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

A prospective observational evaluation of an online health care professional training program to promote healthy pregnancy weight gain

ISSUE ADDRESSED

A lack of programs to develop clinician knowledge and confidence to address weight gain within pregnancy is a barrier to the provision of evidence-based care.

AIM

To examine the reach and effectiveness of the Healthy Pregnancy Healthy Baby online health professional training program.

METHODS

A prospective observational evaluation applied the reach and effectiveness elements of the RE-AIM framework. Health professionals from a range of disciplines and locations were invited to complete questionnaires before and after program completion assessing objective knowledge and perceived confidence around aspects of supporting healthy pregnancy weight gain, and process measures.

RESULTS

There were 7577 views across all pages over a year period, accessed by participants across 22 Queensland locations. Pre- and post- training questionnaires were completed 217 and 135 times, respectively. The proportion of participants with scores over 85% and of 100% for objective knowledge was higher post training (P ≤ .001). Perceived confidence improved across all areas for 88%-96% of those who completed the post- training questionnaire. All respondents would recommend the training to others.

CONCLUSIONS

Clinicians from a range of disciplines, experience and locations accessed and valued the training, and knowledge of, and confidence in delivering care to support healthy pregnancy weight gain improved after completion. SO WHAT?: This effective program to build the capacity of clinicians to support healthy pregnancy weight gain offers a model for online, flexible training highly valued by clinicians. Its adoption and promotion could standardise the support provided to women to encourage healthy weight gain during pregnancy.

Nurses' perspectives, attitudes and experiences related to e-learning: A systematic review

OBJECTIVE

To summarize the current evidence on registered nurses (RNs) perspectives, attitudes and experiences related to e-learning.

DESIGN

A systematic review of the literature.

DATA SOURCES

The CINAHL, PubMed, Embase, the Cochrane Library, Scopus and Web of Science databases were searched for studies published in English from 2000 to 2021.

REVIEW METHODS

The study followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria comprised studies with cross-sectional, quasi-experimental, qualitative, and randomised control designs on the attitudes toward, perspectives and experiences of registered nursing about e-learning. Quality appraisal for each study, based on their designs, was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Data were synthesized using a narrative approach.

RESULTS

In the 15 included studies, 4 were high quality while 11 were moderate quality. Four themes were revealed in this review including e-learning approaches, facilitators of e-learning and barriers to e-learning barriers to e-learning among RNs and learning in practice barriers.

CONCLUSIONS

The systematic review uncovered that E-learning is an effective method for integrating knowledge with practice and promoting professional development among RNs in healthcare settings. However, RNs may lack motivation to engage with E-learning and face challenges associated with user-friendly platforms.

COVID-19 Vaccine Education (CoVE) for Health and Care Workers to Facilitate Global Promotion of the COVID-19 Vaccines

The COVID-19 vaccine is being rolled out globally. High and ongoing public uptake of the vaccine relies on health and social care professionals having the knowledge and confidence to actively and effectively advocate it. An internationally relevant, interactive multimedia training resource called COVID-19 Vaccine Education (CoVE) was developed using ASPIRE methodology. This rigorous six-step process included: (1) establishing the aims, (2) storyboarding and co-design, (3) populating and producing, (4) implementation, (5) release, and (6) mixed-methods evaluation aligned with the New World Kirkpatrick Model. Two synchronous consultations with members of the target audience identified the support need and established the key aim (Step 1: 2 groups: n = 48). Asynchronous storyboarding was used to co-construct the content, ordering, presentation, and interactive elements (Step 2: n = 14). Iterative two-stage peer review was undertaken of content and technical presentation (Step 3: n = 23). The final resource was released in June 2021 (Step 4: >3653 views). Evaluation with health and social care professionals from 26 countries (survey, n = 162; qualitative interviews, n = 15) established that CoVE has high satisfaction, usability, and relevance to the target audience. Engagement with CoVE increased participants' knowledge and confidence relating to vaccine promotion and facilitated vaccine-promoting behaviours and vaccine uptake. The CoVE digital training package is open access and provides a valuable mechanism for supporting health and care professionals in promoting COVID-19 vaccination uptake.

Addressing patient sexuality issues in cancer and palliative care

The impact of cancer and subsequent treatments can have serious implications for patient sexuality, both physically and psychologically. Patients report inadequate communication and support from professionals in relation to sexual issues. The aim of this literature review was to ascertain the educational requirements of health professionals practising in oncology and palliative care, to enable effective assessment and support in this area of clinical practice. There appear to be numerous barriers preventing professionals from addressing patient sexuality-lack of knowledge and poor confidence levels being among the most common. Appropriate education is required to equip staff, and it appears that short training programmes can be effective. The use of sexuality assessment tools and information cards, and accessing information from cancer charity websites may improve clinical practice. Addressing sexuality concerns is the responsibility of each person in the multidisciplinary team. Patients require open discussion and professionals must skilfully address the topic of sexuality. Education in this area must be accessible, cost effective and sustainable.

