Smartphones and mobile applications (apps) in clinical nursing education: A student perspective

Nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare: A cross-sectional study

BACKGROUND

Increasing technology use in healthcare has led to a focus on improving aspects of telehealth delivery to facilitate healthcare. Thus, students' understanding of the importance of telehealth and telenursing must be improved, as this plays a crucial role in shaping the future of healthcare. This study aimed to examine nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare.

METHODS

A cross-sectional study was conducted on a convenience sample of 204 nursing students attending a public university in Saudi Arabia. An online questionnaire, supplemented by additional instruments, was used for data collection. The required bivariate and multivariate analyses were used to analyze the collected data.

RESULTS

The study revealed that nursing students exhibited moderately high levels of awareness, knowledge, and attitudes regarding technology use for high-quality healthcare. Significant differences in the mean frequencies of internet use and knowledge (p < .05) and technology proficiency and knowledge (p < .05) were reported. The Pearson coefficient correlation test demonstrated that awareness was associated with knowledge (r = 0.350, p < .001), attitude (r = 0.660, p < .001), and years of technology use (r = -0.157, p = .025). Furthermore, attitude was significantly associated with knowledge (r = 0.295, p < .001) and years of technology use (r = -0.150, p = .032). In the regression, the awareness, knowledge, and attitude models were all significant (p < .05).

CONCLUSIONS

The study's findings emphasize the need for targeted interventions to enhance nursing students' technological proficiency and awareness of telenursing. The predictive relationships among awareness, knowledge, and attitude also emphasize the need for a comprehensive and integrated educational approach. Future qualitative research studies should explore nursing students' perceptions of telenursing and how this could lead to high-quality healthcare.

Construction and implementation of a laparoscopic skill training course based on a smartphone application and virtual reality

BACKGROUND

To develop a laparoscopic training course that combines a smartphone application (APP) and virtual reality (VR), and initially evaluate the feasibility and effectiveness of its implementation.

METHODS

The Exploring Laparoscopy (Ex-Lap) app was developed to meet training demands. The course was designed by integrating the app with a VR simulator (LapSim®) and animal organ perfusion simulators. From January 2021 to December 2023, 91 participants were enrolled in the study and then divided into 5 separate batches to undergo the first stage of the course. The performance of the participants was evaluated by rating scale, the overall Training and Assessment of Basic Laparoscopic Techniques (TABLT) scores, and pass rates. Statistical analyses were conducted using SPSS 26.0, employing Kruskal-Wallis tests, Chi-squared analysis, and Fisher's exact test, depending on the data type.

RESULTS

The Staged Training and Assessment of Laparoscopic Skills (STALS) course was developed, consisting of three stages. The overall pass rates for the first stage across the five batches ranged from 85 to 100%, with no significant difference (P = 0.387). No significant differences were found in the scale scores or TABLT scores for the training tasks among students from different batches (all P > 0.05).

CONCLUSIONS

The STALS course is applicable in residency training, demonstrating satisfactory teaching effectiveness and replicability.

Mobile devices for developing nursing students' professional skills: scoping review

OBJECTIVE

to map the scientific literature on the use of mobile devices to develop the professional skills of nursing students.

METHOD

this was a scoping review guided by JBI recommendations. Six databases and gray literature were included. The selection of studies was carried out through individual and peer assessment. Data were extracted based on an elaborate script and presented in a descriptive, tabular and graphical format.

RESULTS

264 studies were identified, of which 13 comprised the corpus of analysis. The studies were carried out mainly on the Asian continent. Interventions ranged from one to 12 weeks, with a predominance of the use of Apps. The skills addressed were mainly clinical skills, techniques and procedures inherent to nursing practice, followed by decision-making and problem-solving.

CONCLUSION

the studies analyzed not only revealed the potential of mobile devices in the training context, but also highlighted their contribution to improving clinical capabilities, as they offer support for a more dynamic and effective approach to the learning process. The gap in knowledge appears in the still unexplored possibility of integrating different professional skills through a single digital educational tool.

Student nurses' experiences with a digital educational resource supporting learning in nursing home placements: A qualitative study

BACKGROUND

Nursing education should improve clinical placements in nursing homes to foster and enhance student nurses' learning experiences. Initiatives for digital educational resource used to teach and supervise students to complement learning are increasingly being adopted and considered important in nursing education. However, little is known about how digital educational resources can facilitate learning in placements. Research on the value of such resources from student nurses' perspective is required.

AIM

To explore first-year student nurses' experiences with a digital educational resource developed to support learning in nursing home placements.

DESIGN

This study has a qualitative explorative design and is part of a larger research project in which a digital educational resource named DigiQUALinPRAX was developed.

SETTINGS

This study was conducted at three publicly funded nursing homes affiliated with one Norwegian university.

PARTICIPANTS

Twenty-three first-year student nurses.

METHODS

Data was generated through pre- and post-placement group interviews and analysed using reflexive thematic analysis. Standards for Reporting Qualitative Research were applied in this stud.

FINDINGS

One overreaching theme and three subthemes related to student nurses' experiences with a digital educational resource were identified. The digital educational resource gave a feeling of being acknowledged as a learner by (1) providing a structure and preparation that made the placement feel less overwhelming, (2) supporting professional reflection and assessment practices, and (3) facilitating collaboration when all stakeholders used the resource actively.

CONCLUSIONS

This study indicates that student nurses' learning process in nursing home placements can be supported through digital educational resources customised for this learning arena. The findings indicate that the digital educational resource facilitated pre-placement preparedness, provided structure and flexibility, and enhanced reflection and assessment practices during clinical placement. However, encouraging tripartite usage is essential to exploit the full potential of digital educational resources.

Use of Personal Cell Phones by Nurses is Barrier to Effective Nursing Care in Hospitals: A Qualitative Research

Using cell phones by nurses can affect the quality of care. This study aimed to explore the consequences of using cell phones by nurses in hospitals. A qualitative approach was used. Data were collected through semi-structured interviews. Nursing staff, patients, and their relatives participated in this study. Categories of "emotionless care," "neglect in care," "impaired professional behavior" and a main theme of "Personal cell phone is a barrier to effective nursing care" extracted. Using cell phone during work could jeopardize patients' safety and ruins the nursing profession image. It is necessary to formulate guidelines on how to use cell phones in hospitals.

Scoping communication training in undergraduate children's nursing programmes: A mixed method study examining delivery methods and content

AIM

The aim of this study was to scope communication curriculum reported as currently being delivered within undergraduate children's nursing programmes across the Republic of Ireland and the United Kingdom.

BACKGROUND

Communication between a children's nurse and a child/young person influences a child/young person's healthcare experience. Despite an identified need for a comprehensive and effective communication curriculum within undergraduate nursing, there is a notable gap of understanding of the delivery and content of communication training within children's nursing curricula.

DESIGN

A mixed method, online anonymous self-report survey design was adopted.

METHODS

Programme Leads of undergraduate children's nursing programmes in the Republic of Ireland and the United Kingdom were asked to report on how communication training is delivered to students on undergraduate children's nursing programmes. The Checklist for Reporting of Survey Studies (CROSS) was used for the reporting of this study.

RESULTS

Thirty-two programme leads completed the survey (51 % response rate). Findings show variability in the delivery and content of communication training across Higher Educational Institutions. Core communication modules featured across all nursing programmes, however, only two programme leads reported delivering standalone child-centred communication modules. Communication training was not always delivered by an educator with professional experience of children and young people in healthcare. Curriculum capacity had an impact on the delivery of communication training, with clinical practice being relied on to supplement child specific communication training. Programme leads highlighted the need for greater inclusion of child voice in shaping and delivering undergraduate children's nurse education.

CONCLUSIONS

This study shows that while communication is covered as a core part of the undergraduate nursing curriculum across the Republic of Ireland and the United Kingdom, it generally lacks a focus on children and young people and is not always supported by educators with professional experience of children and young people in healthcare. More work needs to focus on equipping undergraduate children's nurses with the unique skills needed to communicate effectively with children and young people and incorporate learnings into nursing pedagogy.

