Nurse Education Today 35 (2015) 782–788
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Nurse Education Today journal homepage: www.elsevier.com/nedt
Applying Technological Pedagogical and Content Knowledge (TPACK) model to develop an online English writing course for nursing students Hung-Cheng Tai a, Mei-Yu Pan b, Bih-O Lee b,⁎ a b
Department of General Education, Chang Gung University of Science and Technology, Chia-Yi Campus, Taiwan Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi Campus, Taiwan
a r t i c l e
i n f o
Article history: Accepted 18 February 2015 Keywords: TPACK model Writing learning Nursing students Nursing education
s u m m a r y Background: Learning English as foreign language and computer technology are two crucial skills for nursing students not only for the use in the medical institutions but also for the communication needs following the trend of globalization. Among language skills, writing has long been ignored in the curriculums although it is a core element of language learning. Objectives: To apply the TPACK (Technological Pedagogical and Content Knowledge) model to design an online English writing course for nursing students, and to explore the effects of the course to the students' learning progress as well as their satisfactions and perceptions. Research Methods: A single-group experimental study, utilizing the CEEC (College Entrance Examination Center) writing grading criteria and a self-designed course satisfaction questionnaire, is used. Fifty one nursing students who were in their first/four semesters of the two year vocational pre-registration nursing course in a Taiwan university were selected using convenience sampling. Data Analysis Methods: Quantitative data were analyzed using descriptive statistics and repeated measure MANOVA. Qualitative data were analyzed by content analysis. Results: Students' writing competence had been improved significantly in every dimension after the instruction. Only half of the learners preferred online writing compared to the traditional way of writing by hand. Additionally, participants reported that they would prefer to receive feedback from the teacher than peers, yet they did not like the indirect feedback. The teacher perceived the course as meaningful but demanding for both learning and teaching sides. To implement the peer review activities and give feedback on time were two major challenges during the cycles. Conclusions: The TPACK model suggests a comprehensive and effective teaching approach that can help enhance nursing students' English writing performance. Teachers are advised to consider its implementation when designing their syllabus. © 2015 Elsevier Ltd. All rights reserved.
Introduction Following the trend of globalization and the advancement of information and communication technology (ICT), English as foreign language (EFL) and ICT competence have become two necessary skills in the clinical settings for the nursing students as well as practitioners. They have been emerging as two prominent issues in the education field for decades. However, EFL and ICT seem yet to be well discussed in the nursing education individually, not to mention the combination of the two skills. There is a growing recognition at tertiary level in Taiwan that improving university learners' EFL abilities is essential.
⁎ Corresponding author at: Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi Campus, No2, Chia-Pu Road, West Sec., Putz, Chia-Yi County 61363, Taiwan. Tel.: +886 05 3628800x2503; fax: +886 06 2568641. E-mail addresses: [email protected] (H.-C. Tai), [email protected] (M.-Y. Pan), [email protected] (B.-O. Lee).
http://dx.doi.org/10.1016/j.nedt.2015.02.016 0260-6917/© 2015 Elsevier Ltd. All rights reserved.
License obtained from the General English Proficiency Test (GEPT), a popular local language test based on pass or fail criterion, has been commonly required as graduation threshold since 2005. The GEPT assesses whether examinees' four language skills – listening, reading, speaking, and writing – achieve the standard. This GEPT policy has become core educational goal leading to the design of school curricula and has guided EFL instructions. Technology is gradually becoming ubiquitous in education, and there is increasing evidence that technology, when properly infused and integrated into teaching and learning, has a significant positive effect on student's learning (Schrum et al., 2007). In the research context, ICT seems to be able to provide a cyber space to conduct alternative writing instructions overcoming the restrictions of curriculum, syllabus, session times, and classroom interactions. While before applying technologies, quite a few stumbling blocks may be encountered to the use and integration. One difficulty is the lack of both technological and pedagogical training for teachers and faculty (Bennett, 2004; Ertmer,
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2003). Research has shown that college teachers tend to be wellequipped with respect to content knowledge in their specific disciplinary areas, but often lack pedagogical skills and thus do not teach effectively (Clarke and Hollingsworth, 2002; Jang and Chen, 2010). Although it seems all of the resources are already available there, however, language teachers may still feel confused and frustrated about how to integrate and/or coordinate these elements. There has been growing interest in the design and implementation of teacher and faculty professional development theories or methods with which to assist teachers to advance in their teaching practice and to improve student learning (Garcia and Roblin, 2008).
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However, though the TPACK application is increasingly drawing attention from educational researchers, it seems that it has been discussed neither in the field of healthcare professional education nor in the EFL writing training. In this study, the framework was utilized, specifically addressed TPACK development venue situated within a university environment, along with the implementation of a writing skill training program. The TPACK model was applied to design an online collaborative writing training course for nursing students needing to learn English writing skills in a nursing university in southern Taiwan. The Study
Background Objectives Nursing students currently in the vocational system in Taiwan receive five-year nursing training in college after graduating from junior high school (grade 9), and then pursue two-year advanced learning in a nursing university. In general, even those in top universities such as in this research context, do not learn English language as intensive as those studied in the senior high school and academic oriented universities. Although nursing students have studied the English language for at least 8 years before entering university (3 years in junior high schools (4–5 h/week) and 5 years during nursing training (2–3 h/week)), many have never learned English composition as there was no such class embedded in their official curriculums. The students can thus be seen as novice writers prior to the commencement of writing instruction. In the clinical settings, English language is a major communication medium between professionals from medical recorders, doctor's orders, to nursing notes. EFL writing, an ultimate output technique requiring comprehensive instructions and competence, is crucial in healthcare professions. Given the importance of EFL writing skills, it has long been ignored in the vocational system of nursing education — neither required in the curriculum nor provided enough lecture times to teach and learn. Literature Review A comprehensive instruction framework, TPACK model proposed recently by the educational researchers, may offer a promising perspective for technology facilitated learning. In contrast to the merely instrumental view and technological skill acquisition on the learner's end, the current issue of technology (T) in teaching and learning emphasizes the connections and interactions between and among content knowledge (CK) (Mishra and Koehler, 2006). Yet this TCK alone was criticized for its weakness in the inability of adequately addressing the consideration of professional development of college faculty with respect to teaching. Rather, a newly revised theoretical framework – technological pedagogical content knowledge (TPCK) (Koehler and Mishra, 2008) – was renamed as TPACK for the sake of easy remembering. It designates an integrated description for three kinds of knowledge: technology, pedagogy, and content, and is expected to be able to accommodate the educational requisition in the digital age (Thompson and Mishra, 2007). While the first generation TPACK work focused upon defining and conceptualizing the constructs of TPACK, more recent work has concentrated on using the construct in both research and development projects. The latest research and development projects have been directed toward measuring the level of teacher self-assessed TPACK (Archambault and Crippen, 2009; M. Lee and Tsai, 2010; Schmidt et al., 2009), revealing the processes and interactions related to technology-based teaching. More research in different subjects are also progressing, for example, pre-service Science teachers' training (Jang and Chen, 2010), Environmental Chemistry learning (Çalik et al., 2014), Physics subject (Chang et al., 2014), Mathematics and Science teaching (Syh-Jong Jang and Tsai, 2012), and Geography course (Doering et al., 2014), etc.; and most results recognized the significance of this model.
