RESEARCH BACKGROUND
Concentration is a crucial step in the learning process.1 Chang et al2 emphasized the significance of the connection between concentration and learning effectiveness. Thus, awareness of students' current concentration levels and the ability to recover students' attention are important issues for teachers. However, Burke and Ray3 stressed that high levels of concentration are difficult for students to achieve in the classroom. They suggested that teachers can use different media to improve students' concentration and allow students to learn actively and meaningfully, thereby achieving higher learning efficiency.
A number of existing studies have introduced formative assessment strategies into the classroom using information technology systems that provide instant feedback. These are called interactive response systems.1,4,5 Although these have been shown to exert a positive impact, researchers have also pointed out that when instant feedback systems are used during class, students may discuss the answers among themselves, which makes the assessment of each individual student less accurate. In addition, when teachers use the multiple-choice function, they do not process the student responses any further, causing students to not care whether their responses are correct or not. To address these issues, Treagust6 proposed two-tier assessment. In the first tier, the assessment questions focus on core concepts, and in the second tier, the students are asked to explain the reasons for their original responses. This offers a better picture of student understanding and tends to reduce random guessing.
In this study, we sought to combine an instant-feedback system with the two-tier assessment strategy. Our first tier was a multiple-choice assessment, and in the second tier, students were randomly selected to explain the reason for their response. It is hoped that through this assessment strategy, students' learning concentration can be improved, and students' satisfaction with the course can be enhanced.
LITERATURE REVIEW
Concentration and Learning Effectiveness
Concentration or attention plays an important role in improving learning achievement.1 It is a focused state of awareness in which individuals bring a part of the external world into their internal consciousness and adjust their own actions accordingly.7 This state supports learning by securing the learning task, activity, or objective in students' long-term memory.8 Only with concentration can students actively learn, understand, and become familiar with the learning objective.9 Anderson10 indicated that learners with poor concentration may experience restlessness or irritation in class, which may influence their learning effectiveness and prompt them to engage in improper learning behavior, such as chatting or interfering other students, that are ultimately detrimental to their overall learning performance.
Bos et al11 used brain wave sensors to investigate attention to the use of interactive videos. The results indicate that attention status is essential for learning effectiveness. Chen et al conducted a research of 108 students at an industrial vocational high school in Taipei City, Taiwan. The results showed the learners with high attention level in the experimental group have exhibited better review performance and sustained attention than the learners in the control group.12 Chan et al conducted a study with a sample of 247 undergraduate students studying business at a Hong Kong university. The results showed that students tend to be more active expressing their views when they receive more attention. When students more actively participate in learning, interactivity is more likely to enhance their learning performance.13 Chen and Wang14 applied concentration and warning mechanisms to 83 students engaged in online learning and discovered a strong correlation between concentration and learning effectiveness.
Clearly, a close relationship exists between concentration and learning effectiveness.1,11 Thus, curricular designs should enable students to remain concentrated during the learning process to ensure the knowledge they have gained in their short-term memory shifts to their long-term memory.
Instant-Feedback Systems and Concentration Enhancement
As we have already established, a close relationship exists between concentration and learning effectiveness. For this reason, the means of enhancing student concentration is an important issue. Research indicates that teachers can enhance the concentration of students using simple, relevant, and positive interventions.3
A number of recent foreign and domestic studies have demonstrated that instant-feedback systems (like clickers, personal response system, and Classroom Response System) can help students pay attention better in class, which in turn enhances their learning effectiveness and boosts their confidence in learning. Instant-feedback systems enable the teacher to obtain responses from every student at the same time, during class. This expands the one-way teaching model and improves student concentration.15,16 Boden and Hart17 indicated that students become more involved and focused when teachers use Kahoot. Licorish et al18 integrated Kahoot! into Earth Science teaching. They founded that all students commented that they liked Kahoot!. It can help them focus on their learning process. Liu et al19 incorporated a classroom feedback system into an English class and found that students became more involved and interested in the topic at hand. Lee et al15 used the online instant-feedback system Kahoot in an earth science course at a rural school and observed increased student motivation and concentration. Sun and Hsieh20 had similar results; their study indicated that using highly interactive, challenging, and competitive instruments such as an instant-feedback system can prompt students to devote more attention to classroom learning. Malekigorji and Hatahet5 hybridized Classroom Response System with Flipped Classroom and Team-Based Learning and found that students provided positive feedback regarding Flipped Classroom Response System and enhanced their motivation, engagement, attendance, and academic performance.
