The facilitators and barriers to nurses' participation in continuing education programs: a mixed method explanatory sequential study

A game-based multimedia application to improve the ability of clinical nurses to perform geriatric care: A randomized controlled trial

BACKGROUND

Given the realities of global aging, maintaining Comprehensive Geriatric Assessment (CGA) abilities among clinical nurses is very important. Newer methods of continuing education are needed to engage nurses in CGA education. Using multimedia and game-based applications in CGA education (CGA APP) may be an effective method for continuing education.

OBJECTIVES

To test the effectiveness of CGA APP in improving nurses' confidence in their abilities to perform geriatric care.

DESIGN

A randomized, controlled trial were adopted.

SETTING

An 1343-bed tertiary-care medical center in southern Taiwan.

PARTICIPANTS

A total of 1250 nurses met inclusion criteria in 35 adult wards. We employed stratified sampling to recruit a total of 132 nurses proportional to the number of nurses in each ward, from January to March 2019.

METHODS

Based on the Octalysis gamification framework, the CGA APP was developed. Participants were randomly assigned to either an CGA APP or a control group, which received traditional classroom learning of the same content. The main outcome was improvement in confidence in geriatric care ability were measured before and end of the training session, and six months later.

RESULTS

There were no differences in baseline characteristics (except years of experience as a registered nurse), knowledge, attitudes or confidence of geriatric care between the two groups. Clinical nurses in the CGA APP group demonstrated significantly higher confidence in their geriatric care abilities than control group immediately after the intervention (75.85 ± 10.71 vs. 65.93 ± 8.49, p < 0.001) and six-months later (71.13 ± 9.69 vs. 63.57 ± 8.78, p < 0.001). After using GEE to control the confounding variable, the CGA APP group remained significantly higher confidence in their geriatric care abilities than control group.

CONCLUSIONS

Use of multimedia game-based applications my better engage and teach practicing clinical than traditional learning methods. Our findings suggest that such interventions be further developed and tested for a larger variety of continuing education needs.

The CKD-DETECT V2.0 study: A randomised controlled trial evaluating the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' knowledge and learning efficiency about chronic kidney disease risk factors and best practice screening procedures

AIMS AND OBJECTIVES

To evaluate: (a) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' knowledge about chronic kidney disease risk factors and best practice screening procedures and (b) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' learning time and learning efficiency.

BACKGROUND

The screening and early detection of chronic kidney disease is essential in reducing its burden on the health system and those affected by it. General practice nurses are well-positioned to assist in its early detection.

DESIGN

Parallel-group, single-blinded, pre-post interventional randomised control design.

METHOD

This study was reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT). Participants were registered or enrolled nurses working in general practice settings across Australia. The intervention group (n = 173) received an infographic poster about chronic kidney disease risk factors and best practice screening procedures, whereas the control group (n = 170) received an interactive e-learning program. Data were collected using an 8-item pre-post knowledge evaluation instrument. Time spent learning were collected through a self-reported log and a login/logout method.

RESULTS

The overall intervention effect demonstrated no statistical significance in knowledge scores from the baseline scores between the intervention and control group. The intervention group demonstrated higher learning efficiency in comparison to the control group.

CONCLUSION

The study demonstrated an infographic poster is as effective as an e-learning program on improving knowledge scores. However, in comparison to an e-learning program, an infographic poster is a more efficient way of learning.

RELEVANCE TO CLINICAL PRACTICE

Infographic posters can be an efficient educational modality to enhance healthcare professionals' knowledge and could be used as public health campaigns in clinical settings to educate the community.

Culturally sensitive emergency care for sexual and gender minority youth: A quality improvement initiative

BACKGROUND

Despite evidence of the impact of provider implicit bias and overt discrimination experienced by sexual and gender minority youth (SGMY), evidence surrounding sexual and gender minority cultural sensitivity training for pediatric emergency health professionals is limited. No targeted training existed to improve the clinical preparedness of healthcare professionals serving SGMY by increasing providers' knowledge and attitudinal awareness in a pediatric emergency department at a large, urban pediatric hospital in the Southeastern United States.

