The Faculty Voice: Perceptions of Durable Learning

Abstract

Background:

Nursing faculty must rethink teaching strategies to transfer knowledge learned from the classroom to the clinical setting, known as durable learning. This study explores faculty perceptions of durable learning techniques in undergraduate baccalaureate nursing education.

Method:

Consented faculty (n = 28) from two large universities completed a 19-question electronic survey. Descriptive analysis was completed on the demographic questions, and content analysis was completed on the open-ended qualitative survey responses.

Results:

Case studies, group discussions, written assignments, and simulation were valued teaching techniques. Conversely, the flipped classroom design was reported as ineffective. Mixed results were reported for readings and lectures. The greatest barrier to implementing durable learning teaching techniques was lack of time. Participants lacked evaluative measures of outcomes.

Conclusion:

Findings revealed the need for additional research to support evidenced-based durable learning, including developing and validating a tool to evaluate durable learning in nursing education.

Nursing education has undergone profound changes including the recent update of the American Association of Colleges of Nursing (^{AACN, 2021}) Essentials, which has transitioned to a competency-based education approach. This has caused nursing faculty to rethink the way they teach by increasing the complexity of competencies required as students progress through a program and by preparing students to readily transfer knowledge from the classroom to the clinical setting (^{Mechtel et al., 2024}; ^{Reaves et al., 2024}). Faculty have yet to reach a consensus on how to achieve these goals. One potential consideration, however, is durable learning: the teaching/learning techniques that lead to retained knowledge, skills, and attitudes that are stable over time and transferred from the classroom to practice settings (^{Kim, 2019}). Durable learning techniques include retrieval practices, spaced-recall, and interleaving (i.e., spaced-out learning after new content is introduced) (^{Brown & Roediger, 2014}). These techniques produce lasting learning and versatile applications to new situations. For faculty, durable learning relies on using active learning techniques that involve the students' higher-order thinking, such as clinical judgment, for cognitive and psychomotor skills. In doing so, learning endures beyond one-time lectures or a course examination (^{Cook & Babon, 2017}; ^{Roediger & Butler, 2011}; ^{Weeks et al., 2024}) Durable learning is crucial to nursing education because it ensures that the future workforce not only acquires knowledge and skills but also retains and applies those skills to make sound clinical decisions, adapt to challenges, and maintain patient safety.

Background

Research on durable learning teaching techniques is extensive in other fields and recently has expanded to nursing education. However, a gap remains in consistently measuring student outcomes. Additionally, studies often use various active learning techniques, making it difficult to determine the effectiveness of student learning gains (^{Mechtel et al., 2024}). Effective implementation of durable learning techniques relies on the educator's knowledge of effective teaching approaches, but in many cases, faculty's reliance on their personal preference and previous experience hinders the adoption of new teaching approaches, including durable learning techniques. Research on prelicensure nursing faculty's perceptions of teaching techniques is limited (^{Askell-Williams et al., 2012}; ^{Kim, 2019}). Techniques reported in nursing education include (1) flipped classrooms; (2) simulation; (3) virtual reality; (4) concept mapping; and (5) gaming.

Flipped Classrooms

The flipped classroom involves students completing preparatory assignments before class, with in-class time focused on student-centered active learning and applying concepts. Educators facilitate by clarifying concepts and promoting critical thinking through realistic situations (^{Barbour & Schuessler, 2019}). Effective implementation requires faculty to have the foundational knowledge of the material and educational preparation with an emphasis on alignment of objectives with assessment (^{Barbour & Schuessler, 2019}) and clinical background (^{Ward et al., 2018}). However, studies on flipped classrooms show inconsistent measurement of student outcomes beyond exam scores (^{Ward et al., 2018}). Despite the challenges of the flipped classroom, one study has shown substantially higher exam scores with the flipped classroom linked to active student participation (OR 2.3: CI [1.001 to 5.1]) (^{Holm & Beckman, 2022}).

