research papers on teaching methods

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Methods for teaching evidence-based practice: a scoping review

Camilla marie larsen.

1 Health Sciences Research Centre, UCL University College, Niels Bohrs Allé 1, 5230 Odense M, Denmark

2 Department of Physiotherapy, UCL University College, Niels Bohrs Allé 1, 5230 Odense M, Denmark

4 Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark

Anne Seneca Terkelsen

Anne-marie fiala carlsen.

3 Research Service, UCL Library, UCL University College, Niels Bohrs Allé 1, 5230 Odense M, Denmark

Hanne Kaae Kristensen

5 Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark

Associated Data

The data used and analysed during the current scoping review are available from the corresponding author on reasonable request.

This scoping review aims to gather and map inspiration, ideas and recommendations for teaching evidence-based practice across Professional Bachelor Degree healthcare programmes by mapping literature describing evidence-based practice teaching methods for undergraduate healthcare students including the steps suggested by the Sicily Statement.

A computer-assisted literature search using PubMed, Cinahl, PsycINFO, and OpenGrey covering health, education and grey literature was performed. Literature published before 2010 was excluded. Students should be attending either a Professional Bachelor’s degree or a Bachelor’s degree programme. Full-text articles were screened by pairs of reviewers and data extracted regarding: study characteristics and key methods of teaching evidence-based practice. Study characteristics were described narratively. Thematic analysis identified key methods for teaching evidence-based practice, while full-text revisions identified the use of the Sicily Statement’s five steps and context.

The database search identified 2220 records. One hundred ninety-two records were eligible for full-text assessment and 81 studies were included. Studies were conducted from 2010 to 2018. Approximately half of the studies were undertaken in the USA. Study designs were primarily qualitative and participants mainly nursing students. Seven key methods for teaching evidence-based practice were identified. Research courses and workshops, Collaboration with clinical practice and IT technology were the key methods most frequently identified. Journal clubs and Embedded librarians were referred to the least. The majority of the methods included 2–4 of the Sicily Statement’s five steps, while few methods referred to all five steps.

Conclusions

This scoping review has provided an extensive overview of literature describing methods for teaching EBP regarding undergraduate healthcare students. The two key methods Research courses and workshops and Collaboration with clinical practice are advantageous methods for teaching undergraduate healthcare students evidence-based practice; incorporating many of the Sicily Statement’s five steps. Unlike the Research courses and workshop methods, the last step of evaluation is carried out partly or entirely in a clinical context. Journal clubs and Embedded librarians should be further investigated as methods to reinforce existing methods of teaching. Future research should focus on methods for teaching EBP that incorporate as many of the five steps of teaching and conducting EBP as possible.

Dizon et al. state that healthcare can be inefficient, ineffective and/or dangerous when it is not based on current best evidence [ 1 , 2 ]. Therefore, to ensure the quality of healthcare, it is important to implement evidence-based practice (EBP) in all health professional curricula, so that future health professionals learn the fundamentals of research and the application of evidence in practice [ 2 ].

Several definitions of EBP have been suggested in recent years. The scientific evidence was initially developed within medicine, but as many health professionals have embraced an evidence-based way of practice the Sicily Statement [ 3 ] suggested that the original term “evidence-based medicine” should be expanded to “evidence-based practice” in order to reflect a common approach to EBP across all health professions.

The Sicily Statement gives a clear definition of EBP together with a description of the minimum level of educational requirements and skills required to practice in an evidence-based manner. This makes the underlying processes of EBP more transparent and distinguishes between the process and outcome of EBP [ 3 ].

In order to fulfil the minimum requirements of teaching and conducting EBP, the Sicily Statement puts forward a five-step model: (I) asking a clinical question; (II) collecting the most relevant evidence; (III) critically appraising the evidence; (IV) integrating the evidence with one’s clinical expertise, patient preferences and values to make a practice decision; and (V) evaluating the change or outcome [ 4 ].

Internationally, EBP skills are essential requirements in clinical practice among both medical doctors as well as among other health professionals. Healthcare students are mainly taught the first three steps of the Sicily Statement’s five-step model. The last two steps are rarely taught, and students and graduates thus lack competencies in applying their knowledge in the clinical setting during or after graduation [ 5 , 6 ].

In terms of healthcare policy and ambitions in Denmark, it was decided in 2015 that Professional Bachelor Degree healthcare students were to contribute to the development of an evidence-based way of working, a faster implementation of new knowledge in practice, and to the development of greater patient involvement and patient safety in the Danish healthcare system [ 7 ]. The Professional Bachelor’s degree is awarded after 180–270 ECTS and includes a period of work placement of at least 30 ECTS. The programmes are applied programmes. They are development-based and combine theoretical studies with a practical approach. Examples of professional bachelor degree holders are nurses. The Danish title is Professionsbachelor and the English title is Bachelor [ 8 ]. In Denmark the University College institutions solely provide professional bachelor degree educations. Master degrees are awarded at the Universities.

Based on the Sicily Statement students should be able to reflect, ask questions, gather knowledge, critically appraise, apply and evaluate various kinds of knowledge at the end of their course. The aim is that all Professional Bachelor Degree healthcare students across disciplines of nursing, physiotherapy, occupational therapy, radiography, and biomedical laboratory science develop common EBP qualifications in order to contribute towards the development of evidence-based healthcare [ 9 ]. In order to ensure shared prerequisites and mutual understanding of the EBP concepts before entering theoretical or clinical inter-professional education, further knowledge about how to teach EBP across disciplines is required [ 9 ]. By teaching the fundamental principles of EBP, students will develop their EBP skills and ability to put them into practice in their studies and as future graduates.

Previously, some systematic reviews were conducted summarising various educational interventions or strategies for teaching EBP to undergraduate healthcare students [ 2 , 10 – 12 ].

In a review from 2014, Young and colleagues stated that multifaceted interventions integrated into clinical practice contributed to the greatest improvements in EBP knowledge, skills, and attitudes [ 2 ]. In line with this, Kyriakoulis et al. suggested that a combination of interventions, such as lectures, tutorials, workshops, conferences, journal clubs, and online sessions was best suited for teaching EBP to undergraduate healthcare students [ 10 ]. However, the majority of the articles in both reviews synthesized information from interventions or strategies aimed at medical students at various educational levels. Only a few articles elicited information about educational interventions and strategies aimed at undergraduate healthcare students in the disciplines of nursing, physiotherapy, occupational therapy, radiography, and/or biomedical laboratory science. However, two recent reviews have specifically addressed EBP teaching for undergraduate nursing students [ 11 , 12 ]. A systematic review investigated the effectiveness of specific educational methods and found an effect on student knowledge, attitudes, and skills but could not draw a conclusion as to the advisability of one of the methods [ 11 ]. A literature review sought to identify knowledge experiences on teaching strategies from qualitative studies in nursing EBP education to enhance knowledge and skills and points to a limited focus on the use of EBP teaching strategies. Additionally, the study points to the need for more qualitative research investigating interactive and clinically integrated teaching strategies. Despite both reviews being well-informing, a broad scope when mapping updated EBP teaching methods and strategies across healthcare bachelor educations will further qualify future interdisciplinary practices [ 11 , 12 ].

In order to implement the most effective ways of teaching EBP across healthcare undergraduate students, an investigation of existing literature on the subject needs to be undertaken. For identifying, mapping and discussing key characteristics in the literature a scoping review is the better choice [ 13 ].

Aim, objectives and review question

The aim of this scoping review is to gather and map inspiration, ideas, and recommendations for teachers implementing EBP across Professional Bachelor Degree healthcare programmes by mapping existing literature describing EBP teaching methods, including the five steps of EBP suggested by the Sicily Statement, [ 3 ] regarding undergraduate healthcare students.

The primary question of the scoping review is: “Which EBP teaching methods, including The Sicily Statement’s steps of teaching and conducting EBP, have been reported in the literature with respect to undergraduate healthcare students in classrooms and clinical practice?”

Definitions

Classroom is defined as a room where classes are taught in a school, college or university [ 14 ].

Clinical practice refers to the agreed-upon and customary means of delivering healthcare by doctors, nurses and other health professionals [ 15 ].

To ensure a systematic methodology, The Joanna Briggs Institute Reviewers’ Manual - Methodology for JBI Scoping Reviews has been used throughout the scoping review process [ 16 , 17 ].

Inclusion criteria

Participants.

Literature which included undergraduate healthcare students in the disciplines of nursing, physiotherapy, occupational therapy, radiography, and biomedical laboratory science was selected to ensure applicability and relevance to similar scientific disciplines at other institutions of higher education. The undergraduate students should be attending either a Professional Bachelor’s degree or a Bachelor’s degree programme.

Methods for teaching EBP including The Sicily Statement’s steps of teaching and conducting EBP was the main concept to be investigated in the review. That is; literature describing either recommendations of EBP teaching methods, evaluations of EBP teaching methods, teacher and/or student perceptions of EBP teaching and learning methods, or qualifications obtained when learning the principles of EBP.

Literature describing methods for teaching EBP conducted in a classroom setting, in clinical practice as part of the education, or in a combination of classroom and clinical practice was included in the review.

