Research, Technology, Education & Scholarship in the Fourth Industrial Revolution [4IR] : Influences in Nursing and the Health Sciences

The impact of a mixed reality technology-driven health enhancing physical activity program among community-dwelling older adults: a study protocol

Background

Physical inactivity and a sedentary lifestyle among community-dwelling older adults poses a greater risk for progressive physical and cognitive decline. Mixed reality technology-driven health enhancing physical activities such as the use of virtual coaches provide an emerging and promising solution to support healthy lifestyle, but the impact has not been clearly understood.

Methods and analysis

An observational explanatory sequential mixed-method research design was conceptualized to examine the potential impact of a user-preferred mixed reality technology-driven health enhancing physical activity program directed toward purposively selected community-dwelling older adults in two senior centers in the Philippines. Quantitative components of the study will be done through a discreet choice experiment and a quasi-experimental study. A total of 128, or 64 older adults in each center, will be recruited via posters at community senior centers who will undergo additional screening or health records review by a certified gerontologist to ensure safety and proper fit. Treatments (live coaching with video-based exercise and mixed reality technology-driven exercise) will be assigned to each of the two senior center sites for the quasi-experiment. The participants from the experimental group shall be involved in the discreet choice experiment, modeling, and usability evaluations. Finally, a qualitative sample of participants (n = 6) as key informants shall be obtained from the experimental group using purposive selection.

Discussion

This study protocol will examine the health impact of a promising mixed reality program in health promotion among older adults. The study utilizes a human-centered mixed method research design in technology development and evaluation in the context of developing nations.Clinical trial registration: ClinicalTrials.gov, identifier NCT06136468.

Male nurses' adaptation experiences after turnover to community institutions in Korea: A grounded theory methodology

We aimed to develop a substantive theory according to the associations between adaptation experience-related factors identified in male nurses after turnover to community institutions. From April through August 2019, data were collected through direct observations and in-depth interviews of 22 male nurse participants who were recruited purposively and analyzed simultaneously with the method proposed by Strauss and Corbin. Furthermore, 29 subcategories were derived from 11 categories, including: (1) leaving the clinical sector and changing jobs, (2) shaking while settling, (3) characteristics of the new job, (4) personal disposition, (5) support system, (6) finding my place, (7) solidifying my place, (8) demonstrating my professional competence, (9) stable settlement in my place, (10) preparing for a better future, and (11) still confused. The core category was identified as "putting down roots in another place for myself." The verification of this theory in this study's results indicates a need for research into the evaluation and development of professional development programs and related policies to provide support to male nurses who are pursuing opportunities in community institutions to maintain their nursing identity and further their efforts for developing a nursing specialty.

Application of CAD-CAM Technologies for Maxillofacial Bone Regeneration: A Narrative Review of the Clinical Studies

The application of regenerative methods in treating maxillofacial defects can be categorized as functional bone regeneration in which scaffolds without protection are used and in-situ bone regeneration in which a protected healing space is created to induce bone formation. It has been shown that functional bone regeneration can reduce surgical time and obviate the necessity of autogenous bone grafting. However, studies mainly focused on applying this method to reconstruct minor bone effects, and more investigation concerning the large defects is required. In terms of in situ maxillofacial bone regeneration with the help of CAD-CAM technologies, the present data have suggested feasible mesh rigidity, perseverance of the underlying space, and apt augmentative results with CAD-CAM-based individualized Ti meshes. However, complications, including dehiscence and mesh exposure, coupled with consequent graft loss, infection and impeded regenerative rates have also been reported.

Evaluation of knowledge related to competency of nurse educators after participating in international outreach seminar for continuing nursing education in Myanmar

Background and aims

With the drastic changes brought about by the Fourth Industrial Revolution (Industry 4.0) to nursing science and education, public-private collaboration efforts have been crucial in improving skills using technology. Nurse educators are expected to expand their knowledge and develop skills both in clinical and educational institutions to be able to implement evidence-based practice and develop professional competency. This study aimed to evaluate the knowledge related to competency of nurse educators before and after participating in an international outreach seminar for continuing nursing education in Myanmar.

Methods

We conducted an evaluation study to clarify the outcomes of an international outreach seminar before and after its implementation in Myanmar. The seminar focused on the development and improvement of nursing education, as well as research skills and knowledge of nurses. The two-day seminar was conducted at the University of Nursing, Mandalay in Myanmar on September 30, 2019 and October 1, 2019. Pre- and post-questionnaires were distributed before and after the seminar.