METHODS

The Institute for Healthcare Improvement's [15] Model for Improvement informed the project and was completed in four Plan-Do-Study-Act cycles. A cross-sectional, pre-test post-test design was used to gather demographic data, administer the LGBT-DOCSS questionnaire, and collect participant feedback on the training session. The LGBT-DOCSS results were analyzed using an independent samples t-test.

INTERVENTIONS

Evidence-based pedagogical strategies were utilized for a 60-minute staff training session. Staff (n = 25) had six opportunities to attend one of the training sessions over a period of 4 months.

RESULTS

Self-selection and voluntary participation contributed to recruiting participants who demonstrated high baseline LGBT-DOCSS scores, particularly on the subscales that measure knowledge and attitudinal awareness. After the sessions, participants showed an increase in LGBT-DOCSS scores with a statistically significant increase in the clinical preparedness subscale.

CONCLUSIONS

This project was the first at the institution to focus on culturally sensitive emergency care for sexual and gender minority youth. The content was well received by staff, who demonstrated increased clinical preparedness after the training. Implementing the training as a required component of new nurse orientation and onboarding is the next step in creating a safety culture for SGMY in the PED setting.

Barriers and Facilitators in Continuous Medical Education Related to Allogeneic Stem Cell Transplantation: A Qualitative Study of Physicians

INTRODUCTION

This study explored qualitatively, in a sample of German hematologists working in clinical allogeneic hematopoietic stem cell transplantation (alloHSCT), perceptions of barriers and facilitators to participate in continuous medical education (CME), to provide detailed information on how to improve participation in CME activities related to alloHSCT, which may also be applicable to other areas of medicine.

METHODS

Based on a recruitment campaign of the German Association for Hematopoietic Stem Cell Transplantation (DAG-HSZT), 21 semi-structured telephone interviews were conducted, transcribed, and analyzed using framework analysis.

RESULTS

Three clusters of barriers were identified that explain why alloHSCT physicians may or may not participate in CME: individual constraints (e.g., better networking, young physicians being overwhelmed by the complexity of alloHSCT), structural constraints (e.g., time and financial issues, tailoring CME courses according to the targeted audience), and content-related constraints (e.g., requirement of CME sessions, provision of an overview of CME courses, more flexible offers). We discuss the ten most frequently raised issues, including the use of incentives and the need for support at the start of residency, staff shortages, and requirements for learning sessions.

CONCLUSION

There is a need for a paradigm shift in CME related to alloHSCT toward a more individualized and needs-based approach. Close monitoring of residents' needs and learning progress, as well as feedback systems, could help identify appropriate CME courses that should be integrated into a tiered learning system. CME should be more targeted to specific audiences (i.e., residents, fellows, and attendees) to provide training that is tailored to individual CME needs. On-demand courses can help balance work and family obligations. Finally, peer-reviewed, up-to-date information platforms should be expanded.

Development and Implementation of an Online Pain Management Continuing Education Program

BACKGROUND

Multiple studies indicate a lack of pain management training across a range of healthcare specialties. The online Joint Pain Education Program (OJPEP) was created to provide content covering various topics that range from general pain science to integrative care to pain management. The present study evaluates the feasibility of an interdisciplinary, self-guided, online pain management continuing education program, the OJPEP.

PARTICIPANTS/SUBJECTS

A total of 228 learners participted in this study. Of the 228 learners, 58 learners identified as registered nurses and 12 learners identified as nurse practitioners.

DESIGN

Prospective single-arm education feasibility study.

METHODS

Potential learners were provided invitations to participate via emails from clinic leadership and postings to hospital intranet websites. Learners registered online and could select up to eight modules, based on the materials developed from a Department of Defense/Veterans Administration project. Learners evaluated their satisfaction with module quality and applicability.

RESULTS

A variety of providers, predominately non-prescribers, across many health care specialties, registered for modules. Across all modules except one, less than half of participants who registered completed the selected module. Time stamps indicated many learners skipped module content. Of those who completed the continuing education evaluation to obtain certificates, the majority indicated the content was of high-quality, appropriate, and evidence-based. One-third to approximately one-half of learners indicated that they would apply content in their clinical practice. Completion of the intended 3-month follow-up survey was poor.