Nomophobia and Phubbing Levels of Nursing Students: A Multicenter Study

Today, with the enhancement in the usage of smartphones, the concepts of nomophobia and phubbing have emerged. Nomophobia refers to the fear of being deprived of smartphones/smart devices. Phubbing is the use of a person's smartphone in situations that are not appropriate for the situation, time, and place. Therefore, the study purposed to evaluate nursing students' nomophobia and phubbing scores in Turkey, Portugal, and the United States. The data were collected with the Personal Information Questionnaire, Nomophobia Scale, and Phubbing Scale from N = 446 nursing students. The mean age of the students was 22.04 ± 4.08 years, and 86.5% were women. It was found that the total nomophobia scores of the nursing students were 80.15 ± 21.96, 72.29 ± 28.09, and 99.65 ± 6.11, respectively in Turkey, Portugal, and the United States. When the countries' Nomophobia Scale total scores, "giving up convenience," "not being able to communicate," and "losing connectedness" scores were compared with each other, they were found to be statistically significant ( P < .05). When the countries' Phubbing Scale total scores and all subscale scores were compared with each other were found to be statistically significant ( P < .05). It is seen that nomophobia scores were moderate (60 ≤ NMP-Q nomophobia ≤ 99) and phubbing scores (<40) were below the level indicating addiction in all countries.

Mobile applications in nursing science education: A scoping review with snowballing method

OBJECTIVES

To review the available evidence on the use and effectiveness of mobile applications to assist nursing students in comprehending, utilising, and applying specialised language and knowledge terminologies when learning the language of biosciences.

DESIGN

A scoping review.

DATA SOURCES

The databases CINAHL Complete, ERIC, EMCare, MEDLINE, PubMed, the OVID scholarly interface and the web search engine Google Scholar were searched.

REVIEW METHODS

Peer-reviewed literature published in English during the period 2010-2023 was reviewed. Snowballing methods saw the reference lists of all included articles searched, and a secondary search of the Scopus ranked top ten nursing journals. Articles were included if they reported on any app or digital resource used when teaching undergraduate nursing students biosciences/science language skills, concepts, or terminology. Studies were excluded if the participants were non-nursing student cohorts or content did not meet the inclusion criteria.

RESULTS

Mobile applications generally contribute positively to nursing students' education. These applications are deemed valuable tools, offering structured content in easily digestible formats. Some applications also foster teamwork and collaboration during clinical placements, promoting peer learning, and a sense of community. User internet access and preparation for learning were the only noted barriers. A range of science-based concepts were taught using applications, including diabetes mellitus, medical terminology, asthma, and cardiac conditions. Despite the promise shown by using mobile applications to teach nurse sciences, few are dedicated to bioscience language and scientific terminology. Recognising the challenging nature of teaching these concepts, developing specialised applications could substantially improve the educational experience for nursing students.

CONCLUSION

Nurse educators are encouraged to teach with applications given their reported effectiveness in knowledge gains for students learning science concepts. Rigorous interventional study designs are warranted to extend suggestions that using applications enhances student understanding of challenging scientific concepts and support quality in clinical learning.

The effect of educational application in nursing internship clinical training on cognitive and functional skills and students' satisfaction

BACKGROUND

Clinical education plays an essential role in shaping the nursing identity and is one of the central elements in the education of nursing students. Today, with the advancement of novel technologies, utilizing mobile phone-based technologies in the education of medical sciences is inevitable. Therefore, this study was conducted with the aim of investigating the impact of the urology educational application on nursing students' cognitive-functional criteria and satisfaction during the internship period.

METHODS

This experimental educational intervention study was conducted during nursing students' urology internship course at Shahid Beheshti School of Nursing and Midwifery in Rasht. The data collection tools included a demographic characteristics questionnaire, cognitive skills scale, functional skills scale, and satisfaction scale (Stokes, 2001). The data were analyzed using SPSS software version 16, and a significance level was set at 0.05.

RESULTS

Out of 48 studied students, 28 (58.3%) were males. The mean age of the students was 20.34 (SD = 1.51) years. In the application group, the mean of students' cognitive skills after the intervention significantly increased by 2.33 units (95% CI: 1.73 to 2.9) (t(23) = 7.97, P < 0.001, d = 1.626). By controlling the scores before the intervention, the adjusted mean score of cognitive skills in the application group was 0.56 units (95% CI: -0.16 to 1.28) higher than the traditional group; however, this difference was not statistically significant (F(1, 45) = 2.42, P = 0.127, η2p = 0.051). There was no statistically significant difference between the mean score of students' functional skills in traditional and application groups (t(46) = 0.63, P = 0.532, d = 0.184). The total mean score of satisfaction with education in the application group was 83.0 (SD: 10.7). According to the values ​​of the quartiles, 75% of the students scored higher than 75.9, 50% scored higher than 83.9, and 25% scored higher than 91.1.

CONCLUSION

According to the results of this study, students' scores of functional and cognitive assessment and satisfaction with the application in urology clinical training were reported as favorable. Therefore, it is recommended that mobile phone-based technologies be used in students' clinical education and internships in combination with the traditional method.

Nursing Students' Attitudes Toward Technology: Multicenter Cross-Sectional Study

BACKGROUND

The growing presence of digital technologies in health care requires the health workforce to have proficiency in subjects such as informatics. This has implications in the education of nursing students, as their preparedness to use these technologies in clinical situations is something that course administrators need to consider. Thus, students' attitudes toward technology could be investigated to assess their needs regarding this proficiency.

OBJECTIVE

This study aims to investigate attitudes (enthusiasm and anxiety) toward technology among nursing students and to identify factors associated with those attitudes.

METHODS

Nursing students at 2 universities in Sweden and 1 university in Poland were invited to answer a questionnaire. Data about attitudes (anxiety and enthusiasm) toward technology, eHealth literacy, electronic device skills, and frequency of using electronic devices and sociodemographic data were collected. Descriptive statistics were used to characterize the data. The Spearman rank correlation coefficient and Mann-Whitney U test were used for statistical inferences.

RESULTS

In total, 646 students answered the questionnaire-342 (52.9%) from the Swedish sites and 304 (47.1%) from the Polish site. It was observed that the students' technology enthusiasm (techEnthusiasm) was on the higher end of the Technophilia instrument (score range 1-5): 3.83 (SD 0.90), 3.62 (SD 0.94), and 4.04 (SD 0.78) for the whole sample, Swedish students, and Polish students, respectively. Technology anxiety (techAnxiety) was on the midrange of the Technophilia instrument: 2.48 (SD 0.96), 2.37 (SD 1), and 2.60 (SD 0.89) for the whole sample, Swedish students, and Polish students, respectively. Regarding techEnthusiasm among the nursing students, a negative correlation with age was found for the Swedish sample (P<.001; ρSwedish=-0.201) who were generally older than the Polish sample, and positive correlations with the eHealth Literacy Scale score (P<.001; ρall=0.265; ρSwedish=0.190; ρPolish=0.352) and with the perceived skill in using computer devices (P<.001; ρall=0.360; ρSwedish=0.341; ρPolish=0.309) were found for the Swedish, Polish, and total samples. Regarding techAnxiety among the nursing students, a positive correlation with age was found in the Swedish sample (P<.001; ρSwedish=0.184), and negative correlations with eHealth Literacy Scale score (P<.001; ρall=-0.196; ρSwedish=-0.262; ρPolish=-0.133) and with the perceived skill in using computer devices (P<.001; ρall=-0.209; ρSwedish=-0.347; ρPolish=-0.134) were found for the Swedish, Polish, and total samples and with the semester only for the Swedish sample (P<.001; ρSwedish=-0.124). Gender differences were found regarding techAnxiety in the Swedish sample, with women exhibiting a higher mean score than men (2.451, SD 1.014 and 1.987, SD 0.854, respectively).

CONCLUSIONS

This study highlights nursing students' techEnthusiasm and techAnxiety, emphasizing correlations with various factors. With health care's increasing reliance on technology, integrating health technology-related topics into education is crucial for future professionals to address health care challenges effectively.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/14643.

Proposal of a digital tool to develop clinical reasoning of novice nurses in psychiatry: An exploratory study in France

In France, successive reforms in nursing education have resulted in a 90 % reduction in hours of theoretical instruction in clinical psychopathology since 1972. As a result, novice nurses in psychiatry feel that they have not received sufficient theoretical training at the beginning of their careers. This particularly affects their ability to search for reliable data in order to guide and orient their clinical judgment. The objective of this exploratory study is to determine if a digital tool could serve as a lever to help these novice nurses in psychiatry to improve the various phases within clinical judgment. Similar digital tools have shown promising results in other medical fields but, to our knowledge, there are no reports of such a system for nursing psychiatry in the literature. A cross-sectional quotation qualitative study was carried out by interviewing seventeen novice nurses in psychiatry with different profiles. The interview guide, based on Benner's theory and Tanner and Rabardel's models, addresses several topics: professional background and motivation, evaluation of initial training, problems identified in practice, sources of information in the field of psychiatry, and finally acceptance of digital tools. The analysis of these interviews confirms the feeling of lack of knowledge among these professionals and indicates that a digital tool would be well accepted. Several examples were identified for the content of this tool, including ways to use it during the clinical judgment process.

