Distance education in nursing: an integrated review of online nursing students' experiences with technology-delivered instruction

Nurse Educator's experiences and challenges with online teaching: A qualitative descriptive study

Introduction

During the Coronavirus disease (COVID-19) pandemic, many educational institutions faced the challenge of providing and implementing online education. Despite this challenge, most adopted online education systems to ensure that the teaching and learning process continued. This study aimed to explore nursing educators' experiences related to adopting online-only teaching during the (COVID-19) pandemic, providing nursing students with the best learning experiences, and preparing faculty members to teach online.

Method

This qualitative descriptive study was conducted using semi-structured interviews from June 2020 to September 2020. Using purposive sampling, 12 nursing educators in Saudi Arabia who taught university courses online during COVID-19 were recruited. They were selected based on their teaching experience in undergraduate and postgraduate degree nursing programs.

Results

Thematic analysis revealed an overarching theme-faculty challenges-and three sub-themes-emotional, technical, and educational challenges. Secondary sub-themes comprised four challenges that the nursing faculty faced-using online platforms, accessibility, cheating, and dealing with students' clinical practice-which were found to be interconnected and interrelated.

Discussion

Most nursing educators had to shift to online distance teaching suddenly; thus, they faced several challenges related to online teaching, e-learning literacy, classroom management, and connectivity as they transitioned to digitalization. To address these issues, this study recommends that university management organize training programs for educators to help them more effectively conduct online classes. These findings will be valuable for universities, policymakers, designers, and producers to enhance the implementation of their e-learning systems.

Nursing institutions' professors' perception and distant education experience during COVID-19 pandemic lockdown

BACKGROUND

The nursing profession represents a demanding and challenging profession with a purpose to keep up with the evolving health-care demands of the population.

AIMS

The purpose of this study is to assess nursing institutions' professors' previous experience about information and communication technologies (ICTs) and their perception of distant education during the pandemic lockdown.

MATERIALS AND METHODS

This present is a cross-sectional study among participants n = 249 recruited from all academic staff (N = 694) of 23 higher institutes of nursing professions and health techniques in Morocco. The Chi-square test for independence (χ2) and adjusted Z scores were used as a data analysis method to assess the association between the professors' education levels and ICT experience.

RESULTS

A significant association [χ2 (1, n = 249) = 19.510, P < 0.001] was revealed between professors' education level and taken training related to ICT in education; significant few professors (16; 9.3%) reported that taken training session [χ2 (1, n = 249) = 8.940, P = 0.003] belonged to the bachelor degree group. In matters of perception, a few proportion (10%) reported that using technology effectively belonged to the bachelor and low education background group.

CONCLUSIONS

The findings showed that having previous experience in teaching remotely and training related to the ICT was significantly associated with a higher education background. Moreover, professors with higher degrees agreed that distant education could be an alternative to face-to-face course during quarantine.

Becoming accustomed to online teaching: nursing lecturers' experiences in the era of COVID-19

Purpose

This study aimed to explore nursing lecturers' experiences of online teaching and learning during the coronavirus disease 2019 (COVID-19) pandemic. The COVID-19 policy on social and physical distancing urges nursing lecturers to provide online teaching delivery for their students using both synchronous and asynchronous methods. However, the experiences of nursing lecturers providing online teaching delivery in the era of COVID-19 are yet unknown.

Design/methodology/approach

The authors used an interpretive phenomenological analysis study design. Participants were seven nursing lecturers, with whom we conducted in-depth interviews using semi structured questions through telephone calls or video conferences. Interpretive phenomenology analysis was adopted to analyse the generated data.

Findings

The core theme of this current study is that of becoming accustomed to online teaching delivery. The main theme is supported by three sub-themes, which are being comfortable with the technology, difficulties and how to overcome them and caring for students to explain the online teaching experiences of nursing lecturers.

Originality/value

The results of this study demonstrate that familiarity with technology is critical for lecturers to facilitate their online teaching. There is a need for further enhancement of technology and application usage to improve the quality of nursing lecturers' teaching methods and ensure the provision of theory and nursing skill competency to students.

