Running head: ONLINE POST-CLINICAL CONFERENCES 1

Nursing Student Perspectives on Online Post-Clinical Conferences:

A Systematic Review of Literature

Jodi A. Koplitz, BSN, RN

University of Wisconsin Oshkosh College of Nursing

Nursing 793 Nurse Educator Culminating Project

ONLINE POST-CLINICAL CONFERENCES 2

Abstract

Post-clinical conferences are a traditional part of nursing education. Post-clinical conferences

allow nursing instructors to cultivate critical thinking skills among students within a learner-

centered environment. As the trend in nursing education continues to lean towards engaging

students with an increased utilization of technology and online learning, instructors may consider

utilizing similar technology in post-clinical conferences. The purpose of this systematic review

of literature (SROL) is to share evidence from current research surrounding the use of online-

based post-clinical formats in nursing education. In order to understand these perspectives, a

SROL referencing 20 articles was conducted. Acceptable study designs included literature

reviews, evidence from qualitative and quantitative studies, clinical expertise, and research

reviews. Keywords were used to search scholarly databases. This evidence-based review

contributes to the understanding of face-to-face post-clinical conferences. Online modalities that

alleviate barriers will be discussed. Current research indicates that asynchronous online

discussion may replace face-to-face post-clinical conferences. Students perceive the use of online

modalities in place of face-to-face seminars to be beneficial to their critical thinking and

learning. Nurse educators are met with the challenge to instill the same student-centered

approaches in their online teaching as they would in a face-to-face format. After literature

review, there is evidence to support both positive student perceptions and educational benefits of

replacing face-to-face post-clinical conferences with asynchronous online discussions. Further

quantitative and qualitative research would help explain the effects of online post-clinical

conferences on student achievement as well as the success of implementing other online

modalities besides asynchronous online discussion.

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Nursing Student Perspectives on Online Post-Clinical Conferences:

A Systematic Review of Literature

Post-clinical conferences are a cornerstone of nursing education. They are rooted in

tradition and relevancy. Post-clinical conferences allow nursing instructors to cultivate critical

thinking skills among students by asking questions to facilitate deeper learning while creating a

space for a learner-centered environment. Students are given the freedom to process their new

learning and develop critical thinking skills. As the trend in nursing education continues to lean

towards engaging students with an increased utilization of technology and online learning,

instructors may consider utilizing similar technology in post-clinical conferences. Online

education allows greater flexibility for students and educators while increasing peer engagement

and networking (Evans, 2013; Zapko, 2013). Several studies and literature reviews have posed

questions about the risks and benefits of replacing face-to-face post-clinical conference with an

online-based discussion. This systematic review of literature (SROL) will explore the benefits

and challenges of replacing face-to-face post-clinical conferences with online modalities while

taking the student perspective into careful consideration. Implications for the nurse educator will

be discussed.

Objectives of the Evidence-Based Literature Review

The purpose of this SROL is to share evidence from current research surrounding the use

of online-based post-clinical formats in nursing education. Traditionally, post-clinical

conferences are conducted via face-to-face discussion immediately following the clinical day.

Students and instructors experience fatigue and disengagement during discussions that

immediately following a period of clinical learning. This SROL will assess student perspectives

on the use of online modalities in place to face-to-face post-clinical conferences. Benefits of

ONLINE POST-CLINICAL CONFERENCES 4

online education, specifically asynchronous discussion, will be assessed. Upon reading this

SROL, nurse educators may identify and implement additional student-centered strategies in

order to enhance learner engagement and provide greater flexibility for students during post-

clinical conference format via online modalities. The specific question to be answered by this

SROL is as follows: How do pre-licensure nursing students perceive the benefits of online post-

clinical conferences versus face-to-face post-clinical conferences during a semester of clinical

learning?

Statement of the Problem

Current literature tells us that face-to-face post-clinical conferences are ineffective

(Cooper, Taft, & Thelen, 2004). Students and nursing instructors battle fatigue, inattentiveness,

and disengagement immediately following a long day of teaching and learning in clinical

environments. Post-clinical conferences in various formats are designed to help students achieve

clinical goals, foster critical thinking, and make deep connections between theory and clinical

practice (Berkstresser, 2016; Ebersole-Berkstresser, 2013; Heid, 2015). With the increased use of

online modalities in nursing education, nursing instructors should consider if online formats are

an effective means for post-clinical conferences. Student-centeredness may be assessed by

analyzing student perspectives.

