Advancing Information and Communication Technology Knowledge for Undergraduate Nursing Students Paula M Procter, RN, MSc, FBCS, CITP Sheffield Hallam University, South Yorkshire, United Kingdom

Abstract Nursing is a dynamic profession; for registered nurses their role is increasingly requiring greater information process understanding and the effective management of information to ensure high quality safe patient care. This paper outlines the design and implementation of Systems of eCare. This is a course which advances information and communication technology knowledge for undergraduate nursing students within a Faculty of Health and Wellbeing appropriately preparing nurses for their professional careers. Systems of eCare entwines throughout the three year programme mapping to the curriculum giving meaning to learning for the student. In conclusion comments from students convey their appreciation of the provision of this element of the undergraduate programme. Introduction The pervasive use of information and communications technology (ICT) in clinical and remote healthcare settings brings many challenges and new opportunities to all involved in healthcare especially nurses, nurse leaders, nurse researchers and nurse educationalists. It also acts as a catalyst for needed changes in the curriculum to enable nurses to be fit for purpose having acquired the appropriate information skills, knowledge and attitudes. According to the Prime Minister’s Commission on the Future of Nursing and Midwifery in England 2010 "Making best use of technological advances is an increasingly important aspect of high quality care, including innovative ‘remote care’ approaches such as telenursing, as well as improving metrics. … Starting in their initial education, nurses and midwives need a better understanding of and influence over the development of new technologies and informatics, including information and communications technology and remote care"1 . A further key driver in terms of UK Higher Education development was that of widening the opportunity for independent study, the Department for Business, Innovation and Skills 'Higher Ambitions' (DBIS, 2009) stated, "… the next phase of expansion in higher education will hinge on providing opportunities for different types of people to study in a wider range of ways than in the past. The focus will therefore be on a greater diversity of models of learning: part-time, work-based, foundation degrees, and studying whilst at home."2 The degree status of nurses today appears to have had the effect of moving registered nurses one step further away from direct patient with the role changing toward that of coordinating an unregistered workforce for which information management is paramount to ensure safe and effective patient care. To meet this changing status and to prepare nurses for registered practice Systems of eCare was developed and implemented. Systems of eCare Systems of eCare was launched in September 2009 at Sheffield Hallam University. It is a wholly on-line course offered to nursing and midwifery students in the Faculty of Health and Wellbeing. The key contextual objectives underpinning Systems of eCare are to ensure that students are able: • • • • • •

to understand, improve, influence and use new technologies and informatics, including remote care; to find the most reliable sources of information to support evidence based practice; to guide patients through publicly available information sources; to incorporate ICT into patient consultations; to manage the nurse patient relationship when the nurse is not physically with the patient; to perform a quick and accurate data entry at the point of care;

• • • •

to understand the legal and ethical issues associated with managing and sharing patient information; to extract data to support decisions and monitor the outcomes of practice; to understand the role of technology in the delivery and organisation of care to train other users such as patients and carers how to use relevant ICTs

