Effectiveness Of procedural video versus skill demonstration regarding antenatal

examination on knowledge, perception and skills among final year nursing students at
MTPG & RIHS, Puducherry
It's not just the making of babies, but the making of mothers that
midwives see as the miracle of birth.
Barbara Katz Rothman
.

CHAPTER I

INTRODUCTION:

Teaching learning process in totality has an impact of the situation in which the complete
process takes place . Teaching learning is said to bear fruits and is thought to be long lasting if it
is related to the real life situations in totality, teacher always plays a crucial role in imparting the
knowledge to the learners and this is possible only when they are able to take into consideration
the demand of the learner. An effective teaching can take place only when the teacher
understands the need of the learner.

Aparna Pandey, Vijaya Kumar(2018), effectiveness of lecture cum demonstration on

knowledge and skill regarding cranial nerve assessment among B. Sc nursing students.

Teaching learning process has an impact of the situation in which the complete process takes
place . Teaching learning is thought to be long lasting if it is related to the real life situations in
totality. Teacher plays a vital role in imparting the knowledge to the learners and this is possible
only when the teachers considers the demand and understands the need of the learner.

Effective teaching method will influence the students learning process . demonstration can be
defined as visualized explanation of facts , concepts and procedures. A demonstration is useful
either by itself or to accompany a formal lecture or informal talk in the classroom , laboratory or
clinical area. For teaching and training nowadays videos are being used extensively specially in
the field of open education.
Geeta Parwanda et al, effectiveness of video assisted teaching vs demonstration method on
female urinary catheterization in terms of knowledge and practice

Students learning process is influenced by effective teaching method .one of the method of
effective teaching includes demonstration , it can be defined as visualized explanation of facts ,
concepts and procedures. It is also accompanied by a formal lecture or informal talk in the
classroom , laboratory or clinical area. Nowadays increasingly , videos are being used
extensively for teaching and training ,specially in the field of open education.

In the last few decades, nursing education in India has undergone tremendous change, from
informal bedside hospital-based training to university-based graduate, postgraduate, and doctoral
nursing education. Furthermore, the rapid growth and development in science and technology
have largely influenced the need for improved methods of teaching–learning process to nurses in
India. Nurses are actively involved in teaching patients, families, and communities as well as
educating and training the new nurses. India has observed rapid growth and development in
nursing education, resulting in an increased sense of responsibility among Indian nursing faculty
to educate future nurses using educational technology so that they efficiently handle patient
teaching, nursing education, and training. Therefore, the researcher felt a gap in the literature on
pedagogy tailored to the peculiar needs of the teaching–learning process for nurses and nursing
students among developing countries, in particular, India.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

Nursing education in India has undergone tremendous change in the last few decades, from
informal bedside hospital-based training to university-based graduate, postgraduate, and doctoral
nursing education. The rapid growth and development in science and technology have largely
influenced the need for improved methods of teaching–learning process to nurses in India.
Nurses are actively involved in teaching patients, families, and communities as well as educating
and training the new nurses. India has observed rapid growth and development in nursing
education, resulting in an increased sense of responsibility among Indian nursing faculty to
educate future nurses using educational technology so that they efficiently handle patient
teaching, nursing education, and training. Therefore, the researcher felt a gap in the literature on
pedagogy tailored to the peculiar needs of the teaching–learning process for nurses and nursing
students among developing countries, in particular, India.

Learning is the acquisition of habits, knowledge and attitudes. It involves new ways of doing
things and it operates on an individual’s attempt to overcome obstacles or to adjust to new
situations. It represents progressive changes in behavior. An individual starts learning
immediately after the birth or even earlier in the womb of the mother. Experience , direct or
indirect is found to play a dominant role in moulding and shaping the behavior of the individual.

Chandan Pradhan, Rajesh Kumar Sharma, Muthuvenkatchalam Srinivasan(2018),

effectiveness of lecture cum demonstration and lecture cum video assisted teaching method
on knowledge and skill of undergraduate nursing students of selected nursing educational
institution of dehradun, India

Learning is the procurement of habits, knowledge and attitudes. Learning helps individual’s
attempt to overcome obstacles or to adjust to new situations. It represents progressive changes in
behavior. Learning is a process from birth till death of an individual . Experience is found to
plays a superior role in moulding and shaping the behavior of the individual, directly or
indirectly.

