Nurses' perceptions of online continuing education

Effect of web-based health education on nursing students' knowledge, adaptive healthy measures and attitudes regarding polycystic ovary syndrome: a randomized controlled trial

BACKGROUND

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, and it has emerged as a significant global public health issue. This study aimed to investigate the effects of web-based health education on nursing students' knowledge, adaptive healthy measures, and attitudes toward PCOS.

METHODS

A two-group randomized controlled trial (RCT) with pre-test and immediate post-test assessments was conducted. Study participants were recruited using a simple random sampling method from the Faculty of Nursing, Mansoura University, Egypt. A questionnaire consisting of six sections was developed to collect data, which was analyzed with the SPSS 23.0 using Student's t-test, Pearson's correlation test, and chi-square test analysis of variance.

RESULTS

The analysis revealed a significant increase in knowledge scores post-intervention, with the web-based learning groups (32.2 ± 10.5) outperforming the traditional learning group (22.1 ± 10.2), with (p < 0.05). Similarly, there was a notable improvement in adaptive healthy measures scores post-intervention, with the web-based learning group (8.9 ± 2.4) showing better results than the traditional group (6.5 ± 2.9), with (p < 0.05). In terms of attitudes toward PCOS, the web-based group (18.2 ± 4.9) displayed a significant improvement compared to the traditional group (11.7 ± 5.2), with (p < 0.05).

CONCLUSIONS

The findings suggest that web-based learning is more effective than traditional methods in enhancing nursing students' knowledge, adaptive healthy measures, and attitudes toward PCOS.

TRIAL REGISTRATION

This study was registered by Clinical Trials.gov Identifier: (NCT06192381|| https://www.

CLINICALTRIALS

gov/ ) on 5-1-2024.

Online degree programmes in nurse education-Students' perceptions and academic performance: An integrative review

OBJECTIVES

The aim of this integrative review is to identify, describe, and synthesise evidence regarding students' perceptions of online degree programmes in nurse education, their academic performance, and the factors associated with their academic performance.

DESIGN

Integrative review.

DATA SOURCES

Four databases, CINAHL, ERIC (Ebsco), PubMed/MEDLINE, and Web of Science were searched. The reference lists of included studies were reviewed to identify other relevant studies.

REVIEW METHODS

Whittemore and Knafl's method was used as a guideline for the integrative review. Peer-reviewed studies describing students' perceptions of-or academic performance in-online degree programmes in nurse education were included in the review without time limitations. The quality of the selected article was assessed using the Mixed Method Appraisal Tool.

RESULTS

Nursing students' perceptions of online degree programmes were categorised into enabling career development, content delivered online, and community belonging. Factors related to student's academic performance were associated with individual students and the characteristics of online learning environments. Factors associated with students' academic performance were individual self-direction, formal communication skills, and working and educational backgrounds. Factors associated with academic performance in an online learning environment were categorised into regular feedback and methods for learning.

CONCLUSIONS

Online degree programmes in nurse education contribute to developing pedagogy through a satisfactory work-life balance, students' experiences of community and support, pleasant digital content, and various teaching methods by faculties. The study findings of this review have implications for educators to develop and adopt strategies for advancing digital environments with the pedagogy that supports community building to meet the needs of individual students.

Utilizing a Learning Management System to Provide Nursing Professional Development

The provider unit involved in this project was based in a university setting within a school of nursing and serves both the university nursing faculty and nurses within the community. To support effective online content design principles, usability, a connection to the content, and a method for participants to provide sound feedback, a nurse planner for the unit and an instructional designer in the university collaborated to transition nursing professional development activities to an online format utilizing a learning management system. Virtual learning is viable and a potentially effective option to provide interactive and innovative professional development.

Nurses' perspectives, attitudes and experiences related to e-learning: A systematic review

OBJECTIVE

To summarize the current evidence on registered nurses (RNs) perspectives, attitudes and experiences related to e-learning.

DESIGN

A systematic review of the literature.

DATA SOURCES

The CINAHL, PubMed, Embase, the Cochrane Library, Scopus and Web of Science databases were searched for studies published in English from 2000 to 2021.

REVIEW METHODS

The study followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria comprised studies with cross-sectional, quasi-experimental, qualitative, and randomised control designs on the attitudes toward, perspectives and experiences of registered nursing about e-learning. Quality appraisal for each study, based on their designs, was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Data were synthesized using a narrative approach.

RESULTS

In the 15 included studies, 4 were high quality while 11 were moderate quality. Four themes were revealed in this review including e-learning approaches, facilitators of e-learning and barriers to e-learning barriers to e-learning among RNs and learning in practice barriers.

CONCLUSIONS

The systematic review uncovered that E-learning is an effective method for integrating knowledge with practice and promoting professional development among RNs in healthcare settings. However, RNs may lack motivation to engage with E-learning and face challenges associated with user-friendly platforms.

Training a Continent: A Process Evaluation of Virtual Training on Infection Prevention and Control in Africa During COVID-19

BACKGROUND

Strengthening infection prevention and control (IPC) capacity was identified as a key intervention to prepare African Union member states to curb the COVID-19 pandemic. As part of the Africa Taskforce for Coronavirus, which helped implement the Africa Joint Continental Strategy for COVID-19 Outbreak response, the IPC Technical Working Group (IPC TWG) was convened to coordinate the development of IPC core components for preparedness, response, and recovery from COVID-19. As part of the IPC TWG's work, the Africa Centres for Disease Control and Prevention, in collaboration with the Infection Control Africa Network, delivered virtual IPC training sessions targeted to African Union member states. We aimed to undertake a process evaluation of this training to inform and improve both ongoing and future programming.

METHODS

The scope of the evaluation was agreed upon through discussion with the training organizers and advisory members and a design workshop. A mixed-methods approach was used; data collection was partly prospective and partly retrospective due to the rapid start of some of the training activities. Existing available data included: usage analytics, the content of questions posed during the webinar and community of practice, and participant feedback survey results. In addition, in-depth qualitative interviews were conducted with a sample of webinar participants.