CONCLUSIONS

Though modules were acceptable per learner responses, future work is needed to: develop modules that are more engaging (e.g., interactive) and applicable to learners; and improve implementation methods to include dissemination and evaluation metrics.

The role of continuing medical education programs in promoting iranian nurses, competency toward non-communicable diseases, a qualitative content analysis study

BACKGROUND

Continuing medical education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and nurses' vital role in improving health care. It is, therefore, imperative to explore the nurses' experience of CME courses and the extent to which such programs are effective.

OBJECTIVE

The present qualitative study aimed to explore and describe nurses' experiences of the effect of CE programs in promoting their competencies toward non-communicable diseases.

METHODS

This qualitative content analysis study was conducted from December 2019 to April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses who actively worked in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nine nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide, and data collection continued until data saturation was achieved. Each interview took about 30-45 min. Follow up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln.

RESULTS

Analysis of the interview data resulted in 230 primary codes, based on 8 categories, and three themes were identified. The extracted themes were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. The associated categories were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency.

CONCLUSION

Professional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning, and implementation of training programs based on professional needs and effective assessment of the teaching/learning process.

Community nurses' perspectives on a novel blended training approach: a qualitative study

Background

Transiting into the community setting often presents novel difficulties for nurses because the role demands skills that might not have been obtained through usual clinical experience or training. The Ageing-in-Place Community Care Team (AIP-CCT) Community Nurse Basic Training programme was developed to address this learning gap. This training programme prepares nurses to lead in a multi-disciplinary team in delivering patient-centred care to patients with progressive or life-limiting conditions in the community setting. This study evaluated the inaugural training programme provided to a group of nurses from an acute hospital in Singapore.

Methods

Qualitative in-depth interviews were carried out with 13 participants from the training programme three-months after completion of the AIP-CCT Community Nurse Basic Training programme provided by an acute hospital to understand the programme’s impact on their knowledge, skills and clinical practice, as well as barriers and facilitators to learning.

Results

Overall, perception towards the training course was mixed. Course content was found to be relevant, and participants reported that training led to improvement in their practice. However, experienced nurses felt that the content of some modules were lacking in depth. This could have explained why only junior nurses tended to hold favourable attitudes and felt that the training led to increase in their confidence level. Although medical content was assessed favourably, the course was not able to address some of the constraints faced by community nurses such as managing expectations and handling difficult patients in the home care setting. For some modules, face-to-face training was preferred and e-learning components can be improved to increase communication and interaction.

Conclusion

This study provided insights into how a community nurse training programme could be developed to meet the needs of community nurses. The training was able to reinforce skills and knowledge, address knowledge gaps and provide new clinical care approaches and communication strategies. These incremental effects on experienced community nurses could be extrapolated to have greater benefits for inexperienced community nurses. Based on findings of the study, potential changes to the training programme were discussed to improve training outcomes.

Effectiveness of e-Learning on Neonatal Nurses' Pain Knowledge and Pain Measurement Skills: A Pilot Study

BACKGROUND

Reported benefits of virtual programs include user satisfaction and feasibility to train nurses to utilize pain scales. However, the effectiveness of the virtual neonatal pain management program on nurses' knowledge and scoring skill acquisition has not been examined.

PURPOSE

This study developed a comprehensive virtual program on neonatal pain management and examined its effectiveness on nurses' knowledge and skill acquisition of selected pain scales.

METHODS

Evidence-based content was designed as a virtual program and pre-and posttests to examine skill and knowledge acquisition were developed and validated. Analysis of covariance was used to assess the differences from pre- to posttest based on the intensity of participants' involvement while examining the overall effectiveness of the program.

RESULTS

A total of 115 nurses representing 7 hospitals completed the virtual neonatal pain management program, and 52 nurses completed the posttest. The Student paired t test showed an increase in posttest scores from pretest scores among participants. Participants' final degrees and years of experience were not related to posttest scores. The analysis of covariance showed that the high study group had a significantly higher amount of change in total scores and pain measurement skill scores than the low study group on the posttest.

