A descriptive study of registered nurses' experiences with web-based learning

Assessing the quality of a web-based learning system for nurses

Continuing professional education is essential for nurses to update their clinical skills and knowledge to meet the complex demands of current patient care. Compared to traditional in-class continuing education, a web-based learning system is efficient for nurses with a three shift-working schedule and is timely to deliver knowledge about newly emerging epidemics such as Severe Acute Respiratory Syndrome. Many studies reveal the advantages of various web-based learning systems but seldom evaluate them from the perspective of quality. This study develops an instrument to assess the quality of a web-based learning system for nurses' continuing education based on the quality dimensions of a mature information systems success model. The research results show that all indicators of the instrument provide a fit to the quality measurement of a web-based learning system and have high reliability and validity. Based on the research findings, implications and limitations are discussed.

Nurses' opinions about a web-based distance course in a specialist education programme for the care of older people: a questionnaire study

Aim.  The aim of the present study was to investigate students' opinions about a web-based distance learning course that was part of a specialist education programme. Background.  Most registered nurses (RNs) who work with older people in Sweden do not have a specialist education in caring for older people. Design.  Survey. Method.  The study was a descriptive survey with both qualitative and quantitative questions. Results.  The students found the web-based course very useful for their theoretical and professional development. New perspectives on ageing, increased knowledge about analysing and describing theories as well as practising interviews and qualitative analysis as methods were appreciated by the students. Conclusions.  One way for RNs in Sweden to get a university specialist education in the care of older people is to have a distance web-based course, as it allows flexibility and improves the students' theoretical and professional knowledge and communication skills. Relevance for clinical practice.  Managers working in care for older people settings and educators will be interested in this study's finding that distance learning is a useful strategy for providing education for RNs who work with older people.

An evaluation of a weight-loss program incorporating E-learning for obese junior high school students

Obesity in adolescents is continuing to rise at an alarming rate and is becoming an important public health problem in Taiwan. Therefore, the aims of this study were (1) to evaluate the effectiveness of a Weight-loss E-learning Program (WEP) on obese Chinese adolescents and (2) to gauge this group's satisfaction with the WEP. The design was quasi-experimental, using purposive samples from two junior high schools in Taipei, Taiwan. Obese adolescents between 12 and 14 years of age with body mass indexes (BMI) over 25 kg/m2 were recruited. A 14-week WEP was developed to expedite weight loss for the selected adolescents. Data such as BMI, waist-to-hip ratio, waist circumference, hip circumference, mid-arm circumference, triceps skinfold, blood pressure, and physical fitness were collected through standardized instruments and methods before and after the WEP. The satisfaction of the subjects and four psychosocial variables were evaluated and taken into account by authoritative scales and questionnaires. In total, 37 adolescents participated in this study. After the WEP, we found significant decreases in BMI (p < 0.05), waist circumference (p < 0.05), and triceps skinfold (p < 0.001) in the sample population. Improvements were found in three of four tests of physical fitness (p < 0.001, p < 0.05, and p < 0.01, respectively). All psychosocial variables showed significant favorable changes (p < 0.01 for self-esteem scores, p < 0.001 for the other three variables) and satisfaction levels for the WEP ranged from 56.6% to 83.8% in four different criteria. The WEP was effective in helping obese Chinese adolescents lose weight. However, there is still room for improvement.

Transposing Yallom: recognizing and understanding group dynamics in a Canadian online diploma in psychiatric nursing

Given the historical association between psychiatric/mental health (P/MH) nursing education and group formats, and the recent shift to online education, one might expect to see a well developed literature that focuses on P/MH nurse education in online group settings; yet this is patently not the case. This paper attempts to redress this omission by drawing on educational material produced in a regional online diploma in psychiatric nursing. After reviewing the relevant extant literature, it adopts Yallom's seminal work and transposes this into online group settings. Examples of postings drawn from this programme are then used to help recognize and understand online group dynamics. The authors conclude that group dynamics are as much a part of online P/MH nurse education as they have been for 'traditional', face-to-face, educational programs, albeit manifest, expressed and encountered in different ways. Secondly, acknowledging the existence of these group dynamics creates the need for a new skill set, or maybe the transposition of an existing skill set for P/MH nursing educators. Thirdly, examination/analysis of student online postings (virtual case studies) enables the tentative epistemological transposition of face-to-face group dynamics into the online version.