Lapnurse-A Blended Learning Course for Nursing Education in Minimally Invasive Surgery: Design and Experts' Preliminary Validation of Its Online Theoretical Module

Background: The implantation of Minimally Invasive Surgery (MIS) leads to the specialization of nurses in this surgical field. However, there is no standard curriculum of MIS Nursing in Europe. Spanish and Portuguese nurses are inexperienced and have poor training in MIS. For that, a blended learning course for nursing education in MIS (Lapnurse) has been developed. This work aims to detail the course design and to preliminary validate by experts its online theoretical module. Methods: Lapnurse consists of an online module with nine theoretical lessons and a face-to-face module with three practical lessons. The e-learning environment created to provide the online module, with didactic contents based on surgical videos and innovative 3D designs, has been validated by two technicians (functionality) and four nurses with teaching experience in MIS (usability and content). Results: The E-learning platform meets all technical requirements, provides whole and updated multimedia contents correctly applied for educational purposes, incorporates interactivity with 3D designs, and has an attractive, easy-to-use and intuitive design. Conclusions: The lack of knowledge in MIS of Spanish and Portuguese nurses could be addressed by the blended learning course created, Lapnurse, where the e-learning environment that provides theoretical training has obtained a positive validation.

MammographyOnline: An evaluation of an online mammography education program for radiographers

INTRODUCTION

In Australia, the gold standard for post graduate education in mammography is the Certificate of Clinical Proficiency in Mammography (CCPM) awarded by the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT). The award has two components -academic and clinical. This paper reports on the experiences of the first online offering of the academic component, MammographyOnline (MO), by BreastScreen Victoria, Australia. Online learning is well established in health professional education at all levels of learning, however evaluation is essential to ensure its effectiveness and inform future development.

METHODS

Consenting course participants completed module evaluations, and pre and post program evaluations. Course planners (n = 5) attended a 1-h focus group about the development process. Placement supervisors (n = 3) took part in a 30 min semi-structured telephone interview, identifying views of graduate performance. Survey data and rating scales were analysed descriptively. Qualitative data from surveys and interviews underwent content analysis.

RESULTS

Course participants found the content of MO to be beneficial but highlighted technical issues and suggested improvements for more interactive methods of delivery. Enablers to the program's development identified by course planners, included having experienced and knowledgeable staff on-board, appropriate project management processes, and management support. Challenges expressed by course planners included staffing for the duration of the project and the burden of time and finances, though all perceived they had produced a high quality, relevant and comprehensive online programme. Supervisors recognised that MO fulfilled the requirements of the academic component of the CCPM but did not supersede the need for the clinical component.

CONCLUSIONS

Despite numerous challenges associated with its development, the overwhelming view of learners, developers and supervisors was that MO is a high quality academic program of learning, that provides the theory to support and prepare radiographers for their future clinical practice. Some refinement of content, assessment tasks and technical features are required.

Digital health professions education on chronic wound management: A systematic review

BACKGROUND

Continuing education is crucial for healthcare professionals to keep up with research but attending classroom lectures is a major barrier. Chronic wound management is increasingly relevant for continuous professional training. Digital education offers learning tailored to individual needs and could be an effective alternative to healthcare professionals' training. However, the effectiveness of digital education for chronic wound management training has not been explored.

OBJECTIVES

To assess the effectiveness of digital education in improving healthcare professionals' knowledge, attitudes, practical skills and behaviour change on chronic wound management, and their satisfaction with the intervention.

DESIGN

This systematic review follows Cochrane methodology and is one of a series of reviews on the use of digital education for health professions education. Protocol registration: PROSPERO CRD42018109971 DATA SOURCES: Searches were conducted in MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses Database.

REVIEW METHODS

We included randomised control trials, cluster randomised control trials and quasi-randomised control trials comparing digital or blended education with traditional learning, no intervention or other forms of digital or blended education for pre- or post-registration healthcare professionals in chronic wound management. A narrative summary of findings is presented.

RESULTS

Seven studies (1,404 participants) were included. All studies investigated interventions for nursing students or professionals working in hospitals or community settings, and all but one study focused on pressure ulcers. Five studies (935 participants) assessed post-intervention knowledge, and indicated that digital education was more effective than no intervention, while blended learning was superior to exclusive digital education. Three studies (543 participants) assessed post-intervention skills and reported mixed results. One study (140 participants) compared post-intervention behaviour change and satisfaction with blended and online digital education, and reported no difference in behaviour between the groups, and higher satisfaction with blended education. For knowledge retention up to six months, digital education was more effective than no intervention, while blended learning was superior to digital education. The risk of bias in included studies was mostly high or unclear.

CONCLUSIONS

Digital education on chronic wound management appears to be less effective than blended education and more effective than no intervention in improving knowledge among nurses and nursing students. Data for other outcomes is scarce and inconclusive. Future studies should assess participants' skills, attitudes, satisfaction and behaviour change; cost-effectiveness and potential untoward effects of digital education, compare digital education to other learning modalities and include other healthcare professionals in diverse clinical settings.

The Blended Reflective Inquiry Educators Framework; origins, development and utilisation

Reflective practice is widely considered to be an integral part of contemporary pedagogical practice in higher education. The integration of reflection and reflective practice into professional education curricula in areas such as nursing, education and the social sciences, has coincided with an expansion of the reflective practice literature which continues to proliferate within a range of disciplinary fields. However, an interesting paradox is beginning to emerge whereby educators who are charged with developing students reflective ability are often required to do so in the absence of practical educator-focused frameworks and/or guidelines. The purpose of this paper is to contribute to the debate by presenting the 'Blended Reflective Inquiry Educators Framework' which is designed for educators who wish to support students to develop their reflective abilities and reflective capacity. This innovative framework was developed following a two stage action research study which was designed to investigate how registered nurses can be facilitated to develop reflective practice skills and abilities. The study resulted in the development of this innovative educator's framework which uses an inquiry based, blended learning approach, to facilitate reflective practice.