IMPLICATIONS FOR PRACTICE

The virtually delivered neonatal pain management program can be useful for nurses' attainment of knowledge and skills for managing neonatal pain, including an appropriate use of selected scoring tools.

IMPLICATIONS FOR RESEARCH

It is necessary to examine how organizational unit attendance rate for e-learning and posttest results are related to patient outcomes.

VIDEO ABSTRACT AVAILABLE AT

https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=46.

Millions of Bangladeshi Children Missed Their Scheduled Vaccination Amidst COVID-19 Pandemic

The Government of Bangladesh imposed a movement control order as a mass quarantine strategy to control the outbreak of coronavirus disease 2019 (COVID-19). Adherence to the home quarantine may put children at risk by missing routine vaccination. In this study, we investigated the impact of COVID-19 on child routine immunization in a rural area of Bangladesh and consider the broader implications. Data for this study comes from the Chakaria Health and Demographic Surveillance System (HDSS) of icddr,b with a population of 90,000 people residing in 16,000 households in 49 villages in a rural, coastal area of Southeast Bangladesh. We used an explanatory sequential mixed methods design which involved two phases between March 1, 2020, and May 31, 2020: first, we observed 258 outreach sessions of 86 EPI centers. We calculated the number of Expanded Program on Immunization (EPI) outreach sessions suspended and the number of children who missed their routine vaccination due to the COVID-19. We extrapolated the number of Bangladeshi children who missed their routine vaccination using Chakaria HDSS observations. Secondly, we conducted in-depth interviews to explain the quantitative results. The EPI outreach session (EOS) declined to 74.42% (95% CI 63.97–83.22), 10.45% (95% CI 5.00–18.94), and 3.45% (95% CI 1.00–9.75) from 2019 levels in March, April, and May 2020, respectively. By extrapolation, in Bangladesh, between March and May 2020, 3.2 million children missed their scheduled vaccination compared to 2019. Results from in-depth interviews showed that the unwillingness of villagers to hold EOS and the absenteeism of the vaccinators due to social distancing recommendations and lack of personal safety measures were the main reasons for the discontinuation of the EOS. Resuming EPI outreach sessions and introducing a special catch-up program is essential to prevent future outbreaks and deaths due to vaccine-preventable diseases in Bangladesh and the countries where children missed their routine vaccination due to COVID-19. This health system failure should be considered a factor in all future pandemic preparedness plans.

School Nurse Perceptions of Continuing Education: Identifying the Process of Engagement

BACKGROUND

School nurses serve a critical role in academic settings, but evidence indicates that nurses may need help transitioning their generalist nursing training to the school environment (Camp). Continuing education (CE) can be an effective way for school nurses to develop the specialty skills needed for this practice environment (Gormley; Quinn & Smolinski), but a better understanding of how nurses engage in CE is needed to guide course development. The goal of this study is to describe how South Carolina school nurses engage with CE to guide future CE development efforts.

METHOD

A qualitative descriptive design was used to describe engagement in CE for 24 participating South Carolina school nurses.

RESULTS

School nurses experienced CE as a process that included deciding to attend, experiencing the course, and implementing practice change. Subthemes relevant to these steps also emerged.

CONCLUSION

For school nurses, CE is a process and is not perceived as a one-time event. Design recommendations and strategies are presented. [J Contin Educ Nurs. 2022;53(1):35-41.].

Factors Hampering the Participation of Nursing Staff in the Continuing Education Activities of Hospitals Centers in the Casablanca-Settat Region

Aim:

This study aimed to identify the factors hampering the participation of nurses in the activities of CE sessions at the level of hospitals in the region of Casablanca.

Background:

Continuing education (CE) for nursing staff represents a strategic asset for hospitals, identifying the constraints of nursing staff participation in continuing training could help improve the quality of care for patients and the population in general.

Objective:

This study aimed to identify the factors hampering the participation of nurses in the activities of CE sessions at the level of hospitals in the region of Casablanca.

