Designing and evaluating an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care: randomized controlled trial

Sok Ying Liaw, Lai Fun Wong, Sally Wai-Chi Chan, Jasmine Tze Yin Ho, Siti Zubaidah Mordiffi, Sophia Bee Leng Ang, Poh Sun Goh, Emily Neo Kim Ang, Sok Ying Liaw, Lai Fun Wong, Sally Wai-Chi Chan, Jasmine Tze Yin Ho, Siti Zubaidah Mordiffi, Sophia Bee Leng Ang, Poh Sun Goh, Emily Neo Kim Ang

Abstract

Background: Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice.

Objective: This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care.

Methods: Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video, multimedia instructional material, virtual patients, and online quizzes. A randomized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital. Following a baseline evaluation of all participants' clinical performance in a simulated clinical setting, the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program. All participants were re-tested for their clinical performances using a validated tool.

Results: The clinical performance posttest scores of the experimental group improved significantly (P<.001) from the pretest scores after the Web-based simulation. In addition, compared to the control group, the experimental group had significantly higher clinical performance posttest scores (P<.001) after controlling the pretest scores. The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation. Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice, instructional strategies, and fostering problem solving.

Conclusions: Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses' competencies in acute care. Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency.

Keywords: Web-based simulation; acute nursing care; authentic learning; clinical competency; deterioration; instructional strategies; multimedia; simulation.

Conflict of interest statement

The first author is the owner and developer of the simulation software.

Figures

Figure 1
Figure 1
Instructional activities in Web-based simulation.
Figure 2
Figure 2
Flow of data collection.
Figure 3
Figure 3
Pretests and posttests scores on clinical performance.