Digital Education for the Management of Chronic Wounds in Health Care Professionals: Protocol for a Systematic Review by the Digital Health Education Collaboration

Background

Digital education is “the act of teaching and learning by means of digital technologies.” Digital education comprises a wide range of interventions that can be broadly divided into offline digital education, online digital education, digital game-based learning, massive open online courses (MOOCs), psychomotor skills trainers, virtual reality environments, virtual patient simulations, and m-learning. Chronic wounds pose an immense economic and psychosocial burden to patients and the health care system, as caring for them require highly specialized personnel. Current training strategies face significant barriers, such as lack of time due to work commitments, distance from provider centers, and costs. Therefore, there is an increased need to synthesize evidence on the effectiveness of digital education interventions on chronic wounds management in health care professionals.

Objective

Our main objective is to assess the effectiveness of digital education as a stand-alone approach or as part of a blended-learning approach in improving pre- and postregistration health care professionals’ knowledge, attitudes, practical skills, and behavior in the management of chronic wounds, as well as their satisfaction with the intervention. Secondary objectives are to evaluate patient-related outcomes, cost-effectiveness of the interventions, and any unfavorable or undesirable outcomes that may arise.

Methods

This systematic review will follow the methodology as described in the Cochrane Handbook for Systematic Reviews of Interventions. As our systematic review is one of a series of reviews on digital education for health professionals’ education, we will use a previously developed search strategy. This search includes the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library), MEDLINE (Ovid), Embase (Ovid), Web of Science, the Educational Resource Information Centre (ERIC) (Ovid), PsycINFO (Ovid), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), the ProQuest Dissertation and Theses database, and trial registries. Databases will be searched for studies published from January 1990 to August 2018. Two independent reviewers will screen the library for included studies. We will describe the screening process using a flowchart as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will extract the data using a previously developed, structured data extraction form. Included studies will be quality-assessed using the Risk of Bias tool from Cochrane. We will narratively summarize the data and, if possible, we will conduct a meta-analysis. We will use Cochrane’s RevMan 5.3 software for data analysis.

Results

We have completed the screening of titles and abstracts for this systematic review and are currently selecting papers against our inclusion and exclusion criteria through full-text revision. We are expecting to complete our review by the end of April 2019.

Conclusions

This systematic review will provide an in-depth analysis of digital education strategies to train health care providers in the management of chronic wounds. We consider this topic particularly relevant given the current challenges facing health care systems worldwide, including shortages of skilled personnel and a steep increase in the population of older adults as a result of a prolonged life expectancy.

Trial Registration

PROSPERO CRD42018109971; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=109971

International Registered Report Identifier (IRRID)

DERR1-10.2196/12488

Evaluation of the clinical implementation of a large-scale online e-learning program on venous blood specimen collection guideline practices

BACKGROUND

When performed erroneously, the venous blood specimen collection (VBSC) practice steps patient identification, test request management and test tube labeling are at high risk to jeopardize patient safety. VBSC educational programs with the intention to minimize risk of harm to patients are therefore needed. In this study, we evaluate the efficiency of a large-scale online e-learning program on personnel's adherence to VBSC practices and their experience of the e-learning program.

METHODS

An interprofessional team transformed an implemented traditional VBSC education program to an online e-learning program developed to stimulate reflection with focus on the high-risk practice steps. We used questionnaires to evaluate the effect of the e-learning program on personnel's self-reported adherence to VBSC practices compared to questionnaire surveys before and after introduction of the traditional education program. We used content analysis to evaluate the participants free text experience of the VBSC e-learning program.

RESULTS

Adherence to the VBSC guideline high-risk practice steps generally increased following the implementation of a traditional educational program followed by an e-learning program. We however found a negative trend over years regarding participation rates and the practice to always send/sign the request form following the introduction of an electronic request system. The participants were in general content with the VBSC e-learning program.

CONCLUSIONS

Properly designed e-learning programs on VBSC practices supersedes traditional educational programs in usefulness and functionality. Inclusion of questionnaires in the e-learning program is necessary for follow-up of VBSC participant's practices and educational program efficiency.

Using reusable learning objects (RLOs) in wound care education: Undergraduate student nurse's evaluation of their learning gain

BACKGROUND

Both nationally and internationally concerns have been expressed over the adequacy of preparation of undergraduate nurses for the clinical skill of wound care. This project describes the educational evaluation of a series of Reusable Learning Objects (RLOs) as a blended learning approach to facilitate undergraduate nursing students learning of wound care for competence development. Constructivism Learning Theory and Cognitive Theory of Multimedia Learning informed the design of the RLOs, promoting active learner approaches. Clinically based case studies and visual data from two large university teaching hospitals provided the authentic learning materials required. Interactive exercises and formative feedback were incorporated into the educational resource.

METHODS

Evaluation of student perceived learning gains in terms of knowledge, ability and attitudes were measured using a quantitative pre and posttest Wound Care Competency Outcomes Questionnaire. The RLO CETL Questionnaire was used to identify perceived learning enablers. Statistical and deductive thematic analyses inform the findings.

RESULTS

Students (n=192) reported that their ability to meet the competency outcomes for wound care had increased significantly after engaging with the RLOs. Students rated the RLOs highly across all categories of perceived usefulness, impact, access and integration.

CONCLUSION

These findings provide evidence that the use of RLOs for both knowledge-based and performance-based learning is effective. RLOs when designed using clinically real case scenarios reflect the true complexities of wound care and offer innovative interventions in nursing curricula.

Effects of e-learning in a continuing education context on nursing care: a review of systematic qualitative, quantitative and mixed studies reviews (protocol)

INTRODUCTION

Continuing education (CE) is imperative to the future of professional nursing. The use of e-learning by registered nurses for CE is spreading. A review of systematic reviews will be conducted to develop a broad picture of the effects of e-learning in a CE context on nursing care.

