Effect of blended self-directed learning on nursing students: Quasi-experimental approach

BACKGROUND

Higher education institutions are adapting and innovating like never before to provide highly individualized learning environments for both traditional and non-traditional students. This seismic upheaval in the higher education landscape is being observed across the world. The present study aimed to evaluate the effectiveness of a blended learning approach on nursing students' self-directed learning readiness.

MATERIALS AND METHODS

This study is a quasi-experimental approach in which a non-equivalent control group was used in a post-test design. A comparison was carried out with two separate semester cohort students representing the control and intervention groups which had 24 and 30 students, respectively. This study included first-year nursing students that enrolled in a course called "Anatomy and Physiology" course of nursing education at a private university. The control group received all their teaching face-to-face, and the intervention group used information technology and prescribed activities in their online e-book. The self-directed learning readiness (SDLR) tool measures the learners' readiness in self-directed learning in both groups. This scale comprises three subscales which are "self-management," "desire for learning," and "self-control." An independent-samples t-test was conducted to compare self-directed learning readiness in the control and intervention groups. Data were analyzed using IBM SPSS Statistics 25 software to measure the independent t-test.

RESULTS

The self-directed readiness scores were significantly higher in the intervention group with P = 0.019. The intervention group showed a higher mean value on the subscales of self-management and self-control, which demonstrated a significant difference with P values of 0.018 and 0.028, respectively. The subscale desire for learning was insignificant with a P value of 0.166.

CONCLUSION

This study concluded that the overall results demonstrate that incorporating blended learning using e-books for anatomy and physiology courses in nursing education can contribute to students' readiness for self-directed learning. Specifically, the blended learning teaching and learning strategy had a positive impact on nursing students' capacity for self-management and self-control.

Development and Evaluation of an e-Book for Bone Health and Osteoporosis Education in Adolescents

Achieving optimum peak bone mass during adolescence is crucial for lifetime bone health. This study is aimed at developing and assessing an e-book designed for adolescent bone health knowledge and osteoporosis education. A needs assessment was conducted among 43 adolescents, aged 13-16 years, living in urban areas in Malaysia to determine their needs and preference for health educational material. The researchers also searched for relevant guidelines and articles regarding adolescent bone health. Subsequently, an e-book was developed based on the needs assessment and literature search. Five expert panelists (mean work experience = 11.3 years) validated the e-book contents and assessed its understandability and actionability using the Patient Educational Materials Assessment Tool for Audio-Visual Material (PEMAT-A/V). The internet (72.1%), parents (44.2%), television (41.9%), and teachers (39.5%) were the top four sources of health information among the respondents. Magazines (4.6%) and newspapers (11.6%) were the least preferred resources. Most adolescents were interested in cartoon-themed educational materials, and they perceived that including a short video, quiz, and infographic in the educational material would make it much more interactive for users. The developed e-book includes seven infographic chapters, a link to a quiz, and a summary video. The topics cover basic information on bones and the formation and resorption processes, osteoporosis and its risk factors, key nutrients for bone health (calcium and vitamin D), along with their sources and recommended amounts, physical activity and exercise for bone health, and tips for healthy lifestyle practices for bone health. All chapters and the video were rated with a median score of 100% for understandability and actionability, respectively. Some of the comments received from evaluators included that the e-book made good use of infographics, was easy to understand and interesting, and contained well-organized content. Some suggestions for improvement included adding take-home messages relevant to the topic, using colors to highlight keywords, and narrating all points presented in the video. Overall, the newly developed e-book on adolescent bone health was highly rated by expert panelists. However, the acceptance and effectiveness of the e-book in increasing bone health and osteoporosis knowledge among adolescents are yet to be evaluated. The e-book could be used as one of the educational tools to promote bone health in adolescents.

Barriers to and Facilitators of Automated Patient Self-scheduling for Health Care Organizations: Scoping Review

Background

Appointment management in the outpatient setting is important for health care organizations, as waits and delays lead to poor outcomes. Automated patient self-scheduling of outpatient appointments has demonstrable advantages in the form of patients’ arrival rates, labor savings, patient satisfaction, and more. Despite evidence of the potential benefits of self-scheduling, the organizational uptake of self-scheduling in health care has been limited.