RESULTS

The rapid development of this training was efficient and responsive. The training reached more than 3,000 participants across the 2 rounds, but the numbers varied substantially by location. Participants engaged well during the question period during each webinar, but the asynchronous community of practice was less utilized during the evaluation time frame. Many participants appreciated the African focus of the webinars and gave positive feedback on the practical and context-specific content.

CONCLUSIONS

The move toward online training provides an important opportunity to improve IPC across the African continent.

How students learn in small group through online mode during the coronavirus pandemic: Descriptive narratives

Small-group work is a teaching method which promotes students' collaborative attributes. Completing small-group work online can be challenging to students. This study aimed to understand students' learning through online small-group work. Narrative responses to five open-ended questions were collected from students after they accomplished an online small-group work. These narratives were content analyzed by two independent researchers. Based on the narratives of 199 students, five major themes related to students' learning through interactive online group work were identified, including a) Essential communication and interaction, b) A collaborative team, c) Knowledge enrichment, d) Development of intellectual skills, and e) Tutor involvement. These five themes are the essential elements that promote effective learning though online learning. The success of group work greatly depends on these five major factors to promote students' independent and collaborative learning. To make small-group work online more achievable, nurse educators should pay more attention to these five factors so students' learning outcomes can be maximized.

Perception of online learning among health sciences' students- A mixed methods study

BACKGROUND

The outbreak of COVID-19 pandemic has led to a paradigm shift from the traditional classroom setting to online education and webinars. We could not identify any published multidisciplinary studies from Indian institutions that have explored the perception of online learning among health sciences students from different faculties. The study aimed to explore the perception of health sciences students regarding their experience, satisfaction, and challenges with online learning compared to offline learning.

MATERIALS AND METHODS

An explanatory sequential (QUAN-qual) mixed-methods study was conducted between November 2020 and June 2021 among 474 medical, nursing, physiotherapy, and dental students attending online classes. All the students were invited to participate in the study using Google Form questionnaire. Quantitative data was analyzed using MS Excel. For qualitative data, focused group interviews were conducted with a group of six to eight students from each discipline on an online platform for 45 min to 1 h and transcripts were thematically analyzed.

RESULTS

Totally 474 students responded to the survey questionnaire. Nearly 56.3% (267) of the students were not satisfied with the online learning program. Around 62.2% (294) of the students felt that online learning could not retain their interest. Students reported that learning the assigned syllabus was difficult during online lectures. They agreed that online learning could be distracting, time-consuming, and did not provide an adequate pace of learning.

CONCLUSION

Though online learning is an effective learning strategy, it needs to be further improved considering the valuable inputs given by students.

Nursing students' perceptions of online learning and its impact on knowledge level

BACKGROUND

Online learning in nursing education has been demonstrated to exert positive effects on knowledge, skills, learning attitudes, and confidence in performance. However, a noteworthy caveat has been that such benefits could vary depending on the content of pedagogical materials.

AIM

To examine the impact of online-tutorials in place of face-to-face tutorials on knowledge level and understand the perspectives of learners who experience online-tutorials.

METHODS

This study adopted a mixed method experiential design in which the perspectives of learners who experience online-tutorials are embedded within the trial. Two cohort of nursing students enrolled for the module on Psychology for Nurses were recruited to evaluate the impact of online-tutorials compared to face-to-face tutorials in terms of knowledge level. Apart from the dissimilar mode of delivery, both cohorts experienced the same teaching structure, content, and assessments. Examination results from these two cohorts were compared upon completion of the course. For the online group, additional one-to-one interviews were conducted to further understand the impacts exerted by online learning on the level of knowledge among them.

RESULTS

There was a significant difference between the knowledge level of the two cohorts. Responses elicited during the interviews revealed five themes: lack of motivation; limited teamwork; missed learning opportunities; decreased interactions; and differences between online and face-to-face learning.

CONCLUSION

Online-tutorials may be a feasible pedagogical approach but the motivation to learn, teamwork and quality of discussion may be compromised due to the lack of socialization and interactions between students and tutors.

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.

Nurse instructors' perception towards distance education during the pandemic

BACKGROUND

The nursing department also completely switched to distance education during the COVID-19 pandemic. This new situation made the studies regarding attitudes, experiences, and difficulties of nursing instructors towards distance education more important.

OBJECTIVES

To determine the factors affecting the perceptions of nurse instructors towards distance education during the pandemic.

DESIGN

This is a descriptive and cross-sectional study.

PARTICIPANTS

A total of 389 nurse instructors working at a university constituted the sample.

METHODS

An information form and the Perceptions of Distance Education scale were used for data collection. The data were analyzed using frequency, percentage, arithmetic mean, Cronbach Alpha internal consistency analysis, t-test, one-way ANOVA and Kruskal Wallis test were used in the analysis of the data.

RESULT

The nurse instructors' distance education perception scale score and perception regarding basic perspective, and resource access subdimension scores were at a medium level and the education-planning subdimension score at a high level. Those whose opinions on distance education changed compared to the pre-COVID-19 period, those who received education related to distance education, those who used new practices in the lessons, those who believed that distance education is effective, and those who thought that nursing is a suitable program for distance education had higher distance education perception scores.

CONCLUSIONS

It was determined that difficulties experienced by nurse instructors in distance education negatively affected the perception of distance education, and that positive experiences in distance education affected the perception positively. It is recommended to organize trainings for instructors to improve distance education skills, to encourage students to participate in classes, and to support nurse lecturers in overcoming difficulties.

A study of the role and educational needs of ophthalmic specialist nurses

AIMS

To explore the current roles, responsibilities and educational needs of ophthalmic specialist nurses (OSNs) in the UK.

METHOD

A survey of 73 OSNs ranging from band 4 to band 8 was undertaken in May 2018.

FINDINGS

73% of OSNs undertake more than one active role, with 59% involved in nurse-led clinics; 63% felt formal learning resources were limited, with 63% reporting training opportunities and 21% reporting time as major barriers to further training. More than 38% emphasised hands-on clinic-based teaching had a greater impact on their educational needs. Some 64% were assessed on their skills annually and 59% felt confident with their skill set.

