Modeling Students' Perceptions of Simulation-Based Learning Using the Technology Acceptance Model

Clinical virtual simulation: predictors of user acceptance in nursing education

BACKGROUND

Using virtual patients integrated in simulators expands students' training opportunities in healthcare. However, little is known about the usability perceived by students and the factors/determinants that predict the acceptance and use of clinical virtual simulation in nursing education.

OBJECTIVES

To identify the factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing education.

METHODS

Observational, cross-sectional, analytical study of the use of clinical virtual simulation in nursing to answer the research question: What factors/determinants predict the acceptance and use of a clinical virtual simulator in nursing education? We used a non-probabilistic sampling, more specifically a convenience sample of nursing degree students. The data were collected through a questionnaire adapted from the Technology Acceptance Model 3. In technology and education, the Technology Acceptance Model is a theoretical model that predicts the acceptance of the use of technology by users.

RESULTS

The sample comprised 619 nursing students, who revealed mean values of perceived usefulness (M = 5.34; SD = 1.19), ease of use (M = 4.74; SD = 1.07), and intention to use the CVS (M = 5.21; SD = 1.18), in a Likert scale of seven points (1-the worst and 7 the best possible opinion). This study validated the use of Technology Acceptance Model 3 adapted and tested the related hypotheses, showing that the model explains 62% of perceived utility, 32% of ease of use, and 54% of intention to use the clinical virtual simulation in nursing by nursing students. The adequacy of the model was tested by analysis of the direct effects of the relationships between the internal constructs (PU-BI, β = 0.11, p = 0.012; PEOU-BI, β = -0.11, p = 0.002) and the direct relations between some of the constructs internal to the Technology Acceptance Model 3 and the external determinants Relevance for learning and Enjoyability. In the proposed model, the external constructs that best predicted perceived usefulness, ease of use, and behaviour intention to use the clinical virtual simulation in nursing were Relevance for learning and Enjoyability.

CONCLUSIONS

These study results allowed us to identify relevance for learning and enjoyability as the main factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing.

Knowledge Retention From Emergency Medicine Simulation-Based Learning Curriculum for Pre-clinical Medical Students

Introduction Traditional medical school curricula rely on textbook-based learning during the first two years, often limiting students' clinical exposure. Simulation-based learning (SBL) provides an opportunity for students to gain clinical exposure and competency with common procedures as well as to gain knowledge related to common clinical topics. Retention of factual knowledge is a current topic of discussion as medical learners often have difficulty with long-term retention. The aim of this study was to assess if students would learn, retain, and enjoy emergency medicine (EM)-focused SBL. Materials and methods We developed an EM-focused SBL curriculum consisting of four main educational events: suturing, medical stabilization, mass casualty triage, and point-of-care ultrasound (POCUS). Participants were first- and second-year healthcare students enrolled in a traditional, preclinical curriculum, who completed pre- and post-event quizzes consisting of multiple-choice questions on topics covered during the SBL scenario. We compared pre- and post-event quiz scores using a one-way paired t-test. Quizzes were readministered up to 100 days after each SBL event to test knowledge retention, and scores were compared across time by repeated-measures analysis of variance (RMANOVA). Results For suture (n=22), mass casualty (n=20), and ultrasound simulations (n=17), post-event mean quiz scores increased significantly in comparison to mean quiz scores from before the event (p≤0.05). Medical stabilization simulation post-event scores were increased but did not reach statistical significance. Data collected at 45, 74, and 94 days following the suture lab as well as 29 and 49 days after the medical evacuation event, and 20 days after the mass casualty event showed no statistical decrease in quiz means suggesting retention of knowledge among learners. Subjective assessments of participant satisfaction demonstrated an enjoyment of the events. Discussion EM-focused SBL events offered enjoyable learning opportunities for students to effectively obtain and possibly retain clinical knowledge. Conclusion SBL has the potential to improve student retention of clinical knowledge during the preclinical years and, therefore, should be further explored and implemented as a core pillar of medical education as opposed to its current state as a learning adjunct.

