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

Assessment of nurses' level of knowledge of the management of chronic wounds

BACKGROUND

Chronic wounds are a challenge and a major cause of morbidity. A wound is considered chronic if healing does not occur within the expected time frame depending on the etiology and location of the wound.

OBJECTIVE

To assess the level of knowledge about chronic wound management of postgraduate nurses in different areas of the health system and their previous satisfaction with the training received during their undergraduate studies.

DESIGN

Cross-sectional study of a health system of 95,000 inhabitants and 557 nursing professionals working in it.

PARTICIPANTS

Nurses working in the study health system and in areas with care for patients with chronic wounds in social, primary and hospital care.

RESULTS

Survey results described a low knowledge of chronic wound management in general. Data on knowledge according to area of work showed that nurses in primary care had the highest knowledge of wound etiology. Nurses working in health and social care were most knowledgeable in diagnostic knowledge. Hospital nurses showed the lowest knowledge overall. A relationship was observed when nurses had a master's degree followed by an expert with better knowledge in the test. In addition, nurses reported little training in chronic wounds during their university studies (69.73 %, n = 106).

CONCLUSIONS

Therefore, a review of this point should be considered to improve the management of chronic wounds and their correct approach among nursing students. A review of continuing and even specialised training needs in the clinical care setting should also be considered.

The use of clinical simulation in wound care education for nurses: a scoping review protocol

Many nurse educators consider simulation a valuable tool to supplement and augment learning due to current shortages of clinical placements. Wound care is integral to nursing practice yet many students and practicing nurses experience difficulties in securing sufficient learning opportunities or experience at the undergraduate level to feel competent in providing it. Emerging evidence supports simulation as a promising intervention to facilitate student learning in wound care, building nurses' confidence and competence in providing evidence-based wound care.

OBJECTIVE

To understand how clinical simulation is being used to educate nurses about wound assessment and management, and to explore the impact of clinical simulation on learning outcomes, including knowledge, attitudes, confidence, and skills related to wound care.

INCLUSION CRITERIA

Inclusion criteria include studies of nursing students and nurses, simulation educational interventions, and learning outcomes related to wound care evaluated by any measures. Any studies that do not fit these criteria will be excluded.

METHODS

Databases to be searched include PubMed/MEDLINE, CINAHL, ERIC, SciELO up to February 2022. Studies in English with a date limit of 2012 to 2022 will be included. Search results will be imported into Covidence and screened by two independent reviewers, first based on the title and abstract and then full text. Data will be extracted with a novel extraction tool developed by the reviewers and then synthesised and presented in narrative, tabular, and/or graphical forms.

DISSEMINATION

The finished scoping review will be published in a scientific journal once analysis is completed.

Effectiveness of augmented reality in learning about leg ulcer care: A quasi-experimental study in nursing students

BACKGROUND

Chronic wounds are a serious public health problem worldwide. Providing optimal treatment to patients suffering from leg ulcers is a priority for nursing. Therefore, nursing students need to acquire the necessary competencies to provide evidence-based care. Augmented Reality (AR) is an emerging technology in health science education which can help nursing students achieve these skills if it is promoted by both institutions and educationalists.

OBJECTIVES

To test the effectiveness of an AR-based methodology for teaching-learning aspects of the nursing curriculum (leg ulcer care), as well as to describe how AR influences different learning determinants of nursing students.

DESIGN

A quasi-experimental study was carried out.

PARTICIPANTS/SETTINGS

The participants of the study were 137 s-year nursing students from the School of Nursing of the University of Santiago de Compostela (Spain) (average age = 21.59 years, 80.29 % females). Of them, 65 comprised the control group (Non-AR-based teaching) and 72 comprised the experimental group (AR-based teaching).

METHODS

Pre-post tests were used to measure knowledge and skills about leg ulcer care in both groups. Additionally, two validated questionnaires were selected to identify the influence of AR on learning determinants in the experimental group. The study took place during the 2018/2019 academic year.

RESULTS

Significantly higher scores (7.68 vs. 6.14) were found in the knowledge post-test in the experimental group (p ≤ 0.001), while the pre-test did not show differences between groups (4.43 vs. 4.32). Also, nursing students indicated high scores in attention, autonomous learning, understanding and motivation to carry out learning objectives using AR.

CONCLUSIONS

AR is a tool that improves performance related to the specific aspects of the nursing academic curriculum (leg ulcer care), while encouraging positive attitudes towards the teaching-learning process. These findings reinforce the need to include innovative methodologies in nursing classrooms.

Theories informing technology enhanced learning in nursing and midwifery education: A systematic review and typological classification

BACKGROUND

Learning is a complex process involving internal cognitive processes and external stimuli from curricula, pedagogical strategies, and the learning environment. Theories are used extensively in higher education to understand the intricacies of adult learning and improve student outcomes. Nursing and midwifery education uses a range of technology enhanced learning (e-learning) approaches, some of which are underpinned by theoretical frameworks.