From the above literature, we can clearly understand that through the instant-feedback systems, students can pay more focused on learning, so this research integrates instant-feedback systems in the classroom.
Theoretical Basis of Instant-Feedback Systems
Assessment Centered
Khatimah21 indicated that learning environments must be assessment centered, which stresses the importance of feedback to learning. Bransford et al22 explained that an assessment-centered learning environment provides students with opportunities to assess their own learning conditions at any time and obtain instant feedback. In this way, students can understand their mistakes, which helps them clarify their ideas and dispel misconceptions. Furthermore, the instant feedback system provides feedback to the whole class, so students can compare their answers with their classmates and to reflect on their ideas and adjust their thinking.4
Pausing Procedure
The function of the pausing procedure is to stimulate learners to participate actively in new learning materials, thereby promoting learner reflection.23 Rowe24 proposed introducing at least three pauses during each class so that students can discuss the new information presented and organize their notes. There are two theoretical bases for this pausing procedure: (1) students cannot swiftly and efficiently organize the content they hear in class and then store it in their long-term memory, which leads to mental lapses; and (2) pauses can give students the chance to clarify and digest class content, which then helps to overcome mental lapses. The use of instant-feedback systems to conduct formative assessments is a widely implemented method of creating pauses during the learning process.
Drawing Student Attention to Learning
Keller25 suggested that teachers use the following three methods to draw student attention to course content: (1) perceptual arousal: when teaching, teachers can use different sounds, colors, and images to stimulate student senses and capture their attention; (b) inquiry arousal: when teaching, teachers can ask thought-provoking questions of the students; and (3) variability: a wide range of teaching methods can hold student attention and maintain novelty. The use of instant-feedback systems in class can encourage students to become more curious and attentive. When teachers throw out a question every once in a while during teaching activities, it prompts students to think, increases their involvement in learning, and maintains a sense of novelty for them.
Two-Tier Assessment
The two-tier assessment strategy was proposed by Treagust.6 Tests are divided into two tiers: The first focuses on core concepts and the second asks students to explain the reasons for their responses in the first tier. This can help teachers understand student progress and diagnose misconceptions in the moment, enabling them to react accordingly. Supatmi et al26 used a two-tier diagnostic test to explore students' misconceptions of acid-base titrations. Metioui27 created a true-or-false questionnaire justification to study the misunderstandings of 80 junior preservice teachers from Quebec, Canada, about the current source of DC circuits. Data analysis identifies many conceptual difficulties. Hadinugrahaningsih et al28 diagnosed students' alternative conceptions about electrolyte and nonelectrolyte solutions and then provided individualized remedial teaching. He found that this approach effectively reduced student misconceptions. Chang et al29 proposed a nonimmersive virtual reality guidance system combined with a two-tier strategy to help students learn geology knowledge. They found that the guidance system not only improved the students' learning achievement in natural science but also enhanced their learning motivation.
It can be seen from the literature that the two-tier strategy is mostly used to diagnose the misconceptions of student learning, but by answering the question, students should be pay more attention on the class. So in this study, we used two-tier assessment to improve students' concentration, the first tier of assessment comprised multiple-choice questions, and the second tier involved oral questions regarding the reasons students chose the answers they did for the first tier.
METHODOLOGY
Research Participants and Design
We adopted the quasi-experimental method and purposive sampling. The participants comprised 52 first-year nursing students at a science and technology university in Central Taiwan enrolled in an introductory computer course. This course ran for 6 weeks with two classes per week. We adopted a one-group pretest-posttest approach. The course content combined the visualized programming language mBlock and the educational robotic kit mbot. The course began with an introduction to mBlock; the teaching methods included lectures and exercises with game- and animation-themed assignments. In the second week of the course, students used mBlock language to control mbots. At this point, a pretest was administered using our Concentration Questionnaire. From the third to sixth weeks, the two-tier instant assessment strategy was incorporated. As the teacher explained problem-solving concepts during class, Zuvio and oral questions were used to make formative assessments. At the end of the teaching experiment, we administered a posttest using the Concentration Questionnaire, and qualitative data were collected using open-ended questions.