Effectiveness of a virtual reality application-based education programme on patient safety management for nursing students: A pre-test-post-test study

AIMS

We aimed to develop a virtual reality-based smartphone application that improves patient safety competency among nursing students in terms of knowledge, attitudes and confidence in patient safety management. We also sought to evaluate the effects and utility of the application in improving patient safety competency.

DESIGN

A parallel, randomized controlled pre- and post-test trial was conducted to test the effects of knowledge, attitudes and performance confidence in patient safety management.

METHODS

Participants were randomly allocated to the experimental (n = 22), in which nursing students received a two-week mobile web-based training programme covering key topics in patient safety management or the control group (n = 22), in which nursing students received a training booklet. Participants completed a pre-test and two post-test questionnaires to assess the program's impact. The evaluation tools were patient safety management knowledge, attitude and patient safety management performance confidence scale. Data analysis was performed using descriptive statistics, homogeneity test for pre-test, unpaired t-test and repeated measures ANOVA.

RESULTS

Patient safety competency in the experimental group improved significantly in terms of knowledge (from 11.68 to 18.55, p < 0.000), attitude (from 3.38 to 4.01; p < 0.005) and performance confidence (from 3.93 to 4.52; p < 0.000) compared with the control group. Our findings suggest that mobile app-based education using virtual reality may be effective in enhancing patient safety management in nursing education.

Supporting the nurse educator in clinical education - a qualitative evaluation of a digital educational resource DigiVIS

BACKGROUND

Despite the increased use of technology for teaching and learning in clinical nursing education, relatively little attention seems to be directed toward the usefulness of digital educational resources (DERs) to support nurse educators' educational role in clinical nursing education.

METHODS

An interpretive descriptive qualitative study design was conducted to evaluate the usefulness of a DER to support nurse educators in clinical nursing education. Data were collected through two focus group interviews with part-time and novice educators (n = 5) and full-time, more experienced educators (n = 5), after they had overseen student nurses in nursing home placements. Data were analyzed using thematic analysis and Standards for Reporting Qualitative Research guidelines were used for this study.

FINDINGS

The analysis identified three themes related to nurse educators' experiences of the usefulness of a DER to support their educational role while overseeing first-year students on clinical placements in nursing homes: (1) Provides academic support and a sense of security (2) promotes pedagogical efficacy, and (3) represents a flexible resource for educational planning.

CONCLUSION

This study shows that a digital educational resource can be an efficient and useful supplementary strategy to support the nurse educator's role in clinical nursing education. Future research is required to systematize knowledge about the impact of DERs on orientation and training, as well as motivation and facilitators for, and barriers to, their use to enhance quality and strengthen the nurse educator's role in clinical nursing education.

Mobile learning in nursing education: A bibliometric analysis and visualization

AIM

This study performed a bibliometric analysis of studies related to mobile learning in the field of nursing education.

METHODS

The Scopus database was used to determine the most frequently cited studies on mobile learning in nursing education. VOSviewer and Bibliometrix were employed for bibliometric analysis and visualization. Science mapping and performance analysis was adopted from bibliometric analysis techniques. In addition, a synthetic knowledge synthesis approach was used.

RESULTS

A total of 234 publications were published in 107 sources in 2002-2023. The publications had 8797 citations, an average of 88 citations per publication. In terms of total link strength (TLS), links, a number of articles and citations, the US led all other countries in the field. Regarding authors, Hwang was the most frequently cited authors (n = 348). According to trend topics analysis, the keywords "gamification", "simulation", "attitude", "clinical competence" and "online learning" have emerged in the field.

CONCLUSION

Research on mobile learning in nursing education has been increasing in recent years. The findings of this study can provide new ideas in the applications of mobile learning in nursing education to researchers or nursing faculties in the field.

Knowledge, Perceptions and Attitudes of eHealth and Health Technology among Nursing Students from Gauteng Province, South Africa

The use of technology in healthcare settings was identified as a crucial priority in many countries to provide quality healthcare services. eHealth or digital health technology is found to have a positive influence on improving the efficiency and quality of healthcare services. It has been proven to provide opportunities to strengthen health systems. This study aims to assess eHealth literacy, pre-existing knowledge and the nursing students' perceptions and attitudes towards eHealth. A quantitative, descriptive, cross-sectional survey was used in this study. The population of this study comprised 266 nursing students in the undergraduate programme of the Department of Nursing, among which 244 consented to participate in the study. A standardised and self-administered tool was utilised to collect data from nursing students across the four levels of study. Results showed that students in level four exhibit high scores of knowledge in the use of eLearning technology as compared to first-entry university nursing students. Nursing students used the internet frequently, especially to access social media and search for health and medical information for their study. Attitudes towards eHealth and technology were also found to be positive. The study recommends that digital literacy should be enhanced in the nursing education curriculum in other to further strengthen the knowledge and skills towards the use of eHealth and health technology among nursing students.

Exploring the Use of an Electronic Competency Assessment Document Using iPad Minis to Assess Clinical Practice Competency in a Preregistration Nursing Program: A Cross-sectional Feasibility Study

The aim of this study was to explore the feasibility of using iPad minis as a method of completing competency assessment in clinical practice. Digital technology helps to revolutionize all aspects of our lives. The use of digital technologies in clinical practice can facilitate a move toward a more flexible learning environment and enable students to adapt in a rapidly changing, interconnected world. The introduction of electronic clinical booklets in practice placements could facilitate the sharing of clinical information through connected healthcare systems, thus improving the student experience. A cross-sectional design was used in this study. A sample of BSc nursing students (n = 53) and clinically based healthcare professionals (n = 27) (preceptors and clinical placement coordinators) participated in this study. Data were collected using a modified version of Garrett and colleagues' instrument, the System Usability Scale, a demographics questionnaire, and three open-ended questions. There was a significant difference between the students and preceptors/clinical placement coordinators across all items with higher proportions of students (ranging from 66% to 75.5%), indicating that they agreed or strongly agreed with the reliability, ease of use, and effectiveness of the device in assessing their clinical competency (ranging from 11.1% to 40.7%). In addition, the iPad minis were found to be smaller, lighter, and easier to carry than paper-based booklets and encouraged students to access timely online learning resources during placement to help augment their learning. The use of iPad mini to complete the electronic competency assessment document as a replacement for a paper-based system to assess clinical practice is feasible. The introduction of electronic assessment documents should incorporate a robust training plan and standard operating procedures.

Evaluation and Comparison of Two Media-Rich Radiology Apps Regarding Pathology of the Lumbar Spine: Lessons for Medical Education App Developers and Content Creators

BACKGROUND

Mobile applications have become an increasingly popular component of medical education over the past 2 decades. Visual layout and aesthetics are important considerations in app design given Generation Z's strong preference for visually appealing digital content. In this study, we evaluate students' perceptions of an educational app related to pathology of the lumbar spine before and after a redesign of its workflow and illustrations.

OBJECTIVE, MATERIAL AND METHODS

A professional user experience and interface designer was recruited for the revision of an iOS app focused on anatomy and pathology of the lumbar spine on abdominal computed tomography (CT). Revisions focused on developing the app to make it more visually appealing, increasing ease of use, and fixing bugs. An IRB-approved study was conducted in which participants were asked to interact with the original and revised versions of the app prior to completing a survey regarding their perception of the graphics, animation style, overall app design, and content.

RESULTS

Overall impressions of the revised app were more positive than the original app, with 89% of respondents finding the revised app's graphics to be visually appealing compared to 39% regarding the original app. Further, 95% of respondents indicated that the revised app's layout was organized and user-friendly compared to 73% regarding the original. Both apps received similarly positive ratings for participants' understanding of the presented materials.

CONCLUSION

User feedback is key when designing mobile health and educational applications. Feedback may be sought via formal usability testing or app-specific surveys. The aesthetics, layout, and ease of use of mobile apps are important considerations and, in the absence of content alteration, may influence user engagement. Knowledge regarding these factors may guide content creators when developing and deploying mobile health applications.

The effectiveness of designing and evaluating i-STAR applications in pediatric nursing courses

To apply the App to the curriculum could improve students' motivation and concentration, and also strengthen the effectiveness of professional knowledge of nursing students.