Three aims of this study are: (1) to assess the effectiveness of the TPACK model based writing training program contributing to learners' learning outcome; (2) to investigate the learners' perceptions and satisfactions about the TPACK model based writing training program; and (3) to explore the teacher's reflections about the TPACK model based writing training program. Design This is a single-group experimental study, utilizing the National College Entrance Examination Center (CEEC) writing grading criteria and a self-designed course satisfaction questionnaire. This study included quantitative and qualitative data; qualitative data was collected at the end of the course. Participants Fifty one nursing students, studied in a conveniently selected English language classroom, and the EFL teacher (also the researcher) participated in this research voluntarily. After understanding the procedures, agreeing to participate, and signing consent forms, students were randomly assigned into 14 groups consisted of 3 to 4 members each for the sake of conducting peer review activities at the beginning of the sessions. This was their first academic semester of total two year (four semesters) college studies. Since a 5-year nursing diploma, their previous studies, supplied merely 2 hour EFL lectures per week (22 credits in 5 years) (NTIN, 2014), they had limited learning experiences in English; and mostly focused on reading skill, which was neither complete nor sufficient for acquiring a foreign language. Participants had restricted EFL competence and lower level of confidence. They were all aware that EFL is an essential knowledge both for their careers and for future development, thus they had quite strong learning motivation intrinsically and extrinsically. Nevertheless, they felt anxious about learning EFL and writing skills. The Intervention Table 1 summarizes the model dimension, objectives, teaching strategy, and content of the TPACK model writing course. An online writing teaching and learning platform, “E-campus” (http://ecampus.***.edu. tw/eCampus3P/Learn/Default.aspx) maintained by the university, was designed to record the writing process into more details (see Fig. 1). The learning interaction section, the main zone used in the E-campus, contains functions including course/syllabus announcement, teaching and learning materials, writing works submission, and teacher/peer review feedbacks. Five writing topics were practiced: of the first one (Brian's home) is a descriptive style using present tense; the second (Lost wallet) and the third (Next door uncle) apply narrative type using past tense and present tense respectively; the fourth (The tortoise and the hare) exercises story telling with either present or past tense; and the fifth
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Table 1 The intervention course using the TPACK model. Model dimension
Teaching strategy
Objectives
Content
Technology
Information and Communication Technology (ICT) The Internet and the Web 2.0 Process writing approach Multiple revisions
To get familiar with the ICT techniques To learn the basic skills of the Internet and the interactive version of Web 2.0
Participants have to use computers as the communication media. The Internet and Web 2.0 are techniques used for the interactive teaching and learning activities
To view writing as a process of thinking and discovery To practice the process writing approach
Content
EFL writing skills
To help learners get familiar with the genres and grammatical features of GEPT writing.
Technological pedagogy
Online collaborative learning
To learn ICT and collaboration skill together
Technological content
Online writing learning
To learn EFL writing skills online
Process approach views writing as a process of thinking and discovery instead of the traditional ‘product’ perspective, which concentrates on the output and accuracy of compositions (Hyland, 2002). Students needed to write at least 3 versions including initial, second, and then final drafts before submitting for evaluation. During the process, students received one time feedback from an extra peer review activity between the initial and second revisions, and then from their teacher between the second and final drafts. Five writing topics were practiced: two before the mid-term examination and three after that. Every writing topic had its teaching purpose, and was adopted from mock tests testified in the historical GEPTs. The proficiency level of each topic could be seen as consistent in terms of testing validity and reliability. A learning management system called E-campus was used. Three features of E-campus: learning interaction, evaluation, and information square. Most of the writing teaching and learning activities were held in the E-campus other than weekly 2 hour face-to-face lectures, and it lasted one semester of 18
Pedagogical content
Peer review activity Teacher's corrective feedback
To serve extra learning, social comparison, and content knowledge acquisition To provide corrective feedback for the process writing
weeks with five writing cycles. Every individual in the groups had to review their peers' initial writing drafts, and then give feedback and comments by filling a designed peer review form. Each student thus received three feedback forms from their group mates, and they had to modify the compositions according to these comments. To conduct peer review training, two-hour face-to-face lecture and another 2
The integration of all above strategies
hour online tutorials by reading supplement materials were served at the beginning. Blended two modes of teacher's indirect feedback with code system and teacher's direct feedback. Integration of all elements into a whole solution
Pedagogy
Technological pedagogy and content
TPACK model course
(The coming winter vacation) directs how to write a letter to friends concerning with things that will happen in the future. Peer review activities were added (Suls and Wheeler, 2000) so that every student in the groups had to review their peers' initial writing drafts, and then give feedback and comments by filling a designed peer review form. The form integrates 6 parts, including “content”, “having topical and concluding sentences”, “using conjunctions and transitional expressions”, “dictions”, “punctuations and capital words”, “grammar and sentence structure”, with total 33 items of checklist as a guideline for the reviewers to check the target compositions. The meaning and sample of each item was taught during the training sessions. For easier understanding and implementation, reviewers needed to tick either YES or NO on each checking items, and they were asked to provide suggestions as much as possible to help their peer writers revise compositions. Moreover, the teacher's corrective feedback blended two modes of indirect feedback with code system and direct feedback (Sheen, 2010). An indirect feedback method which indicated learners' mistakes or errors with the aid of code system was introduced. For instance, the teacher marked “S” standing for “spelling” errors, “T” for “tense” errors, etc. at the first time he delivered the feedbacks. A code table was attached at the end of each file informed the meaning of each code for the learners' reference. Students had to attempt to revise their writings according to the hint, and search for answers from possible learning resources. After this process, the teacher gave direct feedback which was explicit instructions about the mistakes/errors that had not been resolved.
Measures Demographic Variables Participants' gender, age, ethnicity, and previous EFL writing learning experiences were investigated. The Scale for Rating Composition Tasks (The SRCT) Two writing papers – administered in pre-test and post-test – were evaluated by an experienced writing teacher who was recruited as an external examiner in order to avoid the possibility of teaching bias and the inter-rater reliability. The SRCT (Chen et al., 1993) developed by the National CEEC (College Entrance Examination Centre), an official bureau which is responsible for setting up the nationwide examination criteria, was utilized to assess the learners' writing competences from 6 dimensions including (1) content; (2) organization; (3) grammar; (4) diction (vocabulary and spelling); (5) mechanism (punctuation, discourse markers), and (6) holistic scores. The assessor marked each paper with a 6-point scale rated from 0 to 5 by the rules of the SRCT. The Course Satisfaction Questionnaire (The CSQ). The CSQ is a newly devised scale developed and tested by the researchers. This scale comprises 14 items and 5 open questions to assess learners' satisfaction of this course. Exploratory Factor Analyses (EFAs) demonstrated a four-factor structure for the 14 items explained 69.2% of the total item variance in the scale. Four factors named as “writing teaching”, “course design”, “teacher feedback”, and “peer feedback” were extracted from
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Fig. 1. E-campus as the writing teaching platform.
the EFAs. The Cronbach's alpha value of these items was 0.86. The 14-item division is 5-point Likert Scale questions from strongly agree 5 to strongly disagree 1, and was distributed after the post-writing test. The five qualitative questions explored learners' perceptions about the TPACK activities, including preferences of online vs. traditional writing, teacher's feedback vs. peer review, teacher's direct vs. indirect feedback, difficulties met in the process, and suggestions for the writing course. The Teacher's Diary (TD). The teacher's diary was written by the teacher/ researcher regularly — at least one time a month. All of the difficulties met, successes done, and possible actions to be taken were the concentration of this document.
dependent variables; and then the post hoc analyses further compared the effects in every the SRCT dimension. EFAs were utilized to categorize the items of The CSQ. For both instruments, significant level was set to be 5% (p = .05). Qualitatively, The CSQ was analyzed through a process by means of content analyses (Merriam, 2002). The procedures were: (a) the original recording was read carefully and repeatedly in order to understand the perceptions of learners. (b) specific descriptions and the descriptions mentioned repeatedly were marked, (c) perception of common features were be generalized to form a subtheme, (d) the relationship of each subtheme was explored cautiously, (e) all the themes were generalized to form the context of the subthemes, and (f) the themes of learners' perceptions were formed.
Ethical Considerations Ethical approval was granted from the Institution Research Board (IRB No 00) issued by the xxx Hospital. Participants were properly informed and signed the consent form prior to the beginning of the study. They were clearly aware of their right to withdraw from the activities at any time during the teaching intervention, and none withdrew from the study. All research procedures complied with the code of ethics regulated by the IRB.
Results
Data Analysis Quantitatively, statistical analyses were performed by the SPSS version 21 (SPSS, 2012) including the descriptive and interpretive statistics. Repeated measure MANOVA (Multivariate Analysis of Variance) was opted since the six measurements of the SRCT were included as
Difference in the Pretest and Posttest Results for the SRCT
Demographic Data of the Participants All participants were females aged from 21 to 25 and the majority was 21 (90.2%). They were all Taiwanese girls, and most of their previous EFL writing learning experiences were nearly none (never learnt 88%; less than a semester 12%).
