Integrating computers into the curriculum (2): transforming a concept into a working tool

Integrating computers into the curriculum (2): transforming a concept into a working tool Anne Gwinnett

and Sandy Massie

This article describes the progress made on the Computer Aided Case Studies (CACS) project, which was described in Nurse Education Tody, Vol 6, No 3 (June 1986). It gives a brief outline of the way in which seminars/discussions have been combined with Computer Assisted Learning (CAL), and describes the setting up and early evaluation of this joint venture between the St. George’s District School of Nursing and the University of Manchester Institute of Science and Technology is discussed, and it is hoped that other (UMIST). Th e value of collaboration will be undertaken, and the initial projects between St. George’s and UMIST concept be developed further.

Computer

technology

felt in the patient to know them.

how

activities

We

believe

introduction Therefore

setting,

to use the

It is essential

are introduced threatening and such

is making

care that

facilities the way

to computers practical. Also

as being

relevant

that

ideal

the

is during our

aim

its

and

is

to

need

available in which

to they

is both nonnurses must see to patient

time

basic

presence

nurses

care.

to begin

approach

is that

computer

familiarity.

It was with

these

UMIST

to

Studies

(CACS).

develop

education.

integrate

computer

resources related within a planned

mitted

ing experience ation. Students

ing

the

principle

resource,

(CAL) and

a

of

using

Computer

as an essential useful

spin-off

A Gwinnett PhD, Lecturer in Management

learnof

this

Sciences, University of Manchester Institute of Science and Technology, Manchester S Masaie RNT Dip EdAdmin, Senior Nurse (Ed/Man), St George’s District School of Nursing, St George’s Hospital, London Manuscript accepted January 1987

116

in mind

that

between

of

a joint the

St.

of

Nursing

and

Computer

Aided

Case

WHAT IS CACS?

use of computers as a study support tool. The St. George’s District School of Nursing is comLearning

a degree

this

nurse

The

to

ideas

achieve

undertaken was District School

project George’s

awareness into the curriculum, and we argue that the best way to do this is through student

Assisted

students

basic

amalgam

contains

concept of

the

of CACS

teaching

is the

methods

USC of an

and

to case study learning situation.

learning

information The learn-

begins with a period of preparare given a ‘framework’, which name,

age,

diagnosis

and

orcup-

ation of a fictitious patient, along with basic clinical observations. Using this as their starting point, the students must then interrogate the computer formation on relating

individually which they

to the planning

to gain further incan base decisions

of care.

A BBC Econet

NURSE

Level trd

II system

with

which

are

cludr

is used.

stored

of patient

such

mouth and teeth. ‘I’ha diversity purpose. prioritise are

cverv factor.

individual

useful

of

maximum broadens

the

the

by offering

printout

of

h:ised

in

only

15

items.

that

information of the

he

tutorial/seminar variations

and

use the inf‘ormation

plan

for a particular

gained

database

the students,

by tutors

material.

The

a

menu

setting,

where findings

to write

driven

and

2 months,

patient.

which

coded

the

programs

and worked to refine

Information

concerning stair were

1Z.c believe

that

to be effrctive thr support Staff were

as a learning

and commitment actively

order bility

were

given

project

staff meetings,

encouraged

this is vital,

ot‘ ideas and case the implementation pr,ople

the

We

saw

involved

staff at

all

to be involved. as CAL resource

is unlikely without

specific

responsibilities

softwarr

for ease of use devices

enabling

students

to

choices set

for

both

student

screens

facilities

protection

for tutor

to prevent

of existing

use

accidental

case studies

in

which, with the researthree Senior Nurses for Projects, General

initial

development step

forward

in

However,

we were

very

conscious

to put

further

process

an academic

truly

practical

Initial

testing

if the

of two

their

first

case

study

the

discussion.