It is recognised that there is a general paucity of health informatics teachers available to teach this key subject in every UK University. Systems of eCare overcomes this through a one-stop-shop approach guided by experts in the field of health informatics. Systems of eCare provides programme coordinators (those who have to staff and manage the undergraduate process) a robust solution which requires minimum effort on their behalf whilst meeting an academic and professional education needs. Systems of eCare ‘docks’ alongside the current curriculum at points determined by the student's stage of learning, which does not require curriculum re-design. Systems of eCare is made up of a self directed series of six sections, with each section requiring 10 hours of study on-line by the student. A student completes one section per semester (where there are two semesters per year). At the end of each section, the student undertakes an on-line summative assessment, which the student keeps in their portfolio. The printout can also be stored digitally if desired. The outcome from the section(s) is one of the issues discussed with the student during their regular personal tutor sessions. There are currently over 2,000 students accessing the content on-line with one teacher assigned at 0.05WTE to monitor, respond to students and update as necessary. Throughout the development close liaison with the e-ICE project has been maintained, this NHS Connecting for Health initiative Learning to Manage Health Information: a theme for clinical education: Making a Difference (2009).3 The Student Experience At the start of the undergraduate programme, each student receives a personal email informing them about Systems of eCare and giving key directions as to how to access the course. No additional 'technical' skills are required to undertake the course other than those to navigate any internet content. The student can access the course through a PC, laptop, iPAD, WiFi Tablet, iPhone, Android cellphone or internet television at any time that is convenient to them. Each section of content amounts to some 10 hours of study and the students receive one section per semester. To prevent 'learning' overload, at the start of the programme only the first section (of six) is presented to the student with a suggested completion date. The section is built around an asset based model (Procter, 2006)4 where the content is broken down into Tutorial Guidance, Notes and Assets. The Notes are used as a trigger for the topic and identify key components of content to guide the student which have been synthesised by the content expert; the Assets offer the student choice in the way they extend the depth of their knowledge through different support content to meet their style of learning. The suggested completion date is offered to help the student to pace their learning, however, once the student progresses to the next section any previous section will remain available until they complete the undergraduate three year programme. A multiple choice self-test is available where the student is offered 10 questions from an extensive pool of section specific questions in both a randomised format and randomised question set which the student can attempt as often as they wish. After building their knowledge from the section content, the student can attempt the section final timed test, 10 multiple choice questions are randomly presented from the same topic specific pool of questions as for the self test and a 20 minute timer applied. Each student is permitted three attempts to reach the pass mark of 80%. Once successfully completing a section, the student prints out their test results and stores these in their portfolio of learning. Where the portfolio is digital, the test results are stored as a portable document file (pdf). If the student has made three attempts at the final section test and has been unable to attain 80%, or has had some technical difficulty they can appeal for extenuating circumstances and request a further attempt. All student enquiries are responded to within 24 hours of receipt. The students are able to access Systems of eCare at times that are convenient to them, Figure 1 is taken from one nursing Systems of eCare cohort February 2011 as an example of the spread of student access, it is representative of all cohorts for all months since 2009.

Figure 1: Student Access by Time of Day Access statistics show that students are regular users during the main hours of university attendance, but access increases later in the day and during the evenings, this may be an indicator of when students actively study after the family dinner and child attention, more research is being undertaken in this area. It should be noted that the average age of the nursing and midwifery student entering the undergraduate programme at Sheffield Hallam University is 26. Continuing this theme of learning at a time convenient to the student, Figure 2 is taken from a nursing Systems of eCare cohort July 2011 and is reasonably representative of weekday access. Sunday is listed as Day 2, Monday Day 3, etc.

Figure 2: Student Access by Day of the Week It is clear that Sunday (Day 2) and Saturday (Day 8) are well used to access learning by students. Again, further research is being undertaken in this area. The Personal Tutor Experience Every nursing student is assigned a personal tutor for the three years of their undergraduate programme. The personal tutor has timetabled sessions to meet with their students and additionally carry out a progress review three times a year on a one-to-one basis with each assigned student. Prior to the progress review, the personal tutor receives an update of each of their students' Systems of eCare performance so that this can be discussed during the review. If more detailed access information is required, this can be requested by the personal tutor. In this way the personal tutor is kept informed without having to carry out additional work, releasing them for the tutorial function rather than an administrative function.

