that
different disciplines were not represented in the study. No data were
provided regarding the age of the subjects (Kreber, 1998)16.
Pedley and Arber (1997) also conducted a study to examine students'
perceptions of SDL abilities. The authors sought to evaluate student learning
processes according to the Jarvis' experiential framework. The Jarvis
framework is a decision-making grid that allows students to make clinical
decisions within a structural guide. The grid supports three thought
processes of planning, monitoring and reflecting. In the study, 135 nursing
students were asked to complete a semi-structured questionnaire regarding
their ability to perform self directed learning in the confines of a class
project module. The module was a four-week-long project that required
students to research and examine factors that influenced their clients' health
care needs18.
The only statistical analyses provided by the authors were simple descriptive
statistics and content analysis. The authors stated they searched for broad
themes in the open-ended questionnaires for results and no data was reported
regarding the age of the subjects (Pedley & Arber, 1997)15.
The results of the Pedley & Arber (1997) study indicate an overwhelming
majority (97%) of the subjects found the SDL module to be a positive
learning experience. Twenty percent of the students responded that they
found the autonomy and freedom of choice, for both content and format, a
positive learning experience. Overall, comments indicated students
identified choice and autonomy as important but the authors failed to

13
provide statistical measures. Nineteen percent of the students considered the
opportunity to manage their time, and their motivation and assessment skills
as essential to the SDL process. Ten percent of the subjects indicated they
learned significant information acquisition, summarizing and evaluating
skills as a result of the SDL module.
The authors conclude that the Jarvis framework is instrumental in allowing
subjects to plan, implement and evaluate their SDL performance. They
further conclude that there is a great need to continue development of
student-centered educational methodology in higher education (Pedley &
Arber, 1997).
Jacobus, Grol, Crebolder, Rethans and Vleuten (1998) also conducted a
study in the Netherlands regarding self-assessment of self directed learning.
They noted that little empirical data supported the validity of previous self-
assessment ratings and thus was the impetus for the study. Sixty physicians
were asked to complete a 60-item multiple choice test to ascertain baseline
content knowledge after completing a continuing education course for
medical skills. The subjects were randomly divided into control and
treatment groups. The treatment group received additional skills training and
consistent feedback over the course of three and six months. A 22-item, self
assessment questionnaire was given at three and six month intervals to both
groups. All participants received a detailed written account of their scores,
including comparison to the other participants and corrective actions for
items missed.
The results of the study indicate that there are no significant differences in
the personal characteristics of groups, knowledge or self-assessment skills.
Correlations between the two groups for self assessment and knowledge
were low initially (0.24) and later increased to moderate levels (0.20) toward

14
the six month mark. The data suggests that over time there are moderate
improvements for self assessment skills and knowledge for the treatment
group (Jacobus, et al., 1998).
The study limitations include the small sample size of volunteer physicians
and the significant missing scores from several questionnaires. The authors
report that pre- and post-intervention self assessments were subject to bias
due to the internal motivation of the subjects. No data were reported
regarding the age of the subject, however, it was noted that they were all
experienced physicians (Jacobus et al, 1998)14 .
The study concludes that self-assessment scores may be useful in obtaining
measures of perceived competence. The authors also conclude that providing
regular feedback did not significantly improve any level of skill, knowledge
acquisition, or self assessment for the subjects (Jacobus et al., 1998).

15
 CHAPTER # 3
Methodology

3.1 Research Design (Study design):

This is the comparative study that is applied in this study to achieve
the study objectives. The research design is suitable because it
compares between two different teaching methods most commonly
used as lecture method and self directed learning method. In this study
the researcher wants to see the results between two different teaching
methods.

3.2 Instrument:
In this study researcher conducted the class test for obtaining the
results.

3.3 Population:
Total students of general Nursing diploma Programme at different
schools of Nursing of Sindh, Than School of Nursing sir C J institute
of psychiatry Hyderabad was selected for conducting the research.

3.4 Sample:
The researcher selected 40 participants from 2nd year general nursing
diploma Students School of Nursing sir C J institute of psychiatry
Hyderabad. Their consent was taken before conducting the class test.

16
3.5 Sampling Technique:
In this research study simple stratified randomized probability
sampling was applied. In this connection the class was split in to two
parts, 20 members were selected for lecture method and 20 members
were selected for self directed methodology.

3.6 Procedure:
Initially researcher went to the School of Nursing sir C J institute of
psychiatry Hyderabad. Researcher visited different disciplines and
finally selected 2nd year general nursing diploma Programme students
for conducting the research.
Their consent was taken before implementation of the procedure.
After that 40 participants were selected out of whom 20 participants
were provided with lecture and Other 20 participants were directed for
self directed learning .self directed students were Assigned specific
topics for study and same specific topics were delivered to lecture
method students’ .Than class test was conducted from both groups to
analyze the results.