OBJECTIVES

To construct and evaluate the effectiveness of smartphone applications (i-STAR) in pediatric nursing courses.

METHODS

Quasi-experimental study and two-group repeated-measure design were used to evaluate the effectiveness of smartphone applications (i-STAR) in pediatric nursing courses. The "i" means "interactive", students had to log into App and finish four steps, including "Situation(S), Task(T), Action(A), and Reflection(R). A total of 163 nursing students in the third grade of associate's degree in nursing (ADN) participated in the study. The experimental group consisted of 77 participants, whereas the control group consisted of 86 participants. The instruments included the clinical reasoning readiness scale (CRRS), self-directed learning instrument (SDLI), and learning satisfaction of students. The 1st phase was the development, construction, and testing of the "i-STAR App", including hyperbilirubinemia, pneumonia, and urinary tract infection (UTI). In the 2nd phase, students operated and applied the App in the classroom. The 3rd phase was to evaluate the effectiveness of the "i-STAR App" in the course.

RESULTS

The average scores of CRRS and SDLI were not significantly different between the two groups in the T0 andT1 (p > .05). The experimental group of CRRS and SDLI were better than the control group in T0-T1, T1-T2, and T0-T2 (p < .001). The experimental group showed better CRRS and SDLI scores than the control group in T0-T1, and T0-T2 with Repeated measures ANOVA. Also, the experimental group showed prolonged learning effectiveness. The experimental group (41.22 ± 6.08) was more satisfied than the control group (37.29 ± 7.40) (p < .05), although their academic performance was about the same (p > .05).

CONCLUSION

"i-STAR App" could enhance students' interest in pediatric nursing courses, strengthen nursing students' clinical reasoning and self-directed learning ability.

Determination of nursing students' attitudes toward and readiness for mobile learning: A cross-sectional study

BACKGROUND

Mobile learning is a learning method that enables nursing students to learn anytime and anywhere.

OBJECTIVES

This study was designed to determine nursing students' attitudes toward and readiness for mobile learning.

DESIGN

A descriptive, cross-sectional study design was used.

SETTING

The study was conducted at a nursing faculty in Turkey.

PARTICIPANTS

The sample size was determined using the stratified randomization method by considering the participants' years at school, and 290 nursing students were included in this study.

METHODS

Data were collected using the Sociodemographic Characteristics Questionnaire, Mobile Learning Attitude Scale (MLAS), and Mobile Learning Readiness Scale (MLRS) using the survey method. Statistical Package for the Social Sciences, version 25.0, was used for all data analyses.

RESULTS

The mean scores of the participating nursing students obtained from the MLAS and MLRS were 76.48 ± 9.28 and 79.64 ± 16.62, respectively. Compared to first- and second-year students, fourth-year students, those who had mobile learning experience, and those who wanted to use a mobile learning system in the future obtained higher MLAS and MLRS scores. A positive, weak correlation was found between variables, age and level of computer use, and the MLAS and MLRS scores.

CONCLUSIONS

It was determined that the attitudes of nursing students toward mobile learning were positive and they were ready for mobile learning. The results of this study can be used in designing and implementing mobile learning systems.

A Primer on the Role of iPhone Apps in Medical and Radiology Education and How to Develop Them

Among the numerous innovations implemented in medical education since the beginning of the 21st century, small-group learning experiences have worked well for modern students and the application of computer technology provided access to thousands of lectures, images, and slides via the internet. This has helped to build an electronic foundation on which further educational adaptations have arisen in the current era, coupled with the altered communications landscape represented by Apple's introduction of the iPhone and Google's subsequent entrance onto the playing field. With the advent of smartphone applications (apps), education has taken on an even more personalized approach. Data show that the use of educational apps has been embraced by today's nursing and medical students, notably including radiology students. We survey recent research on the use and desirability of medical apps and offer practical tips for those ready to embark on developing medical, particularly radiology, educational apps including how to assess and hone them for optimal use.

Experiences of first year undergraduate nursing students using Instagram in their clinical practicum during COVID-19 pandemic: A qualitative study

BACKGROUND

Social media provides us with easy access to information. For students, it is an additional learning resource used in different types of theoretical and practical teaching methodologies.

OBJECTIVES

The aim of this paper was to describe the perspective of undergraduate nursing students on the use of Instagram during their clinical practicums in the midst of the COVID-19 pandemic.

DESIGN

A qualitative descriptive and exploratory study based on an interpretative framework.

SETTINGS AND PARTICIPANTS

First-year undergraduate nursing students at the Universidad Europea de Madrid were included.

METHODS

In-depth interviews and researchers' field notes were used to collect the data. Purposive sampling and inductive thematic analysis were applied. During the interviews, themes such as accompaniment during practicums or training opportunities were identified.

RESULTS

The use of Instagram helped students to feel closer to professors, identifying it as an opportunity to remedy the possible lack of connection between theory and practice. Moreover, Instagram helped them build an image of nursing in clinical practicum environments. By using Instagram, undergraduate nursing students were able to better integrate and apply the knowledge acquired at university during their clinical practicums in hospitals.

CONCLUSIONS

Our results can be applied to future studies on the use of social media platforms as teaching tools in clinical practicum settings and to observe the evolution of the image and role of nursing and its relationship with social media.

Effectiveness of an E-Book App on the Knowledge, Attitudes and Confidence of Nurses to Prevent and Care for Pressure Injury

AIMS

This study evaluates the effectiveness of an interactive E-book app training program in improving nurses' knowledge, attitudes, and confidence to prevent and care for pressure injury.

DESIGN

Randomized experimental study.

METHODS

Participants were recruited from a teaching hospital in Taiwan. The study was carried out between 20 March 2014 to 1 April 2016. In total, 164 participants were randomly assigned to a pressure injury E-book app training program (n = 86) or a conventional education program (n = 78) with a one-month follow-up. Outcome variables were levels of pressure injury knowledge, attitudes, and confidence of pressure injury care.

RESULTS

Participants answered 51.96% of the pressure injury knowledge questions correctly before the intervention and 75.5% after the intervention. The pressure injury attitude score was slightly positive, with moderate confidence in pressure injury care. The knowledge, attitudes, and confidence of pressure injury care of the two groups in the pretest and posttest groups increased significantly. Analysis of covariance indicated that nurses in the pressure injury E-book app group had significantly greater improvement in knowledge, attitudes, and pressure injury care confidence as compared with the control group.

CONCLUSION

The pressure injury E-book app interactive training program was effective in improving nurses' knowledge and attitudes toward pressure injury care and in enhancing their confidence in pressure injury care; therefore, this program has potential for nurses' in-service education in both Taiwan and worldwide.

IMPACT

E-book apps allow individuals to control the time and place of learning. Direct observation of procedural skills can provide feedback to trainees on techniques to ensure learning effectiveness and pressure injury care quality.

Use of Digital Technology as a Collaborative Tool among Nursing Students-Survey Study and Validation

BACKGROUND

This research aimed to develop a questionnaire to analyze perceived aspects of using digital technology among nursing students as a collaborative tool. We further sought to evaluate the psychometric reliability of the instrument.

METHODS

A cross-sectional observational study was performed using a questionnaire developed from scratch. Psychometric studies and univariate and bivariate analyses were performed.

RESULTS

132 nursing students participated. The exploratory and confirmatory analyses of the questionnaire excluded 4 of the initial 18 items and established four domains, and internal consistency was found. The mean global score of the answers to the questionnaire was 4.67 on a scale of 1-5 points, and all the domains obtained high scores. Men scored higher on the usefulness and the global score, while no differences were found regarding age.

CONCLUSIONS

Nursing students positively assess the use of digital technology as a collaborative tool, regardless of age. Digital technology as a collaborative tool is perceived as beneficial, improves their involvement, and allows nursing students to obtain a better knowledge of their partners. These findings can help develop group projects and tools based on technology to train future nursing professionals. The questionnaire developed is a valid tool to assess this.

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.

Effectiveness of e-STORY App in clinical reasoning competency and self-directed learning among students in associate nursing program: A quasi experimental study

AIM

The purpose of this study was to promote students' clinical reasoning (CR) and self-directed learning (SDL). The specific aims were: (1) to examine effectiveness of the e-STORY App in promoting nursing students' CR and SDL; and (2) to explore the relationships between levels of learning motivation and suitability of the e-STORY App.

