The transition to blended e-learning. Changing the focus of educational delivery in children’s pain management

Stakeholder perceptions of curriculum design, development and delivery for continuing e-learning for nurses

BACKGROUND

This paper reports the qualitative findings from stage 5 of an action research project which involved the redesign of continuing professional education (CPE) courses in one organisation.

AIM

The aim of this study was to explore key stakeholders perceptions of the teaching, learning and outcomes of a new curriculum design for CPE involving e-learning.

METHOD

This project used participatory action research, involving stakeholders as participants in a process of inquiry about the change. The study took place in an academic teaching hospital and consisted of three focus group interviews with a total of 20 nurses. Participants included stakeholders who had developed curricula and managers from clinical areas where CPE courses had been undertaken.

FINDINGS

Four main themes emerged, revealing staff perceptions on the process of change and their own 'lightbulb moments' experienced during this process. Results also indicate that the change has resulted in learner-focused CPE, with a range of opportunities for continued educational development in future.

CONCLUSION

Key stakeholders' experience is seldom reported in studies related to CPE. This study provides an insight into the experiences of key stakeholders in relation to the development and delivery of CPE courses. Stakeholders indicated that they were able to see the benefits of implementing new CPE curricula they had contributed to. They also commented that clinical-pertinent and competence-based courses were more learner focused as a result of combining online content with supported workshops.

Experiences of nursing undergraduates on a redesigned blended communication module: A descriptive qualitative study

BACKGROUND

Education is going through accelerated changes to accommodate the needs of contemporary students. However, there are ongoing concerns regarding the quality of education in communication skills for nurses and other healthcare professionals. Many studies have been conducted to evaluate the effectiveness of a blended learning pedagogical tool in enhancing the learning of nursing undergraduates. However, little is known about students' experiences of a blended learning model for teaching communication skills.

OBJECTIVE

To explore first year nursing students' experiences of the blended learning design adopted in a communication module.

DESIGN

A descriptive qualitative design was adopted.

SETTINGS AND PARTICIPANTS

Data were collected in the form of written reflections from 74 first year nursing undergraduates who were enrolled in a university-affiliated nursing school.

METHODS

Students were asked to complete an online reflective exercise regarding an undergraduate communication module on their last day of class, and the submitted reflections were analyzed. A thematic analysis was conducted and ethics approval was obtained for this study.

RESULTS

Six overarching themes and fifteen subthemes were generated. The six overarching themes were: 1) Helpful and engaging classroom experience, 2) valuable online activities, 3) meaningful assessment, 4) appreciation for interprofessional education, 5) personal enrichment, and 6) overall feedback and recommendations.

CONCLUSIONS

The students in this study felt that the blended pedagogy communication module enhanced their learning and boosted their confidence in facing similar situations. Interprofessional education was well-accepted among students as they attained a deeper understanding on the importance of interprofessional learning and an appreciation towards other professionals. Blended pedagogy can be used in teaching communication skills to nursing students to provide a holistic and up-to-date learning experience. Future studies should consider engaging students in face-to-face interviews to obtain a deeper understanding on their experiences of a blended pedagogy incorporated communication module.

Extending the expectation-confirmation model with quality and flow to explore nurses’ continued blended e-learning intention

Purpose

– The purpose of this paper is to propose a hybrid model based on the expectation-confirmation model (ECM), flow theory, and updated DeLone and McLean information system (IS) success model to examine whether quality factors as the antecedents to nurse beliefs affected nurses’ intention to continue using the blended electronic learning (e-learning) system.

Design/methodology/approach

– Sample data for this study were collected from nurses at five hospitals in Taiwan. A total of 500 questionnaires were distributed, 396 (79.2 percent) questionnaires were returned. Consequently, 378 usable questionnaires were analyzed in this study, with a usable response rate of 75.6 percent. Collected data were analyzed using structural equation modeling.

Findings

– Information quality, system quality, support service quality, and instructor quality contribute significantly to perceived usefulness (PU), confirmation, and flow, which together explain nurses’ satisfaction with the usage of the blended e-learning system, and this in turn leads to their continued system usage intention.

