A Study of the Effects of Teacher Gender on Learning

Learning the Nursing Process Principles from learning theories,

nursing, audiovisual and instructional research suggest important consider- ations for designing strategies to facili- tate learning the nursing process. The decisions made in developing five in- structional videotapes and five evalu- ation or test videotapes of the nursing process stemmed from such a frame- work.* The specific aspects of some of these decisions, nonetheless, remained undetermined. As a result a research project was designed to answer the following question: Is the sex of the off-screen teacher associated with a sig- nificant difference in learning by bac- calaureate students in nursing?

Review of the Literature The literature concerning sex role

identity, learning theories, audiovisual instruction and the nursing process was reviewed. The following synopsis will serve to indicate the direction and support found concerning decisions made during the creation of the in- structional and test videotapes.

Sex role identity. Cleland (1971) re- ported females in nursing retain a more basic female identification than that inherent in the occupational role. Stromberg (1976) found that graduates of collegiate degree programs in nurs- ing had a more professional image of nursing than students graduated from diploma programs. Plost and Rosen’s (1974) research led to the assertion that female vocational goals appear to be directly affected by the female models available in the educational program. These and similar reports supported the use of a female teacher as narrator for five instructional and five test video- tapes of the nursing process. Others have reported that an unseen narrator is visually inferred, or a mental image is generated (Clark, 1978; Geiselman and Gellezza, 1977; Levie, 1978). That is, a male voice creates the image of a male teacher or authority figure and a female voice creates the counterpart female image.

Learning Theories. Hilgard (1975) summarized thirteen principles from cognitive (Gestalt design) and neobe- haviorist (stimulus-response origin) learning theories useful for designing learning experiences. His cognitive per- ceptual feature principle (p. 563) SUP- ported the decision to use a visual display of the patient, whereas, the visual experience of viewing the nurse in action was supported by the neobe- haviorist principle of novelty (p. 563) by which behavior can be enhanced through imitation of models. Bandura (1977) also reported complex behavior is best learned by observing models. This teacher’s earlier research utilizing these thirteen principles also facilitated and shaped the application (Pearson, 1972).

Audiovisual instruction. Principles from learning theories as reported in the literature were equivocal, and in- sufficient to serve as guides for use of the camera and the microphone. Re- search on instructional films had been summarized into specific guides by Twyford in 1953. These and similar findings served as specific guides for camera angles, the cut and other sub- tleties (Pearson, 1978). For example the commentary, that is the number of words per minute in the film, has a definite effect on learning, so care should be taken not to “pack” the sound track. Twyford’s (1953) generali- zation of the picture - commentary re- lationship coupled with the learning principles which directed the visual emphasis toward the patient and nurse were the basis for the decision to use a voice-over, or unseen, narrator for the instruction. Research on simula- tions was reviewed in order to develop the requisite visual emphasis. Cohen and Bradley (1977) concluded that learning may be most effective from simulations which incorporate both the symbols helpful for generalizations and the actions useful for application to particulars. Simulation thus depicted promotes understanding, reality, in- terest and skill. Clark (1976) defined a

Betty D. Pearson, R.N., Ph.D.

simulation as the creation of an experi- ential situation which mimics processes or conditions that occur in the real world.

Teaching the Nursing Process. Simu- lation techniques have been developed by McGuire (1967) to present problems in patient care which require the se- quential analysis and decision phases of the professional process. To para- phrase from McGuire’s experiences (1967, p. 1) a clinical problem which is to simulate the nurse-patient encounter must have the following characteristics. First, it must be initiated by information of the type a patient gives a nurse, not be a predigested summary of the patient. Second, the exercise must re- quire a series of sequential, interde- pendent decisions representing the various stages of assessment of the patient. Third, as examiner, the nurse must be able to obtain, in realistic form, information about the results of each decision as a basis for subsequent action. Fourth, the task must be ana- lyzed for both complexity and integra- tion of knowledge, and then reduced it to critical components. (Pearson, 1975b). An earlier task analysis of observing (data collection), inferring, and acting (Pearson, 1975a). Further analysis and research indicated the im- portance of distinguishing observation or data collection from the operation of inferring or, the acts of explaining, and reaching conclusions, judgments or diagnosis. Thus, there were six phases in the process.