Methods:

The study used a two-phase mixed method design. First of all, a questionnaire was administered to 930 nurses belonging to 9 hospital centers in the Casablanca-Settat region in order to explore and estimate the frequencies of the factors hindering the participation of nurses in the activities of the FC sessions at the level of hospitals, and a semi-structured interview with 9 persons in charge of continuing education from these different hospitals to complete and explain the data collected by the questionnaire.

Results:

The data analysis confirmed that the work overload is the first individual difficulty hindering the participation of nurses in CE sessions, i.e., 85.4%. The most mentioned organizational difficulties are schedule recommended in the FC not encouraging and not suitable, i.e., 23%, non-targeted content (does not meet the needs of the nursing staff), i.e., 66.7%. Finally, the absence of support measures in terms of monitoring and evaluation to maintain the knowledge and skills acquired during FC sessions in real situations at the workstation occupied is the first institutional difficulty mentioned by the interviewed (88%).

Conclusion:

Those responsible for training should take into account the factors nurse’s face in participating in continuing education sessions when designing, developing, and implementing continuing education sessions.

Continuing Education for Home Care Nurses: An Integrative Literature Review

With the wide range of clinical skills and responsibilities that home care nurses (HCNs) are expected to perform, it is important they are supported with access to relevant continuing nursing education (CNE) to perform their job safely and effectively. An integrative literature review was conducted to explore the current evidence on CNE for HCNs. Medline and CINAHL were searched and 13 articles that met the criteria were reviewed. The analysis identified three themes: (1) learning strategies (simulation, virtual gaming, elearning, traditional learning); (2) challenges (staffing, time, access, skill) and opportunities (incentive to stay employed, decreased burnout); and (3) learning needs (palliative, patient and family needs, older adults and dementia, acute nursing skills). Nurses who provide care to patients in their homes have very complex roles and responsibilities. In order to keep patients and nurses safe, standards of education for HCNs, beyond their basic education program, must be developed. These educational standards must be designed to address the complex medical needs of patients while making the educational opportunities accessible and value-added. Improving the CNE experience for HCNs has the potential to increase patient safety, improve care outcomes, increase nurse competence, improve retention, and decrease nurse burnout.

Evaluation of psychological training for nurses and midwives to optimise care for women with perinatal depression: a systematic review and meta-analysis

Objective Perinatal depression is linked to poor maternal health and infant development outcomes. The World Health Organization recommends expanding the mental health education and training of primary care providers to improve the quality of perinatal depression care. The present study evaluated the effect of various psychological training methods on nurses' and midwives' competence in administering care to and alleviating symptoms in patients with perinatal depression. Methods A comprehensive search of the PubMed, MEDLINE, Cochrane Library, EMBASE, Web of Science, and CINAHL databases was performed. The data were independently extracted by two reviewers, and the critical appraisal tools of the Joanna Briggs Institute were used for quality assessment. Random-effects meta-analysis was conducted using Review Manager 5.4 software. Findings A total of 13 articles including 246 nurses and midwives and 4,381 perinatal women were reviewed. Care administered through both face-to-face (relative risk [RR] 0.70, 95% confidence interval [CI] 0.61-0.74) and digital training (RR 0.44, 95% CI 0.26-0.74) significantly mitigated symptoms of perinatal depression. Significant benefits were observed after 3- to 5-day and 8-day training, for which the RR were 0.75 (95% CI 0.59-0.97) and 0.72 (95% CI 0.66-0.85), respectively. Studies with high intervention fidelity more effectively reduced the risk of depressive symptoms in perinatal women than those with low intervention fidelity. Key conclusions and implications for practice Compared with face-to-face, digital training methods were more effective in reducing the risk of depressive symptoms. High intervention fidelity and 3- to 5-day and 8-day training resulted in better outcomes. The present findings can serve as a reference for the design of psychological training programs for nurses and midwives to equip them with effective strategies for administering care to patients with perinatal depression.

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.

