Students’ cognitive engagement in "Care of Elderly Course" using Blended Learning Methodologies

Document Type



School of Nursing and Midwifery, Pakistan; Centre for Innovation in Medical Education


AKUSONAM has been a trendsetter for nursing education in Pakistan; including the offering of "Care of Elderly" course to 37 undergraduate nursing students in 2013. It was offered in blended learning format, along with hands on exposure in a variety of geriatric care settings. This study was conducted for course enrollees.


Through the retrospective descriptive study design, student's Cognitive Engagement (CE) in Online Discussion Forums (ODF) was assessed. Researcher designed demographic tool was used to collect demographic data; while Zhu (2006) framework was used to assess CE. Discourse analysis of three ODFs was done for participants who consented to participate. Each group was assigned letter A, B or C for anonymity purpose.


The data revealed wide-ranging CE using the Zhu framework. Majority of the participants in all three groups have used statement type I and II, whereas the higher level of CE was least observed amongst the participants. In group (A) statements type I and II were used by 49.99% of participants; only 20.83% participants demonstrated the use of scaffolding. In group (C) 59.25% of participants used statements type I II, and scaffolding. Group (B) used statement type I significantly (25%).


The discourse analysis revealed that CE varied among the three groups. Moreover, higher level of CE such as questioning, mentoring and reflections were the least used in ODFs. This determines the future need to focus on ensuring higher levels of CE amongst course participants.

Publication (Name of Journal)

International Journal of Nursing Education