Simulation and Virtual Reality

Simulation, another teaching technique, is used to enhance student learning. One study that integrated high-fidelity simulation into classroom and clinical teaching found that students demonstrated critical thinking by applying theory to practice. Furthermore, students were less engaged when simulation was omitted (^{Hernandez-Acevedo, 2021}). The Simulation Effectiveness Tool – Modified, a reliable and valid instrument, was developed to evaluate how effectively simulation supports learning when aligned with both classroom and clinical objectives (^{Weeks et al., 2024}). Effective integration of virtual reality simulation into academic or clinical education requires attention to two essential components: adherence to the design standards established by the International Nursing Association for Clinical Simulation and Learning (INACSL) and implementation of a systemic change management approach (^{Willett et al., 2024}).

Concept Mapping and Gaming

Additional studies show that concept mapping enhances students' critical thinking, theory-to-practice application, and improves exam scores. For faculty, concept mapping helps assess learning progress and facilitates content sequencing across the curriculum (^{Gill et al., 2019}; ^{Rababah & Al-Hammour, 2024}). Finally, gaming, another active learning technique, provides immediate feedback and helps assess learning objectives. Gaming can be used for formative evaluation by supplying instant feedback to the learner, thus allowing for deeper learning of the content (^{McEnroe-Petitte & Farris, 2020}). Other techniques (e.g., lectures, assigned readings) continue to be used by nursing faculty despite the lack strong evidence of effectiveness (^{Bristol et al., 2019}; ^{Ogunlowo & Ajibade, 2024}).

This study sought to explore faculty perceptions of how durable learning occurs in undergraduate baccalaureate nursing students. The study will assist in identifying effective durable learning techniques that enable undergraduate baccalaureate students to retain and apply knowledge effectively in clinical practice.

Method

University Institutional Review Board approval was obtained. The recruitment email was sent to an administrative assistant for the school's research department or an administrative assistant for an Associate Dean of the college at each school of nursing, who distributed the email to undergraduate nursing faculty through their respective listservs. Both universities included in the study are large, public research universities located in either the Mid-Atlantic or Midwest region of the United States. University faculty who met the inclusion criteria (i.e., age 18 or older; able to read and speak English; consented to participate; and teach in a prelicensure nursing program) and were interested in participating in the study were instructed to email the principal investigator.

Potential participants were emailed a link to the informed consent form. After reading the informed consent, those willing to participate were instructed to click on the survey link to begin. The Research Electronic Data Capture (REDCap) survey contained 11 demographic questions and eight qualitative, open-ended questions focused on faculty's perceptions of durable learning in pre-licensure nursing students (^{Harris et al., 2009}). The survey questions were drafted based on evidence from two previous studies conducted by the authors (^{Mechtel et al., 2024}; ^{Reaves et al., 2024}). The authors used an iterative process, and questions were refined until consensus was reached (Table A; available in the online version of the article).

Table A

Survey Questions

Qualitative open-ended questions 1. What faculty-initiated teaching techniques do you (faculty) perceive to be effective for student learning? Name and describe them. A. Why do you believe the faculty-initiated technique(s) you listed above are effective for student learning? B. How do you measure the effectiveness of this faculty-initiated learning technique? 2. What faculty-initiated teaching techniques do you (faculty) perceive to be ineffective for student learning? Name and describe them. A. Why do you believe the faculty-initiated technique(s) you listed above are ineffective for student learning? B. How did you determine that this faculty-initiated learning technique was ineffective? C. Do you know of any of these ineffective techniques that are still being used in your nursing program? 3. Are there barriers to implementing faculty-initiated effective teaching techniques? Demographic information 1. Title 2. Full-time or adjunct/part-time 3. Years as a nurse 4. Years of teaching nursing 5. Highest degree 6. Type of program in which you teach (baccalaureate or second degree) 7. Education preparation in nursing education—institutional training, MS in nursing education, certificate program, DNP in nursing education 8. Certification earned (e.g., CNE, CNE®cl) 9. Course level taught—100, 200, 300, or 400, or 1st, 2nd, 3rd, or 4th year 10. Type of course – Fundamentals, Pharmacology, Pathophysiology, Health Assessment, Medical/Surgical, Women's Health/Obstetrics, Pediatrics, Mental Health, Community Health, Leadership/Professional Issues, Capstone, Ethics, Research, Other 11. Where do you teach?

