Online learning: enhancing nurse education?

Beyond the classroom walls: Stakeholder experiences with remote instruction in Post RN baccalaureate nursing program during the COVID-19 pandemic: A qualitative inquiry

The COVID-19 pandemic led to the closure of educational campuses and the suspension of conventional classroom teaching globally and locally, and many switched overnight to an online modality. The change was experienced differently by varied audiences, given the availability of resources. The study aimed to examine stakeholders' experiences of emergency remote instructions in the Post-RN Baccalaureate Nursing Program during the COVID-19 pandemic. A qualitative descriptive exploratory design with a purposive sampling technique was used at a private nursing university in Karachi, Pakistan. Focus group discussions with students and faculty were conducted separately, while in-depth interviews with key informants were held using semi-structured interview guides. The focus group discussions and in-depth interviews were recorded electronically and transcribed and translated, coded, and analysed manually. Findings uncovered two major themes. (a) Remote teaching and learning-a paradigm shift; and (b) Remote learning ecosystem-a challenging team sport. The first theme denotes a major shift in pedagogical approach migrating from blended learning model to a complete online modality. Theme two uncovers the efforts and teamwork of the various stakeholders who assisted in mitigating the challenges collaboratively when migrating to virtual learning environment. Findings suggest that to continue to thrive in the post-COVID world, faculty, students, and key informants must collegially enhance the teaching, learning, and assessment strategies and student-teacher interaction, capitalising on evidence-based practices, trial and error, multi-level support mechanisms, and partnerships. The study recommends building resilience in instructional and administrative infrastructure to prepare for future events like pandemics and suggests development of evidence-informed blended and online nursing programmes in the region.

Perception and attitude towards online clinical modules: a cross-sectional study among medical students from two countries

COVID-19 has deeply affected the world in various aspects including the education system worldwide. In this study, we intended to explore the merits and demerits of online clinical learning and its effect on medical education from a student's perspective. The study also assessed the perception and attitude of final-year medical students towards online clinical modules. This observational study was carried out in the Department of Community Medicine, Kasturba Medical College, Manipal (KMC) in collaboration with King's College London, UK (KCL). In our study, a total of 42 students were enrolled, with 37 students from KMC and 5 students from KCL. 81% of students reported that they were not willing to continue the online mode of learning. The abrupt switch to e-learning without prior preparedness has exposed some pitfalls that must be attended to. Contrary to other fields, the medical field places high importance on offline clinical teaching which has recently been impacted by online teaching. The survey responses were analyzed for improvisation of online clinical modules as well as to come up with better ideas and outcomes since this mode of learning may have to continue till the spread of the disease is under control.

Preparing nursing students for clinical placement using synchronous role-play telesimulation: A descriptive survey study

BACKGROUND

Contemporary teaching modalities in nurse education include teaching clinical skills via telesimulation. The effectiveness of this modality has not been evaluated.

OBJECTIVE

To evaluate undergraduate nursing students' and clinical facilitators' perceptions of student preparedness for placement when clinical skills are taught via role-play telesimulation using home equipment packs.

DESIGN

A descriptive survey study was employed to measure and explore perceptions using Likert scales and open-structured questions delivered via an anonymous online survey.

SETTING

Clinical placement after undertaking preparation via role-play telesimulation for students at an Australian university.

PARTICIPANTS

Data were collected from 180 undergraduate nursing students and 22 clinical facilitators.

METHODS

Quantitative data were analysed using statistical analysis software, SPPS. Open ended responses to survey questions were analysed through the application of Elo and Kyngas (2008) three phases of content analysis.

RESULTS

Seventy-eight percent of students felt prepared for placement, and 86 % of clinical facilitators believed that students were adequately prepared. Three major categories were identified from students' responses: sense of community, learning logistics, and sense of comfort. Three categories emerged from clinical facilitators' responses: nervous and anxious, confidence and preparedness.

CONCLUSIONS

Findings from this study suggest that role-play telesimulation with home equipment packs is a viable, achievable, sustainable and effective modality for teaching hands-on practical skills to prepare undergraduate nursing students for industry placement.

Generation Z nursing students’ online learning experiences during COVID-19 epidemic: A qualitative study

In early 2022, the coronavirus disease 2019 (COVID-19) continued to spread quickly globally and broke out in some metropolitan areas. To stop the spread of infection, all colleges and universities were shifted to a closed model, and higher education was transformed into online learning (OL). These transitions posed numerous challenges for Generation Z students, especially those in the nursing profession that featured face-to-face practice courses. This study aimed to explore and understand the experiences of OL among Generation Z nursing students during COVID-19 epidemic. This qualitative phenomenological research design applied a purposive sampling approach to enroll 14 Generation Z nursing students from a college. Data were collected and analyzed using in-depth, semi-structured interviews and Colaizzi seven-step method. The analysis demonstrated four themes and eleven subthemes: challenges encountered during OL, advantages perceived during OL, experience of loneliness and stress, and developing resilience during OL. This study concluded that the sudden shift in learning styles presents challenges to Generation Z nursing students. Despite the adversity, the students showed tremendous resilience and endurance. During the pandemic, educators should provide support measures based on the characteristics of Generation Z to improve the effectiveness of OL and respond positively to stress.