Judging from the mean values of the SRCT, all of the post-tests' means are higher than the pre-tests', and implies learners had gained learning progresses (see Table 2). The repeated measure
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did not like it. For those held positive perceptions, their reasons included:
Table 2 Learners' writing performance measured by SRCT (n = 51). Descriptive statistics
Content Organization Grammar Diction Mechanism Holistic
Within-subjects contrasts
Time
Mean
S.D.
S.E.
F(1,50)
p
Partial η2
Pre-test Post-test Pre-test Post-test Pre-test Post-test Pre-test Post-test Pre-test Post-test Pre-test Post-test
2.18 3.39 2.20 3.16 1.86 2.92 2.12 2.80 2.10 3.20 2.12 3.14
.79 .87 .83 .95 .75 .87 .74 .83 .73 .75 .74 .85
.11 .12 .12 .13 .11 .12 .10 .12 .10 .11 .10 .12
102.98
.000⁎⁎⁎
.67
43.66
.000⁎⁎⁎
.47
56.25
.000⁎⁎⁎
.53
27.94
.000⁎⁎⁎
.36
94.57
.000⁎⁎⁎
.65
85.57
.000⁎⁎⁎
.63
“It can save the waste of papers, and I can revise it at any time without brushing it everywhere.”
“I can look up the online dictionary whenever I meet difficulty in writing. It is more efficient.” For those learners who disliked the design, participants answered that: “I prefer handwriting … Writing through machine made me feel unreal.”
⁎⁎⁎ p b .001.
MANOVA demonstrates the progresses had reached statistical significance: F(6,45) = 158.37; p b .000; partial η2 = .955. The post-hoc of within-subjects contrasts occurred in every dimension was statistically significant, too. The results of The CSQ Learners responded a moderate satisfaction level toward the TPACK writing course in general. Breaking into parts, they tended to confirm the design of the language course and the teacher's feedback, but they had conservative opinions about the writing instruction and peer feedback. The descriptive statistics of the 14 items of The CSQ shows a mean variance ranging from 2.63 to 3.47 with overall average score of 3.12. According to the factors of The CSQ (see Table 3), four factors' mean scores were writing teaching (M = 2.95), course design (M = 3.39), teacher feedback (M = 3.23), and peer feedback (M = 2.87). Students tended to have higher satisfaction level at the course design and teacher feedback. Qualitative Results In terms of learners' perceptions about this TPACK writing course, three issues were raised from the qualitative data, they are: the learners perceived a positive attitude toward the technology design of online writing; and they preferred the teacher's feedback to their peers; yet they did not like the practice required by the indirect feedback. When asked about the online platform writing, 29 students (57%) responded that they liked the way to learn contrasting to the other 22 (43%) who
“Using online writing is easy to become relying on the translation machine but not to think by oneself. We will become lazy in this way.” As to the corrective feedback provided by either their language teacher or their peers, overwhelming number of students (N = 39, 76%) liked to be guided by the teacher in contrast to their preference to the peers (N = 2, 4%). This perception is consistent with the previous research that learners with lower linguistic competence prefer receiving form feedback from the teacher (Lin and Yang, 2011). Participants' comments are, for example: “The teacher is more experienced in giving useful comments. He can point out my errors, and his wording of feedback is more acceptable.”
“The teacher can indicate the grammar mistakes precisely, and tell me where I did wrong in the composition.” Nevertheless, the design of indirect feedback was not recognized by the students, either. 25 students (49%) responded that the teacher's indirect feedback was the most difficult part to cope with. This finding is echoing the literature in EFL writing research (Ferris and Roberts, 2001). Their attributes to this belief are: “I sometimes don't understand the teacher's real intention about my errors.”
“I cannot catch the ideas suggested by the teacher.”
Teachers' Reflections About this TPACK Writing Course Table 3 Learners' satisfaction level measured by CSQ (n = 51). Factors
Writing teaching
Course design
Teacher feedback Peer feedback
Items
D4 D3 D5 D2 D1 D14 D13 D12 D10 D9 D11 D6 D8 D7
Descriptive
Peer feedback form design Writing cycles design Corrective feedback from the teacher and peers Writing topics selection Teaching resources (online platform, teaching materials, etc.) Overall course design Observation of others' works Assessment method Instruction and feedback from the teacher Indirect and direct feedback from the teacher Times of corrective feedback from the teacher Times of corrective feedback from the peers My own feedback toward the peers Evaluation method from the peers
Note: Cronbach's alpha = .86.
Mean
SD
2.90 2.75 2.80 3.35 3.37
.78 .82 .80 .63 .69
3.25 3.47 3.45 3.45 3.29 2.94 2.63 3.06 2.92
.72 .67 .76 .67 .64 .84 .80 .58 .56
From the analyses of TD, the teacher perceived that the TPACK model suggests a worth framework when designing a writing course. However, teacher also mentioned that it was a demanding task for both the teacher and the learners. Two major challenges – to implement the peer review activities and to give corrective feedback on time – were proposed. “This is really a demanding project when teaching and implementing the writing course. There are so many issues to cover, and it is always a pressure to give online comments and feedback on time. I have too many papers to mark at each time.” (Teacher's Diary)
“Learners seemed not appreciate the peer review activities. A major reason may be that they are not persuaded by their peers' feedbacks due to their general English incompetence. It may be worth considering of inviting other peers who are more competent in doing writing to perform this function.” (Teacher's Diary)
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Discussion With regard to the first aim of the study, results of the SRCT indicated that the learners had gained obvious learning progresses resulted from the TPACK based writing instruction. The most prominent improvement might be the holistic dimension as the GEPT applies this grade to evaluate the test-takers' writing competence. The average scores increased from 2.12 (pre-test) which was definitely unable to pass the criteria to 3.14 (post-test) that could successfully achieve the examination requirement if the other part of single sentence writing is good enough. However, a guaranteed passing mark should be 4.0/5.0 although it is not easy to help all the student writers in a short period. In terms of the sub-dimensions in pre-test, the highest mean happened in the organization (2.20) but the lowest was in grammar (1.86). The GEPT examinations adopt the strategy of guided writing (Nation, 2008), and pictures are supplied to the examinees in order to restrict the possibility of too much divergence. After reading the designed figures, writers established similar organizations guided by the sequential pictures; and this guided strategy might help them perform well in this function. In contrast, the English grammar is always one of their weakest linguistic knowledge, and the grammar competence is difficult to be enhanced in a few months (Ferris and Roberts, 2001). In post-test, on the other hand, learners performed the best in content (3.39) while the worst in diction (2.80). Comparing the differences between pre- and post-tests, the content shows the most significant improvement (1.21) but the diction is the least (0.68). The effect of writing training in content dimension is probably easier through rewriting and error correction, especially for the novice writers (Ferris and Roberts, 2001). Moreover, due to these novice writers' shortage of knowledge in terms of the convention of English composition, the coaching of writing strategies and sample articles has been helpful for constructing a better content. Reversely, diction dimension, mostly about vocabulary use, is not surprisingly presenting the learners' weakness even after a semester's teaching and learning. Corresponding to the previous TESOL research (Chen and Chung, 2008), vocabulary competence is a bottleneck for the EFL writers for the sake of lack practices. To master English vocabulary, it needs repetitive exercises so that it is difficult to improve in a rather limited time and drill. As for the second objective of this study, results of The CSQ illustrate a comparatively low satisfaction for the slightly higher than the average mark of 3 points. It is quite contradictory to the result of writing competence improvement found in the previous section. As the writing course happened online outside the language classroom, and the extra learning activities required students to devote more effort after school, it was not unreasonable to see the participants did not enjoy it. Moreover, the implementation of the TPACK model offered students a course design that they had never or seldom experienced before, and the purpose aimed to help them improve overall English competence including writing skills. The other positive factor came from the teacher for his dedication to the exhausting feedback workload, and his valuable and accurate comments, especially in terms of the content and linguistic knowledge, were recognized by the student writers. These nursing students were able to appreciate the morality behind the course design and their teacher's devotion, though the writing tasks were still too demanding for them. On the other hand, participants felt less satisfied with the writing teaching and peer review factors. This is probably because the extra writing practices outside the classroom had given them pressure, and the implementation of peer review activity was especially unwelcome to them. Although peer review strategy is commonly discussed in the writing literature recently, the effectiveness is still arguable (Covill, 2010). Advocates suggest that peer review benefits learners in at least four aspects — cognitive, affective, social interaction, and linguistic (Connor and Asenavage, 1994); while criticism reminds that EFL learners with lower linguistic competence could not perform roles