Exclusion criteria

In the period up to 2010, the Bachelor Degree healthcare educations began to conform to European requirements regarding evidence-informed and evidence-based education [ 18 ].

A maximum time frame (2010–2018) was applied, determined by the amount of available literature/research studies and requirements of updated teaching strategies [ 19 , 20 ]. Therefore, literature published before 2010 was excluded.

Literature including undergraduate students in other health disciplines such as medicine or dentistry was not reviewed as the structure of their education is based on another paradigm. Nor was literature including participants such as graduates, RN-to-BSN students, and trained health personnel accepted for inclusion as they were considered as postgraduates, not comparable to undergraduate students. With the primary aim of gathering ideas and inspiration for teaching EBP, literature that focused on issues other than methods for teaching EBP was excluded, as well as literature in languages other than English, Danish, Norwegian, or Swedish.

Search strategy

To identify literature relevant to our research question, the databases MEDLINE via PubMed, CINAHL Complete, and PsycINFO (both via EBSCO) were systematically searched. These databases cover both health and education and are available to the primary local target audience of this scoping review. Because of time limitations only the multidisciplinary European database, OpenGrey, was searched in the attempt to find unpublished literature. The searches were conducted May 9th, 2018.

As recommended in The Joanna Briggs Institute Reviewers’ Manual [ 16 , 17 ], the search was conducted in three steps in collaboration with a research librarian.

• Step 1: The databases PubMed, covering the field of biomedicine and CINAHL, covering nursing and allied health literature were searched using the keywords: ‘teaching methods’, ‘teaching’, ‘learning methods’, ‘learning’, ‘teaching strategies’, ‘learning strategies’, ‘undergraduate’, ‘undergraduate education’, ‘student’, ‘biomedical laboratory scientist’, ‘medical laboratory scientist’, ‘medical laboratory technologist’, ‘medical laboratory technologists’, ‘radiographer’, ‘occupational therapist’, ‘physiotherapist’, ‘nurse’, and ‘evidence-based practice’.

Specific search queries, all databases

• Step 3: The reference lists of identified studies were searched for additional studies.

Study selection

All search results from the databases were imported to the web-based bibliographic management software, RefWorks 2017 by ProQuest. After exclusion of duplicates and records before 01.01.2010, two reviewers independently screened titles and abstracts of the remaining articles for relevance in relation to the research question and the inclusion and exclusion criteria. Afterwards, all full-text articles were further checked for relevance by two independent reviewers. Any inconsistencies between the two reviewers regarding study selection for final inclusion were resolved by discussion with a third reviewer.

Data collection

Data from the included articles were extracted using two data extraction tools as recommended in The Joanna Briggs Institute Reviewers’ Manual [ 16 , 17 ]. The first data extraction tool comprised study characteristics, while the other data extraction tool comprised methods for teaching EBP.

Prior to the process of extracting data from the included articles, a pilot test using the data extraction tools was conducted by one reviewer assessing nine articles. To ensure agreement between reviewers, a second reviewer checked the same articles. Any disagreements about the content or use of the data extraction tools were discussed and resolved.

One reviewer then extracted relevant data from all included articles to the data extraction tools. Two other reviewers split the same articles among them and extracted data using the same data extraction tools. As a final step, the first reviewer went through all extracted data from all of the included articles with each of the other reviewers to ensure comparability and completeness in the final data extraction tools.

Synthesis and analysis of results

The data extraction tools formed the basis of the final presentation of the results in two tables consisting of “Study characteristics” and “Key methods for teaching EBP, the Sicily Statement’s five steps of teaching and conducting EBP and context”. Study characteristics included author, year of publication, title, journal, country of origin, study design, study participants, methods for teaching EBP, and main study findings. The key methods for teaching EBP were identified through a thematic analysis. All full text articles were read and every teaching method found was listed. Through a revision of all teaching methods listed, seven themes were found that described the most prominent teaching methods, which were named “Key methods for teaching EBP”. All methods were then divided into one of the key methods for teaching EBP. In some articles, more than one teaching method was described. In that case, the teaching method most frequently described was selected and categorised under the relevant key method. Through full-text revision the Sicily Statement’s steps of teaching and conducting EBP and the context (classroom, clinical practice or a combination of both) in which the teaching took place was found. To further clarify the content of the two tables all results listed were described narratively. All tabulated data, except for the key methods for teaching EBP identified in Table  3 , have been cited directly from the articles.

Key methods for teaching undergraduate healthcare students EBP, the Sicily Statement’s five steps of teaching and conducting EBP and context

Literature search

The database search returned 2220 records: PubMed ( n  = 1469), Cinahl ( n  = 527), PsycINFO ( n  = 173), and OpenGrey ( n  = 51) (Fig.  1 ). Records published before 01.01.2010 and duplicates were removed, which left 1280 records to be screened by title and abstract. Based on relevance, 1088 records were excluded and 192 records were found eligible for full-text assessment. In accordance with the inclusion and exclusion criteria, 111 articles were excluded. The excluded articles concerned study participants other than undergraduate healthcare students (graduates, RN-to-BSN students, trained health personnel), study participants from other healthcare disciplines (medicine, dentistry, midwifery), issues other than methods for teaching EBP (simulation teaching, community health nursing, EBP beliefs, etc.), and full-text articles not available in English, Danish, Norwegian, and Swedish (French, Chinese). In agreement with the other reviewers, 81 studies were finally included in the scoping review.

Modified PRISMA flow diagram illustrating the scoping review selection process

Study characteristics

Study characteristics are presented in Table  2 . All studies were spread across the years 2010–2018. Almost half of the studies ( n  = 40) were conducted in the USA, followed by Canada ( n  = 8), Norway ( n  = 7), Australia ( n  = 6), England ( n  = 6), Sweden ( n  = 3), China ( n  = 2), Finland ( n  = 2), Spain ( n  = 2), Greece ( n  = 1), Iran ( n  = 1), Lebanon ( n  = 1), Scotland ( n  = 1), and Taiwan ( n  = 1). The study designs were primarily qualitative ( n  = 55), while 23 of the studies were quantitative, and three of the studies used a mixed method. The majority of the participants were nursing students ( n  = 72), followed by a combination of nursing students and students from other healthcare disciplines ( n  = 5), nursing and physiotherapy students ( n  = 1), physiotherapy students and students from other healthcare disciplines ( n  = 1), occupational and physiotherapy students ( n  = 1), and physiotherapy students only ( n  = 1).

Study characteristics ( N  = 81)

Key methods for teaching EBP, the Sicily Statement’s five steps of teaching and conducting EBP and context

Table ​ Table3 3 presents the key methods for teaching EBP, the Sicily Statement’s five steps of teaching and conducting EBP, and the context. Seven key methods for teaching EBP were identified: Thirty-two studies described “Research courses and workshops”. “Collaboration with clinical practice” was identified 14 times followed by “IT technology” ( n  = 8), “Assignments” ( n  = 5), “Participation in research projects” ( n  = 5), “Journal clubs” ( n  = 2), and “Embedded librarians” ( n  = 2). In addition, 13 studies described various theories of teaching and learning. These are not elaborated on as the theme is not considered within the objective of this scoping review.

In Table ​ Table3 3 the vast majority of the studies ( n  = 69) referred to one or more of the Sicily Statement’s five steps of teaching and conducting EBP. Eleven studies referred to all five steps. Thirty-one studies referred to three or four steps, while 17 studies referred to two of the steps, and ten studies described one step. Twelve studies had no description of any of the steps.

The steps most often referred to were step two, three, and four. Step two, “Collect the most relevant evidence”, was mentioned in 58 studies. Step three, “Critically appraise the evidence”, was referred to in 55 studies, while step four, “Integrate the evidence with one’s clinical expertise, patient preferences, and values to make practice decision”, was mentioned in 51 studies. Step one, “Ask a clinical question”, and step five, “Evaluate change or outcome” was referred to in 36 and 14 studies, respectively. Seven out of the eleven studies referring to all of the Sicily Statement’s five steps were identified under the key methods “Research courses and workshops” and “Collaboration with clinical practice”.

The context in which the studies were conducted was primarily classroom settings ( n  = 52). Twenty studies described context as a combination of classroom and clinical practice, and nine studies were conducted in clinical practice.

Out of the 68 studies which included the seven key methods, 24 out of 32 “Research courses and workshops” were conducted in classrooms, while “Collaboration with clinical practice” was conducted in a combination of classroom and clinical practice ( n  = 6), clinical practice ( n  = 5), or classrooms ( n  = 3). “IT technology” was used in classrooms ( n  = 6) or clinical practice ( n  = 2). “Assignments” were conducted in classroom settings only ( n  = 5), while “Participation in research projects” took place in a combination of classroom and clinical practice ( n  = 3), classroom ( n  = 1) or clinical practice ( n  = 1). “Embedded librarians” ( n  = 2) and “Journal clubs” ( n  = 2) both took place in classroom settings.

This study provides an overview of existing EBP teaching methods including The Sicily Statement’s steps of teaching and conducting EBP with respect to undergraduate healthcare students both in classrooms and in clinical practice.

