Descriptive findings indicate that retention was fostered through
constructivist activities that mainly included reflective writing, critical thinking, and
problem solving. Factors such as active learning, meaningful and enjoyable learning
environment, and the attitudes of instructors had a positive impact on student
learning. Nevertheless, the load of reflective diary writing and portfolio preparation
tasks, and collaborative work could be overwhelming and discouraging and these
impacted negatively on learners’ attitudes towards the course