Online professional development for digitally differentiated nurses: An action research perspective

Japanese nurse academics' pedagogical development using collaborative action research

BACKGROUND

To meet contemporary professional standards, nurse educators must provide students with educational content that considers active learning strategies.

OBJECTIVE

This study explored the process and challenges faced by nurse academics working collaboratively to implement an online problem-based learning course.

DESIGN

Collaborative action research.

SETTING

This study was conducted with nurse academics at Yamaguchi University in Japan from May 2020 to April 2022.

PARTICIPANTS

Five Japanese nurse academics and two Australian academics participated in this study.

METHODS

Nurse academics met regularly online to discuss issues and plan, act, and reflect on their experiences using Norton's (2001) five-step process. The meetings were recorded, and structured and written reflections from each participant were collected throughout the process. Data collected from the meetings and structured reflections were analysed to identify key themes.

RESULTS

In Step 1, the key stakeholders were discussed and issues were identified. Step 2 included planning a short seminar for the convenience of student participants, Step 3 involved the conduct of an online nursing ethics course (four sessions) for the students, and Step 4 included the evaluation. One year after the academics had completed their teaching, a discussion of future directions was conducted (Step 5). Through the collaborative action research process, four themes were identified: (1) creating a shared understanding, (2) adopting new paradigms for teaching and research, (3) learning and experiences while practicing, and (4) looking back and moving forward.

CONCLUSIONS

Despite some challenges experienced, the action research approach enhanced the curriculum development process, provided collegial opportunities to explore and learn together, and led to increased changes in the educational practice of academics, even beyond the collaborative action research.

Preparing children's nurses for working with children and adolescents who self-harm: Evaluating the 'our care through our eyes' e-learning training package

Rates of self-harm among children and adolescents have risen significantly over the past decade and clinical guidelines place children's nurses at the heart of their care. This article reports on the evaluation of 'Our Care Through Our Eyes', an online self-harm learning programme for children's nurses. A self-selected, convenience sample of registered children's nurses (n = 42) completed scales pre- and postlearning programme that captured their attitudes, beliefs, empathy, anxiety, and confidence. Mean change scores were assessed, and qualitative comments captured postintervention were thematically summarized. There were small improvements in participants' attitudes, empathy and confidence were reported. Anxiety scores increased in a small number of items. Qualitative comments confirmed the value of the online learning programme for improving children's nurses' knowledge and understanding of self-harm among CYP. Our findings demonstrate that children's nurses agree on the importance of mental health training in self harm, and this could be a catalyst for renewal of both pre- and postregistration education including support structures within the National Health Service. This study is the first to explore the feasibility of evaluating 'Our Care Through Our Eyes' delivered using e-leaning and could be used to inform further investigations.

How registered nurses balance limited resources in order to maintain competence: a grounded theory study

Background

Nurses have limited time outside of work for continuing professional development. Consequently, strategies need to be explored to enable them to better maintain their competence. This article describes recent research investigating if nursing behaviours in the use of mobile technologies could be leveraged to better facilitate mobile learning. It addresses a gap in the existing literature around how nurses resource their own professional development and learning in the absence of appropriate learning resources in the workplace.

Methods

The research employed a classic grounded theory methodology which was conducted with 27 registered nurses from Public and Private Hospitals in Queensland and external postgraduate nursing students from Victoria, South Australia and the Northern Territory enrolled at the University of Southern Queensland.

Results

The Theory of Economising Learning describes how nurses maintain competence with limited resources. Unfavourable staffing levels and a fast-paced workplace mean that nurses rarely prioritise their professional learning while at work. Instead, it requires the nurse to contribute personal resources including time and money.

Though the research revealed nurses were unconcerned about using mobile technologies, they were concerned about maintaining competence with limited resources. To counter this, nurses economised their learning by balancing personal resources against their motivation to maintain competence. The process of economising learning begins and ends with the development of the nurse’s personal curriculum in response to what they identify as being the most significant knowledge deficits at work that jeopardise their competence. A learning opportunity that addresses the knowledge deficit is sought. Nurses balance the opportunity to address the deficit against the cost of personal resources, to decide if they will engage with the opportunity and update their personal curriculum accordingly.

