Becoming a web-based learner: registered nurses' experiences

Digital consumer behaviour: insights into the perceptions of late adolescents' consumption of digital media on cognitive health

OBJECTIVES

Digital media has become an indispensable facet of adolescents' everyday lives, playing a crucial role in their daily routines, encompassing various activities such as accessing information, accomplishing academic tasks, and facilitating interpersonal communication. Literature evidence on the effects of digital media on cognitive health is bi-directional, having both positive and negative impacts. The present research aimed to explore the perceptions of digital media consumption on cognitive health in late adolescents between the age of 17 and 21 years.

METHODS

A self-reported online survey was administered to 173 adolescents, and the data were analysed using statistical software (SPSS 17).

RESULTS

The findings revealed that some late adolescents recognize the importance of cognition in their daily activities and health, particularly for activities focused on cognitive, academic, personal, and social skills. Mobile phones, laptops, and television were the most commonly preferred gadgets, while e-pads, Alexa, smartwatches, Kindle, tablets, and play stations were less preferred. Interestingly, a high proportion of participants reported neutral perceptions of digital media's influence on cognitive health, highlighting the need to create awareness and educate late adolescents on healthy digital media consumption.

CONCLUSIONS

The findings hold significant implications for the development of comprehensive guidelines and evidence-based recommendations for digital media usage among late adolescents. Additionally, the research sheds light on the strategies adopted by adolescents to regulate and optimize their consumption of digital media, thereby providing valuable insights into effective practices and potential areas for improvement.

Student performance and perceptions of anatomy and physiology across face-to-face, hybrid, and online teaching lab styles

Health science represents the fastest-growing industry in the United States, a trend not predicted to slow for the next decade. The high demand for health professionals has led to increased demand for anatomy and physiology (A&P) courses and a transition to hybrid-style labs to meet the necessary increased enrollment without increasing the need for lab space and compromising educational quality. The transition to hybrid-style labs has only accelerated and become more important with the COVID-19 pandemic. It has been relatively unclear, however, how the hybrid style has impacted student learning, satisfaction, and performance. Furthermore, there is a general lack of research investigating the advantages and disadvantages across hybrid, online, and face-to-face styles. This lack of research is particularly obvious within biological sciences, including A&P. Attendance, practical grades, and overall grades were compared between face-to-face, hybrid, and online A&P lab styles. A survey was administered to compare student perceptions and experiences between hybrid and online lab styles. The hybrid style had many of the same advantages as online and face-to-face styles yet very few disadvantages. Hybrid lab students reported better experiences and greater satisfaction, attended more labs, and outperformed online lab students. Face-to-face lab students, however, outperformed hybrid lab students. These findings can ultimately inform how to best implement, organize, and improve hybrid-style labs to maximize student learning, achievement, and enjoyment.NEW & NOTEWORTHY Demand for health professionals increased the demand for A&P courses and led to a transition to hybrid-style labs. There is a general lack of research investigating advantages/disadvantages across hybrid, online, and face-to-face styles. I found that the hybrid style had many of the advantages of online and face-to-face styles yet very few disadvantages. Hybrid lab students reported better experiences and greater satisfaction and outperformed online lab students. Face-to-face lab students, however, outperformed hybrid lab students.

No Student Left Behind: Students’ Experiences of a Self-Paced Online Learning Orientation in Undergraduate Studies during COVID-19 Pandemic

The rapid transition to remote online learning modality during the COVID-19 pandemic forced traditional brick-and-mortar universities to implement student support mechanisms to ensure that student learning is not impaired. This paper presents data derived from a study aimed at investigating students’ perceptions of a self-paced online learning orientation (OLO) in an undergraduate Food Science and Technology course. To elicit student responses, a mixed-method survey with a five-point Likert scale and open-ended qualitative questions was conducted via the Blackboard learning management system (LMS). In this study, participants reported having access to the LMS: using smartphones (66.3%), followed by a laptop with a webcam (38.55%), and a laptop with no webcam (26.51%). The participants also felt that it was easy to navigate (M = 3.95 ± 0.88) the OLO course, and they were able to locate the required content (M = 3.83 ± 1.03). Furthermore, results also showed that participants expressed a high commitment to accessing the LMS and reviewing course announcements (M = 4.72 ± 0.57) and kept up to date with the course activities (M = 4.58 ± 0.70) after completing the OLO. Therefore, the authors suggest that using a learner-centered OLO with authentic learning activities that mimic course activities is crucial to online students’ success in online learning. These findings have significant implications for educators who intend to re-design their courses and enhance remote online learning experiences for students.