CONCLUSION

The Ophthalmic Common Clinical Competency Framework provides a curriculum and assessment tools for OSNs to use as a structure to maintain clinical skills and knowledge. Eye departments should use this as guidance to target learning needs and improve standards of care to meet the changing needs of society.

Exploring the knowledge of community-based nurses in supporting parents of preterm babies at home: A survey-based study

Aim

This study aimed to investigate the confidence levels, knowledge base and learning needs of community‐based nurses relating to the care of preterm babies and parents, to explore what education is required and in what format.

Design

An online survey methodology was used.

Methods

A 32‐item questionnaire was distributed via social media platforms to community‐based nurses in Australia.

Results

Descriptive analysis was undertaken relating to knowledge base, confidence levels, previous training, learning and resource needs and barriers to education. It was deemed vital to expand confidence and knowledge in this area. Gaps in learning resources were identified and a need for more training in topics such as developmental outcomes, feeding, expected milestones, weight gain, growth trajectories and supporting parents. Online resources were the preferred format to teach key knowledge to community‐based health professionals, tailored to the specific features of preterm babies and support needs of parents.

Nurses' Attitudes Toward Lifelong Learning via New Technologies

Introduction: Lifelong professional education is considered as a qualitative indicator in the health discipline, as it can improve health professionals' knowledge and skills, as well as nursing care. Purpose: The purpose of this original research is to examine and record the attitudes and behavior of nurses working in state-run hospitals in the Municipality of Thessaloniki regarding lifelong education through new technologies. Identification of nurses' motivations for lifelong distance education, recording of nurses' perception of the need for continuing nursing education, and determining how nurses pursue lifelong learning are the objectives of this study. Methodology: The study was conducted between January and March 2019. The sample of the study consisted of 124 nurses (n = 124) from three state hospitals of the Municipality of Thessaloniki. A questionnaire consisting of 5 parts was used as a research tool. SPSS 23 statistical software platform was used for statistical analysis. Results: The sample consisted of 124 participants, 12 were men and 112 were women. The mean age of the participants was 42.37 years and the mean experience in the field was 16.78 years. Two main reasons for continuing education were attributed to the upgrade of the nursing profession and the need to improve the quality of care provided. Conclusions: Nurses believe that continuing education is essential and their professional knowledge must periodically be enriched and renewed.

The Perinatal Loss Care Educational Programme and its Evaluation

Introduction

Working with bereaved parents is an immense challenge for professionals in the field of perinatal care and requires a high level of knowledge and skill. This article aims to evaluate the effectiveness of the Perinatal Loss Care blended educational programme.

Methods

An evaluative assessment was carried out using a scored questionnaire to gather pre- and post-programme data. Participants were medical and healthcare professionals (n=200) who participated in the programme voluntarily (the Medical Professional/Motivated group and the Others group) or were selected by their employer and for whom attendance was mandatory (the Medical Professional/Non/Motivated group).

Results

Participants’ perception of their own knowledge and understanding of perinatal bereavement care was significantly higher on completion of the educational programme, proving its effectivity. There was a statistically significant effect on overall score in individual groups of respondents, as well as the whole set (p<0.001), with post-intervention scores higher than pre-intervention scores. No statistically significant differences in overall score were detected before participation in the educational programme in individual groups (p=0.204). Participants from the Medical Professional/Non/Motivated group achieved lower post-intervention scores to a significantly greater extent (p<0.05) and more often perceived the educational programme as being “very difficult” (χ²=20.66, df=6, P<0.01) compared to other groups.

Conclusions

The educational programme was assessed as effective. Care of bereaved parents has its specifics and healthcare professionals should possess a basic knowledge of how to provide sensitive care during this time.

MammographyOnline: An evaluation of an online mammography education program for radiographers

INTRODUCTION

In Australia, the gold standard for post graduate education in mammography is the Certificate of Clinical Proficiency in Mammography (CCPM) awarded by the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT). The award has two components -academic and clinical. This paper reports on the experiences of the first online offering of the academic component, MammographyOnline (MO), by BreastScreen Victoria, Australia. Online learning is well established in health professional education at all levels of learning, however evaluation is essential to ensure its effectiveness and inform future development.

METHODS

Consenting course participants completed module evaluations, and pre and post program evaluations. Course planners (n = 5) attended a 1-h focus group about the development process. Placement supervisors (n = 3) took part in a 30 min semi-structured telephone interview, identifying views of graduate performance. Survey data and rating scales were analysed descriptively. Qualitative data from surveys and interviews underwent content analysis.

RESULTS

Course participants found the content of MO to be beneficial but highlighted technical issues and suggested improvements for more interactive methods of delivery. Enablers to the program's development identified by course planners, included having experienced and knowledgeable staff on-board, appropriate project management processes, and management support. Challenges expressed by course planners included staffing for the duration of the project and the burden of time and finances, though all perceived they had produced a high quality, relevant and comprehensive online programme. Supervisors recognised that MO fulfilled the requirements of the academic component of the CCPM but did not supersede the need for the clinical component.

CONCLUSIONS

Despite numerous challenges associated with its development, the overwhelming view of learners, developers and supervisors was that MO is a high quality academic program of learning, that provides the theory to support and prepare radiographers for their future clinical practice. Some refinement of content, assessment tasks and technical features are required.

End-of-Life Care in Acute Hospitals: Practice Change Reported by Health Professionals Following Online Education

Providing quality care for those dying in hospital is challenging for health professionals who receive little training in this. “End of Life Essentials” (EOLE) was developed to address gaps in health professionals’ knowledge, skills and confidence in end-of-life care via the provision of online learning modules and practice resources. This study aimed to determine whether respondents could describe clinical practice change as a result of module completion. Deidentified data were collected between October and November 2018 from learners registered for the online learning modules. Both quantitative and qualitative data were extracted and analysed. The survey design and conduct were reviewed, and ethical approval was obtained. Although the response rate was very low, results from n = 122 learners show improvements in knowledge, skills, awareness and confidence as a result of the undertaking of the learning modules. Two thirds self-reported practice changes (71%, n = 59) following the education, with “communication” cited most commonly (n = 19). The findings suggest that the EOLE education modules can help to improve end-of-life care by increasing health professionals’ awareness of good practice as well as their knowledge, skills and confidence. Online learning has also been reinforced as an appropriate forum for end-of-life education. Following education, implementing what has been learned occurs more easily at a personal level rather than at a team and organisational level. Barriers to and enablers of clinical practice change in hospital are described, including the fact that the organisation may not be responsive to changes or have the relevant resources to support change.