Results

The seminar was attended by 60 participants who were affiliated with a university (41.7%), nursing school (8.3%), hospital (33.3%), and other institutions (16.7%). All the participants had 12.57 years of clinical experience on average. There was a significant increase in the total average score of knowledge from 31.08 (SD = 19.95) before the seminar to 44.15 (SD = 22.19) after the seminar (p = 0.002). Over 90% of the participants recognized changes in their self-efficacy as educators.

Conclusions

The participants acquired valuable up-to-date knowledge related to competency of nurse educators after attending the two-day international outreach seminar. They became keenly aware of the changes in their self-efficacy as educators. To our knowledge, this is the first study in Myanmar to evaluate knowledge related to competency of nurse educators who attended this seminar for continuing nursing education. This seminar was conducted as a mutual collaborative undertaking based on a long academic relationship built on trust and years of partnership between our universities. The findings imply that it is important for low- and middle-income countries to maintain a continuous international collaboration to be able to promote and support professional growth, knowledge, competency, and self-efficacy of their nursing educators.

Tweetable abstract

A two-day international outreach seminar on continuing education for clinical nurses and faculty members in Myanmar improved their knowledge related to competency and enhanced their recognition of changes in their self-efficacy as educators.

Revisiting the nursing metaparadigm: Acknowledging technology as foundational to progressing nursing knowledge

The nursing metaparadigm, as described by Fawcett in 1984, includes human, health, nursing, and the environment, all of which support theory development by giving direction to our focus as a scientific body. Nursing scientists make their mark in biotechnological applications, mobile health, informatics, and human factors research. We give voice to the patient through design feedback and incorporating technological advancements in our evolving nursing knowledge; however, we have not formally acknowledged technology in our metaparadigm. To continue patient-centered care in this age where machines are enmeshed in daily human life, we propose technology must be a domain of the metaparadigm to continue advancing nursing science and knowledge. In this paper, we propose a separate domain of technology within the metaparadigm to challenge nurses to consider approaches within their research and practice of how technology will impact patient care and their personal development within the profession. A technology-specific domain within the metaparadigm also is a signal to other bodies of science of our willingness and ability to run at pace with novel, exciting new discoveries while adding our perspective. Nurses may become active agents in novel developments rather than passive adopters, continuing our legacy of patient advocacy through new knowledge generation. Emerging and continuing nurse leadership has set the stage for the next era of nurse-led innovation and technology development, which provides an opportunity to embed technology as a core aspect of the nursing metaparadigm.

Nursing and human-computer interaction in healthcare robots for older people: An integrative review

Objectives

This study examined the published works related to healthcare robotics for older people using the attributes of health, nursing, and the human-computer interaction framework.

Design

An integrative literature review.

Methods

A search strategy captured 55 eligible articles from databases (CINAHL, Embase, IEEE Xplore, and PubMed) and hand-searching approaches. Bibliometric and content analyses grounded on the health and nursing attributes and human-computer interaction framework were performed using MAXQDA. Finally, results were verified using critical friend feedback by a second reviewer.

Results

Most articles were from multiple authorship, published in non-nursing journals, and originating from developed economies. They primarily focused on applying healthcare robots in practice settings, physical health, and communication tasks. Using the human-computer interaction framework, it was found that older adults frequently served as the primary users while nurses, healthcare providers, and researchers functioned as secondary users and operators. Research articles focused on the usability, functionality, and acceptability of robotic systems. At the same time, theoretical papers explored the frameworks and the value of empathy and emotion in robots, human-computer interaction and nursing models and theories supporting healthcare practice, and gerontechnology. Current robotic systems are less anthropomorphic, operated through real-time direct and supervisory inputs, and mainly equipped with visual and auditory sensors and actuators with limited capability in performing health assessments.

Conclusion

Results communicate the need for technological competency among nurses, advancements in increasing healthcare robot humanness, and the importance of conscientious efforts from an interdisciplinary research team in improving robotic system usability and utility for the care of older adults.