It is beyond the scope of this review to interpret all the findings of the included studies. The findings discussed below are the key methods most frequently identified in the thematic analysis: “Research courses and workshops” and “Collaboration with clinical practice”, as well as the key methods most positively referred to in main findings of the studies: “IT technology”, “Embedded librarians”, and “Journal clubs”. Despite the scarce use of the last three methods (“IT technology”, “Embedded librarians”, “Journal clubs”) these can however provide ideas for how to teach EBP in the future. Furthermore, the scoping review provides useful information as to which of the Sicily Statement’s five steps of teaching and conducting EBP are taught in the various methods and whether one particular method is more useful and applicable than others in a particular learning setting, depending on the context and the learning outcomes. Lecturers, senior lecturers and others who teach EBP at undergraduate healthcare educational institutions can benefit from this information and gain inspiration and ideas for teaching EBP. We are aware that other studies have addressed issues such as teachers’ competencies required for teaching EBP, which we do consider important in order to standardise and improve education in EPB. Interestingly, a study has identified specific sets of EBP core competencies for teachers, which are classified within the 5-step model of EBP [ 101 ]. However, since our primary focus was on methods for teaching EBP to undergraduate healthcare students the aspect of teacher’s competencies has not been further investigated.

Overall, the first 4 steps of the Sicily Statement could more easily be identified. However the last and fifth step proved to be more difficult to identify which often is the case. Furthermore, our results tend to point to the fact that the fifth step is often more theoretically linked at the undergraduate level and that a more specified implemtation and evaluation of the EBP process takes place at a more advanced level.

Research courses and workshops

Research courses and workshops were the most frequently used methods for teaching EBP. The frequent use of this method is in agreement with the systematic review by Kyriakoulis et al., where eight of the 20 methods for teaching EBP were research courses, workshops or similar sessions [ 10 ] and Young et al., where three out of five methods used for teaching evidence-based healthcare (EBHC) were workshops [ 2 ]. The majority of the studies concerning “Research courses and workshops”, referred to three or more of the Sicily Statement’s five steps of teaching and conducting EBP [ 10 , 23 , 26 , 31 , 33 , 40 , 42 , 44 , 47 – 49 , 53 , 55 – 57 , 59 , 76 , 90 , 91 , 96 , 97 , 100 ]. Despite the fact that the fifth step was included in some studies, it was not clear what was covered by the evaluation process, and additionally, if it was part of the students’ assignment work alone or if there was a link to clinical practice. The majority of the research courses and workshops were conducted in classrooms. According to Young et al., EBHC courses can improve appraisal skills in nurses, occupational therapists and physiotherapists, among others [ 2 ]. However, further assessments and analyses of the courses and workshops found in this scoping review must be made to ensure that the content and outcomes are applicable in similar contexts.

Collaboration with clinical practice

In this scoping review, the key method for teaching EBP, “Collaboration with clinical practice” was identified 14 times in the thematic analysis. In comparison, “collaboration with clinical practice” is only mentioned once as a method for teaching EBP in the review by Young et al. [ 2 ] and not mentioned in the systematic review by Kyriakoulis et al. [ 10 ]. The results of this scoping review suggest that collaboration with clinical practice is a frequently used method for teaching EBP with respect to undergraduate healthcare students. The rare use of this method in the review by Kyriakoulis et al. and the review by Young et al. might be explained by the type of participants included in these reviews. Only two studies included undergraduate students in the disciplines of nursing, physiotherapy or occupational therapy: in the review by Young et al. and the review by Kyriakoulis [ 2 , 10 ]. Along this line, a review on teaching EBM to medical students found weak and inconsistent results from a limited number of studies on the effect of clinically integrated methods on knowledge, attitudes, and skills [ 102 ]. Collaboration with clinical practice might be more fundamental among undergraduate students in the disciplines of nursing, physiotherapy or occupational therapy, compared to undergraduate students in medicine primarily included in the other reviews [ 2 , 10 ].

Half of the studies identified in relation to “Collaboration with clinical practice”, referred to four or five of the Sicily Statement’s steps [ 38 , 43 , 70 , 73 , 80 , 87 , 89 , 93 ]. In two of the studies, the steps were taught directly in clinical practice as part of the students’ clinical education [ 70 , 93 ], and unlike the research courses and workshops methods, the last step of evaluation of change or outcome is carried out either partly or entirely in a clinical context. The main findings of all eight studies indicate that collaboration with clinical practice is an effective way of teaching EBP, both with the combination of classrooms and clinical practice settings and in clinical practice settings alone. Despite being a recommended strategy in the literature, a recent literature review points to the fact that EBP teaching strategies including clinical activities in nursing students seems less prioritised [ 12 ].

IT technology

The key method, “IT technology”, described tools, such as mobile devices, video resources and websites, among others, used in classrooms or clinical practice for seeking information in relation to EBP. In clinical practice, mobile devices were used to seek information regarding EBP search strategies, critical appraisal of clinical guidelines [ 66 ], and specific task-oriented information in relation to clinical practice [ 36 ]. Despite the reported improvement in knowledge and skills in relation to EBP and appraisal of clinical guidelines, the use of mobile devices was reported as low [ 66 ]. In classrooms, the use of IT technology as a method for teaching EBP was reported as mainly positive. Today, most students have access to IT equipment and this technology could be integrated in classrooms and clinical practice to seek information regarding EBP. In the review by Kyriakoulis et al. the results support our findings; that IT technology can be an effective method for teaching EBP with respect to undergraduate healthcare students [ 10 ].

Journal clubs

“Journal Clubs” as a method for teaching EBP was only described in two studies in this scoping review. However, the findings indicated that the method improved students’ skills in reading articles and understanding evidence-based nursing [ 60 ], and promoted competenceis needed to deliver evidence-based care [ 58 ]. The studies included two and three steps, respectively, proposed by the Sicily Statement [ 3 ]. Additional steps may advantageously be incorporated into future journal clubs to ensure the quality of healthcare. Young et al. referred to four reviews describing a positive effect of journal clubs as a method for teaching EBP [ 2 ]. However, none of the reviews included Professional Bachelor Degree healthcare students. Further studies must be conducted to assess the effectiveness of journal clubs as a method for teaching EBP in Professional Bachelor Degree healthcare courses and to study the opportunity of incorporating all of the Sicily Statement’s five steps for teaching and conducting EBP.

Embedded librarians

In two studies librarians were introduced to teach students information literacy [ 74 , 77 ]. Librarians are experts in this field and are able to teach students the skills essential to EBP [ 74 ]. Librarians can support students in establishing and managing effective search techniques and help with reviewing and critiquing the information found. Thus, students develop information literacy skills as required in practice [ 77 ]. Research librarians who are embedded as part of a research course for teaching undergraduate healthcare students EBP may be an effective way of ensuring a complete introduction to the Sicily Statement’s five steps of teaching and conducting EBP. The first three steps can be taught in classrooms, followed by practical exercises in the last two steps in clinical practice.

Implications for practice

The majority of the key methods found for teaching EBP were “Research courses and workshops” and “Collaboration with clinical practice”, whereas “Journal Clubs” and “Embedded librarians” were identified only twice. The frequent use of research courses and workshops as methods for teaching EBP may stem from a tradition of classroom lectures and is a relatively manageable way to teach EBP. The findings from this scoping study however suggest that other methods for teaching EBP with respect to undergraduate students exist. Journal clubs could be incorporated as a supplement to classroom lectures or as part of collaboration with clinical practice. Librarians may advantageously be introduced in research courses and workshops. The librarians can help students gain control of EBP definitions and concepts, and master search techniques before entering clinical practice. The effect of journal clubs and embedded librarians on students’ EBP competencies should however be investigated further before being incorporated into Professional Bachelor’s Degree curricula.

EBP education based on the Sicily Statement’s five steps, demanded both internationally and nationally, implies an introduction to all of the Sicily Statement’s five steps of teaching and conducting EBP at undergraduate level [ 5 , 6 , 9 ]. At present, the majority of the methods found for teaching EBP only include 2–4 steps. In line with these results, a recent review found that the majority of evaluated EBP educational interventions are focused on a single step (step 3, critically appraising evidence) of the five steps of teaching and conducting EBP [ 103 ]. This research adds to the statement that an effort must be made to incorporate all five steps of the Sicily Statement in an educational and cooperative way in order to ensure that undergraduate healthcare students are qualified to work in an evidence-based manner.

We did not review available assessment methods for evaluation of EBP education interventions or programmes in this study. The additional importance of this field and the apparent lack of valid evaluation methods have been extensively highlighted in other studies and needs to be taken into account when applying methods for teaching EPB [ 104 , 105 ].

Strengths and limitations

The scoping review presents an updated overview of existing methods for teaching EBP with respect to undergraduate healthcare students, including study specific recommendations for teaching methods to be used in future curricula. It follows recommended guidelines for a priori design requirements and transparent reporting [ 13 , 16 ].

Limitations are however found in relation to the search strategy. Our search did not include literature published before 2010 and due to time constraints, a limited number of databases were searched, which entails the risk that not all relevant literature was identified. Furthermore, the search terms used identified primarily undergraduate nursing students, despite a thorough search for all undergraduate students in the disciplines of nursing, physiotherapy, occupational therapy, radiography, and biomedical laboratory science. Other search terms might have captured these health disciplines to a greater extent. An alternative explanation for the large occurrence of studies regarding nursing students could be that there is a greater publishing tradition in this field. However, the methods for teaching EBP can to a certain extent, be introduced to undergraduate students in the other health disciplines.

