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Khoshbakht-Pishkhani M, Javadi-Pashaki N, Esfandi NA, Koodakani MB, Maroufizadeh S, Madani AH. The effect of educational application in nursing internship clinical training on cognitive and functional skills and students' satisfaction. BMC Nurs 2024; 23:381. [PMID: 38840192 PMCID: PMC11151607 DOI: 10.1186/s12912-024-01954-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/19/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Clinical education plays an essential role in shaping the nursing identity and is one of the central elements in the education of nursing students. Today, with the advancement of novel technologies, utilizing mobile phone-based technologies in the education of medical sciences is inevitable. Therefore, this study was conducted with the aim of investigating the impact of the urology educational application on nursing students' cognitive-functional criteria and satisfaction during the internship period. METHODS This experimental educational intervention study was conducted during nursing students' urology internship course at Shahid Beheshti School of Nursing and Midwifery in Rasht. The data collection tools included a demographic characteristics questionnaire, cognitive skills scale, functional skills scale, and satisfaction scale (Stokes, 2001). The data were analyzed using SPSS software version 16, and a significance level was set at 0.05. RESULTS Out of 48 studied students, 28 (58.3%) were males. The mean age of the students was 20.34 (SD = 1.51) years. In the application group, the mean of students' cognitive skills after the intervention significantly increased by 2.33 units (95% CI: 1.73 to 2.9) (t(23) = 7.97, P < 0.001, d = 1.626). By controlling the scores before the intervention, the adjusted mean score of cognitive skills in the application group was 0.56 units (95% CI: -0.16 to 1.28) higher than the traditional group; however, this difference was not statistically significant (F(1, 45) = 2.42, P = 0.127, η2p = 0.051). There was no statistically significant difference between the mean score of students' functional skills in traditional and application groups (t(46) = 0.63, P = 0.532, d = 0.184). The total mean score of satisfaction with education in the application group was 83.0 (SD: 10.7). According to the values of the quartiles, 75% of the students scored higher than 75.9, 50% scored higher than 83.9, and 25% scored higher than 91.1. CONCLUSION According to the results of this study, students' scores of functional and cognitive assessment and satisfaction with the application in urology clinical training were reported as favorable. Therefore, it is recommended that mobile phone-based technologies be used in students' clinical education and internships in combination with the traditional method.
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Affiliation(s)
- Maryam Khoshbakht-Pishkhani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
- Medical Education Research Center (MERC), Guilan University of Medical Sciences, Rasht, Iran.
| | - Nazila Javadi-Pashaki
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | | | | | - Saman Maroufizadeh
- Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Hamidi Madani
- Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
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Johnson SG, Potrebny T, Larun L, Ciliska D, Olsen NR. Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Scoping Review. JMIR MEDICAL EDUCATION 2022; 8:e38259. [PMID: 35767323 PMCID: PMC9280458 DOI: 10.2196/38259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Mobile devices can provide extendable learning environments in higher education and motivate students to engage in adaptive and collaborative learning. Developers must design mobile apps that are practical, effective, and easy to use, and usability testing is essential for understanding how mobile apps meet users' needs. No previous reviews have investigated the usability of mobile apps developed for health care education. OBJECTIVE The aim of this scoping review is to identify usability methods and attributes in usability studies of mobile apps for health care education. METHODS A comprehensive search was carried out in 10 databases, reference lists, and gray literature. Studies were included if they dealt with health care students and usability of mobile apps for learning. Frequencies and percentages were used to present the nominal data, together with tables and graphical illustrations. Examples include a figure of the study selection process, an illustration of the frequency of inquiry usability evaluation and data collection methods, and an overview of the distribution of the identified usability attributes. We followed the Arksey and O'Malley framework for scoping reviews. RESULTS Our scoping review collated 88 articles involving 98 studies, mainly related to medical and nursing students. The studies were conducted from 22 countries and were published between 2008 and 2021. Field testing was the main usability experiment used, and the usability evaluation methods were either inquiry-based or based on user testing. Inquiry methods were predominantly used: 1-group design (46/98, 47%), control group design (12/98, 12%), randomized controlled trials (12/98, 12%), mixed methods (12/98, 12%), and qualitative methods (11/98, 11%). User testing methods applied were all think aloud (5/98, 5%). A total of 17 usability attributes were identified; of these, satisfaction, usefulness, ease of use, learning performance, and learnability were reported most frequently. The most frequently used data collection method was questionnaires (83/98, 85%), but only 19% (19/98) of studies used a psychometrically tested usability questionnaire. Other data collection methods included focus group interviews, knowledge and task performance testing, and user data collected from apps, interviews, written qualitative reflections, and observations. Most of the included studies used more than one data collection method. CONCLUSIONS Experimental designs were the most commonly used methods for evaluating usability, and most studies used field testing. Questionnaires were frequently used for data collection, although few studies used psychometrically tested questionnaires. The usability attributes identified most often were satisfaction, usefulness, and ease of use. The results indicate that combining different usability evaluation methods, incorporating both subjective and objective usability measures, and specifying which usability attributes to test seem advantageous. The results can support the planning and conduct of future usability studies for the advancement of mobile learning apps in health care education. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19072.