The Development of an “Absyak” Application for ESP Learning: Insights from Indonesia

There has been a dearth of studies exploring the development of online learning platforms in Indonesian ESP classes in recent years. To fill such a lacuna, the present study was designed to develop an online learning application for pharmacy students in their ESP learning in an Indonesian higher education setting. Encapsulated by Gall, Borg, and Gall’s (2003) Research and Development (R&D) model, the study’s findings showcase that (1) the application, named “Absyak,” has been successfully developed at the design stage based on the needs analysis; (2) the variables of material, media, and student responses on learning have been validated and corrected according to the suggestions of two validators as media experts and three validators as material experts; (3) responses from 30 students showed that the indicators for each variable were valid, reliable, and very feasible to implement; and (4) the implementation phase with 60 students indicated that the developed material effectively enhanced the pharmacy students' English speaking skill. Implications from this study are offered at the end of this article.

Development Issues of Healthcare Robots: Compassionate Communication for Older Adults with Dementia

Although progress is being made in affective computing, issues remain in enabling the effective expression of compassionate communication by healthcare robots. Identifying, describing and reconciling these concerns are important in order to provide quality contemporary healthcare for older adults with dementia. The purpose of this case study was to explore the development issues of healthcare robots in expressing compassionate communication for older adults with dementia. An exploratory descriptive case study was conducted with the Pepper robot and older adults with dementia using high-tech digital cameras to document significant communication proceedings that occurred during the activities. Data were collected in December 2020. The application program for an intentional conversation using Pepper was jointly developed by Tanioka’s team and the Xing Company, allowing Pepper’s words and head movements to be remotely controlled. The analysis of the results revealed four development issues, namely, (1) accurate sensing behavior for “listening” to voices appropriately and accurately interacting with subjects; (2) inefficiency in “listening” and “gaze” activities; (3) fidelity of behavioral responses; and (4) deficiency in natural language processing AI development, i.e., the ability to respond actively to situations that were not pre-programmed by the developer. Conversational engagements between the Pepper robot and patients with dementia illustrated a practical usage of technologies with artificial intelligence and natural language processing. The development issues found in this study require reconciliation in order to enhance the potential for healthcare robot engagement in compassionate communication in the care of older adults with dementia.

Development and Effects of Leukemia Nursing Simulation Based on Clinical Reasoning

While the effects of simulation education and the importance of the clinical reasoning process have been well-reported, an acute myelocytic leukemia (AML) patient-care simulation program has yet to be formulated exclusively for the clinical experience of students. This study developed and subsequently applied a simulation program based on clinical reasoning for AML to improve the learning outcomes and describe the learning experience for nursing students. Following a mixed-methods framework, the program’s effects on students’ knowledge were quantitatively measured, while their learning experience was qualitatively measured using self-reflection through journal writing. Differences in the pre- and post-scores between the experimental and control groups were statistically significant for theoretical knowledge and clinical performance. In addition, content analysis of both groups’ journals revealed three themes: (1) transformation into a self-directed learner for understanding the clinical situation, (2) increased awareness of clinical reasoning ability, and (3) embodiment of the clinical reasoning process. Standardizing the developed program’s scenarios prompted the participants’ compliance and engagement, and effectively achieved the learning outcomes. This simulation program aided the assessment of nursing intervention’s effectiveness and suggested objective criteria according to clinical reasoning. Similar programs involving other clinical cases, not exclusive to leukemia, should be developed and evaluated.

Physicians perspectives about medical sources of information: protocol for an overview of systematic reviews

Introduction

Despite the growing availability of evidence and sources of information, it is not clear what are the physicians preferences for filling gaps in their medical knowledge.

Objective

To summarize the available evidence about physicians preferences and perceived barriers and facilitators about sources of information.

Methods

We will undertake an overview of systematic reviews according to PRISMA guidelines. We will search Epistemonikos from inception until March 2019. We will also search PROSPERO, and we will perform a forward citation search in Scopus. Inclusion criteria will consider systematic reviews (qualitative, quantitative, or mixed methods) focusing on physicians preferences about sources of information, as well as perceived barriers and facilitators. Two authors will independently screen and select records for inclusion. We will appraise the quality of included systematic reviews using the Joanna Briggs Institute checklist, and the overlap of primary studies according to the corrected covered area formula. We will conduct a narrative synthesis of quantitative data and a thematic analysis of qualitative findings.

Discussion

We expect that our findings will contribute to improving the evidence-based general practice by identifying physicians perspectives about different sources of medical information.