Background Literature

Traditionally, post-clinical conferences are the period of time immediately following a

clinical experience where students and the clinical instructor debrief, share new learning, and

start to make connections between theory and practice (Berkstresser, 2016; Cooper, et al., 2004;

Heid, 2015; Hermann, 2006; Neumeier & Small, 2014; Vezeau, 2016). Post-clinical

conferencing is designed to give students the time and space to analyze the care that was
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provided during a clinical experience and discuss how to meet the individualized needs of

patients (Berkstresser, 2016). Post-clinical conferences were created to increase critical thinking

skills, facilitate professional development, promote student engagement, and encourage

reflective thinking among students (Evans, 2013; Heid, 2015; Hermann, 2006).

The key objective of post-clinical conferences are to facilitate critical thinking through

deep learning (Berkstresser, 2016; Heid, 2015; Zapko, 2013). As a nurse, critical thinking is at

the core of providing safe, competent, patient-centered care as an effective member of an

interdisciplinary team. Clinical experiences are meant to teach students this vital skills set, yet an

overwhelmingly small percentage of new graduate nurses possess the critical thinking abilities

expected of them (Guhde, 2010).

Widespread changes in healthcare affect clinical education. More demands are placed on

clinical sites due to increased patient acuity, students are required to learn new knowledge at a

more rapid rate, and the importance of safety is at an all-time high. The clinical learning

environment is changing. Increased demands on students and instructors during clinical learning

negatively affect the quality of post-clinical conference time. Students are often exhausted,

distracted, and unavailable for learning, resulting in passive learning and ineffective post-clinical

conferences (Neumeier & Small, 2014; Vezeau, 2016; Yehle & Royal, 2010). As we enter a new

time period where a new generation of clinical students are in nursing school, we see that not

only has the clinical learning environment changed, but so has the type of student. In order to

meet the needs of the contemporary, millennial learner found in most traditional undergraduate

nursing programs, alternate approaches to gaining reflective knowledge must be addressed

(Vezeau, 2016; Yehle & Royal, 2010). The demand for a flexible, collaborative approach is

required to meet the needs of today’s learners (Berkstresser, 2016).

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Online modalities like asynchronous discussion offer a viable alternative (Neumeier &

Small, 2014). Current literature suggests that pre-licensure nursing students perceive online

discussion to be as effective for their learning as face-to-face formats (Bassett, 2011; Neumeier

& Small, 2014; Rentmeester, 2006). Asynchronous online discussion offers greater convenience,

increased flexibility, additional time to reflect and process new learning, equal opportunities to

participate, and supplemental learning through shared peer experiences (Hannans, 2013;

Neumeier & Small, 2014; Rentmeester, 2006; Weed, Spurlock, & Forehand, 2014). As the use of

instructional technology in academia increases, nurse educators must continue to be open to new

ways of integrating this type of learning modality into instruction and learning environments

(Cooper, Taft, & Thelen, 2004).

Methods for Conducting the Evidence-Based Review

In order to conduct an unbiased and comprehensive search for this SROL, a PICOT

question was developed as follows: How do pre-licensure nursing students perceive the benefits

of online post-clinical conferences versus face-to-face post-clinical conferences during a

semester of clinical learning?

Search Strategy, Components, and Procedure

Initial keywords used to conduct the search included ‘online,’ ‘post-clinical conferences,’

and ‘nursing education,’ and ‘student perspectives.’ The Boolean operator ‘and’ was used to

combine initial keywords in varying combinations. Due to the limited number of articles

returned, other keywords used to conduct the search included ‘face-to-face,’ ‘clinical

postconference,’ ‘nursing students,’ ‘discussion,’ ‘online learning,’ ‘clinical learning,’ and

‘benefits.’ The Boolean operator ‘or’ was used to combine keywords ‘undergraduate,’

‘associate,’ and ‘pre-licensure’ in order to search for any of those nursing program descriptors.
ONLINE POST-CLINICAL CONFERENCES 7

The Boolean operator ‘and’ was used to combine keywords ‘post-clinical conferences’ and

‘discussion.’ These keywords were used to search several databases including Academic Search

Complete, CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials,

Cochrane Database of Systematic Reviews, Health Source: Nursing/Academic Edition, and

MEDLINE with Full Text. Reference lists from key published articles were hand searched to

find related research. Due to the limited number of published articles specifically addressing

online post-clinical conferences, articles addressing online learning, online discussions, and face-

to-face post-clinical conferences were included in this SROL in order to define key terms and

enhance background literature. Literature was reviewed and refined by searching for common

themes.

