- Email: [email protected]
Computer resources for staff education in long-term care
GN
M A N A G E M E N T
Computer Resources for Staff Education in Long-Term Care Computer-assisted instruction is well worth considering as a cost-effective way to educate staff. BY
MARY
R.
PRICE
ducational mandates, staffing shortages, quality of care, and practice issues combined with cost containment directives are but a few of the major concerns challenging administrators and educators employed in long-term care facilities. Staff development educators must find cost-effective and efficient teaching learning strategies to meet the educational needs of their staff.
E
E v e r y o n e Can Benefit F r o m C o m p u t e r Instruction There are advantages for the learner, the educator, and the administrator when computer-assisted instruction (CAI) and interactive videodisk (IVD) applications are used to deliver and manage instructional tasks. Learners benefit because learning is individualized. They are empowered to control their rate of learning and the sequence in which content is presented. The control learners have over their learning facilitates their learning and mastery of the information. They control the time they need to spend to learn the content required to achieve the objectives. They bypass that which they know and focus their attention on the content they do not know. The pretest included in most course material is used to diagnose learning needs and individualize instruction. The exercises that follow the instructional sequences give learners the opportunity to apply their newly acquired knowledge and practice their skills. Individualized and immediate feedback for correct and incorrect responses MARY R. PRICE, RN, MA, EdM, Education Consultant, CAI-IVD, CMI Applications, Adjunct Faculty at Hunter CollegeSchool of Nursing and Teacher's College, Columbia, University, New York, New York. 34/1/35936
Immediate feedback for correct and incorrect responses reinforces learning, increases content retention, and increases learners" confidence. reinforces learning, increases content retention, and increases the learners' confidence in their ability to achieve the learning outcomes and objectives. A well-designed, educationally sound CAI and IVD program integrates learning, instructional, and motiva-
Geriatric Nursing January/February1992 47
tional theories to enhance learners' self-esteem and motivate them to strive for success. Strategies are designed to involve learners; involvement stimulates and motivates learners, Learners are no longer the passive recipients of the "information dumps" or "show and tell" classes they are in most instances required to attend. Instead, they are involved in the learning process and are also accountable for validating their achievements. Most computer programs include instructions for use, learner outcomes, a list of menu options, a table of contents, pretests and posttests, instructional activities, and frequent practice exercises followed b y immediate feedback. Some programs include a glossary of terms, a scoring mechanism, and a record-keeping system. Records of employees' attendance and test results are saved in the data base files of these programs.
Tutorials, drill and practice, simulations, assessment, and testing are the instructional design strategies (teaching and learning strategies) used by most software developers to present the content. Although a combination of these strategies is used to design a program, one instructional design predominates and is classified as the main feature when the program is described for marketing. For example, "Eliminating Medication Errors in the Elderly" is described as a simulation; however, it includes drill and practice exercises, information on drugs (tutorial), and simulations, l A review of this program can be found in the Books and Media section of the May-June 1991 issue of GERIATRIC NURSING.1 A review of the IVD program "Nursing Care of Elderly Patients with Cardiac Disorders" can be found in the Books and Media section of the January-February 1991 issue of GERIATRIC NURSING.2
CAI SOFTWARE RECOMMENDATIONS FOR LONG-TERM CARE Publisher Computerized Educational Systems 307 Park Lake Circle P.O. Box 536905 Orlando, FL 32853-6905 (407) 841-6230 (800) 275-1474 To obtain a catalog and free demonstration software call Laura Reasoner at (800) 245-I 474. Discounts are available. Inquire about free computer with purchase of 12 programs.