Changes in university students' behavioral intention to learn online throughout the COVID-19: Insights for online teaching in the post-pandemic era

Many researchers investigated university students' behavioural intention to undertake online courses during COVID. However, few examined how students' intention might change throughout COVID by incorporating their learning capability and approaches. The universities in China went through a process from lockdown in February to reopening in September 2020. It provided a unique context for university students in China to experience emergent online learning for approximately six months before returning to normal face-to-face or blended learning on campus. The researchers conducted a questionnaire survey among 193 Chinese university students to investigate the changes in their behavioral intention to learn online throughout COVID. Additionally, the researchers explored the relationships between the participants' behavioral intention and the factors of learning capability in general, application of specific online learning strategies, online course engagement levels, and academic performance. It was found that the participants' intention to study online significantly increased during COVID and then slightly decreased after the university reopened. The participants' intention of online learning after COVID was predicted by their prior intention, learning capability, application of online learning strategies, and online course engagement. The participants' perceptions about online learning revealed that, when choosing future course delivery modes, they would a) reflect on their own disposition, capability, and needs, b) compare different learning modes, and c) examine course quality and teachers' competency. The participants also shared advice regarding their expectation of future online courses which may help shape university educators' pedagogical practices and provide insights for university online and blended course delivery from learners' perspectives.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10639-022-11320-0.

Exploring the complexity of student nurse relationships with adolescent patients when placing nasogastric tubes

This article aims to explore the complexity of student nurse relationships with adolescent patients when placing nasogastric tubes. The potential inter-connectiveness of this relationship is debated within this article and an evaluation of current practice identifies potential implications for both patients and nursing care.

Experiences of nursing students under the unprecedented abrupt online learning format forced by the national curfew due to COVID-19: A qualitative research study

BACKGROUND

The unprecedented abrupt shift to remote online learning (OL) within the context of the national lockdown due to the 2019 coronavirus disease (COVID-19) highlights the importance of addressing students' preparedness in managing their first experiences with OL.

PURPOSE

To investigate the experiences of undergraduate nursing students during their first uses of OL to increase the understanding of their encountered opportunities and challenges.

DESIGN

A descriptive qualitative design guided by a phenomenological approach was used.

METHODS

The study used a purposive sampling technique to recruit 18 undergraduate nursing students from two universities. Data were collected using two focus group discussions, and the discussions with participants were audio/video recorded through the online platform Zoom due to the national imposed curfew. Content analysis employed Colaizzi's steps to derive the themes/categories.

RESULTS

The study revealed four themes: experience of helplessness, burdens, and burnout; the need for social and technical support to manage OL; the propensity to consider OL as a positive opportunity; and the deficiency of OL in fulfilling the educational outcomes of clinical courses.

CONCLUSIONS

Abrupt remote OL was a challenge to clinical encounters. This format was very stressful; however, it was also useful. The current study highlighted the need for further research on the effectiveness of remote OL platforms in regard to the achievement of the intended learning outcomes of clinical courses.

Evaluation of Simulation Outcomes

Simulation has been used in nursing education and training since Florence Nightingale's era. Over the past 20 years, simulation learning experiences (SLEs) have been used with increasing frequently to educate healthcare professionals, develop and increase the expertise of practicing professionals, and gain competency in key interprofessional skills. This chapter provides a brief overview of simulation evaluation history, beginning in the late 1990s, and the initial focus on learner self-report data. Using Kirkpatrick's Levels of Evaluation as an organizing model, four types of SLE evaluation are reviewed as well as suggestions for future research.

Challenges in Implementing an E-Learning Education Program for Syringe Pump Use

To prevent the incidence of risks imputable to human error during the process of preparing the infusion pump, clarity in teaching and learning are required. Because traditional classroom training is difficult and time-consuming, the aim of the present study was to challenge the implementation of an e-learning education program for syringe pump use. The impact of the e-learning program was evaluated with 100 nurses between March and June 2016. The e-learning program significantly increased general baseline knowledge in syringe pump use; however, aspects of the program confused participants. The feedback from 98 % of nurses on the e-learning program was that it was effective in helping them with this skill. However, only 54 % opted for the e-learning program versus traditional training. The present study showed nurses preferred a blended learning format. Based on our hospital incident and error reports, this study shows local training requires a specific approach strategy for syringe pump education.

