https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article Students’ Perspective about Current Teaching Method in College of Nursing at Hawler Medical University ABSTRACT Background and objectives: The current teaching method in the College of Nursing is mainly lecture, which plays a vital role for teaching and learning nursing students. The purpose of this study was to assess the students' opinions regarding the current teaching methods at the Hawler Medical University College of Nursing. Methods: A cross-sectional descriptive study was carried out at the college of nursing in the Erbil, Kurdistan region, Iraq. The study involved 414 nursing and midwifery students. A non-probability-convenience sample method was utilized to enroll 414 nursing stu- dents who completed a questionnaire to examine their views on the current teaching method at the College of Nursing. Results: The vast majority of the study sample were female students, and while more than half of them are aged between 21 and 24 years old (56.8%) with an average of 21 years. The findings indicate that the majority of students (63.53%) sometimes expressed an agreement with the effectiveness of the teaching methods. The result indicated that a significantly higher proportion of females report being "sometimes" satisfied with the current teaching methods, accounting for 85.6% of responses in this category, similarly compared to only 14.4% from males. Conclusion: Most students believed that the current teaching approach used in the nurs- ing education program significantly contributed to students’ increased academic success. Key words: Teaching Method; Students; Nursing Education; Perspective. Dlzar Sedeeq Anwer; Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq. (Correspondence: dlzar.anwer@hmu.edu.krd) Abubakir Majeed Saleh; Department of Community Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq. Nursing Department, Faculty of Nursing, Tishk International University, Erbil, Kurdistan Region, Iraq. Vian Afan Naqshbandi; Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq. 124 Received: 16/01/2025 Accepted: 22/04/2025 Published: 30/11/2025 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. mailto:dlzar.anwer@hmu.edu.krd)?subject=dlzar.anwer@hmu.edu.krd)%20%20%20%20%20 mailto:dlzar.anwer@hmu.edu.krd)?subject=dlzar.anwer@hmu.edu.krd)%20%20%20%20%20 mailto:dlzar.anwer@hmu.edu.krd) mailto:dlzar.anwer@hmu.edu.krd)?subject=dlzar.anwer@hmu.edu.krd)%20%20%20%20%20 mailto:dlzar.anwer@hmu.edu.krd)?subject=dlzar.anwer@hmu.edu.krd)%20%20%20%20%20 mailto:dlzar.anwer@hmu.edu.krd)?subject=dlzar.anwer@hmu.edu.krd)%20%20%20%20%20 mailto:dlzar.anwer@hmu.edu.krd) mailto:jawdat.baker@hmu.edu.krd?subject=jawdat.baker@hmu.edu.krd%20%20%20 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article One way to enhance nursing education is to determine the effect of teaching meth- ods on nursing students’ achievements and teaching effectiveness at nursing colleges. Delivering nursing education through the traditional lecture format, on the other hand, is criticized for its emphasis on the learners' passive receipt of knowledge ra- ther than learning to think critically [1]. At Hawler Medical University's College of Nursing, lectures are the primary teaching modality used nowadays. A teacher who speaks continually in front of a class about a given subject or topic is said to be using a lecture teaching approach. The size of the group might range from 20 to 1000. Deliv- ering the entire subject matter is the in- structor's responsibility. It is among the most traditional teaching strategies still in use in schools, colleges, and universities across a range of subject areas. The foun- dation of the lecture style of instruction is that the instructor imparts knowledge to the students before they engage with the material themselves. Traditional lecturing or teaching methods are other names for the lecture style of instruction. Since the traditional lecture style is a passive learn- ing approach, many educators and re- searchers think it has no greater impact on students' cognitive growth. It does not al- low students to participate in the learning process. [2].A widely used teaching meth- od is the lecture. It works well for teaching specific facts and fundamental abilities since the information is delivered in an un- derstandable and straightforward way. It also works well for