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appropriately (Lin and Yang, 2011), and peer review training in advance is essential (Min, 2005, 2006). As the TPACK model rooted from the educational scholars who were interested in integrating the thriving of technology into the traditional education context (Lee and Kim, 2014), learners' confirmation about the online platform encourages the future development of this model. The students offered some reasons for favoring the use of technology which were insightful, for example, environmental protection, revision convenience, no physical location restriction, and accessible online learning resources, etc. The younger generation grew up in the so called E-world, and their acceptance to the technology has been undoubtedly increasing and easy. Despite the learners being familiar with the use of technology, they were not supposed to prefer the online learning method without hesitance. Learning online may be an alternative way of the traditional paper and pencil; however, it cannot substitute all of the advantages such as the physical sense brought by the handwriting. The improper use of the technology for language learning, for instance, over-relying on the translation machine was also mentioned by the students. Their opinions expressed some of the worries perceived by the conservatives toward the rapid development of information technology, and it deserves attention when adopting the TPACK model. Furthermore, the implicit benefit of peer review, like social interaction and awareness of audiences, cannot be sensed by the learners during the training process. But the obstruction followed by their peers' incompetent of linguistic knowledge was explicit, and thus increased the difficulty of implementation. The teacher had to spend time to explain the rationale of peer review, persuade them about positive benefits, provide alternatives, and modify some original designs. Finally, with regard to the third aim of this study, the original design of introducing the peer review activity was to reduce the workload of giving feedback and comments for the student writers. The teacher expected to receive better quality student writings after mutual learning from peer interaction. However, it was rare to observe initial drafts with significant improvement after the peer review cycle. This might be because they could have done things before they submitted the initial drafts, but the bottleneck was unable to be conquered through the facilitation of their classmates. In fact, the guided writing topics had clear directions for the content and organization construction, the use of word processing software help improve the mechanism, and the online dictionaries help search for those necessary words, grammar dimension then became the crucial part to be coached. These nursing students received English language education from the vocational system, which did not supply enough grammar rules teaching comparing with the academicoriented senior high school system. Syntax knowledge had become the weakest component for every student, and they had to mostly depend on the teacher's feedback. As a result, the English language teacher needed to not only correct the syntax errors for the second drafts, but also check the comments given by the peers. Plus, in screenings of the indirect feedback, the teacher needed to contribute exertions for the compositions. Furthermore, for nursing education, the TPACK model seems to suggest a potential framework to combine the two important instructional elements of ICT and EFL writing. However, the TPACK model may be of benefit to other healthcare programs outside of this institution, but further research would be required to explore the impact on academic writing. For instance, the technological knowledge can be applied into the other ICTs, for example, the IWBs (Interactive White Boards) (Jang and Tsai, 2012); the pedagogical knowledge can be changed by the other approach such as PBL (Problem Based Learning); and the content knowledge can be replaced by the other nursing subjects like Community Nursing, etc. Even for EFL writing content knowledge, the writing tasks can be carefully designed as clinical relevant topics so that nursing students can become acquainted with the medical terms and writing conventions.
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Limitations Limitations to the methodological design of the stuck are acknowledged including: the study did not design a comparison group due to ethical concerns and the complex components of the TPACK model. The effectiveness and efficiency of the course thus cannot be further testified through the experimental manipulation. Secondly, although the researchers attempted to avoid ethical risk, for example, having research assistants collect data outside the classroom after giving the module score, convenience sampling may still be a potential hazard regarding internal validity. Lastly, the sample size is rather small that the findings may not be suitable for generalization. Conclusion The TPACK model provides a comprehensive and multi-modal teaching approach that is ready for the EFL teachers to consider when designing the writing course. This study demonstrates a possible application of applying TPACK model into writing instruction, and the results suggest an effective way that helped nursing students improve their writing performance in every dimension significantly. The students felt moderate satisfaction about the course design due to the demanding tasks and peer review activities, although they recognized the integration of technology into syllabus. They also preferred receiving the direct feedback and comments from their teacher regarding linguistic forms and content. Corresponding to the learners' perceptions, the teacher reported the TPACK model as a challenging attempt for the implementation of peer review activities and giving feedback on time. Future studies including different academic subjects and/or specific model dimensions based on the TPACK model are recommended. Acknowledgments This paper as part of a research project was funded by Chang-Gang Memorial Hospital (CMRPF6D0031), and researcher's grant sponsored by the Institute of Humanities and Social Sciences of the Ministry of Science and Technology. Appendix A. Supplementary material Supplementary data to this article can be found online at http://dx. doi.org/10.1016/j.nedt.2015.02.016. References Archambault, L., Crippen, K., 2009. Examining TPACK among K-12 online distance educators in the United States. Contemp. Issues Technol. Teach. Educ. 9 (1), 71–88. Bennett, S., 2004. Supporting collaborative project teams using computer-based technologies. In: Roberts, T.S. (Ed.), Online Collaborative Learning: Theory and Practice. Information Science, Hershey, PA, pp. 1–27. Çalik, M., Ozsevgeç, T., Ebenezer, J., Artun, H., Kuçuk, Z., 2014. Effects of ‘environmental chemistry’ elective course via technology-embedded scientific inquiry model on some variables. J. Sci. Educ. Technol. 23 (3), 412–430. http://dx.doi.org/10.1007/ s10956-013-9473-5.