Data then were extracted from REDCap, de-identified, and collated by question. Descriptive analysis was completed on the demographic responses, and content analysis was completed on the open-ended responses. First, each author independently read the open-ended responses discerning inherent learning techniques and prospective themes. The research team then met to discuss emerging techniques and themes, resulting in a code-book. The team revisited the data set, and all data were coded by two researchers independently. The team met a second time to discuss discrepancies in the identified coded text and deliberated until consensus was achieved.

Results

A total of 28 participants completed the study. Demographic analysis revealed the expertise of most of the nursing faculty participants was Instructor or Assistant Professor (n = 24) who were employed full-time (n = 21), and held a doctoral degree (n = 16). Additionally, many of the participants had been RNs for more than 10 years (n = 25) and had been teaching for 7 or more years (n = 21). Finally, the majority of faculty (n = 18) had specific preparation in nursing education (Master of Nursing, Doctor of Philosophy, or Doctor of Nursing Practice).

Multiple faculty-initiated teaching techniques were identified that participants perceived to be effective, ineffective, or both effective and ineffective. Participants offered teaching strategies that they valued as effective and ineffective techniques. Data from the open-ended questions were analyzed concurrently with data collection to ensure saturation. Additionally, participants shared how they measure the effectiveness of the teaching technique(s) implemented, and what barriers, if any, prevent implementing effective teaching techniques. Within each of these categories, common themes were identified.

Perceived Effective Teaching Techniques

Effective faculty-initiated teaching techniques for active student learning included case studies (n = 13), simulations (n = 10), group discussions (n = 14), gaming (n = 7), interactive questions (n = 8), quizzes (n = 4), written assignments (n = 10), and videos (n = 6). Case studies (including unfolding, role-playing, case-based, and problem-based studies) and simulation were found to be effective and engaging teaching techniques. Participants measured the effectiveness of case studies through examinations and quizzes, depth of student analysis and response, observation of the class, qualitative feedback on surveys, reflection papers, and peer review. One participant stated how case studies enhance critical thinking and reasoning skills by “using the information [to] analyze the data, problem solve, make decisions, and draw inferences.” Another participant noted that case studies keep students engaged by being a “fun way to tie in content taught in lecture.” Similarly, participants viewed simulation as an effective way to apply content, critically think, and engage students. One participant said, “[Simulation] requires active participation in learning and helps [students] piece together all the information.” Additionally, simulations prepare students for practice by “thinking through what is happening in a particular situation, similar to a case they may see in real life.” Most of the participants measured the effectiveness of simulation using performance rubrics, written reflections, examinations, and discussion boards.

Group discussions, including discussions in class, discussion boards, or group activities, also were perceived as effective teaching techniques by most of the participants. Participants stated group discussions encouraged “individual reflection, peer discussion, and collaborative learning” while also “reinforcing concepts addressed in class.” The effectiveness of group discussions was measured through graded assignments, examinations and quizzes, responses, and engagement.

Both gaming and interactive questions were perceived as effective. Gaming techniques included Jeopardy!, bingo, trivia, and 20 questions. One participant suggested gaming is effective because “It engages the students.” Another participant said, “This generation of students grew up with computers, video games, and social media. They respond to being involved in their learning and dislike having their entire class time be a lecture.” One participant believed gaming was effective secondary to students “liking a sense of competition.”

Similarly, participants perceived interactive questioning as another way to keep students engaged during lectures. Interactive questions included class or small group Socratic questioning and the use of interactive online learning platforms, such as Kahoot! and iClicker. One participant stated, “[Asking questions] engages the students and encourages them to participate.” Interactive questions and gaming were measured to be effective through examinations, student feedback on surveys, engagement, performance in simulations, and discussion boards.

Finally, written assignments, videos, and quizzing also were deemed effective. Written assignments included preclass and prep worksheets, journaling, reflections, presentations, and crossword puzzles. Regarding crossword puzzles, one participant stated how they “allow [students] to think through the answers and learn spelling.” Another participant stated that preclass assignments allow students to “become knowledgeable of key topics prior to lecture.” Similarly, videos also were perceived as an effective teaching technique. One participant who noted how pre-assigning videos prior to class better prepares students to discuss topics covered in class said, “Students come to class prepared to apply their knowledge.” Relatedly, many participants perceived that quizzing prepared students to apply the knowledge learned. One participant stated, “I believe the application of learning is more durable.” Written assignments, videos, and quizzing were measured through examinations and quizzes, simulations, discussion boards, and graded assignments.