Qualitative exploration of the reproductive health perceptions of middle-aged women in the United States

Empirical literature exploring the reproductive health experiences of middle-aged women is limited. Little is known about their experiences and decision-making processes related to reproductive health. The purpose of the Reproductive Health Seeking (RHS) study was to expand the understanding of reproductive health knowledge and influences impacting health decisions for middle-aged women. Thirty women aged 45-64 participated in semi-structured interviews and a focus group. Results highlighted a variety of experiences related to reproductive health including women's perceptions of reproductive health-related cancers, community resources for reproductive-related health education, and factors that influence reproductive health and healthcare seeking behavior. Results demonstrated that women are impacted by their conversations with family and friends, seek information through a variety of channels, and are calling for more information on a variety of reproductive health-related issues outside of breast cancer campaigns.

Residential aged care staff awareness of and engagement with dementia-specific support services and education

Objective

To examine residential aged care (RAC) staff awareness of and engagement with dementia‐specific support services and education.

Methods

A cross‐sectional survey of staff (n = 179) from 36 Victorian RAC facilities.

Results

60% (n = 107) of respondents were aware of dementia‐specific support services, but only 27% (n = 48) accessed services in the previous 2 years. Approximately 77% (n = 137) were aware of dementia‐specific education, with 66% (n = 115) completing education in the previous 2 years. A significantly higher proportion of registered nurses had accessed dementia‐specific support services in the past 2 years compared with enrolled nurses and personal care assistants (P < 0.001).

Conclusion

A relatively large proportion of RAC staff were unaware of available dementia‐specific support services and education. While approximately two thirds accessed such education, only one in four accessed dementia‐specific support services. To optimise the quality of care for people with dementia, strategies to increase awareness of and access to these resources are warranted.

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.

Professional training on shared decision making with older adults living with neurocognitive disorders: a mixed-methods implementation study

BACKGROUND

Shared decision making with older adults living with neurocognitive disorders is challenging for primary healthcare professionals. We studied the implementation of a professional training program featuring an e-learning activity on shared decision making and five Decision Boxes on the care of people with neurocognitive disorders, and measured the program's effects.

METHODS

In this mixed-methods study, we recruited healthcare professionals in family medicine clinics and homecare settings in the Quebec City area (Canada). The professionals signed up for training as a continuing professional development activity and answered an online survey before and after training to assess their knowledge, and intention to adopt shared decision making. We recorded healthcare professionals' access to each training component, and conducted telephone interviews with a purposeful sample of extreme cases: half had completed training and the other half had not. We performed bivariate analyses with the survey data and a thematic qualitative analysis of the interviews, as per the theory of planned behaviour.

RESULTS

Of the 47 participating healthcare professionals, 31 (66%) completed at least one training component. Several factors restricted participation, including lack of time, training fragmentation into several components, poor adaptation of training to specific professions, and technical/logistical barriers. Ease of access, ease of use, the usefulness of training content and the availability of training credits fostered participation. Training allowed Healthcare professionals to improve their knowledge about risk communication (p = 0.02), and their awareness of the options (P = 0.011). Professionals' intention to adopt shared decision making was high before training (mean ± SD = 5.88 ± 0.99, scale from 1 to 7, with 7 high) and remained high thereafter (5.94 ± 0.9).

CONCLUSIONS

The results of this study will allow modifying the training program to improve participation rates and, ultimately, uptake of meaningful shared decision making with patients living with neurocognitive disorders.

How to … do mixed-methods research

As a clinician, you will often combine patients' narratives with test results in order to obtain a coherent picture and then decide on a way forward. As an educator, you are also likely to combine different information from your learners to arrive at the best feedback, judgement or supervision plan. This is what researchers do when undertaking mixed-methods research: qualitative and quantitative data are typically brought together to provide different insights than could be achieved with a single type of data and analysis. Mixed-methods research has much to offer the clinical teacher but may involve more complex study designs than other types of research. Therefore, this article aims to highlight the different designs of mixed-methods research, and the opportunities and challenges that it provides, in order to support researchers who may be undertaking their first mixed-methods research study.

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.