METHODS AND ANALYSIS

Systematic qualitative, quantitative and mixed studies reviews published in English, French or Spanish from 1 January 2006 will be included. The outcomes of interest will be extracted and analysed inductively and deductively from the Nursing Care Performance Framework; some themes include nursing resources, nurses' practice environment, processes, professional satisfaction, and nursing sensitive outcomes. Three reviewers will independently screen first the title and abstract of the papers, and then the full texts in order to assess eligibility. Two teams of two reviewers will extract the selected reviews' characteristics and data. The results from various types of reviews will be integrated using a data-based convergent synthesis design. We will conduct a thematic synthesis and transform all quantitative and mixed data into qualitative data.

ETHICS AND DISSEMINATION

Ethics approval is not required for review of systematic reviews. We will summarise evidence concerning the negative, neutral and positive effects of various forms of e-learning on different aspects of nursing care. If we find gaps in the literature, we will highlight them and suggest ideas for further research. We will also focus on positive effects and present, if possible, the components and characteristics of e-learning interventions that were found to be successful. We will present this protocol and results in international conferences in nursing, medical, and health informatics domains. We will also submit the results of our work for peer-review publication in a journal indexed in the international bibliographic database of biomedical information.

An integrative review of e-learning in the delivery of self-management support training for health professionals

BACKGROUND

E-learning involves delivery of education through Information and Communication Technology (ITC) using a wide variety of instructional designs, including synchronous and asynchronous formats. It can be as effective as face-to-face training for many aspects of health professional training. There are, however, particular practices and skills needed in providing patient self-management support, such as partnering with patients in goal-setting, which may challenge conventional practice norms. E-learning for the delivery of self-management support (SMS) continuing education to existing health professionals is a relatively new and growing area with limited studies identifying features associated with best acquisition of skills in self-management support.

METHODS

An integrative literature review examined what is known about e-learning for self-management support. This review included both qualitative and quantitative studies that focused on e-learning provided to existing health professionals for their continuing professional development. Papers were limited to those published in English between 2006 and 2016. Content analysis was used to organize and focus and describe the findings.

RESULTS

The search returned 1505 articles, with most subsequently excluded based on their title or abstract. Fifty-two full text articles were obtained and checked, with 42 excluded because they did not meet the full criteria. Ten peer-reviewed articles were included in this review. Seven main themes emerged from the content analysis: participants and professions; time; package content; guiding theoretical framework; outcome measures; learning features or formats; and learning barriers. These themes revealed substantial heterogeneity in instructional design and other elements of e-learning applied to SMS, indicating that there is still much to understand about how best to deliver e-learning for SMS skills development.

CONCLUSIONS

Few e-learning approaches meet the need for high levels of interactivity, reflection, practice and application to practice for health professionals learning to deliver effective SMS. Findings suggest that the context of SMS for patients with chronic condition matters to how health professional training is delivered, to ensure partnership and person-centred care. Further creative approaches and their rigorous evaluation are needed to deliver completely online learning in this space. Blended learning that combines e-learning and face-to-face methods is suggested to support SMS skills development for health professionals.

Internet-based learning programme to increase nurses' knowledge level about venous leg ulcer care in home health care

AIMS AND OBJECTIVES

To test the effectiveness of an Internet-based education programme about venous leg ulcer nursing care on perceived and theoretical knowledge levels and attitudes among nurses working in home health care.

BACKGROUND

Nurses have been shown to have knowledge gaps in venous leg ulcer nursing care. Internet-based learning could offer a means for flexible continuing education for home healthcare environment.

DESIGN

Quasi-experimental study with pre- and postmeasurements and nonequivalent intervention and comparison groups.

METHOD

Nurses (n = 946) in home health care in two Finnish municipalities were invited to participate in the study and divided into intervention and comparison groups. The intervention group received education programme about venous leg ulcer nursing care, while the comparison group did not. Data were collected at baseline, at six weeks and at 10 weeks to test the hypotheses: nurses using education programme about venous leg ulcer nursing care will have higher level of knowledge and more positive attitudes than those not using education programme about venous leg ulcer nursing care. An analysis of variance and mixed models with repeated measures were used to test differences in knowledge and attitudes between and within the groups.

RESULTS

There were statistically significant increases in knowledge levels in the intervention group from baseline to the first and second follow-up measurements. In the comparison group, the knowledge levels remained unchanged during the study. Attitude levels remained unchanged in both groups.

CONCLUSION

Nurses' perceived and theoretical knowledge levels of venous leg ulcer nursing care can be increased with Internet-based education. However, this increase in knowledge levels is short-lived, which emphasises the need for continuous education.

RELEVANCE TO CLINICAL PRACTICE

Internet-based education about venous leg ulcer nursing care is recommended for home healthcare nurses. Education programme about venous leg ulcer nursing care provides flexible method for nurses' learning with feasible and cost-effective access to evidence-based education. Education programme about venous leg ulcer nursing care material can be used in all nursing environments where Internet is available.