An Empirical Investigation of Critical Factors Affecting Acceptance of E-Learning Platforms: A Learner's Perspective

E-learning is evolving as the paradigm of modern-day education. Globally, e-learning has seen a rise; however, failures happen. There is a dearth of studies that discuss why a lot of learners quit e-learning after a preliminary experience. Preceding research studies carried out under diverse task settings have proposed an assortment of factors impacting learners' satisfaction with e-Learning. This study developed an integrated conceptual model with the instructor, course, and learners' dimensions and then empirically validates it. The technology acceptance model (TAM) has been employed for testing the acceptance of various technologies and software within an e-learning context. This study intends to examine the salient factors of effective e-learning acceptance by learners. A survey investigates the critical factors using a self-administered questionnaire influencing the satisfaction of learners in the e-Learning system/platform. The study uses quantitative methodology and data were collected from 348 learners. On performing the structured equation modeling for testing the hypothesized model, outcomes reveal the significant factors influencing learners' perceived satisfaction studied in three dimensions of the instructor, course, and learner. It will facilitate educational institutes and provide directions on improving learners' satisfaction and additionally improve e-Learning implementation.

Smart glasses and telehealth services by professionals in isolated areas in Korea: Acceptability and concerns

BACKGROUND: Smart glass technology offers remote interaction between health professionals for telehealth, alleviating healthcare disparities in isolated areas. OBJECTIVE: To evaluate the professionals’ perceptions of smart glass technology as a tool for telehealth and distance learning. METHOD: This mixed-method study on health professionals in 10 different island areas in Korea involved participants experiencing a smart glass-based telehealth system using the scenario of clinical consultation with remote specialists. A group pre- and post-test design was used to examine the change in attitude and perceived importance among health professionals about using smart glasses in telehealth. RESULTS: Forty-seven participants completed both pre-and post-evaluation of smart glasses. A positive, statistically significant change in participants’ perceptions of smart glasses regarding their implications for telehealth and distance learning (p< 0.05) was found. Fifty-one health workers provided feedback on smart glasses, and a majority expressed their expectations of quality care with telehealth using advanced technology. The main concerns were patients’ privacy issues and inadequate technology for seamless application. CONCLUSION: The incorporation of smart glass technology offers great potential to enrich telehealth as well as distance learning for unskilled health professionals in isolated areas. Future studies are needed to increase efforts to secure a high level of acceptance for clinical consultation with remote specialists on this newly developed device.

The behavioural intention to use MOOCs by undergraduate students: incorporating TAM with TPB

Purpose

The purpose of the study is to determine the impact that the crucial determinants have on the behavioural intention (BI) of undergraduates to adopt Massive Open Online Courses (MOOCs), addressing two perspectives that are students' technical experience and psychosocial factors.

Design/methodology/approach

This is a questionnaire study, and all the respondents are undergraduates in Barcelona, Spain. A total of 188 students are selected as survey subjects. Data collection applies the five-point Likert scale, and the collected information refers to demographic information and constructs related to the technology acceptance model (TAM) and theory of planned behaviour (TPB). Confirmatory factor analysis (CFA) and partial least square (PLS) are used to examine the measurement model's convergent and discriminant validity and test the hypotheses implementing the bootstrapping method.

Findings

The results show perceived usefulness (PU) and perceived ease of use (PEOU) are influential in forming an attitude (ATT), and PU could directly impact BI significantly. Additionally, the mediating role of ATT in the relationships amongst PU, PEOU and BI are investigated. Besides, perceived behavioural control (PBC) is found a critical variable and significantly impacts BI, whereas subjective norms (SN) is not found statistically significant in explaining BI in this study.

Originality/value

This study has confirmed that ATT has a positive mediation effect on PU, PEOU and BI. This study has also confirmed the validity and model fit of the incorporated model of TAM and TPB, which sufficiently accounts for the planned behavioural process of undergraduates to accept a MOOC and contributes to validating literature of the incorporated model of TAM and TPB. Besides, this study provides MOOCs managers with practical suggestions. First, ease-of-use interfaces should be designed and intensified. Second, more channels should be explored to satisfy students' needs. Third, managers should intensify the leverage of the systems and introduce the free trial period to new learners. Fourth, a bonus mechanism could be adopted to motivate students. Last, manager should intensify the construction of oral advertisements amongst students.

