Service Learning in the Nursing Bachelor Thesis: A Mixed-Methods Study

Round 1

Reviewer 1 Report

The paper indicates the advantages of Service-learning combined with bachelor thesis in nursing education. The study is well-designed using Kirkpatrick four-level model and their results will promote collaboration between academic and clinical settings which benefits nursing students and workers in their career.

One thing needs to be clarified is the number of participants, and how many for students, mentors, working nurses, respectively. The number is not consistent according to the statements. They mentioned that “23 participants: 15 nursing students, 4 mentors, and 4 working 77 nurses” in Page 2, line 77, however, they said “55 of 55 participants” in line 78. In addition, “mentors, 4 out of 6 were doctors” in line 80; “6 out of 6 for working nurses” in line 81-82. In Page 3, line 116, does “55 documents were analysed” mean there are 55 participants?

In their findings, the author should mention somewhere about the abbreviation “PE”, “PA”, “PT” they used.

Minor typo mistakes when the authors mentioned about Kirkpatrick four-level model, it should be “learning” instead of “leaning” in Page 1, line 8; Page 2, line 62.

In addition, authors did not mention author information in their main body of the manuscript.

Author Response

The paper indicates the advantages of Service-learning combined with bachelor thesis in nursing education. The study is well-designed using Kirkpatrick four-level model and their results will promote collaboration between academic and clinical settings which benefits nursing students and workers in their career.

Thank you very much for all your contributions and we apologize for the detected errors.

One thing needs to be clarified is the number of participants, and how many for students, mentors, working nurses, respectively. The number is not consistent according to the statements. They mentioned that “23 participants: 15 nursing students, 4 mentors, and 4 working 77 nurses” in Page 2, line 77, however, they said “55 of 55 participants” in line 78.

Our wording has created confusión. We reviewed it. There are actually 23 participants: 15 nursing students, 4 mentors, and 4 working nurses. Participants generated the 55 documents we analyzed.

In addition, “mentors, 4 out of 6 were doctors” in line 80; “6 out of 6 for working nurses” in line 81-82.

A translation mistake, the mentors are PhD, we have improved it.

In Page 3, line 116, does “55 documents were analysed” mean there are 55 participants?

The 23 participants generated 55 documents.

In their findings, the author should mention somewhere about the abbreviation “PE”, “PA”, “PT” they used.

These are the codes we use for the participants. PE students, PA nurses and PT mentors. To facilitate understanding we have changed them to: PS (Participating student, PN (Participating Nurse and PM (Participating Mentor)

We have added them to the tables.

Minor typo mistakes when the authors mentioned about Kirkpatrick four-level model, it should be “learning” instead of “leaning” in Page 1, line 8; Page 2, line 62.

We changed it, thank you.

Author Response File: Author Response.docx

Reviewer 2 Report

Dear Sirs,

 

Thank you for the opportunity to review the paper Service-learning in the nurse bachelor thesis: a mixed-method study.

 

The paper is interesting and contributes to the Discussion on the form of service-learning for nurses. 

 

The work needs some significant additions, especially in the first methodological part of the work. I present my comments below:

 

Lines 21-30. In my view, the paper's first paragraph (Introduction) starts the story from the middle. In a properly prepared scientific work, at this point, I would expect general information about education or problems in the education of nurses and forms of education in the profession. 

 

Moreover, after several changes, I would suggest that this paragraph be moved to Study Design (Line 64), which, for some unknown reason, was included in only one sentence, which does not meet the requirements of a scientific paper. Especially since in Subjects and Settings, the authors return to the discus of FDP. I would drop this subsection and add the information from lines 67-72 to the Study Design section. The lack of justification for the Subjects and Settings subsection is that this section describes the recruitment of people into the study - unless the authors treat them as Subjects. Information about the study participants should be labeled with a separate subsection, e.g., Recruitment of Study Participants or Study Participants. Line 85. shouldn't the subsection Description of the teaching innovation project come before the information about recruiting people for the study? 

Shouldn't the Rigour(?) subsection be combined with the Data Analysis section, which could be called Quantitative and Qualitative Data Analysis?

 

Line 73. What do the authors mean by purposive sampling? Because from the sentence: The participants' eligibility criteria were... it follows that it was purposive sampling and not random sampling. If the authors conducted purposive sampling, it should be presented in the article how many people the sampling frame consisted of and how the drawing was conducted. That is, from what number of students and how the 15 subjects were selected. 

One may also assume that the nurses and mentors were randomly selected. Was this the case? If so, this should be clarified. If not, this should be made clear. 

 

I am also not entirely clear (I can only guess) whether Mixed-methods, as mentioned in the article's title, refers to the data collection method or training methods. 