Workplace wellness using online learning tools in a healthcare setting

The aim was to develop and evaluate an online learning tool for use with UK healthcare employees, healthcare educators and healthcare students, to increase knowledge of workplace wellness as an important public health issue. A 'Workplace Wellness' e-learning tool was developed and peer-reviewed by 14 topic experts. This focused on six key areas relating to workplace wellness: work-related stress, musculoskeletal disorders, diet and nutrition, physical activity, smoking and alcohol consumption. Each key area provided current evidence-based information on causes and consequences, access to UK government reports and national statistics, and guidance on actions that could be taken to improve health within a workplace setting. 188 users (93.1% female, age 18-60) completed online knowledge questionnaires before (n = 188) and after (n = 88) exposure to the online learning tool. Baseline knowledge of workplace wellness was poor (n = 188; mean accuracy 47.6%, s.d. 11.94). Knowledge significantly improved from baseline to post-intervention (mean accuracy = 77.5%, s.d. 13.71) (t(75) = -14.801, p < 0.0005) with knowledge increases evident for all included topics areas. Usability evaluation showed that participants perceived the tool to be useful (96.4%), engaging (73.8%) and would recommend it to others (86.9%). Healthcare professionals, healthcare educators and pre-registered healthcare students held positive attitudes towards online learning, indicating scope for development of further online packages relating to other important health parameters.

Supporting completion of an online continuing professional development programme for newly qualified practitioners: A qualitative evaluation

BACKGROUND

Development programmes to support newly qualified practitioners gain confidence in their first professional role often show varied levels of engagement, due to competing priorities and demands. In Scotland, the Flying Start NHS® programme uses a structured programme of online and work-based learning with associated mentoring, to support individuals through an often difficult transition to become capable, confident practitioners. Whilst the programme was generally well received, the factors leading to widely varying completion rates between professions and organisations were not well understood.

AIM

The aim of this study was to identify the factors leading to successful completion of Flying Start, a transition programme for newly qualified practitioners.

METHOD

A qualitative approach was adopted to gather data from two groups of participants. Semi-structured telephone interviews were conducted with strategic and management level participants (n=23), from five health boards in Scotland. Semi-structured interviews (n=22) and focus groups (n=11) were conducted with practitioners within 6months either side of completing the programme. The interviews were transcribed and analysed using framework analysis.

RESULTS

Three key themes relating to successful completion emerged from the analysis: Management and Delivery; Content and Material; Participation and Completion. Factors leading to successful completion were identified at programme, organisational and individual levels. These included clear communication and signposting, up-to-date and relevant content, links with continuing professional development frameworks, effective leadership, mentor and peer support, setting clear standards for assessment, and facilitating appropriate IT access.

CONCLUSIONS

A strong strategic commitment to embedding a development programme for newly qualified practitioners can ensure that the necessary support is available to encourage timely completion. The mentor's role - to provide face-to-face support - is identified as a key factor in completion and is achieved through setting attainable targets, monitoring progress, and providing motivation. However organisational structures that facilitate the mentoring relationship are also necessary.

Access to, interest in and attitude toward e-learning for continuous education among Malaysian nurses

BACKGROUND

Continuous nursing education (CNE) courses delivered through e-learning is believed to be an effective mode of learning for nurses. Implementation of e-learning modules requires pre-assessment of infrastructure and learners' characteristics. Understanding the learners' needs and their perspectives would facilitate effective e-learning delivery by addressing the underlying issues and providing necessary support to learners.

OBJECTIVE

The aim of this study was to examine access to computer and Internet facilities, interest in and preferences regarding e-learning, and attitudes toward e-learning among nurses in Peninsular Malaysia.

DESIGN

The study utilized a cross-sectional descriptive survey.

SETTING

Government hospitals and community clinics in four main regions of Peninsular Malaysia.

PARTICIPANTS

A total of 300 registered nurses.

METHOD

Data were collected using questionnaires, which consisted of demographic and background items and questions on access to computer and Internet facilities, interest and preferences in e-learning, and attitudes toward e-learning. Descriptive analysis and a chi-squared test were used to identify associations between variables.

RESULTS

Most Malaysian nurses had access to a personal or home computer (85.3%, n=256) and computer access at work (85.3%, n=256). The majority had Internet access at home (84%, n=252) and at work (71.8%, n=215); however, average hours of weekly computer use were low. Most nurses (83%, n=249) did not have an e-learning experience but were interested in e-learning activities. Most nurses displayed positive attitudes toward e-learning. Average weekly computer use and interest in e-learning were positively associated with attitudes toward e-learning.

CONCLUSION

Study findings suggest that organizational support is needed to promote accessibility of information and communications technology (ICT) facilities for Malaysian nurses to motivate their involvement in e-learning.

The development and preliminary effectiveness of a nursing case management e-learning program

The purpose of this article was to describe the development and preliminary effectiveness of a digital case management education program. The e-learning program was built through the collaboration of a nurse educator and an informatics professor. The program was then developed according to the following steps: (1) building a visual interface, (2) scripting each unit, (3) preparing the course material and assessment tests, (4) using teaching software to record audio and video courses, (5) editing the audio recordings, (6) using instructional media or hyperlinks to finalize the interactions, (7) creating the assessment and obtaining feedback, and (8) testing the overall operation. The digital program consisted of five learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. Forty nurses participated in this study and fully completed the questionnaires both before and after the program. The knowledge and confidence levels in the experimental group were significantly higher over time than those of the comparison group. The results supported the use of educational technology to provide a more flexible and effective presentation method for continuing education programs.

Is essential learning being compromised by austerity?

Emeritus professor Alan Glasper, from the University of Southampton discusses the recently published Royal College of Nursing survey report that campaigns to raise awareness of the threats to post-qualifying education for nurses.

Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol

AIM

To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care.

BACKGROUND

The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care.

DESIGN

Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups.

METHODS

During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014.

DISCUSSION

Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300.

The effect of an e-learning course on nursing staff's knowledge of delirium: a before-and-after study

BACKGROUND

Delirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized patients, which might be due to a lack of knowledge of delirium diagnosis and treatment. The objective of the study was to test the effectiveness of an e-learning course on nurses' delirium knowledge, describe nursing staff's baseline knowledge about delirium, and describe demographic factors associated with baseline delirium knowledge and the effectiveness of the e-learning course.