introducing learners to new subjects or topics. It is utilized to in- troduce new content that is not yet pub- lished in books or print. It is seen to be an effective way to deliver information to a big class of students. Large groups of peo- ple can also be presented with a lot of knowledge through lectures. It is the most effective approach to use when the facts or issues are contradictory or unclear; the lecture technique is the most effective ap- proach to employ when time is limited. The lecture technique works best when oral presentations are the most effective way to learn a subject. Lectures organize, clarify, and explain complex ideas. Lectures challenge preconceived notions and learn- ing habits; they generate excitement and drive for additional study; and the lecturer has complete control over the whole cour- se. For pupils who lack creativity and inno- vation, the lecture poses minimal danger. Therefore, for students who learn best by listening, the lectures are appealing [3].Many teaching methods are available in the educational process, especially in uni- versity, for example, the Bologna process, the traditional method process and small group discussion. In Kurdistan, different universities exist, including governmental and private ones. According to the Ministry of Higher Education and Scientific Rese- arch, the teacher-centered approach was the core of education among universities in the past. The system was the traditional teaching method: transferring information from the teacher to the learners in theore- tical classes and applying it in practical o- nes. But nowadays, most of the universi- ties use a student-centered approach by using new teaching methods such as team- work or group work, self-assessment, and peer assessment as a means of deeper learning in the education cycle [4]. Im- portance of the studyThis study is im- portant because researchers want to know or evaluate whether the current teaching method, as a teaching method, is effective, engaging, and well-received by students at the College of Nursing.Aims of the studyTo determine the perspective of the students about the current teaching method in the College of Nursing at Hawler Medical University. 125 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. INTRODUCTION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article form prepared by the researchers for the purpose of studying. The form consisted of 2 parts. Part 1 referred to socio demo- graphic characteristics of the students, in- cluding age, sex, residence, type of second- ary school, students’ stage, and depart- ment. Part 2 assessed the students’ per- spective about the current teaching meth- od, containing 18 principal items. Each item was rated 5 for regularly, 4 for some- times, 3 for rarely, 2 for never and 1 for do not know. A common approach is to set a midpoint cutoff: High frequency (positive) → mean ≥ 4.0 (regularly/sometimes), mod- erate frequency → mean 3.0 – 3.9 (rarely), low frequency (negative) → mean < 3.0 (never/do not know). Categorization of mean scores using the scale mean score range is 4.0 – 5.0 for high frequency (regularly/sometimes), 3.0 – 3.9 for mod- erate frequency (rarely), and 1.0 – 2.9 for low frequency (never/do not know). If an item’s mean score is 4.5, it falls in the high- frequency category. If the mean score is 3.2, it falls under moderate frequency. A mean score of 2.4 is classified as low fre- quency. The Statistical Package for Social Sciences (SPSS, V23) was utilized to ana- lyze the data. Cronbach's alpha, which gauges a construct's internal consistency, was used to conduct a reliability test. For this metric, a reliability "alpha" of 0.60 is the suggested minimum acceptable level [5]. Using the chi-square test because their p-values are higher than the significant lev- el of α =0.05. Cronbach’s alpha was calcu- lated to assess the internal consistency of the data, serving as a reliability measure. A coefficient of 0.60 or above is recommend- ed for exploratory research, with reliability classified as excellent (≥0.90), high (0.70– 0.90), moderate (0.50–0.70), or low (≤0.50). While reliability is essential, it must be paired with validity for meaningful results. In this study, the 18-item scale for teaching methods achieved a Cronbach’s A cross-sectional study was conducted in order to investigate students’ perspectives about the current teaching