Improving breast cancer nurses' management of challenging situations involving family carers: Pilot evaluation of a brief targeted online education module (TRIO-Conflict)

OBJECTIVE

Given the stressful and emotional nature of cancer, challenging interactions between nurses, patients, and family frequently occur. Nurses are rarely equipped with strategies to avoid or de-escalate stressful situations with carers, which can include displays of conflict, anger, or dominance. A brief online education module (TRIO-Conflict) was developed to provide nurses with management strategies to use in situations of conflict. This study aimed to assess the feasibility, acceptability, and potential efficacy of TRIO-Conflict.

METHODS

Nurses were recruited through an Australian breast cancer organisation (McGrath Foundation). Participants completed pre/post module measures of attitudes towards carers, confidence in their skills to effectively navigate challenging interactions with carers, and applied knowledge of management strategies. Data were analysed using Wilcoxon signed-rank tests. Qualitative feedback was analysed using content analysis.

RESULTS

52 nurses completed pre-/post- measures, with 4 semi-structured interviews conducted. Significant improvements in attitudes towards carers (p = .010) and confidence in one's own ability to manage challenging interactions with carers (p < .001) were found, but not knowledge of strategies. Most nurses found TRIO-Conflict very/extremely helpful (87%) and were satisfied with content (94%) and usability (93%).

CONCLUSION

TRIO-Conflict utilised evidence-based learning techniques (provision of example phrases, video vignettes, reflective exercises) to improve nurses attitudes and confidence.

PRACTICE IMPLICATIONS

TRIO-Conflict is a brief, targeted, clinically relevant, and easily accessible online training programme which could be widely disseminated to oncology nurses.

eTRIO trial: study protocol of a randomised controlled trial of online education modules to facilitate effective family caregiver involvement in oncology

OBJECTIVE

Informal family caregivers play a crucial role in cancer care. Effective caregiver involvement in cancer care can improve both patient and caregiver outcomes. Despite this, interventions improving the caregiver involvement are sparse. This protocol describes a randomised controlled trial evaluating the combined effectiveness of novel online caregiver communication education modules for: (1) oncology clinicians (eTRIO) and (2) patients with cancer and caregivers (eTRIO-pc).

METHODS AND ANALYSIS

Thirty medical/radiation/surgical oncology or haematology doctors and nurses will be randomly allocated to either intervention (eTRIO) or control (an Australian State Government Health website on caregivers) education conditions. Following completion of education, each clinician will recruit nine patient-caregiver pairs, who will be allocated to the same condition as their recruiting clinician. Eligibility includes any new adult patient diagnosed with any type/stage cancer attending consultations with a caregiver. Approximately 270 patient-caregiver pairs will be recruited. The primary outcome is caregiver self-efficacy in triadic (clinician-patient-caregiver) communication. Patient and clinician self-efficacy in triadic communication are secondary outcomes. Additional secondary outcomes for clinicians include preferences for caregiver involvement, perceived module usability/acceptability, analysis of module use, satisfaction with the module, knowledge of strategies and feedback interviews. Secondary outcomes for caregivers and patients include preferences for caregiver involvement, satisfaction with clinician communication, distress, quality of life, healthcare expenditure, perceived module usability/acceptability and analysis of module use. A subset of patients and caregivers will complete feedback interviews. Secondary outcomes for caregivers include preparedness for caregiving, patient-caregiver communication and caring experience. Assessments will be conducted at baseline, and 1 week, 12 weeks and 26 weeks post-intervention.

ETHICS AND DISSEMINATION

Ethical approval has been received by the Sydney Local Health District Human Research Ethics Committee (REGIS project ID number: 2019/PID09787), with site-specific approval from each recruitment site. Protocol V.7 (dated 1 September 2020) is currently approved and reported in this manuscript. Findings will be disseminated via presentations and peer-reviewed publications. Engagement with clinicians, media, government, consumers and peak cancer groups will facilitate widespread dissemination and long-term availability of the educational modules.

TRIAL REGISTRATION NUMBER

ACTRN12619001507178.

Enacting evidence-based practice: pathways for community nurses

Community nurses are expected to deliver evidence-based practice, which is challenging given the diversity and breadth of the evidence base from which they can draw. This study aimed to explore community nurses' experiences of implementing change in their practice. Qualitative semi-structured interviews (n=9) and focus groups (n=2) with community nurses (n=17) were conducted. Three pathways to introduce change in practice were identified by participants: bottom-up, top-down and collaborative pathways. These are based on the nature of the proposed change, the available evidence, 'buy in' from colleagues and issues around implementation. The findings identify approaches to implementing change in community nursing practice. Practitioners would benefit from support to navigate the complex process of change through managerial support, ongoing education, accessible online resources and support through a practice development role.