 

Line 133. Did the study consent have some administrative number assigned to it by the faculty?

 

Line 55. In the literature, it is accepted to use the term Kirkpatrick Model. The authors in the article use: Kirkpatrick&Kirkpatrick learning model, Kirkpatrick model, Kirkpatrick or Kirkpatrick&Kirkpatrick, on top of that with some designations the authors' state (2006). One gets the impression that the authors refer to different models in their article. 

 

I understand they are referring to what was published in Kirkpatrick, D. L., & Kirkpatrick, J. D. (2006). Evaluating Training Programs: The paper's Four Levels or the Spanish-language version is sometimes called the New Kirkpatrick Model. 

 

If so, I suggest that in a separate paragraph in a few sentences, you explain what the Kirkpatrick Model was, how it evolved, and for what reason the authors decided on a variation of the 2006 model. Especially since Donald Kirkpatrick presented the first four-level concept for evaluating training and its impact on organizational development more than 60 years ago in the Journal of American Society of Training Disorders.

 

Lines 55, 166, 177 et al. Remove the years of publication of the article with many citations, as well as the Kirkpatrick model.

 

Line 65. Parallel mixed-methods design - which means? It is worth adding a brief description of this method of data collection.

 

Line 80. 66.66% - I propose to remove it because statistically, it is easy to calculate how much 4 of 6

 

80. "were doctors" does this mean they had a Ph.D.? - it is worth specifying

 

83. accepted to use Master level and postgraduate degree

 

150. Table 2. Perhaps it is a matter of translation into English, but the scale given by the authors for evaluation in Level 2 is asymmetrical and does not indicate interval spacing. On a scale of this type, semantics plays a considerable role. Thus, we have not at all, which means null, nothing, zero. The following degree is barely, which is acceptable, but this is immediately followed by somewhat and quite, which in English mean the same thing. So you cannot see the change on the scale. The other end of the scale is very satisfied, which is unfortunately not counterbalanced by do not at all. These comments also apply to Table 4.

 

Line 150. Table 2. In the Activity schedules row, adding more numbers after the decimal point is helpful, even if they are just zeros. This remark also applies to Table 4. 

 

Line 150. Table 2. Instead of *, it is worth writing, for example, Note. Moreover, if the authors choose to *, there should be a cross-reference to it next to the abbreviations at the top of the table, e.g., M* SD* This comment also applies to Table 4. 

 

The last remark concerns the Discussion, which is very poor. It seems that it could also discuss the methodology of nursing education, the evaluation of this education, and many other issues.

 

Author Response

Thank you for the opportunity to review the paper Service-learning in the nurse bachelor thesis: a mixed-method study.

 

The paper is interesting and contributes to the Discussion on the form of service-learning for nurses. 

 

Thank you very much for all your comments. We will try to address them and justify the decisions taken. Your contribution has been of great interest to the research team.

 

Also, your contributions have provoked debate and have obliged us to take decisions we think you will like.

 

The work needs some significant additions, especially in the first methodological part of the work. I present my comments below:

 

Lines 21-30. In my view, the paper's first paragraph (Introduction) starts the story from the middle. In a properly prepared scientific work, at this point, I would expect general information about education or problems in the education of nurses and forms of education in the profession. 

 

You are right. An introduction related to nursing training and the Bachelor theses is missing. We added it.  

 

Moreover, after several changes, I would suggest that this paragraph be moved to Study Design (Line 64), which, for some unknown reason, was included in only one sentence, which does not meet the requirements of a scientific paper.

 

In relation to moving the text, we have decided to leave it in the introduction since it refers to the European/international context of BT in nursing education

 

In relation to the study design, we briefly described it. The other design elements such as: context, participants, data collection, data analysis; would remain specific sections.

 

We have followed the model of other articles published in the journal.

 

Especially since in Subjects and Settings, the authors return to the discus of FDP. I would drop this subsection and add the information from lines 67-72 to the Study Design section.

 

This section relates the situation of BT in the specific context of the research for this article, which helps to understand the development of the environment of the study.

 

We have used the concept Context instead of Setting to avoid confusion.

The lack of justification for the Subjects and Settings subsection is that this section describes the recruitment of people into the study - unless the authors treat them as Subjects. Information about the study participants should be labeled with a separate subsection, e.g., Recruitment of Study Participants or Study Participants.

 

We followed your advice and have separated the two sections.

 

Line 85. shouldn't the subsection Description of the teaching innovation project come before the information about recruiting people for the study? 

 

You are absolutely right. We have changed the location of the Description of the teaching innovation project, according to your proposal.