METHODS

A before-and-after study design, using an e-learning course on delirium. The course was introduced to all nursing staff of internal medicine and surgical wards of 17 Dutch hospitals.

RESULTS

1,196 invitations for the e-learning course were sent to nursing staff, which included nurses, nursing students and healthcare assistants. Test scores on the final knowledge test (mean 87.4, 95% CI 86.7 to 88.2) were significantly higher than those on baseline (mean 79.3, 95% CI 78.5 to 80.1). At baseline, nursing staff had the most difficulty with questions related to the definition of delirium: what are its symptoms, course, consequences and which patients are at risk. The mean score for this category was 74.3 (95% CI 73.1 to 75.5).

CONCLUSIONS

The e-learning course significantly improved nursing staff's knowledge of delirium in all subgroups of participants and for all question categories. Contrary to other studies, the baseline knowledge assessment showed that, overall, nursing staff was relatively knowledgeable regarding delirium.

TRIAL REGISTRATION

The Netherlands National Trial Register (NTR).

TRIAL NUMBER

NTR 2885 , 19 April 2011.

Knowledge transfer from an e-learning course to clinical practice

BACKGROUND

Continuing education is essential in improving practical psychiatric nursing skills. However, little is known about how knowledge gained in continuing education is transferred to nurses' daily work.

OBJECTIVES

To describe the transfer of knowledge gained from an e-learning course to daily practice.

DESIGN

Qualitative study design.

SETTINGS

One hospital district in Southern Finland with three specialized psychiatric wards (acute, rehabilitation, geriatric wards).

PARTICIPANTS

Nursing staff (N=53) were recruited and 35 participated voluntarily in the e-learning continuing education course in spring 2009.

METHODS

The data comprised nurses' reflective writing during the e-learning course and course evaluation forms completed after the course. We used qualitative design with inductive content analysis to analyze nurses' writings.

RESULTS

The nurses were willing and able to transfer what they learned to their daily practice including the course themes, communication and co-operation among staff members, understanding of preventive and alternative treatment methods and critical thinking regarding one's own work. After the e-learning course the nurses were able to identify development areas such as issues related to staff members' daily work, the patient's role on the ward, alternative methods to avoid coercion, issues pertaining to the care environment on the ward, psychiatric nurses' education, and making an action plan for aggressive situations. All nurses would recommend the course to other nurses.

CONCLUSIONS

New knowledge is easily adopted and transferred to daily practice.

The development and evaluation of a holistic needs assessment and care planning learning package targeted at cancer nurses in the UK

A project team from the United Kingdom Oncology Nursing Society developed a blended e-learning website to facilitate nurses to further develop their confidence and competencies in a range of skills related to assessing the holistic needs of people with cancer. The project team identified three areas which were integral to an holistic needs assessment (HNA) implementation project. These were project support information, project management skills, and practical competencies delivered in a blended e-learning package containing a series of accessible video presentations, supporting documents, and practical activities. The team worked with internal and external partners to ensure that a robust and inspiring programme was created.

www.hnaforcancer.com was launched in October 2012 as a blended learning programme that incorporates e-learning on core subjects. These subjects are packaged as videoed presentations with supporting learning material and can be accessed via the UKONS website. By the end of the programme participants were equipped to identify and explore the essential requirements for HNA and care planning, more able to recognise potential need, and initiate care to prevent or minimise the risk of complications. Participants had also developed confidence and competency in new skills, including basic project management.

Comparative descriptors of applicants and graduates of online and face-to-face master of science in nursing programs

AIM

Proper advisement of students about their programs of study requires knowledge of the applicants and confidence that the recommended curricula will lead to success via graduation and certification.

BACKGROUND

Two important strategies to deliver master of science in nursing (MSN) curricula include online and face-to-face (F2F) formats.

METHOD

A nonexperimental, descriptive study of archival data was used to examine and compare the characteristics of F2F and online MSN applicants, admitted students, and graduates as well as family nurse practitioner (FNP) certification pass rates at one eastern Tennessee college of nursing. Administration and FNP concentrations were studied.

RESULTS

The average applicant grade point average (GPA) was higher for the F2F format but no difference in the average admission GPA was found between formats. The online students had more years of RN experience than the F2F students.

CONCLUSION

No significant difference was found between graduating GPAs or FNP certification pass rates.

Using e-learning to support clinical skills acquisition: exploring the experiences and perceptions of graduate first-year pre-registration nursing students - a mixed method study

BACKGROUND

Clinical skills education must accommodate the different needs of nursing students, particularly in view of increasing numbers of graduate entrants. E-learning has been promoted for its ability to engage learners and customise the learning process and evidence supports its use for clinical skill acquisition. However, graduate nursing students have unique needs, and their perceptions and experiences of e-learning require exploration.

AIM

The aim of the study was to explore graduate first year nursing students' perceptions and experiences of e-learning when used to supplement traditional methods to learn clinical skills.

DESIGN/METHOD

Mixed methods, employing qualitative and quantitative approaches, were used. Eighty-three (46%) participants were recruited from a cohort of graduate students (n=180) enrolled in an accelerated pre-registration nursing programme. Participants completed e-learning educational materials prior to attendance at clinical skills sessions. Focus groups (n=2) explored participants' (n=15) experiences and perceptions of e-learning and identified common issues. Discussions were transcribed verbatim and analysed using a thematic approach. Findings informed the development of a questionnaire which sought to confirm perceptions of e-learning and the perceived value for clinical skills acquisition in the larger student group. Data from questionnaires (n=83) were analysed using descriptive statistics.