Professional practice-related training and organizational readiness for change facilitate implementation of projects on the national core value system in care of older people

AIM

To explore whether professional training contributed to implementation of the national core value system in practice in care of older people and to identify course participants' perceptions about factors that facilitated or obstructed them in implementing their projects. To identify participants' perceptions concerning factors that facilitate or obstruct implementation.

DESIGN

Descriptive and cross-sectional.

METHODS

Data were retrieved from 451 participants who had completed the course "Understanding and providing leadership based on the national core value system for older people" at Uppsala University during spring semester and autumn semester of 2018. Quantitative and qualitative data were obtained using a web-based questionnaire.

RESULTS

The results showed that the majority (73%) of project plans were initiated, although not always completed and sometimes interrupted. Organizational readiness in terms of management supporting and prioritizing these plans were two principle facilitators chosen by half of the respondents and consequently the absence of these factors was an obstacle. In addition, successful implementation required dedicated co-workers and certain resources, such as time and funds. Surprisingly, factors related to the project leader were reported to be of limited importance.

Registered nurses' perception of self-efficacy and competence in smoking cessation after participating in a web-based learning activity

AIMS AND OBJECTIVES

To describe how registered nurses having undergone a web-based learning activity perceive their self-efficacy and competence to support patients with smoking cessation in connection with surgery.

BACKGROUND

Smoking cessation in connection with surgery reduces postoperative complications, and the support patients get from registered nurses may be important in helping them become smoke-free in connection with their surgery. Therefore, registered nurses are in need of enhanced understanding about which kind of counselling is the most effective for smoking cessation. Educating large groups of registered nurses in a digital environment appears to be a flexible and cost-effective way.

DESIGN AND METHODS

A convergent mixed-method design with data collection was done using questionnaires (n = 47) and semistructured interviews (n = 11). Inclusion criteria were registered nurses in surgical wards. The samples were nonprobability and modified nested. Descriptive statistics and content analysis were used for data analysis.

RESULTS

After completing the web-based learning activity, the registered nurses perception was that of good self-efficacy and increased competence in supporting patients with smoking cessation in connection with surgery. They improved their understanding of how to talk about smoking cessation with patients in dialogue using open-ended questions. Nevertheless, the registered nurses requested opportunities for dialogue and interaction with colleagues or topic experts.

CONCLUSIONS

The results indicate that registered nurses can enhance their competence in supporting patients to embrace smoking cessation by learning in a digital environment. Self-efficacy and understanding of the topic seems to motivate registered nurses to counsel patients about smoking cessation.

RELEVANCE TO CLINICAL PRACTICE

Findings from this study will be of particular interest to educators in healthcare settings who can devise further development of web-based learning activities.

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

Professional development opportunities for nurses are increasingly being offered in the online environment and therefore it is imperative that learning designers, nurse educators and healthcare organisations consider how best to support staff to enable Registered Nurses to capitalise on the resources available. Research participants explored educational strategies to support digitally differentiated nurses' engagement with professional development activities in an online environment through a participatory action research project that collected data over a 16 month period through six focus groups before being analysed thematically. The reality of work-based, e-learning while managing clinical workloads can be problematic however specific measures, such as having a quiet space and computer away from the clinical floor, access to professional development resources from anywhere and at any time, can be effective. A 'one-size-fits-all' approach to resources offered will not meet the needs of diverse staffing groups whereas heutagogical learning offers tangible benefits to Registered Nurses seeking professional development opportunities in this context. Apparent proficiency with technological skills may not reflect a Registered Nurse's actual ability in this environment and face-to-face support offered regularly, rather than remedially, can be beneficial for some staff. Implementing specific strategies can result in successful transition to the online environment.

Medication competency of nurses according to theoretical and drug calculation online exams: A descriptive correlational study

BACKGROUND

Medication administration is an important task of registered nurses. According to previous studies, nurses lack theoretical knowledge and drug calculation skills and knowledge-based mistakes do occur in clinical practice. Finnish health care organizations started to develop a systematic verification processes for medication competence at the end of the last decade. No studies have yet been made of nurses' theoretical knowledge and drug calculation skills according to these online exams.

OBJECTIVES

The aim of this study was to describe the medication competence of Finnish nurses according to theoretical and drug calculation exams.

DESIGN

A descriptive correlation design was adopted. Participants and settings All nurses who participated in the online exam in three Finnish hospitals between 1.1.2009 and 31.05.2014 were selected to the study (n=2479).

METHODS

Quantitative methods like Pearson's chi-squared tests, analysis of variance (ANOVA) with post hoc Tukey tests and Pearson's correlation coefficient were used to test the existence of relationships between dependent and independent variables.