 

Shouldn't the Rigour(?) subsection be combined with the Data Analysis section, which could be called Quantitative and Qualitative Data Analysis?

 

Thank you for the proposal, we have combined the two sections.

 

Line 73. What do the authors mean by purposive sampling? Because from the sentence: The participants' eligibility criteria were... it follows that it was purposive sampling and not random sampling. If the authors conducted purposive sampling, it should be presented in the article how many people the sampling frame consisted of and how the drawing was conducted. That is, from what number of students and how the 15 subjects were selected. 

 

One may also assume that the nurses and mentors were randomly selected. Was this the case? If so, this should be clarified. If not, this should be made clear.

 

We have used a purposeful sampling. To avoid confusion we have explained a little more and we added the bibliographical reference on sampling and mixed method.

 

Palinkas LA, Horwitz SM, Green CA, et al. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Adm Policy Ment Heal Ment Heal Serv Res 2015; 42: 533–544.

 

All students who chose to perform a BT with SL were included in the study. These already had a tutor assigned. Nurses were selected for subject matter expertise. We clarified the issue.

 

I am also not entirely clear (I can only guess) whether Mixed-methods, as mentioned in the article's title, refers to the data collection method or training methods. 

 

It refers to Mixed methods research; a multimethod investigation (QUAN+QUAL). Therefore, we have put the brief explanation in the design.

 

Line 133. Did the study consent have some administrative number assigned to it by the faculty?

 

We are sorry, but no registration number was assigned to the consent.

 

Line 55. In the literature, it is accepted to use the term Kirkpatrick Model. The authors in the article use: Kirkpatrick&Kirkpatrick learning model, Kirkpatrick model, Kirkpatrick or Kirkpatrick&Kirkpatrick, on top of that with some designations the authors' state (2006). One gets the impression that the authors refer to different models in their article. 

 

I understand they are referring to what was published in Kirkpatrick, D. L., & Kirkpatrick, J. D. (2006). Evaluating Training Programs: The paper's Four Levels or the Spanish-language version is sometimes called the New Kirkpatrick Model. 

 

If so, I suggest that in a separate paragraph in a few sentences, you explain what the Kirkpatrick Model was, how it evolved, and for what reason the authors decided on a variation of the 2006 model. Especially since Donald Kirkpatrick presented the first four-level concept for evaluating training and its impact on organizational development more than 60 years ago in the Journal of American Society of Training Disorders.

 

You are absolutely right. By referring to the bibliographic quote we confuse the reader. We unified it and used it in an English version.

 

Lines 55, 166, 177 et al. Remove the years of publication of the article with many citations, as well as the Kirkpatrick model.

 

We removed it.

 

Line 65. Parallel mixed-methods design - which means? It is worth adding a brief description of this method of data collection.

 

We briefly explained.

 

Line 80. 66.66% - I propose to remove it because statistically, it is easy to calculate how much 4 of 6

 

You are right, we removed it.

 

80. "were doctors" does this mean they had a Ph.D.? - it is worth specifying

 

We rectified it. You are right that it is confusing.

 

83. accepted to use Master level and postgraduate degree

 

In Spain there is a Master´s degree and a postgraduate, which is why we separate it. 

150. 150. Table 2. Perhaps it is a matter of translation into English, but the scale given by the authors for evaluation in Level 2 is asymmetrical and does not indicate interval spacing. On a scale of this type, semantics plays a considerable role. Thus, we have not at all, which means null, nothing, zero. The following degree is barely, which is acceptable, but this is immediately followed by somewhatand quite, which in English mean the same thing. So you cannot see the change on the scale. The other end of the scale is very satisfied, which is unfortunately not counterbalanced by do not at all. These comments also apply to Table 4.

 

Thank you. We revised the table  3 and 4.

 

 Line 150. Table 2. In the Activity schedules row, adding more numbers after the decimal point is helpful, even if they are just zeros. This remark also applies to Table 4. 

 

Thank you. We added two decimals to unify all the results.

 

Line 150. Table 2. Instead of *, it is worth writing, for example, Note. Moreover, if the authors choose to *, there should be a cross-reference to it next to the abbreviations at the top of the table, e.g., M* SD* This comment also applies to Table 4. 

 

We followed your advice.

 

The last remark concerns the Discussion, which is very poor. It seems that it could also discuss the methodology of nursing education, the evaluation of this education, and many other issues.

We tried to improve the discussion by doing a new bibliographic search. But you should know that there are few published works on BT and none on BT and SL. So it is very difficult to introduce a contrasting bibliography.  We have improved level 1, 2 and 4.

We have also valued the length of the article.

We hope that our contributions seem correct and again, thanks for your review.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

No more suggestions. Thank you.