Analysis of pretest –posttest learning outcomes demonstrate that in 9 out of total of 23 items, students intervened through lecture, scored the distinctively highest number of correct responses. All 9 items constituted learning objectives representing the factual knowledge. This definitely confirms the superiority of the lecture method to impart factual knowledge to the students, compared to the other two methods. Data obtained through the evaluative observations of the lecture session both by the independent observers and the students demonstrate that the session was most satisfactorily conducted. Using a five-point Likert scale, the independent observers assigned 98.5% score to the lecture session. More than 75% of students in the lecture group favored the session. Current literature by Snell and Steinert (1999); JHPIEGO, (1995); Edgar Dale, (1995) and Bruning.R.H.et.al, (1995); also support those findings and reiterate that lecture is highly effective to teach declarative knowledge to the students.

Similarly, analysis of pretest –posttest learning outcomes demonstrate that in 1out of a total 23 items, students intervened through small group discussion (SGD), scored the distinctively highest number of correct responses. The item constituted learning objectives representing the insight. Using a five-point Likert scale, the independent observers assigned 69.3% score to SGD session. This is quite low compared to the scores given to the other two methods. Although 83.3% students attending the SGD agreed that the subject matter was understandable, 38.8% of the students suggested that time needs to be increased for the session. Feedback obtained through observation both by independent observers and students demonstrates that the conduction of SGD should be further improved and structured.

In 2 out of a total of 23 items, students intervened through 'mixed' method scored the distinctively highest number of right responses. Out of these two items, one constituted learning objective belonging to procedural knowledge, the other constituted learning objectives belonging to insight. The independent observers assigned 86.4% scores to the 'mixed' session. This is comparatively higher than the score given to SGD but lower than that given to lecture. 84% of students attending 'mixed' session responded excellent in terms of the usefulness of the topic. However, 21% of students also suggested that the teacher needs to explain the objectives more clearly.

Rest of 11 items no. significant variations were found in students' responses. The study's focus was to find out through comparison which of the three instructional methods i.e. lecture, small group discussion and the 'mixed' (i.e. lecture coupled with small group discussion) was the most effective one to learn childhood diarrhoea by the nursing students. Pretest / posttest scores results obtained from 54 students were carefully analyzed and compared in relation to each of the three sessions using three different methods. Each session was assessed through the use of two additional tools namely classroom observation and session evaluation.

While comparing the final results in terms of student learning, it is evident that lecture method had the most significant positive impact on learning of factual knowledge by the students. However, lecture was the least effective in terms of learning either procedural or the insightful knowledge, it had some impact on learning factual knowledge. The 'mixed' method (lecture coupled with small group discussion) had significant positive impact on learning both procedural and insightful knowledge by the students. It also had some impact on learning of factual knowledge. Hence, it could be argued that among, the three instructional methods, the 'mixed' method was the only methods which had impact on all three types of knowledge i.e. factual, procedural and insight. In this regard, the 'mixed' method is qualitatively much better than the other two while teaching a topic or diarrhoea for the PCL nursing students. Thus the analysis of the result has supported the original hypothesis of the study.

1. The study had not included performance skill such as how to prepare ORS by individual student independently.
2. The study had not included communication skill of the nursing students in teaching the mothers in preparation of ORS. Value of small group discussion would have been made clearer if such skills were included.
3. Since teachers have predominantly used the lecture method with emphasis on knowledge objectives, they were not equally competent in small group discussion for experimental comparison.