Towards a team-based, collaborative approach to embedding e-learning within undergraduate nursing programmes

E-Learning Success Model in the Context of COVID-19 Pandemic in Higher Educational Institutions

Nowadays, the extensive use of e-learning in higher educational institutions in many countries leads us to apprehend the reality, precisely the key success/failure factors of the implementation, of e-learning systems in these institutions. This motivation becomes more and more important, inevitable, and urgent, especially for institutions that have heavily adopted e-learning systems under exceptional conditions without any prior planning, such as the COVID-19 pandemic. From this perspective, this research aimed to provide an e-learning success model in the context of the COVID-19 pandemic by assessing e-learning effectiveness and by investigating the key antecedents of e-learning effectiveness. The literature review led to the identification of four main factors influencing e-learning effectiveness: The e-learning system, e-learning readiness, interactivity, and resistance to change. These four variables constituted the antecedents of an effective e-learning system, which was tested in a KSA context. A structured survey, including a sample of 1202 students from Imam Mohammad Ibn Saud Islamic University was used to examine the linkages among our proposed model. The model, with a total of ten direct and six indirect relationships, was tested by using structural equation modeling. The research findings indicate that effective e-learning is supported by the interactions between four factors: the e-learning system, e-learning readiness, interactivity, and resistance to change.

Multidisciplinary Tracheostomy Quality Improvement in the COVID-19 Pandemic: Building a Global Learning Community

OBJECTIVES

To report experience with a global multidisciplinary tracheostomy e-learning initiative.

METHODS

An international multidisciplinary panel of experts convened to build a virtual learning community for tracheostomy care, comprising a web-based platform, five distance learning (interactive webinar) sessions, and professional discourse over 12 months. Structured pre- and post-webinar surveys were disseminated to global participants including otolaryngologists, intensivists, nurses, allied health professionals, and patients/caregivers. Data were collected on audio-visual fidelity, demographics, and pre- and post-tutorial assessments regarding experience and skill acquisition. Participants reported confidence levels for NICU, pediatric, adult, and family care, as well as technical skills, communication, learning, assessment, and subdomains.

RESULTS

Participants from 197 institutions in 22 countries engaged in the virtual education platform, including otolaryngologists, speech pathologists, respiratory therapists, specialist nurses, patients, and caregivers. Significant improvements were reported in communication (P < .0001), clinical assessments (P < .0001), and clinical governance (P < .0001), with positive impact on pediatric decannulation (P = .0008), adult decannulation (P = .04), and quality improvement (P < .0001). Respondents reported enhanced readiness to integrate knowledge into practice. Barriers included time zones, internet bandwidth, and perceived difficulty of direct clinical translation of highly technical skills. Participants rated the implementation highly in terms of length, ability for discussion, satisfaction, applicability to professional practice, and expertise of discussants (median scores: 4, 4, 4, 4 and 5 out of 5).

CONCLUSIONS

Virtual learning has dominated the education landscape during COVID-19 pandemic, but few data are available on its effectiveness. This study demonstrated feasibility of virtual learning for disseminating best practices in tracheostomy, engaging a diverse, multidisciplinary audience. Learning of complex technical skills proved a hurdle, however, suggesting need for hands-on experience for technical mastery. While interactive videoconferencing via webinar affords an engaging and scalable strategy for sharing knowledge, further investigation is needed on clinical outcomes to define effective strategies for experiential online learning and virtual in-service simulations.

Introduction of blended learning in a master program: Developing an integrative mixed method evaluation framework

AIM

The aim of this research is to develop a comprehensive evaluation framework involving all actors in a higher education blended learning (BL) program.

BACKGROUND

BL evaluation usually either focuses on students, faculty, technological or institutional aspects. Currently, no validated comprehensive monitoring tool exists that can support introduction and further implementation of BL in a higher education context.

METHOD

Starting from established evaluation principles and standards, concepts that were to be evaluated were firstly identified and grouped. In a second step, related BL evaluation tools referring to students, faculty and institutional level were selected. This allowed setting up and implementing an evaluation framework to monitor the introduction of BL during two succeeding recurrences of the program.

RESULTS

The results of the evaluation allowed documenting strengths and weaknesses of the BL format in a comprehensive way, involving all actors. It has led to improvements at program, faculty and course level. The evaluation process and the reporting of the results proved to be demanding in time and personal resources.

CONCLUSION

The evaluation framework allows measuring the most significant dimensions influencing the success of a BL implementation at program level. However, this comprehensive evaluation is resource intensive. Further steps will be to refine the framework towards a sustainable and transferable BL monitoring tool that finds a balance between comprehensiveness and efficiency.