17
 CHAPTER # 4
Result and analysis

Figure: 1
Comparison

88%
90%
80%
68%
70%
60%
50%
40%
30%
20%
10%
0%
Lecture Method Self directed method

Figure 1 Describe the result, those students studied through self directed
method (88%) and of lecture method (68%). The results concluded that the
self directed method is effective than lecture method.

18
 CHAPTER # 5
Discussion

5.1 Discussion
According to data it fully supports self directed learning as an
effective strategy from learning point of view, because it provides an
individual to use own point of view learning and brain storming
activities.
In figure 1 total number of participants of self directed learning was
20, total marks were 400, and the percentage of total performance was
88% when the Figure shows the performance of participants in lecture
method of learning, total numbers of participants were 20 and total
marks were 400, the percentage of total marks obtained was 68%.

19
 CHAPTER # 6
Conclusion

6.1 Summary:
There has been the series of changes in education, particularly in
regard to its perceived role in society and its aims and objectives.
These changes include changes in aims and more emphasis on inquiry
and problem solving, a trend towards integration of subject matter, a
growth of non formal education ,a trend towards particularly learning
and a growth of information technology all have demanded the need
of adopting different teaching strategies to understand and face the
new situation. Amongst all teaching strategies self directed learning
method has got more importance compared to other teaching
LEARNING Strategies.
Lecture method is also another teaching learning strategy which is
also widely used .In this researcher observed the effectiveness of self
directed learning method with comparison to lecture method by
conducting the class test. It was seen that results of self directed
learning students were better than the lecture method students.
Our first hypothesis is proved that is self directed learning method is
effective than lecture method of learning by observing the percentage
of the results of self-directed learning with lecture method. Our second
hypothesis is that self directed learning method is less expensive and
time consuming than lecture method is not proved because SDL.
1. Consumes time.

2. Consumes money.

20
6.2 Limitation:
This study is conducted in school of nursing sir C J institute of
psychiatry Hyderabad. This research is limited in only school of
nursing sir C J institute of psychiatry Hyderabad.

6.3 Suggestions:
It is suggested that self directed learning teaching method is more
effective than lecture method of learning. So it must be introduced in
the field of higher education. Opportunities should be provided to the
students. Student should be encouraged in this direction.

21
 REFERENCES:

1. http://ikastenikasten.blogspot.com/2008/05/difference-between-

learning-and-memory.html
2. http://academic.udayton.edu/health/syllabi/health/unit01/lesson01b.ht

m
3. http://pjms.com.pk/issues/aprjun109/article/SC1.html

4. http://www.pmrc.org.pk/survey.htm

5. Alabi, G. A., Gerritsma, J., Maude, G., and Parry, E. (1996). Problem-

based learning for tuberculosis and lepros y supervisors. World Health

Forum 17: 411-414.
6. Albanese, M. A. and Mitchell, S. (1993). Problem-based learning: a

review of literature on its outcomes and implementation issues.

Academic Medicine. 68: 52-81.
7. Albano, M. G., Cavallo, F., Hoogenboom, R., Magni, F., Majoor, G.,

Manenti, F., Schuwirth, L., Stiegler, I., and van, d., V (1996). An
international comparison of knowledge levels of medical students: the
Maastricht Progress Test. Medical Education 30: 239-245.
8. Bell, F. A. and Hendricson, W. D. (1993). A problem-based course in

dental implantology. Journal of Dentistry Education. 57: 687-695.

9. Bernstein, P., Tipping, J., Bercovitz, K., and Skinner, H. A. (1995).

Shifting students and faculty to a PBL curriculum: attitudes changed

and lessons learned. Academic Medicine. 70: 245-247.
10. Blake, R. L., Hosokawa, M. C., and Riley, S. L. (2000). Student

performances on Step 1 and Step 2 of the United States Medical

Licensing Examination following implementation of a problem-based
learning curriculum. Academic Medicine. 75: 66-70.

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11. Bligh, J., Lloyd-Jones, G., and Smith, G. (2000). Early effects of a

new problem-based clinically oriented curriculum on students'

perceptions of teaching. Medical Education 34: 487-489.
12. Cariaga-Lo, L. D., Richards, B. F., Hollingsworth, M. A., and Camp,

D. L. (1996). Noncognitive characteristics of medical students: entry

to problem-based and lecture-based curricula. Medical Education 30:
179-186.
13. Barrows, H. S., “Problem based learning, self-directed learning,”

JAMA, 250, 3077-3080(1983).