In addition to each of the effective faculty-initiated teaching techniques described above, participants stated using a combination of techniques was most effective. One student noted, “I believe that a mix of teaching techniques help keep students engaged with the course content and allows the faculty member to provide content in a variety of ways as all learners may learn best differently.” The concern with mixed techniques is the difficulty in ascertaining the effects of the individual technique.

Perceived Ineffective Teaching Techniques

Faculty-initiated teaching techniques perceived as not contributing to student learning include flipped classrooms (n = 7), mandatory learning modules by a national publisher (n = 1), and memorization (n = 1). Despite participants perceiving each of these teaching techniques as ineffective, participants noted that each is still in use.

Flipped classrooms were perceived as ineffective secondary to students' unwillingness to prepare. One participant stated, “If students do not participate in the prework, which they often don't, the class activities are fruitless even if they are active and engaging.” Additionally, participants perceived flipped classrooms to be ineffective because they “do not require interaction with the instructor.I believe interactions with instructorsopportunity to ask questions and get explanations are critical to student success.” It is important to note that the specific active learning techniques within the flipped classroom were not identified. When asked how the effectiveness of a flipped classroom was measured, participants anecdotally reported student dissatisfaction.

Mixed-Results Teaching Techniques

Participants differed in the effectiveness of three teaching techniques: (1) readings; (2) lectures; and (3) quizzes. Although 10 participants stated that assigned readings were effective, 15 participants viewed assigned readings as being ineffective. The reasons provided by participants regarding the ineffectiveness of assigned readings were that the readings were not engaging or meaningful for students, leading to students not completing the readings. One participant said, “I don't think students gain knowledge from just reading. They seem to be more engaged and receptive with hands-on learning and real-life examples.” Another participant noted, “[The] students do not do the readings.” This results in students being ill-prepared in class when engaging in class activities; one participant said, “It can be hard to incorporate active techniques when the students are not completing the preclass assignments.”

In contrast, to provide support for effectiveness, one participant said, “Students learn better if they have been pre-exposed to the material before coming to class. Having them learn some material and be responsible for teaching helps to keep them engaged.” Additionally, one participant noted the benefit of assigned readings in helping to prepare students for the class was to help relay content. This participant said, “I feel it is necessary for students to read prior to lecture so that they are prepared with background information.” Participants measured whether readings were effective or ineffective through examinations and quizzes, graded assignments, discussion boards, simulations, student feedback on surveys, and reflections.

The effectiveness of lectures also had mixed findings with participants (n = 8); some found lectures to be effective, while others did not. Lecturing on content for an extended time (more than 45 minutes) was perceived as ineffective. One participant stated, “Students must be actively engaged in their learning. The more senses they use, the more they will retain the information. Straight lecture is a thing of the past.” Another participant said, “It is difficult for anyone to sit and listen to one person lecture for 2 hours, especially new content without understanding how this could be applied in a professional nurse's role.” However, participants noted that lectures can be effective when embedded with real-life examples and storytelling. One participant noted, “Students connect strongly with examples that come from real-life practice.” The measurements participants used to determine whether lecture was ineffective were nonverbal student cues and lack of engagement, whereas measurements of its effectiveness were examinations, quizzes, reflections, and simulations.

Finally, administering quizzes had mixed findings, with one participant noting the technique to be ineffective and four participants finding it effective. Quizzes were noted to be formative, while examinations were noted to be summative. One participant stated how quizzes prepare students for the content being presented, “Quizzes are based on the educational material being presented that day. I believe it gets the student thinking about the material being presented.” However, another participant noted how quizzes “create anxiety, which I think can impede learning.”