RESULTS

The majority of nurses mastered the theoretical knowledge needed in medication administration, but 5% of the nurses struggled with passing the drug calculation exam. Theoretical knowledge and drug calculation skills were better in acute care units than in the other units and younger nurses achieved better results in both exams than their older colleagues.

CONCLUSION

The differences found in this study were statistically significant, but not high. Nevertheless, even the tiniest deficiency in theoretical knowledge and drug calculation skills should be focused on. It is important to identify the nurses who struggle in the exams and to plan targeted educational interventions for supporting them. The next step is to study if verification of medication competence has an effect on patient safety.

Odnos študentov zdravstvene nege do e-izobraževanja

Uvod: E-izobraževanje je v terciarnem izobraževanju vse bolj pomembno, kljub temu pa tovrsten način učenja ni povsod uspešno implementiran. Na uspešnost uvajanja e-izobraževanja v študij pomembno vpliva pripravljenost na tovrstno obliko izobraževanja in odnos študentov do njega. Namen raziskave je bil proučiti naklonjenost študentov zdravstvene nege do e-izobraževanja. Metode: Kvantitativno raziskavo s spletnim anketiranjem smo izvedli v marcu 2014, na priložnostnem vzorcu (n = 92) študentov Fakultete za zdravstvo Jesenice. Koeficient Cronbach alfa je bil 0,966. Podatke smo obdelali s SPSS 20.0. Uporabili smo frekvenčno analizo, t-test za neodvisne vzorce, enosmerno analizo variance, korelacijsko, faktorsko in regresijsko analizo. Rezultati: Prednosti e-izobraževanja so najvišje ocenjene s strani študentov, ki so v e-učilnici sodelovali pri treh predmetih (p = 0,000). Odnos do e-izobraževanja je povezan z računalniško pismenostjo študentov (p < 0,05). Na odnos študentov do e-izobraževanja statistično značilno pozitivno vplivajo njegove prednosti (0,211< β

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.

Blended Learning Among Elderly Care Managers Inspires Projects That Take Older People’s Perspectives Into Account

When the national core value system was introduced in Sweden, care professionals were challenged to be part of a paradigm shift by changing their perspective, from regarding older people like passive recipients of societal efforts to treating them as active subjects and taking their preferences and wishes into consideration as well. To realize this shift in attitudes and behavior, an interprofessional blended education course was offered. The present study explored the utility of the blended educational approach in the local implementation of the national policy in elderly care. We argue that the course has contributed to enhanced competence in terms of how professionals relate theories and targeted discussions to specific and concrete improvement in their professions and workplaces.

Home Nurses’ Opinions Toward e-Learning in Continuing Education

There is an increased focus on the introduction of e-learning in the continuing education of home nurses. The aim of this study was to explore the opinions of home nurses toward continuing education via e-learning. The majority of the participants (87.9%) were willing to be educated via e-learning. The five main criteria in the success of an e-learning module were the user friendliness (79.7%), a thorough explanation about the use of the platform (63.7%), a thorough development of the subject (34.7%), the possibility to exchange ideas with colleagues or teachers (30.9%), and the availability of online illustrations (30.8%). The home nurses are willing to be educated via e-learning, but they were not conclusive on their preference toward classical education or education via e-learning.

Learning experience of Chinese nursing students in an online clinical English course: qualitative study

The low English proficiency of Chinese nurse/nursing students affects their performance when they work in English-speaking countries. However, limited resources are available to help them improve their workplace English, i.e. English used in a clinical setting. To this end, it is essential to look for an appropriate and effective means to assist them in improving their clinical English. The objective of this study is to evaluate the learning experience of Chinese nursing students after they have completed an online clinical English course. Focus group interview was used to explore their learning experience. 100 students in nursing programs at Tung Wah College were recruited. The inclusion criteria were: (1) currently enrolled in a nursing program; and (2) having clinical experience. Eligible participants self-registered for the online English course, and were required to complete the course within 3 months. After that, semi-structured interviews were conducted on students whom completed the whole and less than half of the course. One of the researchers joined each of the interviews as a facilitator and an observer. Thematic analysis was used to analyze the data. Finally, 7 themes emerged from the interviews: technical issues, adequacy of support, time requirement, motivation, clarity of course instruction, course design, and relevancy of the course. Participants had varied opinions on the 2 themes: motivation and relevancy of the course. Overall, results of this study suggest that the online English course helped students improve their English. Factors which support their learning are interactive course design, no time constraint, and relevancy to their work/study. Factors which detracted from their learning are poor accessibility, poor technical and learning support and no peer support throughout the course.