Consistent with our objective, this scoping review has provided an extensive overview of literature describing methods for teaching EBP regarding undergraduate healthcare students. The two key methods most often identified were “Research courses and workshops” and “Collaboration with clinical practice”. Despite the first method often being used in this scoping review, as well as in other reviews, fewer of the Sicily Statement’s five steps of teaching and conducting EBP were referred to, and if the fifth step of evaluation of change or outcome was included, the description of content was often unclear.

On the contrary, “Collaboration with clinical practice”, the second most used teaching method, more often referred to four or five steps, making this method an effective approach for teaching EBP while ensuring incorporation of several of the steps. Unlike the Research courses and workshop methods, the last step of evaluation is carried out partly or entirely in a clinical context.

Overall, our results tend to show that the evaluation step is often theoretically linked at the undergraduate level. Despite the small number of studies describing ‘Journal clubs’ and ‘Embedded librarians’, these teaching methods could advantageously be incorporated in the classroom context and could ensure a complete introduction to all five steps.

On the basis of our findings, we argue that future research should focus on identifying methods for teaching EBP that incorporate as many of the Sicily Statement’s five steps of teaching and conducting EBP as possible. Journal clubs and embedded librarians could be further looked into as methods to support the more established methods for teaching EBP across all undergraduate healthcare disciplines.

Acknowledgements

The authors would like to thank research assistants Morten Puck, Martin Mau and Susanne Pommergård for their valuable work in reviewing and editing tables.

Authors’ contributions

AST, HKK, CML contributed in designing the study. AST and AFC conducted the literature search. AST, HKK and CML screened the titles and abstracts. AST, HKK, CML extracted data from the studies. AST and HKK performed a synthesis of study results. AST, HKK, CML and AFC interpreted the data. CML and AST drafted the manuscript. All the listed authors have contributed to and approved the final manuscript.

This project is funded by internal funds granted by Health Sciences Research Centre, UCL University College, Odense, Denmark. The funding part had no role in the design of the study, the collection, analysis and interpretation of the data, or in writing the manuscript.

Availability of data and materials

Ethics approval and consent to participate.

Not applicable.

Consent for publication

Competing interests.

The authors declare that they have no competing interests.

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Contributor Information

Camilla Marie Larsen, Email: kd.lcu@2almc , Email: kd.lcu@almc .

Anne Seneca Terkelsen, Email: kd.lcu@etsa .

Anne-Marie Fiala Carlsen, Email: kd.lcu@acfa .

Hanne Kaae Kristensen, Email: kd.lcu@rkkh .

ORIGINAL RESEARCH article

Teaching reading: a case study through mixed methods.

• 1 Departamento de Didácticas Específicas, Universidad de la Laguna, San Cristóbal de la Laguna, Spain
• 2 Departamento de Psicología Evolutiva y de la Educación, Universidad de la Laguna, San Cristóbal de La Laguna, Spain
• 3 Departamento de Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain

The present study analyzes the relationship between teachers’ beliefs about learning to read, teaching practices, and discourse. To carry out this study, we benefited from the collaboration of six teachers in kindergarten and the first levels of primary education. First, an attribution questionnaire was used to analyze beliefs about learning to read ( Jiménez et al., 2015 ). Secondly, to study teaching practices, an observation tool was used ( Suárez et al., 2018 ). Thirdly, in order to know the opinion of teachers about how to teach reading, we adapted the instrument to assess teaching perspectives elaborated by Clark and Yinger (1979) . Finally, all the information was triangulated and analyzed using mixed methods. The results indicated that the relationship between beliefs, practices, and discourse is not always consistent. In all teachers, a relationship was found between some of their beliefs, practices, and discourse. At the level of beliefs, all teachers presented one predominant attributional profile, although to a lesser extent, their beliefs were also attributable to other learning theories. The results indicated that all the teachers carried out teaching practices associated with the different learning theories. Similarly to their discourse, all teachers showed diverse opinions about the learning processes involved in reading. These results indicate that teachers maintain eclectic approaches, both when they carry out activities in the classroom and when they think about learning to read.

Introduction

For almost three decades, research has documented the influence of teachers’ beliefs on educational practice ( Berthelsen and Brownlee, 2007 ; Kuzborska, 2011 ; Barrot, 2015 ). Teacher’s beliefs are thoughts, perceptions, and values about their roles as educators, education, and how students learn ( Vartuli, 2005 ). It has even been shown that if teachers are aware of their own beliefs, the repertoire of teaching skills can be increased ( Tracey and Mandel, 2012 ), leading to a change in classroom decision making, and teaching strategies and evaluation. If we want to achieve improvements in teaching, it is necessary to examine the teachers’ beliefs and modify them ( McAlpine and Weston, 2002 ). A great deal of research in this direction has shown that instructional events can be catalysts for changing beliefs ( Stevens, 2002 ; Theurer, 2002 ; Fazio, 2003 ), since beliefs are permeable mental structures susceptible to change ( Thompson, 1992 ), although there appears to be no consensus on this ( Block and Hazelin, 1995 ; Richardson, 1996 ).

More recent studies have provided us with more detailed information on how beliefs and implicit knowledge influence teachers’ instructional practices ( Cunningham and Zibulsky, 2009 ), actions, and strategies that they implement to teach reading in the classroom. The research carried out in this regard has focused on differentiating three traits appearing in the teaching and learning of reading. Thus, Tolchinsky and Ríos (2009) analyzed the relationship between what teachers say and do (2.250), teaching practice ( N = 2), and students’ knowledge ( N = 814). To do this, they used a self-report questionnaire of 30 questions, with high reliability (α = 0.81) and a Likert scale (0–6). Through a cluster analysis, they detected three differentiated profiles: instructional practices focused on teaching the names of letters, letter–sound relationships, as well as the importance of learning products; a situational approach to activities arising from classroom situations, where students look for the means to understand texts that they do not know; and multidimensional activities such as letter knowledge, recognition, and letter–sound association, as well as reading and writing work from situations that arise in the classroom. The results showed the following distribution: instructional (33.87%), situational (37.06%), and multidimensional (29.06%). Also, they found that 30% of the children were able to recognize unknown words and did not seem to have difficulty in mastering the code, and that teachers used explicit, early, and systematic teaching practices.

Also, in Spain, Barragán and Medina (2008) , analyzed the practices teachers use through questionnaires. They found significant differences depending on the profile and educational level. Thus, nursery/kindergarten teachers showed a higher profile of situational practices (50%), compared to elementary school teachers who showed a profile of instructional practices (70%). Subsequently, they analyzed the profile of practices according to geographical area, finding that the teachers who carried out the greatest number of situational practices were those of the Basque country, followed by teachers from Almería, Cantabria, Catalonia, and the Community of Madrid (more than 50%). Catalonia and Cantabria showed a lower frequency of instructional practices (less than 20%); however, the teachers from León and Asturias used these practices more frequently (more than 55%). The same authors also observed six Early Childhood Education classrooms in Almeria. The results showed a relationship between the declared belief profile and its practices in the classroom. In another study, Ríos et al. (2010) demonstrated the relationship between the knowledge learned and the practices in teaching reading of two Infant Education teachers. They found that the contents worked on by the teacher with a situational profile were reading and writing functions, identification of words in reading, and letter names and sound values.

The teacher with an instructional profile used word identification and word reading. In the study carried out by Baccus (2004) , a direct relationship was found between the teachers’ beliefs and the instructional time dedicated to the teaching of reading. In addition, Rapoport et al. (2016) focused on analyzing the beliefs that teachers maintain ( N = 144) regarding the contribution of executive functions in reading performance and their teaching practice. Their results showed a positive relationship between these two variables ( r = 0.512, p < 0.01).

Ethnicity has been another feature highlighted in studies assessing the dyad of beliefs and practices in teaching. The Center for the Improvement of Early Reading Achievement [CIERA] (2001) examined the beliefs and practices of 250 early childhood teachers. Their results showed a relationship between beliefs (based on the importance of the development of alphabetic knowledge, word recognition, stories, and oral language) and practices. Differences in relation to beliefs were found based on the ethnicity of teachers. African American teachers tended to believe that it was more important for the child to learn to read through teaching the alphabet (e.g., naming letters, saying their sounds), while white teachers thought it was more important for children to learn to read from teaching oral language activities (e.g., answering questions about a story or telling a story from a drawing). On the other hand, they found significant differences depending on the academic training received, so teachers with a higher academic level believed that teaching of oral language was more important, while teachers with lower academic levels did not share this belief.