The

assist

individual

them

patient.

a

the form

of

first

to The

plan

were

and control

without

experimental control

with students

experience

The

computer

was to on the

year

framework

were subdivided into sets asked to list any factors would

took

surgical

groups. the

to he

provide

discussions

the case study

whilst

interrogate

their

two

was

and

of’

imple-

a policeman

eight

undergoing

to discuss

result

as

nurse

tool.

patient:

Twenty

into

the

the aim of which

given divided

end

of the system

the content

appendicitis.

into

exercise

exercise,

of a specific

the

effort

educational

study

compare

of CACS

imaginative

than

to in of

to ensure the co-ordination and compatiof drvelopments. This group essentially

ti)rmed a project team, cher. consisted of 1F,d/Man, responsible

of the

and colour-coded

mentation

computer,

in the generation

material, and also CACS. A small group

counter

more

were

of the teachers.

study

of

need

care

dis-

and

to

of case stud)

system

and editing

the

an

a pilot

materials. was

for

facilities

tutor

erasure

from

computer

the teaching

the case study

via the srnior

teaching

a researcher

editing

trapping

of their

password

the

required

with

St. George’s seminated

time

student

instruction

writing

being

had been thought through, took place over a period of

during

UMIST

This

facilities

Maintaining the impetus

a care

The development process the idea drvelopment

produced.

features

error

segmented

education.

Once initial

of the

comprehensive

been and

major

keep track

is

in their

a

tutor;

end

for the creation

a selection

selectrd.

experience

the

interrogation

sophisticated

not

receives

stage

input

117

include:

minimal

of

TODAY

a general At

had

and

be used

a

end

has

learning

development

provided

for

may

Health);

technician.

package

this

At the

student

initial

planning

they

Mental

AVA

software

CACS

to

and

the

data

to access

Secondly,

the

discuss

the

enhance

approach

each

to

of care

allowed

part the

can

twofold

all

of for themselves.

second

students

not To

are

session

a

of

students

planning

suggestions

computer

The

has

since

students’

thought

data

to the

in-

aspects

the condition

encourages

patient.

students

have

the

it

and

to hospitalis-

and

information

offered

care

as attitude

of

Firstly,

These

to different

background,

Nursing

is presen-

of information

computer.

relevant

care,

ethnic

student

40 items

in the

information

ation,

The

a list of over

EDUCATIOK

using group

database group

then group the were before

of students

of three, and were that they thought the

discussion

care

of

began

this with

each group proposing ideas, which were then explored. Each member of the computer group used

the computer

program

to select

15 items

118

NURSE

EDUCATION

of information total

of 41.

each

student

about

the same patient

In the discussion

information cularly

was asked that

on

database,

had

The

soon

from a followed,

a piece

thought

discussion

information

but

which

to suggest

he/she

important.

focussed

TODAY

of

partiinitially

retrieved

from

encompassed

the

additional

ideas.

system

have

been

questionnaire encouraging,

had taken place, the students

to

fill

Both

groups

were asked

and the computer

in

complete

a questionnaire program.

It

was

found

questionnaire.

about

the discussion,

specifically

that

discussed

a much

fluencing

the

the

wider

planning

did the control that

a short

group were also requested

computer

cussed. Although important

computer

computer

range

had

to indicate to

being dis-

covered,

the

group did not think so, even though had been

much

again

the theory

that

stimulated

the

supports

computer

had

processes.

in the computer discussion, been

than

group felt that all been

their discussion

thought

in-

students

the subject

the control

group

care

had stimulated

areas

to the

of factors

of patient

think more deeply about the

about

group. This appears

the computer

Several database

broader.

This

Sixty

three

per cent

very

easy

clearly

presented.

enjoyed

using the computer.

to the

in the development

needed using

revision. CACS.

Most This

There

to increase

new

for

found

the

that

they

is an obviindividuals’

technology,

though

reduce

in the ward environment.

that further

this proportion.

for their

views,

use of CACS

Tutors

and commented

range of issues was brought They

also

among

noted

themselves

that

that

students

from the computer.

promoted

a deeper

Such discussions

The use of CACS

a very

that

re-

and evaluation

of this first

has identified

the follow-

stage of development

ing benefits of using a computer

in this way:

_ it provides a focus for students’ thoughts _ it produces tangible points for discussion _ it increases understanding of how various of information

are to

relating

circumstances ~ it encourages

students

likely

care

to affect

in

specific

to use discernment

in their search for information

of

areas

with

care planning.

a lively discussion

to highlight

talked

items of in-

level of thinking

students

use had two

a wider

often

whilst selecting

~ it prepares

In

might

into the discussions.

formation

gard to patient

to It is

also were asked

_ it promotes

of the students

was

short to he

pointers

509/i, said

this

on computer

it was designed

a

the information

were put to use

available.

main purposes. Firstly, it was intended to elicit student opinion about the program, and secondly

to be hoped

decisions

process.