Translating research into practice: evaluation of an e-learning resource for health care professionals to provide nutrition advice and support for cancer survivors

BACKGROUND

Nurses and other allied health professionals are in a key position to provide appropriate and consistent advice on nutritional issues to support cancer survivors. However gaps in their nutrition knowledge and education warrant the need for enhanced learning as part of their Continued Professional Development (CPD). In the UK there are currently no formally recognised nutrition education programmes. Therefore e-learning offers a solution to provide flexible learning to target this need.

AIMS

This study aimed to develop and evaluate the efficacy of a freely available, internet-based learning resource, for nurses and allied health professionals who provide nutrition, diet and lifestyle advice for cancer survivors. It sought to explore the attitudes and conceptions of the resource and current knowledge base of those involved in the care pathway for cancer survivors.

METHOD

The design and development of the e-learning resource were informed by the best available research and policy evidence and in a format to facilitate on-line learning. A robust evaluation strategy incorporated focus groups and telephone interviews to gain in depth insights into the experiences of using the resource.

RESULTS

Themes included 'Plugging a Gap' which shows an improved knowledge base for nutrition. Information was 'All in One Place' showing that the resource was valued as being within a 'trusted' organisation. 'Everyone Benefits' illustrates how learners felt that the resource provided them with an evidence base, whilst the 'Current and Live' theme captured how professionals felt about the information being up-to-date.

CONCLUSIONS

The project has shown the benefits of interprofessional working to develop an e-learning resource for Health Care Professionals to support cancer survivors in following healthier lifestyles. Positive attitudes and potential improvements in the knowledge base and changes for professional practice were demonstrated. Further research is required to gauge sustained impact in the work environment by embedding the resource as part of CPD.

Predictors of attrition for a sexual assault forensic examiner (SAFE) blended learning training program

INTRODUCTION

Participant attrition is a major concern for online continuing education health care courses. The current study sought to understand what factors predicted health care professionals completing the online component of a sexual assault forensic examiner (SAFE) blended learning training program (12-week online course and 2-day in-person clinical skills workshop).

METHODS

The study used a Web-based survey to examine participant characteristics, motivation, and external barriers that may influence training completion. Hierarchical logistic regression was utilized to examine the predictors of training completion, while the Cox proportional hazards (Cox PH) regression model helped determine the factors associated with the timing of participant attrition.

RESULTS

Results show that 79.3% of the enrolled professionals completed the online component. The study also found that clinicians who work in rural communities and those who were interested in a 2-day clinical skills workshop were more likely to complete the online course. In terms of when attrition occurred, we found that participants who were motivated by the 2-day clinical workshop, those who worked in a rural community, and participants interested in the training program because of its online nature were more likely to complete more of the online course.

DISCUSSION

Blending an online course with a brief in-person clinical component may serve as a motivator for completing an online course because it provides the opportunity to develop clinical skills while receiving immediate feedback. Participant attrition appears to be less of a concern for rural clinicians because this modality can reduce their barriers to accessing continuing education.

Registered nurses' thoughts on blended learning in a postgraduate course in cancer care--content analyses of web surveys and a focus group interview

Purpose of the research was to describe registered nurses' (RNs) (n = 53) thoughts on the blended learning format in a 'specialist nursing programme in cancer care'. The study was conducted in autumn 2007 and 2008. A content analysis of answers to open-ended questions in a web-based questionnaire and a focus group interview were carried out. The analysis revealed that the RNs appreciated blended learning. The web lectures facilitated learning and gave RNs access to the education at any time. However, according to the RNs, knowledge is gained through interaction between RNs and teachers, and this aspect needed to be improved. The RNs also thought that the content of the seminars on campus should focus on evidence-based nursing knowledge and practical skills, not just taught as stable facts and procedures. The result from the present study could help to improve the design and content of advanced nursing courses using a blended learning format.

Using an SBAR - keeping it real! Demonstrating how improving safe care delivery has been incorporated into a top-up degree programme

Using a standard communication tool can enhance and provide focus, to ensure that communication is accurately recorded and understood (Marquis and Huston, 2009). The Situation, Background, Assessment and Recommendation (SBAR) approach is common place in healthcare situations today (Institute for Health Improvement, 2011), thus justifying the use of this contemporary way of communicating to structure this article. Patient safety, clinical effectiveness and person centred approaches to care, are top priorities in healthcare today. As nursing is in transition to an all degree profession, these dimensions of care should be integral to any "top-up" qualification. This paper discusses how this current clinical agenda was embedded into a top-up degree along with improvement methodology, in order to prepare newly graduated nurses for the world of modern healthcare. The module was developed and delivered in collaboration with clinical practice to maintain credibility and realism for the students. Based on Salmon's model of e-learning (Salmon, 2004), the completely online delivery meant that the students learning occurred whilst clinically based, allowing for theory and practice to interweave in a meaningful way, resulting in actual quality improvement.