Chang, Y., Jang, S.J., Chen, Y.H., 2014. Assessing university students' perceptions of their physics instructors' TPACK development in two contexts. Br. J. Educ. Technol. http://dx.doi.org/10.1111/bjet.12192. Chen, C.M., Chung, C.J., 2008. Personalized mobile English vocabulary learning system based on item response theory and learning memory cycle. Comput. Educ. 51 (2), 624–645. Chen, K.T., Huang, T.S., Lin, S.R., Lin, M.Y., 1993. College Entrance Examination Research Report: English Writing Assessment Criteria. College Entrance Examination Center, Taipei. Clarke, D.J., Hollingsworth, H., 2002. Elaborating a model of teacher professional growth. Teach. Teach. Educ. 18 (8), 947–967. Connor, U., Asenavage, K., 1994. Peer response groups in ESL writing classes: how much impact on revision? J. Second. Lang. Writ. 3 (3), 257–276. Covill, A.E., 2010. Comparing peer review and self-review as ways to improve college students' writing. J. Lit. Res. 42 (2), 199–226. Doering, A., Koseoglug, S., Scharberg, C., Henricksong, J., Lanegrang, D., 2014. Technology integration in K-12 geography education using TPACK as a conceptual model. J. Geogr. 1–15. http://dx.doi.org/10.1080/00221341.2014.896393. Ertmer, P., 2003. Transforming teacher education: visions and strategies. Educ. Technol. Res. Dev. 51 (1), 124–128. Ferris, D., Roberts, B., 2001. Error feedback in L2 writing classes: how explicit does it need to be? J. Second. Lang. Writ. 10 (3), 161–184. Garcia, L.M., Roblin, N.P., 2008. Innovation, research and professional development in higher education: learning from our own experience. Teach. Teach. Educ. 24 (1), 104–116. Hyland, K., 2002. Teaching and Researching Writing. Pearson, Harlow and London. Jang, S.J., Chen, K.C., 2010. From PCK to TPACK: developing a transformative model for pre-service science teachers. J. Sci. Educ. Technol. 19 (6), 553–564. Jang, S.J., Tsai, M.F., 2012. Exploring the TPACK of Taiwanese elementary mathematics and science teachers with respect to use of interactive whiteboards. Comput. Educ. 59 (2), 327–338. http://dx.doi.org/10.1016/j.compedu.2012.02.003. Koehler, M.J., Mishra, P., 2008. Introducing TPCK. In: AACTE (Ed.), Handbook of Technological Pedagogical Content Knowledge (TPCK) for Educators. Routledge, New York, pp. 3–29. Lee, C.J., Kim, C., 2014. An implementation study of a TPACK-based instructional design model in a technology integration course. Educ. Technol. Res. Dev. 62 (4), 437–460. http://dx.doi.org/10.1007/s11423-014-9335-8. Lee, M., Tsai, C., 2010. Exploring teachers' perceived self-efficacy and technological pedagogical content knowledge with respect to educational use of the World Wide Web. Instr. Sci. 38 (1), 1–21. Lin, W.C., Yang, S.C., 2011. Exploring students' perceptions of integrating wiki technology and peer feedback into English writing courses. Engl. Teach. Pract. Cri. 10 (2), 88–103. Merriam, S.B., 2002. Qualitative Research in Practice: Examples for Discussion and Analysis. Jossey-Bass, San Francisco, Calif.; [Great Britain]. Min, H.T., 2005. Training students to become successful peer reviewers. System 33, 293–308. Min, H.T., 2006. The effects of trained peer review on EFL students' revision types and writing quality. J. Second. Lang. Writ. 15, 118–141. Mishra, P., Koehler, M.J., 2006. Technological pedagogical content knowledge: a new framework for teacher knowledge. Teach. Coll. Rec. 108 (6), 1017–1054. Nation, I.S., 2008. Teaching ESL/EFL Reading and Writing. Routledge. NTIN, 2014. Curriculum Framework: General Education Courses. Retrieved Nov. 07, 2014, from. http://www-news.ntin.edu.tw/teaching.aspx?id=36. Schmidt, D.A., Baran, E., Thompson, A.D., Koehler, M.J., Mishra, P., Shin, T., 2009. Technological pedagogical content knowledge (TPACK): the development and validation of an assessment instrument for preservice teachers. J. Res. Technol. Educ. 42 (2), 123–149. Schrum, L., Thompson, A., Maddux, C., Sprague, D., Bull, G., Bell, L., 2007. Editorial: research on the effectiveness of technology in schools: the roles of pedagogy and content. Contemp. Issues Technol. Teach. Educ. 7 (1), 456–460. Sheen, Y., 2010. Introduction: the role of oral and written corrective feedback in SLA. Stud. Second. Lang. Acquis. 32 (2), 169–179. http://dx.doi.org/10.1017/S0272263109990489. Spss, I., 2012. IBM SPSS Statistics Version 21. International Business Machines Corp, Boston, Mass. Suls, J., Wheeler, L., 2000. Handbook of Social Comparison: Theory And Research. Kluwer Academic/Plenum Publishers, New York. Thompson, A., Mishra, P., 2007. Breaking news: TPCK becomes TPACK! J. Comput. Teach. Educ. 24 (2), 38–64.
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Nurse Education Today journal homepage: www.elsevier.com/nedt
Applying Technological Pedagogical and Content Knowledge (TPACK) model to develop an online English writing course for nursing students Hung-Cheng Tai a, Mei-Yu Pan b, Bih-O Lee b,⁎ a b
Department of General Education, Chang Gung University of Science and Technology, Chia-Yi Campus, Taiwan Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi Campus, Taiwan
a r t i c l e
i n f o
Article history: Accepted 18 February 2015 Keywords: TPACK model Writing learning Nursing students Nursing education
s u m m a r y Background: Learning English as foreign language and computer technology are two crucial skills for nursing students not only for the use in the medical institutions but also for the communication needs following the trend of globalization. Among language skills, writing has long been ignored in the curriculums although it is a core element of language learning. Objectives: To apply the TPACK (Technological Pedagogical and Content Knowledge) model to design an online English writing course for nursing students, and to explore the effects of the course to the students' learning progress as well as their satisfactions and perceptions. Research Methods: A single-group experimental study, utilizing the CEEC (College Entrance Examination Center) writing grading criteria and a self-designed course satisfaction questionnaire, is used. Fifty one nursing students who were in their first/four semesters of the two year vocational pre-registration nursing course in a Taiwan university were selected using convenience sampling. Data Analysis Methods: Quantitative data were analyzed using descriptive statistics and repeated measure MANOVA. Qualitative data were analyzed by content analysis. Results: Students' writing competence had been improved significantly in every dimension after the instruction. Only half of the learners preferred online writing compared to the traditional way of writing by hand. Additionally, participants reported that they would prefer to receive feedback from the teacher than peers, yet they did not like the indirect feedback. The teacher perceived the course as meaningful but demanding for both learning and teaching sides. To implement the peer review activities and give feedback on time were two major challenges during the cycles. Conclusions: The TPACK model suggests a comprehensive and effective teaching approach that can help enhance nursing students' English writing performance. Teachers are advised to consider its implementation when designing their syllabus. © 2015 Elsevier Ltd. All rights reserved.
Introduction Following the trend of globalization and the advancement of information and communication technology (ICT), English as foreign language (EFL) and ICT competence have become two necessary skills in the clinical settings for the nursing students as well as practitioners. They have been emerging as two prominent issues in the education field for decades. However, EFL and ICT seem yet to be well discussed in the nursing education individually, not to mention the combination of the two skills. There is a growing recognition at tertiary level in Taiwan that improving university learners' EFL abilities is essential.
⁎ Corresponding author at: Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi Campus, No2, Chia-Pu Road, West Sec., Putz, Chia-Yi County 61363, Taiwan. Tel.: +886 05 3628800x2503; fax: +886 06 2568641. E-mail addresses: [email protected] (H.-C. Tai), [email protected] (M.-Y. Pan), [email protected] (B.-O. Lee).
http://dx.doi.org/10.1016/j.nedt.2015.02.016 0260-6917/© 2015 Elsevier Ltd. All rights reserved.
License obtained from the General English Proficiency Test (GEPT), a popular local language test based on pass or fail criterion, has been commonly required as graduation threshold since 2005. The GEPT assesses whether examinees' four language skills – listening, reading, speaking, and writing – achieve the standard. This GEPT policy has become core educational goal leading to the design of school curricula and has guided EFL instructions. Technology is gradually becoming ubiquitous in education, and there is increasing evidence that technology, when properly infused and integrated into teaching and learning, has a significant positive effect on student's learning (Schrum et al., 2007). In the research context, ICT seems to be able to provide a cyber space to conduct alternative writing instructions overcoming the restrictions of curriculum, syllabus, session times, and classroom interactions. While before applying technologies, quite a few stumbling blocks may be encountered to the use and integration. One difficulty is the lack of both technological and pedagogical training for teachers and faculty (Bennett, 2004; Ertmer,
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2003). Research has shown that college teachers tend to be wellequipped with respect to content knowledge in their specific disciplinary areas, but often lack pedagogical skills and thus do not teach effectively (Clarke and Hollingsworth, 2002; Jang and Chen, 2010). Although it seems all of the resources are already available there, however, language teachers may still feel confused and frustrated about how to integrate and/or coordinate these elements. There has been growing interest in the design and implementation of teacher and faculty professional development theories or methods with which to assist teachers to advance in their teaching practice and to improve student learning (Garcia and Roblin, 2008).
