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Nursing students respond to a computer assignment
Nursing Students Respond to a Computer Assignment LYNNETTELEESEBERGSTAMLER,PHD, RN,* BARBARATHOMAS,EDD, RN,y AND SHARONMCMAHON,EDD, RN
Computer-generated information is becoming increasingly important in nursing. Nursing schools are faced with the need to ensure that students have basic informatics skills and rudimentary computer literacy. This article describes the introduction of an assignment using electronic communication skills within a teaching-learning course in a baccalaureate program. The assignment was designed to introduce the students to several tasks that would be useful to them in their studies as well as in their care of clients. Students learned to send electronic mail, post to a class list, use search engines, access libraries, and critique web pages. They developed increased confidence and skill, advancing from informed user to proficient user status as identified by Ronald & Skiba. The students' appraisal of the assignment in terms of value to their nursing education and their nursing careers indicated that they recognized the value of these skills for their professional nursing lives. Activities were monitored for content and technical glitches. Lessons learned are highlighted, and "inbox overload" is identified. The authors found that nursing curricula can be designed to meet the challenge of fostering computer literacy. The assignment could be easily adapted for continuing education or other professional education endeavors. (Index words: Computer skills; Communication; Internet; Nursing education) J ProfNurs 15:5258, 1999. Copyright © 1999 by W.B. Saunders Company
HE USE OF computer-generated information is rapidly becoming a necessity in nursing. Although recent high school graduates may have incorporated the use of computers in many of their assignments, many contemporary nursing students do not come directly from high school or from a computer environment. Thus, nursing schools are faced with the challenge of ensuring that students have
T
*AssociateProfessor,Schoolof Nursing, UniversityofWindsor, Windsor, Ontario, Canada. tProfessor,Schoolof Nursing, UniversityofWindsor,Windsor, Ontario, Canada. :~AssociateProfessor,Schoolof Nursing, UniversityofWindsor, Windsor, Ontario, Canada. Address correspondenceand reprint requests to Dr Stamler: University of Windsor, School of Nursing, 401 Sunset Ave, Windsor, Ontario, CanadaNgB 3P4. Copyright© 1999 by W.B. SaundersCompany 8755-7223/99/1501-0012510.00/0
52
basic informatics skills and rudimentary computer literacy. The purpose of this article is to describe the introduction of an assignment using elementary electronic communication skills within a teachinglearning course in a generic baccalaureate nursing program. A survey about the assignment was given to the students at the end of the course to ascertain their perceptions of the value of their newfound skills in terms of their nursing education and their nursing careers. The results of the surveys along with implications for future nursing education, are presented. Literature Review
A review of nursing literature suggests that an increased presence of electronic networking in health care translates into a greater demand for nurses capable of accessing and evaluating electronic information. In 1987, Ronald and Skiba suggested that nursing curricula include knowledge of computers. For instance, electronic mail (e-mail) can be a valuable communication tool; as well, the Internet and other computer networks may allow exchange of data regarding nursing care and needs of specific patient groups (Wink, 1995). Basic skills in informatics are no longer just an asset but a requirement. Therefore, the task of the educator is to ensure that nursing students are comfortable in technological surroundings. Some computer applications have already been utilized in nursing education curricula. Computer conferencing serves as a useful method to connect distance learners to their educators (Sparks, 1993). One application was reported to enhance collaborative problem solving through the use of a computermediated conference in a clinical course (Witucki, Hodson, & Maim, 1996). Computer conferencing also was integrated into a nurse practitioner outreach program as a way to communicate school assignments and interact with students in remote locations (Landis & Wainwright, 1996). Iliad, a computerized diagnostic reasoning expert system, was successfully implemented in a nurse practitioner program to enhance
JournalofProfessionalNursing, Vol 15, No 1 (January-February), 1999: pp 52-58
53
NURSING STUDENTS' COMPUTER ASSIGNMENT
students' diagnostic reasoning through diagnostic consultations and patient simulations (Lange et al., 1997). Better preparation for critical thinking and clinical reasoning are predicted benefits of applied nursing information systems (Poirrier, Wills, Broussard, & Payne, 1996; Tanner, Padrick, Westfall, & Putzer, 1987). Nursing information systems also increase job performance in the work setting and promote compliance with policies and procedures (Drazen, 1990). Ronald and Skiba (1987) developed a framework of basic computer education to be incorporated into nursing curricula. A continuum consisting of three points was devised in which the learner progresses from informed user to proficient user to developer. The proficient user is one who can understand fundamental computer concepts and use the computer in decision making and problem solving in the nursing process (Ronald & Skiba). Although Ronald and Skiba suggested that each faculty decide where their students should be positioned on the continuum on graduation, Poirrier et al. (1996) identify the preparation of a proficient user as a realistic outcome for graduates of baccalaureate programs. Computer-based learning programs utilizing multi-
media technologies are proliferating within the nursing field. Students need basic computer and communication skills to access and benefit from these programs. Implementation of computer assignments within nursing curricula to increase computer literacy and communication have become a priority.