As early as 1965, McLuhan noted that print media“made” a linear thinker. Such an effect presumably might emerge from the many excellent writ- ings on the nursing process, e.g., Berg- gren and Zogornik, (1968) and Yura and Walsh (1978). However, the proc-

Betty D. Pearson, R.N., Ph.D. Associute Dean, Graduate Programs University of Wisconsin-Milwaukee

February, 1981, Volume XI11 /Image

~

Page 15

Effects of Teacher Gender

ess is not linear in practice. The nurs- ing process abstracted from the nursing literature and related research and per- ception theory, led to the adaptation of the nursing process proposed by Berg- gren and Zogornik. (See figure 1). This six phase process served to organize the five instructional and five evaluation videotapes.

Design Procedures were employed to inform

and protect the students who volun- teered to be respondents for the study. These procedures were approved by the Institutional Review Board for the Protection of Human Subjects. The videotapes were a course assignment; however, only the 48 students who volunteered to participate in the re- search were included for the data col- lection. The volunteers were represen- tative of the male and female mix of baccalaureate students enrolled in a large urban university baccalaureate nursing program-8 males (17 percent), and 40 females (83 percent). Thus, if content and sex of listener interaction occurred as has been reported (Caffrey, 1955; Goldhaber and Weaver, 1968; Irwin, 1953) the content was relevant for the discipline in which the students were majoring, and the ratio of male- female was that of the program of which they were a sample.

The students were randomly as- signed to one of three experimental groups (16 each). The students were experienced in learning from video- tapes, although most had not experi- enced these as modes of testing. Each group of students was exposed to the same videotape instruction and same test of the nursing process with different narrators. Group one received male narrated instruction and testing, group two received female narrated instruc- tion and testing, and group three re- ceived mixed narration: either female instruction and male testing or male instruction and female testing. It should be noted that this mix did not constitute a neutral gender. The mixed narration instructional materials were used be- cause in at least one prior study sub- jects have been found to increase learning through the change in gender of the narrator (Gardiner and Cameron, 1974). Students recorded their re- sponses to the instruction and testing.

The experimental design of this re- search required adequate control of the variables, namely male and female narrator voice. The sex of the narrator was controlled in the more general sense, i.e., only one male and one female narrator voice were used. This was done to avoid eliciting different reactions to speakers (Wertsch, 1975). Equivalency of quality of the male and female voices was controlled both quantitatively and qualitatively. This has not been done by other researchers. Quantitative analysis of the male and female voices was performed by an audio engineer who measured three aspects of the voices as recorded on the videotapes: 1) frequency response, 2) signal noise level and 3) output level. Qualitative analysis was done by a trained musician who listened to the recorded voices and judged them to be equivalent.

Videotapes One videotape instruction script and

one videotape test script were used. Each tape was duplicated using a male narrator. Except for the voice of the unseen narrator, the two instruction tapes and the two test tapes were iden- tical. The six phases of the nursing process were taught using a simulated pediatric clinic with the vignettes por- trayed by a nurse, a young mother, and her 10 month old daughter. The 20 question test was constructed utilizing vignettes of a community health nurse in the home of a retired couple. The voices of the nurses and patients were their own. The situations simulated for instruction and for testing were deliber- ately different to enable testing for conceptual learning rather than me- morization.

An example from the instruction videotape of the narrator explaining data collection is, “you need informa- tion, facts, data about your patient. Through observation, you will note facts, actual events which occur. Ob- servable information must be free of bias, distortion or interpretation. To obtain facts, use all of your sensory system. Look, listen, smell, touch - on occasion you may even taste! Gather data about Sue and her daughter Sarah. Observe their activities, movements, and sounds to obtain factual informa- tion about Sarah”. The visual materials

presented during this sequence were printed graphics of “OBSERVATION-

RENCE” followed by vignettes of the nurse, mother, and infant which in- cluded activities from the Denver De- velopmental Test.

