Development and effectiveness of online teaching on practical skills among nursing students: A systematic review and meta-analysis

OBJECTIVE

The purpose of this meta-analysis was to assess the effects of online education for practical skills among nursing students.

METHODS

This research was done by searching PubMed, Embase, CINAHL, and Web of Science electronic databases from inception to August 18, 2023, to identify English-language articles. Data extraction, quality assessment, and literature screening were carried out independently by two researchers. The Cochrane risk of bias tool and the Methodological Items for Nonrandomized Studies (MINORS) tool were used to assess the risk of bias of the included studies. Meta-analysis was carried out using Review Manager (RevMan) version 5.3 software.

RESULTS

Eighteen studies involving 2274 nursing students met the inclusion criteria. Nursing students' skills (SMD = 0.43, 95 % CI [0.33, 0.54], P<0.00001), knowledge (SMD = 0.16, 95 % CI (0.02, 0.30], P = 0.02), satisfaction (SMD = 0.29, 95 % CI (0.10, 0.47], P < 0.01), and confidence (SMD = 0.56, 95 % CI [0.29, 0.83], P < 0.0001) were all significantly improved by the online teaching intervention compared with traditional face-to-face instruction. Self-efficacy (SMD = 0.1, 95 % CI [-0.13, 0.33], P = 0.41) was also improved, but the difference was not statistically significant.

CONCLUSION

Online learning is a novel and efficient approach to teaching practical skills to nursing students. Online education can enhance students' knowledge, skills, confidence, and learning satisfaction, and it is superior to traditional classroom instruction. The findings of this study can serve as a basis for the development of standardized online teaching techniques and assessment metrics.

Effectiveness of a virtual reality application-based education programme on patient safety management for nursing students: A pre-test-post-test study

AIMS

We aimed to develop a virtual reality-based smartphone application that improves patient safety competency among nursing students in terms of knowledge, attitudes and confidence in patient safety management. We also sought to evaluate the effects and utility of the application in improving patient safety competency.

DESIGN

A parallel, randomized controlled pre- and post-test trial was conducted to test the effects of knowledge, attitudes and performance confidence in patient safety management.

METHODS

Participants were randomly allocated to the experimental (n = 22), in which nursing students received a two-week mobile web-based training programme covering key topics in patient safety management or the control group (n = 22), in which nursing students received a training booklet. Participants completed a pre-test and two post-test questionnaires to assess the program's impact. The evaluation tools were patient safety management knowledge, attitude and patient safety management performance confidence scale. Data analysis was performed using descriptive statistics, homogeneity test for pre-test, unpaired t-test and repeated measures ANOVA.

RESULTS

Patient safety competency in the experimental group improved significantly in terms of knowledge (from 11.68 to 18.55, p < 0.000), attitude (from 3.38 to 4.01; p < 0.005) and performance confidence (from 3.93 to 4.52; p < 0.000) compared with the control group. Our findings suggest that mobile app-based education using virtual reality may be effective in enhancing patient safety management in nursing education.

Development and Effectiveness of a Clinical Decision Support System for Pressure Ulcer Prevention Care Using Machine Learning: A Quasi-experimental Study

This study was conducted to develop and evaluate the effectiveness of a clinical decision support system for pressure ulcer prevention on clinical (performance, visual discrimination ability, and decision-making ability) and cognitive (knowledge and attitude) workflow. After developing a clinical decision support system using machine learning, a quasi-experimental study was used. Data were collected between January and April 2020. Forty-nine RNs who met the inclusion criteria and worked at seven tertiary and five secondary hospitals participated. A clinical decision support system was provided to the intervention group during the same period. Differences in outcome variables between the two groups were analyzed using t tests. The level of pressure ulcer prevention nursing performance and visual differentiation ability of skin pressure and oral mucosa pressure ulcer showed significantly greater improvement in the experimental group compared with the control group, whereas clinical decision making did not differ significantly. A clinical decision support system using machine learning was partially successful in performance of skin pressure ulcer prevention, attitude, and visual differentiation ability for skin and oral mucosa pressure ulcer prevention. These findings indicated that a clinical decision support system using machine learning needs to be implemented for pressure ulcer prevention.