OBJECTIVE

Synthesise literature on theories that inform technology enhanced learning in nursing and midwifery education.

DESIGN

A systematic review.

DATA SOURCE

CINAHL, ERIC, MEDLINE and PubMed were searched for relevant studies (2000-2021). Reference lists of related literature reviews were hand searched.

REVIEW METHODS

Title and abstract, followed by full texts were screened by two reviewers independently using predefined eligibility criteria. Quality appraisal was not undertaken. Data were extracted and Merriam and Bierema's typology of adult learning theories used to categorise theories in each study.

RESULTS

Thirty-three studies were included, incorporating twenty-nine distinct learning theories from the behaviourist, cognitivist, constructivist, and social cognitivist domains, with constructivist being the most widely used. Kolb's Experiential Learning Theory and Driscoll's Constructivist Learning Theory were the most commonly reported theories. The population of learners were mainly undergraduate nursing students who used a range of online, mobile, blended or computerised learning, virtual reality, or digital forms of simulation, primarily in university settings. Theories were employed to inform the technology enhanced learning intervention or to help explain how these could improve student learning.

CONCLUSION

This review highlighted a range of theories, particularly constructivist approaches, that underpin research on technology enhanced learning in nursing education, by informing or explaining how these digital interventions support learning. More rigorous research that examines the myriad of theoretical frameworks and their effectiveness in informing and explaining technology enhanced learning is needed to justify this approach to pedagogical nursing research and practice.

Connecting Students’ Interests to a Learning Context: The Case of Ecosystem Services in STEM Education

Interest in a subject matter is a powerful motivation in education. Prior knowledge of students’ interests can be helpful in teaching the concept of ecosystem services (ES) and disservices (ED), which is increasingly being used in science, technology, engineering, and mathematics (STEM) education, including soil science. Study objectives were to evaluate prior students’ soil science-related interests and use them to expand the learning context of a laboratory exercise on soil reaction (pH) with ES/ED in an online introductory soil science course (FNR 2040: Soil Information Systems) taught at Clemson University. Students from multiple fields of study (environmental and natural resources, forestry, and wildlife biology) completed the laboratory exercise in Fall 2021. This exercise on soil regulating and provisioning ES/ED included a sequence of reusable learning objects (RLOs), which are self-contained online modules frequently used for e-learning. Laboratory activities included calculating the liming replacement cost of soil inorganic carbon (SIC) and avoided social cost of carbon (SC-CO2) from soil inorganic carbon (SIC) stocks in the assigned soil. The laboratory exercise was effective in increasing the familiarity with the concept of ES/ED (+39.4 increase in “extremely familiar” category) and the concept of SIC (+44.7 increase in “moderately familiar” category). The graded online quiz consisted of 9 questions and was taken by 55 students with an average score of 7.0 (out of 9). A post-assessment survey found that the laboratory was an effective way to learn about soil pH, SIC, and their ES/ED. Detailed student comments showed learning enjoyment (e.g., calculations, good experience), the value of multimedia (e.g., video, PowerPoint), the learning flexibility (e.g., separate parts), content applicability (e.g., economic values of services), and constructive criticism (e.g., clearer instructions, lots of information). A word cloud based on comments by the students about their soil ES laboratory exercise experience indicated the most common words submitted by students to describe their experience, such as “soil”, “calculations”, “enjoyed”, “learning”, and “values”, among others. Applied recommendations are proposed to develop future exercises based on the alignment of students’ interests, STEM subject matter, and ES/ED applications.

Teaching Field Data Crowdsourcing Using a GPS-Enabled Cellphone Application: Soil Erosion by Water as a Case Study

Crowdsourcing is an important tool for collecting spatio-temporal data, which has various applications in education. The objectives of this study were to develop and test a laboratory exercise on soil erosion by water and field data crowdsourcing in an online introductory soil science course (FNR 2040: Soil Information Systems) at Clemson University. Students from different STEM disciplines (wildlife biology, forestry, and environmental and natural resources) participated in the study in the fall of 2021. They completed a sequence of self-contained digital teaching modules or reusable learning objects (RLOs), which are often used in online learning. The exercise included a field exercise and learning module to teach students about different types of water-based soil erosion as well as field data collection and crowdsourcing tools. As a result of this exercise, student familiarity with crowdsourcing was effectively increased, as shown by the post-assessment survey with a +31.2% increase in the “moderately familiar” category and a +28.3% increase in the “extremely familiar” category. The online quiz contained ten questions and was taken by 56 students with an average score of 9.5 (out of 10). A post-assessment survey found that most of the students indicated that the laboratory was an effective learning experience about field data crowdsourcing using a GPS-enabled cellphone application. Detailed students’ comments indicated enjoyment of learning (e.g., data collection, learning about different technologies), the value of multimedia (e.g., ArcGIS Survey123, cellphone), the flexibility of learning (e.g., field work), the content applicability (e.g., actual field examples of erosion by water), and criticism (e.g., technical issues). A word cloud derived from students’ comments about their laboratory exercise experience indicated the most frequent words used by students, such as “erosion”, “enjoyed”, and “different”, among others. Incorporating a learning module and field exercise using modern data collection technology into an undergraduate soil science education course enabled students to understand the value and methods for leveraging cellphone-based field collection methods to crowdsource data for environmental assessment. Practical recommendations for planning and executing future crowdsourcing exercises were developed using the current study as an example.