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However, though the TPACK application is increasingly drawing attention from educational researchers, it seems that it has been discussed neither in the field of healthcare professional education nor in the EFL writing training. In this study, the framework was utilized, specifically addressed TPACK development venue situated within a university environment, along with the implementation of a writing skill training program. The TPACK model was applied to design an online collaborative writing training course for nursing students needing to learn English writing skills in a nursing university in southern Taiwan. The Study
Background Objectives Nursing students currently in the vocational system in Taiwan receive five-year nursing training in college after graduating from junior high school (grade 9), and then pursue two-year advanced learning in a nursing university. In general, even those in top universities such as in this research context, do not learn English language as intensive as those studied in the senior high school and academic oriented universities. Although nursing students have studied the English language for at least 8 years before entering university (3 years in junior high schools (4–5 h/week) and 5 years during nursing training (2–3 h/week)), many have never learned English composition as there was no such class embedded in their official curriculums. The students can thus be seen as novice writers prior to the commencement of writing instruction. In the clinical settings, English language is a major communication medium between professionals from medical recorders, doctor's orders, to nursing notes. EFL writing, an ultimate output technique requiring comprehensive instructions and competence, is crucial in healthcare professions. Given the importance of EFL writing skills, it has long been ignored in the vocational system of nursing education — neither required in the curriculum nor provided enough lecture times to teach and learn. Literature Review A comprehensive instruction framework, TPACK model proposed recently by the educational researchers, may offer a promising perspective for technology facilitated learning. In contrast to the merely instrumental view and technological skill acquisition on the learner's end, the current issue of technology (T) in teaching and learning emphasizes the connections and interactions between and among content knowledge (CK) (Mishra and Koehler, 2006). Yet this TCK alone was criticized for its weakness in the inability of adequately addressing the consideration of professional development of college faculty with respect to teaching. Rather, a newly revised theoretical framework – technological pedagogical content knowledge (TPCK) (Koehler and Mishra, 2008) – was renamed as TPACK for the sake of easy remembering. It designates an integrated description for three kinds of knowledge: technology, pedagogy, and content, and is expected to be able to accommodate the educational requisition in the digital age (Thompson and Mishra, 2007). While the first generation TPACK work focused upon defining and conceptualizing the constructs of TPACK, more recent work has concentrated on using the construct in both research and development projects. The latest research and development projects have been directed toward measuring the level of teacher self-assessed TPACK (Archambault and Crippen, 2009; M. Lee and Tsai, 2010; Schmidt et al., 2009), revealing the processes and interactions related to technology-based teaching. More research in different subjects are also progressing, for example, pre-service Science teachers' training (Jang and Chen, 2010), Environmental Chemistry learning (Çalik et al., 2014), Physics subject (Chang et al., 2014), Mathematics and Science teaching (Syh-Jong Jang and Tsai, 2012), and Geography course (Doering et al., 2014), etc.; and most results recognized the significance of this model.
Three aims of this study are: (1) to assess the effectiveness of the TPACK model based writing training program contributing to learners' learning outcome; (2) to investigate the learners' perceptions and satisfactions about the TPACK model based writing training program; and (3) to explore the teacher's reflections about the TPACK model based writing training program. Design This is a single-group experimental study, utilizing the National College Entrance Examination Center (CEEC) writing grading criteria and a self-designed course satisfaction questionnaire. This study included quantitative and qualitative data; qualitative data was collected at the end of the course. Participants Fifty one nursing students, studied in a conveniently selected English language classroom, and the EFL teacher (also the researcher) participated in this research voluntarily. After understanding the procedures, agreeing to participate, and signing consent forms, students were randomly assigned into 14 groups consisted of 3 to 4 members each for the sake of conducting peer review activities at the beginning of the sessions. This was their first academic semester of total two year (four semesters) college studies. Since a 5-year nursing diploma, their previous studies, supplied merely 2 hour EFL lectures per week (22 credits in 5 years) (NTIN, 2014), they had limited learning experiences in English; and mostly focused on reading skill, which was neither complete nor sufficient for acquiring a foreign language. Participants had restricted EFL competence and lower level of confidence. They were all aware that EFL is an essential knowledge both for their careers and for future development, thus they had quite strong learning motivation intrinsically and extrinsically. Nevertheless, they felt anxious about learning EFL and writing skills. The Intervention Table 1 summarizes the model dimension, objectives, teaching strategy, and content of the TPACK model writing course. An online writing teaching and learning platform, “E-campus” (http://ecampus.***.edu. tw/eCampus3P/Learn/Default.aspx) maintained by the university, was designed to record the writing process into more details (see Fig. 1). The learning interaction section, the main zone used in the E-campus, contains functions including course/syllabus announcement, teaching and learning materials, writing works submission, and teacher/peer review feedbacks. Five writing topics were practiced: of the first one (Brian's home) is a descriptive style using present tense; the second (Lost wallet) and the third (Next door uncle) apply narrative type using past tense and present tense respectively; the fourth (The tortoise and the hare) exercises story telling with either present or past tense; and the fifth
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Table 1 The intervention course using the TPACK model. Model dimension
Teaching strategy
Objectives
Content
Technology
Information and Communication Technology (ICT) The Internet and the Web 2.0 Process writing approach Multiple revisions
To get familiar with the ICT techniques To learn the basic skills of the Internet and the interactive version of Web 2.0
Participants have to use computers as the communication media. The Internet and Web 2.0 are techniques used for the interactive teaching and learning activities
To view writing as a process of thinking and discovery To practice the process writing approach
Content
EFL writing skills
To help learners get familiar with the genres and grammatical features of GEPT writing.
Technological pedagogy
Online collaborative learning
To learn ICT and collaboration skill together
Technological content
Online writing learning
To learn EFL writing skills online
Process approach views writing as a process of thinking and discovery instead of the traditional ‘product’ perspective, which concentrates on the output and accuracy of compositions (Hyland, 2002). Students needed to write at least 3 versions including initial, second, and then final drafts before submitting for evaluation. During the process, students received one time feedback from an extra peer review activity between the initial and second revisions, and then from their teacher between the second and final drafts. Five writing topics were practiced: two before the mid-term examination and three after that. Every writing topic had its teaching purpose, and was adopted from mock tests testified in the historical GEPTs. The proficiency level of each topic could be seen as consistent in terms of testing validity and reliability. A learning management system called E-campus was used. Three features of E-campus: learning interaction, evaluation, and information square. Most of the writing teaching and learning activities were held in the E-campus other than weekly 2 hour face-to-face lectures, and it lasted one semester of 18
Pedagogical content
Peer review activity Teacher's corrective feedback
To serve extra learning, social comparison, and content knowledge acquisition To provide corrective feedback for the process writing
weeks with five writing cycles. Every individual in the groups had to review their peers' initial writing drafts, and then give feedback and comments by filling a designed peer review form. Each student thus received three feedback forms from their group mates, and they had to modify the compositions according to these comments. To conduct peer review training, two-hour face-to-face lecture and another 2
The integration of all above strategies
hour online tutorials by reading supplement materials were served at the beginning. Blended two modes of teacher's indirect feedback with code system and teacher's direct feedback. Integration of all elements into a whole solution
Pedagogy
Technological pedagogy and content
TPACK model course
(The coming winter vacation) directs how to write a letter to friends concerning with things that will happen in the future. Peer review activities were added (Suls and Wheeler, 2000) so that every student in the groups had to review their peers' initial writing drafts, and then give feedback and comments by filling a designed peer review form. The form integrates 6 parts, including “content”, “having topical and concluding sentences”, “using conjunctions and transitional expressions”, “dictions”, “punctuations and capital words”, “grammar and sentence structure”, with total 33 items of checklist as a guideline for the reviewers to check the target compositions. The meaning and sample of each item was taught during the training sessions. For easier understanding and implementation, reviewers needed to tick either YES or NO on each checking items, and they were asked to provide suggestions as much as possible to help their peer writers revise compositions. Moreover, the teacher's corrective feedback blended two modes of indirect feedback with code system and direct feedback (Sheen, 2010). An indirect feedback method which indicated learners' mistakes or errors with the aid of code system was introduced. For instance, the teacher marked “S” standing for “spelling” errors, “T” for “tense” errors, etc. at the first time he delivered the feedbacks. A code table was attached at the end of each file informed the meaning of each code for the learners' reference. Students had to attempt to revise their writings according to the hint, and search for answers from possible learning resources. After this process, the teacher gave direct feedback which was explicit instructions about the mistakes/errors that had not been resolved.