Smartphone distraction during nursing care: Systematic literature review

AIM

To investigate the impact of smartphone distraction on the quality and safety of care provided by the nursing population during work.

BACKGROUND

About 80% of nurses use the smartphone in the workplace both for personal purposes and as a useful support to improve the quality of care. Distraction from smartphones during care is a phenomenon that should be known and managed within each health service.

METHODS

A systematic review of the literature was conducted using the PRISMA methodology. The sources included in the review study were subjected to a qualitative assessment using the GRADE method.

RESULTS

Sixteen articles were included in the review. Studies included highlight the positive and negative consequences of using mobile devices during nursing practice. Findings identify the smartphone as a generator of stimuli capable of diverting the attention of the person from the priority activities and absorbing the cognitive resources useful for carrying out these activities. Some studies aimed to show the restriction policies and/or the strategies for reducing disruptions. This review highlights how the free and indiscriminate use of the smartphone can negatively affect patient safety and the nurse-patient relationship through the dehumanization and depersonalization of care.

CONCLUSIONS

Mobile technology can improve nurses' performance and the quality of care provided. However, the application of regulations and policies by healthcare facilities is desirable to avoid inappropriate use of these devices by nurses. The available data do not provide a precise estimate of the effect that distraction from smartphones has on the outcomes of nursing care.

The Effect of Cell Phones on Attention and Learning in Nursing Students

The use of cell phones can have a negative effect on nursing students' academic performance. The purpose of this study was to identify the effects that problematic cell phone use and nomophobia have on learning in nursing students. A quasi-experimental study was carried out among nursing students, with a control group (n = 61, 49.2%) and an experimental group (n = 63, 50.8%). The experimental group left their cell phones, in sound or vibration mode, as they normally kept them, on a table located in the corner of the classroom. Both groups showed higher-than-average levels of nomophobia at the beginning of the class. As for problematic cell phone use and attention, it was found that there were statistically significant differences in both cases (U = 1355.500, Z = -2.830, P = .005; U = 1449.000, Z = -2.363, P = .018, respectively), and the experimental group had higher average scores, as well as in those related to knowledge. A relationship has been found between nomophobia and problematic cell phone use. Students who do not have access to their cell phones during class perceive more problematic cell phone usage, in addition to paying closer attention during class. Because of this, it is important to create policies and norms restricting cell phone use during all types of academic training among nursing students.

Using Video Feedback Through Smartphone Instant Messaging in Fundamental Nursing Skills Teaching: Observational Study

BACKGROUND

Video feedback has been shown to be an effective teaching tool that can improve student learning when having them view their own performance. However, the literature on the effect of integrating smartphones with video feedback in fundamental nursing skills teaching is sparse.

OBJECTIVE

This study aimed to explore the potential effects of video feedback through smartphone-based instant messaging on teaching undergraduate nursing students fundamental nursing skills.

METHODS

We conducted a study on teaching fundamental nursing skills to 6 classes of second-year undergraduate nursing students. In 2 classes (the intervention group), the instructor elected to use smartphone-based video feedback to facilitate teaching; instructors in the other 4 classes (the control group) elected to use routine methods of teaching without video feedback. Scores from the final examination, in-class assignments, and the General Self-Efficacy Scale questionnaire were collected and compared between the two groups. Multiple linear regression analysis was performed to estimate the independent effect of video feedback after adjusting for gender, age, and prior experience in the use of WeChat/QQ in learning applications. An ad hoc questionnaire was used for student evaluation of the novel smartphone-based video feedback teaching method.