Overview of Facilities
Students in this baccalaureate nursing program are required to take a course in teaching-learning in their junior year. Traditionally, the course has focused on patient education, with additional content in curriculum building, program development, evaluation, and health promotion. Anecdotal reports from the students in both acute care and community clinical settings indicated that patients are beginning to use the Internet to find information related to their health concerns. Recently, the authors' School of Nursing was the recipient ofa Helene Fuld Health Trust Fund Grant to enable the establishment of a computer laboratory for nursing students. This prompted a decision to include a computer assignment as one of the requirements in
50%
40%
-
30%
--
"E
I
C
~
I ! i
20%
--
10%
--
n
0%
Figure 1. Perceived value of e-mail to my nursing education [] and nursing career D.
I
1
Not At All Useful
2
3
4
5
Vew Use~l
STAMLER, THOMAS, AND McMAHON
54
the teaching-learning course. Although some of the students were computer literate, others had managed to avoid using computers to date. The assignment required the students to access and use computer resources and establish links to computer networks. All students registered in this program are eligible to receive a userid for linking to the student network. This includes Internet and e-mail access. The university has a home page with a special link for student use. Within that link, they may access web pages created specifically for certain courses. Computing services provides consultants and support to faculty, staff, and students. The Assignment
The assignment was developed to introduce the students to several tasks that would be useful to them as they continued their studies and planned patient education for their clients. The tasks included (1) sending e-mail, (2) joining and posting to a class list, (3) moving through search engines to find specific web pages, (4) accessing libraries in other universities, and
(5) finding and critiquing individually chosen web pages suitable for patient education. A web page linked to the university's home page was created for the assignment. Students were given detailed written guidelines for getting a userid, if they did not already have one, from the university and accessing the web page to locate the assignment. Within the assignment were detailed instructions for each activity and identification of what was required to demonstrate completion of each task. Working with friends or requesting assistance from computer consultants was encouraged; however, independent responses from each student were required for the final assignment. During the time frame for this assignment, required readings and other preparation for class was kept to a minimum. Principles of teaching and learning were incorporated into the design of the assignment. For instance, when sending e-mail to the professor, each student was required to send a minimum of three messages on different days in response to replies from the professor. When subscribing to the class list, students were required to post a minimum of three messages on
60%
50%-
40%-
300/0-
20%-
10%-
0%
I
I
1 Not At
Useful
l
]
3
All
5
Very Useful
Perceived value of joining a list for my nursing education [] and nursing career [].
Figure 2.
NURSING STUDENTS' COMPUTER ASSIGNMENT
55
nursing. Independently chosen sites were to focus on patient education topics.
three different days in response to classmates' messages. Thus, repeated use of the computer was necessary to complete the assignment. The value of this was noted in comments at the end of the assignment: "When I started this it took me half an hour to get into my e-mail; now it only takes a couple of minutes." Because the professor was a member of the class list, all activities could be readily monitored for content and technical glitches. Each part of the assignment was designed to build on the skills completed in the previous task. For instance, students had to demonstrate getting to specific web sites through the search engines before being required to find web sites independently. When they finally began to complete the last task, they were comfortable with search engines and had learned which ones were likely to get them to their desired content area most easily. Web sites that the students were required to access (eg, the Journal of Nursing Jocularity, National Institute of Nursing Research, Health Canada) were chosen because of their value to
Students Respond to the Assignment
At the end of the term, an anonymous formal
evaluation was completed by the students. O f the 56 students in the class, 44 (77 per cent) completed the author-designed evaluation instrument. The questions focused on the value of each task in relation to their university education and their nursing careers. The students were asked to circle their responses on a five-point Likert scale from "Not at all useful" to "Very useful." Students also had the opportunity to offer suggestions for improving the assignment through open-ended questions. The responses of the students to the value of e-mail is found in Fig 1. Students perceived e-mail as more useful to their nursing education than their nursing careers. Similarly, they believed that joining a list was
35%-
30%-
25%-
o=20% ¢=. (M
g¢
~ 15%-rE
10%-
5%-
0%-
Figure 3. Perceived value of finding resources in other libraries to my nursing education [] and nursing career D.