method at the College of Nursing. The study was conduct- ed at the College of Nursing/Hawler Medi- cal University, which is a public university in Erbil City, located in the North of Iraq. It is also a capital of Kurdistan. A non- probability-convenience sample (n=414) of students was used in this study. The sam- ple consists of 414 students from the Col- lege of Nursing. The G power sample size calculator was used to determine the re- quired sample size for conducting the study. To determine the appropriate sam- ple size for a finite population of 841 indi- viduals, we use the standard sample size formula for surveys. Giving a 95% confi- dence level (Z=1.96Z = 1.96Z=1.96), an ex- pected proportion of 50% (p=0.5p = 0.5p=0.5), and a margin of error of 5% (E=0.05E = 0.05E=0.05), the calculation in- volves plugging these values into the for- mula. After performing the necessary com- putations, the required sample size is found to be 264. This means that to achieve statistically significant results while maintaining the specified confidence level and margin of error, a survey should in- clude at least 264 respondents from the population. N = 841 # Population size Z = 1.96 # Z-score for 95% confidence level p = 0.5 # Expected proportion E = 0.05 # Margin of error The second, third, and fourth stages of the students from the College of Nursing were included. First-stage students were exclud- ed because they do not have enough expe- rience with the current teaching method. The study was carried out from 1st Sep- tember to 15th November 20242024. The data was collected through a questionnaire 126 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. METHODS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article alpha of 0.743, indicating high reliability and ensuring the credibility of the findings. [6] [7] [8].The questionnaire form about the current teaching method was sent to ten nursing faculty experts in order to re- view the items of the questionnaire form. Each expert returned their comments and suggestions about the questionnaire form. After that, the researchers carefully re- viewed their comments and feedback and corrected and edited the items of the ques- tionnaire form accordingly. Formal ethical approval from the Ethical Committee of the College of Nursing/ Hawler Medical Univer- sity was received by researchers on June 06, 2024 with the number of 2410. Before they agreed to take part willingly, the par- ticipants in the study were made aware of the research's goals. Additionally, the re- spondents were assured that their re- sponses would remain anonymous and be utilized just for academic investigation. The responders filled out the questionnaires and handed them in to the researcher. Most of the responders are female (85.5%) while more than half of them are aged be- tween 21 and 24 years old, because 56.8% are 21 years old on average. The percent- age of students coming from public sec- ondary school (84.5%) is higher than the percentage from private school (15.5%) while most of them are studying in the fourth grade (41.1%). More than half of the students are living in urban (54.6%) fol- lowed by suburban (22.9%), and rural (22.5%) respectively, since most of them are staying at home (63%). The percentage of participating students who were study- ing at the nursing department (56.8%) were higher than those who were studying at the midwifery department (43.2%). Among the items analyzed, do teachers provide students with a written syllabus (course book) for each course? Standing out with the highest mean score of 4.239, indicating a strong level of agreement or satisfaction with the aspect it addresses. In contrast, the question about the library providing you with educational aids such as digital library and internet access rec- orded the lowest mean score of 2.879, suggesting relatively lower satisfaction or agreement. The overall mean score for this set of questions is calculated at 3.735, with a standard deviation of 0.450, reflecting moderate variability in the responses. 