Participating by activity or by week in MOOCs

Purpose

The purpose of this study was to provide a new characterization of the extent to which learners complete learning activities in massive open online courses (MOOCs), a central challenge in these contexts. Prior explorations of learner interactions with MOOC materials have often described these interactions through stereotypes, which accounts for neither the full spectrum of potential learner activities nor the ways those patterns differ across course designs.

Design/methodology/approach

To overcome these shortcomings, the authors apply confirmatory and exploratory factor analysis to learner activities within three MOOCs to test different models of participation across courses and populations found within those courses.

Findings

Courses varied in the extent to which participation was driven by learning activities vs time/topic or a mixture of both, but this was stable across offerings of the same course.

Research limitations/implications

The results call for a reconceptualization of how different learning activities within a MOOC are designed to work together, to better allow strong learning outcomes even within one activity form or more strongly encourage participation across activities.

Originality/value

The authors validate new continuous-patterns rather than a discrete-pattern participation model for MOOC learning.

Values exchange: using online technology to raise awareness of values and ethics in radiography education

INTRODUCTION

Ethics and values are increasingly significant aspects of patient-centred healthcare. While it is widely agreed that ethics and values are essential for healthcare delivery, there is also an acknowledgement that these are areas that are challenging to teach. The purpose of this study is to report a small-scale evaluative research project of a web-based technology with the educational potential to facilitate learning in relation to ethics, values, self-reflection and peer-based learning.

METHODS

Five diagnostic radiography students took part in a semi-structured focus group with the aim of exploring their experiences of using Values Exchange, an online ethical decision-making framework, to examine practice-based ethical issues. Transcripts were interrogated for key themes.

RESULTS

From the thematic analysis three major themes emerged, understanding and appreciating others, addressing the theory-practice gap and delivering a safe and effective learning environment. Perceived limitations of the platform included students' fear of misinterpreted responses and possibility of poor group dynamics.

CONCLUSIONS

There are varied approaches to how ethics and values are taught and assessed within health-related environments. Values Exchange is one such teaching tool and has been investigated and described positively by radiography students in this study. Online teaching tools can have a positive effect in helping students identify their own values but require skilled implementation to reap positive rewards.

Supporting student mental health nurses in clinical placement through virtual in-practice support (VIPS): Innovation uptake and the 'VIPS' project

OBJECTIVE

The integration of technology in nurse education has become an essential element of academic practice. Yet innovation uptake between academic institutions across the four countries of the UK and their clinical practice partners has proved problematic, leading to a slow introduction of digitally enhanced teaching and learning innovations, particularly in the area of clinical decision making and leadership.

PARTICIPANTS

The Virtual in Practice Support (VIPS) project involved two academic institutions working with the same mental health care service partner aiming to maximise student clinical placement learning. Student nurses in their final year of training were invited to take part in testing the viability of distance e-tutoring (via computer access to academic nurse lecturers) for facilitated critical reflection.

DESIGN

An evaluation of the use of video linked conference sessions, set up for students to undertake a group based online (i.e. virtual) group tutorial is presented.

METHODS

All participants completed an evaluation data sheet using a five point Likert scale and free text evaluation feedback form completed at the end of each online tutorial session. Students were also invited to a focus group and all tutors were interviewed at the completion of the project.

RESULTS

The VIPS project findings highlight; i) the importance of a clear project vision for innovation uptake ii) consequences of working with innovation champions and iii) how technology can be used to maximise student learning across geographical distance through online facilitated group critical discussion.

CONCLUSION

VIPS' participants were able to articulate positive outcomes as a result of engaging in a multi-institutional project that capitalised on the richness of nursing clinical practice learning experience for both the students and the academics involved as innovation champions.

Training students to use syringe pumps: an experimental comparison of e-learning and classroom training

The inadequate use of syringe pumps can jeopardize patient safety, and syringe pump trainings are conducted to manage this risk. A critical step in this risk management process is the learning success of trainees. In the present paper, we compared an e-learning approach with standard classroom training in learning success effectives, trainees' opinion on the trainings, and investigated the relation between technological affinity and learning success. The results showed that e-learning was as effective as classroom training but nursing students' confidence in using the pump and satisfaction with the training was decreased for e-learning compared with classroom training. We discuss the results in context of the nursing e-learning literature. Finally, we discuss the literature for risk identification, risk analysis, risk treatment, and risk monitoring and control in the context of syringe pump training and add the lessons learned from the evaluated e-learning program.

Design and evaluation of an interactive training system for scrub nurses

OBJECTIVE

The current trend toward increasingly integrated technological support systems and the rise of streamlined processes in the OR have led to a growing demand for personnel with higher levels of training. Although simulation systems are widely used and accepted in surgical training, they are practically non-existent for perioperative nursing, especially scrub nursing. This paper describes and evaluates an interactive OR environment simulation to help train scrub nurses.