Social Distancing Impact on Higher Education during COVID-19 Lockdown

During the COVID-19 pandemic, education online meant limited or no in-person interaction with professors and peers. In this article, research questions look for social distancing impact on subjects attending computer-mediated education. Educational technology factors were selected and exposed to students’ evaluation in a semi-structured questionnaire. Results confirm that online education increased students’ acceptance and positive attitude towards digital learning for 8 out of 10 subjects. On the other hand, factors that drive motivation showed diminished satisfaction with content for 4 out of 10 students and reduced capacity to stay focused for 7 out of 10 students. This research points toward factors that convert interaction with peers and instructors to such an extent that they impact basic educational fields such as motivation and satisfaction. There were interrogated social interactivity factors, as half of the subjects reported missing learner–learner and learner–instructor interaction. Results showed that up to one third of surveyed students showed diminished motivation alongside less satisfaction with content. The article concludes that digital education should multiply and adapt its own content and delivery routines and it suggests that the online education experience should serve development of computer-mediated learning as well augmenting of in-person education.

Educational Technology Adoption: A systematic review

During the past decades a respectable number and variety of theoretical perspectives and practical approaches have been advanced for studying determinants for prediction and explanation of user's behavior towards acceptance and adoption of educational technology. Aiming to identify the most prominent factors affecting and reliably predicting successful educational technology adoption, this systematic review offers succinct account of technology adoption and acceptance theories and models related to and widely applied in educational research. Recognised journals of the Web of Science (WoS) database were searched with no time frame limit, and a total of 47 studies published between 2003 and 2021 were critically analysed. The key research findings revealed that in educational context a vast majority of selected studies explore the validity of Technology Acceptance Model (TAM) and its many different extensions (N=37), along with TAM's integrations with other contributing theories and models (N=5). It was exposed that among numerous predictors, thematically grouped into user aspects, task & technology aspects, and social aspects, self-efficacy, subjective norm, (perceived) enjoyment, facilitating conditions, (computer) anxiety, system accessibility, and (technological) complexity were the most frequent predictive factors (i.e. antecedents) affecting educational technology adoption. Considering types of technologies, e-learning was found to be the most common validated mode of delivery, followed by m-learning, Learning Management Systems (LMSs), and social media services. The results also revealed that the majority of analysed studies were conducted in higher education environments. New directions of research along with potential challenges in educational technology acceptance, adoption, and actual use are discussed as well.

Applying the Technology Acceptance Model to Explore Nursing Students' Behavioral Intention to Use Nursing Information Smartphones in a Clinical Setting

The integration of mobile devices and nursing information systems has become a trend in modern clinical practice with various information and communication technologies available. Smartphones are gradually replacing notebooks in clinical practice as a medium for nursing information systems. Clinical nursing practicums are a necessary means for nursing students to foster their professional competence. In addition to professional skills, nursing students must also learn to apply information technologies in clinical settings. This study aimed to understand nursing students' behavioral intention toward nursing information smartphones and to further identify the factors influencing nursing students' behavioral intentions based on the technology acceptance model. A cross-sectional research design was used in this study. Eighty nursing students were recruited from a regional teaching hospital in Central Taiwan. The findings demonstrated that subjects' perceived ease of use and perceived usefulness of nursing information smartphones, as well as their attitude toward using and behavioral intention to use the smartphones, were positive, and they provided constructive feedback and suggestions to improve nursing information systems in hospitals. The findings can serve as a reference for hospitals and clinical training institutions seeking to integrate nursing information systems in clinical nursing education.