Also, the report presented by the Teaching and Learning International Survey (TALIS) ( OCDE, 2009 ) provides detailed information on the development of variables involved in the teaching and learning process. This report analyzed the beliefs of secondary school teachers in several countries. Their results indicated that most countries (Northeastern Europe, Scandinavia, Australia, and Korea) showed constructivist positions ( p < 0.05). Humanities teachers presented more structured beliefs and were little oriented toward students ( p < 0.05), also with differences depending on teaching experience, so the teachers with more years of experience thought and performed more structured practices ( p < 0.05). The analyses also revealed a positive correlation between constructivist beliefs and practices in teachers from different countries ( p < 0.05), except in Korea, where a weak relationship was found between beliefs and practices with a direct style. Finally, they found that positioning depended largely on the quality of the learning environment and job satisfaction ( p < 0.05). In subsequent reports ( OCDE, 2013 ), an average 95% of OECD teachers stated that they agree with constructivist practices.

Other lines of research have not found a bidirectional relationship between the teachers’ thinking and their action in the classroom. An example is the study carried out by Miglis et al. (2014) with 90 Norwegian teachers. They used a 130-item questionnaire to measure beliefs (e.g., their role as teachers, the role of teachers in teaching reading, consistency with current research about the importance of early literacy) and teaching practices (e.g., books, book contents, alphabetic knowledge, phonological awareness, and reading and writing). They found that teachers reported moderately positive beliefs about their role as a teacher in their students’ reading success, and they “agreed” with the idea that research has found that early literacy is necessary. These beliefs were not related to their practices, since the time devoted to this type of instruction was minimal. However, they discovered that the most widely used practice was “shared reading and reading aloud for 10 min a day” (29.3%). There are numerous studies that have not found a relationship between these two variables ( Wilcox-Herzog, 2001 ). Thus, for example, through two teachers’ collaboration, Pérez-Peitx (2013) was able to observe classroom practices and analyze interviews. Their results also indicated that there was no relationship between these two variables. Along the same lines, another recent study ( Utami et al., 2019 ) based on socio-cognitive theory studied teacher beliefs and practices in reading comprehension tasks. They found that the practices were not always consistent with their beliefs.

To our knowledge, there is no research assessing the profile of the teacher and teaching practices, in relation to all the theoretical principles that govern the teaching and learning processes of reading (i.e., innatist, maturationist, corrective, repetition, sociocultural, constructivist, psycholinguistic approaches).

The objective of this study is to find out whether or not there is a relationship between the beliefs, practices, and discourse used in teaching reading in the classroom, in order to propose more effective teaching strategies.

Materials and Methods

The study was carried out from a mixed methods perspective, integrating qualitative and quantitative sources of information through “merge” ( Creswell and Plano-Clark, 2007 ). The proposed design was triangulation ( Morse, 2003 ; Creswell and Plano-Clark, 2007 ; Tashakkori and Teddlie, 2010 ; Anguera et al., 2012 , 2018 ; Creswell, 2014 ), which was found suitable for the aims. A direct observation of teaching reading practices was carried out. The observational study was configured based on three criteria: study’s units, temporality, and dimensionality ( Anguera et al., 2011 ). The observational design can be classified as Nomothetic/Follow-up/Multidimensional (N/F/M) ( Sánchez-Algarra and Anguera, 2013 ; Portell et al., 2015 ). Frequency was analyzed. In order to analyze the relationship between teacher’s beliefs, practices, and discourse, a Pearson’s correlation was carried out.

Participants

Six teachers with an age between 25 and 50 years participated. The teachers’ years of experience ranged from 10 to 35 years. They belonged to different Infant and Primary Education units on the island of Tenerife (Canary Islands, Spain). The selection criteria were based mainly on the fact that the staff member taught the subject Spanish Language and Literature, devoting an average time period of 1 h a day to the teaching of reading.

To carry out this study, three fundamental tools were used: a questionnaire to know the teachers’ beliefs, an observation tool to analyze their practices, and a semi-structured interview to analyze the teachers’ speech about teaching and learning to read.

– Questionnaire on Beliefs about Learning and Teaching Reading , composed of 60 items (see Suárez et al., 2013 ; Jiménez et al., 2014 , 2015 ) corresponding to the basic postulates of each learning theory: innatist, maturationist, sociocultural, constructivist, corrective, repetition, and psycholinguistic (see for review Tracey and Mandel, 2012 ). Teachers had to respond according to their degree of agreement or disagreement using a Likert scale of 0–10, where 0 means strongly disagree, and 10, strongly agree. Cronbach’s Alpha was 0.88.

Observation Tool on Reading Teaching Practices. This tool used here was developed by Suárez et al. (2018) and combines a field format and systems of categories. This consists of 14 criteria—alphabetic knowledge, phonological awareness, use of teaching resources, prior knowledge of children, reinforcement, feedback, modeling, direct instruction, guided oral instruction, extracurricular tasks, reading and writing, psychomotor skills, functional reading skills, and vocabulary—and 77 categories on practices in teaching reading. For the measurement plan, the results showed that the absolute and relative generalizability measures were acceptable (at 0.970 and 0.989) at 30 sessions and that 40 sessions were needed to reach 0.977 and 0.992, respectively. For the generalizability indexes to measure inter- and intraobserver reliability, a four-faceted SRC/O (Session, Criterion, Category/Observer) design was used, and analysis showed the greatest percentage of variability to be related to the Criterion facet (33%), while the Observer facet showed no variability at all. The absolute generalizability coefficient was 0.999, and the relative coefficient was also 0.999. With respect to the intra-rater reliability, using a four-faceted SRC/M (Session, Criterion, Category/Moment) design, analysis showed that 32% of variability corresponded to the Session facet and 33% corresponded to Criterion, while Moment showed no variability. The absolute and relative generalizability coefficients obtained for Observer 1 were both 0.999. The absolute and relative coefficients for Observer 2 were both 0.997, facet showed no variability at all. The absolute generalizability validity using a two-faceted model [Observation (2) and Criterion (74)] showed a value of 0.000 (absolute and relative validity).

– Four digital video cameras and Match Vision 3.0 software ( Perea et al., 2006 ) were used for the sessions to record teaching practices. Data quality was analyzed using the Generalizability Study (GT) version 2.0.E program ( Ysewijn, 1996 ) and the SAS 9.1 statistical package. Teacher discourse was analyzed using Atlas.ti 6.0 ( Friese, 2011 ).

– Structured Teacher Interview on Teaching Practices . We adapted the interview on teaching perspectives elaborated by Clark and Yinger (1979) , composed of 28 questions on aspects related to teaching and learning: general questions about teaching, daily classes, teaching and learning, curriculum, time, and teachers’ “philosophy.” Changes were included in the nomenclature of the subjects of the curriculum and in the section on teacher philosophy (F), where the questions were guided toward the field of reading (see Table 1 ).

Table 1. Interview adapted from Clark and Yinger (1979) .

– For the interviews, a video camera and two Panasonic recorders, model RR-US455 (with 66 h of recording capacity), were used to ensure safe information storage.

– To transcribe information, the program Naturally Dragon Speaking ( Baker, 1975 ), version 12 was employed, and Atlas.ti, version 6, for information analysis ( Friese, 2011 ).

Before the recordings were made, authorization was obtained from both the teachers and the pupils’ parents. All participants provided written informed consent prior to their participation. Likewise, a schedule was agreed on for when the study would be carried out. On the day indicated, the belief questionnaire was applied to the participating teachers, their doubts in this regard were clarified, and approximately an hour was spent to complete it. Seven recording sessions per teacher (twice a week for 1 h each day) led to total of 42 h of recording (see Suárez et al., 2018 ). The interviews were held with the participating teachers and recorded in classrooms devoid of noise. Cameras were located in front of each teacher, and the furniture was arranged in an interview layout. The interviews of the six teachers were recorded, each lasting approximately 1 h. The audio was later transferred to the computer for the literal transcription of the interviews. Subsequently, the available information was collated and all the material subject to data processing organized. To conclude this phase, each interview was reviewed to gain an overall impression of the information provided by each teacher.

In the next phase, the document was segmented and coded through the Atlas.ti 6.0 program. The data were processed using the thematic analysis technique, according to the proposal of Braun and Clarke (2006) . Initially, the hermeneutic units were defined according to the interview questions, taking into account the theories about learning to read. Subsequently, the primary documents were worked on and information segmented. In this case, we focused on words as well as phrases/sentences and texts. The relevant information was then selected, and these units were encoded. Later, we established code families composed of the different variables affecting teaching and its context. Teachers’ opinions about learning to read were categorized. The code families structured the relationship between the previously identified categories and theories on the learning of reading (e.g., innatist, maturationist, sociocultural, constructivist, corrective, repetitive, and psycholinguistic).

In order to classify each teacher according to his/her attributional profile, factor scores for each theoretical approach defined the teachers’ beliefs according to the percentiles (see Table 2 ).

Table 2. Teachers’ profiles in each theory in percentiles.

To determine which theory should be attributed most to each teacher, the score was set around the percentile ≥75, and to determine which theories fitted less, around percentile ≥50 (see Figure 1 ).

Figure 1. Example teacher F. profile.

Although all teachers were characterized by a predominant attributional profile that defined their particular beliefs, we found that their reading teaching behavior could also be attributed to any of the other theories to a lesser extent (see Table 3 ).

Table 3. Summary of teachers’ profiles.