METHODS

A system comprising multiple computers and monitors, including an interactive table and a touchscreen combined with a client-server software solution, was designed to simulate a scrub nurse's workplace. The resulting demonstrator was evaluated under laboratory conditions with a multicenter interview study involving three participating ear, nose, and throat (ENT) departments in Germany and Switzerland.

RESULTS

The participant group of 15 scrub nurses had an average of 12.8 years hands-on experience in the OR. A series of 22 questions was used to evaluate various aspects of the demonstrator system and its suitability for training novices.

DISCUSSION

The system received very positive feedback. The participants stated that familiarization with instrument names and learning the instrument table setup were the two most important technical topics for beginners. They found the system useful for acquiring these skills as well as certain non-technical aspects.

CONCLUSIONS

Interactive training through simulation is a new approach for preparing novice scrub nurses for the challenges at the instrument table in the OR. It can also improve the lifelong training of perioperative personnel. The proposed system is currently unique in its kind. It can be used to train both technical and non-technical skills and, therefore, contributes to patient safety. Moreover, it is not dependent on a specific type of surgical intervention or medical discipline.

Does online learning click with rural nurses? A qualitative study

OBJECTIVE

To explore the factors that influence rural nurses engagement with online learning within a rural health district in New Sound Wales (NSW), Australia.

DESIGN

This qualitative study based on appreciative inquiry methodology used semi-structured interviews with managers and nurses. Purposive sampling methods were used to recruit facility managers, whereas convenience sampling was used to recruit nurses in 2012-2013.

SETTING

Three public health facilities in rural NSW.

PARTICIPANTS

Fourteen nurses were involved in the study, including Health Service Managers (n = 3), Nurse Unit Manager (n = 1), Clinical Nurse Specialists (n = 3), Registered Nurses (n = 2), Enrolled Nurses (n = 2) and Assistant in Nursing (n = 3).

MAIN OUTCOME MEASURE

The research found that online learning works well when there is accountability for education being undertaken by linking to organisational goals and protected time. Nurses in this study valued the ability to access and revisit online learning at any time. However, systems that are hard to access or navigate and module design that did not provide a mechanism for users to seek feedback negatively affected their use and engagement.

CONCLUSION

This study demonstrates that rural nurses' engagement with online learning would be enhanced by a whole of system redesign in order to deliver a learning environment that will increase satisfaction, engagement and learning outcomes.

Effects of mobile phone-based app learning compared to computer-based web learning on nursing students: pilot randomized controlled trial

Objectives

This study aimed to determine the effect of mobile-based discussion versus computer-based discussion on self-directed learning readiness, academic motivation, learner-interface interaction, and flow state.

Methods

This randomized controlled trial was conducted at one university. Eighty-six nursing students who were able to use a computer, had home Internet access, and used a mobile phone were recruited. Participants were randomly assigned to either the mobile phone app-based discussion group (n = 45) or a computer web-based discussion group (n = 41). The effect was measured at before and after an online discussion via self-reported surveys that addressed academic motivation, self-directed learning readiness, time distortion, learner-learner interaction, learner-interface interaction, and flow state.

Results

The change in extrinsic motivation on identified regulation in the academic motivation (p = 0.011) as well as independence and ability to use basic study (p = 0.047) and positive orientation to the future in self-directed learning readiness (p = 0.021) from pre-intervention to post-intervention was significantly more positive in the mobile phone app-based group compared to the computer web-based discussion group. Interaction between learner and interface (p = 0.002), having clear goals (p = 0.012), and giving and receiving unambiguous feedback (p = 0.049) in flow state was significantly higher in the mobile phone app-based discussion group than it was in the computer web-based discussion group at post-test.

Conclusions

The mobile phone might offer more valuable learning opportunities for discussion teaching and learning methods in terms of self-directed learning readiness, academic motivation, learner-interface interaction, and the flow state of the learning process compared to the computer.

Using evidence-integrated e-learning to enhance case management continuing education for psychiatric nurses: a randomised controlled trial with follow-up

BACKGROUND

E-learning is a flexible strategy to improve nurses' knowledge of case management, but there are methodological limitations in previous research into the effectiveness of such programs.

PURPOSE

To describe the development and effectiveness of an evidence-integrated e-learning program in case management continuing education for Taiwanese psychiatric nurses.

DESIGN

Multiple methods were adopted to develop the program and a randomised controlled trial with repeated measures was employed to evaluate it.

METHODS

The e-learning program was developed in four stages: (1) systematic review of literature; (2) needs assessment through a national survey and focus group; (3) development of learning materials; and (4) pilot test. Following program development, psychiatric nurses were recruited and randomly allocated into an experimental or comparison group. The experimental group participated in an e-learning continuing education program. The case management knowledge index with sufficient reliability and validity and a satisfaction survey were used to determine the outcomes. A generalised estimating equation was used to assess the difference between the 2 groups before, after, and at 3 months follow-up.