Teaching is distinctively a human activity. Systematic attention to methods and materials of

teaching and learning as well as mastery of the subject matter are essential for the development
of artistic teaching. The nursing curriculum includes various subjects to be taught in each year of
the course.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

Teaching is s characteristic of a human activity. Methodic consideration to methods and

materials of teaching and learning and subject matter are essential for the development of
creative teaching. The nursing curriculum is composed with various subjects that to be handled
in each year of the course.

The nursing curriculum is continuously changing. Teaching methods have failed to keep up with
the changing curriculum. Bandura stated that the style of teaching preferred by a student is a
reflection of his or her learning style. The teaching of different skills requires various techniques
and contemporary methods along with the traditional lecture method. Video-based education can
be a suitable substitution when the demonstration method is unavailable. One of the advantages
of video-based education is that the voice of the broadcaster can be heard. Moreover, the figures,
movements, illustrations used, and demonstrations presented can be seen.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

The nursing curriculum is continuously changing according to the develepments of nursing

education. Teaching methods have failed to adapt or cope up with the changing nursing
curriculum. Bandura stated that the style of teaching a student prefers is a reflection of his or
her learning style. Various skills are taught using various techniques and contemporary methods
along with the traditional lecture method. When the demonstration method is unavailable it is
substituted with Video-based education which has the advantages of video-based education is
that the voice of the broadcaster can be heard. Moreover, the figures, movements, illustrations
used, and demonstrations presented can be seen.

One of the most important principles in education is adopting a teaching method in concordance
with objectives, contents, and learners. The individual can learn more and quicker than once was
previously thought by means of improved teaching strategies aimed specifically at boosting
memory storage and cognition, retrieval and learning.

Sushma Prabhu(2013), comparison traditional versus video based teaching on

neurological assessment among undergraduate nursing students
The important principles in education is adopting a teaching method in concordance with
objectives, contents, and learners. The individual can learn more faster and quicker through
improved teaching strategies which is aimed specifically at improving memory storage and
cognition, retrieval and learning.

Multimedia is a mix of numerous digital media type such as pictures, content, sound and video
into a coordinated multi sensory interactive application or demonstration to convey information
to an audience. The students are able to learn better by incorporating digital media into the
system of education since they utilize numerous sensory modalities , which would make them
more roused to give careful consideration to the data offered and hold the data better.

Hanam El- Sayed Mohamed El- Sayed et al (2017), effectiveness of utilizing video- assisted
and lecture cum demonstration method on the nursing students knowledge and skills in
using partograph.

Multimedia is a combination of numerous digital media such as pictures, content, sound and
video into a coordinated multi sensory interactive application or demonstration to convey
information to an audience. As the students are more attracted to technology they are able to
learn better by incorporating digital media into the system of education since they utilize
numerous sensory modalities , which would make them more stimulated to give careful
consideration to the data offered and hold the data better for longer period of time.

Teaching and learning clinical skills are challenging aspects of education in the field of medicine
and the allied health professions. Some of the new researchers have shown that video-based
instruction has many advantages in comparison with other methods. But in the domain of the
psychomotor learning, there is not enough evidence to show that video-based instruction is an
effective teaching method.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.
Teaching and learning clinical skills are challenging aspects of education in the field of medicine
and the allied health professions. Some of the new researchers have shown that video-based
instruction has many advantages in comparison with other methods. The domain of the
psychomotor learning, there is not enough evidence to show that video-based instruction is an
effective teaching method.

Obstetrical and midwifery nursing is one of the final-year subjects. The effective management of
the antepartum and intrapartum periods is completely dependent on the accuracy of obstetrical
assessment, including assessment of women's abdomen for fetal presentation, position, and
wellbeing, which in turn helps in making early decisions regarding the place and mode of
delivery.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

As per the nursing educagtion curriculum , Obstetrical and midwifery nursing is one of the final-
year subjects. Obstetrical assessment, includs the assessment of women's abdomen for fetal lie,
presentation, position, and wellbeing. The antepartum and intrapartum periods can be
effectively managed with the help of accurate obstetrical assessment which in turn helps in
making early decisions regarding the place and mode of delivery.

