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By Susan Chumley
Nursing Department
Delaware Technical Community College
Terry Campus

Teaching has evolved through the years. Instructors are no longer considered strictly the providers of information, but now they are the “facilitator(s) of knowledge” (p. 121) to self-directed learners, according to Carol S. Sternberger in her research article entitled Interactive Learning Environment: Engaging Students Using Clickers, published in the 2012 issue of Nursing Education Perspectives.

For a recent faculty development class, I was part of a group researching Turning Technologies clicker tools, and my curiosity to ascertain if this type of technology would actually be proven to be beneficial to nursing students led me to Sternberger’s article. I wondered why learn another piece of technology unless the research substantiates its efficacy?!

The article was really quite interesting. The study was descriptive in nature and explored the pedagogical approach of using clickers to enhance a learning scenario with nursing students. The learning environment in this research project utilized the constructivist theory. This model states that “learners construct their knowledge by building on their internal representations and previous experiences and thus create their own meaning or constructs” (p. 121).

In other words, new learning takes place via the building of new synapses on the already existing synapses. The research sample consisted of 72 students enrolled in a one-credit weekend undergraduate nursing course on disaster health care. The students used the clickers to answer multiple-choice questions from different short scenarios that were meant to assess the application, analysis, and evaluation skills of students.

The instrument in the study was a 22-item fivepoint Likert-type scale questionnaire that measured four subscales. The subscales ranged from how the students were able to integrate the clickers into the classroom setting to how much they thought the clickers helped them with their critical thinking skills. At the end of the course, a 50-item, multiple-choice comprehensive exam was administered online and was available to the students for a four week time period. The questions on the exam were all different than the questions given with the clicker scenarios.

The results from this study indicated that the students enjoyed using the clickers to enhance their understanding of the presented material. Most students either agreed or strongly agreed with items on the Likert-type scale questionnaire. Fifty-one students added comments at the bottom of the questionnaire. The written statements contained three themes. The students commented on the “novelty of using clickers in a learning environment,” that the scenarios “promoted discussion and analysis,” and that the clickers “created a competitive game-like environment” that made “learning fun” (p. 122).

Another result that was analyzed was the scores from the comprehensive exam. The mean score was 41.8 and scores ranged from 30 to 49. The author described the scores as “disappointing” (p. 122) since the students reported that the clickers helped them to create and explore new concepts instead of just memorizing answers to test questions. The author suggested that perhaps the four week time period for completion of the exam might have contributed to the lower scores. She suggested that short-term knowledge gain might be lost as time passes.

So, how does this study impact the educator who might chose clickers as a way to enhance learning? The author states that other studies indicate that clickers may encourage more discussion among students and this discourse could inevitably lead to a deeper understanding of complex issues. If a student commits to an answer, the student is more willing to discuss the rationale behind their choice. Also, students report a higher level of satisfaction in the learning environment while using this technology. It’s all about keeping the students tuned in verses tuned out.

However, the educator must be aware that studies do not necessarily indicate higher overall exam scores when students use clickers. This technology can definitely be used to foster classroom discussion and student participation, but instructors should not hope for a miracle with the dreaded examination scores.


Sternberger, C. (2012). Interactive learning environment: Engaging students using clickers. Nursing Education Perspectives, 33(2), 121-124.

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