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Affiliation(s)
- Susanne Grødem Johnson
- Faculty of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Thomas Potrebny
- Faculty of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Lillebeth Larun
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Donna Ciliska
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Nina Rydland Olsen
- Faculty of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
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ÖZTÜRK YILDIRIM T, TİRYAKİ ŞEN H, KUŞCU KARATEPE H, ÖZTÜRK ÇALIKOĞLU H, POLAT Ş. Do University Students Cyberloaf with Their Smartphones in Class? A Descriptive Study. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.1041336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Nezamdoust S, Abdekhoda M, Rahmani A. Determinant factors in adopting mobile health application in healthcare by nurses. BMC Med Inform Decis Mak 2022; 22:47. [PMID: 35193552 PMCID: PMC8862523 DOI: 10.1186/s12911-022-01784-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mobile applications are among effective learning tools and have a significant role in transferring information and knowledge to nurses. The current study was carried to identify the factors affecting nurses’ use of practical health related mobile applications in education and patient interaction based on the combined Technology Acceptance Model (TAM) and Diffusion of Innovation (DOI). Method The study is a descriptive-analytical study with a cross-sectional method. The research population includes nurses working at Tabriz University of Medical Sciences hospitals, 150 of which were selected as the research sample using simple and available sampling. The data collection instrument was a questionnaire, the validity and reliability of which were confirmed (α = 0.9). Data analysis was carried out using a correlation test and regression analysis by applying SPSS v16 software. Results The findings show that perceived usefulness and perceived ease of use have a direct and significant effect on the rate of using mobile applications by nurses (P value ≤ 0.01), [(β = 0.52), (β = 0.40)]. Other findings indicate that relative advantage, compatibility, trialability and observability, have a direct and significant effect on nurses’ use of mobile applications, while complicatedness does not have a significant effect. Conclusion The current study identifies the effective factors in nurses’ use of health-related mobile applications based on an integrated model of TAM and DOI. Designers of mobile applications should consider these factors in designing and developing programs so that mobile applications can successfully fulfill their purpose in healthcare. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01784-y.