Program Title
Audience
Cost*
Hardware
$250 $250
IBM PC, XT, AT, PS-2 or compatible 512 K RAM 3½" or 5 ¼" drive Color monitor preferred Cost: $1500-3000
Complications of IV Therapy Everybody Needs a Nurse (two versions available) Eliminating Medication Errors in the elderly
LPNs and RNs Students, LPNs, RNs, nursing assistants LPNs and RNs
Eliminating Medication Errors Therapeutic Communications, I Therapeutic Communications, II Type II Diabetes, DM Math General Hospital Minims, Milliliters, and Drops Preventing Patient Falls Universal Precautions Protecting Patient/ Resident Rights Legal Aspects of Nursing Effective Staff Communications Documentation-Doing the "Write" thing Body Mechanics
LPNs and RNs RNs and LPNs RNs and LPNs RNs and LPNs (?) RNs and LPNs RNs and LPNs RNs, LPNs, nursing assistants
$250 $250 $259 $250 $250 $250 $250
RNs and LPNs RNs and LPNs
$250 $250
RNs and LPNs RNs
$275
RNs and LPNs
$250
RNs, LPNs, nursing assistants RNs, LPNs, nursing assistants RNs, LPNs, nursing assistants
$250
RNs, LPNs, nursing assistants RNs
$195 $250
RNs, LPNs ?
$275
Handwashing Electrical Safety in the Health Care Setting The Firebug The Causes of Pressure Sores Those Fabulous Nitrates
$250
$250
$195 $250
*Variable. You must preview the software to determine whether it is appropriate for licensed practical nurses and no~professionol staff in your facilfly. I have identified CAI programs I believe appropriate for orientation and staff development pro~lrams in long-term core. The scenarios in some of the simulcrtio~s occur in the acute core environment; however, the content addressed is applicable to acute and long-term core. Note: Some of the programs may be too advancedfor LPNs or nursing assistants employed in your agency. You will need to make this decision.
48 Geriatric Nursing January/February 1992
Compare the names and costs of CAI and IVD programs appropriate for use in long-term care. (See "'CAI
Software Recommendations for Long-Term Care" and "Interactive Video Programs for Long- Term Care. ") Costs of some programs are contingent on state educational requirements and reimbursement policies. Contact the company and review state requirements and reimbursement policies. Some programs are designed to meet the educational requirements mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987 and revised 1990. Flexible scheduling is another benefit of using CAI and IVD technology. Educators provide the resources and indicate when CAI or IVD assignments The instructor are due, and the staff members available 24 complete the assignments when it is convenient. The instructor (computer) is available 24 hours a day. By delegating repetitive teaching tasks to the computer, educators have the time to evaluate whether learning is being applied. Time saved can be used to assess the staff's learning needs, and to assure patients, their families, and accrediting regulatory bodies that high-quality care is being given and that performance standards are being met. The educator's role changes from that of content deliverer and attendance monitor to facilitator of learning. The coordination of learning activities, assessment of learning needs, evaluation of educational resources, and evaluation of the staff's ability to apply its knowledge and skills become the educator's primary concern. The emphasis is not on what the teacher teaches but on what the learner learns and is able to apply in practice. Studies reveal a 30% to 50% reduction in learning time when CAI and IVD are used for instruction. This reduction in learning time reduces the time staff members
spend off the unit for mandatory in-service programs or continuing education classes, thus reducing costs. Timeefficient programs are also cost-effective programs. Money is saved when time spent on program development, presentation, record keeping, and overtime for class attendance is reduced. Travel, workshop, and consultants' fees are also reduced because consultation is now readily available. Experts in the field participate in the development and design of high-quality CAI and IVD programs. Rogers, 3 to convince administration of the cost benefits of using the technology, designed a worksheet and calculated the time and the amount of money it takes to develop and (computer) is present a progr/im. Following Rogers' example, you can calcuhours a day. late cost factors for your institution. (See "'Traditional Costs" and "'Nontraditional CAI-IVD Costs.") Fifteen to 30 hours per 1 hour of instruction is usually allocated for development time. Development costs for CAI-IVD are higher than traditional methods at first; however, presentation costs are lower. Compare traditional program development and presentation costs with the cost of using c o m p u t e r resources. (See "'Comparison o f Cost-