The questionnaire

Over

using

use a computer

items

own

came out of the free

options

to use and

for CACS in

students’

and some of these have subsequently

added

in

continue

of students

system

the use of the

areas not mentioned

way the results of the exercise

fill

!20?$ said that they would still be reluctant

Evaluation of the pilot study asked

to

results

whilst also providing

ous tendency

were

the

future work.

confidence

After the seminars

asked

and

clinically

for the interactive

based

patient

use

information

systems ~ it provides teachers integrate educational

computers

with an opportunity to their current into

strategies

enjoyed

encouraging

Individual

students

select

different

sets of in-

reaction with regard to future development, and has been duplicated in subsequent groups. Most of the students liked the presentation of the information, and found the program easy to use. Following the pilot study exercise, fur-

formation, and possibly reach different sions as a result. This in itself forms

ther case studies were developed and have been used by the students. Most students using the

circumstances. awareness of

conclua good

basis for discussion. In particular, it highlights the impact on a decision which various items of information are likely to have, and in what It is hoped that this evokes an the types of questions which

NURSE

should also

be asked teaches

additional decisions

in a variety

of situations.

It

nature

students

be

to

than

the

information if necessary.

to

received

receptive

and

to modify

of

the

development

adopting

methods combined

EDUCATION

one

that of the systems a highly interactive

Lessons learned

has produced

The

speed

initial

experiment teaching

of the

CACS

a new,

or at least

method

computer tional

aim with

classroom

students

and

head

have

include

and 100 students

several have

on been

The

more major

as follows.

to practice in

a

environment.

use

as

developed

one

our initial

to

to

both

topics More so far,

for

non-threatening,

we

findings. identified

enables

learners

evaluative

thinking and informed decison making. Thirdly, it promotes discussion on a wider variety of issues related We have encountered, from

other

to planning

patient

and

consultation,

such

cussion,

When

within

a school

imaginative missing

rarely

when

with an ordinary disc drive (DFS) system, random access of files on the network (NFS) is SIOW,

and

special

routines

have

had

to

be

added to the program to speed up the loading of the case files. This is only a temporary solution, from under

however, BBC way.

Acorn.

and

help

Further

has

been

refinements

sought are

The value of collaboration We believe success

that a major influence on the of the project has been the collaborative

independ-

house, This

presented.

as a single

exploratory

software

is

to

the

pro-

entirely

ability

practice

limited

dis-

this

developed

of nursing,

of

Minimal

to overcome

due

be due

understanding

be

into

it often

may

sufficient

to put

is frequently

programing

with

that

educators

skills.

the effort

both

systems

have

an

expended.

analysts

important

balance

their

and contri-

bution to make to the development software, but each needs the other’s

of CAL skill to

own.

against

such

a background

that

the

project took shape and the on-going interactive working relationship was established. In this case,

it

Econet

problem

is developed software

commensurate

freely

is no

of the

to

ideas

is obvious

During the development of CACS WC ha\re learned more about the working of the there

of the

validity

the

Although software has been developed in this way with some success, the end results are

necessary.

Although

is not

blem.

ability

system.

in terms

and

incomplete

matter

care.

organisations

have with

advantages

software

analysts’

It was

discovered that problems may be and it is important to seek help institutions

we tutors

and programers in environment. This

a lack of imagination.

nurse

non-pressured

CAL

subject

It

information

it stimulates

many

by a commercial

the

the of

and

outcomes

a computer

so far is

suffers

schizophrenia,

occasion,

When

conven-

on

analysts working

Rather

conventional

development, of the nurse

of development

ently

teaching

neurosis. the system

CACS

Secondly,

a

more

119

end product. of

A number

colitis,

learning

Firstly,

using

is new

institutional have used

able to verify

three

retrieval

been

than

more

interest.

ulcerative

injury,

than

its

to

use

Experience

CACS

teachers,

was

a different

novel

the

discussion.

has generated

studies

which

a

with

Because

technique case

mixing

technology

encouraging.

are

-

project

process.

of the

of software the expertise

TODAY

into

was of the

the

School

with

experience

both

of

enhanced researcher

Nursing,

staff

to date

collaborative produce

considerably U,MIST

and

approach

and

to

students.

we firmly has

by

the

to integrate our

that

this

potential

to

believe the

mingle

From

exciting

results in terms of more imaginative and stimulating CAL software. It is hoped that further collaborative ventures will be

undertaken

UMIST lications

between St. George’s as the full potential and possible of CACS are explored.

and app-

Bibliography Phelps M D 1986 Computer aided case studies integrating computers into the curriculum. Unpublished BSc dissertation, UMIS’I