RESULTS

The learning material comprised 5 simulated learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. A total of 200 participants completed the 3 measurements. Knowledge scores in the experimental group significantly exceeded those in the comparison group after the program and at the 3-month follow-up. Participants reported positive learning perceptions.

CONCLUSION

The program provides an evidence-based educational resource for nursing continuing education in case management.

E-learning & information communication technology (ICT) in nursing education: A review of the literature

OBJECTIVES

To examine primary research articles published between January 2001 and December 2012 that focused on the issues for students and educators involved with E-learning in preregistration nursing programs. The literature was systematically reviewed, critically appraised and thematically analyzed.

BACKGROUND

E-learning is arguably the most significant change to occur in nursing education since the move from hospital training to the tertiary sector. Differences in computer and information literacy for both students and educators influence the success of implementation of E-learning into current curricula.

DATA SOURCES

Online databases including CINAHL, MEDLINE, OVID, the ProQuest Central, PubMed, ERIC and Science Direct were used.

METHODS

The criteria used for selecting studies reviewed were: primary focus on electronic learning and issues faced by nursing students and/or nurse educators from undergraduate preregistration nursing programs; all articles had to be primary research studies, published in English in peer reviewed journals between January 2001 and December 2012.

RESULTS

Analysis of the 28 reviewed studies revealed the following three themes: issues relating to E-learning for students; use of information technologies; educator (faculty) issues involving pedagogy, workload and staff development in E-learning and associated technology.

CONCLUSION

The review highlighted that commencing preregistration nursing students required ongoing education and support surrounding nursing informatics. This support would enable students to progress and be equipped with the life-long learning skills required to provide safe evidence based care. The review also identified the increased time and skill demands placed on nurse educators to adapt their current education methodologies and teaching strategies to incorporate E-learning.

A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education

AIM

To determine whether the use of an online or blended learning paradigm has the potential to enhance the teaching of clinical skills in undergraduate nursing.

BACKGROUND

The need to adequately support and develop students in clinical skills is now arguably more important than previously considered due to reductions in practice opportunities. Online and blended teaching methods are being developed to try and meet this requirement, but knowledge about their effectiveness in teaching clinical skills is limited.

DESIGN

Mixed methods systematic review, which follows the Joanna Briggs Institute User guide version 5.

DATA SOURCES

Computerized searches of five databases were undertaken for the period 1995-August 2013.

REVIEW METHODS

Critical appraisal and data extraction were undertaken using Joanna Briggs Institute tools for experimental/observational studies and interpretative and critical research. A narrative synthesis was used to report results.

RESULTS

Nineteen published papers were identified. Seventeen papers reported on online approaches and only two papers reported on a blended approach. The synthesis of findings focused on the following four areas: performance/clinical skill, knowledge, self-efficacy/clinical confidence and user experience/satisfaction. The e-learning interventions used varied throughout all the studies.

CONCLUSION

The available evidence suggests that online learning for teaching clinical skills is no less effective than traditional means. Highlighted by this review is the lack of available evidence on the implementation of a blended learning approach to teaching clinical skills in undergraduate nurse education. Further research is required to assess the effectiveness of this teaching methodology.

Tutors' opinions of suitability of online learning programmes in continuing professional development for midwives

BACKGROUND

Online learning is frequently used in continuing professional development for qualified nurses and midwives. It is frequently assumed that the same package is appropriate for different groups of learners and that by reducing the need for tutorial input, tutorial time is saved.

OBJECTIVES

We evaluated the suitability of an online learning resource for suitability in continuing professional development for midwives. Originally developed for use as part of a work-based package for a specific audience, there had always been plans for more general use of the resource with other groups of health workers.

DESIGN

Sequential mixed methods study.

SETTING

English universities.

PARTICIPANTS

Seventy university tutors.

METHODS

Online questionnaire and in-depth interviews.

FINDINGS

Tutors did not consider that the online learning materials would be suitable for a wider audience without significant adaptation. They thought that uptake would increase need for tutorial input.

CONCLUSION

Our findings demonstrate the pitfalls of removing learning from the context of practice. Technology customised to meet the needs of one group of learners probably does not have the potential for transfer to another group without significant adaptation. Those responsible for designing e-learning should take into account the needs of all the different audiences for whom the resource is intended from the outset, with consideration for the context in which learning will be applied to practice and how students will be supported. If the same package is to be used by different audiences and in different settings, tutors and students will require explicit instructions of how they should use the resource and depth of knowledge and level of competency that should be attained at the conclusion of the programme.