Effectiveness.") Privacy, instructional consistency, and learner satisfaction must be added to our list of advantages. Learning becomes a private experience. Learners can ask questions, explore content, and make mistakes without fear of repercussions. Administrators, regulatory bodies, educators, and learners are all assured that the same information is presented. Learners have the same instructor, who never fails to repeat the content, in the same way, whenever it is convenient for them to learn. Interactive video technology offers users the following
INTERACTIVE VIDEO PROGRAMS FOR LONG-TERM CARE Publisher
Program Title
Audience
Cost
Hardware
FITNE 28 Station St. Athens, OH 45701 (614) 592-2511
Therapeutic Communications IV Therapy
RNs and LPNs RNs and LPNs
$700 Computer Videodisk player $595 Touch screen monitor ($395 for (Hardware must be FITNE members) compatible)
The American Journal of Nursing Co. 555 W. 57th St. New York, NY 10019 (212) 582-8820 (800) 223-2282
The Right to DiG The Case of Dax
RNs and LPNs
$1195
Cowart (Module II) The Right to Die (Module I) Ethical Dilemmas and Legal Issues in Core of the Elderly
RNs and LPNs RNs and LPNs
$1 !95 $995
Nursing Assistants $8000?. Interactive Health Network* ProCare--An interactive videodisc 1201 Peachtree St., NE program nursing assistants Suite 1500 designed to meet OBRA requirements Atlanta, GA 30361 (404) 872-9700 Dedicated system
RNs and LPNs
(See above)
(Call company)
$1600
Understanding Aging
"Cost contingent on state educarti~ml requirements and re/mbuesementpolk/es.
Geriatric Nursing January/February 1992 ,19
additional advantages: random access to content, which gives learners more control, and exposure to simulations that are more representative of reality. The technology allows designers to create learning experiences that other technologies cannot provide. 2 When Computer Technology May Not Be the Answer
phobia"; and resistance to change. An argument frequently made by educators against computers is that computers are impersonal. My reply is that the teaching and learning process is not personal and individualized when 50 to 100 persons attend the same class at the same time. The use of computers individualizes learning, allowing educators the time to become more involved with the learner.
The disadvantages of using computer technology include: cost, especially with IVD applications; "computer
NONTRADITIONAL CAI-IVD COSTS D e v e l o p m e n t Costs
TRADITIONAL COSTS Development Costs
Presentation Costs
Include time and money spent on:
Include time and money spent on:
• Planning • Researching content • Designing program Purpose Objectives Content Evaluation tools • Hardware and software (Purchase and development costs) Slides Videos Handouts and duplication Other • Applying for CEUs • CEU application fees
• Preparation Obtaining resources Preparing room • Presentation • Evaluation • Cleanup • Staff salaries • Overtime • Refreshments • Other
Include time and money spent on:
Presentation Costs Include time and money spent on:
• Hardware costs • Research (software and IBM XT/AT/PS2 compatible hardware) with color monitor Usually once per event • Evaluation and software Range $1000-$3000 (price depends on features review and where it is purchased) • Planning how to use CAI and IVD resources Once per event • Handouts Preparation and duplication costs • Software costs • CEU Some software deveJopers $200-$300 for CAI $500-$1000+ for IVD have obtained and provide CEU credits • Presentation coordination, educational management cost~ Scheduling Scoring and record keeping
COMPARISON OF COST-EFFECTIVENESS Nursing homes A and B must provide 8 hours of mandatory staff education for their 400 employees each year. Nursing home A uses traditional lecture, and nursing home B uses CAl. D e v e l o p m e n t ~ P r e p a r a t i o n Costs
Nursing home A (traditional)
It takes 20 hours of instructor time to prepare an hour of lecture. Instructor time = $15/hr, average hourly rate in area. Twenty hours X $15 -- $300 to develop 1 hour of class. $300/class X 8 classes = $2400 Development costs = $2400 for 8 classes CE application fees = $35 X 8 -- $280 Total cost = $2680
Nursing home B (CAI)
Computer = $1000 Software (CAI) = $250 average $250 X 8 = $2OOO total cost = $3000 CE fees included in program Computer maintenance fee = $0 for first year
Pr esent at i on/ Del i ven I Costs
Each of the 8 classes is repeated four times (a class for each shift plus a makeup). 4 X 8 = 32 classes 32 X $15/hr = $480 Presentation cost: $480 for 32 classes Salaries: 400 employees; 8 hr of class per year, average wage per hour = $12 400 X 12 = $4800 X 8 = $38,400/yr Overtime = ? Total cost = $38,880 Program coordination (notices, schedules, data collection) 4 hr. 4 X $15 = $ 6 0 / y r Salaries -- $19,200-$26,880 (learning time reduced by one third to one half) Total cost = $1%260-$24,140
Cost.effectlveness of CAI is evident. Use of IVD hardware and software requires additional calculalions and invesligation. .SomeIVD course materials may be reimbursal by the sta~.