Continuing education among Chinese nurses: a general hospital-based study

BACKGROUND

Continuing education (CE) is increasingly critical for nurses to keep abreast of rapid changes in patient care due to advancements in knowledge and technology.

OBJECTIVE

The objective of this study was to explore Chinese nurses' perceptions on continuing education, how best CE practices meet their learning needs, and the motivation and barriers nurses face in completing CE.

METHODS

A cross-sectional study of 2727 hospital-employed Chinese nurses from ten general hospitals was conducted from September to October 2010. Nurses' perceptions on CE, as well as motivational and preventive factors in CE were assessed.

RESULTS

The majority of nurses (97.3%) attended CE activities in the last twelve months. More than 92.2% of the nurses were familiar with the value of CE. Nurses expected CE activities to take place within a five-day period and to consist of 2h per activity. The major factors that motivate nurses to participate in CE are the desire to gain and update their knowledge of the newest nursing development and procedures, to improve their practical skills and comprehensive qualities, to maintain professional status and to receive an academic degree. Factors that hindered nurses' participation in CE included time constraints, work commitments, a lack of opportunity, cost of the courses and previous negative experiences with CE programs.

CONCLUSION

Chinese nurses considered CE an extremely important measure to further develop their professional competency. Nurses' actual expectations for CE and the motivation and barriers for participation in CE from nurses' individual, family and hospital perspective must be taken into the account in order to make CE programs more effective.

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.

The roles of social factor and internet self-efficacy in nurses' web-based continuing learning

This study was conducted to explore the relationships among social factor, Internet self-efficacy and attitudes toward web-based continuing learning in a clinical nursing setting. The participants recruited were 244 in-service nurses from hospitals in Taiwan. Three instruments were used to assess their perceptions of social factor, Internet self-efficacy (including basic and advanced Internet self-efficacy) and attitudes toward web-based continuing learning (including perceived usefulness, perceived ease of use, affection and behavior). Structural equation modeling (SEM) was utilized to identify the hypothesized structural model. The results of this study support that social factor is a significant factor correlated to Internet self-efficacy and attitudes toward web-based continuing learning (including perceived usefulness, perceived ease of use and affection). In addition, nurses' basic Internet self-efficacy plays a key role in attitudes including perceived usefulness, perceived ease of use and affection. However, advanced self-efficacy was not correlated to any of the attitudes. The behavior dimension was not linked to social factor or Internet self-efficacy, but was linked to perceived ease of use and affection.

Is there a place for e-learning in infection prevention?

BACKGROUND

In the last few decades, e-learning, a method which integrates information technology and the learning process by using materials delivered through the internet, has become widely used in educational initiatives for healthcare professionals.

PURPOSE

To evaluate whether there is a place for e-learning in the field of infection prevention.

METHODS

Non-comprehensive review of the literature.

FINDINGS

E-learning courses in the field of infection prevention and control are still scarce, often restricted to local initiatives and not specifically directed toward critical care providers. Although methodological flaws and potential biases hamper the generalizability of results from some currently available studies, findings related to both learners' satisfaction and effectiveness suggest that e-learning might prove an effective educational tool for the (continuing) education of healthcare providers. Further investigations, including research pertaining to the cost-effectiveness of e-learning, are required to provide a better insight in these issues.

CONCLUSION

Further research is required to determine the (cost)effectiveness of e-learning in general, and in the field of infection prevention and control in particular. Current insights suggest that e-learning should be based Web 2.0 technologies to address a wide range of learning styles and to optimize interactivity. As a gap in the literature was detected with respect to e-learning modules on infection prevention and control which are specifically oriented toward critical care providers, it can be recommended to promote the development and subsequent assessment of such tools that meet high-quality standards.

The relationships among nurses' job characteristics and attitudes toward web-based continuing learning

The purpose of this study was to explore the relationships between job characteristics (job demands, job control and social support) and nurses' attitudes toward web-based continuing learning. A total of 221 in-service nurses from hospitals in Taiwan were surveyed. The Attitudes toward Web-based Continuing Learning Survey (AWCL) was employed as the outcome variables, and the Chinese version Job Characteristic Questionnaire (C-JCQ) was administered to assess the predictors for explaining the nurses' attitudes toward web-based continuing learning. To examine the relationships among these variables, hierarchical regression was conducted. The results of the regression analysis revealed that job control and social support positively associated with nurses' attitudes toward web-based continuing learning. However, the relationship of job demands to such learning was not significant. Moreover, a significant demands×job control interaction was found, but the job demands×social support interaction had no significant relationships with attitudes toward web-based continuing learning.