Systematic Review of Continuing Education Interventions for Licensed Nurses Working in Psychiatry

Continuing education is an important part of nursing practice. These interventions help maintain clinical competence and are mandated by regulatory bodies. Often, continuing education interventions are created ad hoc and implemented without testing or formal evaluation of learning outcomes. In the current health care context, where resources are limited, educators are pressed to do more with less. Having access to a repository of existing continuing education interventions will facilitate the use of evidence-informed learning strategies and save valuable time by reducing duplication of efforts. Therefore, this systematic review aimed to explore continuing education interventions for licensed nurses working in psychiatry. All standard systematic review procedures were followed, including double screening, data extraction, and quality appraisal. This article presents an inventory of existing interventions, including summaries, as well as the reported effectiveness of each for nursing outcomes. Generally, the continuing education interventions result in positive nurse-related outcomes, such as increased knowledge, confidence, and skills, or improved attitudes; however, more rigorous research is needed to advance science in this area. [J Contin Educ Nurs. 2019;50(5):233-240.].

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

Nurses' perceptions about a web-based learning intervention concerning supportive family conversations in home health care

Aims and objectives

To describe the perceptions that municipal primary healthcare nurses and municipal registered nurses had about a web‐based learning intervention concerning supportive family health conversations in municipal home health care.

Background

Even though family health conversations are well grounded in theory with several reported benefits for patients and families, most working nurses have little or no training in practising family systems nursing including family health conversations. Continued learning is necessary for nurses, where web‐based learning may be one answer of updating the professional skills and knowledge of nurses regarding supporting families.

Design

The study used a descriptive design and followed the “Consolidated criteria for reporting qualitative research” (COREQ) checklist.

Methods

Twenty‐one nurses participated in an educational intervention that consisted of web‐based learning and two face‐to‐face seminars about family systems nursing including family health conversations. The nurses were interviewed after completion, and the audio‐recorded interviews were transcribed verbatim and analysed using qualitative content analysis.

Results

The findings consist of nurses’ perceptions regarding the disposition of instruction, the prerequisites for learning and a changed approach when working with families. The findings are further reflected on through Illeris’ theory concerning learning triangle.

Conclusions

The findings are encouraging for educating nurses in family health conversations at their workplace, with the purpose of supporting patients and families. However, it is important to be aware of the different dimensions of learning, in addition to the appraisal of social aspects and organisational circumstances when educating nurses as they influence the utilisation of the knowledge.

Relevance to clinical practice

This web‐based learning intervention seems to be suitable for educating nurses in family health conversations and could be an appropriate step towards implementing these conversations in home health care with the purpose of supporting families.

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 e-learning in a continuing education context on nursing care: a review of systematic qualitative, quantitative and mixed studies reviews (protocol)

INTRODUCTION

Continuing education (CE) is imperative to the future of professional nursing. The use of e-learning by registered nurses for CE is spreading. A review of systematic reviews will be conducted to develop a broad picture of the effects of e-learning in a CE context on nursing care.

METHODS AND ANALYSIS

Systematic qualitative, quantitative and mixed studies reviews published in English, French or Spanish from 1 January 2006 will be included. The outcomes of interest will be extracted and analysed inductively and deductively from the Nursing Care Performance Framework; some themes include nursing resources, nurses' practice environment, processes, professional satisfaction, and nursing sensitive outcomes. Three reviewers will independently screen first the title and abstract of the papers, and then the full texts in order to assess eligibility. Two teams of two reviewers will extract the selected reviews' characteristics and data. The results from various types of reviews will be integrated using a data-based convergent synthesis design. We will conduct a thematic synthesis and transform all quantitative and mixed data into qualitative data.

ETHICS AND DISSEMINATION

Ethics approval is not required for review of systematic reviews. We will summarise evidence concerning the negative, neutral and positive effects of various forms of e-learning on different aspects of nursing care. If we find gaps in the literature, we will highlight them and suggest ideas for further research. We will also focus on positive effects and present, if possible, the components and characteristics of e-learning interventions that were found to be successful. We will present this protocol and results in international conferences in nursing, medical, and health informatics domains. We will also submit the results of our work for peer-review publication in a journal indexed in the international bibliographic database of biomedical information.