Objective

The objective of this scoping review is to identify and to catalog existing evidence of the barriers to and facilitators of self-scheduling for health care organizations.

Methods

A scoping review was conducted by searching 4 databases (PubMed, CINAHL, Business Source Ultimate, and Scopus) and systematically reviewing peer-reviewed studies. The Consolidated Framework for Implementation Research was used to catalog the studies.

Results

In total, 30 full-text articles were included in this review. The results demonstrated that self-scheduling initiatives have increased over time, indicating the broadening appeal of self-scheduling. The body of literature regarding intervention characteristics is appreciable. Outer setting factors, including national policy, competition, and the response to patients’ needs and technology access, have played an increasing role in influencing implementation over time. Self-scheduling, compared with using the telephone to schedule an appointment, was most often cited as a relative advantage. Scholarly pursuit lacked recommendations related to the framework’s inner setting, characteristics of individuals, and processes as determinants of implementation. Future discoveries regarding these Consolidated Framework for Implementation Research domains may help detect, categorize, and appreciate organizational-level barriers to and facilitators of self-scheduling to advance knowledge regarding this solution.

Conclusions

This scoping review cataloged evidence of the existence, advantages, and intervention characteristics of patient self-scheduling. Automated self-scheduling may offer a solution to health care organizations striving to positively affect access. Gaps in knowledge regarding the uptake of self-scheduling by health care organizations were identified to inform future research.

Discussion of Students' E-book Reading Intention With the Integration of Theory of Planned Behavior and Technology Acceptance Model

The emergence of e-books with the characteristics of easy access and reading any time anywhere is a subject of debate in academia. Topics include the use of e-books in libraries, their use in support teaching, new possibilities for reading activities, potential uses for library archives, and the motivation and intention of e-book users. Students at Guilin University of Technology participated in a survey. Of the 300 copies of the questionnaire distributed, 263 valid copies were returned, a retrieval rate of 88%. The research results show that (1) Usability and reading need are the key factors in e-book usage. Usability refers to convenient keyword searches, portability, and any time reading. E-books are considered to make searching and reading large amounts of data easier. (2) E-books are not restricted to time and space so that the overall reading quantity is increasing. Readers become accustomed to reading e-books, and the quality of their digital reading is gradually enhanced. (3) Students should complete e-book use courses offered by libraries to enhance their familiarity with e-books and their use of e-book software, thereby enhancing postgraduate student readers' e-book information literacy. The results of the research prompt suggestions to enhance the promotion of reading and e-book information to encourage student readers' e-book reading intention.

Toddlers raised in multi-dialectal families learn words better in accented speech than those raised in monodialectal families

Multi-accent environments offer rich but inconsistent language input, as words are produced differently across accents. The current study examined, in two experiments, whether multi-accent variability affects infants' ability to learn words and whether toddlers' prior experience with accents modulates learning. In Experiment 1, two-and-a-half-year-old Norwegian toddlers were exposed, in their kindergarten, twice per day for one week, to a child-friendly audiovisual tablet-based e-book containing four novel pseudowords. Half of the toddlers heard the story in three Norwegian accents, whereas the other half heard it in one Norwegian accent. The results revealed no differences between conditions, suggesting that multi-accent variability did not hinder toddlers' word learning. In experiment 2, two-and-a-half-year-old Norwegian toddlers were exposed, in their homes, for one week, to the e-book featuring three Norwegian accents. The results revealed overall better learning in toddlers raised in bi-dialectal households, as compared to mono-dialectal peers - suggesting that accent exposure benefits learning in multi-accent environments.

The Impact of E-Book Reading on Young Children's Emergent Literacy Skills: An Analytical Review

Young children's use of digital devices is increasing as we progress through the 21st century and handheld and mobile devices, such as smartphones and tablets, have become increasingly available. While older children using tablets to read has been more broadly investigated, less is known about the impacts of digital reading on children at the stage of literacy acquisition. An analytical review was conducted on the effects of interactive e-book interventions for young children's literacy development when compared to (a) listening to print books, (b) regular school programs, and (c) reading non-enhanced and non-interactive e-books. A significant additional beneficial effect of e-book interventions was found for phonological awareness and vocabulary learning based on data from 1138 children in 14 randomized controlled trial (RCT) studies. When e-books are properly selected and used, children develop literacy skills equally well and sometimes better than with print books. Additionally, e-book interventions outperformed the regular school program in the development of literacy skills. Similarly, enhanced e-book conditions revealed benefits over the non-enhanced e-book interventions in literacy skill acquisition. The impact of these findings related to health issues, e-book design, disadvantaged populations, and adult-led e-book sharing is discussed.