127 Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. RESULT Table 4.1: Descriptive Statistics for Demo- graphic Questionnaire Variables N (%) Sex Male 60 (14.5) Female 354 (85.5) Age 18 - 20 164 (39.6) 21 - 24 235 (56.8) 24 + 15 (3.6) Secondary School Private 64 (15.5) Public 350 (84.5) Staying Home 261 (63.0) Dorm 153 (37.0) Resident Rural 93 (22.5) Suburban 95 (22.9) Urban 226 (54.6) Student Stage Second 108 (26.1) Third 136 (32.9) Fourth 170 (41.1) Department Nursing 235 (56.8) Midwifery 179 (43.2) Are you satis- fied with the current teach- ing methods in the college? Yes 162 (39.1) No 252 (60.9) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article 76 * Percentage of agreement Copyright ©2025 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 4.2: Students’ perspective about the current teaching methods Do not know Never Rarely Sometimes Regularly Mean SD * % N (%) N (%) N (%) N (%) N (%) Lecture is the main method of teaching in the college? 3 (0.7) 21 (5.1) 42 (10.1) 219 (52.9) 129 (31.2) 4.087 0.82 81.74 Teachers are using different teaching strategies during teaching process? 2 (0.5) 43 (10. 4) 96 (23.2) 219 (52.9) 54 (13) 3.676 0.85 73.53 Teachers encourage discus- sion with students during teaching. 2 (0.5) 10 (2.4) 63 (15.2) 187 (45.2) 152 (36.7) 4.152 0.80 83.04 How often teachers are using teaching aids (audiovisual aids) during teaching: 15 (3.6) 32 (7.7) 93 (22.5) 139 (33.6) 135 (32.6) 3.838 1.08 76.76 \ Do teachers update their lecture according to the feedbacks of the students? 22 (5.3) 83 (20) 128 (30.9) 125 (30.2) 56 (13.5) 3.266 1.09 65.31 \ How often teachers update their lectures 34 (8.2) 40 (9.7) 108 (26.1) 190 (45.9) 42 (10.1) 3.401 1.06 68.02 \ Do teachers provide stu- dents with a written syllabus (course-book) for each course? 8 (1.9) 22 (5.3) 46 (11.1) 125 (30.2) 213 (51.4) 4.239 0.98 84.78 Q8: The whole planned written curriculum is imple- mented during the course? 14 (3.4) 29 (7) 66 (15.9) 195 (47.1) 110 (26.6) 3.865 1.00 77.29 Q9: The library provides you with educational aids such as digital library and internet access. 23 (5.6) 17 3 (41. 8) 92 (22.2) 83 (20) 43 (10.4) 2.879 1.12 57.58 Q10: The library provides you with educational aids such as textbooks and jour- nals 17 (4.1) 93 (22. 5) 103 (24.9) 118 (28.5) 83 (20) 3.379 1.16 67.58 Q11: Facilities such as (classrooms or halls, projec- tor, labs, simulators, etc) needed for proper teaching in the college are available? 8 (1.9) 36 (8.7) 78 (18.8) 164 (39.6) 128 (30.9) 3.889 1.00 77.78 Q12: The current mid-term and final examination meet learning objectives as sum- mative evaluation: 16 (3.9) 59 (14. 3) 71 (17.1) 179 (43.2) 89 (21.5) 3.643 1.09 72.85 Q13: Lecturer deliver lec- tures with great interest. 6 (1.4) 37 (8.9) 103 (24.9) 198 (47.8) 70 (16.9) 3.698 0.90 73.96 Q14: lecturers easily found outside of class time. 10 (2.4) 74 (17. 9) 113 (27.3) 134 (32.4) 83 (20) 3.498 1.08 69.95 Q15: lecturers interested in student achievement and giving feedback on student progress. 11 (2.7) 61 (14. 7) 102 (24.6) 185 (44.7) 55 (13.3) 3.512 0.99 70.24 Q16: lecturers are prepared to answer questions. 7 (1.7) 26 (6.3) 44 (10.6) 170 (41.1) 167 (40.3) 4.121 0.95 82.42 Q17: Does the lecturer give enough time and space for students to ask questions? 8 (1.9) 22 (5.3) 49 (11.8) 167 (40.3) 168 (40.6) 4.123 0.95 82.46 Q18: lecturers give course contents and framework at the beginning of each lec- ture. 19 (4.6) 20 (4.8) 63 (15.2) 167 (40.3) 145 (35) 3.964 1.05 79.28 Overall 3.735 0.45 74.70 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article times, there is room for improvement to enhance regular approval. The finding of the study showed that there is a statistical- ly significant association between nursing students' responses (Never, Rarely, Some- times, and Regularly) and the variables of gender, stage of study, and satisfaction with the current teaching methods be- cause their p-values (0.043, <0.001, and <0.001) are less than the significant level of α =0.05. environment. Also, students in the fourth stage report the highest percentage of be- ing "sometimes" satisfied with the current teaching methods, accounting for 48.7% of responses in this category. This is noticea- bly higher compared to students in the third stage, who make up 27.8%, and those in the second stage, who represent 23.6%. These findings suggest that satisfaction with the teaching methods tends to in- crease as students’ progress to higher stag- es of their education. Then, the percentage of students who are "sometimes" satisfied with the current teaching methods (36.9%) is less than the percentage of students who are not satisfied (63.1%). However, the percentage of students who are 129 The findings indicate that the