An example of the graphic visual for the test videotape interpretation ques- tion following a simulation is:

NOTING OF FACT OR OCCUR-

A. Adequate Hygiene B. Emotional Stability C. Accept Care D. Therapeutic Ability

The narrator asks, “How do you inter- pret these data from this interaction of the Martins and the nurse? The Martins are (A) maintaining an adequate level of general hygiene, rest and sleep, (B) the Martins are meeting their stresses with emotional stability, (C) the Martins ac- cept health care to some degree, but feel care is unnecessary for some prob- lems, or (D) the Martins are carrying out prescribed therapeutic measures safely and efficiently. Which of these (A,B,C,D) is the best interpretation of the Martins?’

Findings The research problem was stated as

a question. Is the sex of the off-screen teacher associated with a significant difference in learning by baccalaureate students in nursing? The twenty multi- ple choice questions were scored one point for each correct answer. The mean score for the 48 subjects, 16 per group, were the group female narrator 13.43, male narrator 13.06 and mixed narrator 13.50. Analysis of variance was used to test statistical significant differences between the mean scores of the three groups. The resulting F ratio of .433 is not significantly greater than chance; the corresponding signifi- cance is .651. Therefore, the groups, as tested, did not differ in their learning.

Discussion The following cautious conclusions

seem warranted. First, it appears that sex of the speaker was a negligible in- fluence on learning if the voices were quantitatively and qualitatively equiva- lent. Second, the gender of the narrator did not alter the number or pattern of correct/incorrect responses across groups.

Page 16 /Image February, 1981, Volume XIII, No. 1

Effects of Teacher Gender

Several interpretations are possible. First, the female narrator, teacher or professional appears to be as well re- ceived by the student nurse as the more traditional male figure. The learner may be concentrating on content, making the sex of voice irrelevant. Again, au- thority may not appear to these sub- jects as sex-related. Second, the respondents could answer questions initiated by simulated verbal and non- verbal information from a patient to a professional nurse regardless of nar- rator. Third, the answers provided quantified evaluation results, but the questions also generated student dis- cussion.

These verbalizations, although not a formal part of the study may be inter- preted to mean a) that students con- tinued to regard the test tape as an instructional tape (desire for immediate feedback) and b) weighing of the pros and cons of each choice had been or was in process. It would be interesting to know the reasons for the answers selected. An improved test would specify questions which not only re- quired selection of an answer but the reason for the selection.

Limit at ions Recognition of limitations generally

implicit in the decision of the instruc- tional planner, evaluator and researcher may be problematic. Such limitations include 1) specifications of the nursing process employed, 2) circumstances surrounding selection and scheduling of the learners, 3) testing procedures, and 4) the researcher’s knowledge of the media technology and creative a- bility in applying research from learning theories, media research, and nursing. No attempt was made to weigh these limitations.

The specifications of the nursing process, presented as figure 1, have not been researched to establish whether the relationship occurs e.g., that im- proving observational skills would pro- duce inferences of a different quality than if quality data collection were not present. Reflection on the logic of the process makes these conditions seem obvious but experimental testing is lacking. Whether the philosophical basis for the nursing actions portrayed in the simulations stemming from the

writing of Henderson, (1966) Orem (1971) and others influenced the results of this study remains a question.

The real world imposes constraints on access to students. Those who volunteer may represent a different population than those who do not. The respondents in this study, all from one baccalaureate program, may or may not be truly representative of the bac- calaureate student population in nurs- ing. The percentage of males is higher than the national average, although representative of the program of which they were a part.

The testing procedures seemed ap- propriate for the task. Judgments were required in formulating the test ques- tions. Prior reliability (responses always the same) evaluation of the test had revealed some questions were respond- ed to with relatively high or low percent- ages of correct answers. The responses of the students in this study followed that pattern. The development of the videotapes had included expert nurse evaluation of the validity (measure what is intended to be measured) of the materials. A main probtem may be that simulation produces an artificial or con- trolled situation. Therefore, the possi- bility exists that the responses of the participants are also artificial. Research is not available on the cognitive proc- esses active during simulation; only the outcomes have been measured.

Conclusion Sophisticated development of in-

struction for nursing practice must be drawn from a scientific base of theory and research. However, the theorist’s and researcher’s findings are not always in agreement, conclusive and available. Analysis of theories and research, how- ever, does necessitate sorting out values, knowledge, and the unknown in reaching decisions. Such analysis also facilitates the generation of knowl- edge by raising new research questions.