Massive Open Online Courses for continuing education for nursing professionals in Peru

METHOD

to determine the global offer of Massive Open Online Courses (MOOCs) in health and nursing, and to know the characteristics of its content, for continuing education in nursing professionals in Peru. Exploratory study was carried out on the websites: Coursera, edX, FutureLearn, XuetangX and Udacity, Class Central and MOOC List. The courses were classified according to the five nursing areas recognized by the Peruvian College of Nurses (Colegio de Enfermeros del Perú, CEP). From each course, data was collected on institution and country of origin, hours per week and total duration in weeks, audio and subtitle language.

RESULTS

a total of 654 courses in this modality are offered in health were found, covering the five areas contemplated by the Peruvian College of Nurses. Fourteen courses were specifically developed for nursing with an average duration of five weeks (3.2 hours per week of activities). Eleven came from Anglo-Saxon institutions, with content in English. Only two courses were offered in Spanish and one in Turkish.

CONCLUSION

Massive Open Online Courses would be a useful tool for the continuing education of the Peruvian nurse given the wide offer, including some specifically for nurses, in the different areas of nursing. The content of the course is mostly in English. Expanding the range of languages or subtitles would facilitate the participation of a larger audience.

Digital health professions education on chronic wound management: A systematic review

BACKGROUND

Continuing education is crucial for healthcare professionals to keep up with research but attending classroom lectures is a major barrier. Chronic wound management is increasingly relevant for continuous professional training. Digital education offers learning tailored to individual needs and could be an effective alternative to healthcare professionals' training. However, the effectiveness of digital education for chronic wound management training has not been explored.

OBJECTIVES

To assess the effectiveness of digital education in improving healthcare professionals' knowledge, attitudes, practical skills and behaviour change on chronic wound management, and their satisfaction with the intervention.

DESIGN

This systematic review follows Cochrane methodology and is one of a series of reviews on the use of digital education for health professions education. Protocol registration: PROSPERO CRD42018109971 DATA SOURCES: Searches were conducted in MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses Database.

REVIEW METHODS

We included randomised control trials, cluster randomised control trials and quasi-randomised control trials comparing digital or blended education with traditional learning, no intervention or other forms of digital or blended education for pre- or post-registration healthcare professionals in chronic wound management. A narrative summary of findings is presented.

RESULTS

Seven studies (1,404 participants) were included. All studies investigated interventions for nursing students or professionals working in hospitals or community settings, and all but one study focused on pressure ulcers. Five studies (935 participants) assessed post-intervention knowledge, and indicated that digital education was more effective than no intervention, while blended learning was superior to exclusive digital education. Three studies (543 participants) assessed post-intervention skills and reported mixed results. One study (140 participants) compared post-intervention behaviour change and satisfaction with blended and online digital education, and reported no difference in behaviour between the groups, and higher satisfaction with blended education. For knowledge retention up to six months, digital education was more effective than no intervention, while blended learning was superior to digital education. The risk of bias in included studies was mostly high or unclear.

CONCLUSIONS

Digital education on chronic wound management appears to be less effective than blended education and more effective than no intervention in improving knowledge among nurses and nursing students. Data for other outcomes is scarce and inconclusive. Future studies should assess participants' skills, attitudes, satisfaction and behaviour change; cost-effectiveness and potential untoward effects of digital education, compare digital education to other learning modalities and include other healthcare professionals in diverse clinical settings.

Comparison of healthcare professionals' motivations for using different online learning materials

IMPORTANCE

Online learning is increasingly prevalent throughout all stages of medical education. There is little published literature exploring what motivates healthcare professionals to engage with different types of e-learning content. Learner motivations must be understood in order to design effective educational solutions and to optimize the overall online learning experience.

OBJECTIVE

Examine engagement, satisfaction, and motivations of healthcare professionals using OPENPediatrics, an open-access medical e-learning platform.

METHODS

Retrospective analysis of online survey data. Users were asked to report engagement and satisfaction with the platform, as well as to select motivations for using different types of content on the site: Courses, Simulators, and World Shared Practice Forum videos.

RESULTS

Majority of respondents were physicians and nurses in North America and Europe. Overall satisfaction with the platform was high. Most frequently cited motivations for using Courses and Simulators were: learn basic and in-depth information around topics, and learn how to deliver safer or more effective patient care. For World Shared Practice Forum videos, most commonly cited motivations were: learn in-depth information about a topic, learn the latest advances or developments in an area, and learn how to deliver safer or more effective patient care.

INTERPRETATION

We appreciated both commonalities and differences in learning motivations among clinicians accessing different kinds of medical e-learning content. Respondents were consistently motivated to learn in order to deliver safer or more effective patient care, but they reported using different types of educational content depending on whether they were learning basic information versus updating or changing their knowledge.

Digital Education for the Management of Chronic Wounds in Health Care Professionals: Protocol for a Systematic Review by the Digital Health Education Collaboration

Background

Digital education is “the act of teaching and learning by means of digital technologies.” Digital education comprises a wide range of interventions that can be broadly divided into offline digital education, online digital education, digital game-based learning, massive open online courses (MOOCs), psychomotor skills trainers, virtual reality environments, virtual patient simulations, and m-learning. Chronic wounds pose an immense economic and psychosocial burden to patients and the health care system, as caring for them require highly specialized personnel. Current training strategies face significant barriers, such as lack of time due to work commitments, distance from provider centers, and costs. Therefore, there is an increased need to synthesize evidence on the effectiveness of digital education interventions on chronic wounds management in health care professionals.