1
Not At All Useful
2
3
4
5
Ve~ Use~l
56
STAMLER, THOMAS, AND McMAHON
more useful for their nursing education (Fig 2). Supportive of this finding was the request by these students to create a class list for their senior year for ease of communication between students in differing clinical settings. Finding resources in other libraries was deemed to be the least useful of the tasks surveyed (Fig 3). Students chose the neutral point more often when evaluating this task. Locating information on the Internet was clearly believed to be the most useful of all the tasks, both for nursing education and their nursing careers (Fig 4). Several students noted that in caring for clients in hospital and community settings, they were finding many clients who already had searched the Internet themselves. Responses to the open-ended questions included "Thank you for the opportunity, .... The assignment was great," and "I found it very useful." To improve the assignment, students suggested adding more content related to computers and informatics to the course, allowing more time for completing the assignment, and ongoing teaching assistance. They also identified that the computer laboratory was particu-
larly crowded during the last week of the assignment and requested more computers. Discussion
All students completed the assignment successfully. An added benefit for each student was a list of Uniform Resource Locators of the patient education sites found by their classmates. Thus, all participants now had a small library of web sites for future use. During the time of the assignment, classroom discussion focussed on both positive and negative aspects of the assignment. For instance, one of the negative aspects was discovering that Internet searches did not reveal the same web sites in the same order every time, leading to frustration at trying to locate a particular site. When critiquing the independent sites, students discovered some information that was misleading or sites that were "infomercials" for particular products. This lead to discussions in class and through electronic communication about the ethics of helping clients to understand that Internet information may be unreliable. Other discussion topics related to the
lOO%
80%-
60%¢I o
40%-
20%-
O%
I 1
Not At All Useful
I
I
M I
I
5 Very Useful
Figure 4. Perceived value of finding information on the Internet for my nursing education [] and nursing career [].
NURSING STUDENTS' COMPUTER ASSIGNMENT
57
TABLE 1. Summary of Lessons Learned Suggestions for professors Current published resources are hard to find Allow for double the preparatory time expected Assignment guidelines must be extremely clear Monitoring the assignment is labor intensive Expect frustration from students in beginning stages Suggestions for students Begin the assignment early Be aware of and use sources of help Flexibility must be blended with accuracy Share successes with others Persistence is valuable
Internet included such general subjects as pornography, potential censorship of undesirable content, protection of young surfers, current events, and world news. Students also discovered the practical realities of belonging to a list. Initially, some students impatiently awaited the first piece of e-mail addressed just to them. Later, however, "inbox overload" became an oft-heard complaint, leading to the realization that joining several lists at once might not be a good idea.
The experience was successful in increasing confidence and competence...
A summary of lessons learned from this endeavor may be found in Table 1. When this assignment is repeated in subsequent years, some changes will be made. One of the problems was finding adequate and up-to-date published material that described the current reality of electronic communication. For instance, articles published recently about the Internet described resources that are now considered obsolete. This made preparation for the classes and the assignment difficult. The assignment provided students with a reason for discussing the role of computers in their personal and nursing lives. Many recognized the value of instant
communication and long-distance linkages; however, others felt that they were in university to learn about nursing, not how to run another machine. Concern that nursing would become more mechanistic and lose its focus on human caring was raised. These issues were extended to reflection on a growing technological dependence in everyday life. One of the most positive aspects was the increase in confidence levels of the participants. Students who had never used a computer before were pleased to learn that they really could accomplish the tasks. Students who already had skills found they were in great demand as consultants. Many were amazed to find how much information was available on the Internet and subsequently used it for many of their clinical patient assignments. Conclusions
M1 of the students were able to complete the entire assignment. The experience was successful in increasing confidence and competence in electronic communication skills for the students in the class. By completing the various activities within the assignment, students experienced practical applications that the classroom alone could not provide. Evidence was seen throughout the assignment to indicate that students moved from informed user to proficient user status as described by Ronald and Skiba (1987). The authors were encouraged to find that nursing curricula can be designed to meet the challenge of fostering computer literacy. This assignment is being adapted for students in the postdiploma baccalaureate program. The authors also believe the assignment could be modified to meet the needs of professional nurses in continuing nursing education or graduate programs. When nursing students are given the opportunity to interact with electronic communication/ computer systems in an organized manner and within a supportive setting, they can develop the basic informatics skills necessary to meet the demands of a changing world.