50 Geriatric Nursing January/February 1992
Although appropriate for professional staff, CAI may not be an effective strategy for teaching nonprofessional employees who cannot read or speak English. However, interactive videodisk course material, if properly designed, can overcome these barriers. In industry, programs are designed to improve employee literacy while teaching employees the procedures they must learn to do their job. The language barrier in teaching can be overcome by using dual audio tracks, one in English and the other in the learner's language. At present, programs to accommodate these special learning needs have not been designed for educating employees working in long-term care facilities.
It is time you evaluated the benefits of using CA! for yourself. Explore the market and see what is available. There are several IVD programs appropriate for use in long-term care. (See "Interactive Video Programs for Long-Term Care.") The one designed for nonprofessionals complies with OBRA requirements. Another major obstacle that impedes the use of the technology is poorly designed software. If the value of CAI and IVD is to be realized, the best features of these methods must be incorporated into the programs. Choosing high-quality software is in itself an important and complex issue that is beyond the scope of this article; however, educators must learn to evaluate software to distinguish good design from bad.
Faced with budget constraints, staffing shortages, and demands to meet educational mandates of regulatory bodies, long-term care administrators and educators are investigating the advantages computer technology offers. Although few CAI and IVD programs are available to educate staff members in long-term care at present, rapid progress is being made to correct this deficiency. I anticipate that a dramatic increase in the use of computer technology will occur in long-term care in the next few years as it has in nursing education. The need is there, and it really is a better and more efficient way to teach. REFERENCES 1. Price M. Eliminating medication errors in the elderly. [Review.] Geriatr Nurs 1991;12:157. 2. Price hi. Nursing care of elderly patients with cardiac disorders. [Review.] Geriatr Nurs 1991;12:46. 3. Rogers S. Saving money on education: traditional teaching vs. computer assisted instruction. Computer Tutor 1990;Spring:2. SUGGESTED READINGS Belfry M J, Winnie PH. A review of the effectiveness of computer assisted education in nursing education. Computers in Nursing 1988;6(2):77-85. Bolwell C. Directory of educational software for nursing. New York: National League for Nursing. NLN Publication No. 41-2279, 1989. Price M. Nursing care of elderly patients with cardiac disorders: reviewof nursing care of elderly patients with cardiac disorders. GERIATRNURS 1991;11:46. Price M. Eliminating medication errors in the elderly: review of eliminating medication errors in the elderly. GtRI^TR Nuts 1991;11:157. Rogers S. Saving money on education: traditional teaching vs. computer assisted instruction. Computer Tutor [Newsletter], Spring 1990;2. Zengota E. Interactive videodisc training for long-term care personnel. Contemp Long-Term Care [Reprint]. August 1989.
How to Get Started with CAI
It is time you evaluated the benefits of using CAI for yourself. Explore the market and see what is available. Send for free demonstration disks and review the software. Ask your staff to preview and evaluate the materials with you. If you do not have a computer in your office look for one in admitting, accounting, the pharmacy, or elsewhere in your facility. Perhaps a friend has one at home. Most software publishers provide technical support; all you need to do is call. You do not need to be a computer whiz to use CAI; you just need to turn on the computer and insert the program. If you do not know how, find someone who does.
GERIA'rRICNtrRSINa welcomes unsolicited manuscripts related to all aspects of care for the elderly. See the " I n f o r m a t i o n for A u t h o r s " on pages 3 and 4 for details about the JouRr~xt's editorial policies and manuscript preparation.