Self-assessment of nursing informatics competencies for doctor of nursing practice students

This study examined the informatics competencies of doctor of nursing practice (DNP) students and whether these competencies differed between DNP students in the post-baccalaureate (BS) and post-master's (MS) tracks. Self-reported informatics competencies were collected from 132 DNP students (68 post-BS and 64 post-MS students) in their first year in the program (2007 to 2010). Students were assessed in 18 areas of 3 competency categories: computer skills, informatics knowledge, and informatics skills. Post-BS students were competent in 4 areas (computer skills in communication, systems, documentation, and informatics knowledge about impact of information management), whereas post-MS students were competent in only 1 area (computer skills in communication). Students in both tracks reported computer skills in decision support as their least competent area. Overall, post-BS students reported slightly higher than or similar competency scores as post-MS students, but scores were statistically significant in only 3 of 18 areas. The assessment indicated that knowledge and skills on informatics competencies need to be improved, especially in computer skills for data access and use of decision support systems. Strategies are suggested to integrate competencies into existing informatics course and DNP curricula. Further studies are recommended using an objective measure of informatics competencies.

The effectiveness of an e-learning program on pediatric medication safety for undergraduate students: a pretest-post-test intervention study

BACKGROUND

Safe medication management is a major competency taught in the nursing curriculum. However, administering pediatric medications is considered a common clinical stressor for Taiwanese students. A supplemental e-learning program that helps students fill the gap between basic nursing skills and pediatric knowledge on medication safety was developed.

OBJECTIVE

To evaluate the effectiveness of an e-learning program to increase pediatric medication management among students who take pediatric nursing courses.

DESIGN

This intervention study used a historical comparison design.

SETTING

A university in Northern Taiwan.

PARTICIPANTS

A total of 349 undergraduate nursing students who took pediatric nursing courses participated. Eighty students in the comparison group received regular pediatric courses, including the lectures and clinical practicum; 269 students in the intervention group received an e-learning program, in addition to the standard pediatric courses.

METHODS

Between February 2011 and July 2012 pediatric medication management, including pediatric medication knowledge and calculation ability, was measured at the beginning of the first class, at the completion of the lectures, and at the completion of the clinical practicum. The program was evaluated qualitatively and quantitatively.

RESULTS

The intervention group had significantly higher pediatric medication management scores at completion of the lecture course and at the completion of the clinical practicum than the comparison group based on the first day of the lecture course, after adjusting for age, nursing program, and having graduated from a junior college in nursing. Overall, the students appreciated the program that included various teaching modalities content that related to the administration of medication.

CONCLUSION

Using an e-learning program on pediatric medication management is an effective learning method in addition to sitting in a regular lecture course. The different emphases in each module, provided by experienced instructors, enabled the students to be more aware of their role in pediatric medication safety.

Web-based distance learning for nurse education: a systematic review

BACKGROUND

Web-based distance learning is considered a promising approach to replace or supplement conventional nursing instruction. However, no systematic review has been seen to explore the effect of web-based distance education in nursing.

AIM

To examine the efficacy of the web-based distance education for nursing students and employed nurses.

METHODS

A systematic review of randomized controlled studies was undertaken. Multiple search strategies were performed in PubMed and Embase until July 2012. Two reviewers independently selected trials, conducted quality critical appraisal, and extracted the data from the included studies.

RESULTS

Nine randomized controlled trials met inclusion criteria, among which five studies were rated as A quality level, and the other four studies as B quality level. The results showed that web-based distance learning has produced equivalent or better effects in knowledge acquisition. For nursing skill performance, four studies revealed a positive role for the new teaching mode, and one study showed a negative viewpoint. This review also demonstrated that participants generally accepted web-based education with high satisfaction rates. Two studies reported a more positive trend for self-efficacy in performing nursing skills in the experiment group compared with control group. Some negative feedbacks were also expressed.

CONCLUSION

Web-based education has encouraging effects in improving both participants' knowledge and skills performance, and in enhancing self-efficacy in performing nursing skills, with a high satisfaction rate expressed by participants. More rigorous experimental studies are advocated.

Instructional multimedia: an investigation of student and instructor attitudes and student study behavior

BACKGROUND

Educators in allied health and medical education programs utilize instructional multimedia to facilitate psychomotor skill acquisition in students. This study examines the effects of instructional multimedia on student and instructor attitudes and student study behavior.

METHODS

Subjects consisted of 45 student physical therapists from two universities. Two skill sets were taught during the course of the study. Skill set one consisted of knee examination techniques and skill set two consisted of ankle/foot examination techniques. For each skill set, subjects were randomly assigned to either a control group or an experimental group. The control group was taught with live demonstration of the examination skills, while the experimental group was taught using multimedia. A cross-over design was utilized so that subjects in the control group for skill set one served as the experimental group for skill set two, and vice versa. During the last week of the study, students and instructors completed written questionnaires to assess attitude toward teaching methods, and students answered questions regarding study behavior.