BACKGROUND

CR and SDL are core competencies for nursing students. However, new graduates tend to be in adequately prepared in these competencies. Humanoid diagram uses diagrams to guide students in gaining a comprehensive view of the patient issues, which may promote attainment of these competencies. The Z generation students favor learning through smart devices for the feature of no time and spatial limitations. The e-STORY App was developed to overcome the setbacks of creating hard-copy drawings to promote learning effectiveness.

DESIGN

This quasi-experimental study used two-group repeated measure design with a convenience sample.

METHODS

A total of 77 students from two sections of the "Seminar for Clinical Case Studies" course participated in the study (experimental group: 39 students; control group: 38 students). Data were collected before, one week after and four weeks after the teaching intervention. The instruments used were demographic information sheet, Huang et al.'s (in press) Clinical reasoning scale and Cheng et al. (2010) Self-directed learning instrument.

RESULTS

There were no significant differences in the CR and SDL scores between the experimental and control groups one week after the intervention (p＞.05). Analyses of the delay effects four weeks after the intervention found significantly higher CR scores in the experimental group than the control group (p < .05). However, there were no significant differences in the SDL scores between groups (p＞.05). Analysis of the findings from the experimental group found that students with moderate and low learning motivation showed significantly higher CR scores on the posttest and follow-up test (p < .05).

CONCLUSIONS

Application of the e-STORY App as a supplementary teaching strategy promoted nursing students' CR ability, especially in students with moderate or low learning motivation. It is recommended to use the App in students with moderate or low learning motivation to promote learning effectiveness.

The effect of a virtual simulation-based educational application on nursing students' belief and self-efficacy in communicating with patients about complementary and alternative medicine

BACKGROUND

Simulation-based learning that focuses on the development and assessment of communication and counseling skills can help nursing students achieve better skill performance and gain self-confidence with decision-making ability. It is unknown whether virtual simulation as an instructional design significantly improves educational outcomes than a traditional lecture with low-fidelity simulation in students.

OBJECTIVES

The aim was to explore the effect of a virtual simulation-based educational smartphone application on nursing students' beliefs and self-efficacy in communicating with patients about complementary and alternative medicine (CAM) use.

DESIGN

A quasi-experimental study with pretest-posttest nonequivalent control group design.

SETTINGS AND PARTICIPANTS

A total of 101 nursing students, who were in their second or third-year nursing program at a Southern Taiwan university volunteered to participate in the academic year 2020-2021. Participants were assigned to an experimental or control group in an elective course.

METHODS

All participants received a 4-hour lecture that included an in-class lecture with low-fidelity simulation (paper-based scenarios) about the risk-benefit assessment of a patient's CAM use. The experimental group received a series of 13 virtual simulation exercises with clinical scenarios by means of a smartphone application. Data from belief and self-efficacy scales were collected at the beginning and end of the course from September 2020 to February 2021. Descriptive and inferential statistics were analyzed using the IBM® SPSS® version 23.0.

RESULTS

Although both groups significantly improved their belief and self-efficacy scale scores, the experimental group had significant differences in overall self-efficacy in communicating with patients about CAM use compared with the control group, specifically the CAM perceptions and self-confidence scores.

CONCLUSIONS

Although both in-class and virtual simulation improved nursing students' belief and self-efficacy, the virtual simulation-based educational app is effective as an adjunct learning tool in significantly increasing nursing students' self-efficacy in communicating with patients about CAM use to help minimize their risks.

Nursing students' motivational and self-regulated learning during the COVID-19 pandemic: A cross-sectional study

On‐site clinical training, which has been greatly hindered during the COVID‐19 pandemic, is essential in nursing practicum. This study aimed to identify the predictors of nursing students' motivational and self‐regulated learning in clinical nursing practicum during the pandemic. This cross‐sectional study aimed to identify the predictors of motivational and self‐regulated learning among nursing students in clinical nursing practicum during the COVID‐19 pandemic. An online survey was completed by 195 nursing students in Korea in 2021. Students' moral sensitivity and motivational and self‐regulated learning were assessed using the Moral Sensitivity Questionnaire and the Motivated Strategies for Learning Questionnaire. Multiple regression analysis revealed that moral sensitivity was the most potent predictor of motivational and self‐regulated learning, followed by online clinical practicum experience, determination to become a nurse, and online practicum type; these factors explained 21.0% of the variance. Practicum courses using a tailored hybrid model, combining online and in‐person approaches for imparting nursing practices and inspiring moral sensitivity, can enhance nursing students' motivational and self‐regulated learning. Modules to enhance nursing students' moral sensitivity should be included in online practicum curricula.

Technology usage for teaching and learning in nursing education: An integrative review

Background

The increasing availability of technology devices or portable digital assistant devices continues to change the teaching-learning landscape, including technology-supported learning. Portable digital assistants and technology usage have become an integral part of teaching and learning nowadays. Cloud computing, which includes YouTube, Google Apps, Dropbox and Twitter, has become the reality of today’s teaching and learning and has noticeably improved higher education, including nursing education.

Objectives

The aim of this integrative literature review was to explore and describe technology usage for teaching and learning in nursing education.

Method

A five-step integrative review framework by Whittemore and Knafl was used to attain the objective of this study. The authors searched for both empirical and non-empirical articles from EBSCOhost (health information source and health science), ScienceDirect and African Journals Online Library databases to establish what is already known about the keywords. Key terms included in literature search were coronavirus disease 2019 (COVID-19), digital learning, online learning, nursing, teaching and learning, and technology use.

Results

Nineteen articles were selected for analysis. The themes that emerged from this review were (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19.

Conclusion

Technology in nursing education is used in both clinical and classroom teaching to complement learning. However, there is still a gap in its acceptance despite its upward trend.

Contribution

The findings of this study contribute to the body of knowledge on the phenomenon of technology use for teaching and learning in nursing education.

Improving Active Collaborative Clinical Learning Through a Mobile Application for Undergraduate Nursing Students

Innovative teaching and learning strategies in pediatric clinical education are needed to ensure that learning outcomes are achieved efficiently and to improve students' satisfaction with the learning process. We developed a mobile application to enhance the clinical learning of nursing students during pediatric clinical practice and explored the participants' perceptions of the learning method. A mixed-method design and an online survey were used to assess participants' perceived achievement of learning objectives and satisfaction with the clinical practicum. Focus groups explored the participants' experience of using the application. The overall achievement of learning outcomes was 4.1 out of 5, and participants reported high satisfaction with the clinical practicum using the mobile application. Qualitative analysis of the transcripts revealed four major themes: (1) facilitation of collaborative learning through real-time interactions and communication; (2) engagement in active learning through an application; (3) a useful tool for enhancing critical thinking; and (4) the "curate's egg" nature of the application. The mobile application can be incorporated into the clinical education of nursing students to promote self-regulated learning and collaboration with faculty. Clear guidance on how to use the application in a clinical environment should be provided to students and preceptors to achieve better learning outcomes.

Assessing Repurchase Intention of Learning Apps during COVID-19

Learning apps are becoming increasingly popular, and consumers have widely recognized their benefits, particularly during COVID-19 and the resultant lockdowns. However, despite the growing popularity of learning apps, little is known about the consumer values that impact repurchase intent. Learning apps must increase client engagement by providing stronger value propositions to overcome this hurdle. The current study proposes the consumption values theory to find this gap, better explaining customer behavior toward learning apps. Data from 429 learning app users are used to test the suggested model. According to the research, all consumption values have a favorable and significant impact on the intention to repurchase learning apps. In addition, the moderating effect of Visibility on intent to use and trust’s mediating role are confirmed. The study’s findings add to our knowledge of consumer behavior and practice.

Digital professionalism on social media: The opinions of undergraduate nursing students

BACKGROUND

Social media are a suite of popular online technologies that enable people to share and co-create digital content. Evidence suggests some nursing students utilise social media inappropriately but there is limited literature on nursing students' opinions of professionalism in online environments. This study aimed to examine the opinions of nursing students in relation to digital professionalism on social media.

METHOD

A descriptive, cross-sectional study was conducted with undergraduate nursing students in the United Kingdom (n = 112). An existing self-reported questionnaire was adapted for data collection. This was distributed to adult nursing students enrolled across all four years of a Bachelor of Nursing programme. Data were analysed using descriptive statistics.