["Arrhythmia Reading": A Diverse Teaching Approach to Improve the Ability of 2 Year NPGY Nurses to Interpret and Manage Arrhythmias]

BACKGROUND

The author of this paper works in the critical care ward of an internal medicine department. During the study period, current trainees in a nurse post graduate year (NPGY) program joined our nurse team. While at our ward, they were required to demonstrate clinical nursing competencies in intensive care units in the facets of nursing knowledge, equipment use, prediction of emergencies, emergency response, and patient evaluation and management. The ability to interpret arrhythmias is critical to connecting and coordinating these competencies. However, arrhythmia interpretation is usually the most difficult skill for nurses to master.

PURPOSE

This study was developed to improve the knowledge of NPGY trainees regarding arrhythmia interpretation, the accuracy of their arrhythmia interpretation and management, and their confidence in caring for patients with arrhythmia.

RESOLUTION

The period of this study spanned from April 5th to June 18th, 2018. After surveying the current capabilities of the NPGY trainees to provide a reference for improvement, several teaching strategies were adopted. These strategies included: (1) provision of arrhythmia clinical scenarios; (2) establishment of multimedia teaching and interactive e-books; (3) development of memory strategies; and (4) mind mapping.

RESULTS

The accuracy of the trainees' knowledge regarding arrhythmia interpretation increased from 52.5% pretest to 92.5% posttest, while their arrhythmia interpretation skill improved from 56.3% pretest to 92.5% posttest. Furthermore, their caring-for-patients-with-arrhythmia confidence score increased from 5.5 to 9.1. All of the objectives of this study were achieved.

CONCLUSIONS

The diverse teaching approach employed in this study enhanced the ability of trainees to remember and recall relevant theories as well as improved their related practical skills. Furthermore, posttest, the trainees were significantly less nervous during encounters with patients with arrhythmia and demonstrated improved problem-solving abilities. Participation in this intervention significantly improved the confidence of trainees to serve as critical care nurses and to pursue a career in critical care nursing.

Evaluation of an e-book assignment using Fink's Taxonomy of Significant Learning among undergraduate dental hygiene students

CONTEXT

With significant learning experiences, students undergo positive, substantial, and lasting influences on their personal and professional lives. With grant support from The Ohio State University's Affordable Learning Exchange Program, students created e-book chapters for a Current Concepts in Dental Hygiene as a significant learning experience.

OBJECTIVE

The purpose of this study was to evaluate the impact of an e-book chapter creation project on the learning of undergraduate dental hygiene students using Fink's Taxonomy of Significant Learning.

DESIGN

Upon IRB exemption, this study involved a mixed-methods, cross-sectional research design involving a survey of attitudinal and reflective questions. The data were analyzed using descriptive statistics and thematic analysis.

RESULTS

The data from 100% (n = 41) of the dental hygiene students enrolled in the Current Concepts in Dental Hygiene course were analyzed. Most students recognized the alignment of the 6 scaffolded assignments with the 6 domains of Fink's Taxonomy of Significant Learning. Most students agreed the project focused on foundational knowledge (68.8%, n = 27), promoted active learning (73.2%, n = 30), applied to real life problems (63.4%, n = 26), and provided life lessons (56.1%, n = 23). Thematic analysis revealed students appreciated the teamwork involved and the scaffolding of assignments, recognized the challenges of inconsistent feedback and technical issues with the software, and felt that more faculty guidance and technical support would have improved their experiences.

CONCLUSION

Future research should evaluate the impact of using Fink's Taxonomy of Significant Learning with the design of courses or course-long projects on the education of dental and dental hygiene students.