The ethics of this research were followed the guiding principles of the Taiwan Academic Research Ethics Education Center.30 Before conducting the research, all participants were informed of the purpose of the research and how the research was conducted. All data collected by the institute are kept anonymously and kept confidential.
Implementation of Two-Tier Instant-Feedback Assessment
To prevent students from answering for their neighbors or giving them the answers while using the instant-feedback system and to understand the reasons underlying their responses, we adopted the two-tier strategy proposed by Treagust.6 As shown in Figure 1, the first tier used multiple-choice questions to assess core concepts, and in the second tier, students were randomly selected and asked to explain the reason for their response. It was hoped that this would prompt students to focus on the teacher's lecture.
Research Instruments
Zuvio Instant-Feedback System
Zuvio is currently one of the most mature instant-feedback systems on the market in Taiwan. One of its major features is that it helps with preclass preparation. For instance, it offers a slideshow plug-in feature that enables teachers to design their own questions. It also supports a variety of question types and statistics models and even has a peer assessment mechanism. During class, students can use their mobile devices to answer questions, and the teacher can immediately grasp their learning progress via graphs. Zuvio has four major features:
1. Diverse question types stimulate creative thinking in students.
Aside from the multiple-choice problem model, the Zuvio system also provides question-and-answer and group-response mechanisms. Illustrations can also be added to the questions to help teachers design interactive teaching materials for class.
2.Diverse statistics models keep track of student progress.
Zuvio can instantly tally and display student responses so that teachers can more easily grasp the learning effectiveness of the lecture. The response records and results can then be output in an Excel file after class to help teachers keep track of student progress.
3.Peer assessment increases student engagement.
Peer assessments can be made when students give oral presentations. The students can assess each other, which induces them to concentrate when others are giving their presentation, thereby increasing their engagement in class.
4.Microsoft PowerPoint is supported.
In addition to having a web interface, the Zuvio system also supports Microsoft PowerPoint (Microsoft Inc, Redmond, WA, USA). Premade questions can be displayed in slideshows for interactions with students.
Classroom Concentration Questionnaire
To respond to the research questions, the research instrument used in this study was the Classroom Concentration Questionnaire (CCQ), which was developed by Yang and Chen.31 The reason this instrument was chosen is that the scale of the form had been shown to be suitable for senior high school students' empirical data. The participants of this study were freshmen of a 5-year junior college, which is about the stage of the first 3 years in high school. In addition, Knudsen's attention functional component model was used in the scale.32 His model mastered the latest concentration research, which emphasized the principle of multidimensional structure. In the CCQ, four main factors were addressed, which were salience filtering, sensitivity control, competitive selection, and working memory. Relevant experts in the field were invited to examine the contents of the questions. Cronbach's [alpha] coefficient was .96, which indicated that the internal scale reliability and validity were very strong. The assessment form used was the Likert 6-point scale, with a total of 19 questions. The subject circled the options that matched his or her feelings according to the description of each question. The corresponding sequences were 1, 2, 3, 4, 5, and 6 points. Higher scores showed that the subject had higher concentration or otherwise did not. The scale included four construction concepts, defined as follows31:
1. Salience filters (five items): This refers to an individual who can screen prominent stimulus messages from the outside world, so that these messages can be delivered into working memory. For example, teachers asking students to answer questions is the event that less likely happened in class; therefore, it is easier to arouse students' attention; or the teacher particularly emphasized the contents of the examination in class, and the students paid attention to the teachers' lectures.
2. Competitive selection (three items): This refers to an individual facing external stimuli and messages from his or her long-term memory at the same time, through competitive selection. One has to decide which may enter working memory. For example, in class, although there are students chatting, if a student feels that the course is more important, he or she will focus on the teacher's lecture and ignore students chatting.
3. Working memory (six items): Working memory is at the highest order of the concentration process. Its main function is to deal with messages and evaluate the importance of the messages. For example, a student with higher concentration in the classroom can use working memory not only to understand the message that teacher delivers but also to evaluate the importance of the messages from the lecture. It allows a student to pay more attention to the classroom learning activities.