Online or not? A comparison of students' experiences of an online and an on-campus class

Educational discourse has long portrayed online, or e-based, learning and all non-campus-based learning options as second best to traditional face-to-face options. Critically much of the research and debate in this area of study has focused on evidence relating to student performance, attrition and retention with little consideration of the total learning experience, which values both the traditional learning outcome measures side-by-side with student-centered factors, such as students' satisfaction with their learning experience. The objective of this study was to present a synchronous head-to-head comparison between online and campus-based students' experiences of an undergraduate course. This paper reports on a qualitative comparative cross-sectional study, which used multiple data collection approaches to assess student learning and student satisfaction of 61 students who completed a semester of an undergraduate course. Of the 61 students, 34 were enrolled purely as online students, whilst the remaining 27 students studied the same material entirely through the traditional face-to-face medium. Methods included a standardised student satisfaction survey and an 'achievement of learning outcomes' measurement tool. Students on the online cohort performed better in areas where 'self-direction' in learning was indicated, for example self-directed problem-based tasks within the course. Online students gave less positive self-assessments of their perceived content mastery than their campus-based counterparts, despite performing just as well in both summative and formative assignments. A multi-factorial comparison shows online students to have comparable educational success and that, in terms of student satisfaction, online learners reported more satisfaction with their learning experience than their campus-based counterparts.

Development of an online education program for midwives in australia to improve perinatal oral health

It is recommended that all pregnant women should receive a comprehensive oral health evaluation because poor maternal oral health may affect pregnancy outcomes and the general health of the woman and her baby. Midwives are well placed to provide dental health advice and referral. However, in Australia, little emphasis has been placed on the educational needs of midwives to undertake this role. This article outlines the development of an online education program designed to improve midwives' dental health knowledge, prepare them to assess the oral health of women, refer when required, and provide appropriate dental education to women and their families. The program consists of reading and visual material to assist with the oral health assessment process and includes competency testing.

Student outcomes of distance learning in nursing education: an integrative review

Distance learning offers a distinctive environment to educate nursing students. While there is a significant body of evidence in the literature related to course, program, and faculty outcomes of distance education, little attention has been given by researchers to evaluate student outcomes, with the exception of student satisfaction. There is a need to evaluate and translate findings related to student outcomes in distance learning into educational practice. Integrative reviews offer one strategy to contribute to evidence-based teaching practice initiatives. A search of available published qualitative and quantitative research on student outcomes of distance learning from 1999 to 2009 was conducted using a number of databases. Astin's Input-Environment-Output conceptual model provided a framework for this review. Thirty-three studies met the inclusion criteria. Bothcognitive and affective student outcomes emerged. The cognitive outcomes were student learning, learning process, and technology proficiency. Affective outcomes included personal and professional growth, satisfaction, and connectedness. Implications, recommendations, and future research are discussed.

Developing an online certification program for nutrition education assistants

OBJECTIVE

To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses.

DESIGN

An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and Nutrition Education Program core competencies was delivered to employees of both programs. Traditional vs online training was compared. Course content validity was determined through expert review by registered dietitians. Parameters studied included increase of nutrition knowledge and teaching technique/ability, educator satisfaction, and programming costs related to training.

SETTING

Utah State University Extension.

PARTICIPANTS

Twenty-two Supplemental Nutrition Assistance Program-Education and Expanded Food and Nutrition Education Program educators in Utah.

MAIN OUTCOME MEASURES

Knowledge and skills were measured using pre/posttest statistics. Participant satisfaction was measured with a survey.

ANALYSIS

Paired t test; satisfaction survey.

RESULTS

The change in paraprofessional knowledge score was statistically significant (P < .001). Forty percent of paraprofessionals strongly agreed and 60% agreed they were better prepared as nutrition educators because of the training. An estimated $16,000 was saved by providing the training online as compared to a face-to-face training.

CONCLUSIONS AND IMPLICATIONS

This interactive online program is a cost-effective way to increase paraprofessional knowledge and job satisfaction.

