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Evaluation Goal #2

Evaluation Goal #2: Leading innovation in education and supporting knowledge translation to practice

New Standards of Practice and guidelines from provincial and national bodies have been routinely incorporated into de Souza curriculum.  In 2010, the Symptom Guides to Practice  and related Algorithms (CCO, 2010),  and the Assessment of Psychosocial Health Care Needs of the Adult Cancer Patient Guideline(CAPO, CPAC, 2010) were published and immediately brought into front line practice via de Souza curriculum.

The uptake of these guidelines was supported by clinically relevant tools and templates and via eLearning and on the ground workshops.  The Institute will continue to expand and improve curriculum, leveraging innovation in information technology.  At the same time, the institute will evaluate and compare various learning modes and their impact on learner outcome, collect and compare multiple ways of teaching and learning, and consider accessibility issues for those who could be disadvantaged or have special needs.  As a knowledge broker, the institute feels the need to take an active role in shaping how, when and where technology is used, to enhance the design of teaching and to contribute to the development of future of nursing education.

Examples included in the evaluation goal #2 are:

1. Needs Assessment 

A needs assessment project was conducted in April 2010 to gather feedback from 30 nurses throughout the province, in order for the Institute to develop programs that will meet the needs of oncology nurses. Earlier focus group work has revealed that both individual learning styles and technological confidence are important factors in eLearning uptake, and that there is diverse variation in the learning styles as well as comfort level with technology and even access to basic equipment (i.e. computers, Internet access). These are important issues to consider as the Institute develops and implements programming in order to achieve its goals and objectives. 

The objective of the needs assessment study was to:

  • Elicit the oncology nurses’ perceived needs of ongoing educational support in their career development; 
  • Explore generational differences in modes of learning, familiarity with information technology; and specific knowledge gaps; 
  • Examine the geographic barriers that nurses face across the province and its impact on the need for various models of educational support;
  • Test face validity of various forms of technologies in eLearning and their uptake rate by nurses from different generations, diverse locations and unique health care settings.

The needs assessment used an innovative Photo Journal method. Nurses were provided with a disposable camera to take pictures associated with how they conceptualize or perceive the meaning of being an oncology nurse, perceived excellence in oncology nursing, facilitators and barriers that support or hinder oncology practice, their educational needs, their perceived ideal workplace and their view on the future of oncology nursing. Nurses then wrote a narrative concerning each photo.  

During the focus group, nurses came to Toronto to share their photo journals, and to try out different learning stations which include: didactic teaching (lecture), videoconference teaching, eLearning in a static format and eLearning in avatar, all conducted in a well-constructed learning laboratory, specifically designed for the study.

Purposeful sampling was used to recruit 32 oncology nurses across Ontario, stratified evenly by age (<29, 30-45, 45+) and workplace setting (teaching hospital, community hospital and community care).  The stratification is to allow sufficient sample size for emerging themes for each subgroup.  

Participants had an average of 7.9 years of oncology experiences (range 0 to 25 years).  An assessment of exposure to eLearning technologies was performed and different levels of experience and sophistication were reported.  23% of contributors had never participated in an online eLearning course. Over 80% of the group reported some experience with online eLearning courses, many of which incorporated online quizzes and and/or games. The survey asked responders to identify barriers or challenges they would anticipate with eLearning. The majority stated that they had limited access to computers or an internet connection, and a lack of technology skills. Approximately half of participants reported they would take an online eLearning course in the future as it could effectively meet their educational needs.

Qualitative research software NVivo 8 is being used to identify themes that impact oncology nursing practice and to inform the future of de Souza curriculum development. The needs assessment study was part of a round table presentation on the International Cancer Nursing Conference in 2010.  

2. Mobile Learning in Oncology Nursing Education Project

The use of mobile devices and the ever increasing number of “apps” to support user interface has attracted attention from many commercial and educational institutions.  As de Souza scans the horizon for innovative oncology nursing education, the potential benefits of the mobile devices to improve accessibility to nursing education is apparent.  The capacity of mobile devices to potentially handle various oncology content remains to be tested. It is also unknown about oncology nurses’ acceptance level, their ability to use it as a learning tool, and their academic performance when using this technology as compared to computer based eLearning.

A research study was carried out in January 2011 to explore the usefulness of mobile devices in oncology nursing education and gather feedback from oncology nurses from different age groups and geographic locations on the following areas:

  1. To examine the use of a particular mobile platform, such as the iPod Touch©, as a medium for de Souza Institute eLearning courses and test its ability to deliver oncology curriculum as compared to the computer based eLearning. 
  2. To test efficacy of mLearning by gathering feedback from nurses after using the device to complete learning modules. 
  3. To compare mLearning with computer based eLearning to explore whether there are any differences in knowledge improvement between using mLearning versus computer based eLearning.

A de Souza course – eHealth Nursing and Oncology – was offered in January 2011. Housed in the de Souza eLearning centre, it consists of 4 modules covering content in the following areas: history of health informatics in cancer care, impact of technology in oncology nursing practice and future direction using case-based interactive format.

Thirty study participants took the first two modules using the de Souza eLearning Centre and then switch to iPod Touch© to complete the third and fourth modules via mLearning.   A purposeful sampling method was used to ensure participants come from across the trajectory of cancer care, (i.e. regional cancer centres, acute care hospitals, and community agencies), in different geographic locations and from various age groups within the workforce.

These participants were compared with de Souza “regular” learners – nurses who took the entire course via online access.  The following contrasts were explored:

  • Group equivalence tested via comparison of change in confidence in Module 1 and 2, when both group used eLearning
  • Comparison of the effectiveness of mLearning vs. eLearning in module 3 and 4

The outcome variables include: quantitative measures of academic performance (change in knowledge), total time spent on learning, and participant satisfaction.  Qualitative data includes analysis of text recorded by nurses on their experiences with mLearning and analyzed using software Nvivo 8 (QSR).  Results showed that mLearning was as effective as eLearning in delivering content – both groups improved the same way while using different method. eLearning was especially valued for its accessibility & convenience. We will continue to develop and explore potential/impact of Wi-Fi/Internet access in content. The study was presented at the 4th International Conference of the Canadian Network of Innovation in Education in May 2011.