Geriatric Nursing January/February 1992 51
M A N A G E M E N T
Computer Resources for Staff Education in Long-Term Care Computer-assisted instruction is well worth considering as a cost-effective way to educate staff. BY
MARY
R.
PRICE
ducational mandates, staffing shortages, quality of care, and practice issues combined with cost containment directives are but a few of the major concerns challenging administrators and educators employed in long-term care facilities. Staff development educators must find cost-effective and efficient teaching learning strategies to meet the educational needs of their staff.
E
E v e r y o n e Can Benefit F r o m C o m p u t e r Instruction There are advantages for the learner, the educator, and the administrator when computer-assisted instruction (CAI) and interactive videodisk (IVD) applications are used to deliver and manage instructional tasks. Learners benefit because learning is individualized. They are empowered to control their rate of learning and the sequence in which content is presented. The control learners have over their learning facilitates their learning and mastery of the information. They control the time they need to spend to learn the content required to achieve the objectives. They bypass that which they know and focus their attention on the content they do not know. The pretest included in most course material is used to diagnose learning needs and individualize instruction. The exercises that follow the instructional sequences give learners the opportunity to apply their newly acquired knowledge and practice their skills. Individualized and immediate feedback for correct and incorrect responses MARY R. PRICE, RN, MA, EdM, Education Consultant, CAI-IVD, CMI Applications, Adjunct Faculty at Hunter CollegeSchool of Nursing and Teacher's College, Columbia, University, New York, New York. 34/1/35936
Immediate feedback for correct and incorrect responses reinforces learning, increases content retention, and increases learners" confidence. reinforces learning, increases content retention, and increases the learners' confidence in their ability to achieve the learning outcomes and objectives. A well-designed, educationally sound CAI and IVD program integrates learning, instructional, and motiva-
Geriatric Nursing January/February1992 47
tional theories to enhance learners' self-esteem and motivate them to strive for success. Strategies are designed to involve learners; involvement stimulates and motivates learners, Learners are no longer the passive recipients of the "information dumps" or "show and tell" classes they are in most instances required to attend. Instead, they are involved in the learning process and are also accountable for validating their achievements. Most computer programs include instructions for use, learner outcomes, a list of menu options, a table of contents, pretests and posttests, instructional activities, and frequent practice exercises followed b y immediate feedback. Some programs include a glossary of terms, a scoring mechanism, and a record-keeping system. Records of employees' attendance and test results are saved in the data base files of these programs.
Tutorials, drill and practice, simulations, assessment, and testing are the instructional design strategies (teaching and learning strategies) used by most software developers to present the content. Although a combination of these strategies is used to design a program, one instructional design predominates and is classified as the main feature when the program is described for marketing. For example, "Eliminating Medication Errors in the Elderly" is described as a simulation; however, it includes drill and practice exercises, information on drugs (tutorial), and simulations, l A review of this program can be found in the Books and Media section of the May-June 1991 issue of GERIATRIC NURSING.1 A review of the IVD program "Nursing Care of Elderly Patients with Cardiac Disorders" can be found in the Books and Media section of the January-February 1991 issue of GERIATRIC NURSING.2
CAI SOFTWARE RECOMMENDATIONS FOR LONG-TERM CARE Publisher Computerized Educational Systems 307 Park Lake Circle P.O. Box 536905 Orlando, FL 32853-6905 (407) 841-6230 (800) 275-1474 To obtain a catalog and free demonstration software call Laura Reasoner at (800) 245-I 474. Discounts are available. Inquire about free computer with purchase of 12 programs.