Factors influencing the utilisation of e-learning in post-registration nursing students

The learning environment extends beyond the classroom and establishing an e-learning culture is seen as essential to the future of nurse education and the facilitation of life long learning. This paper reports on a study that sought to identify the factors that may influence the utilisation of e-learning by nursing, midwifery and health visiting students undertaking post-registration studies. The findings presented draw on quantitative and qualitative data drawn from analysis of a questionnaire exploring experience and perceptions of e-learning. This research finds the perception of e-learning is positively influenced by its flexibility in time management, pace of learning, self direction and widening access to information. Potential barriers relate to the functional capability of students, perceived levels of computer literacy, perceptions of e-learning as time consuming, competing home life elements and the lack of work based support. Student expectations in relation to reasons for choosing this mode of learning and the probability that they may be inadequately supported to make the best use e-learning were inherent in the findings. This raised questions of the potential for inequity in educational delivery with increasing use of e-learning. The implications from this research highlight the challenge for nurse educators in understanding, developing awareness of and identifying strategies to manage these factors.

Satisfaction with web-based training in an integrated healthcare delivery network: do age, education, computer skills and attitudes matter?

BACKGROUND

Healthcare institutions spend enormous time and effort to train their workforce. Web-based training can potentially streamline this process. However the deployment of web-based training in a large-scale setting with a diverse healthcare workforce has not been evaluated. The aim of this study was to evaluate the satisfaction of healthcare professionals with web-based training and to determine the predictors of such satisfaction including age, education status and computer proficiency.

METHODS

Observational, cross-sectional survey of healthcare professionals from six hospital systems in an integrated delivery network. We measured overall satisfaction to web-based training and response to survey items measuring Website Usability, Course Usefulness, Instructional Design Effectiveness, Computer Proficiency and Self-learning Attitude.

RESULTS

A total of 17,891 healthcare professionals completed the web-based training on HIPAA Privacy Rule; and of these, 13,537 completed the survey (response rate 75.6%). Overall course satisfaction was good (median, 4; scale, 1 to 5) with more than 75% of the respondents satisfied with the training (rating 4 or 5) and 65% preferring web-based training over traditional instructor-led training (rating 4 or 5). Multivariable ordinal regression revealed 3 key predictors of satisfaction with web-based training: Instructional Design Effectiveness, Website Usability and Course Usefulness. Demographic predictors such as gender, age and education did not have an effect on satisfaction.

CONCLUSION

The study shows that web-based training when tailored to learners' background, is perceived as a satisfactory mode of learning by an interdisciplinary group of healthcare professionals, irrespective of age, education level or prior computer experience. Future studies should aim to measure the long-term outcomes of web-based training.

Developing an E-learning education programme for staff nurses: processes and outcomes

OBJECTIVE

To describe the Instructional System Design Processes (analysis, design, development, implementation, and evaluation) used to develop an e-learning education programme for staff nurses at a 700-bed teaching medical center in Taiwan.

BACKGROUND

Evidence has shown that education via e-learning improves knowledge and skills; however, with cost constraints and limited resources, finding effective alternatives is critical for health professionals.

METHODS

Five courses required for N2 to N3 level nurses were designed for both e-learning and traditional in-classroom programmes. Multiple-choice written test questions and a satisfaction questionnaire were used to compare outcomes between programmes. Nursing care skills were rated as pass or fail. Both programmes were begun at the same time and completed within a 3-month period.

RESULTS

Forty-two staff nurses participated in this study. All nurses' knowledge scores were >70 points (out of 100) and all passed nursing care skills. In five courses, only teaching and learning and communication were statistically significantly different (p=0.001). Nearly all nurses (97.6%) felt satisfied or very satisfied with the programmes.

CONCLUSIONS

Instructional System Design Processes provide an alternative delivery system for in-service nursing education which allows for individualized leaning.

WebQuests

The nursing shortage, coupled with growing case loads, limits the available time for nurses in home care to attend continuing professional education programs necessary to keep abreast of the changes in nursing practice and enhance their clinical competency. The purpose of this case study was to evaluate the effectiveness of the WebQuest, a Web-based inquiry-oriented model congruent with the pedagogical approaches and cognitive activities commonly used with nursing education, in providing continuing education content to nurses in a mid-sized home health care agency. A convenience sample of registered nurse case managers completed a researcher-designed WebQuest, modified for independent learning, on diabetes education utilizing their personal computers from home. WebQuests proved to be an innovative and creative approach to provide new information, promote higher level thinking skills, and develop nurses' confidence with computer technology.