Usability of Microsoft Teams and Stream in Nursing Education

This manuscript presents a technology acceptance and usability evaluation of an online software platform utilized for educating nursing students. Online nursing education is a complex and multifaceted process requiring nurse educators to be competent in technical informatics. Increasingly, nurse educators are asked to transform the traditional face-to-face classroom to include remote or hybrid experiences with little or no formal training. The pandemic may have created an atmosphere of stress and confusion while forcing a transition to an online learning environment. Recent trends in nursing education call for the increased use of technology that enhances the learning experience and mimic clinical practice. As the pandemic's restrictions are removed, nursing education will continue to require technological innovations. Variables measured during the study were usability (System Usability Scale), perceived usefulness, and perceived ease of use. The results of the study suggest participants perceived Microsoft Teams and Stream as useful and easy to use. In this situation, the use of technology positively supported the teaching-learning process.

Nursing students' insights of learning evidence-based practice skills using interactive online technology: Scoping review

This scoping review aims to explore nursing students' insights of learning evidence-based practice skills through the use of interactive online technology. Studies were obtained from seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global) until May 2021. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews and was guided by the Arksey and O'Malley framework (Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 2005, 8(1), 19-32). Findings were analyzed using thematic analysis. Three themes were derived from the 22 included studies: (1) embracing new changes, (2) challenges to tackle, and (3) towards future improvement. Many nursing students reported positive learning experiences of evidence-based practice skills using interactive online technology. The challenges faced by students and suggestions for improvement were discussed. Future online evidence-based practice courses should consider blended pedagogies, providing students with effective scaffolding (step-by-step guidance) and allowing students to choose their preferred instructional strategies. Thorough planning, testing, and orientation should be conducted before the programs' implementation. Lastly, future studies should aim to achieve higher study rigor to obtain more accurate results.

Nursing student experiences of remote learning during the COVID-19 pandemic

Background

The emergence of the COVID‐19 pandemic resulted in a sudden transition to remote learning. These circumstances presented many challenges for higher education faculty and students around the world but especially for nursing education programs which are traditionally conducted in a face‐to‐face learning environment that includes hands‐on experiential learning.

Methods

Guided by Meleis' Transition Theory, a qualitative descriptive design was utilized to explore prelicensure nursing students’ experiences of the transition to remote learning during the Spring 2020 semester. Participants were recruited from one baccalaureate program in the Pacific Northwestern United States. Interviews were conducted and transcribed using a web conferencing platform. Data were analyzed using Colaizzi's phenomenological reduction.

Results

Eleven students participated. Interviews revealed four overarching themes: technological challenges, academic relationship changes, role stress and strain, and resilience.

Conclusion

The sudden transition to remote learning resulted in a number of challenges for nursing students. Despite these challenges, students demonstrated a remarkable sense of resilience and perseverance. Faculty have an opportunity to address student stressors and design remote courses in such a way to facilitate student engagement and community building.

Blended learning via distance in pre-registration nursing education: A scoping review

Prior to the Covid-19 global pandemic, we reviewed literature and identified comprehensive evidence of the efficacy of blended learning for pre-registration nursing students who learn across distances and/or via satellite campuses. Following a methodological framework, a scoping literature review was undertaken. We searched six databases (EBSCOHOST (CINHAL plus; Education research Complete; Australia/New Zealand Reference Centre); Google Scholar; EMBASE (Ovid) [ERIC (Ovid); Medline (Ovid)]; PubMed: ProQuest Education Journals & ProQuest Nursing & Allied Health Source) for the period 2005-December 2015. Critical appraisal for critiquing qualitative and quantitative studies was undertaken, as was a thematic analysis. Twenty-eight articles were included for review, which reported nursing research (n = 23) and student experiences of blended learning in higher education (n = 5). Four key themes were identified in the literature: active learning, technological barriers, support, and communication. The results suggest that when delivered purposefully, blended learning can positively influence and impact on the achievements of students, especially when utilised to manage and support distance education. Further research is needed about satellite campuses with student nurses, to assist with the development of future educational practice.

