The influences of teaching strategies and reinforcement techniques on health care workers' learning and retention

Cecilia Tolentino Burke


The purpose of this study was to investigate the effects of using different teaching strategies and game-based reinforcement techniques on health care workers' cognitive learning and knowledge retention. The sample consisted of 237 health care workers employed in a small community acute care facility in Mississippi. An experimental equivalent control group design was used to study the three hypotheses. Initially, the subjects were randomly assigned into one of the two possible teaching strategies. These strategies included the completion of a self-learning module on the topic and the viewing of a commercially-prepared videotape on the content. A 20-item combination true/false and multiple choice test was administered as a pretest and posttest to both groups. Analysis of data showed statistically significant differences between the mean posttest scores of the self-learning module group and the videotape group. One month later, the subjects were assigned to either experimental or control groups. These groups consisted of a self-learning module group with gaming; self-learning group without gaming; videotape group with gaming; and videotape group without gaming. All groups received the same delayed posttest that was administered for pretest and immediate posttest. The results of ANCOVA revealed that there were statistically significant differences on the retention of knowledge between the experimental and control groups. Additionally, there was a statistically significant interaction between type of instruction and the reinforcement technique. The study showed three important findings: (a) the self-learning group with or without gaming produced the highest delayed posttest scores; (b) the videotape group with gaming produced the second highest delayed posttest scores; and (c) the videotape group without gaming produced the lowest delayed posttest scores. The importance and efficacy of self-directed learning are explored in this study. Recommendations for future research are indicated to analyze the cost benefit of one methodology over another given today's limited financial resources of staff development education.