Measures Demographic Variables Participants' gender, age, ethnicity, and previous EFL writing learning experiences were investigated. The Scale for Rating Composition Tasks (The SRCT) Two writing papers – administered in pre-test and post-test – were evaluated by an experienced writing teacher who was recruited as an external examiner in order to avoid the possibility of teaching bias and the inter-rater reliability. The SRCT (Chen et al., 1993) developed by the National CEEC (College Entrance Examination Centre), an official bureau which is responsible for setting up the nationwide examination criteria, was utilized to assess the learners' writing competences from 6 dimensions including (1) content; (2) organization; (3) grammar; (4) diction (vocabulary and spelling); (5) mechanism (punctuation, discourse markers), and (6) holistic scores. The assessor marked each paper with a 6-point scale rated from 0 to 5 by the rules of the SRCT. The Course Satisfaction Questionnaire (The CSQ). The CSQ is a newly devised scale developed and tested by the researchers. This scale comprises 14 items and 5 open questions to assess learners' satisfaction of this course. Exploratory Factor Analyses (EFAs) demonstrated a four-factor structure for the 14 items explained 69.2% of the total item variance in the scale. Four factors named as “writing teaching”, “course design”, “teacher feedback”, and “peer feedback” were extracted from
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Fig. 1. E-campus as the writing teaching platform.
the EFAs. The Cronbach's alpha value of these items was 0.86. The 14-item division is 5-point Likert Scale questions from strongly agree 5 to strongly disagree 1, and was distributed after the post-writing test. The five qualitative questions explored learners' perceptions about the TPACK activities, including preferences of online vs. traditional writing, teacher's feedback vs. peer review, teacher's direct vs. indirect feedback, difficulties met in the process, and suggestions for the writing course. The Teacher's Diary (TD). The teacher's diary was written by the teacher/ researcher regularly — at least one time a month. All of the difficulties met, successes done, and possible actions to be taken were the concentration of this document.
dependent variables; and then the post hoc analyses further compared the effects in every the SRCT dimension. EFAs were utilized to categorize the items of The CSQ. For both instruments, significant level was set to be 5% (p = .05). Qualitatively, The CSQ was analyzed through a process by means of content analyses (Merriam, 2002). The procedures were: (a) the original recording was read carefully and repeatedly in order to understand the perceptions of learners. (b) specific descriptions and the descriptions mentioned repeatedly were marked, (c) perception of common features were be generalized to form a subtheme, (d) the relationship of each subtheme was explored cautiously, (e) all the themes were generalized to form the context of the subthemes, and (f) the themes of learners' perceptions were formed.
Ethical Considerations Ethical approval was granted from the Institution Research Board (IRB No 00) issued by the xxx Hospital. Participants were properly informed and signed the consent form prior to the beginning of the study. They were clearly aware of their right to withdraw from the activities at any time during the teaching intervention, and none withdrew from the study. All research procedures complied with the code of ethics regulated by the IRB.
Results
Data Analysis Quantitatively, statistical analyses were performed by the SPSS version 21 (SPSS, 2012) including the descriptive and interpretive statistics. Repeated measure MANOVA (Multivariate Analysis of Variance) was opted since the six measurements of the SRCT were included as
Difference in the Pretest and Posttest Results for the SRCT
Demographic Data of the Participants All participants were females aged from 21 to 25 and the majority was 21 (90.2%). They were all Taiwanese girls, and most of their previous EFL writing learning experiences were nearly none (never learnt 88%; less than a semester 12%).
Judging from the mean values of the SRCT, all of the post-tests' means are higher than the pre-tests', and implies learners had gained learning progresses (see Table 2). The repeated measure
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did not like it. For those held positive perceptions, their reasons included:
Table 2 Learners' writing performance measured by SRCT (n = 51). Descriptive statistics
Content Organization Grammar Diction Mechanism Holistic
Within-subjects contrasts
Time
Mean
S.D.
S.E.
F(1,50)
p
Partial η2
Pre-test Post-test Pre-test Post-test Pre-test Post-test Pre-test Post-test Pre-test Post-test Pre-test Post-test
2.18 3.39 2.20 3.16 1.86 2.92 2.12 2.80 2.10 3.20 2.12 3.14
.79 .87 .83 .95 .75 .87 .74 .83 .73 .75 .74 .85
.11 .12 .12 .13 .11 .12 .10 .12 .10 .11 .10 .12
102.98
.000⁎⁎⁎
.67
43.66
.000⁎⁎⁎
.47
56.25
.000⁎⁎⁎
.53
27.94
.000⁎⁎⁎
.36
94.57
.000⁎⁎⁎
.65
85.57
.000⁎⁎⁎
.63
“It can save the waste of papers, and I can revise it at any time without brushing it everywhere.”
“I can look up the online dictionary whenever I meet difficulty in writing. It is more efficient.” For those learners who disliked the design, participants answered that: “I prefer handwriting … Writing through machine made me feel unreal.”
⁎⁎⁎ p b .001.
MANOVA demonstrates the progresses had reached statistical significance: F(6,45) = 158.37; p b .000; partial η2 = .955. The post-hoc of within-subjects contrasts occurred in every dimension was statistically significant, too. The results of The CSQ Learners responded a moderate satisfaction level toward the TPACK writing course in general. Breaking into parts, they tended to confirm the design of the language course and the teacher's feedback, but they had conservative opinions about the writing instruction and peer feedback. The descriptive statistics of the 14 items of The CSQ shows a mean variance ranging from 2.63 to 3.47 with overall average score of 3.12. According to the factors of The CSQ (see Table 3), four factors' mean scores were writing teaching (M = 2.95), course design (M = 3.39), teacher feedback (M = 3.23), and peer feedback (M = 2.87). Students tended to have higher satisfaction level at the course design and teacher feedback. Qualitative Results In terms of learners' perceptions about this TPACK writing course, three issues were raised from the qualitative data, they are: the learners perceived a positive attitude toward the technology design of online writing; and they preferred the teacher's feedback to their peers; yet they did not like the practice required by the indirect feedback. When asked about the online platform writing, 29 students (57%) responded that they liked the way to learn contrasting to the other 22 (43%) who
“Using online writing is easy to become relying on the translation machine but not to think by oneself. We will become lazy in this way.” As to the corrective feedback provided by either their language teacher or their peers, overwhelming number of students (N = 39, 76%) liked to be guided by the teacher in contrast to their preference to the peers (N = 2, 4%). This perception is consistent with the previous research that learners with lower linguistic competence prefer receiving form feedback from the teacher (Lin and Yang, 2011). Participants' comments are, for example: “The teacher is more experienced in giving useful comments. He can point out my errors, and his wording of feedback is more acceptable.”
“The teacher can indicate the grammar mistakes precisely, and tell me where I did wrong in the composition.” Nevertheless, the design of indirect feedback was not recognized by the students, either. 25 students (49%) responded that the teacher's indirect feedback was the most difficult part to cope with. This finding is echoing the literature in EFL writing research (Ferris and Roberts, 2001). Their attributes to this belief are: “I sometimes don't understand the teacher's real intention about my errors.”
“I cannot catch the ideas suggested by the teacher.”
Teachers' Reflections About this TPACK Writing Course Table 3 Learners' satisfaction level measured by CSQ (n = 51). Factors
Writing teaching
Course design
Teacher feedback Peer feedback
Items
D4 D3 D5 D2 D1 D14 D13 D12 D10 D9 D11 D6 D8 D7
Descriptive
Peer feedback form design Writing cycles design Corrective feedback from the teacher and peers Writing topics selection Teaching resources (online platform, teaching materials, etc.) Overall course design Observation of others' works Assessment method Instruction and feedback from the teacher Indirect and direct feedback from the teacher Times of corrective feedback from the teacher Times of corrective feedback from the peers My own feedback toward the peers Evaluation method from the peers
Note: Cronbach's alpha = .86.