majority of students (63.53%) sometimes expressed an agreement with the effectiveness of the teaching methods. This is followed by 21.5% of students who rarely agreed, 13.53% who regularly agreed, and a small fraction (1.4%) who reported never agree- ing with the current teaching methods. These percentages reflect varying levels of satisfaction, highlighting that while most students find the methods acceptable at For instance, the result indicates that a significantly higher proportion of females report being "sometimes" satisfied with the current teaching methods, accounting for 85.6% of responses in this category, compared to only 14.4% from males. Simi- larly, the percentage of females who ex- press being "regularly" satisfied is even higher, at 94.6%, while males account for just 5.4% in this category. These findings highlight a notable gender disparity in satisfaction levels, with females consist- ently reporting higher agreement with the effectiveness of the teaching methods than their male counterparts. This trend may point to gender-specific perceptions or experiences within the educational Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Figure 4.1 : Overall percentage about the current teaching methods https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article 130 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. "regularly" satisfied with the current teaching methods (73.2%) is significantly higher compared to those who are not regularly satisfied (26.8%). This indicates that while occasional satisfaction is evenly split, there is a stronger trend toward reg- ular satisfaction among the respondents. On the other hand, there is no statistically significant difference between nursing stu- dents' responses (Never, Rarely, Some- times, and Regularly) and each of the (age, secondary school, staying, resident, and department) variables separately. Table 4.3 : Association between Nursing Students response (Never, Rarely, Never, and Regularly) with demographic question using Chi-square test Variables Overall Total Chi- square P-value Never Rarely Sometimes Regularly Sex Male N 0 19 38 3 60 8.164 0.043 (%) (0) (21.3) (14.4) (5.4) (14.5) Female N 6 70 225 53 354 (%) (100) (78.7) (85.6) (94.6) (85.5) Age 18 - 20 N 3 47 89 25 164 2.343 0.126 (%) (50) (52.8) (33.8) (44.6) (39.6) 21 - 24 N 3 40 162 30 235 (%) (50) (44.9) (61.6) (53.6) (56.8) 24 + N 0 2 12 1 15 (%) (0) (2.2) (4.6) (1.8) (3.6) Secondary School Private N 0 12 44 8 64 1.747 0.627 (%) (0) (13.5) (16.7) (14.3) (15.5) Public N 6 77 219 48 350 (%) (100) (86.5) (83.3) (85.7) (84.5) Staying Home N 5 60 162 34 261 2.157 0.540 (%) (83.3) (67.4) (61.6) (60.7) (63) Dorm N 1 29 101 22 153 (%) (16.7) (32.6) (38.4) (39.3) (37) Resident Rural N 1 17 65 10 93 3.708 0.716 (%) (16.7) (19.1) (24.7) (17.9) (22.5) Suburban N 1 20 63 11 95 (%) (16.7) (22.5) (24.0) (19.6) (22.9) Urban N 4 52 135 35 226 (%) (66.7) (58.4) (51.3) (62.5) (54.6) Student Stage Second N 0 29 62 17 108 25.157 <0.001 (%) (0) (32.6) (23.6) (30.4) (26.1) Third N 5 39 73 19 136 (%) (83.3) (43.8) (27.8) (33.9) (32.9) Fourth N 1 21 128 20 170 (%) (16.7) (23.6) (48.7) (35.7) (41.1) Depart- ment Nursing N 4 56 141 34 235 3.035 0.386 (%) (66.7) (62.9) (53.6) (60.7) (56.8) Midwifery N 2 33 122 22 179 (%) (33.3) (37.1) (46.4) (39.3) (43.2) Satisfied in current teaching methods Yes N 1 23 97 41 162 35.74 <0.001 (%) (16.7) (25.8) (36.9) (73.2) (39.1) No N 5 66 166 15 252 (%) (83.3) (74.2) (63.1) (26.8) (60.9) Total N 6 89 263 56 414 (%) (100) (100) (100) (100) (100) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article deepened their perspectives, and demon- strated enthusiasm. [11].According to the outcome of the current study, it showed that the percentage of students who are "sometimes" satisfied with the current teaching methods (36.9%) is less than the percentage of students who are not satis- fied (63.1%). Cooperative learning and tra- ditional learning methods in theoretical classes have been compared in an Iranian study on nursing students' ability to com- municate with patients in practical settings. The findings indicated that there was no significant difference between the two groups' pre-teaching intervention communication skills scores, but there was a significant difference between the two groups' post-teaching intervention interac- tion skills and problem follow-up subscale scores. It is advised