References
Drazen, E. L. (1990). Bedside computer systems overview. In P. E Abrami & J. E. Johnson (Eds.), Bringing computers to the hospital bedside (pp. 1-15). New York: Springer. Landis, B. J., & Wainwright, M. (1996). Computer conferencing: Communication for distance learners. Nurse Educator, 21(2), 9- l 4.
Lange, L. L., Haak, S. W., Lincoln, M. J., Thompson, C. B., Turner, C. W., Weir, C., Foerster, V., Nilasena, D., & Reeves, R. (1997). Use of Iliad to improve diagnostic performance of nurse practitioner students. Journal of Nursing Education, 36, 36-45. Poirrier, G. P., Wills, E. M., Broussard, P. C., & Payne,
58 R. L. (1996). Nursing information systems: Applications in nursing curricula. Nurse Educator, 21(1), 18-22. Ronald, J. S., & Skiba, D. J. (1987). Guidelinesfor basic computer education in nursing. New York: National League for Nursing Press. Sparks, S. M. (1993). Electronic networking for nurses. Image--The Journal of Nursing Scholarship, 25, 245248.
STAMLER, THOMAS, AND McMAHON
Tanner, C. A., Padrick, K. P., Westfall, U. E., & Putzier, D. J. (1987). Diagnostic reasoning strategies of nurses and nursing students. Nursing Research, 36, 358-363. Wink, D. M. (1995). An introduction to nursing on the Internet: Part one. Nurse Educator, 20(6), 9-13. Witucki, J. M., Hodson, K. E., & Malm, L. D. (1996). Integrating electronic conferencing to enhance problem solving in nursing. Nurse Educator, 21(4), 8-12.
Computer-generated information is becoming increasingly important in nursing. Nursing schools are faced with the need to ensure that students have basic informatics skills and rudimentary computer literacy. This article describes the introduction of an assignment using electronic communication skills within a teaching-learning course in a baccalaureate program. The assignment was designed to introduce the students to several tasks that would be useful to them in their studies as well as in their care of clients. Students learned to send electronic mail, post to a class list, use search engines, access libraries, and critique web pages. They developed increased confidence and skill, advancing from informed user to proficient user status as identified by Ronald & Skiba. The students' appraisal of the assignment in terms of value to their nursing education and their nursing careers indicated that they recognized the value of these skills for their professional nursing lives. Activities were monitored for content and technical glitches. Lessons learned are highlighted, and "inbox overload" is identified. The authors found that nursing curricula can be designed to meet the challenge of fostering computer literacy. The assignment could be easily adapted for continuing education or other professional education endeavors. (Index words: Computer skills; Communication; Internet; Nursing education) J ProfNurs 15:5258, 1999. Copyright © 1999 by W.B. Saunders Company
HE USE OF computer-generated information is rapidly becoming a necessity in nursing. Although recent high school graduates may have incorporated the use of computers in many of their assignments, many contemporary nursing students do not come directly from high school or from a computer environment. Thus, nursing schools are faced with the challenge of ensuring that students have
T
*AssociateProfessor,Schoolof Nursing, UniversityofWindsor, Windsor, Ontario, Canada. tProfessor,Schoolof Nursing, UniversityofWindsor,Windsor, Ontario, Canada. :~AssociateProfessor,Schoolof Nursing, UniversityofWindsor, Windsor, Ontario, Canada. Address correspondenceand reprint requests to Dr Stamler: University of Windsor, School of Nursing, 401 Sunset Ave, Windsor, Ontario, CanadaNgB 3P4. Copyright© 1999 by W.B. SaundersCompany 8755-7223/99/1501-0012510.00/0
52
basic informatics skills and rudimentary computer literacy. The purpose of this article is to describe the introduction of an assignment using elementary electronic communication skills within a teachinglearning course in a generic baccalaureate nursing program. A survey about the assignment was given to the students at the end of the course to ascertain their perceptions of the value of their newfound skills in terms of their nursing education and their nursing careers. The results of the surveys along with implications for future nursing education, are presented. Literature Review