RESULTS

There were no differences between the two instructional groups in attitudes, but students in the experimental group for skill set two reported greater study time alone compared to other groups.

CONCLUSIONS

Multimedia provides an efficient method to teach psychomotor skills to students entering the health professions. Both students and instructors identified advantages and disadvantages for both instructional techniques. Reponses relative to instructional multimedia emphasized efficiency, processing level, autonomy, and detail of instruction compared to live presentation. Students and instructors identified conflicting views of instructional detail and control of the content.

Evaluation of Online Instruction to Improve Medical and Dental Students’ Communication and Counseling Skills

Online, interactive video modules were created to demonstrate good skills in history taking, counseling, and communication. The authors evaluated the effect of the modules on students’ data gathering, counseling, and communication skills with standardized patients (SPs). A student cohort without the online modules ( n = 76 medical students and n = 43 dental students) was compared to a cohort of different students who were assigned the modules ( n = 88 medical students and n = 39 dental students). Students were evaluated by SPs using case-specific content checklists and the Master Interview Rating Scale (MIRS). Compared to their counterparts who did not use the modules, medical and dental students who used the modules showed significantly higher performance on several outcomes. The areas that showed benefit were those that were novel to students. Student accuracy in grading others was generally unrelated to their own performance. In conclusion, the online, interactive video modules were associated with improvements in a majority of clinical skills.

Developing competence in cardiac care through the use of blended learning: course members' and mentors' accounts

The use of blended learning to develop the clinical knowledge and skills of healthcare professionals is increasing. This paper reports the qualitative findings from an evaluation of a blended learning course designed to equip registered nurses with the knowledge and skills required to practice competently in cardiac nursing. The aims of the study were to explore whether a cardiac care course could be successfully delivered mainly online and it had any impact on the students' clinical practice. The sample consisted of course members and their mentors. Data were obtained through focus groups and interviews and analysed using thematic analysis. All students felt they had benefited from undertaking the course. Mentors identified higher levels of confidence and greater depth of knowledge and skills amongst their students. Areas identified for further development by both groups were firstly, the preparation of mentors for their role in supporting the students undertaking an online course and secondly, the expected level of competence that students needed to display in practice. This study indicates online learning is useful in enhancing student competence but may be wrongly seen as requiring less time commitment for both course members and mentors when compared to taught courses.

Nursing students' perception of a Web-based intervention to support learning

Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point(R) presentations, animations and digitised video clips were introduced in a first year Bachelor of Nursing biological sciences subject at a university in metropolitan Sydney. All students enrolled in this unit were invited to obtain access to the site and the number of hits to the site was recorded using the student tracking facility available on WebCT, an online course delivery tool adopted widely by many educational institutions and used in this study. Eighty-five percent of students enrolled in the subject accessed the learning support site. Students' perception of the value of a learning support site was assessed using a web-based survey. The survey was completed by 123 participants, representing a response rate of 22%. Three themes emerged from the qualitative data concerning nursing students' perception of the web-based activities: 'enhances my learning', 'study at my own pace', and 'about the activities: what I really liked/disliked'. Web-based interventions, supplementing a traditionally presented nursing science course were perceived by students to be beneficial in both learning and language development. Although students value interactive, multimedia learning they were not ready to completely abandon traditional modes of learning including face-to-face lectures. The findings of this study contribute to an understanding of how web-based resources can be best used to support students' learning in bioscience.

Development of a web-based learning medium on mechanism of labour for nursing students

This study aimed to develop a web-based learning media on the process and mechanism of labour for the third-year university nursing and midwifery students. This media was developed based on integrating principles of the mechanism of labour with the 5Es inquiry cycle and interactive features of information technology. In this study, the web-based learning unit was used to supplement the conventional lecture as in the traditional teaching. Students' achievements were assessed by using the pre- and post-test on factual knowledge and semi-structured interviews on attitude to the unit. Supplementation with this learning unit made learning significantly more effective than the traditional lecture by itself. The students also showed positive attitude toward the learning unit.

Managing nursing assistants with a web-based system: an empirical investigation of the mixed-staff strategy

Under the global shortage of Registered Nurses (RNs), some hospitals have integrated nursing assistants (NAs) into their teams to help to provide maximum quality care for acute patients, while keeping the hospital's staff-related costs down. However, the RNs may have to shoulder an increased burden of assigning and overseeing NAs. A web-based Nursing Assistants Management System (NAMS) was developed and evaluated for a case hospital in Taiwan to compare the processes of assigning and managing NAs before and after the NAMS intervention. The results showed that NAMS saved 80% of the time needed for manual operation and there were no more complains about NAs being slow in dealing with patients after the system intervention. The satisfaction levels of all NA managers and RNs were acceptable. Based on the research findings, the implication and limitations of this study were discussed.