Mean
SD
2.90 2.75 2.80 3.35 3.37
.78 .82 .80 .63 .69
3.25 3.47 3.45 3.45 3.29 2.94 2.63 3.06 2.92
.72 .67 .76 .67 .64 .84 .80 .58 .56
From the analyses of TD, the teacher perceived that the TPACK model suggests a worth framework when designing a writing course. However, teacher also mentioned that it was a demanding task for both the teacher and the learners. Two major challenges – to implement the peer review activities and to give corrective feedback on time – were proposed. “This is really a demanding project when teaching and implementing the writing course. There are so many issues to cover, and it is always a pressure to give online comments and feedback on time. I have too many papers to mark at each time.” (Teacher's Diary)
“Learners seemed not appreciate the peer review activities. A major reason may be that they are not persuaded by their peers' feedbacks due to their general English incompetence. It may be worth considering of inviting other peers who are more competent in doing writing to perform this function.” (Teacher's Diary)
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Discussion With regard to the first aim of the study, results of the SRCT indicated that the learners had gained obvious learning progresses resulted from the TPACK based writing instruction. The most prominent improvement might be the holistic dimension as the GEPT applies this grade to evaluate the test-takers' writing competence. The average scores increased from 2.12 (pre-test) which was definitely unable to pass the criteria to 3.14 (post-test) that could successfully achieve the examination requirement if the other part of single sentence writing is good enough. However, a guaranteed passing mark should be 4.0/5.0 although it is not easy to help all the student writers in a short period. In terms of the sub-dimensions in pre-test, the highest mean happened in the organization (2.20) but the lowest was in grammar (1.86). The GEPT examinations adopt the strategy of guided writing (Nation, 2008), and pictures are supplied to the examinees in order to restrict the possibility of too much divergence. After reading the designed figures, writers established similar organizations guided by the sequential pictures; and this guided strategy might help them perform well in this function. In contrast, the English grammar is always one of their weakest linguistic knowledge, and the grammar competence is difficult to be enhanced in a few months (Ferris and Roberts, 2001). In post-test, on the other hand, learners performed the best in content (3.39) while the worst in diction (2.80). Comparing the differences between pre- and post-tests, the content shows the most significant improvement (1.21) but the diction is the least (0.68). The effect of writing training in content dimension is probably easier through rewriting and error correction, especially for the novice writers (Ferris and Roberts, 2001). Moreover, due to these novice writers' shortage of knowledge in terms of the convention of English composition, the coaching of writing strategies and sample articles has been helpful for constructing a better content. Reversely, diction dimension, mostly about vocabulary use, is not surprisingly presenting the learners' weakness even after a semester's teaching and learning. Corresponding to the previous TESOL research (Chen and Chung, 2008), vocabulary competence is a bottleneck for the EFL writers for the sake of lack practices. To master English vocabulary, it needs repetitive exercises so that it is difficult to improve in a rather limited time and drill. As for the second objective of this study, results of The CSQ illustrate a comparatively low satisfaction for the slightly higher than the average mark of 3 points. It is quite contradictory to the result of writing competence improvement found in the previous section. As the writing course happened online outside the language classroom, and the extra learning activities required students to devote more effort after school, it was not unreasonable to see the participants did not enjoy it. Moreover, the implementation of the TPACK model offered students a course design that they had never or seldom experienced before, and the purpose aimed to help them improve overall English competence including writing skills. The other positive factor came from the teacher for his dedication to the exhausting feedback workload, and his valuable and accurate comments, especially in terms of the content and linguistic knowledge, were recognized by the student writers. These nursing students were able to appreciate the morality behind the course design and their teacher's devotion, though the writing tasks were still too demanding for them. On the other hand, participants felt less satisfied with the writing teaching and peer review factors. This is probably because the extra writing practices outside the classroom had given them pressure, and the implementation of peer review activity was especially unwelcome to them. Although peer review strategy is commonly discussed in the writing literature recently, the effectiveness is still arguable (Covill, 2010). Advocates suggest that peer review benefits learners in at least four aspects — cognitive, affective, social interaction, and linguistic (Connor and Asenavage, 1994); while criticism reminds that EFL learners with lower linguistic competence could not perform roles
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appropriately (Lin and Yang, 2011), and peer review training in advance is essential (Min, 2005, 2006). As the TPACK model rooted from the educational scholars who were interested in integrating the thriving of technology into the traditional education context (Lee and Kim, 2014), learners' confirmation about the online platform encourages the future development of this model. The students offered some reasons for favoring the use of technology which were insightful, for example, environmental protection, revision convenience, no physical location restriction, and accessible online learning resources, etc. The younger generation grew up in the so called E-world, and their acceptance to the technology has been undoubtedly increasing and easy. Despite the learners being familiar with the use of technology, they were not supposed to prefer the online learning method without hesitance. Learning online may be an alternative way of the traditional paper and pencil; however, it cannot substitute all of the advantages such as the physical sense brought by the handwriting. The improper use of the technology for language learning, for instance, over-relying on the translation machine was also mentioned by the students. Their opinions expressed some of the worries perceived by the conservatives toward the rapid development of information technology, and it deserves attention when adopting the TPACK model. Furthermore, the implicit benefit of peer review, like social interaction and awareness of audiences, cannot be sensed by the learners during the training process. But the obstruction followed by their peers' incompetent of linguistic knowledge was explicit, and thus increased the difficulty of implementation. The teacher had to spend time to explain the rationale of peer review, persuade them about positive benefits, provide alternatives, and modify some original designs. Finally, with regard to the third aim of this study, the original design of introducing the peer review activity was to reduce the workload of giving feedback and comments for the student writers. The teacher expected to receive better quality student writings after mutual learning from peer interaction. However, it was rare to observe initial drafts with significant improvement after the peer review cycle. This might be because they could have done things before they submitted the initial drafts, but the bottleneck was unable to be conquered through the facilitation of their classmates. In fact, the guided writing topics had clear directions for the content and organization construction, the use of word processing software help improve the mechanism, and the online dictionaries help search for those necessary words, grammar dimension then became the crucial part to be coached. These nursing students received English language education from the vocational system, which did not supply enough grammar rules teaching comparing with the academicoriented senior high school system. Syntax knowledge had become the weakest component for every student, and they had to mostly depend on the teacher's feedback. As a result, the English language teacher needed to not only correct the syntax errors for the second drafts, but also check the comments given by the peers. Plus, in screenings of the indirect feedback, the teacher needed to contribute exertions for the compositions. Furthermore, for nursing education, the TPACK model seems to suggest a potential framework to combine the two important instructional elements of ICT and EFL writing. However, the TPACK model may be of benefit to other healthcare programs outside of this institution, but further research would be required to explore the impact on academic writing. For instance, the technological knowledge can be applied into the other ICTs, for example, the IWBs (Interactive White Boards) (Jang and Tsai, 2012); the pedagogical knowledge can be changed by the other approach such as PBL (Problem Based Learning); and the content knowledge can be replaced by the other nursing subjects like Community Nursing, etc. Even for EFL writing content knowledge, the writing tasks can be carefully designed as clinical relevant topics so that nursing students can become acquainted with the medical terms and writing conventions.
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Limitations Limitations to the methodological design of the stuck are acknowledged including: the study did not design a comparison group due to ethical concerns and the complex components of the TPACK model. The effectiveness and efficiency of the course thus cannot be further testified through the experimental manipulation. Secondly, although the researchers attempted to avoid ethical risk, for example, having research assistants collect data outside the classroom after giving the module score, convenience sampling may still be a potential hazard regarding internal validity. Lastly, the sample size is rather small that the findings may not be suitable for generalization. Conclusion The TPACK model provides a comprehensive and multi-modal teaching approach that is ready for the EFL teachers to consider when designing the writing course. This study demonstrates a possible application of applying TPACK model into writing instruction, and the results suggest an effective way that helped nursing students improve their writing performance in every dimension significantly. The students felt moderate satisfaction about the course design due to the demanding tasks and peer review activities, although they recognized the integration of technology into syllabus. They also preferred receiving the direct feedback and comments from their teacher regarding linguistic forms and content. Corresponding to the learners' perceptions, the teacher reported the TPACK model as a challenging attempt for the implementation of peer review activities and giving feedback on time. Future studies including different academic subjects and/or specific model dimensions based on the TPACK model are recommended. Acknowledgments This paper as part of a research project was funded by Chang-Gang Memorial Hospital (CMRPF6D0031), and researcher's grant sponsored by the Institute of Humanities and Social Sciences of the Ministry of Science and Technology. Appendix A. Supplementary material Supplementary data to this article can be found online at http://dx. doi.org/10.1016/j.nedt.2015.02.016. References Archambault, L., Crippen, K., 2009. Examining TPACK among K-12 online distance educators in the United States. Contemp. Issues Technol. Teach. Educ. 9 (1), 71–88. Bennett, S., 2004. Supporting collaborative project teams using computer-based technologies. In: Roberts, T.S. (Ed.), Online Collaborative Learning: Theory and Practice. Information Science, Hershey, PA, pp. 1–27. Çalik, M., Ozsevgeç, T., Ebenezer, J., Artun, H., Kuçuk, Z., 2014. Effects of ‘environmental chemistry’ elective course via technology-embedded scientific inquiry model on some variables. J. Sci. Educ. Technol. 23 (3), 412–430. http://dx.doi.org/10.1007/ s10956-013-9473-5.
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