Nurse educators are responsible for producing nurse graduates that are competent, safe, and prepared to manage the complex clinical situations they will face. These graduates must possess sound clinical judgment skills that ensure safe and effective delivery of patient care. The decreasing capacity of clinical placements available for students to acquire hands-on experience presents an additional challenge. Educators must develop and implement innovative, effective teaching strategies to address these issues. An initial comparative concept analysis of engagement and reciprocity focused on the educator-student relationship as one in which all members contribute to the learning atmosphere is included in Chapter 2. Subsequently, a study aimed at investigating how a metacognitive strategy employed in an active learning exercise influenced student achievement and engagement was conducted. A parallel explanatory, mixed methods design in a sample of nursing students (N=124) was employed. Ultimately, all participants experienced a significant increase in learning (p < .01). There was a nonsignificant increased interaction effect between the intervention and control group in the pre- versus post-test repeated measure (p = .085). The metacognitive strategy was found to be nonsignificant (p = .625) in impacting student scores. The intervention group did exhibit a larger increase in learning from pre to post-test than the control group. Fifty-two of the 63 participants in the intervention group reported an increase in engagement with the content at hand while using the metacognitive strategy.

Date of publication

Spring 4-10-2018

Document Type




Persistent identifier


Committee members

Jenifer Chilton PhD (Chair), Belinda Deal PhD, and Colleen Swain PhD


Doctor of Philosophy in Nursing

Available for download on Monday, May 11, 2020

Included in

Other Nursing Commons