Program Title
Audience
Cost*
Hardware
$250 $250
IBM PC, XT, AT, PS-2 or compatible 512 K RAM 3½" or 5 ¼" drive Color monitor preferred Cost: $1500-3000
Complications of IV Therapy Everybody Needs a Nurse (two versions available) Eliminating Medication Errors in the elderly
LPNs and RNs Students, LPNs, RNs, nursing assistants LPNs and RNs
Eliminating Medication Errors Therapeutic Communications, I Therapeutic Communications, II Type II Diabetes, DM Math General Hospital Minims, Milliliters, and Drops Preventing Patient Falls Universal Precautions Protecting Patient/ Resident Rights Legal Aspects of Nursing Effective Staff Communications Documentation-Doing the "Write" thing Body Mechanics
LPNs and RNs RNs and LPNs RNs and LPNs RNs and LPNs (?) RNs and LPNs RNs and LPNs RNs, LPNs, nursing assistants
$250 $250 $259 $250 $250 $250 $250
RNs and LPNs RNs and LPNs
$250 $250
RNs and LPNs RNs
$275
RNs and LPNs
$250
RNs, LPNs, nursing assistants RNs, LPNs, nursing assistants RNs, LPNs, nursing assistants
$250
RNs, LPNs, nursing assistants RNs
$195 $250
RNs, LPNs ?
$275
Handwashing Electrical Safety in the Health Care Setting The Firebug The Causes of Pressure Sores Those Fabulous Nitrates
$250
$250
$195 $250
*Variable. You must preview the software to determine whether it is appropriate for licensed practical nurses and no~professionol staff in your facilfly. I have identified CAI programs I believe appropriate for orientation and staff development pro~lrams in long-term core. The scenarios in some of the simulcrtio~s occur in the acute core environment; however, the content addressed is applicable to acute and long-term core. Note: Some of the programs may be too advancedfor LPNs or nursing assistants employed in your agency. You will need to make this decision.
48 Geriatric Nursing January/February 1992
Compare the names and costs of CAI and IVD programs appropriate for use in long-term care. (See "'CAI
Software Recommendations for Long-Term Care" and "Interactive Video Programs for Long- Term Care. ") Costs of some programs are contingent on state educational requirements and reimbursement policies. Contact the company and review state requirements and reimbursement policies. Some programs are designed to meet the educational requirements mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987 and revised 1990. Flexible scheduling is another benefit of using CAI and IVD technology. Educators provide the resources and indicate when CAI or IVD assignments The instructor are due, and the staff members available 24 complete the assignments when it is convenient. The instructor (computer) is available 24 hours a day. By delegating repetitive teaching tasks to the computer, educators have the time to evaluate whether learning is being applied. Time saved can be used to assess the staff's learning needs, and to assure patients, their families, and accrediting regulatory bodies that high-quality care is being given and that performance standards are being met. The educator's role changes from that of content deliverer and attendance monitor to facilitator of learning. The coordination of learning activities, assessment of learning needs, evaluation of educational resources, and evaluation of the staff's ability to apply its knowledge and skills become the educator's primary concern. The emphasis is not on what the teacher teaches but on what the learner learns and is able to apply in practice. Studies reveal a 30% to 50% reduction in learning time when CAI and IVD are used for instruction. This reduction in learning time reduces the time staff members
spend off the unit for mandatory in-service programs or continuing education classes, thus reducing costs. Timeefficient programs are also cost-effective programs. Money is saved when time spent on program development, presentation, record keeping, and overtime for class attendance is reduced. Travel, workshop, and consultants' fees are also reduced because consultation is now readily available. Experts in the field participate in the development and design of high-quality CAI and IVD programs. Rogers, 3 to convince administration of the cost benefits of using the technology, designed a worksheet and calculated the time and the amount of money it takes to develop and (computer) is present a progr/im. Following Rogers' example, you can calcuhours a day. late cost factors for your institution. (See "'Traditional Costs" and "'Nontraditional CAI-IVD Costs.") Fifteen to 30 hours per 1 hour of instruction is usually allocated for development time. Development costs for CAI-IVD are higher than traditional methods at first; however, presentation costs are lower. Compare traditional program development and presentation costs with the cost of using c o m p u t e r resources. (See "'Comparison o f Cost-