Inclusion/Exclusion Criteria and Data Extraction

Randomized control trials were sought out initially, but limited experimental studies have

been conducted in this topic area. Due to the nature of the PICOT question, acceptable study

designs were broadened to literature reviews of qualitative studies, evidence from qualitative and

other quantitative studies, clinical expertise, and research reviews. Initial publication date criteria

was set for five years. Articles not published or updated within the last 5 years were still included

due to limited research and the applicability to the proposed PICOT question. Literature

published within ten years was considered acceptable. Seven additional pieces of evidence

published eleven, twelve, thirteen, and fourteen years ago were also accepted due to the specific

applicability to online post-clinical conferences. Published works in English were exclusively

accepted.

Demographic characteristics for the population included any gender, age, and race. For

the purposes of this literature review, pre-licensure nursing students from baccalaureate and
ONLINE POST-CLINICAL CONFERENCES 8

associate programs were included. The Boolean operator ‘or’ was used to combine keywords

‘undergraduate,’ ‘associate,’ and ‘pre-licensure’ in order to search keywords describing pre-

licensure nursing students. Evidence that addressed graduate-level nursing students were

excluded.

Literature including any type of post-clinical discussion was exclusively included as long

as it discussed any type of benefit to the student, the inclusion of online modalities, student or

instructor perspectives, or the comparison of different teaching formats. In order to holistically

answer the PICOT question, topics of interest included the use of online discussion in post-

clinical conferences, the comparison of traditional face-to-face post-clinical conferences to

online deliveries, and student perspectives. Outcomes of interest included student perceptions on

the benefits of using online discussions in post-clinical conferences and strategies for the nurse

educator to successfully implement online modalities in post-clinical conferences.

For the purposes of this SROL, several keywords are defined. ‘Post-clinical conference’

is defined as a period of time pre-determined by the nursing instructor immediately following a

clinical experience where students debrief and share experiences, discuss new learning, and

connect theory to clinical practice (Berkstresser, 2016). ‘Discussion’ is defined as the act of

sharing of ideas through student to student and student to instructor interactions (Buckley,

Beyna, & Dudley-Brown, 2005). ‘Face-to-face’ is defined as verbal and nonverbal

communication between students and instructors that happens within each other’s’ presence

(Hsu, 2007). The face-to-face delivery of post-clinical conferences are deemed the traditional

educational modality in nursing programs.

Using the initial search strategy outlined above, initial results generated 293 potential

sources. Several combinations of keywords were used to generate an additional 54 sources. After
ONLINE POST-CLINICAL CONFERENCES 9

screening potential sources using inclusion and exclusion criteria, 303 sources were eliminated.

The remaining 47 records were screened, 33 full-text articles were assessed for eligibility, and as

a final product, eight qualitative evidence articles, two quasi-experimental evidence articles, and

one evidence article with a quantitative and qualitative design were included. There are 20 cited

references to include the above-mentioned qualitative, quantitative, and quasi-experimental

evidence, a non-experimental pilot study, literature reviews, research reviews, and clinical

expertise articles.

Research in this SROL included levels II, III, and V. Level II evidence included

quantitative studies (quasi-experimental studies) and one study that included both qualitative and

quantitative data, level III evidence included quantitative research studies and research reviews,

and level V evidence include clinical expertise and literature review. No level I or IV evidence

was included. The majority of findings are rated as high or good quality according to the

research and non-research evidence appraisal tools by John Hopkins Hospital and University.

Most of the research may be considered high or good quality due to professional sponsorship,

thorough systematic search strategy, consistency, clear conclusions, evaluation of strengths and

limitations of studies, and recent publication within the last 10 years.

Results

Literature review of level II, III, and V evidence of good or high quality yielded three

major themes in the use of online post-clinical conferences. These themes include (1) the

limitations of face-to-face post-clinical conferences, (2) the benefits of replacing face-to-face

post-clinical conferences with online modalities, and (3) positive student perspectives on the use

of asynchronous online discussion (See Individual Evidence Summary Tool and Synthesis and

Recommendation Tool).
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Limitations of Face-to-Face Post-Clinical Conferences

Traditionally, post-clinical conferences are comprised of a small group discussion or

activity that immediately follows an assigned period of clinical learning (Berkstresser, 2016).