FINDINGS

Many nursing students were heavy social media users (n = 49, 44%), with Facebook, Instagram, and Snapchat being the most popular applications. Nursing students were also aware of the professional nursing regulator, the Nursing and Midwifery Council, guidelines on responsible social media use (n = 48, 43%). Nursing students' responses to various digitally professional scenarios revealed agreement that posts about alcohol or sexually explicit content, along with comments about colleagues or patients were inappropriate. However, there were mixed views around taking photographs at work, with some nursing students across all four years of the degree programme perceiving this to be satisfactory behaviour.

DISCUSSION

The opinions of nursing students towards digital professionalism on social media are somewhat aligned with professional standards, although students can hold varying views on the subject. More research on how nursing students employ social media is warranted to ensure their opinions match their actual practice in online environments. It is also recommended to educate nursing students about the professional values and behaviours required on social media and how best to communicate, interact, and share information on the various online platforms, to minimise personal and organisational risk.

Determinant factors in adopting mobile health application in healthcare by nurses

Background

Mobile applications are among effective learning tools and have a significant role in transferring information and knowledge to nurses. The current study was carried to identify the factors affecting nurses’ use of practical health related mobile applications in education and patient interaction based on the combined Technology Acceptance Model (TAM) and Diffusion of Innovation (DOI).

Method

The study is a descriptive-analytical study with a cross-sectional method. The research population includes nurses working at Tabriz University of Medical Sciences hospitals, 150 of which were selected as the research sample using simple and available sampling. The data collection instrument was a questionnaire, the validity and reliability of which were confirmed (α = 0.9). Data analysis was carried out using a correlation test and regression analysis by applying SPSS _v16 software.

Results

The findings show that perceived usefulness and perceived ease of use have a direct and significant effect on the rate of using mobile applications by nurses (P value ≤ 0.01), [(β = 0.52), (β = 0.40)]. Other findings indicate that relative advantage, compatibility, trialability and observability, have a direct and significant effect on nurses’ use of mobile applications, while complicatedness does not have a significant effect.

Conclusion

The current study identifies the effective factors in nurses’ use of health-related mobile applications based on an integrated model of TAM and DOI. Designers of mobile applications should consider these factors in designing and developing programs so that mobile applications can successfully fulfill their purpose in healthcare.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01784-y.

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: A Mixed Methods Systematic Review (Preprint)

Background

Objective

Methods

Results

Conclusions

International Registered Report Identifier (IRRID)

Designing and Piloting of a Mobile Learning Curriculum for Quality Point-Of-Care Diagnostics Services in Rural Clinics of KwaZulu-Natal, South Africa

Background

The use of mobile technology has been reported to help improve access to education for people in remote areas. However, there is limited evidence of its adoption in resource-limited settings. The aim of this study was to utilize stakeholder generated ideas to design and pilot a mobile learning curriculum, with the purpose of facilitating training to improve the quality of point-of-care diagnostics services in KwaZulu-Natal (KZN) rural clinics.

Methods

Nominal Group Technique was employed to enable collaboration with stakeholders in designing and piloting of a POC diagnostics curriculum. Stakeholders were selected from 11 KZN districts to participate in a clinic-based piloting of the curriculum using an online application. The application was designed in collaboration with a teacher training institute in Durban. Moodle was used as an established reliable online learning management system. During piloting, quantitative and qualitative data were generated and analyzed using descriptive statistics and content analysis.

Findings and Conclusion

Guided by the Nominal Group Technique results, five delivery modes for curriculum content through Mobile Learning were generated. An interactive course page was created on the Moodle site, titled: Quality HIV Point of Care Diagnostics Curriculum Delivery for Nurses in Rural Areas. The course content consisted of three teaching units, activities, an online quiz and an online survey. An analytic-algorithm built into the online course enabled monitoring of participation and assessment outcomes automatically. At piloting, 64% of the invited representative clinics were able to access the course, with 47% meeting the course completion requirements. All the participants achieved the set pass mark of 75% with an average of 87%. The activity completion report showed that topics presented through images, videos and simple text were accessed more than those presented as attachments of national documents. Despite poor network coverage and limited access to mobile technology, exacerbated by Covid-19 related restrictions, Point of care diagnostics Mobile Learning curriculum was well-received in participating rural clinics. Recommendations relating to course improvement and access, included extending collaboration with specialists in eHealth systems development and with South African cell phone network providers.

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

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

The impact of a multilevel interactive nursing quality control and audit application on nursing quality management

Background

This study aims to investigate the effects of a nursing quality control and audit application (app) on the autonomous learning of nursing staff and nursing quality management by nursing supervisors. A multilevel interactive app is developed to assist nursing staff in conducting online autonomous learning and nursing supervisors in identifying problems and creating nursing quality improvement plans. The app could also present the different evaluation results of wards in visual charts for supervisors to review.

Methods

A single-group pre- and post-test design was applied. Data were collected from 131 nurses between October 2019 and October 2020 to analyze the differences between nursing staffs’ willingness to engage in autonomous learning and the integrity of nursing quality improvement plan writing before and after the intervention. The structured questionnaires included open-ended questions that cover aspects of nursing quality control, the audit app, and the information acceptance intention of nurses.

Results

The participants’ age and job title are negatively correlated with the app’s usability, while the ability to use 3C (Computer, Communication, and Consumer Electronics products including mobile phones and laptops) equipment is positively correlated with the willingness to use the app. Nurses’ satisfaction with the convenience of the online autonomous learning method is 92%, which indicates that the app could improve their willingness to learn. Following the intervention of the app, nursing supervisors’ satisfaction with the integrity of nursing quality improvement plan writing increased from 41 to 88%.

Conclusions

Using information technology products to assist in nursing quality management in clinical practice has a significant effect on nurses’ load reduction and head nurses’ satisfaction. Multilevel interactive nursing quality control and audit apps can improve nursing staff’s willingness to learn independently, nursing quality, and the integrity of plan writing. Thus, nursing quality control and audit apps can be considered as suitable nursing quality control tools.

Using an educational mobile application to teach students to take vital signs

BACKGROUND

The utilization of smartphone applications in educational settings, specifically in the field of nursing, has grown increasingly popular. To date, there have been few, if any, smartphone applications dedicated specifically to the teaching of vital signs. The Clinic Vitals app was designed to be an acceptable substitute for in-person vital signs instruction.

OBJECTIVES

The objective of this study was to show the utility of the Clinic Vitals app as a pedagogical tool in comparison to in-person nursing educational instruction.

DESIGN

A crossover design was employed within collegiate nursing educational sessions to determine if Clinic Vitals was an equivalent alternative to traditional vital sign teaching methods.

PARTICIPANTS

Participants were first-year nursing students from six different lab sessions within the same undergraduate university.

METHODS

Students with little to no vital sign experience were given instruction via the Clinic Vitals mobile application or traditional learning. After the learning session, students were given skills assessments. After one week, students were given the opposite method of instruction followed by skills assessments.

RESULTS

Results showed that no significant difference was found between the two groups based on skills assessments. Mobile application and in-person instruction teaching methods produced a similar level of competency in students learning to take vital signs.

CONCLUSIONS

The utility of being able to access the application's videos and instructional articles at any time and anywhere that there is an internet connection would make the app particularly useful. The present study provides evidence that the Clinic Vitals mobile application can be a reliable substitute for in-person vital signs instruction. Recent educational advances have demonstrated that online videos, simulations, and mobile applications can be effective resources for nursing educators. There is potential for further study of the uses of educational mobile applications, including Clinic Vitals, for nursing education.

Leveraging e-Learning technology to enhance pre-service training for healthcare trainees in Ghana: evidence from a pilot project and pointers to policy reforms

BACKGROUND

E-Learning solutions are increasingly being advocated to augment existing traditional teaching and learning efforts in health training institutions. Unfortunately, these emerging technologies rarely focus on health sciences education within the context of public universities, hence the need for this study. This project evaluated experiences of healthcare trainees with a pilot e-Learning project (SMART e-Learning project) initiated in one of Ghana's public universities in 2017. The study used a mixed methods cross-sectional approach among 363 healthcare trainees. Data collection was between 17th October, 2019 to 3rd December, 2019. Data was analysed descriptively and test for variable differences done using Pearson Chi-square and Fisher's Exact for categorical variables. Wilcoxon Mann-Whitney test was used to test for differences in the Likert scale items. Additionally, rotated varimax factor analysis was performed for the health trainees' rated satisfaction factors.

RESULTS

Out of 446 respondents who consented to participate in the study, 363 responses were complete and valid, representing a response rate of 81 %. Most frequently used e-learning facilities by healthcare trainees were: writing interim assessments (IAs) (82 %) while the least used function was live chating with faculty (5 %). Challenges associated with the e-learning pilot project were: limited workspace in the pilot computer laboratory (33 %), slow internet/intranet speed (29 %) and limited capacity of teaching and ICT staff to support users (28 %).