A review of nursing literature suggests that an increased presence of electronic networking in health care translates into a greater demand for nurses capable of accessing and evaluating electronic information. In 1987, Ronald and Skiba suggested that nursing curricula include knowledge of computers. For instance, electronic mail (e-mail) can be a valuable communication tool; as well, the Internet and other computer networks may allow exchange of data regarding nursing care and needs of specific patient groups (Wink, 1995). Basic skills in informatics are no longer just an asset but a requirement. Therefore, the task of the educator is to ensure that nursing students are comfortable in technological surroundings. Some computer applications have already been utilized in nursing education curricula. Computer conferencing serves as a useful method to connect distance learners to their educators (Sparks, 1993). One application was reported to enhance collaborative problem solving through the use of a computermediated conference in a clinical course (Witucki, Hodson, & Maim, 1996). Computer conferencing also was integrated into a nurse practitioner outreach program as a way to communicate school assignments and interact with students in remote locations (Landis & Wainwright, 1996). Iliad, a computerized diagnostic reasoning expert system, was successfully implemented in a nurse practitioner program to enhance
JournalofProfessionalNursing, Vol 15, No 1 (January-February), 1999: pp 52-58
53
NURSING STUDENTS' COMPUTER ASSIGNMENT
students' diagnostic reasoning through diagnostic consultations and patient simulations (Lange et al., 1997). Better preparation for critical thinking and clinical reasoning are predicted benefits of applied nursing information systems (Poirrier, Wills, Broussard, & Payne, 1996; Tanner, Padrick, Westfall, & Putzer, 1987). Nursing information systems also increase job performance in the work setting and promote compliance with policies and procedures (Drazen, 1990). Ronald and Skiba (1987) developed a framework of basic computer education to be incorporated into nursing curricula. A continuum consisting of three points was devised in which the learner progresses from informed user to proficient user to developer. The proficient user is one who can understand fundamental computer concepts and use the computer in decision making and problem solving in the nursing process (Ronald & Skiba). Although Ronald and Skiba suggested that each faculty decide where their students should be positioned on the continuum on graduation, Poirrier et al. (1996) identify the preparation of a proficient user as a realistic outcome for graduates of baccalaureate programs. Computer-based learning programs utilizing multi-
media technologies are proliferating within the nursing field. Students need basic computer and communication skills to access and benefit from these programs. Implementation of computer assignments within nursing curricula to increase computer literacy and communication have become a priority.
Overview of Facilities
Students in this baccalaureate nursing program are required to take a course in teaching-learning in their junior year. Traditionally, the course has focused on patient education, with additional content in curriculum building, program development, evaluation, and health promotion. Anecdotal reports from the students in both acute care and community clinical settings indicated that patients are beginning to use the Internet to find information related to their health concerns. Recently, the authors' School of Nursing was the recipient ofa Helene Fuld Health Trust Fund Grant to enable the establishment of a computer laboratory for nursing students. This prompted a decision to include a computer assignment as one of the requirements in
50%
40%
-
30%
--
"E
I
C
~
I ! i
20%
--
10%
--
n
0%
Figure 1. Perceived value of e-mail to my nursing education [] and nursing career D.