Regarding teaching reading practices, it was found that the most used was feedback (praising or correcting the student), followed by the use of teaching resources (e.g., stories, songs, or poetry), direct instruction (e.g., individual–group reading, aloud or silent, with or without intonation, and fluency) and functional knowledge of reading (e.g., summary, questions, comprehension exercises). To a lesser extent, they used literacy activities, reinforcement through praise (e.g., tangible or verbal), reading and writing, and work on alphabetic knowledge.

The latter strategy indicated that teachers mostly referred to constructivist theory, except teacher M.C., who chose to position herself in psycholinguistic theory. Similarly, teacher F. emphasized that students should build their learning and that teachers should function as a guide. To a lesser extent, she commented on aspects of the maturation and behaviorist theory (see Figure 2 ). Teacher M. also focused on the foundations of constructivism (e.g., prior knowledge, children discover their learning). She also talked about the importance of psychomotor skills, correctness in reading, as well as the involvement of parents. Teacher C. commented that students learn through construction and must discover reading autonomously through the support offered by the teacher. She also emphasized the role that parents play in reading, the importance of resources, oral language work, phonological awareness, as well as maturity in the development of reading. Teacher M.C. placed greater emphasis on the development of phonological awareness and oral language to teach reading. However, teacher S. focused more on student autonomy in the learning process and to a lesser extent on oral language, use of resources, and correction during reading (feedback). Teacher I. focused mostly on the construction of learning and less so on the role of oral language and the use of resources (library).

Figure 2. Teacher F. Network summarizing key concepts associated with the teaching process.

Subsequently, the information was triangulated after analyzing the beliefs, practices, and discourse of the teachers. For this, several researchers who are experts in the learning and teaching of reading skills agreed on the following relationship, in accordance with the basic postulates of each of the theories considered (see Table 4 ).

Table 4. Triangulation between theoretical profile, teaching practices, and teacher discourse.

Then the teachers’ scores were compared in relation to their beliefs, teaching practices (in terms of frequency), as well as teacher discourse, previously analyzed through its categorization into teaching–learning processes and their context (see Table 5 ). Finally, the results were interpreted according to Pearson’s correlation analysis. The results showed a high correlation ( r = 0.72, p < 0.05) in teacher F. and in teacher I. ( r = 0.71, p < 0.05) and a negative and high correlation in teacher M. ( r = −0.81, p < 0.05) between beliefs and practices. Moreover, they showed a moderate correlation in teacher C. ( r = 0.52) and in teacher M. ( r = 0.45) between beliefs and discourse. Finally, the results showed a negative and high correlation in teacher I. ( r = −0.74, p < 0.05) and in teacher M.C. ( r = −0.76, p < 0.05) between practices and discourse.

Table 5. Percentages of teachers’ beliefs, reading practices, and discourse.

Teacher F. showed links between his theoretical profile and his practices. A relationship between corrective beliefs (27.8%) and practices (29.2%) was found. On the other hand, we observed that in his practices, he used activities associated with other theories: repetition (23.5%), constructivism (19.9%), and psycholinguistic (16%). This also happened when he thought about how children learn to read, since he considered that the construction of learning (77.8%), maturation (11.1%), and providing feedback (11.1%) were fundamental. Other discourse makers, teacher M. did not show a link between her sociocultural (22%) and maturationist (23.4%) theoretical profile and her practices (5.7% and 0.6%). However, the results indicated that her maturationist (23.4%), sociocultural (22%) beliefs were related only to her discourse. So, she thought that the use of psychomotor skills (21.4%), teaching resources such as stories, stories, poems, and texts (14.3%), and teaching previous knowledge (50%) were important. However, practices based on other currents were observed: corrective reading (32.6%) and repeated reading (25.2%), as well as constructivism (19.1%), such as working previous knowledge or reading and writing and psycholinguistic skills (16.6%) [e.g., alphabetic knowledge: teaching letter names and sounds, rules with support rhymes, etc.; phonological awareness: stimulating children to become aware of letter sounds, saying words that begin with a certain sound, separating words into syllables, playing the game veo-veo (I spy.); vocabulary: teaching the meaning of words]. During the interview, opinions related to other theories were also found (i.e., corrective).

As for teacher C., there was a bidirectional relationship between her sociocultural theoretical profile (39.6%) (e.g., use of teaching resources such as stories, songs, writings from different sources, etc.) and her discourse (33.3%). Also, it was found that her psycholinguistic profile (28.9%) was related to her discourse (11.1%) (e.g., oral language or phonological awareness). However, the results indicated that this teacher carried out other practices not related to her theoretical beliefs, such as: feedback (50.8%) and repetition (16.9%). The same occurred with her discourse; she thought that maturation was also important (22.3%).

Regarding teacher M.C., a negative relationship was found between her psycholinguistic discourse (59.3%) and her teaching practices (4.1%). The same happened with her corrective practices (37.6%) and her discourse (14.8%) (e.g., correct when the child is wrong, point out, provide examples, deny). However, when we analyzed her practices, we found activities justified by other theories, such as functional knowledge of reading or use of teaching resources (13%) or repetition (19.6%) and constructivism (13%) (e.g., previous reading and writing, and likewise when we asked her opinion about how children learn to read (e.g., constructivism).

Regarding teacher S., she showed a corrective (17.6%), innatist (17.6%), sociocultural (17.6%), maturationist (16.6%), and constructivism (15.3%) profile. Then, she carried out corrective (35.1%) practices (e.g., feedback, direct instruction). During her discourse, opinions were also found that were constructivist (47.9%) and psycholinguistic (20%). Nevertheless, repetition practices (36%) were observed that had nothing to do with her expressed beliefs.

A relationship was found between the constructivism profile (23%) of teacher I. and her practices (19.3%). Then the result showed a relationship between corrective (12.6%) and repetitive (12.6%) beliefs and practices. Furthermore, this teacher used other practices unrelated to any of her attributed beliefs, such as: sociocultural (10.6%). No relationship between corrective (23%) and repetition (25.3%) practices and discourse were found. In the same way, she referred to the implication of other (e.g., sociocultural and psycholinguistic) theories in infant readers’ learning. The innatist profile of teacher I. was not related to her practices or discourse.

The results of the present study are congruent with previous study results that showed that teachers hold eclectic positions ( Clemente, 2008 ; Jiménez and O’Shanahan, 2008 ; Clemente et al., 2010 ; Rodríguez and Clemente, 2013 ). Other research has shown quite different results, from studies finding a relationship between beliefs and teaching practices in reading learning ( Cunningham and Zibulsky, 2009 ; Tolchinsky and Ríos, 2009 ; Rapoport et al., 2016 ) to studies which indicated a moderate correlation ( Baumann et al., 1998 ). On the opposite side, other authors found no such relationship ( Pérez-Peitx, 2013 ; Miglis et al., 2014 ; Enyew and Melesse, 2018 ; Utami et al., 2019 ).

The data extracted from the belief questionnaires have been complemented with the analysis of teaching practices and each teacher’s interviews, which allowed us to provide additional information ( Castañer et al., 2013 ). In our case, the interview helped us complete the teacher’s profile. We found that the teaching and learning processes are mediated by multiple contextual variables that were not identified by the questionnaire or recorded observations.

Analysis of the practices allowed us to identify not only what activities the teachers performed in their real teaching context but also how their sequence of instruction was oriented in all cases toward the use of their own multiple resources, applying other theories. The relationship found between some beliefs and practices in this study suggests that if teachers are aware of their own beliefs, the repertoire of teaching practices can be increased ( Tracey and Mandel, 2012 ), causing changes in decision making in the classroom and in teaching and evaluation strategies. In addition, as all teachers used many activities characteristic of other theories they did not explicitly hold, we focused on the opposite process, modifying their practices to cause a change in their beliefs ( Fazio, 2003 ), since these are permeable mental structures that can be modified ( Thompson, 1992 ). But how can we achieve this? Some studies confirm that people form their implicit theories through the knowledge they acquire ( Suárez and Jiménez, 2014 ).

The first step is to achieve the teacher’s predisposition to change, always through invitation ( Baena, 2000 ), by encouraging reflection. To do this, they should become aware how their own beliefs are involved in their teaching practice and how they influence student performance. In addition, the false myths about learning to read and teaching practices should be recognized, as prescribed by the National Reading Panel [NRP] (2000) . The question remains whether teachers have received training based on the latest advances in scientific research on the teaching of reading, in order to provide young students (who may or may not have difficulties) with the tools necessary for their learning to proceed optimally.

Online training offers teachers the opportunity to recycle their knowledge ( Costi et al., 2005 ; Jiménez, 2015 ; Jiménez et al., 2015 ; Jiménez and O’Shanahan, 2016 ), which generates an important pillar supporting success, integration, and sustainability in education ( Haydon and Barton, 2007 ; Somekh, 2008 ). It is also an alternative solution to the lack of time and difficulties in reconciling work and family life. It has been found that experience with these resources plays a fundamental role, since it favors a positive attitude of teachers and also confidence in the use of these tools for education ( BECTA, 2009 ). Joshi et al. (2009) found that the training teachers receive is inadequate because textbooks and courses in education reflect superstitions, anecdotes, and beliefs that are not based on scientific evidence. Research has also found that teachers do not properly use the practices that are based on scientific evidence ( Moats, 2009 ). If the learning environment is effective, it can even happen that only a small percentage of students present difficulties in learning to read ( Cunningham and Zibulsky, 2009 ).

