Strategies to improve student engagement in online nursing education: A systematic review

The science of nursing education is shifting from comparisons of online and in-person modalities toward development and testing of online instructional strategies to optimize student learning. We conducted a systematic review (1) to identify instructional strategies designed to improve student engagement in online nursing education and (2) to evaluate the impact of instructional strategies on specific domains of nursing student engagement and learning outcomes.

We searched Web of Science, PubMed, Embase, and the Cumulative Index of Nursing and Allied Health Literature for search terms that aligned with our population, intervention, and outcomes of interest. We applied the concept of student engagement by Jennifer A. Fredricks and colleagues to guide inclusion and exclusion criteria, data extraction, and synthesis.

Our search yielded 4847 articles, of which 8 met inclusion criteria and were included in this systematic review. Instructional strategies varied widely across studies and included game-based learning, case-based learning, novel instructor-to-student communication methods, and course redesign. Compared to traditional online strategies, game- and case-based approaches were associated with improvements in behavioral, emotional, and cognitive engagement and learning outcomes. Participant sociodemographic were underreported across all studies.

Our findings provide early support for the use of game-based learning or gamification elements and case-based learning to improve student engagement and subsequent learning outcomes. Future research on student engagement in online nursing education should evaluate the effects of different educational levels, incorporation of virtual reality, and report participants' sociodemographic data to examine subgroup effectiveness.