Although professional training of nursing has been running for more than quarter a century in Nepal, till now it seems that no research has been carried out to compare the effectiveness of different instructional methods commonly used in such training programs.

This probably has deprived the nursing faculty teachers of the much needed research evidence on the basis of which they could select the most appropriate teaching strategy for appropriate learning to occur. To address this gap the research study has aimed to compare the effectiveness of various instructional methods in terms of quality of the learning outcomes in fifty-four nursing students from the Second Year Proficiency Certificate Level Programme of the Maharajgunj Nursing Campus of the TU Institute of Medicine. The students were subjected to interventions of lecture, small group discussion (SGD) and lecture coupled with small group ('mixed') methods.

The students were randomly assigned to three groups; each group was systematically intervened through one instructional method in the topic childhood diarrhoea.

The research findings confirm the original hypothesis that 'mixed' method is qualitatively better than lecture method or small group discussion method taken alone to teach a topic on childhood diarrhoea. Pretest, posttest outcomes demonstrated that in 9 out of a total 23 items, students intervened through lecture, scored the distinctively highest number of correct responses. All these nine items constituted the factual knowledge. The independent observers assigned 89.5% score to the effective delivery of lecture.More than 75% of students in the lecture group favoured the session.

In 2 out of a total of 23 items, students intervened through 'mixed' method scored the distinctively highest number of correct responses. Each of those items represented procedural knowledge. The independent observers assigned 86 % scores to the mixed session. 84% of students attending mixed method responded 'excellent' about the usefulness of the topic. However 21% of students suggested that teachers need to explain the objectives clearly. In 11 out of 23 items, representing factual knowledge, three groups scored equal, no significant variations was found in students' responses.

Above results demonstrated that among the three instructional methods, 'mixed' method was the only method which had impact on all three types of knowledge while lecture had the most significant impact on the learning of factual knowledge, it was less effective to learn either procedural knowledge or the insightful knowledge.

Among others the major limitations of the study were: it did not include performance skills and communication skills, similarly, teachers' predominant use of lecture method and their relatively less competence to run SGD would raise question in regards to validity of the experimental comparison among the two methods.

Based on the results of the study, it could be argued that no single method is perfect. 'Mixed' method is comparatively more effective in terms of students' learning of all three types of knowledge i.e factual, procedural and insightful. Hence, it is recommended that teachers should select instructional method according to the type of objectives to be taught in the classroom. Combining two or more instructional methods could be another strategy to achieve the objectives of the curriculum. In any case, nursing teachers need to be trained in on how to effectively use in practice all these methods. This will provide then option to select the most appropriate strategy to achieve the goals of the nursing programme.