14. Lake DA. Problem-based learning: student perceptions of lecture and

problem-based learning format .Phys Ther. 1996; 76:S62.

15. Frederick P. Active learning in history classes. Teaching
History.1991; 162:6783.
16. Heravi M, Milani M, Rogeh N. The effects of educations through

lecture and group investigation on level of learning nursing students.

Iranian Magazine Edu in Med Sci 2004; 11:55-60.
17. Salsali M. The development of nursing education in Iran. Inter History

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18.Marsick, V. J. (1990). Case Study. In M. W. Galbraith (Ed.) Adult
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Malabar, FL: Krieger Publishing Company.

23
 APPENDIX- I
School of Nursing Sir C J Institute of Psychiatry Hyderabad
Consent Form
Name: _______________________________ Age: __________________

1. The procedure includes responding to do questionnaire.

2. The participants in this study take approximately 40 minutes.
3. Your participation in this project is entirely voluntary and there will
be no negative consequences if you refuse to participate in it,
withdraw from it, or refuse to answer certain questions.
4. The study data will be coded so it will not be linked to your name.
5. Your identification will not be revealed while the study is being
conducted or when the study is reported to publish.
6. The study data will be placed in secure place and not shared without
your permission.
Having understood the above information and after being given an
opportunity to have my questions answered, I agree to participate in this
study.

Signature of Participant______________________
Date______________

I have explained this study to above subject and have sought its
understanding for informed consent.

Investigators Signature__________________
Date_______________

24
 APPENDIX – 1
SCHOOL OF NURSING
SIR C J INSTITUTE OF PSYCHIATRY HYDERABAD
Medical Surgical Nursing I
SECOND YEAR
CLASS TEST
Student Name: ________________ Roll No: ________
Maximum Marks: 20 Passing Marks: 10
Time: 40 Minutes Date:

MCQS
Note: Circle the Correct Answer.

1. Acute gastritis is often caused by…

a. Indigestion of strong acids
b. Overuse of aspirin
c. Irritating foods
d. All of the above.

2. The most common site for peptic ulcer formation is…

a. Duodenum
b. Esophagus
c. Pylorus
d. Stomach

25
3. To promote daily fluid balance when treating gastritis, up to...
a. 1.0 lit
b. 1.5 lit
c. 2.0 lit
d. 2.5 lit

4. The blood group that seems most susceptible to peptic ulcer

disease is group…
a. A
b. B
c. AB
d. O

5. A Helicobacter pylori bacterium is present in ____________ of

those with duodenal ulcers.

a. 25%
b. 50%
c. 75%
d. 95%

6. Peptic ulcer occurs with the most frequency in those between the
ages of.
a. 15-25 years
b. 20-30 years
c. 40-60 years
d. 60-80 years

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7. A characteristic associated with peptic ulcer pain is a...

a. Burning sensation localized in back or epigastrium

b. Sever growing pain that increases in severity
c. Feeling of emptiness that precedes meals from 1 to 3 hours
d. Combination of all of the above.

8. The best time to administer an antacid is...

a. With the meal
b. 30 minutes before meal
c. 1 to 3 hours after meal
d. Immediately after meal

9. The most common complication of peptic ulcer disease...

a. Hemorrhage
b. Perforation
c. Intractable ulcer
d. Pyloric obstruction

10.If peptic ulcer hemorrhage were suspected, an immediate nursing

action would be to...
a. Place the patient supine with his/her legs elevated
b. Prepare a peripheral and central line for intravenous infusion
c. Assess vital signs
d. Accomplish all of the above

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 TRUE FALSE

Tick the correct answer.

1. Emotional factors can also cause peptic ulcer. ______ T- F
2. Maxolon is not anti-emetic drug. _________ T- F
3. Haematemisis occurs in duodenal ulcer. _____ T- F
4. Anticholingeric inhabit the secretion of gastric acid. _____

T- F
5. Smoking and alcohol can not cause any ulcer. ______ T- F

SHORT ANSWERS

1. Name the two conditions specifying related to peptic ulcer

development.
a. ____________________________________________
b. ____________________________________________
2. Name three major complications of peptic ulcer.
a. ____________________________________________
b. ____________________________________________
c. ____________________________________________
3. Describes clinical manifestations associate with peptic ulcer
perforation.
a. ____________________________________________
b. ____________________________________________
c. ____________________________________________

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4. List the bacillus that is commonly associated with gastric and possibly
duodenal ulcer.
a. ____________________________________________
b. ____________________________________________
c. ____________________________________________
5. Define the term ulcer.
_________________________________________________________
_________________________________________________________
_________________________________________________________
______________________________

Good Luck

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