I
1
Not At All Useful
2
3
4
5
Vew Use~l
STAMLER, THOMAS, AND McMAHON
54
the teaching-learning course. Although some of the students were computer literate, others had managed to avoid using computers to date. The assignment required the students to access and use computer resources and establish links to computer networks. All students registered in this program are eligible to receive a userid for linking to the student network. This includes Internet and e-mail access. The university has a home page with a special link for student use. Within that link, they may access web pages created specifically for certain courses. Computing services provides consultants and support to faculty, staff, and students. The Assignment
The assignment was developed to introduce the students to several tasks that would be useful to them as they continued their studies and planned patient education for their clients. The tasks included (1) sending e-mail, (2) joining and posting to a class list, (3) moving through search engines to find specific web pages, (4) accessing libraries in other universities, and
(5) finding and critiquing individually chosen web pages suitable for patient education. A web page linked to the university's home page was created for the assignment. Students were given detailed written guidelines for getting a userid, if they did not already have one, from the university and accessing the web page to locate the assignment. Within the assignment were detailed instructions for each activity and identification of what was required to demonstrate completion of each task. Working with friends or requesting assistance from computer consultants was encouraged; however, independent responses from each student were required for the final assignment. During the time frame for this assignment, required readings and other preparation for class was kept to a minimum. Principles of teaching and learning were incorporated into the design of the assignment. For instance, when sending e-mail to the professor, each student was required to send a minimum of three messages on different days in response to replies from the professor. When subscribing to the class list, students were required to post a minimum of three messages on
60%
50%-
40%-
300/0-
20%-
10%-
0%
I
I
1 Not At
Useful
l
]
3
All
5
Very Useful
Perceived value of joining a list for my nursing education [] and nursing career [].
Figure 2.
NURSING STUDENTS' COMPUTER ASSIGNMENT
55
nursing. Independently chosen sites were to focus on patient education topics.
three different days in response to classmates' messages. Thus, repeated use of the computer was necessary to complete the assignment. The value of this was noted in comments at the end of the assignment: "When I started this it took me half an hour to get into my e-mail; now it only takes a couple of minutes." Because the professor was a member of the class list, all activities could be readily monitored for content and technical glitches. Each part of the assignment was designed to build on the skills completed in the previous task. For instance, students had to demonstrate getting to specific web sites through the search engines before being required to find web sites independently. When they finally began to complete the last task, they were comfortable with search engines and had learned which ones were likely to get them to their desired content area most easily. Web sites that the students were required to access (eg, the Journal of Nursing Jocularity, National Institute of Nursing Research, Health Canada) were chosen because of their value to
Students Respond to the Assignment
At the end of the term, an anonymous formal
evaluation was completed by the students. O f the 56 students in the class, 44 (77 per cent) completed the author-designed evaluation instrument. The questions focused on the value of each task in relation to their university education and their nursing careers. The students were asked to circle their responses on a five-point Likert scale from "Not at all useful" to "Very useful." Students also had the opportunity to offer suggestions for improving the assignment through open-ended questions. The responses of the students to the value of e-mail is found in Fig 1. Students perceived e-mail as more useful to their nursing education than their nursing careers. Similarly, they believed that joining a list was
35%-
30%-
25%-
o=20% ¢=. (M
g¢
~ 15%-rE
10%-
5%-
0%-
Figure 3. Perceived value of finding resources in other libraries to my nursing education [] and nursing career D.
1
Not At All Useful
2
3
4
5
Ve~ Use~l
56
STAMLER, THOMAS, AND McMAHON
more useful for their nursing education (Fig 2). Supportive of this finding was the request by these students to create a class list for their senior year for ease of communication between students in differing clinical settings. Finding resources in other libraries was deemed to be the least useful of the tasks surveyed (Fig 3). Students chose the neutral point more often when evaluating this task. Locating information on the Internet was clearly believed to be the most useful of all the tasks, both for nursing education and their nursing careers (Fig 4). Several students noted that in caring for clients in hospital and community settings, they were finding many clients who already had searched the Internet themselves. Responses to the open-ended questions included "Thank you for the opportunity, .... The assignment was great," and "I found it very useful." To improve the assignment, students suggested adding more content related to computers and informatics to the course, allowing more time for completing the assignment, and ongoing teaching assistance. They also identified that the computer laboratory was particu-
larly crowded during the last week of the assignment and requested more computers. Discussion
All students completed the assignment successfully. An added benefit for each student was a list of Uniform Resource Locators of the patient education sites found by their classmates. Thus, all participants now had a small library of web sites for future use. During the time of the assignment, classroom discussion focussed on both positive and negative aspects of the assignment. For instance, one of the negative aspects was discovering that Internet searches did not reveal the same web sites in the same order every time, leading to frustration at trying to locate a particular site. When critiquing the independent sites, students discovered some information that was misleading or sites that were "infomercials" for particular products. This lead to discussions in class and through electronic communication about the ethics of helping clients to understand that Internet information may be unreliable. Other discussion topics related to the
lOO%
80%-
60%¢I o
40%-
20%-
O%
I 1
Not At All Useful
I
I
M I
I
5 Very Useful
Figure 4. Perceived value of finding information on the Internet for my nursing education [] and nursing career [].