Barriers to Implementing Effective Teaching Techniques

Participants also were asked to identify the barriers to implementing effective teaching techniques. Five themes that emerged were time (n = 10), money and technology (n = 4), class size (n = 2), administrative support (n = 2), and student engagement and perception of learning (n = 2). Most of the participants cited time as the biggest barrier to implementing effective teaching techniques. One participant stated, “The large amount of content that needs to be taught in a particular course can make it difficult to incorporate a variety of teaching techniques because of the limited time available to cover all the content.” Another participant said, “[There is no] time to change the way you currently teach with all the other responsibilities facing a nurse educator.”

Money and technology also were noted to be barriers to implementing effective teaching techniques. Participants stated how students needed money to purchase the technology used, but oftentimes students sought to save money by purchasing outdated technology. One participant said, “Nursing students are asked to purchase a lot, which can impede learning if they don't have the resources to purchase or have to purchase secondhand.”

Class size and administrative support also were identified as barriers. An exemplar from a participant stated, “Having class sizes of 70 to 150+ makes it challenging to do anything besides lecture.” Another participant said, “At times I feel that faculty are not provided enough resources and support from administration to make the changes required.”

Finally, student engagement and student perception of learning also were perceived as barriers to implementing effective teaching techniques. For example, one participant stated, “Students can be rather opinionated if they perceive that they do not ‘like’ an assignment or activity and yet do not understand the rationale behind the assignment or activity even if faculty explain the ‘why.’” This can lead to students being unprepared, which one participant noted can “impact the ability to effectively utilize active teaching strategies.”

Discussion

There was general agreement by expert nursing faculty that case studies and simulation were among the most useful techniques in promoting durable learning. Participants perceived student engagement to be most prevalent in activities such as case studies and simulation. Although participants agreed that student engagement was beneficial, student engagement must not be confused with learning; imagine a popular professor conducting an entertaining simulation that failed to meet the course's learning objectives.

Importantly, objective assessment methods, including examinations and quizzes as well as performance rubrics, were cited by participants as supporting evidence for simulation and case studies. For teaching methods including discussions, assigned readings, lectures, gaming, interactive questions, quizzing, written assignments, and videos, participants were unable to provide objective data supporting effectiveness but rather referenced “student feedback” and “lack of engagement.” Many of the participants stated they evaluate the effectiveness of their teaching technique(s) through examinations and quizzes. Yet, examinations and quizzes alone make it difficult to determine the effectiveness of any teaching-learning technique when a combination of techniques is used.

The flipped classroom model, while not clearly defined by participants, was perceived as ineffective due to students not completing preclass assignments. The flipped classroom approach therefore is based on active learning, defined as any instructional method that involves students in the learning process (^{Talbert & Mor-Avi, 2019}). Ambiguity around the interpretation of the flipped classroom by faculty is consistent with the literature (^{Talbert & Mor-Avi, 2019}). The flipped classroom has three main components: (1) preclassroom assignment; (2) active learning strategy; and (3) evaluation (^{Barbour & Schuessler, 2019}). However, the active learning strategy is not well defined and often multiple learning strategies can be used. This makes it difficult to assess clear outcomes. Without this preparation, students treat the class as a lecture and struggle to apply content in a flipped classroom environment, making it challenging to draw meaningful conclusions about the technique's effectiveness. The faculty concluded that while engaging, the flipped classroom fails to enhance student learning.

Some faculty found assigned readings ineffective for student learning, as students unprepared for lectures cannot fully engage in the content. Anecdotal evidence of poor student preparation since 2020 has been attributed to the global pandemic; however, the trend of poor academic preparation for college preceded the pandemic (^{Harris et al., 2009}). Students today read less, have poorer reading comprehension, and have shorter attention spans than their counterparts in previous generations (^{Ball et al., 2024}; ^{Reibel et al., 2024}), all of which are negative prognostic indicators of success in nursing school (^{Mitchell, 2024}). Furthermore, these traits are significantly worse among diverse student groups (^{Reibel et al., 2024}). If students are ill-prepared for college-level work, how can faculty expect durable learning to materialize?