Use of the internet in staff development and its application in helping critical care nurses to lower family stress

A systematic review evaluated use of the Internet in nursing staff development and the feasibility of using the Internet to teach critical care nurses how to help families. Use of the Internet to provide staff development had varying success. The keys to success are careful development of the program according to needs and capabilities of the users, strong education pedagogical principles, and constant evaluation for success in order to make alterations as they are needed.

Evaluating a Web-enhanced bachelor of nursing curriculum: perspectives of third-year students

Little is known about nursing students' information literacy skills and perceptions of Web-enhanced educational approaches. This study examined graduating Bachelor of Nursing (BN) students' perceptions of a Web-enhanced learning environment, their computer literacy skills, and use of technology, and how these influenced their satisfaction. This Australian survey produced a 64% (n = 170) response rate. The 3-year BN program provides Web-enhanced learning opportunities by incorporating online activities and content such as quizzes, videos, and virtual laboratories that augment on-campus and off-campus learning approaches. Upon graduation, 61.4% of the students reported having competent information literacy skills. The quality and usefulness of the Web-enhanced material was rated fair to above average. The students' perception of technical and faculty support for Web-enhanced learning was low. Overall satisfaction with the Web-enhanced program was associated with level of information technology (IT) skills and perceived quality and usefulness of the Internet material. A regression analysis of factors contributing to students' overall satisfaction of a Web-enhanced learning environment (IT literacy skills, access, and perceived quality, usefulness, and support) accounted for 18.5% of variance. As more nursing programs use Web-based resources, greater attention should be given to the initial assessment and development of students' information literacy skills. Students with good IT skills are more likely to perceive Web-enhanced material as useful.

Research awareness: making learning relevant for pre-registration nursing students

This paper outlines efforts to improve the teaching and learning methods for research on a second year pre-registration nursing programme in one university in Wales, UK. This focussed on experiential approaches supported by electronic learning resources. A subsequent evaluation aimed to elicit participating students' and lecturers' perceptions of the success of the experiential approaches and the supporting resources. A questionnaire was distributed to 53 student nurses who participated in the experiential learning and this was supplemented with an informal qualitative 'graffiti board' evaluation with the cohort; and a group interview with 4 of the lecturers who had acted as group facilitators during the experiential research sessions. The findings revealed that similar issues were pertinent for both lecturers and students and these were contained within three distinct themes relating to the structure, process and outcomes of the teaching and learning approaches. The student-led approach to evaluation offers a fresh outlook which ensures that the emic perspective is included through the study. The study sheds light on the strengths and limitations of experiential approaches to research teaching and suggest that this is a challenging approach both for students and lecturers, which should not be entered into lightly.

A feasibility study on the adoption of e-learning for public health nurse continuing education in Taiwan

The purpose of this study is to investigate the feasibility of developing e-learning and to examine reasons for adopting or rejecting e-learning as an alternative way to conduct continuing education (CE) for public health nurses (PHNs). A nationwide-based cross-sectional study was conducted with a randomly selected sample of 233 PHNs in Taiwan. A structured questionnaire was used to collect data by mailing methods. The majority of PHNs (88.84%, n=207) showed an affirmative intention towards adopting e-learning as their one way of CE. Reasons for adopting e-learning included achieving life learning, fulfilling personal interests, time-saving, based on job needs, information diversity, flexible in time and space, self-regulatory learning, cost-effectiveness, less impact on family duties and life. Twenty-six PHNs (11.16%) who rejected e-learning as their way of CE indicated main reasons including poor computer competence, lack of personal computer and without internet access, heavy work load, heavy family duties, conflict with personal preference, heavy economic burden, lack of motivation, and low self-control. This study reveals a high feasibility of developing e-learning that coexists with other CE models (e.g. traditional instruction). Reasons analyses provide directions for decreasing barriers for developing a learning model of this new medium for nurses' CE.

Distance education in nursing: an integrated review of online nursing students' experiences with technology-delivered instruction

One proposed solution to educating more nurses to decrease and eventually eliminate the nursing shortage is distance education. But what are nursing students' experiences with distance education? Answering this question can assist in the development of effective teaching and learning strategies to provide for the development of quality distance education programs. This article provides an integrative review of the nursing literature to ascertain the student perspective of distance education. A review of nursing literature was completed using a number of databases and specific criteria to locate research studies specific to this topic. The studies were analyzed for validity and reliability, and limitations were mentioned. Student perceptions garnered from the research studies analyzed are summarized with the acronym DISTANCE ED. Implications, recommendations, and needs for future research are discussed. A supplementary review of the literature is used to augment the findings.