Activities for post-clinical conferences include student presentations, instructor-facilitated

discussion, guest speakers, and case studies (Cooper, Taft, & Thelen, 2004). All of these

activities require a student’s full attention and engagement in reflective thinking in order to

synthesize new information. An effective post-clinical conference allows students to participate

as a group member, meet clinical objectives, and share personal feelings and attitudes about their

clinical experiences (Hamera & Wright, 2004). Since face-to-face post-clinical conferences

typically happen at the end of a long clinical day, students are often exhausted, distracted, and

unavailable for learning, resulting in passive learning and ineffective post-clinical conferences

(Evans, 2013; Heid, 2015; Neumeier & Small, 2014; Vezeau, 2016; Yehle & Royal, 2010).

Nursing instructors are not immune from similar consequences. Instructors often experience

mental and physical fatigue after a long day of clinical teaching and find themselves asking

surface-level questions and giving poor feedback during post-clinical conferences (Evans, 2013).

Face-to-face post-clinical conferences lack sufficient time for all students to share

information and make the cognitive connections between the care provided during clinical time

with the information learned during theory courses (Berkstresser, 2016; Evans, 2013). Many

clinical sites lack a private conferencing space that is suitable for an effective learning

environment (Evans, 2013). A lack of structure during post-clinical conference time paired with

an emotionally drained group of students frequently results in increased discussion about

irrelevant topics, faculty dominance, and minimal student involvement (Berkstresser, 2016).
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With all of these challenges, face-to-face post-clinical conferences do not meet the intended

purpose of developing critical thinking skills (Berkstresser, 2016).

Literature shows the importance of supporting the affective domain of learning via

reflection and sharing of clinical experiences within a group setting (Hsu, 2007). Reflective

learning during post-clinical conferences support critical thinking by encouraging learners to

think about integrating their prior understanding with newly obtained knowledge (Ebersole-

Berkstresser, 2013).Nursing instructors are challenged with the task of carefully planning

conferences where open-ended questions are asked and group adhesion is established (Oermann,

2008). Due to learner and faculty fatigue nursing instructors may find themselves lacking the

opportunity to ask open-ended questions during face-to-face post-clinical conference experiences

(Ebersole-Berkstresser, 2013).

Benefits of Using Online Modalities

Asynchronous online learning environments promote active learning among students

(Berkstresser, 2016). In online learning, students have the ability to actively share their

experiences within a time and place that allows them to think reflectively before responding to

their peers (Berkstresser, 2016; Hannans, 2013; Rentmeester, 2006). Shared experiences via

online discussion foster deep thinking (Heid, 2015). When students are given the time and space

to reflect and write responses to online prompts they become actively engaged in their own

learning. Reflective discussion promotes student-centeredness and increased critical thinking by

moving the student away from passive learning into an active learning role (Berkstresser, 2016).

Students who may be struggling are less likely to become discounted as they are in a passive

learning situation as all students are required to take an active learning role in their own learning

(Buckley, Beyna, & Dudley-Brown, 2005).

ONLINE POST-CLINICAL CONFERENCES 12

The average face-to-face post-clinical conference is 50.5 minutes (Berkstresser, 2016).

The time constraints of a face-to-face post-clinical conference impede the opportunity for all

students to share their experiences. Online modalities allow all students to share their

experiences and become aware of the implications for caring for other types of patients

(Buckley, Beyna, & Dudley-Brown, 2005). Online asynchronous discussion helps student

develop critical thinking by allowing students ample time to reflect on the complexity of patient

care and correlate theory into practice (Heid, 2015). Students find that online post-clinical

conferences allow them a chance to rest, think about their answers, and utilize additional

resources outside of clinical in order to enhance learning (Rentmeester, 2006). Since online

learning can be accessed at any time of the day, students are given the opportunity to engage in

learning when they are physically and emotionally available for learning (Berkstresser, 2016).

This type of flexibility increases student satisfaction and retention (Campbell, Gibson, Hall,

Richards, & Callery, 2008; Weed, Spurlock, & Forehand, 2014). Asynchronous online

discussion equals the playing field for students. Students who may be anxious to speak and share

ideas in front of other students may be more comfortable and willing to communicate via online

discussion (Bassett, 2011; Cooper, Taft, & Thelen, 2004).

Nursing instructors have immediate access to student learning resulting in increased

communication between the learner and instructor (Berkstresser, 2016; Buckley, et al., 2005).