Exploring and Improving Student Engagement in an Accelerated Undergraduate Nursing Program through a Mentoring Partnership: An Action Research Study

This Participatory Action Research (PAR) project aimed to engage students from an accelerated 'fast track' nursing program in a mentoring collaboration, using an interdisciplinary partnership intervention with a group of academics. Student participants represented the disciplines of nursing and paramedicine with a high proportion of culturally and linguistically diverse (CALD) students. Nine student mentors were recruited and paired with academics for a three-month 'mentorship partnership' intervention. Data from two pre-intervention workshops and a post-intervention workshop were coded in NVivo11 using thematic analysis. Drawing on social inclusion theory, a qualitative analysis explored an iteration of themes across each action cycle. Emergent themes were: 1) 'building relationships for active engagement', 2) 'voicing cultural and social hierarchies', and 3) 'enacting collegiate community'. The study offers insights into issues for contemporary accelerated course delivery with a diverse student population and highlights future strategies to foster effective student engagement.

Virtual Patients in Health Professions Education

The field of health professions continues to struggle with the impact of increasing practitioner and educator shortages. Health professions education is also faced with the issues of limited clinical placements and an increasing demand for online education. To address these issues, health professions educators have increasingly turned to simulations to provide experiential learning in safe, controlled environments. One of the newest simulation technology innovations to emerge is that of virtual patient simulations. This chapter reviews the context in which virtual patients have emerged, the range of virtual patient technologies available, and the ways in which health professions educators currently use virtual patient simulations.

Online intravenous pump emulator: As effective as face-to-face simulation for training nursing students

BACKGROUND

The expansion of online education for nursing students has created the challenge of finding innovative ways to teach clinical skills. An online intravenous pump emulator (IVPE) modelled on actual IV pumps used in clinical healthcare settings was developed to facilitate online education delivery.

OBJECTIVES

The objectives of the study were to implement the online IVPE and evaluate student learning outcomes and perceptions of device use.

DESIGN

A mixed method, quasi-experimental design was used.

SETTING

The study was conducted in the School of Nursing and Midwifery at a regional university in Queensland, Australia.

PARTICIPANTS

Participants were 179 first year nursing students enrolled in a medications course, ranging in age from 18 to 44years, of whom 150 were female.

METHODS

Participants were assigned to one of three groups and trained in the use of IV infusion pumps. Group 1 (n=57) were trained online using the IVPE (ONL); Group 2 (n=73) were trained on-campus using an actual IV pump (ONC); Group 3 (n=49) were trained both on-campus using the actual IV pump and online using the IVPE (ONL+ONC). Competence in using the actual IV pump was assessed for all participants at the conclusion of the training period.

RESULTS

No significant differences in learning outcomes, measured by assessment scores out of 80 points, were found between the ONL (M=65.5±9.2) and ONC (M=62.0±14.8; p>.05) groups. Significantly better learning outcomes were evident for the ONL+ONC group (M=68.7±4.9) compared to the ONC group (p<.01).

CONCLUSIONS

This study highlights that the nursing students became more competent in the skill of preparing and administrating IV infusions when face-to-face and online learning were combined.

Nursing education research in Finland--A review of doctoral dissertations

OBJECTIVES

The aim of this literature review was to describe the focus of nursing education research in Finnish doctoral dissertations in the field of nursing and caring sciences between the years 1979-2014. In addition, the characteristics (methods, study informants and reporting of validity, reliability, and research ethics) of the dissertations were described.

METHODS AND DATA

A literature review was carried out. Altogether 51 Finnish doctoral dissertations of nursing and caring sciences focusing on nursing education research were included in the final analysis. The dissertations were published in 1990-2014. The data were analyzed by content analysis both deductively and inductively.

RESULTS

Finnish nursing education research was focused on four main areas: structural factors in nursing education, nurse teacherhood, teaching activities, and learning and learning outcomes in nursing education. The most central focus was learning in nursing education whereas nurse teacherhood and structural factors in nursing education were studied the least. Students were the predominant study informant group while nurse staff including nurse mentors were next and nurse educators only the third. Surveys and interviews were the most common data collection methods. In the findings there were a lot of similarities with international nursing education research.

