Using Mobile Learning to Enhance Nursing Practice Education

1. Using Mobile Learning to Enhance Nursing Practice Education Richard Kenny & Caroline Park Athabasca University Jocelyne Van Neste-Kenny, Pam Burton, & Jan Meiers North Island College

2. The Promise of M-Learning • Focus on knowledge that is location & situation dependent. • Fits a learner-centric, Constructivist view of learning. • Supports more situated, experiential learning, contextualized within specific domains. • Delivers discourse in real time to wherever participants are.

3. Purpose of This Paper • Explore potential of m-learning for Nursing practice education. • Use Koole’s (2005) FRAME model to clarify health care / Nursing literature on m-learning. • Present initial findings from our 2007 research study.

4. M-Learning in Health Care & Nursing: Review of Literature • Use has “exploded”. (Cahoon, 2002) • 1/3 of Canadian physicians using PDAs. (George,2005) • Medical use mainly relates to research on drugs, dosages & calculations. • There are major issues of confidentiality.

5. M-Learning in Health Care & Nursing • In hospital WAN use has been tried for access to records & recording data at bedside in Great Britain (Cacae, 2006). • Reports on benefits & barriers. • Reports on likes & dislikes. • Reports on usage.

6. Benefits • Quick access to current drug databases. • The ability to manage patient & procedural information. • Patient health management with team access to current information. • Improved team communication.

7. Barriers • Risks of storing confidential information. • Cost & ease of loss or damage to PDA. • Not enough research on use in nursing. • Difficult to read. • Difficult to understand. • Slow data entry.

8. Park (64) Pharmacy & lab related Calculator Calendar Keeping up-to-date Referring to texts & guidelines E-mail Studying Nurse Practitioner PDA Usage Stroud et.al. • To do Memo pad • Calculator • Expense tracker • Calendar/date book • Patient manag’t tools • Clinical refer. materials • Address/phone book • Info exchange - beaming • E-mail • Games • Recreational reading • Internet access

9. Reasons to Recommend (Park, 2006) • Safety • Decrease in medication errors • Safer than memory • security blanket • Portability • Lighter to carry than textbooks • Aids mobility • Organization • Concise & easy to transport • Edit & highlight most important information • Add personal notes

10. Reasons to Recommend (Park, 2006) • Access to Resources • Valuable with right software • Information available is immense & valuable • Up-to-date information • Back-up quick reference • Decision-making • Use to explore options with client • Convenience • Convenient useful tool • Image • Way of the future • Looks professional

11. FRAME Model (Koole, 2005) (Reproduced with permission)

12. Research Study – Phase 1: m-technology in a community-based practice experience Device (PDA, software) Student Learning activities M-learning supported student practice at the point of care Learning activities (peer-to-peer, student/instructor interactions) Connectivity (device-to-device &internet) Practice Environment Community-based course Social Context of Practice (clients, clinicians, instructors, students, agencies, community) Koole’s FRAME Model for Nursing Practice Education (adapted with permission)

13. Vancouver Island, British Columbia North Island College Courtenay, Vancouver Island

14. Mobile Learning to Improve Clinical Nursing Education • Two stage formative evaluation: one –on–one trial & field trial. • Stage 1: Three 4th Year Nursing students & 2 Nursing instructors teaching Nursing 357 in Stage 2 field trial. • Stage 2: 3rd Year spring NIC Nursing practice course, Nursing 357 – 5 weeks duration. • 2 groups: mobile learning (12) and comparison group (6).

15. Research Questions • Implement & sustain in independent learning setting? • Useful in practice setting? • Appeal to / comfort for target audience in real life instructional settings? • Mobile learning strategies enhance reflective practice, facilitate communication, & support theory / evidence-based practice?

16. Research Methods – Stage 1 • One-on-one trial • N=5 (2 instructors / 3 4th Year students) • Pre-study demographics survey • Semi-structured interviews. • Reflective logs kept by faculty.

17. Research Methods – Stage 2 • Field trial in actual class - Nursing 357. • N=17 (12 mobile / 5 comparison) • Instructors’ observations (Reflective journal / log ). • Pre-study demographics survey. • Post survey of student use . • 4 – 6 Semi-structured interviews (mobile group). • Student practice narratives / notes about their practice experiences kept on mobile devices. • Cell phone & data download statistics on device usage.

18. Demographic Survey Results

19. Demographic Survey Results

20. Demographic Survey Results

21. Demographic Survey Results

22. Demographic Survey Results

23. Prior Knowledge of Mobile Devices • Ample cell phone experience • Novices – no direct PDA use experience • 1st experience with mini computer - PDA • Used Windows / MSOffice / Hotmail / Skype on PC • Aware of PDA Nursing software

24. Features Needed to Learn • Use of touch & thumbing keyboards • Use of cursive to text transcription • To enable wireless connectivity for email & Internet • Use of Nursing drug & lab values software • Use of text & audio messaging (Skype)

25. Ease of Use • 1 -3 hours learning after 2 hour orientation • Easy to master overall • Cell phone & camera easy to use • Pocket Word much like MSWord • Nursing software user friendly & most used feature in trial

26. Barriers to Use • Lack of WIFI connectivity in hospital & community • Problems obtaining GPRS connection • Lack of GPRS wireless coverage in rural communities • Inability to access WebCT course website

27. Portability • Suitable to carry in purse or pocket • 2 carried iPAQ in uniform pants (leg) pocket in hospital • Convenient to have handy for immediate reference • Easy to access when needed

28. Visibility • Clear to read re. colour & type size • Brightness adjustable • Screen size correct (bigger means heavier) • Requires websites that can be formatted for up – down scrolling (e.g., by Google)

29. Usefulness in Nursing Practice Education • Option to reference Nursing software at bedside • Ability to remain current via software updates • Aids in patient teaching by using “layman’s” language. • Option of use of phone or email to contact instructors

30. Usefulness in Nursing Practice Education • Potential to allow private communications via mobility • Disadvantage of being constantly accessible • Useful for document storage and access • Permits students to participate in technology-driven society

31. We welcome your questions, ideas, comments

32. Demographic Survey Results