Exploring nursing e-learning systems success based on information system success model

E-learning is thought of as an innovative approach to enhance nurses' care service knowledge. Extensive research has provided rich information toward system development, courses design, and nurses' satisfaction with an e-learning system. However, a comprehensive view in understanding nursing e-learning system success is an important but less focused-on topic. The purpose of this research was to explore net benefits of nursing e-learning systems based on the updated DeLone and McLean's Information System Success Model. The study used a self-administered questionnaire to collected 208 valid nurses' responses from 21 of Taiwan's medium- and large-scale hospitals that have implemented nursing e-learning systems. The result confirms that the model is sufficient to explore the nurses' use of e-learning systems in terms of intention to use, user satisfaction, and net benefits. However, while the three exogenous quality factors (system quality, information quality, and service quality) were all found to be critical factors affecting user satisfaction, only information quality showed a direct effect on the intention to use. This study provides useful insights for evaluating nursing e-learning system qualities as well as an understanding of nurses' intentions and satisfaction related to performance benefits.

The impact of an interactive Web-based module on residents' knowledge and clinical practice of injury prevention

OBJECTIVE

To determine the effectiveness of an interactive Web-based module on knowledge acquisition, retention, and clinical practice by residents.

METHODS

Residents were randomized to complete an interactive Web-based module on injury prevention or a noninteractive Web-based module of identical content. Acquisition and retention of medical knowledge were measured by pretest, posttest, and long-term test scores, and change in clinical practice was measured by videotaped clinical encounters.

RESULTS

Fifty-seven residents completed the modules. The control group had higher posttest scores than the intervention group (P = .036). Thirty-seven residents completed the long-term test with scores that were significantly higher than pretest scores (P = .00). Thirty-six residents had videotaped encounter scores (232 visits), with no difference in these scores after the intervention (P = .432).

CONCLUSION

The noninteractive module was more effective in promoting knowledge acquisition. Residents successfully demonstrated knowledge retention with completion of either module. The modules were insufficient to change clinical practice.

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.

Flexible online learning options for graduate nursing students

Students juggle multiple roles and expect faculty to accommodate their hectic schedules. By increasing our flexibility and offering graduate nursing students the option, within a single course, of completing course activities either fully online or blended, we increased student enrollment into courses that prepare faculty. Our approach also identified a potentially cost-saving strategy for low enrollment course sections. Results underscore the importance of ongoing creativity to meet student expectations for responsiveness and inventiveness.

Barriers to electronic portfolio access in the clinical setting

BACKGROUND

The University of Queensland has developed the Clinical Practice Performance electronic Portfolio (CPPeP) as a learning and assessment tool for third year nursing students. To promote effective use of the CPPeP in the clinical setting, barriers must be identified and strategies developed to overcome them.

METHODS

A 24-question survey exploring the use and perceptions of the CPPeP was administered to 42 third year nursing students. Questions explored actual barriers encountered while eight open-ended questions were thematically analysed for perceived barriers.

RESULTS

A 100% response rate was achieved. Students were comfortable with working with computers. Twenty nine students (69%) encountered specific barriers. Of the 152 written comments to the open-ended questions, perceived barriers were evident in 72 of them. Barriers experienced related to gaining access, finding time and staff attitude. The majority of students made their portfolio entries at home.

CONCLUSION

Students enjoyed using the CPPeP but competed with staff for the limited numbers of computers available. Heavy workloads and 'busyness' of the wards also prohibited access along with negative staff attitudes and reluctance of registered nurses to engage as student preceptors. The issue of overcoming barriers is more complex than simply providing more computers or overcoming staff prejudices. Finding time is a barrier not easily overcome given the current and projected nursing shortage.

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.

Comparison of Web-based and face-to-face training concerning patient education within a hospital system

The authors examined education records of 1,661 registered nurses from four affiliated hospitals who attended either a 1-hr face-to-face instructor-led training program, an instructor-facilitated Web-based training program, or an independent Web-based training program to fulfill a training requirement concerning patient education. The authors compared post-test results, course evaluation results, and costs and also developed a demographic profile of nurses' preferences for Web-based and face-to-face learning options. There was no significant difference in course effectiveness or satisfaction between the training methods studied; however, because of the large number of nurses who selected Web-based training, it was the most cost-effective alternative.

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.

Assessing the quality of a web-based learning system for nurses

Continuing professional education is essential for nurses to update their clinical skills and knowledge to meet the complex demands of current patient care. Compared to traditional in-class continuing education, a web-based learning system is efficient for nurses with a three shift-working schedule and is timely to deliver knowledge about newly emerging epidemics such as Severe Acute Respiratory Syndrome. Many studies reveal the advantages of various web-based learning systems but seldom evaluate them from the perspective of quality. This study develops an instrument to assess the quality of a web-based learning system for nurses' continuing education based on the quality dimensions of a mature information systems success model. The research results show that all indicators of the instrument provide a fit to the quality measurement of a web-based learning system and have high reliability and validity. Based on the research findings, implications and limitations are discussed.

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.