The evidence for 'flipping out': A systematic review of the flipped classroom in nursing education

BACKGROUND

The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of today's students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula.

OBJECTIVES

The aims of this systematic review were to examine how the flipped classroom has been applied in nursing education and outcomes associated with this style of teaching.

DATA SOURCES

Five databases were searched and resulted in the retrieval of 21 papers: PubMed, CINAHL, EMBASE, Scopus and ERIC.

REVIEW METHODS

After screening for inclusion/exclusion criteria, each paper was evaluated using a critical appraisal tool. Data extraction and analysis were completed on all included studies.

RESULTS

This systematic review screened 21 titles and abstracts resulting in nine included studies. All authors critically appraised the quality of the included studies. Five studies were identified and themes identified were: academic performance outcomes, and student satisfaction implementing the flipped classroom.

CONCLUSIONS

Use of the flipped classroom in higher education nursing programmes yielded neutral or positive academic outcomes and mixed results for satisfaction. Engagement of students in the flipped classroom model was achieved when academics informed and rationalised the purpose of the flipped classroom model to students. However, no studies in this review identified the evaluation of the process of implementing the flipped classroom. Studies examining the process and ongoing evaluation and refinement of the flipped classroom in higher education nursing programmes are warranted.

Virtual collaboration in the online educational setting: a concept analysis

PURPOSE

This study was designed to explore the concept of virtual collaboration within the context of an online learning environment in an academic setting.

METHOD

Rodgers' method of evolutionary concept analysis was used to provide a contextual view of the concept to identify attributes, antecedents, and consequences of virtual collaboration.

FINDINGS

Commonly used terms to describe virtual collaboration are collaborative and cooperative learning, group work, group interaction, group learning, and teamwork. A constructivist pedagogy, group-based process with a shared purpose, support, and web-based technology is required for virtual collaboration to take place. Consequences of virtual collaboration are higher order thinking and learning to work with others.

CONCLUSION

A comprehensive definition of virtual collaboration is offered as an outcome of this analysis. Clarification of virtual collaboration prior to using it as a pedagogical tool in the online learning environment will enhance nursing education with the changes in nursing curriculum being implemented today. Further research is recommended to describe the developmental stages of the collaborative process among nursing students in online education and how virtual collaboration facilitates collaboration in practice.

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.

'A caring professional attitude': What service users and carers seek in graduate nurses and the challenge for educators

With the publication of the new NMC standards for pre-registration nursing education, undergraduate curricula are being written in universities across England. There are many drivers for the curricula but one that has until recently received scant attention is the service user's and carer's voice. This paper discusses the findings of a qualitative study that asked 52 service users and carers about the qualities they sought in nurses and their views on nurse education. Eight focus groups were conducted with a broad range of service users and carers from primary and secondary care, and voluntary organisations. Data were analysed using the framework approach facilitated by a qualitative analysis software programme. The sample was diverse, but there were similarities in the qualities they valued in nurses. They sought technical competence, knowledge and willingness to seek information, but overwhelmingly prioritised 'a caring professional attitude'. This was articulated as empathy, communication skills and non-judgmental patient centred care: major themes in the new NMC standards. Our participants also expressed concern about whether the educational preparation of nurses can develop these caring qualities. We discuss this concern, the challenges for nurse educators it presents and how we can engage service users and carers in shaping and delivering our new curricula.

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 students' perception of a Web-based intervention to support learning

Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point(R) presentations, animations and digitised video clips were introduced in a first year Bachelor of Nursing biological sciences subject at a university in metropolitan Sydney. All students enrolled in this unit were invited to obtain access to the site and the number of hits to the site was recorded using the student tracking facility available on WebCT, an online course delivery tool adopted widely by many educational institutions and used in this study. Eighty-five percent of students enrolled in the subject accessed the learning support site. Students' perception of the value of a learning support site was assessed using a web-based survey. The survey was completed by 123 participants, representing a response rate of 22%. Three themes emerged from the qualitative data concerning nursing students' perception of the web-based activities: 'enhances my learning', 'study at my own pace', and 'about the activities: what I really liked/disliked'. Web-based interventions, supplementing a traditionally presented nursing science course were perceived by students to be beneficial in both learning and language development. Although students value interactive, multimedia learning they were not ready to completely abandon traditional modes of learning including face-to-face lectures. The findings of this study contribute to an understanding of how web-based resources can be best used to support students' learning in bioscience.