RESULTS

A total of 195 nursing students (65 in the video feedback group and 130 in the control group) completed the study and were included in the final analysis. Mean and standard deviation of scores on the final examination, bed making, aseptic procedure, vital signs measurement, and oxygen therapy were 91.29 (SD 2.36), 90.52 (SD 3.18), 93.23 (SD 3.16), 91.65 (SD 4.21), and 92.06 (SD 3.58), respectively, in the video feedback group and 89.99 (SD 3.12), 81.71 (SD 8.63), 87.12 (SD 5.50), 87.45 (SD 8.00), and 90.37 (SD 6.36), respectively, in the control group (differences were statistically significant). The mean and standard deviation of scores for assignments in catheterization and enema and General Self-Efficacy Scale were 89.69 (SD 3.22), 91.14 (SD 3.15), and 24.52 (SD 5.35), respectively, in the video feedback group and 88.82 (SD 7.48), 90.79 (SD 6.08), and 24.50 (SD 6.16), respectively, in the control group (differences were not statistically significant). The majority (over 98%) of nursing students were satisfied with this smartphone-based video feedback teaching method.

CONCLUSIONS

Video feedback through smartphone-based instant messaging may be an effective way to improve nursing students' academic performance and professional skills.

Effects of Smartphone-Based Mobile Learning in Nursing Education: A Systematic Review and Meta-analysis

PURPOSE

A systematic review and meta-analysis was conducted to evaluate the effects of smartphone-based mobile learning for nurses and nursing students.

METHODS

Electronic literature search of PubMed, Cochrane Library, Embase, SCOPUS, Web of Science, ProQuest Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Educational Resource Information Center (ERIC) was conducted. Two authors independently reviewed empirical studies for inclusion and extracted the design, sample size, intervention method, outcome variables, and statistical values of them. Methodological quality was assessed using Cochrane collaboration risk of bias tool. To estimate the effect size, meta-analysis was performed using R meta program.

RESULTS

Authors identified 11 randomized or nonrandomized controlled trials of a total of 3,419 studies. Overall effect sizes by random-effects model was large [Hedges'g (g) = 1.12, 95% confidence interval (CI) 0.72-1.52], with learning attitude (g = 1.69), skills (g = 1.41), knowledge (g = 1.47), and confidence in performance (g = 1.54). For heterogeneity, subgroup analyses using meta-analysis of variance were performed, but no significant difference was found. Finally, a funnel plot and Egger's regression test along with trim-and-fill analysis and fail-safe N were conducted to check for publication bias, but no significant bias was detected.

CONCLUSION

Smartphone-based mobile learning had significantly positive influence on nursing students' knowledge, skills, confidence in performance, and learning attitude. Smartphone-based mobile learning may be an alternative or supportive method for better education in nursing fields.

The Relationship Between Acceptance Intention Toward a Smartphone Healthcare Application and Health-Promoting Behaviors Among Nursing Students

The purpose of this study was to identify the relationship between acceptance intention toward a smartphone healthcare application and health-promoting behaviors among nursing students in order to propose a method to encourage nursing students' personal health management. Data were collected from June to July 2015 in two cities located in South Korea, targeting 450 nursing students. There was a weak positive relationship between acceptance intention toward a smartphone healthcare application and health-promoting behaviors (r = 0.281, P < .001). There were differences in health-promoting behaviors according to the level of acceptance intention toward a smartphone healthcare application: health-promoting behavior scores for the upper 50% of participants with higher intention scores (high-score group) were statistically higher than those for the lower 50% of participants (low-score group) (t = 4.247, P < .001). In the logistic regression, the high-score group had a greater likelihood of performing health-promoting behaviors (odds ratio, 2.260; P < .001, 95% confidence interval, 1.539-3.321). Health-promoting behaviors tended to increase among nursing students when the acceptance intention toward a smartphone healthcare application was high. To increase nursing students' intention to accept a smartphone healthcare application, it is necessary to develop applications featuring diverse, interesting health-related content suitable for their needs, so that they want to use these applications to promote health.

Mobile Technology in Undergraduate Nursing Education: A Systematic Review

Objectives

This study aimed to identify and systematically review the literature on the use of mobile technology in nursing education. The research findings could evidence the effectiveness of mobile technology in undergraduate nursing students' learning outcomes.