Generation of reusable learning objects from digital medical collections: An analysis based on the MASMDOA framework

Learning Objects represent a widespread approach to structuring instructional materials in a large variety of educational contexts. The main aim of this work consists of analyzing the process of generating reusable learning objects followed by Clavy, a tool that can be used to retrieve data from multiple medical knowledge sources and reconfigure such sources in diverse multimedia-based structures and organizations. From these organizations, Clavy is able to generate learning objects that can be adapted to various instructional healthcare scenarios with several types of user profiles and distinct learning requirements. Moreover, Clavy provides the capability of exporting these learning objects through standard educational specifications, which improves their reusability features. The analysis proposed is conducted following criteria defined by the MASMDOA framework for comparing and selecting learning object generation methodologies. The analysis insights highlight the importance of having a tool to transfer knowledge from the available digital medical collections to learning objects that can be easily accessed by medical students and healthcare practitioners through the most popular e-learning platforms.

Incorporating Ecosystem Services into STEM Education

The framework of ecosystem services (ES) and disservices (ED) has increasingly been used in various science, technology, engineering, and mathematics (STEM) disciplines, including soil science. The objectives of this study were to use ES/ED concepts to extend and test an existing lecture and laboratory exercise on soil organic carbon (SOC) in an online introductory soil science course (FNR 2040: Soil Information Systems) taught to Clemson University students from various STEM disciplines (forestry, wildlife biology, and environmental and natural resources) in Fall 2020. The laboratory exercise was extended with a series of reusable learning objects (RLOs), which are self-contained digital modules commonly utilized in e-learning. The laboratory exercise consisted of identifying ES and calculating the avoided social cost of carbon (SC-CO2) from soil organic carbon stocks in the assigned soil’s topsoil horizon. The laboratory exercise effectively increased student familiarity with ES/ED as indicated by the post-assessment survey with a +24.4% increase in the moderately familiar category and a +36.1% increase in the extremely familiar category. The graded online quiz consisted of ten questions and was taken by 51 students with an average score of 8.7 (out of 10). A post-assessment survey indicated that most of the students found that the laboratory was an effective way to learn about ES/ED with examples from soil science. Detailed students’ comments indicated enjoyment of learning (e.g., calculations, applying new knowledge), the value of multimedia (e.g., PowerPoint, video), the flexibility of learning (e.g., different parts in the laboratory), the applicability of content (e.g., real-world examples), and criticism (e.g., tedious calculations). A word cloud based on students’ comments about their experience with the laboratory exercise on soil ES indicated the most common words used by students to describe their experience, such as “soil services”, “learning”, “enjoyed”, and “ecosystems”, among others. Incorporating ES/ED into an undergraduate STEM course enabled students to connect ES/ED provided by soil with the societal systems reliant on the soil resources.

Reusable learning objects: a blended learning tool in teaching computer-aided design to engineering undergraduates

Purpose

Blended learning is an emerging trend across many educational settings, adopting the purposeful integration of traditional face-to-face and online teaching to establishing an engaging learning experience for the students. Blended learning provides an ideal platform for the implementation of reusable learning objects (RLOs) as a pedagogical tool to support classroom instruction.

Design/methodology/approach

This study had conducted a quasi-experiment followed by semi-structured interviews to determine if a blended learning approach using RLOs can enhance students’ learning in an undergraduate engineering computer-aided design (CAD) module. This study involved learners studying engineering in two different academic years.

Findings

Students from the first year were taught using traditional face-to-face teaching approach. The cohort of students from the subsequent year adopted a blended learning approach: face to face and access to a series of RLOs. The analysis revealed statistical evidence that the use of blended learning had a significant impact on the students' end of term exam grades in the CAD module in comparison to the students who undertook traditional face-to-face teaching approach. The qualitative findings highlighted the positive impact of RLOs on students’ learning behaviour, engagement and knowledge retention.