The Course Tutor Experience There are four nursing intakes each academic year, two in September and two in January amounting to around 700 students. Each intake has its own version of Systems of eCare, this in the main is to reduce the complexity of the course management. Different intakes (cohorts) are at different stages of Systems of eCare, for example the September 2009 undergraduate cohort have five sections live, whereas the January 2011 undergraduate cohort have the first two sections live. The sections are: • • • • • •

The Where, Why, What and How of e-Care - Year One Information governance - Year One Information systems - Year Two Information mapping - Year Two Information intelligence - Year Three Information future - Year Three

Prior to the release of a section, the content is reviewed and updated in terms of the tutorial notes and the corresponding assets; the question pool is reviewed and amended with new questions being added as appropriate. In line with any teaching, the content expert is at the forefront of local, national and international developments in their field in this instance health informatics (eHealth) and can synthesise new material for student consumption. As the content is built around an asset based model this requires no expensive object updates. Once the release occurs, all activity is monitored through the managed learning environment, this includes monthly access statistics down to individual student level; assessment attempts and overall performance of the course. The course tutor responds to student queries within 24 hours whenever practicable, student queries are usually associated with section final tests, these are two reasonably typical messages received: jst a quick question... i clicked on the wrong test for the systems of E-care, i started test 2 for sum stupid reason, obviously iv scored low as i hadnt a clue wot the answers wur as its not wot iv bin revising, iv done test 1 an got 100%, but was jst woundering if it matters that iv already had 1 attempt an failed the 2 test.....? Hi I have completed the marked test for the module, however I had some issues whilst doing it and want to make sure I have passed it. The first time I attempted it, my laptop switched off, so I left it for another day. I went to complete it tonight, and it still showed me logged on the test, so it has taken me well over 20 minutes. The second time, my laptop froze again, so had to re-boot but it still shows test in progress on 'my grades'. The third time, I got 90 out of 100 (phew!) but just wanted to check that everything is ok. I think I need a new laptop! Many thanks for your time. Conclusion Systems of eCare is a unit of learning and as such does not count towards the final marks for the degree, which is clearly stated to the students, and yet students are successfully completing the sections, Figure 3 gives the percentage successful completion rates by cohort, this is unusual student behaviour.

Figure 3: Successful course completion (to date) by Cohort Formal evaluation is underway, however, informally it is noted that students are including their information and communication technology knowledge in their written assignment essays. Starting in September 2011 additional student disciplines will be added, these being all the allied health professionals (for example physiotherapists, radiographers, paramedics, occupational therapists, operating department assistants) and social carers. Systems of eCare has students at the centre of its learning and it seems appropriate to allow the students to add their comments to conclude this paper. 'Systems of eCare has helped me enormously. I actually look forward to sections being released because undertaking the pre-tests and obtaining an instant result has given me confidence and a desire to succeed. The last session on governance was particularly helpful as this linked to many of the assignments that I had to do and this has helped me to understand how the NHS system operates.' Stewart Effendi, second year student nurse 'Systems of eCare provides me with a good introduction to the information structure and developments of the NHS. It directs me to useful resources which give me a holistic understanding of the laws, rights and funding around the NHS, and in particular the implementation of ICT for patient care.' First year postgraduate nursing student 'I really enjoyed the Systems of eCare module in nursing and I feel that it's an invaluable part of the nursing education programme. As the NHS moves towards an online patient record keeping system, we as student nurses need to be educated about such programmes as we will be directly involved with them throughout our careers.' Louise Eccles, second year nursing student

References 1.

Keen, A. (Chair) Front Line Care: the future of nursing and midwifery in England. Report of the Prime Minister’s Commission on the Future of Nursing and Midwifery in England 2010.


Department for Business, Innovation & Skills. HIGHER AMBITIONS The future of universities in a knowledge economy. London 2009


Department of Health . Learning to Manage Health Information: a theme for clinical education: Making a Difference. NHS Connecting for Health, London. 2009


Procter, P M (2006) An Asset Based Model for Postgraduate Education. In: Consumer-Centered ComputerSupported Care for Healthy People. H.-A. Park et al. (Eds.), IOS Press, 2006:167-172


Advancing information and communication technology knowledge for undergraduate nursing students.

Nursing is a dynamic profession; for registered nurses their role is increasingly requiring greater information process understanding and the effectiv...
103KB Sizes 0 Downloads 0 Views