Originality/value

– First, the application of the ECM with the view of updated DeLone and McLean IS success model reveals deep insights into quality evaluation (including information quality, system quality, and support service quality) in the field of nurses’ e-learning continuance intention. Especially, this study additionally contributes to the identification of instructor quality that may lead to nurses’ continued blended e-learning usage intention. Next, the empirical evidence on capturing both extrinsic motivator (i.e. PU) and intrinsic motivator (i.e. flow) for completely explaining quality antecedents of nurses’ blended e-learning continuance intention is well documented.

A cross-country comparison on the use of blended learning in property education

Purpose

– The purpose of this paper is to compare the use of blended learning in property education courses in different countries. The rationale for this study is to fill the research gap in this area. The focus of previous research on blended learning has been on individual countries only, and there is yet to appear any research on a cross-country comparison. The purpose of this study is to identity the differences as well as the good practices using blended learning as a delivery approach in different countries As a result, individual countries can learn experience from another country. It is expected academics interested in using blended learning as a delivery approach will benefit from the research findings of this paper, through gaining an understanding of the advantages and challenges of using blended learning in different countries.

Design/methodology/approach

– This paper presents the research findings of questionnaire surveys and interviews with academics teaching property courses in Australia and the UK. The questionnaire aimed to gather academics’ views on blended learning, their reasons for using blended learning as a teaching method, their design of blended learning courses and the support they provide to students on dealing with web technology. The aim of the interviews was to gain deeper insight into the successful factors and challenges in the use of blended learning. In total, 16 interviews were conducted. The interviews were recorded, transcribed and coded to identify similar themes. Content analysis was used as a method to analyse the interview data. The frequency of the answer in the questionnaire and comments from interviewees is presented.

Findings

– The Australian and UK property academics have similar views on many aspects of blended learning. Their definitions of blended learning are similar as their reasons to use it as a teaching method. The commonly used teaching and learning activities in their blended learning courses in both countries are, again, similar, such as the use of lectures, case studies and guest lecturers. On the other hand, the academics in the two countries face different challenges. A challenge faced by the Australian property academics is to deliver online courses to students who have limited internet downloading capacity and broadband width. Australia is a very large country and has more regional and remote areas. Another challenge faced by the Australian academics is keeping up with the constant introduction of new teaching and learning technology by their universities. On the other hand, the UK academics faced a different challenge, which was to sufficiently engage and encourage students to contribute in online Discussion Boards. The finding is possibly because the UK study was conducted two years prior to the Australian study and the idea of online discussions was relatively new to students at the time. The conclusion drawn from this research is that “time” and the size of the country influence the use of blended learning.

Originality/value

– This project is the first to conduct a cross-country comparison on the use of blended learning in professionally accredited property courses.

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

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

Using e-learning to enhance nursing students' pain management education

CONTEXT

Absence of standardised pain curricula has led to wide diversity in the understanding and awareness of pain by healthcare students. Indeed pain management is frequently under-prioritised in nursing education, providing potential to negatively impact upon patient care. Yet the recent addition of Pain to the UK National Health Service's Essence of Care Benchmarks has highlighted the need to address this issue, and in response pain educators have called for the development of high quality, globally accessible e-learning resources in pain management.

OBJECTIVES

This study will determine the effectiveness of an e-learning intervention on pain management developed for nursing students.

METHODS

Two variants of an e-learning resource on pain management were developed, each containing the same core content but one with a section focusing on pain assessment and the other on pharmacological management. Nursing students (n=42) were randomly assigned to trial one resource, after which they undertook a questionnaire adapted (to ensure alignment with the content of the e-learning resources) from Ferrell and McCaffrey's Nurses Knowledge and Attitudes Towards Pain Survey. Scores were analysed for each resource and year of study, and compared with scores from a standard non-intervention group completing the questionnaire only (n=164).

RESULTS

Scores averaged 19.2% higher for students undertaking the e-learning resources (p<0.005). Specifically, undertaking the assessment resource improved assessment knowledge more, whilst assignment to the treatment resource particularly enhanced pharmacological knowledge (p<0.005). Correlation was found between year of study and pain knowledge.