Decreasing transactional distance in a Web-based course

The Horizon Wimba online Web-conferencing voice system was used to facilitate dialogue and decrease transactional distance in a Web-based course. Small-group (< or =6)discussion sessions were held and addressed topics pertinent to clinical practice. Students were asked to evaluate the synchronous voice discussion groups via a Flashlight survey at the end of the semester. Anecdotal and survey responses indicated that discussion groups increased dialogue between faculty and students.

Applying the technology acceptance model to explore public health nurses' intentions towards web-based learning: a cross-sectional questionnaire survey

BACKGROUND

In the era of the knowledge economy, public health nurses (PHNs) need to update their knowledge to ensure quality of care. In pre-implementation stage, policy makers and educators should understand PHNs' behavioural intentions (BI) toward web-based learning because it is the most important determinant of actual behaviour.

OBJECTIVES

To understand PHNs' BI toward web-based learning and further to identify the factors influencing PHNs' BI based on the technology acceptance model (TAM) in pre-implementation stage.

DESIGN

A nationwide-based cross-sectional research design was used in this study.

SETTING

Three hundred and sixty-nine health centres in Taiwan.

PARTICIPANTS

A randomly selected sample, 202 PHNs participated in this study.

METHODS

Data were collected by mailing in a questionnaire.

RESULTS

The majority of PHNs (91.6%, n=185) showed an affirmative BI toward web-based learning. PHNs rated moderate values of perceived usefulness (U), perceived ease of use (EOU) and attitude toward web-based learning (A). Multiple regression analyses indicated that only U revealed a significantly direct influence on BI. U and EOU had significantly direct relationships with A; however, no significant relationship existed between A and BI. Additionally, EOU and an individual's computer competence revealed significant relationships with U; Internet access at the workplace revealed a significant relationship with EOU.

CONCLUSION

In the pre-implementation stage, PHNs perceived a high likelihood of adopting web-based learning as their way of continuing education. In pre-implementation stage, perceived usefulness is the most important factor for BI instead of the attitude. Perceived EOU, an individual's computer competency, and Internet access at workplaces revealed indirect effects on BI. Therefore, increasing U, EOU, computer competence, and Internet access at workplace will be helpful in increasing PHNs' BI. Moreover, we suggest that future studies should focus on clarifying problems in different stages of implementation to build a more complete understanding of implementing web-based learning.

Addressing the issue of e-learning and online genetics for health professionals

Health-care professionals need an appropriate genetics knowledge base to care for patients and their families. However, studies have indicated that nurses and midwives lack the requisite genetics knowledge to practice effectively and safely, with a paucity of resources to address their educational needs. This paper describes an action research study aimed at developing an online genetics resource for students and practitioners in a range of health professions. A literature review of current health-care genetics education was undertaken. In the first phase of the action cycle, a sample of nurses and midwives were surveyed using a questionnaire to discover their perceived learning needs and the acceptability of an e-learning approach. Using the findings, an online resource for health professionals was developed, by means of a life stage structure to expedite accessibility. The developmental process leading to the construction of clinical case studies in this resource (including theory, ethical, and practical issues) and the evaluation strategy are discussed.

The need for nurses to have in service education to provide the best care for clients with chest drains

Chest drains are a widespread intervention for patients admitted to acute respiratory or cardiothoracic surgery care areas. These are either inserted intraoperatively or as part of the conservative management of a respiratory illness or thoracic injury. Anecdotally there appears to be a lack of consensus among nurses on the major principles of chest drain management. Many decisions tend to be based on personal factors rather than sound clinical evidence. This inconsistency of treatment regimes, together with the lack of evidence-based nursing care, creates a general uncertainty regarding the care of patients with chest drains. This study aimed to identify the nurses' levels of knowledge with regard to chest drain management and identify and to ascertain how nurses keep informed about the developments related to the care of patients with chest drains. The data were collected using survey method. The results of the study revealed deficits in knowledge in a selected group of nurses and a paucity of resources. Nurse managers are encouraged to identify educational needs in this area, improve resources and the delivery of in service and web-based education and to encourage nurses to reflect upon their own knowledge deficits through portfolio use and ongoing professional development.

Supporting pre-registration students in practice: A review of current ICT use

It is unclear how current healthcare students based in the United Kingdom (UK) use information and communication technology (ICT) to support their learning and care delivery in practice environments. This position reflects the dearth of current empirical evidence that needs development in this rapidly changing field. Using focus group interviews involving 16 students from nursing and the allied health professions, to reflect the interprofessional nature of healthcare education, this research explored how students employ technology in placement settings. The students drew on networked resources for personal learning and gave examples of use to meet patient and user needs. Technology also provided a vehicle for communication with the University, though use was complicated by a number of issues. Access to computers and the Internet whilst in placement environments proved problematic for some, with the culture not seeming to support ICT use. Lack of time, attitudes towards computers and ICT skills also affected student engagement. These findings provide information to guide the development of ICT use in placement settings.