to increase nursing stu- dents' participation in arguments by imple- menting active teaching strategies that can offer the chance for improved communica- tion skills, as this study shows that cooper- ative learning is an effective way to im- prove and increase nursing students' com- munication skills, particularly in the inter- active skills and follow-up the problems subscale [12]. The majority of students thought that the nursing education program's present teaching methodology had a significant part in raising students' academic achieve- ment. The findings show that, in compari- son to their male counterparts, a much larger percentage of females say they are "sometimes" satisfied with the existing teaching methods. The present study indicated that the stu- dents agreed that their teachers provide the students with a written syllabus (course book) for each course. The find- ings showed that the majority of students (63.53%) sometimes expressed an agree- ment with the effectiveness of the current teaching methods. A study, on the opin- ions of students on nursing education was carried out in Jordan. The findings showed that the course material and instructional strategies were comprehensive, well- structured, and easy to understand. Em- phasis was placed on online resources and teachers who are well-prepared, well- organized, and make efficient use of class time. Conversely, the most common factor that adversely impacted pupils' learning was a noisy atmosphere [9].The finding of the current study mentioned that most of the students (43.2%) responded that they sometimes agree that the current midterm and final examination meet learning objec- tives in the current teaching method. Ad- ditional research conducted in Hong Kong has verified that evaluation techniques can affect nursing students' learning strate- gies. A deep learning technique may bene- fit from assessments that measure com- prehension rather than memorization [10]. The result of this research identified that most of the students responded that (52.9%) sometimes their teachers were able to use different teaching strategies during their teaching process. Another study, on how instructional context influ- ences nursing students' adoption of a deep learning strategy, was carried out in Japan. According to the study's findings, students were more likely to embrace the deep approach to learning when teachers actively engaged their attention, support- ed learning activities, gave them explana- tions that helped them understand, im- parted knowledge that broadened and 131 Copyright ©2025The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Discussion CONCLUSION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2025.13 Erbil j. nurs. midwifery, Vol. 8, No. (2), Nov 2025 Original Article [7] Zhong, Y., Xu, T., Dong, R., Lyu, J., Liu, B., Chen. The analysis of reliability and validity of the IT-MAIS, MAIS and MUSS. International Journal of Pediatric Oto- rhinolaryngology. 2017; 96, 106-110. doi.org/10.1016/j.ijporl.2017.03.006. [8] Vaske JJ, Beaman J, Sponarski CC. Rethinking internal consistency in Cronbach's al- pha. Leisure Sciences. 2017; 39(2):163-173. doi.org/10.1080/01490400.2015.1127189 [9] Ahmed MZ, Touama H, Rayan A. Students' Perspectives about Nursing Education. American Journal of Educational Research. 2015;3(3):288-91. DOI:10.12691/education- 3-3-6 [10] Leung SF, Mok E, Wong D. The impact of assessment methods on the learning of nursing students. Nurse Education Today. 2008;28(6):711-719.doi:10.1016/ j.nedt.2007.11.004. [11] Takase M, Imai T, Niitani M, Okada M. Teaching context contributing to nursing students' adoption of a deep approach to learning. Journal of Professional Nursing. 2019; 35(5):379-388. doi:10.1016/ j.profnurs.2019.04.006 [12] Baghcheghi N, Koohestani HR, Rezaei K. A comparison of the cooperative learning and traditional learning methods in theory clas- ses on nursing students' communication skill with patients at clinical settings. Nurse Edu- cation Today. 2011; 31(8): 877-82. doi: 10.1016/j.nedt.2011.01.006. Limitations of the Study and Recommenda- tions The geographic area that just encom- passes Hawler Medical University and the College of Nursing is the limitation of the study. It is advised to conduct additional study with the addition of other colleges of nursing in Iraqi Kurdistan. 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