Several methods can be used to identify fetal position, presentation, attitude, engagement, and
wellbeing. Methods such as ultrasonography, vaginal examination, and abdominal palpation can
be used to identify position, presentation, attitude engagement, and wellbeing of fetus inside the
mother's uterus. However, ultrasonography is not cost-effective as the equipment is costly and
its use requires expertise. Vaginal examination, on the contrary, is only reliable when women are
in established labor because its accuracy depends on dilatation and effacement of the cervix
along with descent of the fetus presenting part. This emphasizes the need for accurate obstetrical
palpation that can be performed by the student nurses or registered nurses. It is noninvasive and
does not require any equipment and can be performed by a trained nurse at any time of the day,
establishing its popularity as the most feasible test of fetal wellbeing.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

The methods used to identify fetal position, presentation, attitude, engagement, and wellbeing
includes ultrasonography, vaginal examination, and abdominal palpation. Ultrasonography is not
cost-effective as the equipment is costly and its use requires expertise. Vaginal examination, on
the contrary, is only reliable when women are in established labor because its accuracy depends
on dilatation and effacement of the cervix along with descent of the fetus presenting part. This
accentuate the need for accurate obstetrical palpation which is performed by the student nurses
or registered nurses. It is noninvasive procedure and it does not require any equipment and it
can be performed by a trained nurse at any time of the day, establishing its popularity as the
most feasible test of fetal wellbeing.

The importance of obstetrical palpation in antenatal assessment is a globally acclaimed fact. As

stated by Crede and Leopald in 1982, the four maneuver techniques in obstetrical palpation
ensure identification of the fetal presentation, lie, attitude, position of different parts of the body,
and wellbeing. Mak and Wong conducted a study and found that midwives had a favorable
attitude toward obstetrical palpation but their confidence to practice was inadequate.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

The importance of obstetrical palpation in antenatal assessment is a globally renowned fact. As

stated by Crede and Leopald in 1982, the four maneuver techniques in obstetrical palpation
ensure the fetal presentation, lie, attitude, position of different parts of the body, and wellbeing.
In the pressured environment of a classroom, if tools are not intuitive and simplified for the
educator and student, they won't be used. However, the right technology will be quickly adopted
by all. Every educator knows that delivery in a stimulating fashion, including visual input, can
be key to learning in terms of understanding, application, and retention.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.

In the closed environment of a classroom, if tools are not intuitive and simplified for the
educator and student, that cannot be used. Every educator knows that delivery in a stimulating
fashion, including visual input, can be key to learning in terms of understanding, application,
and retention by adapting new technology.

The use of video in nursing education classes provides an easy, innovative, and user-friendly
way to engage today's nursing students. Video presentations can be easily adapted into nursing
courses at any level, whether a fundamental course for undergraduate students or a theoretical
foundations course for graduate students. Increasingly, nursing students enter nursing programs
experienced in the latest communication technologies and knowledgeable about various media
offerings. Today, it is expected that nurse educators should use creative communication
technologies to enrich the learning environment. Clinical practice is an essential part of nursing
education which links theory with practice. Obstetrical palpation is one of the areas of clinical
practice which demands accuracy and expertise that improve with the length of experience. As
today's student nurses are tomorrow's professional nurses who can contribute more in the field of
treatment, educating these students and creating awareness, helping them to learn more about
obstetrical examination, will bring about positive outcomes in the future health indicators and
quality of care. According to the famous saying, right practice is the safest investment toward
hazard-free care, and right practice comes from right education.

Barkha Devi, Bidita khandelwal, Mridula Das(2019), comparison of the effectiveness of

video assisted teaching program and traditional demonstration on nursing students
learning skills of performing obstetrical palpation.
Video assisted teaching in nursing education classes provides an easy, innovative, and user-
friendly way to engage today's nursing students. Video presentations can be easily utilised in all
level of nursing education , like fundamental course for undergraduate students or a theoretical
foundations course for graduate students. Now a days , Nursing students enter nursing programs
experienced in the latest communication technologies and knowledgeable about various media
offerings so it is expected that nurse educators should use creative communication technologies
to enrich the learning environment. Essential part of nursing education is Clinical practice as it
links theory with practice. Obstetrical palpation is one of the areas of clinical practice which
demands accuracy and expertise that improve with the length of experience. Today's student
nurses are tomorrow's professional nurses, they contribute more in the field of treatment,
educating these students and creating awareness, helping them to learn more about obstetrical
examination, will bring about positive outcomes in the future health indicators and quality of
care.
NEED FOR THE STUDY:

Lecture can be the effective method of instruction due to its versatility. At the same time it
can be one of the least effective methods if improperly used. A video- assisted curriculum
has three distinct parts.

There is a facilitator who guides the discussion, the video cassette that contains
consistent current information and handouts for the participants so they can be actively
involved in the process. The advantages of video-assisted teaching are, one-time
investment will allow the agency to train as many people as they want over a long time,
flexibility because you can present the curriculum at one time or divide it and the video
cassettes contain the correct information, and you will not have people getting different
messages from different people.