Video-Based Surgical Learning: Improving Trainee Education and Preparation for Surgery

BACKGROUND

Since the end of the XIX century, teaching of surgery has remained practically unaltered until now. With the dawn of video-assisted laparoscopy, surgery has faced new technical and learning challenges. Due to technological advances, from Internet access to portable electronic devices, the use of online resources is part of the educational armamentarium. In this respect, videos have already proven to be effective and useful, however the best way to benefit from these tools is still not clearly defined.

AIMS

To assess the importance of video-based learning, using an electronic questionnaire applied to residents and specialists of different surgical fields.

METHODS

Importance of video-based learning was assessed in a sample of 141 subjects, using a questionnaire distributed by a GoogleDoc online form.

RESULTS

We found that 98.6% of the respondents have already used videos to prepare for surgery. When comparing video sources by formation status, residents were found to use Youtube significantly more often than specialists (p < 0.001). Additionally, residents placed more value on didactic illustrations and procedure narration than specialists (p < 0.001). On the other hand, specialists prized surgeon's technical skill and the presence of tips and tricks much more than residents (p < 0.001).

CONCLUSION

Video-based learning is currently a hallmark of surgical preparation among residents and specialists working in Portugal. Based on these findings we believe that the creation of quality and scientifically accurate videos, and subsequent compilation in available video-libraries appears to be the future landscape for video-based learning.

12-Year Use of a Digital Reference Library (VitalBook) at a U.S. Dental School: Students' and Alumni Perceptions

Digital textbooks are being used to reduce production and storage costs of printed copies, enhance usage, and include search capabilities, but the use of digital texts is not universally accepted. In 2001, the New York University College of Dentistry introduced a digital reference library, the VitalBook. Beginning in 2005, the college annually surveyed senior students and, from 2012, also surveyed alumni on their opinions and extent of use of the VitalBook. The aim of this study was to evaluate 12 years of students' perspectives and three years of alumni perspectives on the value of the VitalBook to their dental educational experience. Students were asked how frequently they used the VitalBook, if it was a good investment, if they would use it after graduation, and if they would recommend it to others. Alumni were asked the last three questions. This study reports the results from 4,105 students over 12 years (average response rate 95.3%) and 184 alumni over three years (average response rate 17.4%). The results indicated that students used the VitalBook on average 24% of their study time, but they were split regarding the other questions. The majority opinion in 2005 was negative on all questions. These opinions shifted to become more favorable to a peak in 2010, but declined since then to a more negative overall view of the VitalBook. A split opinion among students continued through 2016, with fewer recommending it although more considered it a good investment with plans to use it after graduation. Alumni mirrored their responses as students. These results suggest that, as more flexible and dynamic digitized reference systems emerge, the use of student-paid traditional digitized textbooks may become an even less favored choice.

Legibility difference between e-books and paper books by using an eye tracker

The aim of the study was to evaluate the difference in legibility between e-books and paper books by using an eye tracker. Eight male and eight female subjects free of eye disease participated in the experiment. The experiment was conducted using a 2 × 3 within-subject design. The book type (e-book, paper book) and font size (8 pt, 10 pt, 12 pt) were independent variables, and fixation duration time, saccade length, blink rate and subjective discomfort were dependent variables. In the results, all dependent variables showed that reading paper books provided a better experience than reading e-books did. These results indicate that the legibility of e-books needs further improvement, considering fixation duration time, saccade movement, eye fatigue, device and so on.

PRACTITIONER SUMMARY

This study evaluated the legibility difference between e-books and paper books from the viewpoint of readability, eye fatigue and subjective discomfort by using an eye tracker. The results showed that paper books provided a better experience than e-books. This indicates that the readability of e-books needs further improvement in relation to paper books.

Growing concerns with the flow of misinformation from electronic books

In 2012, several kinds of electronic books (e-books) became available in Japan. Since several major book retailers launched e-book businesses, it is expected that e-books will become a popular source of information in the country. However, we are concerned that e-books may also be a source of misinformation. In examining 24 available materials published by anti-vaccinists, "atopy businesses", and "wellness maintenance" authors, each was found to contain inaccuracies or misinformation. Thus far, such information is only available in printed books. If these books are scanned and circulated, or published in e-book format, this misinformation may circulate rapidly as e-book devices are becoming popular, and, consequently, harm people’s health. We think that it is important for the government to formulate ethical guidelines for the publishing e-books with due consideration to freedom of expression.