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Affiliation(s)
- Soghra Nezamdoust
- School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadhiwa Abdekhoda
- Department of Medical Library and Information Sciences, School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Azad Rahmani
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Integration of Technology to Clinical Teaching: The Impact of Mobile and Web-Based Software Automation Designed for Midwifery Students on Motivation, Time Management and Anxiety Levels. Midwifery 2022; 106:103248. [DOI: 10.1016/j.midw.2021.103248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 11/22/2022]
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Pei-Ying KO, Chen-Shie HO, Pei-Hung LIAO. The impact of a multilevel interactive nursing quality control and audit application on nursing quality management. BMC Nurs 2021; 20:243. [PMID: 34872533 PMCID: PMC8647066 DOI: 10.1186/s12912-021-00767-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background This study aims to investigate the effects of a nursing quality control and audit application (app) on the autonomous learning of nursing staff and nursing quality management by nursing supervisors. A multilevel interactive app is developed to assist nursing staff in conducting online autonomous learning and nursing supervisors in identifying problems and creating nursing quality improvement plans. The app could also present the different evaluation results of wards in visual charts for supervisors to review. Methods A single-group pre- and post-test design was applied. Data were collected from 131 nurses between October 2019 and October 2020 to analyze the differences between nursing staffs’ willingness to engage in autonomous learning and the integrity of nursing quality improvement plan writing before and after the intervention. The structured questionnaires included open-ended questions that cover aspects of nursing quality control, the audit app, and the information acceptance intention of nurses. Results The participants’ age and job title are negatively correlated with the app’s usability, while the ability to use 3C (Computer, Communication, and Consumer Electronics products including mobile phones and laptops) equipment is positively correlated with the willingness to use the app. Nurses’ satisfaction with the convenience of the online autonomous learning method is 92%, which indicates that the app could improve their willingness to learn. Following the intervention of the app, nursing supervisors’ satisfaction with the integrity of nursing quality improvement plan writing increased from 41 to 88%. Conclusions Using information technology products to assist in nursing quality management in clinical practice has a significant effect on nurses’ load reduction and head nurses’ satisfaction. Multilevel interactive nursing quality control and audit apps can improve nursing staff’s willingness to learn independently, nursing quality, and the integrity of plan writing. Thus, nursing quality control and audit apps can be considered as suitable nursing quality control tools.
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Affiliation(s)
- K O Pei-Ying
- Department of Nursing, School of Nursing, Cheng Hsin General Hospital and National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - H O Chen-Shie
- Department of Healthcare Administration, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
| | - L I A O Pei-Hung
- School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan.
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Chen B, Yang T, Wang Y, Xiao L, Xu C, Shen Y, Qin Q, Wang Y, Li C, Chen F, Leng Y, Pu Y, Sun Z. Nursing students' attitudes toward mobile learning: An integrative review. Int J Nurs Sci 2021; 8:477-485. [PMID: 34631998 PMCID: PMC8488805 DOI: 10.1016/j.ijnss.2021.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose This study aimed to explore whether the attitudes of nursing students toward the use of mobile learning are positive or negative and to identify the factors influencing their attitudes by reviewing the literature. Methods Electronic search of six databases, including PubMed, the Cumulative Index of Nursing and Allied Health Literature, ProQuest, Web of Science, EMBASE, and Cochrane Library, was conducted, and relevant references within articles were manually searched. Retrieval time was from inception to October 21, 2020. The literature review was conducted in accordance with the PRISMA guidelines and the integrative review method. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. Results A total of 316 articles were identified, and 18 English-language studies were finally included by reviewing titles, abstracts, and full text. Six quantitative, five qualitative, and seven mixed-method articles related to nursing students’ attitudes toward the use of mobile learning were identified. The results showed that most nursing students had positive attitudes toward mobile learning. Although students expressed strong intentions for mobile learning, the actual usage rate in practical settings was low. Several advantageous factors included usefulness, convenience, and ease of use, whereas disadvantageous factors included hardware facility, updated content, and software stability. Conclusion Most nursing students have positive attitudes and willingness to mobile learning, but the actual use rate remains low. Advantageous and disadvantageous factors coexist. Further studies are needed to assess how mobile learning improves nursing students’ clinical knowledge and improves patient care.
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Affiliation(s)
- Bin Chen
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.,Evidence Based Nursing Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ting Yang
- Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yan Wang
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lei Xiao
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Changxia Xu
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan Shen
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qin Qin
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuanyuan Wang
- Evidence Based Nursing Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Cheng Li
- Department of Basic Teaching, Nanjing Vacational Health College, Nanjing, China
| | - Fengqin Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yufei Leng
- Auxiliary Teaching Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yalou Pu
- School of Nursing, Suzhou Vocational Health College, Suzhou, China
| | - Zhiling Sun
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Chen B, Wang Y, Xiao L, Xu C, Shen Y, Qin Q, Li C, Chen F, Leng Y, Yang T, Sun Z. Effects of mobile learning for nursing students in clinical education: A meta-analysis. NURSE EDUCATION TODAY 2021; 97:104706. [PMID: 33360012 DOI: 10.1016/j.nedt.2020.104706] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/17/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
The objective of this meta-analysis was to assess the effects of mobile learning for nursing students in clinical nursing education. Five electronic databases including PubMed, CINAHL, EMBASE, the Cochrane library and Web of Science were searched for English language articles published on or before February 10, 2020. Two reviewers retrieved articles, evaluated quality and extracted data independently. Review Manager (RevMan) version 5.3 software was used to perform meta-analysis. A total of 9 studies including 580 nursing students receiving clinical nursing education met the inclusion criteria. The mobile learning intervention led to significant improvements in nursing students' skills (SMD = 1.22, 95% CI [0.29, 2.14], P = 0.009), knowledge (SMD = 0.43, 95% CI [0.11, 0.76], P = 0.009), satisfaction (SMD = 0.31, 95% CI [0.05, 0.56], P = 0.020), and confidence (SMD = 0.4, 95% CI [0.16, 0.63], P < 0.001) compared with the control group. Due to differences in experimental design among studies and limited data availability, we cautiously conclude that mobile learning has a beneficial effect on clinical nursing education for nursing students compared with conventional methods.