Conclusions

It is suggested that workplaces need to create reasonable expectations within nurses to address knowledge deficits and provide the resources, including time, to allow them to do so without personal cost. It is also necessary for workplaces to moderate the flow of learning opportunities so as not to overwhelm and demotivate the nurses. Currently, nurses use several strategies to optimise their learning using mobile technologies which could be leveraged in the workplace.

Lifelong learning and nurses' continuing professional development, a metasynthesis of the literature

Background

Continuing professional development (CPD) is central to nurses’ lifelong learning and constitutes a vital aspect for keeping nurses’ knowledge and skills up-to-date. While we know about the need for nurses’ continuing professional development, less is known about how nurses experience and perceive continuing professional development. A metasynthesis of how nurses experience and view continuing professional development may provide a basis for planning future continuing professional development interventions more effectively and take advantage of examples from different contexts. The aim of this paper is to conduct such a metasynthesis, investigating the qualitative research on nurses’ experiences of continuing professional development.

Methods

A metasynthesis of the qualitative literature was conducted. A total of 25 articles fulfilled the inclusion criteria and were reviewed.

Results

We determined five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. This metasynthesis highlights that nurses value continuing professional development and believe that it is fundamental to professionalism and lifelong learning. Moreover CPD is identified as important in improving patient care standards.

Conclusions

Based on the metasynthesis, we argue that access to continuing professional development could be made more attainable, realistic and relevant. Expediently, organizations should adequately fund and make continuing professional development accessible. In turn, nurses should continue to actively engage in continuing professional development to maintain high standards of nursing care through competent practice. This paper highlights the perceived benefits and challenges of continuing professional development that nurses face and offers advice and understanding in relation to continuing professional development. We believe that this metasynthesis contributes with insights and suggestions that would be valuable for nurses and policy makers and others who are involved in nurse education and continuing professional development.

"It's given me confidence": a pragmatic qualitative evaluation exploring the perceived benefits of online end-of-life education on clinical care

BACKGROUND

Hospital admissions for end-of-life care are increasing exponentially across the world. Significant numbers of health professionals are now required to provide end-of-life care with minimal training. Many health professionals report they lack confidence to provide this care, particularly those in acute hospital settings. This study explored the perceived benefits of online education on health professionals' capacity to provide end-of-life care.

METHODS

This qualitative study adopted a pragmatic approach. Thirty semi-structured interviews were conducted with allied health professionals, nurses and doctors who had completed a minimum of three End-of-Life Essentials online education modules. Interviews were held on line and face-to-face, audio-recorded and transcribed verbatim. Demographic data were also collected. Three major themes and one minor theme were constructed from the data using inductive thematic analysis.

RESULTS

Themes were (1). Perceptions of preparedness to provide end-of-life care, (2). Shifts in approaching end-of-life discussions and (3). Motivation for engagement with online modules. Participants reported validation of knowledge and improved confidence to have end-of-life discussions with patients, carers and team members. They also noted improved ability to recognise the dying process and improved conversations with team members about patient and carer needs. Videos portraying a novice and then more able end-of-life discussions were particularly valued by participants. Modules provided practical guidance on how to engage in discussions about the end of life and care needs. Participants were self-motivated to improve their knowledge and skills to enhance end-of-life care provision. Continuing professional development requirements were also a motivator for module completion.

CONCLUSIONS

This study explored health professionals' perspectives about the perceived benefits of online education modules on their clinical practice. Module completion enhanced participant confidence and self-reported improved competence in end-of-life care provision. Findings build on existing research that supports the valuable role online education plays in supporting confidence and ability to actively engage with patients, carers and colleagues about provision of end-of-life care; however, self-report cannot be used as a proxy for improved clinical competence.

Northeastern Ontario nurses' perceptions of e-learning: An interpretive description

BACKGROUND

E-learning is a common method of continuing education for nurses that supports professional competencies and learning needs. However, variations in setting, information technology, and quality of the e-learning may impact these experiences.

OBJECTIVE

To explore registered nurses' perceptions of e-learning in a hospital setting.

DESIGN

A qualitative study using an Interpretive Description methodology.

SETTING

A small urban Northeastern Ontario hospital.

PARTICIPANTS

Ten registered nursing staff from acute medical and surgical inpatient departments.