Objective

Our main objective is to assess the effectiveness of digital education as a stand-alone approach or as part of a blended-learning approach in improving pre- and postregistration health care professionals’ knowledge, attitudes, practical skills, and behavior in the management of chronic wounds, as well as their satisfaction with the intervention. Secondary objectives are to evaluate patient-related outcomes, cost-effectiveness of the interventions, and any unfavorable or undesirable outcomes that may arise.

Methods

This systematic review will follow the methodology as described in the Cochrane Handbook for Systematic Reviews of Interventions. As our systematic review is one of a series of reviews on digital education for health professionals’ education, we will use a previously developed search strategy. This search includes the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library), MEDLINE (Ovid), Embase (Ovid), Web of Science, the Educational Resource Information Centre (ERIC) (Ovid), PsycINFO (Ovid), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), the ProQuest Dissertation and Theses database, and trial registries. Databases will be searched for studies published from January 1990 to August 2018. Two independent reviewers will screen the library for included studies. We will describe the screening process using a flowchart as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will extract the data using a previously developed, structured data extraction form. Included studies will be quality-assessed using the Risk of Bias tool from Cochrane. We will narratively summarize the data and, if possible, we will conduct a meta-analysis. We will use Cochrane’s RevMan 5.3 software for data analysis.

Results

We have completed the screening of titles and abstracts for this systematic review and are currently selecting papers against our inclusion and exclusion criteria through full-text revision. We are expecting to complete our review by the end of April 2019.

Conclusions

This systematic review will provide an in-depth analysis of digital education strategies to train health care providers in the management of chronic wounds. We consider this topic particularly relevant given the current challenges facing health care systems worldwide, including shortages of skilled personnel and a steep increase in the population of older adults as a result of a prolonged life expectancy.

Trial Registration

PROSPERO CRD42018109971; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=109971

International Registered Report Identifier (IRRID)

DERR1-10.2196/12488

Teaching Critical Care Nursing Online for RNs

Registered nurses are choosing to further their educational careers by seeking a bachelor's of science degree online (RN-to-BSN). The impetus for choosing the online delivery method is related to the ability to sign into a Learning Management System during times that are advantageous to their hospital work schedules, family, and daily living activities. The RN-to-BSN online option degree requires a Critical Care/Advanced Health Care Course as part of their curriculum plan; therefore, the article presents an overall view of the critical care course, the theoretical underpinnings for progression to the online delivery method, and examples of a module required by the critical care course.

Assessing the impact of a partnership-based work/study nursing upgrade programme in a low- and middle-income setting

AIMS AND OBJECTIVES

To evaluate the 15-year impact of the work/study nursing upgrading programme in East Africa.

BACKGROUND

Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work/study upgrade programme for enrolled- and diploma-level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access.

DESIGN

A mixed-method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory bodies, professional associations and senior nursing officials.

METHOD

Quantitative data were analysed using frequencies and percentages. Inductive thematic analysis was used for qualitative data. Equator guidelines informed reporting of both qualitative and quantitative results.

RESULTS

Of the 549 graduates who completed the survey, 81.2% (n = 446) were female, 93.1% were currently employed and 98% worked within East Africa. They reported improved professional competence (69.4%), nursing practice (25.9%) and patient outcomes (4.6%) on graduation. Extracted themes included the following: flexible/accessible programme; friendly learning environment; effective teaching and learning strategies; acquisition of nursing knowledge, skills and competencies; stakeholders' role in the programme; career/professional advancement; and strengthened health systems.

CONCLUSION

The work/study programme was an effective nursing workforce capacity development strategy. Programme access was strengthened via the supporting donor partnership. Positive outcomes were achieved with respect to the university's values of quality, access, relevance and impact.

RELEVANCE TO CLINICAL PRACTICE

Long-term sustainable development of nurses and midwives is fundamental to achieving sustainable development goals. Work/study programmes and private-public partnerships are effective mechanisms to strengthen the development of nursing and the overall healthcare workforce in low-resource settings.

Nurses' Attitudes toward, and Needs for Online Learning: Differences between Rural and Urban Hospitals in Shanghai, East China

Health professionals need continuing education to maintain their qualifications and competency. Online learning increases the accessibility and flexibility of continuing education. Assessment of nurses' attitudes toward, and needs for, online learning can provide suggestions regarding learning program design and delivery. This study aimed to evaluate Chinese nurses' attitudes toward, and needs for, online learning, and to explore the differences in attitudes and needs between nurses working in rural and urban hospitals. This work is a secondary analysis of a multicenter cross-sectional study conducted in Shanghai in 2015 (n = 550). Multiple regression techniques were used to determine the factors associated with nurses' attitudes toward, and needs for, online learning. Results showed that nurses in rural hospitals had more positive attitudes toward online learning (102.7 ± 14.2) than those in urban hospitals (98.3 ± 12.9) (p < 0.001). For rural hospitals, nurses who could use computers and access the internet in their workplace reported more positive attitudes than those who could not. For urban hospitals, nurse educators showed significantly more positive attitudes than others. Communication skills (86.5%) and patient education (86.3%) were the most commonly-reported learning needs for nurses regardless of their working settings. Chinese nurses were willing to adopt online learning as a continuing education method. Nurses working in rural hospitals displayed more positive attitudes toward, and needs for, online learning than those working in urban hospitals. Nursing educators and managers should develop online learning programs and provide appropriate support to fulfill nurses' learning needs, especially for those working in rural healthcare settings.

Effects of different methods of reflection on nurses' gaze and judgement in a task using a touch panel

AIMS AND OBJECTIVES

To clarify the effects of different methods of reflection on nurses' gaze and judgement in a task using a touch panel, written and oral methods of reflection were compared.

BACKGROUND

Recently, with the development of ICT, nursing education and learning with ICT have spread. However, there are few studies that have analysed the objective effects of learning with ICT and the effects of different methods of learning.

DESIGN

This study was a randomised controlled trial comparing writing and oral reflection groups.