A report by the Association of American Medical Colleges points out that 37 percent of
North American medical schools scheduled over 1,000 hours of lecturers for the first
two-year preclinical medicine curriculum, and another 42 percent scheduled between
800 and 1,000 hours. With abundant evidence that the educational yield from lectures is
generally low, the report recommends reducing scheduled lectures by one-third to one-
half, and allowing students unscheduled time for more productive learning activities.
Video may offer several training benefits. First, video models can present various
behaviours in realistic contexts. Second, video can efficiently display numerous examples of
stimulus and response variations

Third, video may be a useful medium for learners who cannot take advantage of print
materials. Fourth, with video recordings, the learner can repeatedly review a model's
behaviour, if necessary. Finally, video standardizes the presentation of stimuli in training,
which strengthens internal consistency and allows more confident comparison of data
across learners and sessions.

After the introduction of the Internet, many researchers report its successful use in
nursing education. Cunningham and Plot kin reported Internet use in nursing clinical
practice use and Todd noted very positive experiences with the use of E-mail in
undergraduate teaching.
Educators have added computer-assisted instruction to compete for student attention
and to accommodate and to recognize the difference in students learning styles. This
accommodation has caused a paradigm shift in higher education from traditional
classroom instruction to computer-assisted instruction. Results from technology use,
brevity, movement and colour have been added to education. This shift is requiring
changes in both the way educators teach and students learn. Communication and
interaction skills have been affected and reshaped by technology.

Computer assisted instruction allows the students to be active participants in their

learning and therefore students can progress at their own pace. Computer assisted
instruction may help students develop creative abilities and include changes in the
cognitive and affective outcomes. Computer assisted instruction provides flexibility in
developing new knowledge and supporting competence in the use of information
technology. Information technology is part of the health care professionals’ daily life.
Computers enable practitioners to process information that is accurate, unduplicated, error
free and accessible by multiple persons at the same time. Interactive media offers learning
that appeals to every learner with the sounds images and words available at the same time

STATEMENT :

A study to evaluate Effectiveness Of procedural video versus skill demonstration regarding

antenatal examination on knowledge, perception and skills among final year nursing students at
MTPG & RIHS, Puducherry
OBJECTIVES:
 To assess the pre existing level of knowledge on antenatal examination among final year
nursing students at MTPG & RIHS, Puducherry
 To compare the effectiveness of procedural video and skill demonstration regarding
antenatal examination on knowledge and skills among final year nursing students at
MTPG & RIHS, Puducherry.
 To associate the post test level of knowledge and skill of final year nursing students with
their selected demographic variables.
OPERATIONAL DEFINITION:

• Effectiveness: - In this study effectiveness refers to the extent which the students
understands the antenatal examination from the video assisted teaching method and
traditional teaching method.

• Procedural Video : It refers to teaching antenatal examination with the help of video

• Skill demonstration : It refers to teaching antenatal examination by using lecture cum

demonstration method

• Antenatal examination: examining a pregnant women to determine the well being of

mother and fetus.

• Knowledge: It refers to the students ability to recall the facts and information regarding
antenatal examination

• Skill: It refers to the ability and capacity of the students to implement the knowledge
practically.

HYPOTHESIS:

• H0:There will be no significant association between procedural video and skill

demonstration on knowledge and skill among final year nursing students, MTPG &
RIHS.

DELIMITATIONS:

This study is delimited to

• Sample size of 80

• Final year B Sc nursing students

• Data collection period of 1 month

CHAPTER II

REVIEW OF LITERATURE:
Section A: Literature related to traditional method of teaching