The development and evaluation of the use of a virtual learning environment (Blackboard 5) to support the learning of pre-qualifying nursing students undertaking a human anatomy and physiology module

Students commence nurse education with varying levels of understanding of human anatomy and physiology due to a wide range of previous exposure to the topic. All students, however, are required to attain a broad knowledge of this topic prior to qualification. This paper describes the use of a Virtual Learning Environment (VLE), Blackboard 5, and the associated development of appropriate resources aimed at supporting nursing students undertaking a human anatomy and physiology module at Higher Education Level 1. The VLE was used as part of a blended learning approach. The results suggested that the majority of students utilised the VLE throughout the academic year. Opportunities for independent and self-directed learning were available in that students chose when and where to learn. Students generally commented favourably on ease of use and type of resources available. Frequency of use of the VLE, however, did not correlate strongly with the final examination mark achieved. Overall the VLE and the associated available resources appeared useful in supporting student learning and has been adopted for use in subsequent years.

Educational mentor program in a Web-based doctor of pharmacy degree pathway

OBJECTIVE

To establish a successful educational mentor program for the Web-based doctor of pharmacy pathway at Creighton University, School of Pharmacy and Health Professions.

DESIGN

A recruitment process was established and the educational mentor's responsibilities were identified. The roles of faculty instructors, the Office of Information Technology and Learning Resources, the Office of Faculty Development and Assessment, and Web-based Pharmacy Pathway Office as it pertains to the training of educational mentors were clearly delineated. An evaluation process for all key aspects of the program was also put in place.

ASSESSMENT

Student, instructor, and mentor evaluations showed overall satisfaction with the program. Persistent areas of concern include the difficulty in motivating students to participate and/or engage in learning with the mentors. Many students remain unclear about mentors' roles and responsibilities. Lastly, in regards to mentors, there is a limited utilization of provided online resources.

CONCLUSION

The educational mentor program has become an invaluable component of the Web pathway and has enhanced the interactions of students with the content and mentor.

Strategies for Online Teaching and Learning

Distance learning and Web-based learning are accepted components of the American higher educational system. Strategies for teaching and learning in this medium require a different perspective on the teacher-student relationship and the educational process. The authors describe an innovative online learning endeavor focusing on a specialty practice area in contemporary healthcare: wound, ostomy, and continence nursing. Special emphasis is placed on the teaching-learning approaches that were successfully incorporated into the program.

Web-based learning in professional development: experiences of Finnish nurse managers

AIM

The aim of this article is to describe the nurse managers' expectations, attitudes and experiences on web-based learning before and after participation in a web-based course.

BACKGROUND

Information technology has rapidly become more common in health care settings. However, little is known about nurse managers' experiences on web-based learning, although they have a crucial role in promoting the professional development of their staff.

METHODS

Diagnostic assignments (n = 18) written before and interviews (n = 8) taken after the web-based education. The data were analysed by inductive content analysis.

RESULTS

Nurse managers found web-based education to be a suitable and modern method of learning. On the basis of their experience they found multiple ways to utilize web-based learning environments in health care. Information technology skills, equipment, support and time were considered essential in web-based learning. Additionally, they found that their own experience might lead to more widespread implementation of web-based learning in health care settings.

CONCLUSIONS

Information technology skills of nurse managers and staff need to be developed in order to use information technology effectively. In order to learn in a web-based environment, everyone needs the opportunity and access to required resources. Additionally, nurse managers' own experiences are important to promote wider utilization of web-based learning.

Effectiveness of a 6-week Online Course in the Canadian Triage and Acuity Scale for Emergency Nurses

INTRODUCTION

There is increasing interest in 5-level triage systems in emergency departments; however, the adoption of a new system places heavy training demands on ED department nurses and physicians. One emerging training option is online learning. The purpose of this study was to explore the effectiveness of an online course in the 5-level Canadian Triage and Acuity Scale (CTAS) on the clinical practice of the triage nurse.

METHODS

Interviews were held with 23 emergency nurses from across Canada. A chart audit of triage codes from 367 charts from 6 hospitals was conducted.