CONCLUSIONS

Finnish nursing education research has been relatively student-centered yet studies focusing on the education of other nursing-based professions are rare. Future research about nurse teacherhood, curricula and structural factors in nursing education is recommended also. In addition, nursing education research should focus on the central phenomena of nursing education and working life. All in all, more nursing education research is needed. Nursing education dissertations cover only 12.3% of all the dissertations of nursing and caring sciences in Finland.

How can students contribute? A qualitative study of active student involvement in development of technological learning material for clinical skills training

Background

Policy initiatives and an increasing amount of the literature within higher education both call for students to become more involved in creating their own learning. However, there is a lack of studies in undergraduate nursing education that actively involve students in developing such learning material with descriptions of the students’ roles in these interactive processes.

Method

Explorative qualitative study, using data from focus group interviews, field notes and student notes. The data has been subjected to qualitative content analysis.

Results

Active student involvement through an iterative process identified five different learning needs that are especially important to the students: clarification of learning expectations, help to recognize the bigger picture, stimulation of interaction, creation of structure, and receiving context- specific content.

Conclusion

The iterative process involvement of students during the development of new technological learning material will enhance the identification of important learning needs for students. The use of student and teacher knowledge through an adapted co-design process is the most optimal level of that involvement.

What deters nurses from participating in web-based graduate nursing programs?: A cross-sectional survey research study

BACKGROUND

A graduate degree is required of nursing faculty in America. Because of the nursing faculty shortage, web-based graduate nursing programs are being offered to encourage nurses to return to school. The identification of deterrents to participating in these programs is an important step in increasing enrollment.

OBJECTIVE

To identify deterrents to participation in web-based graduate nursing programs.

DESIGN

Descriptive survey research.

SETTING

Louisiana

PARTICIPANTS

Two hundred and eighty-one registered nurse members of the Louisiana Nurses' Association.

METHODS

The 54-item four-point Likert-type interval scale Deterrents to Participation in Web-Based Graduate Nursing Programs Survey Instrument was used. Data were collected over 8weeks using SurveyMonkey.com to administer the web survey tool to all members of the Louisiana State Nurses' Association.

RESULTS

A factor analysis revealed a three-factor solution that explained 55.436% of the total variance in deterrents to participation in web-based graduate nursing programs. The factors were labeled "concerns about quality, cost, and time," "concerns about access to resources: technological and personal," and "concerns about electronic mediated communication." Multiple regression analysis revealed an overall model of three predictors of deterrents to participation in web-based graduate nursing programs: no computer literacy, annual household income between 20,000 and 50,000 dollars, and having the current educational status of graduating from a diploma RN program. This model accounted for 21% of the variance in the deterrents to participation scores.

CONCLUSIONS

Since these three significant predictors of deterrents to participation in web-based graduate nursing programs were identified, web-based nursing graduate program administrators might consider an outreach to RN diploma graduates in an effort to make them aware of available technology support programs to foster participation. Scholarships for lower income nursing students are recommended, and programs to support computer literacy within the nursing community should be considered.

Building a Community of Scholars: One Cohort's Experience in an Online and Distance Education Doctor of Philosophy Program

BACKGROUND

Online and distance education is becoming increasingly common in higher education. As students explore graduate programs, they are often overwhelmed with the variety of program delivery options available. For graduate students pursuing a Doctor of Philosophy (PhD), a particular concern relates to building a community of scholars and how to do so through an online and distance learning program.

METHOD

Through a review of literature and personal stories, this article will highlight innovative strategies utilized by a cohort of PhD students related to online and distance learning and developing a community of scholars.

RESULTS

PhD students developed a community of scholars using innovative strategies to communicate and collaborate.

CONCLUSION

Building a community of scholars is possible through online and distance education using simple forms of technology to connect and collaborate.

Technology and its ethics in nursing and caring journals: An integrative literature review

BACKGROUND

Over the past 20 years, the impact of technology has increased significantly in health care. The diversity of technology is growing and its knowledge scattered. The concept of technology is ambiguous in caring and nursing sciences and its ethics remains unidentified.