Methods

Computerized searches were conducted using the Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library, and CINAHL databases for relevant primary studies and limited to those between 2000 and February 2018. Only randomized controlled trials (RCTs) and quasi-experimental studies published in either English or Korean were included and critically appraised using Joanna Briggs Institute tools.

Results

Seven RCTs and 7 quasi-experimental studies were identified. The mobile device and intervention applied varied throughout all the studies. Studies published earlier in the 2000s found that immediate access to clinical and pharmacological referencing information through the mobile device increased students' efficacy in clinical practice. Later studies, which were mostly conducted in Korea, reported that smartphone-based applications could promote nursing students' learning motivation and satisfaction but not their clinical skills and knowledge.

Conclusions

We still seem to be in the beginning stage of implementing mobile technology in nursing education due to the limited implication of mobile technology and inconsistent research conclusions. In the future, rigorous primary empirical studies are needed to suggest the effective use of mobile devices in nursing education.

Use of mobile devices and medication errors in acute care: a systematic review protocol

REVIEW QUESTION/OBJECTIVE

The objective of this review is to synthesize the best available evidence on the effects of healthcare providers using mobile devices at any stage of medication provision on medication errors in acute care settings. Provision of medication includes prescribing, dispensing or administrating medicine in the acute care setting.

The Effects of an Interactive Nursing Skills Mobile Application on Nursing Students' Knowledge, Self-efficacy, and Skills Performance: A Randomized Controlled Trial

PURPOSE

Clinical nursing practice is important because it helps nursing students experience realities of clinical nursing that cannot be learned through theoretical education. This study aimed to evaluate the effect of an interactive nursing skills mobile application for nursing students.

METHODS

Sixty-six senior nursing students were randomly assigned to experimental or control groups. The experimental group used an interactive nursing skills mobile application for 1 week. The control group was provided with a mobile application containing noninteractive nursing video contents for 1 week. Before (pre-test) and 1 week after (post-test) using the mobile application, participants' knowledge of clinical nursing skills, self-efficacy of nursing practice, and nursing skills performance were assessed.

RESULTS

The experimental group showed a significantly higher value for knowledge after 1 week of treatment via their mobile application than the control group (t = 3.34, p = .001). In addition, they showed significantly improved self-efficacy before and after intervention (t = 2.46, p = .017) than the control group. The experimental group's nursing skills performance was also significantly enhanced after intervention (t = 7.05, p < .001), with a significant difference in the degree of improvement (t = 4.47, p < .001).

CONCLUSION

The interactive learner-centered nursing education mobile application with systematic contents was an effective method for students to experience practical nursing skills. Developing and applying a mobile application with other nursing contents that can be effectively used across all range of nursing students is recommended.

Development and Cross-cultural Validation of the Korean Version of SMArtphone's uSability Heuristics (SMASH)

Objectives

The purpose of this study was to develop and cross-culturally validate the Korean version of SMArtphone's uSability Heuristics (K-SMASH).

Methods

In the study, it was used the adaptation process consisted of five stages, namely, translation, synthesis, back translation, expert committee review, and pretesting. In the pretesting stage, a mobile application, using the prefinal K-SMASH, was evaluated for the severity of usability problems by three experts in computer science and informatics. Each participant completed the evaluation and was interviewed about their understanding, interpretation, and opinion of the cultural relevance of the prefinal K-SMASH. Next, we reviewed the differences in the experts' opinions and the questionnaire results.

Results

Twelve SMASH items, words and sentences, were translated, back translated, and revised, considering the conceptual meaning in the context of the Korean culture, by experts in various fields, including a Korean linguist and a bilingual translator, through the first stage to the fourth stage. In the pretesting stage, the results showed no major differences among the severity ratings of participants. Furthermore, all participants answered that there were no critical discrepancies or inconsistencies with the cultural relevance of the prefinal K-SMASH.

Conclusions

The results of the study provide preliminary evidence that the modified K-SMASH can be used for heuristic evaluation, one of the usability tests, when developing applications in Korea.