RESULTS

The most consistent finding was that the majority of RN staff enjoyed the online course and believed it had improved their triage practice. Nurses believed that their patient assessments were more thorough, accurate, and consistent throughout the department. Improved communication between staff and with patients and families was identified. Nurses reported using what they learned to improve triage assessment. Triage accuracy was high; the overall agreement between CTAS graduates and the chart auditor/expert within one CTAS level was 99.7%. Nurses also identified a number of organizational barriers to CTAS implementation after the course.

DISCUSSION

The online format appears to be an effective, efficient, and convenient way to educate large numbers of ED staff in CTAS. Further research is needed regarding the use of multimedia and computer online chat options to further enhance the online learning experience for nurses.

E-Orientation

The reality of the nursing shortage, combined with limited education resources, requires a flexible and efficient approach to orienting experienced nurses seeking per diem or temporary employment. A solution to meet the learners' needs and maximize educational resources involves making a transition from traditional instructor-led orientation programs to an e-orientation Web-based learning methodology. To operationalize a Web-based curriculum, the nurse educator can apply the standards of practice for nursing professional development to effectively develop an e-orientation that meets the needs of administrators, the educators, and the temporary/per diem nurses.

Being a Supportive Presence in Online Courses: Knowing and Connecting with Students Through Writing

Enacting Narrative Pedagogy, teachers often reflect on how practices, such as knowing and connecting, influence the nature of the experiences they co-create with students. There is a reciprocity in the tone of both students' and teachers' communication-in both classroom and online environments. Through attention to how teachers know and connect with students, the words and phrases they use can help put students at ease and preserve a continual future openness for learning. Without attention to how language "speaks" to students, especially in distance education, teachers perhaps, too often, "look through" experience to the outcomes of learning and do not address the potentially problematic nature of the experiences they co-create with students. Focusing attention on the meaning and significance of language in online learning restores the connective and gathering possibilities of written communication.

Nurses’ knowledge of chest drain care: an exploratory descriptive survey

Chest drains are a common feature of patients admitted to acute respiratory or cardio-thoracic surgery care areas. Chest drains are either inserted intraoperatively or as part of the conservative management of a respiratory illness or thoracic injury. Anecdotally, there appears to be a lack of consensus among nurses on the major principles of chest drain management. Many decisions tend to be based on personal factors rather than sound clinical evidence. This inconsistency of treatment regimes, together with the lack of evidence-based nursing care, creates a general uncertainty regarding the care of patients with chest drains. This study aimed to identify the nurses' levels of knowledge with regard to chest drain management. The research objective of this study was to describe the nurses' levels of knowledge regarding the care of the patient with chest drains. The data were collected using survey method. The results of the study revealed deficits in knowledge in a select group of nurses. Several service-led options exist with regard to improving knowledge in this area, such as service study days as well as ward-based tutorials. However, in an era of increasing accountability together with the impetus for each nurse to provide evidence-based care, it is crucial for individual nurse responsibility in the pursuit of knowledge in this area. Nurses must be supported by local practice development and through personal portfolio use to identify gaps in knowledge and seek appropriate training and resources.

Indicators of Success in Distance Education

Distance education offers many advantages to students, faculty, and educational institutions. Despite these advantages, distance education classes historically have higher dropout rates than do the courses taught in the traditional, face-to-face setting. Current research includes information related to technology, teaching tips, and resources for these extended learning opportunities. However, information related to student success in distance education is limited and success indicators are poorly defined. Current studies on success indicators often lack a defining framework that provides an opportunity for study replication and strengthens the credibility of study findings. An empirical model developed by Powell et al divides potential determinants of success into three categories. This literature review identifies indicators in each category and indicates a need to revise the current framework to include technology as a fourth category. The revised framework should provide a basis for additional research in this rapidly growing area.

Integration of Internet-based learning and traditional face-to-face learning in an RN-BSN course in Korea

This article describes the development of and student satisfaction with a distance learning course using both online and face-to-face methods in an RN-BSN program in Korea. Four steps were used for course development: (1) assessment of students' learning needs and determination of objectives of the course, (2) designing of module/assignment instructions, (3) development of the Internet-based learning platform, and (4) evaluation of course and Internet-based learning platform. Student satisfaction was evaluated by using a 4-point Likert-type questionnaire. Forty-eight (92.3%) questionnaires were returned. Overall satisfaction with this course was high (X = 3.29). Appropriateness of learning methods (X = 3.35) was rated the most satisfactory, followed by appropriateness of content (X = 3.31). Most of the students enjoyed the course and they wanted more nursing courses to be offered through the online and on-site format. On the basis of the findings, additional courses using both online and face-to-face methods for RN-BSN students should be developed and implemented for RN-BSN nursing programs in Korea.