METHODS

Forty-one nurses were divided into two groups as follows: 21 nurses in the writing group and 20 nurses in the oral group. Eye movements were recorded as subjects performed a task on a touch panel. A still photograph of the hospital room was displayed on the touch panel, and the subjects touched the panel according to the instructions provided. Statistical analyses were performed using the Mann-Whitney test to compare the results between the two groups.

RESULTS

In an observation task using a touch panel of a setting requiring environmental improvement, we found no observable differences between the two reflection methods with regard to gaze and judgement in the overall setting. However, with respect to the items in the setting, the writing group judged with gazing after reflection, whereas the oral group judged without gazing.

CONCLUSIONS

Oral reflection as well as reflective writing had positive effects on observation for tasks requiring overall gaze and judgement. On the other hand, reflective writing promoted the visual verification of items requiring observation in the hospital setting.

RELEVANCE TO CLINICAL PRACTICE

Reflective writing promotes visual verification in nurses in a clinical setting while performing a task using a touch panel.

Nurses views on accepting the creation of a nurses' health monitoring system

Background

Nurses’ health is often accompanied by various dangers due to the nature of their career. Therefore, it is required to monitor their health. Based on designing any system, users’ views should be investigated relative to the usefulness, necessity and acceptance of the system. Then, a designing and implementing process is conducted.

Objective

To investigate nurses’ views on accepting the creation of a Nurses’ Health Monitoring System.

Methods

This cross-sectional study was conducted in 2015. Sample size was 586 nurses of Shahid Beheshti University of Medical Sciences. Sampling was conducted using multi-stage random sampling method. Research tool was a two-section researcher-made questionnaire. In the first section, demographic data were studied and in the second section, a twelve-item questionnaire was presented based on technology acceptance model. Five-item questions were regulated on perceived usefulness (PU) and perceived ease of use (PEU) and views towards creating this system. Validity of the questionnaire was approved by content validity and content validity index and its reliability was approved by Cronbach’s alpha. Data were analyzed using SPSS16 and descriptive statistics (frequency distribution, percentage, mean).

Results

The majority of participants (75.3%) were females between 25–35 years of age (44.4%) and (58.2%) were married. Mean work experience was 11.5±8.19. Mean perceived usefulness (PU) (17.36±2.66) and perceived ease of use (PEU) (16.75±2.65) and views towards using a Nurses’ Health Monitoring System was (16.220±3.05).

Conclusion

Over two-thirds of nurses demonstrated perceived usefulness and perceived ease of use as well as positive views towards creating a nurses’ health monitoring system. It is recommended to design and implement a nurses’ health monitoring system based on local culture of Iranian nurses using IT in the health sector.

Nursing student evaluation of NIOSH workplace violence prevention for nurses online course

INTRODUCTION

As primary targets of workplace violence in health care settings, nurses may suffer negative physical and psychological consequences. NIOSH created an online course to educate nurses about violence prevention techniques.

METHOD

A mixed-methods approach assessed workplace violence awareness and knowledge among nursing students. A pre/post/post-test survey and focus group discussions evaluated participant awareness and knowledge, assessed course design, and solicited recommendations for increasing participation and strategies for improving message retention.

RESULTS

The mean awareness scores differed significantly between pre-course and both post-course time points (Wilk's λ=0.319, F(2, 46)=49.01, p<0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased awareness of workplace violence from pre-course scores (M=0.75, SD=0.438) to immediate post-course (M=2.13, SD=0.789) and four-week post-course (M=1.96, SD=0.771) scores on a 3-item measure. Similarly, mean knowledge scores increased between pre-course and both post-course time points (Wilk's λ=0.495, F(1.57, 73.66)=37.26, p<0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased knowledge of workplace violence from pre-course scores (M=6.65, SD=1.45) to immediate post-course (M=8.56, SD=1.32) and four-week post-course (M=8.19, SD=1.42) scores on a 10-item measure. Qualitative data from the focus groups reinforced the quantitative findings. Participants citing benefits from the content strongly recommended including the course in nursing curriculums. Incorporating the course early in the nursing educational experience will better prepare students to deal with workplace violence when they enter health care professions.

CONCLUSIONS

The results indicate that NIOSH and its partners created an effective online workplace violence awareness and prevention course. Practical applications: Nursing students and professionals can be effectively educated about workplace violence using an online format.

Investigating the roles and training of paediatric research nurses working across Europe: a questionnaire-based survey

BACKGROUND

The key role played by research nurses in coordinating clinical trials in a paediatric setting has developed in line with increasing complexities of trial design. A questionnaire-based survey was conducted to investigate the training of research nurses involved in paediatric trials across Europe, to identify potential training needs and compare roles across specialties and countries.

METHODS

A structured, cross-sectional questionnaire survey was used, with the aim of describing and quantifying research nurse experiences. The questionnaire was designed to cover four main areas of interest: demographics, training, clinical trial experience and research nurse roles/activities.

RESULTS

The questionnaire was completed by 341 respondents across 45 different specialties in 20 European countries. A higher percentage of research nurses within 3 years of taking up post were dissatisfied with the level of training received (16%), as compared with those in post for 3-6 years (8%) and >6 years (6%). There was a trend towards a higher percentage of respondents receiving self-funded training in mainland Europe, with reported values of 15%-20%, as compared with <5% in the UK and Ireland. Only 3% of research nurses prescribed investigational medicinal products in a clinical trial setting, with contrasting roles observed between countries.

CONCLUSIONS

While high levels of training satisfaction were observed, 67% of respondents felt they would benefit from additional training in line with frequently changing practices. Currently, low levels of nurse prescribing are observed in a paediatric clinical trial setting across Europe. Appropriate research nurse training programmes should be promoted through national networks across Europe.

ENRICH: A promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients

OBJECTIVE

We describe the impact of ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare), a web-based communication-skill-building curriculum for oncology nurses regarding AYA fertility and other reproductive health issues.

METHODS

Participants completed an 8-week course that incorporated didactic content, case studies, and interactive learning. Each learner completed a pre- and post-test assessing knowledge and a 6-month follow-up survey assessing learner behaviors and institutional changes.