When looking at ineffective teaching techniques, there are some key considerations. First, does any of this matter? Is anything lost by not following faculty's instructional design, like in the flipped classroom, or can students learn effectively without preparation or reading assignments? Examinations do not isolate the learning from prework and reading; however, passing scores suggest learning is occurring. But is it durable learning? Or are students passing the exam with minimal effort and are unable to apply the content clinically? One participant criticized compulsory modules from a national publisher, and anecdotally other faculty voiced the same criticism. While there is value in completing those assignments, should quality or the cost be adjusted to deem this work more valuable to students?

A key takeaway from the study was the disagreement among faculty on the value of lectures and assigned readings, with equal numbers noting them as effective and ineffective. This is consistent with the literature, but evidence for the ineffectiveness of lectures is lacking (^{Tronchoni et al., 2022}). Some participants voiced opinions that lecture is an ineffective method. One conclusion to be drawn from this duplicity is that faculty have deeply held notions of what is effective. When participants were asked how they assess the effectiveness teaching techniques, most responded with subjective assessments, such as personal observations (e.g., student level of engagement or distraction) and student reports. Student reports could be a few vocal students and may not be representative of all students. Since participants could not support their responses with data, their views may reflect personal preferences and biases.

Limitations

Participants in the study were faculty from two large universities, similar in size, population, and programs (baccalaureate). Faculty who teach in diploma or associate degree programs could provide valuable insights on durable learning, even though they are not beholden to teaching The Essentials (^{AACN, 2021}). Detailed demographics were not collected to protect anonymity. Additionally, the online survey format limited the ability to ask clarifying questions for a deeper understanding of participants' responses. Another limitation is faculty biases, as participants would voice strong opinions on effective techniques without solid evidence, and the questionnaire did not capture why participants choose the instructional methods they use. Finally, this study did not address learning in asynchronous online courses, which increased during the pandemic and may increase in the future.

Conclusion

This study showed suboptimal teaching techniques persist in nursing education, with disagreement on what is effective. While some support the flipped classroom, others find it ineffective, citing a lack of student preparation. Similarly, lectures remain endemic in nursing education. Although students may expect and base their learning strategies around lectures, many educators believe lectures are less effective than other methods. Meanwhile, the evidence supports neither perspective (^{Tronchoni et al., 2022}). As previously addressed, these teaching methods persist.

The findings suggest faculty may be entrenched in their beliefs about teaching techniques, influenced by factors including ignorance of best practices, organizational rigidity, and tradition (e.g., “I’ve always done it this way”). Most confounding is this strong opinion without objective evidence. These findings highlight the need for a tool to measure durable learning and effective teaching in nursing education.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Askell-Williams, H., Lawson, M. J., & Skrzypiec, G. (2012). Scaffolding cognitive and metacognitive strategy instruction in regular class lessons. Instructional Science, 40(2), 413–443. 10.1007/s11251-011-9182-5

Ball, I., Banerjee, M., Holliman, A., & Tyndall, I. (2024). Investigating success in the transition to university:Asystematic review of personal risk and protective factors influencing academic achievement. Educational Psychology Review, 36, 52. 10.1007/s10648-024-09891-0

Barbour, C., & Schuessler, J. B. (2019).Apreliminary framework to guide implementation of the flipped classroom method in nursing education. Nurse Education in Practice, 34, 36–42. 10.1016/j.nepr.2018.11.001 PMID: 30439682

Bristol, T., Hagler, D., McMillian-Bohler, J., Wermers, R., Hatch, D., & Oermann, M. H. (2019). Nurse educators' use of lecture and active learning. Teaching and Learning in Nursing, 14(2), 94–96. 10.1016/j.teln.2018.12.003

Brown, P. C., & Roediger, H. L., III. (2014). Making it stick. The Belknap Press of Harvard University Press.