Online learning environments give instructors the ability to closely monitor student performance.

Instructors can view discussion responses, note the frequency in which individual students access

content, and keep documented evidence of student progress (Cooper, Taft, & Thelen, 2004).

Cooper, Taft, and Thelen (2004) found no differences in quiz scores that measured

achievement of clinical learning objectives between a clinical group that participated in a

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traditional post-clinical conference when compared to a clinical group that participated in an

online-based post-clinical conference. When comparing student responses on a clinical

conference evaluation tool, students who participated in online post-clinical conferences had

statistically higher scores on the following items: “clinical conferences facilitated participation

by all students; clinical conferences provided an opportunity to examine ethical issues related to

patient care; the timing of clinical conferences was convenient for me; and descriptions of other

students’ experiences helped me learn” (Cooper, Taft, & Thelen, 2004, p. 163). The research

suggests that students learn just as much, if not more, from online post-clinical conference

modalities and prefer the online educational environment over face-to-face methods.

Positive Student Perspectives

According to Megel, Nelson, Black, Vogel, and Uphoff (2013), student must have access

to faculty support, cohesion, organization, involvement, and innovation in order to be successful

and feel positive about online learning environments. Hermann (2006) reported positive student

feedback on the use of online discussion in place of traditional post-clinical conferences. In

Hermann’s (2006) qualitative study, students felt supported and connected to other students in

asynchronous online discussions by reading peer posts. Students reported increased self-

confidence, self-awareness, and overall increased learning when participating in online

discussion (Hermann, 2006). In a qualitative study by Zapko (2013), participants not only

contributed to their own postings, they also researched and answered questions that other

participants posted demonstrating increased student engagement and participation.

Evans (2013) argues similar findings in a qualitative study review among nursing

students. Student feedback regarding the use of asynchronous discussion to replace face-to-face

post-clinical conferences was positive, with students stating that they benefited from reading
ONLINE POST-CLINICAL CONFERENCES 14

each other’s postings and having additional time to reflect on the discussion when compared to a

face-to-face discussion (Evans, 2013). Similarly, a qualitative study by Guhde (2010) indicates

students acknowledged that an online case study and discussion assignment supported their

critical thinking and increased their awareness of important course content. Upon evaluation,

students who completed the assignment viewed it as a good learning exercise that should be kept

in the course (Guhde, 2010). Neumeier and Small (2014) also found that students perceive

asynchronous online post-clinical conferences to be as effective for their learning as face-to-face

formats and would recommend online discussion formats to other students. Students felt that

online asynchronous post-clinical discussion support their learning, added convenience to their

schedule, gave them equal opportunities to participate, and extra time to reflect on content

(Neumeier & Small, 2014).

Discussion and Implications for Practice, Education, and Research

Research shows that if the structure and timing of an online asynchronous discussion is

done correctly, an inclusive environment can be established among students (Bassett, 2011). The

challenge for nurse educators is to instill the same student-centered approaches in their online

teaching as they would in a face-to-face format. Nurse educators in clinical environments must

develop broad, open-ended questions that provoke deep thought (Buckley, Beyna, & Dudley-

Brown, 2005). The same standards have to be met within an online learning environment when

the goal of post-clinical conferences are to develop critically reflective thinking and clinical

problem solving among students (Hsu, 2007).

Nurse educators have to implement creative teaching methods in order to keep students

interested in online learning. Debates, role playing, reaction-based responses, case scenarios, and

literature critiques should be utilized in addition to asynchronous discussion in order to foster

ONLINE POST-CLINICAL CONFERENCES 15

student participation and interest (Buckley, Beyna, & Dudley-Brown, 2005). The literature tells

us that nurse educators value reflective discussion, student participation, the use of different

teaching methods, and group cohesion to be instrumental parts of a successful post-clinical

conference (Hsu, 2007). Nursing programs should find ways to weave these characteristics into

online modalities for students.

Nurse educators must take student perspectives into consideration when designing post-

clinical conferences. The research shows that students value the flexibility, supportive peer

environment, additional reflective time, and peer-to-peer learning that asynchronous online

discussions have to offer. As educators think about ways to foster critical thinking the challenges

of utilizing online modalities must also be considered.

Conclusion and Recommendations

Findings from this SROL warrant further research in this topic. Limited quantitative and

qualitative data is available on the use of online modalities in place of traditional face-to-face

post-clinical conferences. Student and instructor perspectives should be explored further.