S.KARWASRA(2005) conducted a descriptive study on Popularization of Water

purifying Technology at Household Level in Slum Areas of Delhi after selecting 200
women respondents randomly. Mass media (Lecture cum Demonstration) related to water
purifying technology was prepared by analyzing the target audience. The pre test was
administered to assess the existing level of knowledge of the respondents regarding Janta
Water Filter. A week after pre test, the respondents were initially exposed to the media
package (Lecture cum demonstration). Then, immediately after the exposure, the post test
was administered to find out the gain in knowledge regarding Janta water filter. Frequency,
percentage, mean scores and‘t’ test were used to draw meaningful inferences. Results
regarding water facility showed that most of the respondents 56.50 percent used hand
pump water for drinking, stored drinking water in pitchers 83 percent, washed water storage
containers frequently 62 percent, had not adopted measure for safe storage of drinking
water 89 percent, took water with glass holding in the hand 91.50 percent and stored
drinking water in covered storage container 73.50 percent.
HARMESH SINGH et al (2004) conducted a cross sectional study in UK to assess the immediate
cognitive impact of kangaroo mother care workshop on medical students. A cross sectional,
intervention carried out in Neonatal unit of a teaching hospital on 63 Final professional medical
students. Knowledge about kangaroo mother care assessed by a pre-test Questionnaire. A one hour
lecture cum demonstration was carried out following which the same questionnaire was given as a
post test assessment. In results, the maximum possible score was 25. The pre test score was zero in
54 % of students, one in 39.7% and 2 in 6.3 % of them respectively. The post test percent score was
100 in 46 % of students. It was 96,92,88,84 and 76 in 19%, 11.1%, 6.4% of student’s respectively.
Conclusion was the immediate cognitive impact of kangaroo mother care workshop on medical
students was excellent.

FJ SHIH et al (1999) conducted a qualitative study in Taiwan on the development of lecture on

spiritual care for adult critical care trainees, and to evaluate the trainees’ appraisal of the
effectiveness of this lecture in preparing them to provide spiritual care for their clients in a critical
care setting. A questionnaire and descriptive qualitative content analysis was used. A convenience
sampling consisting of 64 registered nurses. A total 64 female participants completed the
questionnaire. Ninety two percent of the subjects considered the lecture on spiritual care to be
helpful in assisting them to provide holistic care to critical ill patients in the intensive care unit.
Three types of helps were identified by the subjects

Help in clarifying the abstract concept related to spiritual care 86%, Help in self- disclosing the
nurse’s personal beliefs and values regarding life goals, nurse and spiritual needs 67 %t, Help in
learning how to provide spiritual care patients in a critical care setting 34 %t. The study concluded
that the lecture method of teaching on spiritual care for adult critical care trainees, was effective.
Yoo et al. (2010) conducted an experimental study on the effect of the video recording of Foley's
catheterization to evaluate its effect on three outcomes: measures of the competency of
procedure, communication skills, and learning motivation. The study was conducted through
self-evaluation using a video recording of the Foley's catheterization of the students. The
students in the experimental group (n = 20) evaluated their Foley's catheterization performance
by reviewing video recordings, whereas students in the control group (n = 20) received written
evaluation guidelines only. The results showed that the students in the experimental group had
better scores on competency (p < 0.001), communication skills (p < 0.001), and learning
motivation (p = 0.018) than the control group at the posttest, which was conducted 8 weeks after
the pretest. The inference of the study indicates that self-awareness of one's performance
developed by reviewing a videotape appears to increase the competency of clinical skills among
nursing students.

Section B: Literature related to video assisted method of teaching

Barka devi et al(2019), conducted a study on Effectiveness of Video-assisted Teaching Program

and Traditional Demonstration on Nursing Students Learning Skills of Performing Obstetrical
Palpation on 60 Bsc nursing students, quasi-experimental pretest, posttest, control group
design were used and the results showed significant difference between the pretest and posttest
skill scores of students who were exposed to video-assisted teaching program and traditional
demonstration.

CHAPTER III

METHODOLOGY:

Research approach : Quantitative research approach

Research design: Pre experimental research design

Setting: MTPG & RIHS

Population: All Final year nursing students

Sample: Final year nursing students of MTPG&RIHS

Sample size: 80

Sampling technique : Purposive sampling technique

Inclusion criteria:

• Students willing to participate

• Final year nursing students

• Students who are present in the class during data collection

Variable:

Independent variable: traditional method of teaching and Video Assisted method of teaching
on antenatal assessment

Dependent variable: knowledge and skill of students after attending Video-assisted and
method of teaching and traditional method of teaching.

DATA COLLECTION PROCEDURE:

Data collection tool consists of three sections

• Section A: Demographic Variables

• Section B : semi Structured questionnaire on Knowledge and skills on antenatal

examination.

• Section C: Video assisted teaching method and traditional teaching method on antenatal
examination

• Antenatal examination: def, objectives, scientific principles, article needed , procedure

and inference.
PLAN FOR DATA ANALYSIS:

• The data obtained was planned to be analyzed based on the objectives of the study using
descriptive and inferential statistics

• Organize data in master sheet

• Demographic variables are to be analyzed in terms of frequencies and percentage.