Cook, B. R., & Babon, A. (2017). Active learning through online quizzes: Better learning and less(busy) work. Journal of Geography in Higher Education, 41(1), 24–38. 10.1080/03098265.2016.1185772

Gill, M. E., Zhan, L., Rosenberg, J., & Breckenridge, L. A. (2019). Adverse childhood experiences: Concept mapping in the bachelor of science in nursing curriculum. Journal of Nursing Education, 58(4), 193–200. 10.3928/01484834-20190321-02 PMID: 30943293

Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture(REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. 10.1016/j.jbi.2008.08.010 PMID: 18929686

Hernandez-Acevedo, B. (2021). Nursing faculty integrate simulation instruction into their teaching practice:Aphenomenological study. Teaching and Learning in Nursing, 16(3), 205–209. 10.1016/j.teln.2021.03.003

Holm, P., & Beckman, L. (2022). Flipped or traditional online teaching? Two different strategies to handle teaching in nursing education during the COVID-19 pandemic. International Journal of Nursing Education Scholarship, 19(1),1– 6. 10.1515/ijnes-2021-0119 PMID: 35187926

Kim, J. (2019). Teaching for now and later: Key factors in creating durable learning. Discussions on University Science Teaching: Proceedings of the Western Conference on Science Education, 2(1). https://ojs.lib.uwo.ca/index.php/wcsedust/article/view/8117

McEnroe-Petitte, D., & Farris, C. (2020). Using gaming as an active teaching strategy in nursing education. Teaching and Learning in Nursing, 15(1), 61–65. 10.1016/j.teln.2019.09.002

Mechtel, M., Kitt-Lewis, E., Reaves, C., Sinacori, B., O'Brien, T., Logan, P., Rimbey, P., Streiff, K., & Phillips, K. (2024). Durable learning strategies in nursing education: State-of-the-evidence review. Journal of Nursing Education, 63(1), 24–31. 10.3928/01484834-20231112-05 PMID: 38227323

Mitchell, K. M. (2024). Does reading ability predict student success?Ascoping review. Nurse Education Today, 136, 106150. 10.1016/j.nedt.2024.106150 PMID: 38457950

Ogunlowo, S. O., & Ajibade, B. L. (2024). Investigating the differential efficacy of lecture and demonstration teaching methods in teaching medical-surgical nursing among nursing students. BMC Nursing, 23(1), 884. 10.1186/s12912-024-02541-4 PMID: 39627740

Rababah, J., & Al-Hammour, M. M. (2024). Improving clinical decision-making self-directed learning among Jordanian nursing students using concept mapping. Teaching and Learning in Nursing, 19(2), e283–e287. 10.1016/j.teln.2023.11.011

Reaves, C., Kitt-Lewis, E., Mechtel, M., & Logan, P. (2024). The student voice: Perceptions of durable learning. Nurse Educator, 49(6), 333–338. 10.1097/NNE.0000000000001653 PMID: 38718802

Reibel, M. D., Terzulli, D. M., Poston, K., & Cason, M. L. (2024). Dual application of interactive whiteboard technology to develop students' clinical judgment skills. Teaching and Learning in Nursing, 19, e182–e188. 10.1016/j.teln.2023.10.017

Roediger, H. L., III, & Butler, A. C. (2011). The critical role of retrieval practice in long-term retention. Trends in Cognitive Sciences, 15(1), 20–27. 10.1016/j.tics.2010.09.003 PMID: 20951630

Talbert, R., & Mor-Avi, A. (2019).Aspace for learning: An analysis of research on active learning spaces. Heliyon, 5(12), e02967. 10.1016/j.heliyon.2019.e02967 PMID: 32368631

Tronchoni, H., Izquierdo, C., & Anguera, M. T. (2022).Asystematic review on lecturing in contemporary university teaching. Frontiers in Psychology, 13, 971617. 10.3389/fpsyg.2022.971617 PMID: 36405191

Ward, M., Knowlton, M. C., & Laney, C. W. (2018). The flip side of traditional nursing education:Aliterature review. Nurse Education in Practice, 29, 163–171. 10.1016/j.nepr.2018.01.003 PMID: 29414110

Weeks, K., Herron, E., & Buchanan, H. (2024). Aligning simulation-based education with didactic learning in prelicensure baccalaureate nursing education. Nurse Educator, 49(3), 125–129. 10.1097/NNE.0000000000001554 PMID: 37851404

Willett, J., Adelman-Mullally, T., Ng, H., & Chung, S. Y. (2024). Virtual reality simulation integration inaprelicensure nursing program: Lessons learned. Nurse Educator, 49(4), 217–221. 10.1097/NNE.0000000000001586 PMID: 38235752