CONCLUSION

Results support the effectiveness of the resources independent of voluntary-response bias. Conclusions recommend that introducing e-learning has substantial benefit to enhance pain education in nursing.

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

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

The most effective way of delivering a train-the-trainers program: a systematic review

INTRODUCTION

Previous literature has shown that multifaceted, interactive interventions may be the most effective way to train health and social care professionals. A Train-the-Trainer (TTT) model could incorporate all these components. We conducted a systematic review to determine the overall effectiveness and optimal delivery of TTT programs.

METHODS

We searched 15 databases. Reference lists and online resources were also screened. Studies with an objective follow-up measure collected over 1 week after the intervention were included. The intervention had to be based on a TTT model for health and social care professionals.

RESULTS

Eighteen studies met the inclusion criteria. TTT interventions varied greatly, ranging from didactic presentations to group discussions and role-plays. The heterogeneity of the studies and limited data prevented meta-analysis. A narrative review found that the TTT programs in 13 studies helped to increase knowledge, improve clinical behavior, or produce better patient outcomes. One study showed no effect. Three studies showed possible effect and one study showed that a CD-ROM training method was more effective than a TTT training method in improving participants' knowledge. Ratings of the studies' methodologies suggested moderate risk of bias, which limits interpretation of the results.

DISCUSSION

There is evidence that using a blended learning approach to deliver TTT programs--combining different techniques such as interactive, multifaceted methods and accompanying learning materials--can help to effectively disseminate and implement guidelines and curricula to health and social care professionals. However, further research is needed to determine the optimum "blend" of techniques.

Understanding the essential elements of work-based learning and its relevance to everyday clinical practice

AIM

To critically review the work-based learning literature and explore the implications of the findings for the development of work-based learning programmes.

BACKGROUND

With NHS budgets under increasing pressure, and challenges to the impact of classroom-based learning on patient outcomes, work-based learning is likely to come under increased scrutiny as a potential solution. Evidence from higher education institutions suggests that work-based learning can improve practice, but in many cases it is perceived as little more than on-the-job training to perform tasks.

EVALUATION

The CINAHL database was searched using the keywords work-based learning, work-place learning and practice-based learning. Those articles that had a focus on post-registration nursing were selected and critically reviewed.

KEY ISSUES

Using the review of the literature, three key issues were explored. Work-based learning has the potential to change practice. Learning how to learn and critical reflection are key features. For effective work-based learning nurses need to take control of their own learning, receive support to critically reflect on their practice and be empowered to make changes to that practice.

CONCLUSIONS

A critical review of the literature has identified essential considerations for the implementation of work-based learning. A change in culture from classroom to work-based learning requires careful planning and consideration of learning cultures.

IMPLICATIONS FOR NURSING MANAGEMENT

To enable effective work-based learning, nurse managers need to develop a learning culture in their workplace. They should ensure that skilled facilitation is provided to support staff with critical reflection and effecting changes in practice. CONTRIBUTION TO NEW KNOWLEDGE: This paper has identified three key issues that need to be considered in the development of work-based learning programmes.

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

AIM

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

BACKGROUND

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

METHODS

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

FINDINGS

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

CONCLUSION

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

Surfing or still drowning? Student nurses' Internet skills

A study into student nurses' ability to use the Internet was published in Nurse Education Today in 2004. This paper repeats the research with a cohort of students starting their pre-registration programme in a UK university in 2007. In 2004 students were reported as having poor Internet skills, and as not being frequent users of the Internet. In this study students were found to have significantly better ability to carry out basic tasks and significantly higher levels of Internet use. Their ability to apply these skills to more complex information literacy tasks however had not increased, with more than half of all students saying they found far too much irrelevant information when searching for specific information on the Internet. The earlier study found that skills and age were not related, which appears to still be the case. The need for these skills is increasing as education, lifelong learning, and patient information are all increasingly drawing on the developing Internet. Nurse education however is not integrating the skill and knowledge base essential to support this into pre-registration programmes, and the evidence suggests that this will not happen without active management.