Originality/value

This study provided empirical evidence of the benefits of using RLOs as a blended learning tool in engineering domain. From a theoretical perspective, the findings highlighted the importance of good instructional design and sound theoretical underpinning of the pedagogical strategy. From a practical point of view, this study informed academics on how to improve learner's academic achievement using RLOs.

Increasing competence in wound care: A cross-sectional study to evaluate use of a virtual patient by undergraduate student nurses

Concerns have arisen internationally over the competency of student nurses to perform wound care. A global shortage of nursing faculty and clinical practice opportunities is regarded as a contributing factor. Virtual simulation offers a possible solution. The aim of this study was to describe the development and educational evaluation of a virtual patient to supplement undergraduate learning of wound care. The National League for Nursing Jeffries model informed the design of the media. Evaluation of the virtual patient by penultimate year nursing students (n = 148) was conducted using a survey design. Findings are presented from statistical and directed content analyses. Most students rated the educational value of the virtual patient and its support of learning highly. They reported a perceived increase in confidence and ability to meet wound care competency outcomes. The virtual patient also provided students with opportunities to develop their clinical reasoning skills. This study provides evidence that virtual patient simulation is an effective pedagogy to increase clinical competence in wound care. It allows nursing students the opportunity to practice skills and utilise theory repetitively in a safe environment, unhampered by a lack of resources such as clinical placement availability and a declining faculty.

Translating facilitated multimodal online learning into effective person-centred practice for the person living with dementia among health care staff in Australia: an observational study

BACKGROUND

This paper aims to identify whether health care staff perceive a 12-week online facilitated, multimodal, person-centred care, dementia education program influences their knowledge, skills, behaviour and practice improvement activities in dementia care. In particular it will examine a dementia education program 'Positive Approach to Care of the Older Person with Dementia' (The Program).

METHODS

Three clusters of online questions were developed. Participants completed the first cluster at course completion (N = 1455;2013-2016). The second cluster was added into the 2015-2016 exit-surveys to measure clinical practice improvement (CPI) activities implementation (N = 520). Thirdly, all participants were invited to a 2018 follow-up survey (N = 343). The Program was also matched with key factors that are likely to result in effective online dementia education programs.

RESULTS

The Program had a 78% completion rate. At course completion (2013-2016, N = 1455), 62% felt that the online forums generated useful discussion and 92% thought their work would support implementing their new knowledge and skills. In 2015-16, participants (N = 520) reported that The Program had influenced their practice in terms of new knowledge (87%), understanding (87%), awareness (88%), and new ideas about delivering dementia care (80%). Almost all (95%) participants indicated they had changed 'an aspect of their own professional practice'. Sixty-three percent had planned to develop a CPI activity. Of those (N = 310), 40% developed a new or improved tool and 21% planned to deliver education or create new resources. The most common CPI activities reported in the 2018 follow-up survey (N = 343) included education (49%) and role modelling of new behaviour (47%). Additionally, 75% indicated their CPI influenced their practice and had influenced patients (53%) and colleagues (53%). Fifty-seven percent reported their projects were sustained for 12 months or more.

CONCLUSION

The Positive Approach to Care of the Older Person with Dementia education program can potentially improve training the dementia workforce. Participants perceived that a multimodal online platform facilitated by clinical champions influences knowledge transfer, skills and behaviour, encourages workplace CPI activities. Further effort could be directed towards empowering and supporting care staff on system, procedure and practice change and engaging management to translate training activities into practice.

Digital Story Map Learning for STEM Disciplines

Modern technological advances and trends require new pedagogy and delivery of mapping materials to prepare the future workforce in the disciplines of Science, Technology, Engineering, and Mathematics (STEM) for an increasingly technology-dominated society. The purpose of this study was to develop an Environmental Systems Research Institute (ESRI) Story Map “Soil Forming Factors: Climate” for multiple STEM disciplines based on the design guidelines from the Cognitive Theory of Multimedia Learning (CTML). The study incorporated a two-group post-test only design that utilized multiple methods of analysis, including a quality assessment of the ESRI Story Map using the five principles of effective storytelling, direct quantitative measures of learning (quiz), and surveys of participants’ perceptions (PowerPoint presentation versus ESRI Story Map) using QualtricsTM. Survey results were summarized by gender, academic classification (year), and academic major program. The newly developed ESRI Story Map was an effective teaching tool as demonstrated by quiz scores and students’ positive responses. Post-testing scores indicated that ESRI Story Maps were an effective way to learn and were viewed as effective as traditional teaching methods (e.g., PowerPoint). Additionally, students reported feeling comfortable using ESRI Story Maps. These positive responses were consistent by gender, major, and academic classification (year). This research indicates that adding audio may improve the use of this ESRI Story Map for educational concept delivery. Empirical studies such as this that include multifaceted quantitative and qualitative assessments are critical to understanding the benefits of new types of multimedia learning in an educational setting.