Experiences of online learning: students' perspective

This paper explores students' views of an online learning initiative within a post-registration degree in nursing in Hong Kong. A self-administered questionnaire was used for data collection. One hundred and ninety eight students completed the study. Online learning was seen to be convenient allowing students to study at their own pace and time. Students reported that online learning enabled them to hold a higher level of accountability for their own learning and to learn independently. Not all experiences were positive. A major hindrance to online learning was the inadequate opportunity for human interaction which was deemed necessary for establishing peer support and developing in-depth group discussion on subject matter. These findings provide a guide for further development and improvement in online teaching and learning methodologies.

Factors influencing nursing students' preference for a hybrid format delivery in a pathophysiology course

A growing number of courses in higher education are adopting a hybrid format of course delivery. Hybrid courses use both online learning activities with traditional classroom teaching and thus offer the efficiency and flexibility of online delivery without the complete loss of face-to-face contact. This paper explores students' satisfaction with a hybrid course delivery format, where students were required to attend the traditional tutorial session as well as complete the prescribed web-based learning activities. The study also sought to determine if age, part-time employment or academic performance were associated with satisfaction levels of the hybrid format. Participants were 143 undergraduate nursing students enrolled in a final year pathophysiology course at a university in Sydney, Australia. A survey design was used to evaluate hybrid versus traditional face-to-face classroom instruction, resulting in a high overall satisfaction with the hybrid course delivery format. Students' age and the hours they spent in part-time employment were not associated with satisfaction levels of the hybrid format. Students who achieved higher marks in the final examination expressed stronger preference for the traditional format of course delivery indicating a perceived reliance on teacher-based instruction. It is recommended that additional support be provided to students while they make the shift to a more active independent mode of learning when using web-based formats.

Rehabilitation education program for stroke (REPS): learning and practice outcomes

INTRODUCTION

New research knowledge acquired from Web-based sources may have a better chance of being translated into practice when accompanied by additional educational strategies. This study was undertaken to investigate that hypothesis.

METHODS

The Rehabilitation Education Program for Stroke (REPS) combines a self-directed online learning module with support from peer mentors, technical skills workshops, and organizational supports. Participants completed learning tests and practice surveys before and after the program and at a 6-month follow-up.

RESULTS

Learning and self-reported practice outcomes improved in the areas of assessment, client-centered practice, support for family and caregivers, and detecting depression. Participants also identified and reported specific strategies for individual and programmatic practice change.

DISCUSSION

A multifaceted, interdisciplinary online education intervention can positively influence stroke rehabilitation practices.

An exploration of four web-based open and flexible learning modules in post-registration nurse education

This paper presents an exploratory evaluation of four newly developed web-based modules for post-registration nurses. The topics for the modules were: dermatology; diabetes; mentorship; and prescribing.

STUDY OBJECTIVE

To explore the students' perceptions of the web-based modules before and after completing the modules.

DESIGN

A pre-post test design using questionnaires and group interviews.

PARTICIPANTS

39 students enrolled on the modules, pre-module data were collected on 74% (n = 29) and post-module data on 71% (n = 28). None of students had previous web-based education experience. 79% (n = 31) completed and 66% (n = 26) passed the modules. Students level of IT skills prior to commencing the modules were important in explaining module completion and outcome. The modules were rated highly in terms of achieving learning outcomes with moderate ratings for level of support and utility of learning materials. The content analysis of the interviews highlighted the importance of preparing students ensuring they have the IT and independent learning skills necessary to participate in web-based learning programmes, together with a number of issues relating to the accessibility of the learning materials. The perceived benefits of this mode of learning were that they offered flexible and resource rich learning. The downside was that the learning can be isolating.

CONCLUSIONS

This form of learning may not be suited to all groups of nurses or all educational topics. Further research is required to establish the educational benefits of different approaches to e-learning.

Becoming a web-based learner: registered nurses' experiences

AIMS

The purpose of the study was to describe Registered Nurses' experiences when taking a web-based course from either the workplace or home, and the impact of their learning on clinical practice.

RATIONALE

Little is known about the web-based learners' experience, particularly when courses are accessed from the nursing practice setting. Even less is known about whether nurses transfer their web-based learning to clinical practice.

METHODS

A qualitative design employing focus group interviews was used. Participants included hospital and community nurses from three Canadian provinces and one territory. Data were collected at three points over a 6-month period and analysed using a thematic analysis process. These findings emanate from a larger study using survey method and focus group interviews.