RESULTS

Out of 77 participants, the majority (72%) scored higher on the post-test. Fifty-four participants completed the follow-up survey: 41% reviewed current institutional practices, 20% formed a committee, and 37% gathered patient materials or financial resources (22%). Participants also reported new policies (30%), in-service education (37%), new patient education materials (26%), a patient navigator role (28%), and workplace collaborations with reproductive specialists (46%).

CONCLUSION

ENRICH improved nurses' knowledge and involvement in activities addressing fertility needs of oncology patients. Our study provides a readily accessible model to prepare oncology nurses to integrate American Society of Clinical Oncology guidelines and improve Quality Oncology Practice Initiative measures related to fertility.

PRACTICE IMPLICATIONS

Nurses will be better prepared to discuss important survivorship issues related to fertility and reproductive health, leading to improved quality of life outcomes for AYAs.

Improving Health Care Providers' Capacity for Self-Regulated Learning in Online Continuing Pharmacy Education: The Role of Internet Self-Efficacy

INTRODUCTION

Although Internet-based learning is widely used to improve health professionals' knowledge and skills, the self-regulated learning (SRL) activities of online continuing education in pharmacy are seldom discussed. The main purpose of this study was to explore the relationships between pharmacists' Internet self-efficacy (ISE) and their SRL in online continuing education.

METHODS

A total of 164 in-service pharmacists in Taiwan were surveyed with the Internet Self-Efficacy Survey, including basic ISE (B-ISE), advanced ISE (A-ISE) and professional ISE (P-ISE), as well as the Self-Regulated Learning Questionnaire consisting of preparatory SRL (P-SRL) and enactment SRL (E-SRL).

RESULTS

Results of a 1-by-3 (educational levels: junior college versus bachelor versus master) analysis of variance and a 1-by-4 (institutions: community-based versus hospital versus clinic versus company) analysis of variance revealed that there were differences in ISE and SRL among different education levels and working institutions. The hierarchical regression analyses indicated that B-ISE and P-ISE were significant predictors of P-SRL, whereas P-ISE was a critical predictor of E-SRL. Moreover, the interaction of P-ISE × age was linked to E-SRL, implying that P-ISE has a stronger influence on E-SRL for older pharmacists than for younger pharmacists. However, the interactions between age and ISE (A-ISE, B-ISE, and P-ISE) were not related to P-SRL.

DISCUSSION

This study highlighted the importance of ISE and age for increasing pharmacists' SRL in online continuing education.

Access to, interest in and attitude toward e-learning for continuous education among Malaysian nurses

BACKGROUND

Continuous nursing education (CNE) courses delivered through e-learning is believed to be an effective mode of learning for nurses. Implementation of e-learning modules requires pre-assessment of infrastructure and learners' characteristics. Understanding the learners' needs and their perspectives would facilitate effective e-learning delivery by addressing the underlying issues and providing necessary support to learners.

OBJECTIVE

The aim of this study was to examine access to computer and Internet facilities, interest in and preferences regarding e-learning, and attitudes toward e-learning among nurses in Peninsular Malaysia.

DESIGN

The study utilized a cross-sectional descriptive survey.

SETTING

Government hospitals and community clinics in four main regions of Peninsular Malaysia.

PARTICIPANTS

A total of 300 registered nurses.

METHOD

Data were collected using questionnaires, which consisted of demographic and background items and questions on access to computer and Internet facilities, interest and preferences in e-learning, and attitudes toward e-learning. Descriptive analysis and a chi-squared test were used to identify associations between variables.

RESULTS

Most Malaysian nurses had access to a personal or home computer (85.3%, n=256) and computer access at work (85.3%, n=256). The majority had Internet access at home (84%, n=252) and at work (71.8%, n=215); however, average hours of weekly computer use were low. Most nurses (83%, n=249) did not have an e-learning experience but were interested in e-learning activities. Most nurses displayed positive attitudes toward e-learning. Average weekly computer use and interest in e-learning were positively associated with attitudes toward e-learning.

CONCLUSION

Study findings suggest that organizational support is needed to promote accessibility of information and communications technology (ICT) facilities for Malaysian nurses to motivate their involvement in e-learning.

A Multi-Method Study of the Geriatric Learning Needs of Acute Care Hospital Nurses in Ontario, Canada

Older people are at risk of experiencing functional decline and related complications during hospitalization. In countries with projected increases in age demographics, preventing these adverse consequences is a priority. Because most Canadian nurses have received little geriatrics content in their basic education, understanding their learning needs is fundamental to preparing them to respond to this priority. This two-phased multi-method study identified the geriatrics learning needs and strategies to address the learning needs of acute care registered nurses (RNs) and registered practical nurses (RPNs) in the province of Ontario, Canada. In Phase I, a survey that included a geriatric nursing knowledge scale was completed by a random sample of 2005 Ontario RNs and RPNs. Average scores on the geriatric nursing knowledge scale were in the "neither good nor bad" range, with RNs demonstrating slightly higher scores than RPNs. In Phase II, 33 RN and 24 RPN survey respondents participated in 13 focus group interviews to help confirm and expand survey findings. In thematic analysis, three major themes were identified that were the same in RNs and RPNs: (a) geriatric nursing is generally regarded as simple and custodial, (b) older people's care is more complex than is generally appreciated, and (c) in the current context, older people's care is best learned experientially and in brief on-site educational sessions. Healthcare providers, policy-makers, and educators can use the findings to develop educational initiatives to prepare RNs and RPNs to respond to the needs of an aging hospital population.

Comparing Person-Centered Communication Education in Long-Term Care Using Onsite and Online Formats

Educating nursing home (NH) staff to provide person-centered care is complicated by scheduling, costs, and other feasibility issues. The current study compared outcomes for an in-service program focused on person-centered communication provided in onsite and online formats. The Changing Talk program was provided onsite in seven NHs (n = 327 staff). The online program included eight NHs (n = 211 staff). Analysis of variance revealed an interaction between format type and pre-/post-test scores with improved recognition of person-centered communication in the onsite group only. Group program evaluations based on the modified Diffusion of Innovation in Long-Term Care Battery indicated no significant differences between training formats. Staff perception of the program was similar. Although statistically significant gains were noted in posttest scores indicating awareness of person-centered communication for the onsite group, gains were of limited clinical significance. Feasibility and effectiveness are important considerations for in-service education supporting NH culture change.