What Motivates People to Pay for Online Sports Streaming? An Empirical Evaluation of the Revised Technology Acceptance Model

With the rapid development of Internet technology, sports media consumption is migrating toward streaming. The online streaming of sporting events has become the important way of copyrights holders to engage sports fans, especially young fans. Therefore, it is vital to understanding users' willingness to pay (WTP). Given that previous studies of the livestream sports broadcasts online have not dealt with users' payment intention, the originality of this study is that it explore users' motivation by combining information system research with the consumer demand theory. The study aimed to examine the factors that influence users' payment intention to stream online sports by using the extended Technology Acceptance Model (TAM). Data from questionnaires completed by 330 Chinese respondents determined how perceived usefulness, ease, enjoyment, and satisfaction, influence users' WTP. Satisfaction positively correlated with users' payment intentions, impacted WTP values, mediated ease of use. The analysis also revealed the necessity for broadcast platforms to improve satisfaction and to increase payment intentions.

Development of student simulated patient training and evaluation indicators in a high-fidelity nursing simulation: a Delphi consensus study†

Objective

This study is aimed to develop student simulated patient (SSP) training content and evaluation indicators, and further explores their validity and reliabilities.

Methods

Delphi consultations with 20 nursing experts were conducted. The weights of indicators were calculated through the analytic hierarchy process. SSP training was conducted with a high-fidelity nursing simulation.

Results

The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation. The expert authority coefficient was reported as 0.87. The training included role and responsibility of simulated patient (SP), script interpretation, plot performance, and training for a rater, with a total of 17 indicators. SSP evaluation consisted of disease knowledge, role portrayal, and performance fidelity and since being a rater, it consists of 20 indicators in total. The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918. The content validity of SSP evaluation indicators was 0.95. The inter-rater reliability was reported as 0.866, and the internal consistency established using Cronbach’s α was 0.727.

Conclusions

Students as SPs should have first-hand knowledge and experience within the simulated scenarios. SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process. The evaluation indicators were valid and reliable, and provided the objective and quantifiable measurements for SSP training in nursing.

Urinary Bladder Test Device to Integrate Basic Ultrasound Training for Nurses

Ultrasound is a useful tool for integrating clinical assessment with a bedside reliable imaging technique, but it requires adequate training. Ultrasonographic training involves examination performed on human models, in which many pathologic findings are not always readily available for the trainee to observe. The possibility of creating test objects that reproduce pathologic images allows the provision of training courses with those elements that are not always available. Our aims were to describe how to create a urinary bladder test object and to test its image quality and usefulness. Thus, we compared computed volume with the actual filling volume for five different devices to assess their reliability in volume estimation. Moreover, we evaluated the image quality and teaching utility using a 5-point Likert-type questionnaire among a group of learners. Computed bladder volume had excellent correlation with actual filling volume (p < 0.001, R² = 0.9874). Trainees judged the ultrasound exploration realistic and considered the device useful in understanding ultrasound images and improving ultrasound skills. In conclusion, our device contributes to ultrasound training by providing a realistic ultrasound image, improving image understanding and skill development and allowing reliable bladder volume estimation.

Predicting Students’ Behavioral Intention to Use Open Source Software: A Combined View of the Technology Acceptance Model and Self-Determination Theory

This study focuses on students’ behavioral intention to use Open Source Software (OSS). The article examines how students, who were trained in OSS, are motivated to continue using it. A conceptual model based on Self-Determination Theory and the Technological Acceptance Model (TAM) was defined in order to test the behavioral intention to use OSS, comprising six constructs: (1) autonomy, (2) competence, (3) relatedness, (4) perceived ease of use, (5) perceived usefulness and (6) behavioral intention to use. A survey was designed for data collection. The participants were recent secondary school graduates, and all of them had received mandatory OSS training. A total of 352 valid responses were used to test the proposed structural model, which was performed using the Lisrel software. The results clearly confirmed the positive influence of the intrinsic motivations; autonomy and relatedness, to improve perceptions regarding the usefulness and ease of use of OSS, and; therefore, on behavioral intention to use OSS. In addition, the implications and limitations of this study are considered.

Visualizing Co-citations of Technology Acceptance Models in Education

With the rapid development of information and communication technologies, studies devoted to technology-assisted education have been soaring up. Nevertheless, the studies on technology acceptance model (TAM) appear relatively fewer. This study, through reviewing high quality papers, analyzed the co-citations of TAM on the basis of the basic TAM and numerous extended TAMs. Co-citations of TAM were revealed and discussed in terms of citation counts, bursts, betweenness centrality, and sigma. It also reviews the basic concept underlying user acceptance models, as well as its extended TAMs in details. Future research into the TAM may resort to statistical support, as well as critical analysis. The interdisciplinary research design is also needed between computer science, education, psychology, statistics and mathematics.

