Other Titles

Mastery Learning Using Past Exam Questions to Enhance Achievement and Self-Directed Learning in Nursing Students [Title Slide]

Abstract

Purpose: This quasi-experimental study aimed to evaluate the effects of a mastery learning strategy based on past examination questions on nursing students’ self-directed learning ability and academic achievement in fundamental nursing.

Methods: A total of 106 second-year nursing students from a nursing junior college in Taipei participated in the study. The experimental group (n = 54) received mastery learning interventions, which included practice with past examination questions, error correction, and individualized feedback, while the control group (n = 52) received traditional instruction. The intervention lasted 18 weeks, and data on the Self-Directed Learning Instrument (SDLI) and academic achievement were collected at pretest, posttest, and delayed posttest. Questionnaires were administered between August 31, 2020, and February 28, 2021. Data analysis was conducted using SPSS version 20.

Results: The experimental group achieved significantly higher academic performance than the control group (p < .05), demonstrating that mastery learning effectively improved academic achievement. However, no significant improvements were found in most self-directed learning subscales, and the control group showed greater progress in learning motivation, interpersonal communication, and overall SDL scores (p < .05).

Conclusion: Mastery learning using past exam questions significantly improved academic achievement in fundamental nursing but had limited effects on self-directed learning ability. Future curriculum design should extend the intervention duration and incorporate motivational enhancement and reflective learning strategies to comprehensively foster nursing students’ self-directed learning skills.

Notes

References:

Lee, C.-T. (2022). An exploration of perceived stress during the first clinical practicum among five-year junior college nursing students. VGH Nursing, 39(1), 60–72. https://doi.org/10.6142/VGHN.202203_39(1).0007

Ching, C. H. K., Man, S. S. E., Lam, D. O. S., & Ho, K. Y. (2023). Associations among stressors, perceived stress, and psychological distress in nursing students: a mixed methods longitudinal study of a Hong Kong sample. Nursing Open. https://doi.org/10.1002/nop2

Cheng, W. L. S., Chow, P. P. K., Wong, F. M. F., & Ho, M. M. (2023). Associations among stressors, perceived stress, and psychological distress in nursing students: a mixed methods longitudinal study of a Hong Kong sample. Frontiers in psychology, 14, 1234354.

Finn, A., Fitzgibbon, C., Fonda, N., & Gosling, C. M. (2025). Self-directed learning and the student learning experience in undergraduate clinical science programs: a scoping review. Advances in Health Sciences Education, 30(3), 973-1005.

Lipsky, M. S., Cone, C. J., Watson, S., Lawrence, P. T., & Lutfiyya, M. N. (2019). Mastery learning in a bachelor’s of nursing program: The roseman university of health sciences experience. BMC Nursing, 18(1), 1-9. doi:10.1186/s12912-019-0371-x

Li, F., Zeng, Y., Fu, Y., Wang, Y., Lin, T., Deng, Q., & Li, J. (2024). Stressors and coping styles of nursing students in the middle period of clinical practicum: a qualitative study. BMC nursing, 23(1), 394.

Madou, T., & Iserbyt, P. (2020). Mastery versus self - directed blended learning in basic life support: a randomised controlled trial. Acta Cardiologica, 75(8), 760-766. doi:10.1080/00015385.2019.1677374

Morgan, E. (2022). Student Success Through Mastery Learning in a Nursing Health Assessment Course. Journal of Nursing Education, 61(12), 720-723.

Morris, R., Perry, T., & Wardle, L. (2021). Formative assessment and feedback for learning in higher education: A systematic review. Review of Education, 9(3), e3292.

Mehdipour–Rabori, R., Bagherian, B., & Nematollahi, M. (2021). Simulation-based mastery improves nursing skills in BSc nursing students: a quasi-experimental study. BMC nursing, 20, 1-7.

Porter, S. R. (2016). Competency-based education and federal student aid. Journal of Student Financial Aid, 46(3), 2-3

Schuwirth, L. W., & Van der Vleuten, C. P. (2011). Programmatic assessment: from assessment of learning to assessment for learning. Medical teacher, 33(6), 478-485.

Toqan, D., Ayed, A., Malak, M. Z., Hammad, B. M., AlBashtawy, M., Hayek, M., & Thultheen, I. (2023). Sources of stress and coping behaviors among nursing students throughout their first clinical training. SAGE Open Nursing, 9. https://doi.org/10.1177/23779608231207274

McGaghie, W. C (2015). Mastery learning: It is time for medical education to join the 21st century. Academic Medicine , 90(11), 1438–1441. doi:10.1097/ACM.0000000000000911

Winget, M., & Persky, A. M. (2022). A practical review of mastery learning. American journal of pharmaceutical education, 86(10), ajpe8906.

Yurdal, M. O., & Toraman, Ç. (2023). Self-directed learning, academic achievement and motivation: A meta-analytical study. Alberta Journal of Educational Research, 69(2), 233-253.

Description

This study examined the effects of a mastery learning strategy using past exam questions on nursing students’ self-directed learning and academic achievement in fundamental nursing. The 18-week quasi-experimental results showed significantly higher academic performance in the experimental group, suggesting mastery learning enhances achievement but has limited impact on self-directed learning.

Author Details

Chin-Ting Lee, MSN, RN - Doctoral Student,College of Nursing, National Yang Ming Chiao Tung University, Department of Nursing, MacKay Junior College of Medicine, Nursing, and Management

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Quantitative Research

Keywords:

Learning Methods, Self-Directed Learning, Nursing Students, Nursing Education, Academic Achievement

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-30

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Mastery Learning Using Past Exam Questions to Enhance Achievement and Self-Directed Learning

Toronto, Ontario, Canada

Purpose: This quasi-experimental study aimed to evaluate the effects of a mastery learning strategy based on past examination questions on nursing students’ self-directed learning ability and academic achievement in fundamental nursing.

Methods: A total of 106 second-year nursing students from a nursing junior college in Taipei participated in the study. The experimental group (n = 54) received mastery learning interventions, which included practice with past examination questions, error correction, and individualized feedback, while the control group (n = 52) received traditional instruction. The intervention lasted 18 weeks, and data on the Self-Directed Learning Instrument (SDLI) and academic achievement were collected at pretest, posttest, and delayed posttest. Questionnaires were administered between August 31, 2020, and February 28, 2021. Data analysis was conducted using SPSS version 20.

Results: The experimental group achieved significantly higher academic performance than the control group (p < .05), demonstrating that mastery learning effectively improved academic achievement. However, no significant improvements were found in most self-directed learning subscales, and the control group showed greater progress in learning motivation, interpersonal communication, and overall SDL scores (p < .05).

Conclusion: Mastery learning using past exam questions significantly improved academic achievement in fundamental nursing but had limited effects on self-directed learning ability. Future curriculum design should extend the intervention duration and incorporate motivational enhancement and reflective learning strategies to comprehensively foster nursing students’ self-directed learning skills.