References

    1. Fuhrmann L, Østergaard D, Lippert A, Perner A. A multi-professional full-scale simulation course in the recognition and management of deteriorating hospital patients. Resuscitation. 2009 Jun;80(6):669–73. doi: 10.1016/j.resuscitation.2009.03.013.
    1. Liaw SY, Scherpbier A, Klainin-Yobas P, Rethans JJ. A review of educational strategies to improve nurses' roles in recognizing and responding to deteriorating patients. Int Nurs Rev. 2011 Sep;58(3):296–303. doi: 10.1111/j.1466-7657.2011.00915.x.
    1. Kinsman L, Buykx P, Cant R, Champion R, Cooper S, Endacott R, McConnell-Henry T, Missen K, Porter J, Scholes J. The FIRST2ACT simulation program improves nursing practice in a rural Australian hospital. Aust J Rural Health. 2012 Oct;20(5):270–4. doi: 10.1111/j.1440-1584.2012.01296.x.
    1. Liaw SY, Rethans JJ, Scherpbier A, Piyanee KY. Rescuing A Patient In Deteriorating Situations (RAPIDS): A simulation-based educational program on recognizing, responding and reporting of physiological signs of deterioration. Resuscitation. 2011 Sep;82(9):1224–30. doi: 10.1016/j.resuscitation.2011.04.014.
    1. Lebow D. Constructivist values for instructional systems design: five principles toward a new mindset. Educational Technology Research and Development. 1993;41(3):4–16.
    1. Bastiaens TJ. Design of an authentic e-learning environment. Hershey, PA: IGI Global; 2012.
    1. Bonnetain E, Boucheix JM, Hamet M, Freysz M. Benefits of computer screen-based simulation in learning cardiac arrest procedures. Med Educ. 2010 Jul;44(7):716–22. doi: 10.1111/j.1365-2923.2010.03708.x.
    1. Farrell GA, Cubit KA, Bobrowski CL, Salmon P. Using the WWW to teach undergraduate nurses clinical communication. Nurse Educ Today. 2007 Jul;27(5):427–35. doi: 10.1016/j.nedt.2006.07.005.
    1. Lahti M1, Hätönen H, Välimäki M. Impact of e-learning on nurses' and student nurses' knowledge, skills, and satisfaction: a systematic review and meta-analysis. Int J Nurs Stud. 2014;51(1):136–49. doi: 10.1016/j.ijnurstu.2012.12.017.
    1. Karaman S. Nurses' perceptions of online continuing education. BMC Med Educ. 2011;11:86. doi: 10.1186/1472-6920-11-86.
    1. Mayer RE. The promise of multimedia learning. The Cambridge Handbook of Multimedia Learning. Cambridge, MA: Cambridge University Press; 2009.
    1. Holt D, Segrave S, Cybulski JL. Professional education using e-simulations: benefits of blended learning design. Hershey, PA: IGI Global; 2012.
    1. Cook DA. Agency for Healthcare Research and Quality. 2013. Mar, [2014-12-04]. The literature on health care simulation education: What does it show? Perspective .
    1. Cant RP, Cooper SJ. Simulation in the Internet age: The place of Web-based simulation in nursing education. An integrative review. Nurse Educ Today. 2014 Dec;34(12):1435–1442. doi: 10.1016/j.nedt.2014.08.001.
    1. Liaw SY, Chan SW, Chen FG, Hooi SC, Siau C. Comparison of virtual patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: randomized controlled trial. J Med Internet Res. 2014;16(9):e214. doi: 10.2196/jmir.3322.
    1. Durmaz A, Dicle A, Cakan E, Cakir Ş. Effect of screen-based computer simulation on knowledge and skill in nursing students' learning of preoperative and postoperative care management: a randomized controlled study. Comput Inform Nurs. 2012 Apr;30(4):196–203. doi: 10.1097/NCN.0b013e3182419134.
    1. Cook DA, Erwin PJ, Triola MM. Computerized virtual patients in health professions education: a systematic review and meta-analysis. Acad Med. 2010 Oct;85(10):1589–602. doi: 10.1097/ACM.0b013e3181edfe13.
    1. Liaw SY, Chan SW, Scherpbier A, Rethans JJ, Pua GG. Recognizing, responding to and reporting patient deterioration: transferring simulation learning to patient care settings. Resuscitation. 2012 Mar;83(3):395–8. doi: 10.1016/j.resuscitation.2011.08.021.
    1. Cook DA, Garside S, Levinson AJ, Dupras DM, Montori VM. What do we mean by web-based learning? A systematic review of the variability of interventions. Med Educ. 2010 Aug;44(8):765–74. doi: 10.1111/j.1365-2923.2010.03723.x.
    1. Smith PL, Ragan TJ. Instructional design. Hoboken NJ: Wiley; 2005.
    1. Liaw SY, Scherpbier A, Klainin-Yobas P, Rethans JJ. Rescuing A Patient In Deteriorating Situations (RAPIDS): an evaluation tool for assessing simulation performance on clinical deterioration. Resuscitation. 2011 Nov;82(11):1434–9. doi: 10.1016/j.resuscitation.2011.06.008.
    1. Wang YS, Wang HY, Shee DY. Measuring e-learning systems success in an organizational context: Scale development and validation. Computers in Human Behavior. 2007 Jul;23(4):1792–1808. doi: 10.1016/j.chb.2005.10.006.
    1. Woo Y, Agostinho S, Reeves TC. Implementing authentic tasks in web-based learning environments. EDUCAUSE Quarterly. 2007 Jul 30;:3.
    1. Herrington J, Reeves TC, Oliver R. A guide to authentic e-Learning. New York: Routledge; 2010.
    1. Keller JM, Suzuki K. Learner motivation and e-learning design: A multinationally validated process. Journal of Educational Media. 2004;29(3):229–39.
    1. Marshall S. The use of cognitive aids during emergencies in anesthesia: a review of the literature. Anesth Analg. 2013 Nov;117(5):1162–71. doi: 10.1213/ANE.0b013e31829c397b.
    1. Kolb DA. Experiential Learning: Experience as the sources of learning and development. New Jersey: Prentice-Hall; 1984.
    1. Georg C, Zary N. Web-based virtual patients in nursing education: development and validation of theory-anchored design and activity models. J Med Internet Res. 2014;16(4):e105. doi: 10.2196/jmir.2556.
    1. Consorti F, Mancuso R, Nocioni MA, Piccolo A. Efficacy of virtual patients in medical education: A meta-analysis of randomized studies. Computers & Education. 2012 Nov 01;59(3):1001–1008. doi: 10.1016/j.compedu.2012.04.017.
    1. Salminen H, Zary N, Björklund K, Toth-Pal E, Leanderson C. Virtual patients in primary care: developing a reusable model that fosters reflective practice and clinical reasoning. J Med Internet Res. 2014;16(1):e3. doi: 10.2196/jmir.2616.
    1. Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions: a meta-analysis. JAMA. 2008 Sep 10;300(10):1181–96. doi: 10.1001/jama.300.10.1181.
    1. Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Instructional design variations in internet-based learning for health professions education: a systematic review and meta-analysis. Acad Med. 2010 May;85(5):909–22. doi: 10.1097/ACM.0b013e3181d6c319.
    1. Norman G. Research in clinical reasoning: past history and current trends. Med Educ. 2005 Apr;39(4):418–27. doi: 10.1111/j.1365-2929.2005.02127.x.
    1. Youngblood P, Harter PM, Srivastava S, Moffett S, Heinrichs WL, Dev P. Design, development, and evaluation of an online virtual emergency department for training trauma teams. Simul Healthc. 2008;3(3):146–53. doi: 10.1097/SIH.0b013e31817bedf7.
    1. Hansen MM. Versatile, immersive, creative and dynamic virtual 3-D healthcare learning environments: a review of the literature. J Med Internet Res. 2008;10(3):e26. doi: 10.2196/jmir.1051.
    1. Eysenbach G, CONSORT-EHEALTH Group CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions. J Med Internet Res. 2011;13(4):e126. doi: 10.2196/jmir.1923.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다