4. Sensitivity control (five items): In addition to passively accepting messages from external stimuli, working memory can also take the initiative to enhance the strength of the stimulus message through sensitivity control. For example, when a student concentrates on the lectures, he or she will not only focus his or her vision on the teacher's action on the blackboard but also draw lines under the key points with his or her hand. These sensitivity control mechanisms can further enhance the quality of the teaching message.
Data Analysis
The data collected from the 52 students demonstrated that students' concentration changed with in the two-tier assessment. The quantitative data analyses of this study were processed using IBM SPSS Statistics version 18 (IBM Inc, Armonk, NY, USA). Means, SDs, percentages, significances for each item, and so on were obtained.
RESULTS AND DISCUSSION
Concentration has great effect on learning. This study used a two-tier instant-feedback assessment to improve the concentration of college nursing students. The findings are described in this section.
Concentration Performance of Students Before and After Experiment
Table 1 presents the results of the dependent t test for the CCQ pretest and posttest. All 52 of the participants completed the CCQ, resulting in a questionnaire recovery rate of 100%. The students' overall performance on the CCQ was better in the posttest than in the pretest, with the difference achieving statistical significance (t = 1.83, P < .05). The mean scores for salience filters (t = 1.28, P < .05), competitive selection (t = 1.67, P < .05), working memory (t = 2.63, P > .05), and sensitivity control (t = 1.46, P < .05) in the posttest were all higher than those in the pretest. Nevertheless, a significant difference was found in salience filters, competitive selection, and sensitivity control. It was evident that the two-tier instant-feedback assessment could indeed improve students' concentration. This finding echoed the viewpoint of Sadiyani33 that the modifications and improvements made by teachers in their instructional methods serve as the key to improving students' concentration. These results also support the view that instant-feedback mechanisms can increase student concentration.5,34
Influence of Two-Tier Instant Assessment on Student Performance in Various Concentration Dimensions
Salience Filters
Broadbent35 likened attention to a selective filter. Such a filter allows individuals to receive certain specific messages, whereas unnoticeable messages are discarded. Knudsen32 pointed out that an individual can select stimulus messages from the outside world, so that these messages can be delivered into working memory. As shown in Table 1, the mean score for salience filters was higher in the posttest (24.98) than in the pretest (16.14), and the difference was significant. Student responses regarding this included the following:
We must stay focused because the teacher would ask them questions spontaneously.
With Zuvio or the oral questions, I must pay more attention in class so that I can answer the questions.
The teacher asks questions from time to time, so you have to pay attention to what the teacher is saying so you won't get the answer wrong.
Because the teacher will ask why? So I can't play on the mobile phone anymore, otherwise I don't know what the teacher is asking.
Competitive Selection
Liu et al36 stated that students with high intrinsic motivation often experience satisfaction and enjoyment in learning environments. This means that if students are not motivated toward the subject, the intensivity of their concentration will decline, and they will be easily distracted. This study had similar findings. Table 1 illustrates the mean score for competitive selection was higher in the posttest (16.85) than in the pretest (9.35), and the difference was significant. Student responses included the following:
To achieve good academic performance, I have to listen to the teacher's instruction attentively and disregard my classmates' chatter or playing mobile games.
I think the robot course is very interesting and I have learned a lot, so I will answer the teacher's questions.
It was definitely an eye-opening experience to study robotics course. It made me feel a sense of accomplishment, I forgot to play with my mobile phone.
Working Memory
Knudsen32 believed that students' working memory can focus entirely on information processing when they adopt certain strategies to organize and interpret the class content. O'Brien and Battista37 indicated that when students do not understand the application context of the learning content, they will lose interest and pay less attention. The results of this study correspond to this finding. As shown in Table 1, the mean score for working memory was higher in the posttest (25.67) than in the pretest (20.69), but the difference was not significant. Some of the students stated the following:
I would take notes in class to re-organize the class content, in order to force himself to stay more focused.
Medical combined with robots is the future trend, I must study hard.
I must listen carefully to the teacher's explanation, because the answer cannot be guessed, and I must answer verbally.