Electronic learning and constructivism: a model for nursing education

Nurse educators are challenged to teach nursing students to become competent professionals, who have both in-depth knowledge and decision-making skills. The use of electronic learning methods has been found to facilitate the teaching-learning process in nursing education. Although learning theories are acknowledged as useful guides to design strategies and activities of learning, integration of these theories into technology-based courses appears limited. Constructivism is a theoretical paradigm that could prove to be effective in guiding the design of electronic learning experiences for the purpose of providing positive outcomes, such as the acquisition of knowledge and decision-making skills. Therefore, the purposes of this paper are to: describe electronic learning, present a brief overview of what is known about the outcomes of electronic learning, discuss constructivism theory, present a model for electronic learning using constructivism, and describe educators' roles emphasizing the utilization of the model in developing electronic learning experiences in nursing education.

Predictive validity of Perceived Emotional Intelligence on nursing students' self-concept

This study examines the role of Perceived Emotional Intelligence, in nursing students' self-concept, controlling personality dimensions. Self-image is a cognitive component of the self that contains images of who we are, what we want to be and what we express and wish to express to others. Likewise, there is also an emotional and assessable component known as self-esteem. For a profession that requires not only technical expertise but also psychologically oriented care, knowledge about the self in nursing would be crucial to further development and growth of the profession. However, the role of emotions in the formation of nursing professionals has been scarcely studied. One hundred and thirty five undergraduates from nursing studies voluntarily participated in our study. They completed a questionnaire that comprises several scales. Our results show positive correlations between the Clarity and Emotional Repair components of Perceived Emotional Intelligence and all scales of the self-concept scale. Furthermore, we found positive relationships between the Extraversion and Accountability components of personality with almost all the scales of the self-concept and negative relationships with personality and neuroticism components of the self-concept.

Towards a team-based, collaborative approach to embedding e-learning within undergraduate nursing programmes

E-learning approaches are incorporated in many undergraduate nursing programmes but there is evidence to suggest that these are often piecemeal and have little impact on the wider, nurse education curriculum. This is consistent with a broader view of e-learning within the higher education (HE) sector, which suggests that higher education institutions (HEIs) are struggling to make e-learning a part of their mainstream delivery [HEFCE, 2005. HEFCE Strategy for E-Learning 2005/12. Bristol, UK, Higher Education Funding Council for England (HEFCE). [online] Available at: <http://www.hefce.ac.uk/pubs/hefce/2005/05_12/> Accessed: 30 May 07]. This article discusses some of the challenges that face contemporary nurse education and seeks to account for reasons as to why e-learning may not be fully embedded within the undergraduate curriculum. These issues are considered within a wider debate about the need to align e-learning approaches with a shift towards a more student focused learning and teaching paradigm. The article goes on to consider broader issues in the literature on the adoption, embedding and diffusion of innovations, particularly in relation to the value of collaboration. A collaborative, team-based approach to e-learning development is considered as a way of facilitating sustainable, responsive and multidisciplinary developments within a field which is constantly changing and evolving.

Baccalaureate nursing students' information technology competence--agency perspectives

Baccalaureate nurses must meet information technology (IT) competencies expectations for employment and future professional development. Unfortunately, educational programs and accrediting groups have not identified specific outcomes, and IT is not integrated formally into many undergraduate program curricula. Meanwhile, nursing students and faculty are practicing in clinical agencies undergoing an informatics and technology revolution. Adding courses and content, hardware, software, and strategies such as distance learning and simulation have been recommended to improve competency development. However, little is known regarding nursing students' experiences with IT in clinical practice. Agencies used as sites for one undergraduate program were surveyed and asked to identify barriers and facilitators to students' IT competencies attainment. Ten agency, program, and policy factors affecting the quality of the learning experience in clinical agencies were identified. Results underscored that leadership to improve collaboration and communication between nursing practice, education, and policy groups is necessary to improve clinical environments for IT learning.

Graduating nurses' self-evaluation of information technology competencies

Using a standardized instrument, graduating baccalaureate nurses reported moderate information technology skills. The students were most confident in their Internet, word processing, and systems operations skills; the students' rated themselves lowest on care documentation and planning, valuing informatics knowledge, skills development, and data entry competencies. Exposure to the latest informatics systems was a priority. Students want fair access to informatics and technology-rich clinical settings; more realistic informatics and technology simulations; enthusiastic and capable faculty; and better hardware, software, and literature-searching support in agencies, classrooms, laboratories, and residences. Nursing programs, clinical agencies, and policy makers need to recognize that students are advancing beyond acquiring informatics skills to integrating health information literacy into practice. To facilitate current and future skills attainment and innovation, nursing informatics education and evaluation must keep pace.