RESULTS

The focus group interviews captured the hurdles nurses faced during the first weeks when they struggled with technology, re-framed their views of teaching and adjusted to web-based learning from home and work. These first stressful weeks were followed by a period during which nurses developed relationships with the teacher and peers that enabled them to focus on learning and prevented attrition. Most nurses reported the web course was convenient and that they would be interested and comfortable using technology for learning and work purposes in the future. Six weeks after the course was completed, nurses articulated a number of ways the course had improved their practice.

CONCLUSION

Initial weeks in a web-based course can be very challenging for novice Internet users, however, most nurses who completed the course reported a positive learning experience. Nurses, employers and educators should evaluate computer skills, computer access and the learning environment when preparing for web-based learning.

Internet continuing education for health care professionals: an integrative review

INTRODUCTION

The objective was to review key articles and research studies on practices, preferences, and evaluation of on-line continuing education used by health care professionals.

METHODS

Data sources included searches of the MEDLINE, CINAHL, and ERIC databases (January 1990 to June 2004) and manual searches of the Journal of Continuing Education in the Health Professions and the Journal of Continuing Education in Nursing. Articles included reviews and research studies focusing on the use of Internet CE by health care professionals. The articles were categorized according to intervention, subjects, study design, and key findings.

RESULTS

Seventeen articles were eligible and were reviewed. Although in-person CE remains the most frequent and most preferred format, Internet CE is gaining in popularity. Most participants who engage in on-line CE are satisfied with the experience and find it to be an effective learning format. Barriers to on-line CE include technical difficulties and lack of computer knowledge.

DISCUSSION

Although the Internet is an effective and satisfactory educational format, barriers to use of the Internet for CE still exist. Additional studies are needed to measure the impact of Internet CE on practice performance, reduce barriers to on-line CE, and identify appropriate theoretical frameworks for on-line learning.

Computer and internet use by first year clinical and nursing students in a Nigerian teaching hospital

BACKGROUND

The internet is an important source of up-to-date medical information. Although several studies in different countries have explored the extent to which health science students use the computer and the internet, few researches are available on this subject in Nigeria. The aim of this study was to assess the uptake of computer and internet by health science students studying in the country.

METHODS

One hundred and eighty three first year medical and nursing students of the University College Hospital, Ibadan, Nigeria, completed a-25 item questionnaire during routine Library Orientation Program in the medical library. The EPI-Info software was used for data analysis.

RESULTS

The mean ages for medical students and the student nurses were 22 and 24.6 years respectively. Overall, 42.6% of the entire sample could use the computer, 57.4% could not. While more than half (58%) of the medical students are computer literate, majority (75.9%) of the student nurses are not. Slightly more than two thirds (60.7%) of the entire students had ever used the internet, 33. 9% had not. E-mail was the most popular of internet services used by the students (76.4%) and the cyber café was the common place where students had accessed these services. The students' mean scores on a 15-point perceived self-efficacy scale for internet-related tasks was 3.8 for medical and 0.7 for nursing students (p = 0.00). Students who are computer literate had superior mean scores (4.8) than those without (0.6) (p = 0.000).

CONCLUSION

First year clinical and nursing students in Ibadan Nigeria have not fully utilised the opportunity that the use of computer and internet offer for medical education. Improved efforts such as inclusion of computer education in medical and nursing curricular and establishment of computer laboratories are required to increase the student's access to computers and internet.

Comparison of Oncology Nurse and Physician Use of the Internet for Continuing Education

BACKGROUND

In the past 10 years, there has been a dramatic increase in published literature on the topic of Internet use by healthcare professionals. Learners and organizations providing grants to the continuing education (CE) division of a medical education and publishing company have expressed increasing interest in the area of Internet CE. To quantify and analyze this trend, the company began using surveys to evaluate this growing area of interest.

METHOD

Since 1998, annual surveys at the annual meetings of the Oncology Nursing Society and the American Society of Clinical Oncology were used to determine trends in educational use of the Internet for CE.

FINDINGS

Internet use and frequency of use, including use of the Internet for CE among both nurses and physicians, have been increasing. When asked what would make these professionals more likely to use the Internet for CE, both indicated making the activities low cost or free and easier access.

CONCLUSIONS

Nurses and physicians are looking to the Internet for quick access to reliable information, thus challenging CE educators to develop ways to implement Internet CE activities quickly. Ongoing needs assessment of target audiences and evaluation of the effectiveness of Internet CE is essential to optimizing the role of this educational format for healthcare professionals.