Effectiveness.") Privacy, instructional consistency, and learner satisfaction must be added to our list of advantages. Learning becomes a private experience. Learners can ask questions, explore content, and make mistakes without fear of repercussions. Administrators, regulatory bodies, educators, and learners are all assured that the same information is presented. Learners have the same instructor, who never fails to repeat the content, in the same way, whenever it is convenient for them to learn. Interactive video technology offers users the following
INTERACTIVE VIDEO PROGRAMS FOR LONG-TERM CARE Publisher
Program Title
Audience
Cost
Hardware
FITNE 28 Station St. Athens, OH 45701 (614) 592-2511
Therapeutic Communications IV Therapy
RNs and LPNs RNs and LPNs
$700 Computer Videodisk player $595 Touch screen monitor ($395 for (Hardware must be FITNE members) compatible)
The American Journal of Nursing Co. 555 W. 57th St. New York, NY 10019 (212) 582-8820 (800) 223-2282
The Right to DiG The Case of Dax
RNs and LPNs
$1195
Cowart (Module II) The Right to Die (Module I) Ethical Dilemmas and Legal Issues in Core of the Elderly
RNs and LPNs RNs and LPNs
$1 !95 $995
Nursing Assistants $8000?. Interactive Health Network* ProCare--An interactive videodisc 1201 Peachtree St., NE program nursing assistants Suite 1500 designed to meet OBRA requirements Atlanta, GA 30361 (404) 872-9700 Dedicated system
RNs and LPNs
(See above)
(Call company)
$1600
Understanding Aging
"Cost contingent on state educarti~ml requirements and re/mbuesementpolk/es.
Geriatric Nursing January/February 1992 ,19
additional advantages: random access to content, which gives learners more control, and exposure to simulations that are more representative of reality. The technology allows designers to create learning experiences that other technologies cannot provide. 2 When Computer Technology May Not Be the Answer
phobia"; and resistance to change. An argument frequently made by educators against computers is that computers are impersonal. My reply is that the teaching and learning process is not personal and individualized when 50 to 100 persons attend the same class at the same time. The use of computers individualizes learning, allowing educators the time to become more involved with the learner.
The disadvantages of using computer technology include: cost, especially with IVD applications; "computer
NONTRADITIONAL CAI-IVD COSTS D e v e l o p m e n t Costs
TRADITIONAL COSTS Development Costs
Presentation Costs
Include time and money spent on:
Include time and money spent on:
• Planning • Researching content • Designing program Purpose Objectives Content Evaluation tools • Hardware and software (Purchase and development costs) Slides Videos Handouts and duplication Other • Applying for CEUs • CEU application fees
• Preparation Obtaining resources Preparing room • Presentation • Evaluation • Cleanup • Staff salaries • Overtime • Refreshments • Other
Include time and money spent on:
Presentation Costs Include time and money spent on:
• Hardware costs • Research (software and IBM XT/AT/PS2 compatible hardware) with color monitor Usually once per event • Evaluation and software Range $1000-$3000 (price depends on features review and where it is purchased) • Planning how to use CAI and IVD resources Once per event • Handouts Preparation and duplication costs • Software costs • CEU Some software deveJopers $200-$300 for CAI $500-$1000+ for IVD have obtained and provide CEU credits • Presentation coordination, educational management cost~ Scheduling Scoring and record keeping
COMPARISON OF COST-EFFECTIVENESS Nursing homes A and B must provide 8 hours of mandatory staff education for their 400 employees each year. Nursing home A uses traditional lecture, and nursing home B uses CAl. D e v e l o p m e n t ~ P r e p a r a t i o n Costs
Nursing home A (traditional)
It takes 20 hours of instructor time to prepare an hour of lecture. Instructor time = $15/hr, average hourly rate in area. Twenty hours X $15 -- $300 to develop 1 hour of class. $300/class X 8 classes = $2400 Development costs = $2400 for 8 classes CE application fees = $35 X 8 -- $280 Total cost = $2680
Nursing home B (CAI)
Computer = $1000 Software (CAI) = $250 average $250 X 8 = $2OOO total cost = $3000 CE fees included in program Computer maintenance fee = $0 for first year
Pr esent at i on/ Del i ven I Costs
Each of the 8 classes is repeated four times (a class for each shift plus a makeup). 4 X 8 = 32 classes 32 X $15/hr = $480 Presentation cost: $480 for 32 classes Salaries: 400 employees; 8 hr of class per year, average wage per hour = $12 400 X 12 = $4800 X 8 = $38,400/yr Overtime = ? Total cost = $38,880 Program coordination (notices, schedules, data collection) 4 hr. 4 X $15 = $ 6 0 / y r Salaries -- $19,200-$26,880 (learning time reduced by one third to one half) Total cost = $1%260-$24,140
Cost.effectlveness of CAI is evident. Use of IVD hardware and software requires additional calculalions and invesligation. .SomeIVD course materials may be reimbursal by the sta~.
