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This study investigated the efficacy of the Think-Pair-Share (TPS) instructional strategy in online biostatistics courses for graduate-level nursing students. Using an Explanatory Sequential Mixed Methods design, the research assessed the evolution of student responses from the 'Think' step to the 'Share' step and determined whether collaborative engagement led to a higher likelihood of correct answers in final submissions. Quantitative analysis revealed a significant association between providing correct responses and progressing from the 'Think' to 'Share' step. Qualitative analysis of student feedback highlighted the positive impact of TPS on learning experiences. The findings suggest that TPS enhances student engagement, comprehension, and learning outcomes in biostatistics education, contributing to the growing body of literature on active learning strategies in nursing education.