AIM

To find evidence on how the concept of technology and its ethics are defined in caring and nursing sciences and practice. The purpose of this study is to describe and summarize the concept of technology and its ethics in the past nursing and caring literature.

METHOD

The integrative literature review of the past nursing and caring literature. The data were collected from caring and nursing journal articles from 2000 to 2013 focusing on technology and its ethics.The results were summarized and themed.

RESULTS

Technology as a concept has three implications. First, technology is devices and products, including ICT and advanced, simple and assistive technology. Second, technology refers to a process consisting of methods for helping people. Third, technology as a service indicates the production of care by technology. The ethics of technology has not been established as a guiding principle. Some studies excluded ethical reflection completely. Many studies discussed the ethics of technology as benefits such as improved communication and symptoms management, and the simple use of e-health services whilst others remained critical presenting ethical problems such as unwillingness and the inability to use technology, or conflicts with human aspects or questions of inequality.

CONCLUSION

In conclusion, this study indicates that technology as a concept is described diversely. The relation between technology and ethics is not a truism. Despite some evidence, more is needed to promote ethical care when using technology.

Facilitating student retention in online graduate nursing education programs: a review of the literature

Online education, a form of distance education, provides students with opportunities to engage in lifelong learning without the restrictions of time and space. However, while this approach meets the needs of employed nursing professionals, it poses some challenges for educators. Student retention is one such challenge. Student retention rates serve as measures of program quality and are reported to accrediting bodies. Therefore, it is imperative that administrators and program faculty implement comprehensive programs to ensure student retention. This review of the literature was designed to identify strategies to improve student retention in online graduate nursing education programs. The review includes 23 articles that address models, research, and best practices supported in nursing and higher education. The findings indicate that student retention in online programs is a multidimensional problem requiring a multifaceted approach. Recommendations for facilitating retention in online nursing programs include ensuring social presence and program and course quality, and attentiveness to individual student characteristics.

Online biostatistics: evidence-based curriculum for master's nursing education

Rapid changes in health care delivery require nurses to attain advanced knowledge, skills, and attitudes in biostatistics to provide high-quality, safe patient care. Advances in educational technologies support the delivery of graduate nursing education in online formats. Given the diversity of learning styles among graduate nursing students and the specific challenges in delivering biostatistics content in traditional formats, it is vital to include different delivery formats to engage and meet the learning needs of graduate nursing students who take biostatistics courses online. This article describes the pioneering approach of one graduate nursing program to implementing best practices for delivering an online biostatistics course to help master's-prepared nurses attain both statistical literacy and statistical communication skills.

School Nurse Intention to Pursue Higher Education

In 2011, the Institute of Medicine recommended that 80% of the nurses possess a minimum of a bachelor of science in nursing by 2020 and double the number of doctorally prepared nurses. This has prompted a significant number of registered nurses to advance their educational level. School nurses in Louisiana are not required to have a bachelor’s degree. In many states, the bachelor’s degree is required for all school nurses, and many school nurses are prepared at the masters’ and doctoral levels. The purpose of this study was to examine the intention of Louisiana school nurses to pursue higher education in nursing. A survey was distributed to all members of the Louisiana School Nurses Organization, and results indicated that 65% of the participants were motivated to return to school. Incentives and barriers to pursuing higher education were identified, and strategies for overcoming these barriers were proposed.

Continuing education for primary health care nurse practitioners in Ontario, Canada

The Council of Ontario University Programs in Nursing offers a nine-university, consortium-based primary health care nurse practitioner education program and on-line continuing education courses for primary health care nurse practitioners. Our study sought to determine the continuing education needs of primary health care nurse practitioners across Ontario, how best to meet these needs, and the barriers they face in completing continuing education. Surveys were completed by 83 (40%) of 209 learners who had participated in continuing education offered by the Council of Ontario University Programs in Nursing between 2004 and 2007. While 83% (n=50) of nurse practitioners surveyed indicated that continuing education was extremely important to them, they also identified barriers to engaging in continuing education offerings including; time intensity of the courses, difficulty taking time off work, family obligations, finances and fatigue. The most common reason for withdrawal from a continuing education offering was the difficulty of balancing work and study demands. Continuing education opportunities are important to Ontario primary health care nurse practitioners, and on-line continuing education offerings have been well received, but in order to be taken up by their target audience they must be relevant, readily accessible, flexible, affordable and offered over brief, intense periods of time using technology that is easy to use and Internet sites that are easily navigated.