Building a foundation for brief motivational interviewing: communication to promote health literacy and behavior change

The use of collaborative communication styles such as motivational interviewing promotes patient engagement, health literacy, self-management, and improved outcomes for individuals with chronic illness. Brief motivational interviewing is an adaptation developed for use with medical populations in time-limited encounters. Inpatient nurses caring for individuals with chronic diagnoses may lack knowledge regarding brief motivational interviewing. This evidence-based quality improvement project used an online approach to introduce continuing education regarding brief motivational interviewing within the constraints of the inpatient setting. Nurses on four units in a community hospital completed a web-based learning module in preparation for context-based skills training. A significant increase in knowledge scores, combined with strong positive attitudes prior to and following the module, indicated a reliable foundation for skills training within the practice setting. Nurses' enhanced ability to recognize the practice of motivational interviewing in scenarios following online education supported the potential value of a hybrid approach to education.

Developing blended online and classroom strategies to deliver an occupational health nursing overview course in a multi-state region in the United States

This article describes how hybrid online and classroom learning approaches were used to design and offer an occupational health nursing review course throughout a multi-state region of the northwest United States. In response to demand from practicing occupational health nurses for board certification preparation, a series of asynchronous and synchronous continuing education modules was created covering a range of occupational health nursing topics. This review course illustrates how innovative educational delivery models can serve the needs of occupational health nurses challenged by geographic and time constraints.

The effect of an e-learning course on nursing staff's knowledge of delirium: a before-and-after study

BACKGROUND

Delirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized patients, which might be due to a lack of knowledge of delirium diagnosis and treatment. The objective of the study was to test the effectiveness of an e-learning course on nurses' delirium knowledge, describe nursing staff's baseline knowledge about delirium, and describe demographic factors associated with baseline delirium knowledge and the effectiveness of the e-learning course.

METHODS

A before-and-after study design, using an e-learning course on delirium. The course was introduced to all nursing staff of internal medicine and surgical wards of 17 Dutch hospitals.

RESULTS

1,196 invitations for the e-learning course were sent to nursing staff, which included nurses, nursing students and healthcare assistants. Test scores on the final knowledge test (mean 87.4, 95% CI 86.7 to 88.2) were significantly higher than those on baseline (mean 79.3, 95% CI 78.5 to 80.1). At baseline, nursing staff had the most difficulty with questions related to the definition of delirium: what are its symptoms, course, consequences and which patients are at risk. The mean score for this category was 74.3 (95% CI 73.1 to 75.5).

CONCLUSIONS

The e-learning course significantly improved nursing staff's knowledge of delirium in all subgroups of participants and for all question categories. Contrary to other studies, the baseline knowledge assessment showed that, overall, nursing staff was relatively knowledgeable regarding delirium.

TRIAL REGISTRATION

The Netherlands National Trial Register (NTR).

TRIAL NUMBER

NTR 2885 , 19 April 2011.

Designing and evaluating an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care: randomized controlled trial

Background

Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice.

Objective

This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses’ competencies in acute nursing care.

Methods

Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video, multimedia instructional material, virtual patients, and online quizzes. A randomized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital. Following a baseline evaluation of all participants’ clinical performance in a simulated clinical setting, the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program. All participants were re-tested for their clinical performances using a validated tool.

Results

The clinical performance posttest scores of the experimental group improved significantly (P<.001) from the pretest scores after the Web-based simulation. In addition, compared to the control group, the experimental group had significantly higher clinical performance posttest scores (P<.001) after controlling the pretest scores. The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation. Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice, instructional strategies, and fostering problem solving.

Conclusions

Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses’ competencies in acute care. Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency.

Comfort and experience with online learning: trends over nine years and associations with knowledge

BACKGROUND

Some evidence suggests that attitude toward computer-based instruction is an important determinant of success in online learning. We sought to determine how comfort using computers and perceptions of prior online learning experiences have changed over the past decade, and how these associate with learning outcomes.

METHODS

Each year from 2003-2011 we conducted a prospective trial of online learning. As part of each year's study, we asked medicine residents about their comfort using computers and if their previous experiences with online learning were favorable. We assessed knowledge using a multiple-choice test. We used regression to analyze associations and changes over time.

RESULTS

371 internal medicine and family medicine residents participated. Neither comfort with computers nor perceptions of prior online learning experiences showed a significant change across years (p > 0.61), with mean comfort rating 3.96 (maximum 5 = very comfortable) and mean experience rating 4.42 (maximum 6 = strongly agree [favorable]). Comfort showed no significant association with knowledge scores (p = 0.39) but perceptions of prior experiences did, with a 1.56% rise in knowledge score for a 1-point rise in experience score (p = 0.02). Correlations among comfort, perceptions of prior experiences, and number of prior experiences were all small and not statistically significant.

CONCLUSIONS

Comfort with computers and perceptions of prior experience with online learning remained stable over nine years. Prior good experiences (but not comfort with computers) demonstrated a modest association with knowledge outcomes, suggesting that prior course satisfaction may influence subsequent learning.

Overcoming barriers in online workshop development: an ELITE experience

The Emerging Learning and Integrated Technologies Education (ELITE) Faculty Development Program created eight online workshops to assist nurse educators in using technology within their organization's nurse education program. Continuing education units were provided for completion of the individual online workshops. The ELITE program worked through several barriers to transform content that was previously presented during face-to-face workshops into standalone online offerings. Barriers and implementation strategies for the on-site to online transition included restructuring workshop objectives, keeping current with rapid technology changes, altering a course management system to meet the needs of the program and the learner, and crafting independent practice opportunities for the online learner. The online workshop development experience of the ELITE program may assist other continuing education and staff development professionals who are updating their program offerings or pursuing online education for the first time.