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

Digital Educational Tools for Undergraduate Nursing Education: A Review of Serious Games, Gamified Applications and Non-Gamified Virtual Reality Simulations/Tools for Nursing Students

Educational technology has advanced tremendously in recent years, with several major developments becoming available in healthcare professionals’ education, including nursing. Furthermore, the COVID-19 pandemic resulted in obligatory physical distancing, which forced an accelerated digital transformation of teaching tools. This review aimed to summarize all the available digital tools for nursing undergraduate education developed from 2019 to 2023. A robust search algorithm was implemented in the Scopus database, resulting in 1592 publications. Overall, 266 relevant studies were identified enrolling more than 22,500 undergraduate nursing students. Upon excluding multiple publications on the same digital tool, studies were categorized into three broad groups: serious games (28.0%), gamified applications (34.5%), and VR simulations and other non-gamified digital interventions (37.5%). Digital tools’ learning activity type (categories = 8), geographical distribution (countries = 34), educational subjects (themes = 12), and inclusion within a curriculum course (n = 108), were also explored. Findings indicate that digital educational tools are an emerging field identified as a potential pedagogical strategy aiming to transform nursing education. This review highlights the latest advances in the field, providing useful insights that could inspire countries and universities which have not yet incorporated digital educational tools in their nursing curriculum, to invest in their implementation.

The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial

BACKGROUND

Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients.

OBJECTIVES

To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students.

DESIGN

A single-blind, randomized controlled trial with a parallel group.

SETTINGS

This study was conducted in a nursing school and hospitals covered by it in Iran.

PARTICIPANTS

98 students studying in the fourth semester of the Bachelor of Nursing course.

METHODS

Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests.

RESULTS

The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion.

CONCLUSIONS

Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.

Comparative study of clinical reasoning competence and self-directed learning competence in nurses across varied years of experience

OBJECTIVES

To compare and analyse the differences in the clinical reasoning competence of nurses with different working years and their relationship with self-directed learning competence.

METHODS

A cross-sectional survey design (online investigation) was used. A total of 376 nurses were recruited from four independent hospitals in China. Online questionnaires collected data on nurses' demographic characteristics and assessed their clinical reasoning and self-directed learning competence. Pearson correlation analysis, t-test, analysis of variance (ANOVA) and multivariate regression analysis were used.

RESULTS

Clinical reasoning competence scores of nurses with working years >10 years were higher than those of other nurses. Self-directed learning competence scores of nurses with working years of <1 year and (from ≥1 year to <3 years) were lower than those of nurses with working years of 6-10 years and >10 years. Self-directed learning competence scores of nurses with working years of 3-5 years were lower than those of nurses with working years of >10 years. There was a positive correlation between clinical reasoning competence, self-directed learning competence and each dimension among nurses of different working years. There are differences in the influence of different dimensions of self-directed learning competence on clinical reasoning competence among different working years.

CONCLUSION

There were differences in clinical reasoning and self-directed learning competence among nurses with different working years. Self-directed learning competence is a positive predictor of nurses' clinical reasoning competence, which applied to nurses with all working years; however, the specific effect of self-directed learning competence on clinical reasoning competence differed among nurses with different working years.

IMPLICATION FOR NURSING MANAGERS

Nursing managers should pay attention to the development characteristics of clinical reasoning competence and self-directed learning competence of nurses with different working years and determine effective intervention strategies according to specific influencing factors.

Using "board games" to improve the effectiveness of extracorporeal membrane oxygenation care for nurses in intensive care unit

AIM

The purpose of this study was to evaluate the effectiveness of ECMO care board games facilitated teaching approach (ECMO care board games) in enhancing ECMO care knowledge, clinical reasoning and learning engagement among intensive care unit (ICU) nurses.

BACKGROUND

ECMO is a highly complex, relatively low-incidence, high-risk clinical life support device system used in the intensive care unit (ICU). Its usage has increased nearly tenfold over the past 30 years. Traditionally, ECMO education has been delivered through classroom teaching, which has demonstrated limited effectiveness in promoting nurses' learning engagement, clinical reasoning competency and confidence. The literature suggests that well-designed board games can enhance learning engagement, stimulate higher-level thinking and improve the effectiveness and confidence of nurses' learning.

DESIGN

A quasi-experimental study two-group repeated measure design.

METHODS

A purposive sample of 73 ICU nurses from two campuses of one medical center was recruited (37 in the experimental group and 36 in the control group). The experimental group received ECMO care training through ECMO care board games facilitated teaching approach, whereas the control group completed the training through a traditional teaching approach. Instruments used for data collection include a demographic information sheet, ECMO Care Knowledge Scale, Clinical Reasoning Scale (Huang et al., 2023) and Learning Engagement Scale (Ciou , 2020). Both groups completed a pre-test before the training, a post-test one week after the training and a second post-test three weeks after the training.

RESULTS

Prior to the intervention, there were no significant differences between the two groups in ECMO care knowledge and learning engagement. However, there was a significant difference in clinical reasoning. One week after the intervention, the experimental group demonstrated significantly higher scores in ECMO care knowledge, clinical reasoning and learning engagement than the control group (p <0.01). Three weeks after the intervention, the experimental group showed significantly higher scores in ECMO care knowledge, clinical reasoning and learning engagement (p <0.001).

CONCLUSIONS

The content for ECMO care is complex and difficult. Board games can enhance ECMO care knowledge, clinical reasoning and learning engagement. This teaching strategy may be applied to learning challenging subjects in the future to improve learning effectiveness. The clinical reasoning framework is conducive to guiding nurses' learning. In future continuing education, board games designed based on the clinical reasoning framework and tailored to the focus of in-service education can effectively enhance nurses' learning effectiveness.

Self-directed learning assessment practices in undergraduate health professions education: a systematic review

PURPOSE

The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.

METHODS

Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.

RESULTS

Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001).

CONCLUSIONS

The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

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.