Quantitative data on student attainment of clinical goals must be considered. Does the use of

online modalities in post-clinical conferences make a difference in student attainment of critical

thinking when compared to face-to-face methods? A majority of the current research specifically

studies the use of asynchronous online discussion in place of face-to-face discussion, but what

about other online activities such as case studies? More research should be conducted on the use

of online modalities in place of face-to-face post-clinical conferences.

ONLINE POST-CLINICAL CONFERENCES 16

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Education in Practice, 16(1), 27-32. doi:10.1016/j.nepr.2015.06.007

Bristol, T. J., & Secor, C. (2012). Clinical postconference online. Teaching & Learning In

Nursing, 7(3), 123-126. doi:10.1016/j.teln.2012.03.001

Buckley, K., Beyna, B., & Dudley-Brown, S. (2005). Promoting active learning through on-line

discussion boards. Nurse Educator, 30(1), 32-36.

Cooper, C., Taft, L., & Thelen, M. (2004). Examining the role of technology in learning: an

evaluation of online clinical conferencing. Journal Of Professional Nursing, 20(3),

160-166.

Ebersole-Berkstresser, K. A. (2013). Online clinical post-conference, face-to-face clinical

postconference: Effects on critical thinking in associate degree nursing students

(Doctoral dissertation). Retrieved from CINAHL Plus with Full Text Database.

(Accession No. 109863953)

Evans, M. (2013). Using asynchronous discussion forums for clinical post-conferences.

Med-Surg Matters, 22(2), 17.

Guhde, J. (2010). Clinical decision-making: using online exercises and patient simulation to

improve students' clinical decision-making. Nursing Education Perspectives (National

League For Nursing), 31(6), 387-389. doi:10.1043/1536-5026-31.6.387

Hamera, E., & Wright, T. (2004). Evaluation of the content and interaction in an online clinical

conference for students in advanced psychiatric mental health nursing. Archives Of

Psychiatric Nursing, 18(1), 4-10.

Hannans, J. (2013). Testing a reflection education intervention on baccalaureate nursing

students’ level of reflection during online clinical post conference. (Doctoral

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dissertation). Retrieved from

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rtations

Heid, C. (2015). Fostering deep learning: An on-line clinical postconference pilot study.

Teaching and Learning in Nursing, 10(3), 124-127.

Hermann, M. (2006). Technology and reflective practice: the use of online discussion to

enhance postconference clinical learning. Nurse Educator, 31(5), 190-191

Hsu, L. (2007). Conducting clinical post-conference in clinical teaching: a qualitative study.

Journal Of Clinical Nursing, 16(8), 1525-1533. doi:10.1111/j.1365-2702.2006.01751.x

Megel, M. E., Nelson, A. E., Black, J., Vogel, J., & Uphoff, M. (2013). A comparison of student

and faculty perceptions of clinical post-conference learning environment. Nurse

Education Today, 33(5), 525-529. doi:10.1016/j.nedt.2011.11.021

Neumeier, M., & Small, S. (2014). Moving the discussion online: Asynchronous discussion for

clinical post-conference in a baccalaureate nursing program. Canadian Journal of

Nursing Informatics, 9(1).

Oermann, M. (2008). Ideas for postclinical conferences. Teaching and Learning in Nursing, 3(3),

90-93.

Rentmeester, M. (2006). Syllabus selection: innovative learning activity. Integrating online

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Vezeau, T. (2016). In defense of clinical conferences in clinical nursing education. Nurse

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Yehle, K. S., & Royal, P. A. (2010). Changing the postclinical conference: New time, new place,

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Running head: ONLINE POST-CLINICAL CONFERENCES 20

Individual Evidence Summary Tool

Article Author Evidence Sample, Sample Study findings that help Limitations Evidence
Number and Date Type Size, and Setting answer the EBP question Level and
Quality
1 Berkstresser, Literature N/A Post-clinical conferences None identified. Level V
K., 2016 Review allow the learner to synthesize A
knowledge and connect theory
to practice. Asynchronous
online discussion promotes
active learning and increases
student centeredness. Online
learning provides more time
for reflection.
2 Bristol, T., & Qualitative A pre-licensure Students found value in online None identified. Level V
Secor, C. Review nursing program discussion with faculty A
(2012). who used online support. Students were able to
postconference via participate in each other’s
asynchronous learning. Clinical instructors
discussion found that additional time is
needed to read all student
posts and provide feedback.
Clinical instructors found that
they were able to assess
student thinking.
3 Buckley, K., Literature N/A Online discussion boards may Not published within Level V
et al., 2005 Review be used in place of post- the last ten years. B
clinical conferences if they are
well-designed. Online
discussion boards allow
students to benefit from other
students’ learning as well as
their own. Implications for the
nurse educator are discussed.
ONLINE POST-CLINICAL CONFERENCES 20