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

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

What can faculty members and programs do to improve students' learning?

Purpose. To understand what faculty members can do to improve students' learning, we explored (1) program and course characteristics important to students, (2) choices within courses students feel are important, and (3) students' perceptions of learning online. Background. Web delivery alters interactions among students and faculty, thereby changing the learning environment. Methods. Master of Nursing students currently enrolled in one graduate program were invited to participate in a web-based survey. Findings. The students valued (1) frequent feedback and interaction with the instructor, (2) organized, structured, and current content, (3) flexibility in deadlines and participation, (4) seamless navigation and technical support, and (5) choices in assignments. Students perceived their learning in online courses as less than if they had taken the course on campus. Conclusions. Professors can address some of the items identified by students as important, such as being flexible with due dates and expectations for participation in online discussion.

A Comparison of Student Performance between Two Instructional Delivery Methods for a Healthcare Ethics Course

Healthcare ethics has become part of the standard curriculum of students in the health professions. The goals of healthcare ethics education are to give students the skills they need to identify, assess, and address ethical issues in clinical practice and to develop virtuous practitioners. Incorporating the medical humanities into medical school, for example, is intended to foster empathy and professionalism among students and to provide mechanisms for enhanced physician well-being. Yet, despite the long-standing inclusion of the humanities in nursing curricula, increases in the amount and kinds of scientific knowledge essential for clinical practice has resulted in the erosion of the “humanistic arts” from nursing education. One potential solution to this challenge comes with the increase in interprofessional education, where students in a variety of healthcare professions programs come together to learn about issues common to all healthcare fields.

Benefits and drawbacks of electronic health record systems

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the "stimulus package" represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a "meaningful" way.

Flexible online learning options for graduate nursing students

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

Satisfaction with a distance continuing education program for health professionals

This study assessed differences in program satisfaction among health professionals participating in a distance continuing education program by gender, ethnicity, discipline, and community size. A one-group posttest design was used with a sample of 45,996 participants in the University of Arkansas for Medical Sciences, Rural Hospital, Distance Continuing Medical Education Program during 1995-2007. This program provided 2,219 continuing education programs for physicians (n = 7,047), nurses (n = 21,264), allied health (n = 3,230) and dental (n = 305) professionals, pharmacists (n = 4,088), administrators (n = 1,211), and marketing/finance/human resources professionals (n = 343). These programs were provided in Arkansas hospitals, clinics, and area health education centers. Interactive video technology and the Internet were used to deliver these programs. The program satisfaction instrument demonstrated adequate internal consistency reliability (Cronbach's alpha = 0.91) and construct validity. Participants had high levels of satisfaction regarding knowledge and skills, use of information to enhance patient care, program quality, and convenience of the technology (mean total satisfaction score = 4.44, range: 1-5). Results from the t-test for independent samples and one-way analysis of variance indicated that men (p = 0.01), African-Americans and Hispanics (p < 0.01), dental professionals (p < 0.01), and participants in larger urban communities (population of 75,001-185,000) (p < 0.01) had significantly greater satisfaction. Nurses and physicians had significantly greater satisfaction regarding the use of information in practice to enhance patient care (p < 0.01). Results suggest that socioeconomic and demographic factors can affect satisfaction with distance continuing education programs.

Pretest online discussion groups to augment teaching and learning

Tests and final examination scores of three semesters of control students in a nursing foundation course were compared with tests and final examination scores of three semesters of participating students. Participating students were offered access to an asynchronous pretest online discussion activity with a faculty e-moderator. While the simplified Bloom's revised taxonomy assisted in creating appropriate preparatory test and final examination questions for pretest online discussion, Salmon's five-stage online method provided direction to the e-moderator on how to encourage students to achieve Bloom's higher-order thinking skills during the pretest online discussions. Statistical analysis showed the pretest online discussion activity had a generally positive impact on tests and final examination scores, when controlling for a number of possible confounding variables, including instructor, cumulative grade point average, age, and credit hours.