The updating of knowledge according to research conclusions is proposed as an alternative for teachers who specialize in teaching reading, since teaching quality is one of the main factors determining the academic success of students ( European Council, 2008 ). For teachers to learn good practices, it is important that they have the following knowledge at their disposal: (1) fundamental research and theories about the development of language and reading; (2) strategies for use in the classroom to teach word recognition, vocabulary, text comprehension, and fluency; (3) tools to work on reading and writing at the same time; (4) the best strategies to teach reading and the materials to use; (5) different techniques for student evaluation; (6) how to maintain a good balance between theory, practice, and information technologies; (7) knowledge of dyslexia and other learning disorders ( IRA, 2007 ); and (8) how to interpret and administer assessment tests to plan teaching ( IDA, 2010 ). In addition, they must learn to ask more complex questions to help students make inferences and more elaborate reflections, as well as work with students’ prior knowledge ( RAND, 2002 ). However, the teacher alone should not be responsible for this process, because we have confirmed that in the teaching environment, there are other strong factors such as society or culture ( Quintana, 2001 ). The challenge now consists of achieving a change in the ways of thinking of those responsible for educational administration. The necessary means should also be provided to facilitate refresher courses and ongoing e-learning for teachers, with training programs that include content based on scientific evidence. One limitation is that the study consisted of six teachers and is not generalizable to a greater audience.

In general terms, we can conclude that the relationship between beliefs, practices, and discourse varies according to certain nuances. Thus, of the two beliefs attributed to teacher F., only one (corrective) was related to his form of instruction and his opinion. Among the four beliefs attributed to teacher M. (sociocultural, maturationist, repetition, and psycholinguistic), a relationship was found only between her maturationist and sociocultural profile and her discourse. Both beliefs attributed to teacher C. (sociocultural and psycholinguistic) were related to the discourse content. Of the two beliefs attributed to teacher M.C. (corrective and psycholinguistic), neither of them was related to her actions and reflections. Among the five beliefs attributed to teacher S. (sociocultural, innatist, corrective, maturationist, and constructivist) only two (corrective and sociocultural) were related to her active practices and discourse comments. Finally, of the two beliefs of teacher I. (innatist and constructivist), only constructivism was related to her practices or her opinion.

Although it is true that a relationship was found in all the teachers between some of their beliefs, practices, and discourse, as revealed in their discursive talks, all the teachers thought that learning to read depended on factors underlying other theories not related to their attributional profile. Therefore, despite attributing to them certain beliefs when they teach children to read and when they think of learning to read, it can be concluded that all teachers maintain an eclectic approach.

Data Availability Statement

All datasets generated for this study are included in the article/supplementary material.

Ethics Statement

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

Author Contributions

NS: this author’s grant was used to run the project Integrando creencias y prácticas de enseñanza de la lectura (Integrating beliefs and practices about teaching reading), ref: PSI2009-11662. She participated actively in the research, analyzed the teaching practices and discourse, and was responsible for the literature review and drafting of this manuscript. JJ: supervised the project and the preparation of the study, offered theoretical guidance, and was responsible for reviewing the manuscript. CS: supervised the design and preparation of the study, offered guidance on methodology, and helped review the manuscript. All authors approved the final version of this article.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

This research has been funded through the Plan Nacional I + D + i (R+D+i National Research Plan of the Spanish Ministry of Economics and Competitiveness), project ref: PSI2009-11662 and project ref: PSI2015-65009-R, with the second author as the principal investigator. We also gratefully acknowledge the support of a Spanish Government subproject, Integration ways between qualitative and quantitative data, multiple case development, and synthesis review as main axis for an innovative future in physical activity and sports research (PGC2018-098742-B-C31) (2019–2021) (Ministerio de Ciencia, Innovación, y Universidades/Agencia Estatal de Investigación/Fondo Europeo de Desarrollo regional), that is part of the coordinated project New approach to research in physical activity and sport from a mixed methods perspective (NARPAS_MM) (SPGC201800 × 098742CV0).

Key Concepts

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Keywords : beliefs, teaching practices, reading, teacher discourse, triangulation, mixed methods

Citation: Suárez N, Jiménez JE and Sánchez CR (2020) Teaching Reading: A Case Study Through Mixed Methods. Front. Psychol. 11:1083. doi: 10.3389/fpsyg.2020.01083

Received: 30 November 2019; Accepted: 28 April 2020; Published: 10 June 2020.

Reviewed by:

Copyright © 2020 Suárez, Jiménez and Sánchez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Natalia Suárez, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Research paper Teaching methods

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Karthick Kumar

Imtiaz Ahmad Warraich

ABSTRACT: The present research examines the different teaching strategies especially among the graduated students. This research focuses on the different teaching strategies and how can these types affected on the students. The study examines the effectiveness of the different strategies among graduated students. The main objective of this research is to explore the different teaching strategies, who much they are different from each other and what’s the linkage between the different teaching strategies. Because researcher objective to examined the effectiveness on the graduated students. That’s why the universe for this research consisted of all the graduated students of Multan in Pakistan. Then the target population of the present research was the students of Bahauddin Zakariya University, Multan. For this research, 800 respondents were selected through the convenient sampling technique from the different department of the Bahauddin Zakariya University, Multan. Relationship among variables and statistical analysis was done through SPSS Software. Chi square test was used to find out the association between the teaching technique and its effectiveness. The main finding of this research is that different teaching strategies raise the level of interest of learners. Teacher should make their teaching style more interesting and challenging for the students. For this purpose teacher can take help from the different teaching strategies. Different students come from the different culture and linguistic background. That’s why no single strategy is effective for the entire learner and adopt such a technique that is effective for all the students. KEYWORDS: Sociological, Effectiveness, Teaching Strategies, Graduated Students, learning techniques.

adeel ur rehman

Progression of Global Strategies in Indian Business.

Thomas M Walter

Teaching is successful only to the extent to which students are able to grasp it fully. In this age of science and technology, the process of teaching has reached new dimensions. Teaching is not a one sided affair. In the context of modern developments, teaching is a tripolar process. The traditional teaching 30 or 40 students is no longer effective. Information explosion and propulsion explosion are bringing about changes in both developed and developing countries. The teaching practices in our universities continue to be the same. The method of teaching links the teacher and his pupils into an organic relationship with constant mutual interaction. The methods that could be followed for different levels of students discussed in this article are: play way method, Dalton’s plan, project method, Heuristic method, seminar method, demonstration method.

Prof.Dr.Suaad AL-Taai

Teaching is a science that has its origins and rules, and it can be observed, measured, evaluated and then trained on its skills. And raising the efficiency of the teacher using teaching methods and methods leads to raising the efficiency of public education, including the research aspects in it. The study of modern trends and teaching methods is one of the important studies that has received the attention of researchers and scholars due to its educational importance in the field of teaching and education. Teaching methods have varied and varied, and each method has its own rules, advantages, and steps. The research covered the most prominent teaching methods such as the lecture, the hot chair, brainstorming, exploration, and investigation. The research shed light on the most prominent reasons for choosing the appropriate method of teaching, taking into account the individual differences and the topic of the lesson and its importance.

Mohammed E A Mohammed

Abstract: From biochemical education point of view, it is so difficult to make the biochemistry more interesting by adopting one teaching method. The aim of this article is to investigate the perceptions of the undergraduate students of the department of chemistry at king Khalid university about three teaching methods; lectures, practical and problem based learning sessions. A second objective is to compare the students perceptions to their performance in three different exams depending on the information gained from the three teaching methods. 63 students were registered for the basic biochemistry course at the faculty of science- King Khalid University. At the end of the course and before the final exam, the students perceptions about the three teaching methods were investigated through a simple questionnaire composed of four best answer Questions. However, 59 students responded to the questionnaire. The questionnaire was analyzed and its results were compared to the students performance results in the three different final exams. Regarding the students perceptions about the three teaching methods; 22 students (37.3%)stated that the practical sessions were the best teaching method for them followed by the problem based learning sessions (19, 32.2%), 7 students (11.9%) preferred the lectures while 11 students (18.6%) expressed that the three teaching methods were not their favorite methods. Concerning the recalling of the information; 24 (40.6%) expressed that the information of the problem based learning sessions was easy to recall and difficult to forget followed by the information of the practical sessions (17, 28.8%) and lectures (9, 15.3%)and 9 (15.3%) stated the information of all the three methods was difficult to recall and easy to forget. The performance of the students in the final exams and their perceptions were comparable since the success percentage in the practical and problem based learning sessions and lectures were 95.2%, 82.5% and 82.5% respectively. Although the practical and the problem based learning sessions were the best teaching methods for the bulk of the students (41, 69.5%), it is better to follow more different teaching methods to satisfy the majority of the students and to obtain better student performance.