CONCLUSIONS

There is the need to engage relevant stakeholders at the University, ministries of health and education through policy dialogues to develop statutory e-Learning guidelines for health educational institutions of higher learning to complement existing traditional teaching and learning approaches.

Nursing students' attitudes toward mobile learning: An integrative review

Purpose

This study aimed to explore whether the attitudes of nursing students toward the use of mobile learning are positive or negative and to identify the factors influencing their attitudes by reviewing the literature.

Methods

Electronic search of six databases, including PubMed, the Cumulative Index of Nursing and Allied Health Literature, ProQuest, Web of Science, EMBASE, and Cochrane Library, was conducted, and relevant references within articles were manually searched. Retrieval time was from inception to October 21, 2020. The literature review was conducted in accordance with the PRISMA guidelines and the integrative review method. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment.

Results

A total of 316 articles were identified, and 18 English-language studies were finally included by reviewing titles, abstracts, and full text. Six quantitative, five qualitative, and seven mixed-method articles related to nursing students’ attitudes toward the use of mobile learning were identified. The results showed that most nursing students had positive attitudes toward mobile learning. Although students expressed strong intentions for mobile learning, the actual usage rate in practical settings was low. Several advantageous factors included usefulness, convenience, and ease of use, whereas disadvantageous factors included hardware facility, updated content, and software stability.

Conclusion

Most nursing students have positive attitudes and willingness to mobile learning, but the actual use rate remains low. Advantageous and disadvantageous factors coexist. Further studies are needed to assess how mobile learning improves nursing students’ clinical knowledge and improves patient care.

Joining the workforce during the COVID-19 pandemic: views of Allied Health Profession students

In the United Kingdom, the onset of the COVID-19 pandemic placed great pressures on universities to ensure final year health care students completed their studies earlier than planned in order to join the National Health Service workforce. This study aimed to explore the anticipations and support needs of final year allied health profession students transitioning to practice during a pandemic. Final year university students across seven healthcare professions were asked to complete an online survey. Demographic data were analyzed by descriptive statistics and responses to open questions were explored using content analysis. Sixty participants completed the survey. Content analysis regarding students' anticipations, fears, and support needs identified the following themes: professional identity and growth; opportunities for improvement; preparedness for transition from university to the workplace, the workplace environment; COVID-19; support from lecturers; daily support within the workplace and innovative methods of support. Although the transition from student to practitioner continues to be a stressful period, only a minority of participants reported COVID-19 as an explicit stressor. However, as the effects of COVID-19 continue to evolve in the United Kingdom, universities and healthcare trusts must ensure adequate supports are in place for recent graduates navigating this transition during a healthcare crisis.

Personalized and Self-Management: Systematic Search and Evaluation Quality Factors and User Preference of Drug Reference Apps in Taiwan

Background: Drug reference apps promote self-management and improve the efficiency and quality of work for physicians, nurses, pharmacists, and patients. This study aimed to describe a systematic and stepwise process to identify drug reference apps in Taiwan, assess the quality of these apps, and analyze the influential factors for user ratings. Methods: A two-step algorithm (KESS) consisting of keyword growing and systematic search was proposed. Seven independent reviewers were trained to evaluate these apps using Mobile App Rating Scale (MARS). A logistic regression model was fitted and average marginal effects (AME) were calculated to identify the effects of factors for higher user ratings. Results: A total of 23 drug reference apps in Taiwan were identified and analyzed. Generally, these drug reference apps were evaluated as acceptable quality with an average MARS score of 3.23. Higher user engagement, more functionality, better aesthetics, and more information associated with higher user ratings. Navigation is the most influential factor on higher user ratings (AME: 13.15%) followed by performance (AME: 11.03%), visual appeal (AME: 10.87%), credibility (AME: 10.67%), and quantity of information (AME: 10.42%). Conclusions: User experience and information clearly affect user ratings of drug reference apps. Five key factors should be considered when designing drug reference apps.

Is there a relationship between nursing students' smartphone use, their fear of missing out and their care-related behaviour?

AIM

This study aims to determine the relationship between smartphone use among intern nursing students, fear of missing out and their care-related behaviour.

BACKGROUND

Today, smartphone use is common and fear of missing out is a prominent issue in our society; this behaviour and issue are linked and may lead to adverse consequences.

DESIGN

The study is conducted as a cross-sectional design.

METHODS

The target population in this research consists of senior nursing students (n = 101). There was no sampling selection and the study was completed with 97 students who agreed to participate in the research. Data were collected with introductory questionnaire forms, the Smartphone Addiction Scale (SAS), the Fear of Missing Out Scale (FoMOs) and the Caring Assessment Questionnaire (Care-Q). The valid and reliable SAS, FoMOs and Care-Q were transformed into online forms and the link was distributed to the participants via online Google forms.

RESULTS

Based on the results of the study, the mean scores were 83.30 ± 2.21 of SAS, 21.56 ± 6.42 for FOMOs and 5.54 ± 0.87 for Care-Q scale. There were statistically significant differences between gender and Care-Q score and between the duration of smartphone use, daily smartphone usage time and SAS score (p < 0.05). There was a weak positive relationship between SAS and FoMOs scale scores, along with a weak negative relationship between the accessibility and comfort sub-dimensions of the SAS and Care-Q scale. Also, the SAS score explains 0.4% of the comfort subscale of the Care-Q scale (p < 0.05).

CONCLUSIONS

Further research focusing on nursing students is recommended to identify potential adverse effects created by the use of smartphones and the fear of missing out. In addition, educators are recommended to develop guidelines and prepare new policies for smartphone use to minimise the potential negative effects of smartphone use and fear of missing out on student care behaviour.

The effectiveness of the iLearning application on chest tube care education in nursing students

BACKGROUND

Tube dislodgment has been ranked as the top three medical accidents for five years consecutively in Taiwan. Chest tube care accidents affect patient's health and life significantly. Typically, education on chest tube care focuses on the knowledge transmission with limited guiding nursing students in learning clinical reasoning. The Generation Z students prefer mobile devices. It is crucial to incorporate mobile applications to learning.

PURPOSE

The purpose of this study was to evaluate effectiveness of the teaching intervention program ("iLearning app for chest tube care") in improving nursing students' clinical reasoning ability and self-directed learning.

METHOD

A quasi-experimental study with a cluster sample was used. A total of 107 nursing students were recruited with the intervention group (n = 53) using the "iLearning app" to learn chest tube care, and the comparison group (n = 54) using the "traditional teaching". Data were collected before the intervention, one week and one month after the intervention.

RESULT

The result showed that there was no difference in clinical reasoning and self-directed learning between groups before the intervention. However, the intervention group showed significantly higher clinical reasoning and self-directed learning scores than the comparison group (p < .05) one week and one month after the intervention. It indicated that the students' clinical reasoning abilities and self-directed learning improved with implementation of the intervention.

CONCLUSION

The results indicated that the "iLearning app" intervention improved the clinical reasoning and self-directed learning in nursing students. This intervention used situated learning with concept mapping to guide student learning and demonstrated effectiveness in improving their clinical reasoning ability. Immediate feedback of the course instructor might trigger deeper learning and self-correction of clinical reasoning. The "iLearning app" could be used as a tool to improve students' clinical reasoning and self-directed learning, and thus enhance lifelong learning.

Exploring Factors of Mobile Device Adoption in Nursing Education

The world has seen an explosion in mobile device technology over the past decade, in addition to the impact that COVID-19 has placed on nursing education programs. More specifically, mobile devices have afforded users with endless possibilities. This upsurge in mobile technology has altered the way people use and interact with their device. One such example is how these devices are being utilized for the purposes of learning due to social distancing guidelines. Thus, it becomes important to explore and understand those factors that will influence the use of mobile devices for learning. The purpose of this study was to explore variables that might influence the adoption of mobile devices among nursing faculty. The Unified Theory of Acceptance and Use of Technology served as the theoretical basis for this study and guiding framework. An exploratory quantitative survey research design was utilized to explore specific variables and their impact on mobile device adoption among participants. It was found that 85%, six of the seven research variables were statistically significant predictors of mobile device adoption. Mobile devices have the potential to leverage a wealth of resources for both users and faculty. Therefore, recommendations for developing increased use of mobile device technology for teaching and learning will be suggested.