50 Geriatric Nursing January/February 1992
Although appropriate for professional staff, CAI may not be an effective strategy for teaching nonprofessional employees who cannot read or speak English. However, interactive videodisk course material, if properly designed, can overcome these barriers. In industry, programs are designed to improve employee literacy while teaching employees the procedures they must learn to do their job. The language barrier in teaching can be overcome by using dual audio tracks, one in English and the other in the learner's language. At present, programs to accommodate these special learning needs have not been designed for educating employees working in long-term care facilities.
It is time you evaluated the benefits of using CA! for yourself. Explore the market and see what is available. There are several IVD programs appropriate for use in long-term care. (See "Interactive Video Programs for Long-Term Care.") The one designed for nonprofessionals complies with OBRA requirements. Another major obstacle that impedes the use of the technology is poorly designed software. If the value of CAI and IVD is to be realized, the best features of these methods must be incorporated into the programs. Choosing high-quality software is in itself an important and complex issue that is beyond the scope of this article; however, educators must learn to evaluate software to distinguish good design from bad.
Faced with budget constraints, staffing shortages, and demands to meet educational mandates of regulatory bodies, long-term care administrators and educators are investigating the advantages computer technology offers. Although few CAI and IVD programs are available to educate staff members in long-term care at present, rapid progress is being made to correct this deficiency. I anticipate that a dramatic increase in the use of computer technology will occur in long-term care in the next few years as it has in nursing education. The need is there, and it really is a better and more efficient way to teach. REFERENCES 1. Price M. Eliminating medication errors in the elderly. [Review.] Geriatr Nurs 1991;12:157. 2. Price hi. Nursing care of elderly patients with cardiac disorders. [Review.] Geriatr Nurs 1991;12:46. 3. Rogers S. Saving money on education: traditional teaching vs. computer assisted instruction. Computer Tutor 1990;Spring:2. SUGGESTED READINGS Belfry M J, Winnie PH. A review of the effectiveness of computer assisted education in nursing education. Computers in Nursing 1988;6(2):77-85. Bolwell C. Directory of educational software for nursing. New York: National League for Nursing. NLN Publication No. 41-2279, 1989. Price M. Nursing care of elderly patients with cardiac disorders: reviewof nursing care of elderly patients with cardiac disorders. GERIATRNURS 1991;11:46. Price M. Eliminating medication errors in the elderly: review of eliminating medication errors in the elderly. GtRI^TR Nuts 1991;11:157. Rogers S. Saving money on education: traditional teaching vs. computer assisted instruction. Computer Tutor [Newsletter], Spring 1990;2. Zengota E. Interactive videodisc training for long-term care personnel. Contemp Long-Term Care [Reprint]. August 1989.
How to Get Started with CAI
It is time you evaluated the benefits of using CAI for yourself. Explore the market and see what is available. Send for free demonstration disks and review the software. Ask your staff to preview and evaluate the materials with you. If you do not have a computer in your office look for one in admitting, accounting, the pharmacy, or elsewhere in your facility. Perhaps a friend has one at home. Most software publishers provide technical support; all you need to do is call. You do not need to be a computer whiz to use CAI; you just need to turn on the computer and insert the program. If you do not know how, find someone who does.
GERIA'rRICNtrRSINa welcomes unsolicited manuscripts related to all aspects of care for the elderly. See the " I n f o r m a t i o n for A u t h o r s " on pages 3 and 4 for details about the JouRr~xt's editorial policies and manuscript preparation.
Geriatric Nursing January/February 1992 51