Benefits, barriers, and intentions/desires of nurses related to distance learning in rural island communities

BACKGROUND

This study assessed distance learning needs among nurses on the Neighbor Islands in Hawaii.

METHODS

An exploratory study was conducted using a descriptive qualitative design. Of the 37 nurses who completed the study, 7 were nurse administrators and 30 were staff nurses. There were 18 focus groups of nurses recruited from six public hospitals on the Neighbor Islands.

RESULTS

Three major themes related to distance learning emerged in this study: benefits, barriers, and intentions/desires. Each major theme had several linkages to categories and subcategories.

CONCLUSION

Overall findings were as follows: (1) cost was mentioned more often in three major thematic areas (benefit, barriers, and intentions/desires); (2) the need to revisit and address current curriculum approaches and practices in distance learning programs was identified; and (3) strong recommendations were made for programs and organizational support for distance learning in hospital settings. These findings have implications for nursing research, education, and practice.

Teaching thoughtful practice: narrative pedagogy in addictions education

Preparing practitioners for this rapidly changing and demanding health care environment is challenging. A surge in knowledge development and scientific advancement has placed a priority on technical skill and a focus on content driven educational processes that prepare students for evidence-based practice. However, the most difficult health care scenarios require thinking-in-action and thoughtfulness as well as didactic knowledge. It is our contention that interpretive educational methods, like narrative pedagogy, will promote judgment-based practice that includes use of evidence and delivery of thoughtful care. In this article, we describe and interpret a narrative approach to addictions content and teaching thoughtful practice. We present our pedagogical process, including observations and field notes, to show how interpretive pedagogies can be introduced into nursing curricula. By presenting this process, the reader is invited to consider interpretive methods as a way to inspire and habituate thoughtful practice and judgment-based care.

The effectiveness of web-based and face-to-face continuing education methods on nurses' knowledge about AIDS: a comparative study

BACKGROUND

Information about web-based education outcomes in comparison with a face-to-face format can help researchers and tutors prepare and deliver future web-based or face-to-face courses more efficiently. The aim of this study was to compare the effectiveness of web-based and face-to-face continuing education methods in improving nurses' knowledge about AIDS.

METHODS

A quasi-experimental method was used with a pre-test and post-test design. In this study 140 nurses with BSc degrees were chosen through a random sampling method and divided into a web-based and a face-to-face group by random allocation. For the former group the intervention consisted of a web-based course on AIDS; the latter received a 3-hour lecture course on the same subject. At the beginning and end of the course in both groups, the nurses' knowledge was measured by a questionnaire. Pre- and post-test scores were compared within and between the groups.

RESULTS

The results show that there was no significant difference between the groups in either the pre-test (t(138) = -1.7, p = 0.096) nor the post-test (t(138) = -1.4, p = 0.163) scores in the knowledge test. However, there was a significant difference in the pre-test and post-test scores within each group (web-based, t(69) = 26, p < .001; face-to-face, t(69) = 24.3, p < .001).

CONCLUSION

The web-based method seems to be as effective as the face-to-face method in the continuing education of nurses. Therefore, the web-based method is recommended, as complementary to the face-to-face method, for designing and delivering some topics of continuing education programs for nurses.

WebQuests

The nursing shortage, coupled with growing case loads, limits the available time for nurses in home care to attend continuing professional education programs necessary to keep abreast of the changes in nursing practice and enhance their clinical competency. The purpose of this case study was to evaluate the effectiveness of the WebQuest, a Web-based inquiry-oriented model congruent with the pedagogical approaches and cognitive activities commonly used with nursing education, in providing continuing education content to nurses in a mid-sized home health care agency. A convenience sample of registered nurse case managers completed a researcher-designed WebQuest, modified for independent learning, on diabetes education utilizing their personal computers from home. WebQuests proved to be an innovative and creative approach to provide new information, promote higher level thinking skills, and develop nurses' confidence with computer technology.