4 Cooper, C., et Quantitative 77 undergraduate Mean scores on clinical Not published in the Level II
al., 2004 and nursing students in evaluation tools were higher last ten years. B
Qualitative ten clinical sections for students who participated
in a senior nursing in online post-clinical
course conferences than those in face-
to-face conferences. Greater
participation and convenience
among students who
participated in online post-
clinical conferences.
5 Ebersole- Quasi- 44 nursing students Critical thinking scores of Small sample size. Level II
Berkstresser, experimental in an ADN program students who participated in B
K. A. (2013). online asynchronous
discussion for post-clinical
conferences showed no
statistical difference from
scores of students who
participated in face-to-face
formats.
6 Evans, M., Qualitative A group of senior Positive student feedback Unspecified sample Level III
2013 Review level undergraduate regarding the use of size. Brief summary of B
nursing students asynchronous discussion to study. Not published
completed replace traditional post- in the last ten years.
asynchronous conferences. Students feel that
discussion in place online modalities allow
of post-clinical additional time for reflection.
conferences Instructors feel that students
display an increase in critical
and reflective thinking.
7 Guhde, J., Qualitative 83 clinical students Online discussion allows Small sample size. Level III
2010 divided into online students to analyze their own B
discussion groups to critical thinking. Online
debrief on learning increased critical
simulation activity thinking and self-awareness
among students.
ONLINE POST-CLINICAL CONFERENCES 21

8 Hamera, E., Qualitative 10 students enrolled Qualities desired in face-to- Small sample size. Level III
& Wright, T., in a psychiatric face conferences can be Not published in the B
2004 nursing clinical achieved with online last ten years.
across multiple modalities.
settings
9 Hannans, J., Quasi- 47 baccalaureate Additional time to reflect Homogenous, small Level II
2013 experimental nursing students of online through guided sample size. B
homogeneous thinking exercises promotes
ethnicity enrolled in increased reflection among
an acute care students.
clinical across all
levels
10 Heid, C., 2015 Qualitative 10 students in one of Post-clinical conferences Small sample size, but Level III
six clinical groups allow students to reflect on the appropriate for the A
in the final term of complexity of patient care and type of study
an ADN program correlate theory into practice. conducted.
Shared experience enhance
deep learning. Mental and
physical fatigue at the end of a
clinical day result in
diminished conversation and
engagement.
11 Hermann, M., Qualitative Eight freshman Positive student feedback Small sample size, but Level III
2006 Review ADN students reported on the use of online appropriate for the B
participating in a discussion in place of face-to- type of study
medical-surgical face post-clinical conferences. conducted. Not
clinical Students feel supported and published in the last
connected to other students in ten years.
online discussions through
reading other students’ posts.
Students report increased self-
confidence, self-awareness,
and overall increased learning
when participating in online
discussions.
ONLINE POST-CLINICAL CONFERENCES 22

12 Hsu, L., 2007 Qualitative 50 students and 10 Nurse educators are Does not address the Level V
faculty were instrumental in facilitating use of online B
observed during discussion during post-clinical modalities for post-
post-clinical conferences. The study clinical conferences,
conferences addresses both student and but gives insight into
educator perspectives on post- baseline perspectives
clinical conference content. of traditional post-
clinical conferences.
Not published in the
last ten years.
13 Megel, M. E., Qualitative 475 baccalaureate Compares student and faculty None identified. Level III
et al., 2013 student nurses, 70 perceptions of post-clinical A
faculty, and 20 conference. Faculty support,
graduate teaching cohesion, organization,
assistants completed involvement, and innovation
an online survey are needed by the student
learner in order to be
successful in an online
learning environments.
14 Neumeier, M., Qualitative 20 nursing students Student perceive Small sample size, but Level III
& Small, S., enrolled in their asynchronous online post- appropriate for the A
(2014) second year clinical clinical conference as type of study
in a BSN program effective for their learning. conducted.
Students would recommend
online discussion formats to
other students.
15 Oermann, M., Clinical N/A Post-clinical conferences are a For the purposes of Level V
2008 Expertise form of discussion. Discussion this SROL, does not B
is a tool to promote learning. address online
Case studies are a reliable learning modalities in
learning tool. post-clinical
conferences.
16 Rentmeester, Qualitative A group of first- Nursing students find that Unspecified sample Level III
M., 2006 Review semester ADN online post-clinical size. Brief summary of B
nursing students conferences allow them a
ONLINE POST-CLINICAL CONFERENCES 23