The effects of a virtual simulation-based, mobile technology application on nursing students' learning achievement and cognitive load: Randomized controlled trial

BACKGROUND

The use of virtual simulation methods in nursing education offers potential advantages for students to experience and learn in a safe and realistic environment by acquiring skills and attitudes to prepare for clinical experiences.

OBJECTIVE

The study's aim was to test the hypothesis that nursing students who used a mobile learning app would have significantly (1) higher levels of knowledge about medication administration and nasotracheal suctioning, (2) better development of skill performances on medication administration and nasotracheal suctioning, (3) higher satisfaction, and (4) lower cognitive load than a control group.

DESIGN

A randomized experimental study with pretest and posttest design.

SETTINGS AND PARTICIPANTS

One hundred nursing students were randomly assigned to an experimental or control group at a Southern Taiwan university's school of nursing.

METHODS

The experimental group received the virtual simulation-based mobile learning app and the control group used traditional paper materials. Participants were assessed on knowledge before and after the intervention. Skill performance and intrinsic and extraneous cognitive load were measured after the intervention.

RESULTS

The experimental group who used the mobile app had significantly higher knowledge scores, significantly lower intrinsic and extraneous cognitive load, better skill performance, and higher satisfaction than the control group.

CONCLUSIONS

The implementation of a mobile app for simulation learning had a positive impact on nursing students' knowledge and skill performances as well as the reduction of learning cognitive loading. Nurse educators and researchers should collaborate in developing virtual learning resources to support clinical nursing education. Tweetable abstract: The mobile app for learning achieved higher knowledge and satisfaction scores, demonstrated better skill performance without increasing cognitive load.

Undergraduate nursing students' experience of learning respiratory system assessment using flipped classroom: A mixed methods study

BACKGROUND

Knowledge and skill acquisition to perform an accurate respiratory system assessment is a key competency expected in undergraduate nursing students. Learning physical assessment requires the integration of multiple knowledge bases and skills; hence, applying an innovative teaching approach, such as the flipped-classroom (FC) approach, fosters an active and student-centered learning environment for physical assessment class.

OBJECTIVES

This study evaluated FC's feasibility in delivering respiratory system assessment content in a health assessment course and explored the changes in nursing students' perceptions regarding student-centeredness and active learning environments before and after applying FC.

DESIGN

A single group pre- and post-test concurrent mixed-methods design was used.

SETTINGS

This study was conducted in a private nursing college in South Korea.

PARTICIPANTS

A convenience sample of 91 second year undergraduate nursing students enrolled in a health assessment course.

METHODS

FC was offered at one didactic session of a physical assessment course. In the FC, students completed a self-directed pre-class activities using online lecture videos and reading materials prior to the class and participated in interactive team-based learning activities inside the classroom. Skills lab practicum took place after the FC. Students' perceptions regarding student-centeredness and active learning environments, in terms of teaching, social, and cognitive presences were measured before (T1) and after (T2) conducting the FC. Qualitative data were obtained at T2 using free-response questions, which required students to comment on their FC experience.

RESULTS

Participants' perceptions of student-centeredness significantly increased from T1 to T2. Although student-perceived teaching and social presence in their learning environment showed upward trends from T1 to T2, these changes were not statistically significant. Students considered FC an acceptable approach to foster active learning in a supportive learning environment.

CONCLUSIONS

This study revealed that incorporating FC to deliver respiratory system assessment content was feasible and considered acceptable by undergraduate nursing students.

Effects of mobile learning for nursing students in clinical education: A meta-analysis

The objective of this meta-analysis was to assess the effects of mobile learning for nursing students in clinical nursing education. Five electronic databases including PubMed, CINAHL, EMBASE, the Cochrane library and Web of Science were searched for English language articles published on or before February 10, 2020. Two reviewers retrieved articles, evaluated quality and extracted data independently. Review Manager (RevMan) version 5.3 software was used to perform meta-analysis. A total of 9 studies including 580 nursing students receiving clinical nursing education met the inclusion criteria. The mobile learning intervention led to significant improvements in nursing students' skills (SMD = 1.22, 95% CI [0.29, 2.14], P = 0.009), knowledge (SMD = 0.43, 95% CI [0.11, 0.76], P = 0.009), satisfaction (SMD = 0.31, 95% CI [0.05, 0.56], P = 0.020), and confidence (SMD = 0.4, 95% CI [0.16, 0.63], P < 0.001) compared with the control group. Due to differences in experimental design among studies and limited data availability, we cautiously conclude that mobile learning has a beneficial effect on clinical nursing education for nursing students compared with conventional methods.

Effects of a mobile phone application for graduate nurses to improve central venous catheter care: A randomized controlled trial

AIM

To develop and test a mobile phone application (app) for graduate nurses on the use and care of central venous catheters.

DESIGN

A randomized controlled trial was conducted at a teaching hospital in the central east coast of Taiwan.

METHODS

Recruitment occurred from 1 August 2019 -31 October 2019. All graduates (N = 90) attending a 2-week induction program attended a lecture and completed a 10-item questionnaire on central venous catheter assessment and care at the end of Week 1 (Time 1). Volunteers were then randomly allocated to receive a link to the learning app on their mobile phone (n = 39 Group A) or control condition (N = 40 Group B). One week later, all graduates completed the knowledge assessment (Time 2) and a simulated clinical assessment with a mannequin. Skills were assessed using an 11-item, direct observation of procedural skills form. Only data from consenting participants were analysed.

RESULTS

Compared with controls, nurses receiving the intervention reported significantly better knowledge (t = -7.98, p < .001, CI = 20.9~34.8) and skill scores (t = 2.83, p = .006, CI = 1.14~6.61). More frequent use of the mobile phone app was associated with higher knowledge (r = 0.39, p = .02, CI = 0.11~0.99) and skills (r = 0.42, p = .008, CI = 0.17~1.03).

CONCLUSION

Mobile app instruction for graduate nurses on central venous catheter care increased specific knowledge and skills compared with conventional methods of instruction.

IMPACT STATEMENT

Implementation of mobile phone application technology can be considered a feasible means to proactively provide training and education. Mobile phone apps could be developed for a range of clinical procedures and various settings. Future studies with a larger sample and a longitudinal follow-up are warranted to confirm results.

Configuration of Mobile Learning Tools to Support Basic Physical Assessment in Nursing Education: Longitudinal Participatory Design Approach

Background

As many students in higher education are skilled users of mobile technology, mobile learning (mLearning) can be a promising educational strategy to enhance their learning experience. mLearning might also be well suited for nursing students as they navigate between multiple learning contexts in their educational curriculum. As an educational strategy, mLearning may also reduce challenges caused by the theory-practice gap in nursing by supporting skills and knowledge transfer between the university and clinical settings. As the introduction of basic physical assessment skills (B-PASs) into Norwegian bachelor’s degree education in nursing occurred quite recently, there is a lack of competence in supervision and teaching in both university and clinical settings. As such, mLearning appears to be a good strategy to support student B-PAS learning and knowledge transfer across learning contexts.

Objective

This study aims to explore and elicit the perspectives of students regarding the way in which a selection of digital learning resources supports B-PAS learning and application in clinical rotation, which of the selected digital learning resources are beneficial to include in a suite of mLearning tools, and how the selected digital learning resources could support the transfer of skills and knowledge from the academic to clinical context.

Methods

We used a longitudinal participatory design approach to co-design a suite of mLearning tools. The co-design processes took place in several workshops (WSs) over a period of 3 months: 2 WSs with first-year students (n=6), 3 WSs with second-year students (n=6), and 3 WSs with third-year students (n=8). The students evaluated several digital learning resources in both academic and clinical contexts. The digital learning resources included digital simulation with virtual patients, massive open online courses, and multimedia learning material. In the co-design WS, the potential and benefits of these digital learning resources for the learning and application of B-PASs were explored.

Results

The students reported that the digital learning resources stimulated learning in 7 different ways. They also emphasized the importance of including all selected and tested digital learning resources. Moreover, students supported the inclusion of additional learning material, such as multiple-choice tests and written assignments, aimed at providing feedback and contributing to knowledge development.

Conclusions

The co-design processes and collaboration with the nursing students provided insight into how a suite of mLearning tools may support the learning and application of B-PASs and human bioscience knowledge in clinical rotation. From the students’ perspective, one of the strengths of the suite of mLearning tools was the range of content, as this met a broader range of student learning preferences regarding learning B-PASs. The suite of mLearning tools contributes to and supports skills training and knowledge transfer between multiple learning contexts.