Determinants of the Effectiveness of Using Renewable Resource Management-Based Simulations in the Development of Critical Thinking: An Application of the Experiential Learning Theory

The twenty-first century’s society experiences new challenges in being immersed in a new paradigm of the educational system. Higher education institutions should train professionals so that they are able to experience real situations in order to encourage reflection on affective, aesthetic, and ethical dimensions of these people in their relations with the natural and sociocultural environment. Learning strategies must allow the acquisition of creative, active, and applied knowledge as well as the development of critical thinking. According to the experiential learning theory, to achieve this, higher education should use student-centered interactive and collaborative teaching methodologies and focus studies on the skills that graduates must have, promoting student know-how, initiative, and autonomous learning. Business simulations are instruments that fulfil the above characteristics, facilitating learning. The objective of this research was to provide a model that identifies the determining factors (simulation’s realism and structure, perceived usefulness, and students’ learning motivation) in the effectiveness of using these tools to develop critical thinking focused on sustainability. Three hundred and twenty-six surveys completed by undergraduate students were obtained, which used a structural equation model (SEM) to analyze the influence of realism, simulation structure, perceived usefulness, and students’ motivations to develop critical thinking. The outcomes according to the experiential learning theory showed that the game’s realism lets students perceive its usefulness and, together with an adequate simulation structure, determines the students’ learning motivations by developing critical thinking.

A Perception Study of an Integrated Water System Project in a Water Scarce Community in the Philippines

The Integrated Water System (IWS) offers alternative water and sanitation services that can potentially benefit rural communities experiencing water scarcity. The IWS described in this study comprises three systems: The Rainwater Harvesting System (RWHS), Water Treatment System (WTS), and Eco-Toilet System (ETS). RWHS and WTS make use of rainwater, which can be utilized for several domestic uses, especially during wet season. ETS has several benefits to users including promotion of environmental and public health, as well as food security. Despite the potential benefits of the IWS components, the perceived acceptance of its users threatens the success of its implementation. This study focuses on determining the significant factors that can influence the social acceptance of IWS in the Municipality of Mulanay, Quezon Province, Philippines. This study considers behavioral intention as an indicator of social acceptance of the IWS components. The framework of this study is based on the combined technology acceptance model and theory of planned behavior (C-TAM-TPB) concept. C-TAM-TPB was analyzed using Partial Least Square–Structural Equation Modeling (PLS–SEM). The result of the C-TAM-TPB evaluation reveals that the user’s attitude towards use (ATU), including its significant predictors, can promote behavioral intention towards use of the IWS components. This study can further improve the development of IWS projects.

Acceptance of Online Medical Websites: An Empirical Study in China

As a new type of public health service product, online medical websites (OMWs) are becoming quite popular. OMWs can address patients' basic medical problems remotely and give health guidance online. Compared to traditional hospitals, OMWs are more convenient and inexpensive, they can usually provide a better service for patients with poor medical conditions (especially in rural areas), and they also contribute to the rational distribution of medical resources. Therefore, key factors that affect patients' acceptance of OMWs must be identified to contribute to public health. By integrating perceived risk (PR) and the technology acceptance model (TAM), we proposed a modified TAM and clarified how PR and other factors affect patients' behavioral intention (BI) towards OMWs. A sample of 245 research participants in China took part in this study and the structural equation model (SEM) was used to test our hypotheses. The results revealed that perceived usefulness (PU) is a positive predictor of BI but has no significant effect on attitude (ATT), while perceived ease of use (PEOU) can affect BI through PU and attitude (ATT). Moreover, trust (TRU) was identified as a mediator of PR and PU/PEOU. Also, the doctor⁻patient relationship (DPR) was shown to moderate PR and TRU. In order to increase patients' BI, OMW providers need further innovations to improve patients' TRU and reduce their PR.