enrolled in an chance to rest, think about study. Not published

introductory clinical their answers, and utilize in the last ten years.
course additional resources outside of
clinical. Students report that
learning is gained by reading
other students’ perspectives
from online modalities.
17 Vezeau, T., Literature N/A Post-clinical conferences None identified. Level V
2016 Review support the affective domain. A
Online learning meets the
needs of the millennial
generation and allows the
student to be engaged.
18 Weed, D., et Clinical N/A Online learning increases Limited to online Level V
al., 2014 Expertise access to learning, enhances discussions in nursing A
critical thinking, and gives education. Does not
greater flexibility to students. address post-clinical
conferences.
19 Yehle, K.S., Qualitative 144 junior year Physical and mental fatigue None identified. Level III
& Royal, P. nursing students in during face-to-face post- A
A., 2010 adult health nursing clinical conferences increases
clinical over three the likelihood of passive
semesters learning. Post-clinical
conferences should include
multiple modalities in order to
appeal to the millennial
learner. Student perspectives
give insight for the nurse
educator.
20 Zapko, K. A., Qualitative 8 senior Five of the eight participants Small sample size, but Level III
2013 baccalaureate reached the highest stage of appropriate for the A
nursing students reflection at least once during type of study
participated in the course of the study. conducted.
online Participants not only
researched questions or
ONLINE POST-CLINICAL CONFERENCES 24

clinical post- problems that they themselves

conferences over six had, they also researched the
weeks resulting in answers to questions that other
720 individual participants
online discussion posted.
postings
ONLINE POST-CLINICAL CONFERENCES
Total Number
Category (Level Type)
of Sources/Level
Level I
-Experimental study
-Randomized Controlled Trial (RCT)
-Systematic review of RCTs with or
without meta-analysis
Level II
-Quasi-experimental studies
-Systematic review of a combination of
RCTs and quasi-experimental studies, or
quasi experimental studies only, with or
without meta-analysis
Level III
-Non-experimental study
-Systematic review of a combination of
RCTs, quasi-experimental, and non-
experimental studies only, with or with-
out meta-analysis
-Qualitative study or systematic review of
qualitative studies with or without meta-
analysis
Level IV
-Opinion of respected authorities and/or
reports of nationally recognized expert
committees/consensus panels based on
scientific evidence
Level V
-Evidence obtained from literature
reviews, quality improvement, program
evaluation, financial evaluation, or case
reports
-Opinion of national recognized expert(s)
based on experiential evidence
25
Synthesis and Recommendations Tool
Overall
Synthesis of Findings
Quality
Evidence that Answers the EBP Question
Rating
0 - N/A
Increases in online learning were associated with higher clinical
attainment. Mean scores on clinical evaluation tools were higher
for students who participated in online post-clinical conferences
3 A/B
than those in face-to-face conferences. There is greater
participation and convenience among students who participated in
online post-clinical conferences.
Student perceptions of online learning are positive overall, giving
insight to the nurse educator. Physical and mental fatigue during
face-to-face post-clinical conferences increases the likelihood of
passive learning. Nursing students find that online post-clinical
10 A/B
conferences allow them a chance to rest, think about their answers,
and utilize additional resources outside of clinical. Students report
that learning is gained by reading other students’ perspectives from
online modalities.
0 - N/A
Post-clinical conferences support the affective domain and allow
the learner to synthesize knowledge and connect theory to practice.
Asynchronous online discussion promotes active learning and
increases student centeredness. Online learning meets the needs of
7 A/B
the millennial generation and allows the student to be engaged.
Online discussion boards may be used in place of post-clinical
conferences if they are well-designed. Online discussion boards
allow students to benefit from other students’ learning as well as
ONLINE POST-CLINICAL CONFERENCES 26

their own. Nurse educators are instrumental in facilitating

discussion during post-clinical conferences.