Reference Notes

Twyford, L. C. Summary of Reports of the Instructional Film Research Program. Unpublished Special Devices Center Technical Report, U. S. Navy, Port Washins ton, L. I., New York, 1953. (Mimeographed, A. S. C. Library No. 371.3342300 P. 3841, Pennsylvania State College.)

Wertsch, J. V. The Influence of Listener Perception of the Speaker on Psycholinguistics Processing. Doc- toral Dissertation, University of Chicago. 1975.

References Bandura, A. Social learning theory. Englewood Cliffs,

N. J.: Prentice-Hall, 1977. Bergsen, H. and Zogornik, D. Teachingnursingprocess

to beginning students, Nursing Outlook, 1968, 16, 32-34.

Caffery, J . Auding ability at the secondary level, Edu- cation, 1955, 75, 303-310.

Cantril, H. and Allport, G. The psychology of radio. New York: Harper, 1936.

Clark, C. C. Simulation Gaming: A new teachingstrategy in nursing education, Nurse Educator, 1976, 1.4-9.

Cleland. V. Sex discrimination: nursing’s most pervasive problem, American Journal of Nursing, 1971, 71, 1542- 1547.

Cohen. R. B. and Bradley, R. H. Teaching superordinate concepts with simulation games, Alberta Journal of Educational Research, 1977, 23, 298-304.

Gardiner, J. M. and Cameron, P. C. Change in speaker’s voice and release from proactive inhibition, Journal of Experimental Psychology, 1974, 102, 863-867.

Geiselman, R. E. and Bellezza, F. S. Incidental retention of speaker’s voice, Memory and Cognition, 1977, 5, 658-665.

Globig, L. J. and Touky, J. C. Sex and effective deter- minants of lecture content retention, Psychological Reports, 1971, 29, 538.

Goldhaber, C. M. and Weaver, C. H. Listener compre- hension of compressed speech when the difficulty, rate of presentation, and sex of listener are varied, Speech Monographs, 1968, 35,20-25.

Henderson, V. The nature of nursing, New York Macmillan Company, 1966.

Hilgard, E. R. and Bower, G. H. Theories of learning. (4th edition) New York: Appleton-Century-Crofts, 1975.

Irwin, C. E. Evaluating a training program in listening for college freshman, School Review, 1953, 61, 25-29

Levie, W. H. A prospectus for instructional research on visual literacy, ECTJ, 1978, 26, 25-37.

Light, L. L., Stansbury, C., Rulin, C., and Linde, S. Memory for modality of presentation: within modality discrimination, Memory and Cognition, 1973, 1, 395-400.

McGuire, C. Simulation technique in the teaching and testing of problem solving skills, Proceedings of the 46th Annual Meeting of the National Association for Research in Science Teaching, March 1973. (ERIC ED 091152).

McLuhan, M. Understanding media: the extensions of man. New York: McGraw-Hill, 1965.

Orem, D. Nursing: Concepts of practice. New York McGrawHill, 1971.

Pearson, B. D. Applying learning theory to films, AV Communication Review, 1972, 20,281-295.

Pearson, B. D. Professional process task analysis: use of theory, Journal of Continuing Education in Nursing, 1975, 6, 24-29. (a)

Pearson, B. D. Simulation techniques for nursing edu- cation, International Nursing Review, 1975, 22, 144-146. (b)

Pearson, B. D. Evaluation of the nursing process through visual motion media, International Nursing Review, 1978,35, 119120.

Rossiter, C. M. Sex of the speaker, sex of the listener, and listening comprehension, Journal of Communi- cation, 1972.22.64-69.

Severin, W. J. The effectiveness of relevant pictures in multi-channel communication, AV Communication Review, 1967, 15,386-401.

Stromberq, M. F. Relationship of sex role identity to oc- cupational image of female nursing students, Nursing Research, 1976, 25,363369.

Yura, H. and Walsh, M. The nursing process. New York: Appleton-Century-Crofts, 1978.

*Acknowledgement: The original uideo- tapes were the result of PHS Special Project Grant 05 DO0 531 -01 NUDIO, Betty Pearson, Project Director.

February, 1981, Volume Xlll /Image Page 17