NURSING STUDENTS' COMPUTER ASSIGNMENT
57
TABLE 1. Summary of Lessons Learned Suggestions for professors Current published resources are hard to find Allow for double the preparatory time expected Assignment guidelines must be extremely clear Monitoring the assignment is labor intensive Expect frustration from students in beginning stages Suggestions for students Begin the assignment early Be aware of and use sources of help Flexibility must be blended with accuracy Share successes with others Persistence is valuable
Internet included such general subjects as pornography, potential censorship of undesirable content, protection of young surfers, current events, and world news. Students also discovered the practical realities of belonging to a list. Initially, some students impatiently awaited the first piece of e-mail addressed just to them. Later, however, "inbox overload" became an oft-heard complaint, leading to the realization that joining several lists at once might not be a good idea.
The experience was successful in increasing confidence and competence...
A summary of lessons learned from this endeavor may be found in Table 1. When this assignment is repeated in subsequent years, some changes will be made. One of the problems was finding adequate and up-to-date published material that described the current reality of electronic communication. For instance, articles published recently about the Internet described resources that are now considered obsolete. This made preparation for the classes and the assignment difficult. The assignment provided students with a reason for discussing the role of computers in their personal and nursing lives. Many recognized the value of instant
communication and long-distance linkages; however, others felt that they were in university to learn about nursing, not how to run another machine. Concern that nursing would become more mechanistic and lose its focus on human caring was raised. These issues were extended to reflection on a growing technological dependence in everyday life. One of the most positive aspects was the increase in confidence levels of the participants. Students who had never used a computer before were pleased to learn that they really could accomplish the tasks. Students who already had skills found they were in great demand as consultants. Many were amazed to find how much information was available on the Internet and subsequently used it for many of their clinical patient assignments. Conclusions
M1 of the students were able to complete the entire assignment. The experience was successful in increasing confidence and competence in electronic communication skills for the students in the class. By completing the various activities within the assignment, students experienced practical applications that the classroom alone could not provide. Evidence was seen throughout the assignment to indicate that students moved from informed user to proficient user status as described by Ronald and Skiba (1987). The authors were encouraged to find that nursing curricula can be designed to meet the challenge of fostering computer literacy. This assignment is being adapted for students in the postdiploma baccalaureate program. The authors also believe the assignment could be modified to meet the needs of professional nurses in continuing nursing education or graduate programs. When nursing students are given the opportunity to interact with electronic communication/ computer systems in an organized manner and within a supportive setting, they can develop the basic informatics skills necessary to meet the demands of a changing world.
References
Drazen, E. L. (1990). Bedside computer systems overview. In P. E Abrami & J. E. Johnson (Eds.), Bringing computers to the hospital bedside (pp. 1-15). New York: Springer. Landis, B. J., & Wainwright, M. (1996). Computer conferencing: Communication for distance learners. Nurse Educator, 21(2), 9- l 4.
Lange, L. L., Haak, S. W., Lincoln, M. J., Thompson, C. B., Turner, C. W., Weir, C., Foerster, V., Nilasena, D., & Reeves, R. (1997). Use of Iliad to improve diagnostic performance of nurse practitioner students. Journal of Nursing Education, 36, 36-45. Poirrier, G. P., Wills, E. M., Broussard, P. C., & Payne,
58 R. L. (1996). Nursing information systems: Applications in nursing curricula. Nurse Educator, 21(1), 18-22. Ronald, J. S., & Skiba, D. J. (1987). Guidelinesfor basic computer education in nursing. New York: National League for Nursing Press. Sparks, S. M. (1993). Electronic networking for nurses. Image--The Journal of Nursing Scholarship, 25, 245248.
STAMLER, THOMAS, AND McMAHON
Tanner, C. A., Padrick, K. P., Westfall, U. E., & Putzier, D. J. (1987). Diagnostic reasoning strategies of nurses and nursing students. Nursing Research, 36, 358-363. Wink, D. M. (1995). An introduction to nursing on the Internet: Part one. Nurse Educator, 20(6), 9-13. Witucki, J. M., Hodson, K. E., & Malm, L. D. (1996). Integrating electronic conferencing to enhance problem solving in nursing. Nurse Educator, 21(4), 8-12.