METHOD

Face-to-face semi-structured interviews were conducted to explore nurses' e-learning perceptions. Interview transcripts were analyzed for themes.

RESULTS

Three key themes were found that described the participants' perceptions of e-learning and how it related to their continuing education: Unsatisfactory, Meaningful, and Enhancing learning experiences.

CONCLUSION

E-learning can be a useful method of continuing education for registered nurses; however, there are challenges in the delivery of e-learning and an ongoing need for quality development.

A study on improving nursing clinical competencies in a surgical department: A participatory action research

Aims

The purpose of the present study was to improve clinical competencies in nursing staff in a selected surgical department in Kashan/Iran during 2016-2018.

Design

This was a participatory action research.

Methods

This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Conditions of Work Effectiveness Questionnaire-II, job satisfaction and patients' satisfaction questionnaires were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis.

Results

Three main problems could affect the clinical competencies including professional insufficiency, basic shortages and external influences. Three changes were implemented in the surgical department including improving education, involving nursing students in patients' education and increasing the motivations by peer evaluation and selecting the nurse of the week. The changes significantly increased patients' satisfaction, nurses' job satisfaction and work effectiveness.

Finding the Best Way to Deliver Online Educational Content in Low-Resource Settings: Qualitative Survey Study

BACKGROUND

The reach of internet and mobile phone coverage has grown rapidly in low- and middle-income countries (LMICs). The potential for sharing knowledge with health care workers in low-resource settings to improve working practice is real, but barriers exist that limit access to online information. Burns affect more than 11 million people each year, but health care workers in low-resource settings receive little or no training in treating burn patients. Interburns' training programs are tailor-made to improve the quality of burn care in Asia, Africa, and the Middle East; the challenge is to understand the best way of delivering these resources digitally toward improved treatment and care of burn patients.

OBJECTIVE

The aim of the study, funded by the National Institute for Health Research (NIHR), was to understand issues and barriers that affect health care worker access to online learning in low-resource settings in order to broaden access to Interburns' training materials and improve burn-patient care.

METHODS

A total of 546 participants of Interburns' Essential Burn Care (EBC) course held in Bangladesh, Nepal, Ethiopia, and the West Bank, the occupied Palestinian Territories, between January 2016 and June 2018 were sent an online survey. EBC participants represent the wide range of health care professionals involved with the burn-injured patient. A literature review was carried out as well as research into online platforms.

RESULTS

A total of 207 of 546 (37.9%) participants of the EBC course did not provide an email address. Of the 339 email addresses provided, 81 (23.9%) "bounced" back. Surgeons and doctors were more likely to provide an email address than nurses, intern doctors, or auxiliary health care workers. A total of 258 participants received the survey and 70 responded, giving a response rate of 27.1%. Poor internet connection, lack of time, and limited access to computers were the main reasons for not engaging with online learning, along with lack of relevant materials. Computers were seen as more useful for holding information, while mobile phones were better for communicating and sharing knowledge. Health care workers in LMICs use mobile phones professionally on a daily basis. A total of 80% (56/70) felt that educational content on burns should be available through mobile apps.

CONCLUSIONS

Health care workers in low-resource settings face a variety of barriers to accessing educational content online. The reliance on email for sign-up to learning management systems is a significant barrier. Materials need to be relevant, localized, and easy to consume offline if necessary, to avoid costs of mobile phone data. Smartphones are increasingly used professionally every day for communication and searching for information, pointing toward the need for tailored educational content to be more available through mobile- and web-based apps.

Effect of e-learning on nurses' continuing professional development

BACKGROUND

E-learning can provide nurses with the opportunity to undertake lifelong learning and continuing professional development (CPD) in a flexible, practical and engaging manner. However, much of the research focuses on pre-registration nursing students' experiences of e-learning, despite nursing students not always experiencing the same clinical demands as registered nurses.

AIM

To explore the concept of e-learning and nurses' perception of its value for engaging with lifelong learning and CPD, as well as to determine attitudes towards e-learning, what influencing factors exist and how they affect the perceived value of e-learning.