RESULTS/DISCUSSION

Students found e-learning valuable for developing clinical skills and, although they viewed it positively, they did not want to relinquish conventional teaching methods, preferring both in combination. Video clips were perceived as the most useful feature while online readings were viewed as the least useful. An underestimate of time requirements, navigational issues and technical difficulties were reported frustrations.

CONCLUSION

Although limited by potential volunteer bias, findings contribute to the ongoing discourse on how e-learning can support clinical skills education and provides insights from the perspective of graduate nursing students. E-learning does not suit the needs of all learners. This must be recognised to enhance the learning experience.

Designing, delivering and evaluating a distance learning nursing course responsive to students needs

BACKGROUND AND PURPOSE

The majority of available studies in distance learning in nursing and health lack the sufficient details of course design and delivery processes which greatly affect the learning outcomes. Also, little is available about the fairness of this method of education to students with limited access to course resources. We describe the design and delivery processes and experience, in terms of satisfaction and achievement, of undergraduate nursing students in a distance course. The difference in achievement between the distance students and a comparable cohort of hybrid students is also examined. We also demonstrate the possibility of providing accessible education to students with limited technological resources.

METHODS

Participants included all undergraduate nursing students who were enrolled in a distance and a hybrid section of a communication skills course offered at a School of Nursing in Jordan. The distance course was created using Blackboard and Tegrity learning management systems. The design and delivery processes of the distance course incorporated three pedagogical principles that enhance: (a) course access and navigation; (b) communication and interaction; and (c) active and collaborative learning experiences. After course completion, distance students completed a 27-item satisfaction questionnaire. Achievement in the course and correlates of satisfaction were measured.

RESULTS

The final sample included 25 students in the distance section and 35 in the hybrid section (N=60). The mean score of overall satisfaction in the distance section was 4.14 (0.32) out of a 5-point scale, indicating a high satisfaction. Results revealed significant associations between total satisfaction score and achievement in the distance course, grade expected in the course, and frequency of accessing the course materials (p<.05). All distance students, including students with limited technological resources available at home, managed to successfully complete the course. Major concerns reported by distance students were related to lack of time management skills and negative attitudes toward group assignments. The mean final course grade of the distance section (80±8.2) was significantly higher than the hybrid section (72.2±9.5), (t=3.5, p<.05).

CONCLUSIONS

The use of effective instructional strategies resulted in delivering successful distance learning, even for students with limited resources. Institutions have to make strategic decisions on how to optimize the use of technology to fit their individualized learning environments. Instructors need to become familiar with the characteristics of students cohort served by the course and design the course accordingly. In addition, students should be guided on how to manage their time in distance learning environments and work effectively in group assignments.

Improving access to CPD for nurses: the uptake of online provision

Qualified nurses want to access courses that develop their knowledge and skills base within specific areas that are relevant to the work that they do. Traditional methods of delivery for post registration education usually involve attendance at a university or continuing professional development department for lectures and seminars. It is well known that barriers exist which prevent staff from being released to attend such educational activities, or to fund nurses education and development directly. Furthermore, education of the nursing workforce presents a dilemma for many education providers due to the range of learning styles of the current pool of potential students together with the ever changing demographics of the workforce. This paper aims to explore the dilemma faced by education providers and makes suggestions regarding possible solutions to supporting the continuing professional development of the nursing work force. In particular, education providers are encouraged to consider developing non-traditional study packages which maximise uptake through mechanisms such as on-line provision.

Students' experiences of blended learning across a range of postgraduate programmes

The article describes the students' experiences of taking a blended learning postgraduate programme in a school of nursing and midwifery. The indications to date are that blended learning as a pedagogical tool has the potential to contribute and improve nursing and midwifery practice and enhance student learning. Little is reported about the students' experiences to date. Focus groups were conducted with students in the first year of introducing blended learning. The two main themes that were identified from the data were (1) the benefits of blended learning and (2) the challenges to blended learning. The blended learning experience was received positively by the students. A significant finding that was not reported in previous research was that the online component meant little time away from study for the students suggesting that it was more invasive on their everyday life. It is envisaged that the outcomes of the study will assist educators who are considering delivering programmes through blended learning. It should provide guidance for further developments and improvements in using Virtual Learning Environment (VLE) and blended learning in nurse education.

The development and evaluation of a 'blended' enquiry based learning model for mental health nursing students: "making your experience count"

To meet the demands required for safe and effective care, nurses must be able to integrate theoretical knowledge with clinical practice (Kohen and Lehman, 2008; Polit and Beck, 2008; Shirey, 2006). This should include the ability to adapt research in response to changing clinical environments and the changing needs of service users. It is through reflective practice that students develop their clinical reasoning and evaluation skills to engage in this process. This paper aims to describe the development, implementation and evaluation of a project designed to provide a structural approach to the recognition and resolution of clinical, theoretical and ethical dilemmas identified by 3rd year undergraduate mental health nursing students. This is the first paper to describe the iterative process of developing a 'blended' learning model which provides students with an opportunity to experience the process of supervision and to become more proficient in using information technology to develop and maintain their clinical skills. Three cohorts of student nurses were exposed to various combinations of face to face group supervision and a virtual learning environment (VLE) in order to apply their knowledge of good practice guidelines and evidenced-based practice to identified clinical issues. A formal qualitative evaluation using independently facilitated focus groups was conducted with each student cohort and thematically analysed (Miles & Huberman, 1994). The themes that emerged were: relevance to practice; facilitation of independent learning; and the discussion of clinical issues. The results of this study show that 'blending' face-to-face groups with an e-learning component was the most acceptable and effective form of delivery which met the needs of students' varied learning styles. Additionally, students reported that they were more aware of the importance of clinical supervision and of their role as supervisees.