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Affiliation(s)
- Bin Chen
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China; School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Yan Wang
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Lei Xiao
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Changxia Xu
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Yuan Shen
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Qin Qin
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Cheng Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Fengqin Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Yufei Leng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Ting Yang
- Department of Nursing, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Zhiling Sun
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China.
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Egilsdottir HÖ, Heyn LG, Brembo EA, Byermoen KR, Moen A, Eide H. Configuration of Mobile Learning Tools to Support Basic Physical Assessment in Nursing Education: Longitudinal Participatory Design Approach. JMIR Mhealth Uhealth 2021; 9:e22633. [PMID: 33410756 PMCID: PMC7819782 DOI: 10.2196/22633] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/22/2020] [Accepted: 10/25/2020] [Indexed: 01/05/2023] Open
Abstract
Background As many students in higher education are skilled users of mobile technology, mobile learning (mLearning) can be a promising educational strategy to enhance their learning experience. mLearning might also be well suited for nursing students as they navigate between multiple learning contexts in their educational curriculum. As an educational strategy, mLearning may also reduce challenges caused by the theory-practice gap in nursing by supporting skills and knowledge transfer between the university and clinical settings. As the introduction of basic physical assessment skills (B-PASs) into Norwegian bachelor’s degree education in nursing occurred quite recently, there is a lack of competence in supervision and teaching in both university and clinical settings. As such, mLearning appears to be a good strategy to support student B-PAS learning and knowledge transfer across learning contexts. Objective This study aims to explore and elicit the perspectives of students regarding the way in which a selection of digital learning resources supports B-PAS learning and application in clinical rotation, which of the selected digital learning resources are beneficial to include in a suite of mLearning tools, and how the selected digital learning resources could support the transfer of skills and knowledge from the academic to clinical context. Methods We used a longitudinal participatory design approach to co-design a suite of mLearning tools. The co-design processes took place in several workshops (WSs) over a period of 3 months: 2 WSs with first-year students (n=6), 3 WSs with second-year students (n=6), and 3 WSs with third-year students (n=8). The students evaluated several digital learning resources in both academic and clinical contexts. The digital learning resources included digital simulation with virtual patients, massive open online courses, and multimedia learning material. In the co-design WS, the potential and benefits of these digital learning resources for the learning and application of B-PASs were explored. Results The students reported that the digital learning resources stimulated learning in 7 different ways. They also emphasized the importance of including all selected and tested digital learning resources. Moreover, students supported the inclusion of additional learning material, such as multiple-choice tests and written assignments, aimed at providing feedback and contributing to knowledge development. Conclusions The co-design processes and collaboration with the nursing students provided insight into how a suite of mLearning tools may support the learning and application of B-PASs and human bioscience knowledge in clinical rotation. From the students’ perspective, one of the strengths of the suite of mLearning tools was the range of content, as this met a broader range of student learning preferences regarding learning B-PASs. The suite of mLearning tools contributes to and supports skills training and knowledge transfer between multiple learning contexts.
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Affiliation(s)
- H Ösp Egilsdottir
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lena Günterberg Heyn
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Espen Andreas Brembo
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Kirsten Røland Byermoen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Anne Moen
- Institute for Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Alsayed S, Bano N, Alnajjar H. Evaluating Practice of Smartphone Use Among University Students in Undergraduate Nursing Education. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2019.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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