METHOD

This study used a mixed-methods sequential explanatory design, in which there were two phases of data collection and analysis. In the first phase, 39 children's nurses completed questionnaires about e-learning and its flexibility, accessibility, value and contribution to CPD. Their responses were analysed and used to inform questions for the second phase, which involved semi-structured interviews exploring the findings and emerging themes from the completed questionnaires. Of the 39 questionnaire respondents, 12 agreed to participate in the interviews.

FINDINGS

More than half of the questionnaire respondents ( n =22/39) agreed or strongly agreed that e-learning aids their CPD, while 29 respondents valued e-learning that is specific to their practice area. Three main factors were identified that may influence the effect of e-learning on nurses' CPD: motivation to engage with CPD and e-learning; the perceived value of e-learning as a method for CPD; and challenges to effective engagement with e-learning.

CONCLUSION

Engagement with e-learning is influenced by the content of its modules and, while mandatory training is often provided through e-learning, this should not be its sole purpose. Nurses should take the opportunity to develop and engage with e-learning that is specific to their area of practice, which may increase its value.

Novel (Multilevel) Focus Group Training for a Transdisciplinary Research Consortium

Health researchers are increasingly turning to qualitative research for a nuanced understanding of complex health phenomena. The quality and rigor of qualitative research relies on individual data collector skills, yet few guidelines exist for training multidisciplinary, multi-institution qualitative research teams. Specific guidance is needed on qualitative research practices that ensure scientific rigor by optimizing diverse experience and expertise across research centers. We describe our systematic approach to training a cohort of 15 focus group moderators from seven universities in the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium's Study of Habits, Attitudes, Realities, and Experiences (SHARE). SHARE's aim was to explore women and girls' experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health and function across the life course. Drawing on adult education and action-learning best practices, a three-phase curriculum was designed to maximize moderator proficiency and qualitative research expertise. The phases involved online, interactive web-based education, in-person didactic training with experiential components, and tailored supplemental online training. Evaluative feedback was collected before, during, and after the training. Feedback was used to identify emergent training needs. This training approach may be used by transdisciplinary research teams conducting multisite research to assure qualitative research credibility and trustworthiness.

Resources and competencies for management of educational practices by nurses: integrative review

OBJECTIVE

To know the resources used and the necessary skills to the nurse for the management of educational practices in health services.

METHOD

This is an integrative literature review, carried out in the Latin American and Caribbean databases on Health Sciences Information (BIREME), PubMed Central (PMC), Scopus and Web of Science (WoS). After analysis resulted in 18 studies, published between the period 2011 to 2017, which were presented in three categories.

RESULTS

The results were presented in the categories: instrumental resources used in health education, technological resources applied to educational practices and competencies for management of educational practices.

CONCLUSION

This study brings as a contribution to the practice of nurses subsidies for the development of management of educational practices in health services through technological and instrumental resources and professional skills that aim at team development, user autonomy and institutional growth.

Implementation of a Flipped Classroom for Nuclear Medicine Physician CME

INTRODUCTION

Increasingly, emerging technologies are expanding instructional possibilities, with new methods being adopted to improve knowledge acquisition and retention. Within medical education, many new techniques have been employed in the undergraduate setting, with less utilization thus far in the continuing medical education (CME) sphere. This paper discusses the use of a new method for CME-the "flipped classroom," widely used in undergraduate medical education. This method engages learners by providing content before the live ("in class") session that aids in preparation and fosters in-class engagement.

METHODS

A flipped classroom method was employed using an online image-rich case-based module and quiz prior to a live CME session at a national nuclear medicine meeting. The preparatory material provided a springboard for in-depth discussion at the live session-a case-based activity utilizing audience response technology. Study participants completed a survey regarding their initial experience with this new instructional method. In addition, focus group interviews were conducted with session attendees who had or had not completed the presession material; transcripts were qualitatively analyzed.

RESULTS

Quantitative survey data (completed by two-thirds of the session attendees) suggested that the flipped method was highly valuable and met attendee educational objectives. Analysis of focus group data yielded six themes broadly related to two categories-benefits of the flipped method for CME and programmatic considerations for successfully implementing the flipped method in CME.

DISCUSSION

Data from this study have proven encouraging and support further investigations around the incorporation of this innovative teaching method into CME for nuclear imaging specialists.