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Building Transdisciplinary SoTL: Creating a Culture and Language of Listening and Learning for Understanding

• Marian McCarthy University College Cork

This paper explores a range of metaphors and methods (Shulman, 2012) that have impacted the development of SoTL across the disciplines at our university. Given that faculty are spread across approximately 60 disciplines and four Colleges at UCC, it is important to figure out how we can communicate effectively about how we teach and how our students learn. A number of research questions are central to the paper: How can faculty talk about teaching and learning effectively across the disciplines if the latter work primarily in specific ways? How can we find an overarching language that facilitates transdisciplinary dialogue, communication and critique? Some of Shulman’s questions are also central regarding the nature of the discourse on teaching and learning, how it has changed and how it challenges the discipline.

SoTL does not develop accidentally, overnight. We have trod a SoTL pathway for over 20 years and can identify certain methods and metaphors that have led the way. The latter provide historical and cultural clues that beget a scholarly approach. SoTL itself provides methods that are at once processes of documentation and investigation, found in its portfolio genres, for example. The paper will explore these research methods, as well as the pedagogical methods central to Teaching for Understanding and Disciplinary Understanding on which we have drawn in our professional development accredited programs over many years. Our findings suggest that it is possible to develop a robust language of theory and practice across the disciplines that advances teaching and learning within and beyond the disciplines.

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ChatGPT for Teachers

Trauma-informed practices in schools, teacher well-being, cultivating diversity, equity, & inclusion, integrating technology in the classroom, social-emotional development, covid-19 resources, invest in resilience: summer toolkit, civics & resilience, all toolkits, degree programs, trauma-informed professional development, teacher licensure & certification, how to become - career information, classroom management, instructional design, lifestyle & self-care, online higher ed teaching, current events, 5 methods to teach students how to do research papers.

When teaching students how to construct research papers, the scaffolding method is an effective option. This method allows students to research and then organize their information. The scaffold provides understandable support for expository papers. Students greatly benefit from having the majority of the research and proper structure in place before even starting the paper.

With well-prepared references, students are able to:

• Study informational text
• Practice strategies that are genre-specific for expository writing
• Use an inquiry-based approach
• Work individually
• Work collaboratively

The following tips and methodologies build off the initial preparation:

• Students formulate a logical thesis that expresses a perspective on their research subject.
• Students practice their research skills. This includes evaluating their sources, summarizing and paraphrasing significant information, and properly citing their sources.
• The students logically group and then sequence their ideas in expository writing.
•  They should arrange and then display their information on maps, graphs and charts.
• A well-written exposition is focused on the topic and lists events in chronological order.

Formulating a research question

An example research paper scaffold and student research paper should be distributed to students. The teacher should examine these with the students, reading them aloud.

Using the example research paper, discuss briefly how a research paper answers a question. This example should help students see how a question can lead to a literature review, which leads to analysis, research, results and finally, a conclusion.

Give students a blank copy of the research paper Scaffold and explain that the procedures used in writing research papers follow each section of the scaffold. Each of those sections builds on the one before it; describe how each section will be addressed in future sessions.

Consider using Internet research lessons to help students understand how to research using the web.

Have students collect and print at least five articles to help them answer their research question. Students should use a highlighter to mark which sections pertain specifically to their question. This helps students remain focused on their research questions.

The five articles could offer differing options regarding their research questions. Be sure to inform students that their final paper will be much more interesting if it examines several different perspectives instead of just one.

Have students bring their articles to class. For a large class, teachers should have students highlight the relevant information in their articles and then submit them for assessment prior to the beginning of class.

Once identification is determined as accurate, students should complete the Literature Review section of the scaffold and list the important facts from their articles on the lines numbered one through five.

Students need to compare the information they have found to find themes.

Explain that creating a numbered list of potential themes, taken from different aspects proposed in the literature collected, can be used for analysis.

The student’s answer to the research question is the conclusion of the research paper. This section of the research paper needs to be just a few paragraphs. Students should include the facts supporting their answer from the literature review.

Students may want to use the conclusion section of their paper to point out the similarities and/or discrepancies in their findings. They may also want to suggest that further studies be done on the topic.

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Artificial intelligence is rapidly transforming education, in both worrisome and beneficial ways. On the positive side of the ledger, new research shows how AI can help improve the way instructors engage with their students, by way of a cutting-edge tool that provides feedback on their interactions in class.

The M-Powering Teachers tool provides feedback with examples of dialogue from the class to illustrate supportive conversational patterns. Click on image to enlarge. (Image credit: Courtesy Dora Demszky)

A new Stanford-led study , published May 8 in the peer-reviewed journal Educational Evaluation and Policy Analysis, found that an automated feedback tool improved instructors’ use of a practice known as uptake, where teachers acknowledge, reiterate, and build on students’ contributions. The findings also provided evidence that, among students, the tool improved their rate of completing assignments and their overall satisfaction with the course.

For instructors looking to improve their practice, the tool offers a low-cost complement to conventional classroom observation – one that doesn’t require an instructional coach or other expert to watch the teacher in action and compile a set of recommendations.

“We know from past research that timely, specific feedback can improve teaching, but it’s just not scalable or feasible for someone to sit in a teacher’s classroom and give feedback every time,” said Dora Demszky , an assistant professor at Stanford Graduate School of Education (GSE) and lead author of the study. “We wanted to see whether an automated tool could support teachers’ professional development in a scalable and cost-effective way, and this is the first study to show that it does.”

Promoting effective teaching practices

Recognizing that existing methods for providing personalized feedback require significant resources, Demszky and colleagues set out to create a low-cost alternative. They leveraged recent advances in natural language processing (NLP) – a branch of AI that helps computers read and interpret human language – to develop a tool that could analyze transcripts of a class session to identify conversational patterns and deliver consistent, automated feedback.

For this study, they focused on identifying teachers’ uptake of student contributions. “Uptake is key to making students feel heard, and as a practice it’s been linked to greater student achievement,” said Demszky. “But it’s also widely considered difficult for teachers to improve.”

Dora Demszky is an assistant professor at Stanford Graduate School of Education. (Image credit: Courtesy Stanford GSE)

The researchers trained the tool, called M-Powering Teachers (the M stands for machine, as in machine learning), to detect the extent to which a teacher’s response is specific to what a student has said, which would show that the teacher understood and built on the student’s idea. The tool can also provide feedback on teachers’ questioning practices, such as posing questions that elicited a significant response from students, and the ratio of teacher/student talk time.

The research team put the tool to work in the Spring 2021 session of Stanford’s Code in Place , a free online course now in its third year. In the five-week program, based on Stanford’s popular introductory computer science course, hundreds of volunteer instructors teach basic programming to learners worldwide, in small sections with a 1:10 teacher-student ratio.

Code in Place instructors come from all sorts of backgrounds, from undergrads who’ve recently taken the course themselves to professional computer programmers working in the industry. Enthusiastic as they are to introduce beginners to the world of coding, many instructors approach the opportunity with little or no prior teaching experience.

The volunteer instructors received basic training, clear lesson goals, and session outlines to prepare for their role, and many welcomed the chance to receive automated input on their sessions, said study co-author Chris Piech , an assistant professor of computer science education at Stanford and co-founder of Code in Place.

“We make such a big deal in education about the importance of timely feedback for students, but when do teachers get that kind of feedback?” he said. “Maybe the principal will come in and sit in on your class, which seems terrifying. It’s much more comfortable to engage with feedback that’s not coming from your principal, and you can get it not just after years of practice but from your first day on the job.”

Instructors received their feedback from the tool through an app within a few days after each class, so they could reflect on it before the next session. Presented in a colorful, easy-to-read format, the feedback used positive, nonjudgmental language and included specific examples of dialogue from their class to illustrate supportive conversational patterns.

The researchers found that, on average, instructors who reviewed their feedback subsequently increased their use of uptake and questioning, with the most significant changes taking place in the third week of the course. Student learning and satisfaction with the course also increased among those whose instructors received feedback, compared with the control group. Code in Place doesn’t administer an end-of-course exam, so the researchers used the completion rates of optional assignments and course surveys to measure student learning and satisfaction.

Testing in other settings

Subsequent research by Demszky with one of the study’s coauthors, Jing Liu, PhD ’18, studied the use of the tool among instructors who worked one-on-one with high school students in an online mentoring program called Polygence . The researchers, who will present their findings in July at the 2023 Learning at Scale conference, found that on average the tool improved mentors’ uptake of student contributions by 10%, reduced their talk time by 5%, and improved students’ experience with the program as well as their relative optimism about their academic future.

Demszky is currently conducting a study of the tool’s use for in-person, K-12 school classrooms, and she noted the challenge of generating the high-quality transcription she was able to obtain from a virtual setting. “The audio quality from the classroom is not great, and separating voices is not easy,” she said. “Natural language processing can do so much once you have the transcripts – but you need good transcripts.”

She stressed that the tool was not designed for surveillance or evaluation purposes, but to support teachers’ professional development by giving them an opportunity to reflect on their practices. She likened it to a fitness tracker, providing information for its users’ own benefit.

The tool also was not designed to replace human feedback but to complement other professional development resources, she said.

Along with Dora Demszky, Jing Liu, and Chris Piech, the study was co-authored by Dan Jurafsky , a professor of linguistics and of computer science at Stanford, and Heather C. Hill, a professor at the Harvard Graduate School of Education.

Media Contacts

Dora Demszky, Stanford Graduate School of Education: [email protected]

Carrie Spector, Stanford Graduate School of Education: [email protected]