Sensitivity Control
Knudsen32 stressed that students can actively enhance the strength of the stimulus information in class through sensory control. Cook and Crewther38 stated that when students compete with their peers, they are better able to maintain their learning concentration. Table 1 illustrates the mean score for sensitivity control was higher in the posttest (25.66) than in the pretest (18.32), and the difference was significant. Student responses included the following:
If you didn't pay attention in class, you wouldn't be able to answer the question if the teacher suddenly called on you, and that would be embarrassing.
In order to answer the teacher's question, I force myself to focus on learning.
Everyone can answer the teacher's questions, and I have to study harder.
We speculate that the instant assessment and test function of the instant-feedback system made the more ambitious students competitive, and naturally, they then concentrated more in class.
CONCLUSION
Concentration is a key factor of learning effectiveness; however, there is little empirical research on student concentration in nursing education. This study attempted to increase student engagement and concentration using a two-tier instant-feedback assessment strategy. After 7 weeks of experimental instruction, the results indicated the following.
Proposed Model Offers Feasible Method of Enhancing Concentration
This study found that the overall concentration performance of the participants was better in the posttest than in the pretest. Significant differences were found in concentration capacity, consciousness, movement, and duration. The participating students had an affirmative attitude toward the Two-Tier Instant-Feedback Environment and opined that allowing the whole class to ask questions instantaneously through mobile phones could improve their concentration in class. Data analysis revealed that, overall, the students' posttest performance on the CCQ was significantly better than their pretest performance, with the difference achieving statistical significance. In terms of the subscales, significant differences were achieved on the dimension of "competitive selection," which indicated that students would stay focused in class without being distracted by their classmates' chatter or their mobile phones if they had a strong learning objective, such as to strive toward academic excellence.
Practical Suggestions for Incorporating Proposed Model Into Introductory Computer Courses
Information literacy is a necessary skill for nursing; however, there are no licenses, entrance examinations, or work in nursing directly involving computers, so it is natural for nursing students to lack learning motivation for this topic. In the paper "Situated Cognition and the Culture of Learning," Brown et al39 pointed out that knowledge is generated through interactions with the environment and that the process of gaining knowledge is inseparable from the social environment and background that one exists in. We therefore suggest that situational topics or courses be designed for nursing students to help them link learning content to their future workplace. This will cast the knowledge presented by the course as meaningful to the students.
With regard to question-asking, the principles set by Beatty et al40 are useful. For instance, the questions should be short enough so that students can read and answer them in 30 to 60 seconds. Assessments should be made at intervals of 10 to 15 minutes, with one or two questions at a time. Classes should not consist only of questions; this would resemble a test format rather than an interactive lecture and is unlikely to arouse the interest of students.
The privacy of student answers is important; some students may be unwilling to use the system because they are afraid of their peers knowing their answers. For this reason, the teacher should gain consent from everyone in the class before displaying their individual answers.
Directions for Future Research
This study revealed that applying a two-tiered evaluation strategy in teaching significantly increased student concentration; however, individual concentration dimensions that increased are not reported herein. Future studies are suggested to explore further the changes in each concentration dimension to increase the comprehensiveness of the research results.
In terms of the research method, we suggest extending the research duration to more clearly understand the effectiveness of the two-tier evaluation strategy over time. Studies can compare the changes in student concentration after employing the two-tier valuation strategy for two semesters of a school year to observe increases in student concentration and avoid the media novelty effect. This would increase the reference value of the study results.
Regarding data collection, in addition to simple open-ended questionnaires, future studies can employ in-depth interviews and focus group interviews to collect student opinions to understand further the students' perception of the two-tier evaluation strategy.
For the selection of research participant, studies can perform comparative analysis of the effect of two-tier evaluation strategies on students with high, medium, and low learning outcomes. Additionally, future studies may reference learning styles to determine which type of students exhibit the greatest increase in concentration in response to the implementation of the two-tier evaluation strategy.
With respect to the research objective, in addition to increasing student concentration with the two-tier evaluation strategy, future studies can employ learning attitude scales or learning motivation scales to explore changes in student attitudes or motivation. Furthermore, the learning anxiety scale can be used to compare student concentration before and after the strategy implementation.
References