Competence is a necessary achievement for nursing students validated by a passing score on the NCLEX, and most importantly positive patient outcomes. Nurse educators are challenged with determining the most effective and efficient teaching methods that can influence the highest levels of student nurse competence. This endeavor requires research comparing commonly used teaching methods, such as traditional lecture, with those that best utilize adult learning principles, such as interactive teaching.

Because intervention research requires manipulation of concepts that are clearly developed and understood, a concept analysis of interactive teaching was developed to explicate characteristics which served to foster the construct validity of interactive teaching as a treatment in the dissertation study. Development of the research protocol also necessitated an ethical analysis of how the recipients of the intervention, nursing students, would be treated considering their vulnerability with regards to the power differential between them and the nurse educator/researcher conducting the study.

Once preliminary analyses were completed, a triangulated study using quantitative and qualitative methods was conducted. The primary purpose was to compare the effect of interactive teaching versus traditional lecture on 116 generic BSN students' competence using a randomized control design. Competence outcomes (knowledge, comprehension, application, and critical thinking) were measured using the Association of Women's Health and Neonatal Nurses Competence Assessment Tool on Perinatal Medication Administration. A post hoc ANOVA indicated that students in the interactive teaching group scored significantly higher on immediate knowledge, comprehension, and application posttests than students in the lecture group (F(1,114) = 4.07, p=.046). There were no differences between groups on critical thinking.

A secondary purpose of this study was to explore these students' ideas about the nature of competence and analyze their perceptions of how interactive teaching versus lecture affected their competence using focus group data and grounded theory analysis. Developing the Ability to "Do" emerged as the core variable to describe the nature of student nurse competence. Six main categories emerged that describe the process. Each of these categories and subcategories further explicated dimensions that were not revealed using the competence assessment tool alone.