Nurses' Internet self-efficacy and attitudes toward web-based continuing learning

OBJECTIVE

There are increasing opportunities for nurses to engage in continuing learning via the Internet; hence, it is important to explore nurses' attitudes toward web-based continuing learning.

METHOD

This paper explores 267 Taiwanese clinical nurses' attitudes toward web-based continuing learning. In addition, the role of the nurses' Internet self-efficacy in their attitudes is investigated. This study utilizes two questionnaires to respectively survey the nurses' Internet self-efficacy and their attitudes toward web-based continuing learning. In particular, the Internet Self-efficacy Survey includes two scales: 'Basic self-efficacy' (the perceived confidence of using basic Internet functions, such as the confidence in using a web browser or searching for online information) and 'Advanced self-efficacy' (the perceived confidence of using advanced Internet functions, such as the confidence in online discussion or making online payments).

RESULTS AND FINDINGS

Exploratory factor analyses indicated adequate reliability and validity of the two questionnaires. The regression analyses revealed that both nurses' basic and advanced Internet self-efficacy can positively explain the perceived usefulness, ease of use and friendly feeling when using web-based continuing learning environments, whereas nurses' advanced Internet self-efficacy was the only predictor to explain how they intend to use web-based continuing learning environments more.

How 'blended' is blended learning?: students' perceptions of issues around the integration of online and face-to-face learning in a Continuing Professional Development (CPD) health care context

PURPOSE

This paper explores students' perceptions of blended learning modules delivered in a Continuing Professional Development (CPD) health care context in the UK. 'Blended learning' is the term used to describe a hybrid model of learning where traditional face-to-face teaching approaches and newer electronic learning activities and resources are utilised together.

METHOD

A new model of CPD for health care practitioners based on a blended learning approach was developed at a university in the south west of England. As part of the evaluation of the new modules, a qualitative study was conducted, in which 17 students who had experienced the modules were interviewed by telephone.

RESULTS

Three main themes emerged from the interviews relating to the 'blended' nature of the blended learning modules. These were i) issues around the opportunities for discussion of online materials face-to-face; ii) issues of what material should be online versus face-to-face and iii) balancing online and face-to-face components.

CONCLUSION

Teaching staff engaged in the development of blended learning courses need to pay particular attention to the ways in which they develop and integrate online and face-to-face materials. More attention needs to be paid to allowing opportunity for students to come together to create a 'community of inquiry'.

Developing competence in cardiac care through the use of blended learning: course members' and mentors' accounts

The use of blended learning to develop the clinical knowledge and skills of healthcare professionals is increasing. This paper reports the qualitative findings from an evaluation of a blended learning course designed to equip registered nurses with the knowledge and skills required to practice competently in cardiac nursing. The aims of the study were to explore whether a cardiac care course could be successfully delivered mainly online and it had any impact on the students' clinical practice. The sample consisted of course members and their mentors. Data were obtained through focus groups and interviews and analysed using thematic analysis. All students felt they had benefited from undertaking the course. Mentors identified higher levels of confidence and greater depth of knowledge and skills amongst their students. Areas identified for further development by both groups were firstly, the preparation of mentors for their role in supporting the students undertaking an online course and secondly, the expected level of competence that students needed to display in practice. This study indicates online learning is useful in enhancing student competence but may be wrongly seen as requiring less time commitment for both course members and mentors when compared to taught courses.

Professionalisation of gerontological nursing--the development of an international online gerontological master degree programme

Due to demographic changes and the growing demand for a nursing workforce in the gerontological field adequate nursing curricula are required. This paper describes the development of the international online gerontological master degree programme GEROM. Health and nursing science institutions from six European countries are collaborating in this EU-project. The project milestones as well as the study programme architecture are introduced. Furthermore, the evaluation concept is illustrated. Collaboration across the partners is affected by some problems; varying accreditation procedures and cultural differences inhibit the implementation of a joint degree. Institutional commitment and communication between the partners are essential for a successful process.

Nursing and healthcare students' experiences and use of e-learning in higher education

AIM

This paper presents research on nursing and healthcare students' experiences and use of e-learning.

BACKGROUND

The inception of e-learning in higher education is supported by a policy background and technological developments, yet little is known of student experience and use in the United Kingdom.

METHODS

Conducted in 2007 and 2008, this study employed a mixed methods approach. An initial quantitative questionnaire was completed by 25 Higher Education Institutions and nine case study sites were visited. In the sites 41 students took part in focus groups and 35 staff were interviewed.

FINDINGS

Twenty-four Higher Education Institutions used a virtual learning environment and all respondents used e-learning to enable access to course materials and web-based learning resources. Three main themes were identified from student interviews, 'Pedagogic use'; 'Factors inhibiting use' and 'Facilitating factors to engagement'. Student's main engagement with e-learning was at an instructivist level and as a support to existing face-to-face modes of delivery. Student use of Web 2.0 was limited, although a number were using social software at home. Limited computer access, computing skills, technical issues and poor peer commitment affected use. Motivation and relevance to the course and practice, in addition to an appreciation of the potential for student-centred and flexible learning, facilitated use.

CONCLUSION

There is scope to broaden the use of e-learning that would engage students in the social construction of knowledge. In addition, experiences of e-learning use could be improved if factors adversely affecting engagement were addressed.