The Integration of Mobile Learning and Teaching in Nursing

EducationGlynda Doyle, RN, MSN

British Columbia Institute of Technology

CNIA/IFHIMA

May 2013

• Rogers Diffusion of Innovation Model

• BCIT process of integration• Study outcomes• Future plans

OUTLINE

Mobile computing has the power to make nursing

practice safer, more efficient, evidence informed,

and of a higher quality. (Patillo et al., 2007; Thede &

Sewell, 2010; Thompson, 2005)

• Access at point of care is becoming an accepted standard in current healthcare environment (Kuiper, 2010)

• Technology integration is significant element of education (Educause, 2011; Hunt, 2002; Tooey & Mayo, 2003, Wali et al., 2008; )

• Today’s student expects immediacy, engagement and internet access (Arhin & Cormier, 2007; Skiba, 2005; White et al., 2005)

• Current healthcare environment is increasingly complex (Adler, 2007; Doran, 2009; Goldsworthy et al., 2006)

• Necessary for nurses to integrate increasingly large amount of info into decision making processes (Doran et al., 2010; Farrell et al., 2007)

• Expected competency for nursing grads (CASN, 2012; CNA, 2012; Kuiper, 2010)

Why else……

Rogers Diffusion of Innovation Model

http://www.utwente.nl/cw/theorieenoverzicht

http://infrae.com/presentations/present_OSSWATCH_osmodel/techcycle

Ministry of Advanced Education Mandate

2008

Pilot Studies RFP

November 2008

uCentral Site License

February 2011

Policies for BCIT and Health Authorities

January 2012

Clinical/Sim lab/Classroom

2010-Present

Bookshelf/iBooksBCIT App

2013/2014

BCIT Mobile Technologies Integration Process

Healthcare apps:• Clinicalc• Virtual body• Medspeak

“when I receive a patient with something I am not sure off, it's right at the tip of my hands to quickly get the answers. Even when patients and families are asking me a question and no one is around to help me right away I can figure it out on my own. Makes me more independent as well.” A big advantage is that I can access 'to the minute" information, on any subject, from any where in the world. I am up to date with the most current news and information related to healthcare, and all the information I need fits in my pocket.

However, if one doesn't know how to differentiate between websites that are reliable resources and those that are not, there is a risk that the information one is looking up is inaccurate.

I would be able to look up any medical terms or diagnoses that I'm not familiar with and access documents like CRNBC standards and BCIT policies

BCIT Nursing Student Comments

“Great potential uses - no longer need to carry textbooks, instant access to drug references, diagrams for patient education, sharing pertinent websites, quick communication both in and out of clinical. Barriers - perception of personal use when using device in clinical, not fully accepted for nursing - medicine not a problem, staff nurses not using/scared of technology discourage use.”

BCIT Nursing Faculty Comment

“Potential uses: -show photos of instruments used at clinical -show youtube images/videos –log onto internet to verify information -use the recording feature to record a quick lesson so students can review whenever they like Challenges: -requires data and not all faculty have data (or enough) data on phone -screen may not be big enough to show more than 2 students at a time”

Benefits Challenges• No heavy outdated textbooks• No need to access ward

computer• Real time efficient access to

information• Patient teaching• Translation tools• Peer-reviewed information• Improved confidence, less

anziety

• Perception of staff• Perceived perception of

patients• Digital Divide• Confidentiality• Effect on critical thinking• Screen size for sharing

Themes from BCIT 2012/2013 student/faculty qualitative surveys

Benefits: Increased feelings of student:

• self-efficacy

• confidence

• productivity

• research ability (Bauldoff et al., 2008; Doran et al., 2010; Goldsworthy, 2006; White et al., 2005)

• Decreased med errors (Greenfield, 2007)

• Decreased stress/anxiety (Jamieson et al., 2009)

• Evidence based, current decision support in real time (Farrell & Rose, 2008; Fisher & Koren, 2007)

• Interprofessional collaboration (Davenport, 2004; Farrell & Rose, 2008)

• Patient education

Challenges:

• Cost (Kuiper, 2010; Scollin et al., 2006; Zurmehly, 2010)

• Privacy & confidentiality (Adler, 2007; Altmann & Brady, 2005)

• Infection control (Bauldoff et al., 2008; Goldblatt et al., 2007)

• Time taken to become familiar with device use (Huffstutler et al., 2002)

• Touch vs. Tech (Rosenthal, 2003)

• Patient perception (Lee, 2007)

• Limited battery power (George & Davidson, 2005; Rosenthal, 2003)

• Tech support (Scollin et al., 2006; Zurmehly, 2010)

• Evaluate critical thinking and clinical judgment

Current and Future Plans

Goal of Informatics is:

And not:

The Fundamental Theorem of Informatics (Friedman, 2009)

Friedman, C. (2013). What informatics is and isn’t. J Am Med Inform Assoc, 20. 224-226

Educator support to encourage and influence critical thinking

• Evaluate critical thinking and clinical judgment

• E-text pilots

Current and Future Plans

• Evaluate critical thinking and clinical judgment

• E-text pilots

• Integration trials with EHRs in Sim lab

Current and Future Plans

• Evaluate critical thinking and clinical judgment

• E-text pilots

• Integration trials with EHRs in Sim lab

• Projectors for clinical post-conferences

Current and Future Plans

• Evaluate critical thinking and clinical judgment

• E-text pilots

• Integration trials with EHRs in Sim lab

• Projectors for clinical post-conferences

• Provide info sessions for Health Authority staff

Current and Future Plans

Questions?

Thank You

Glynda_Doyle@bcit.ca

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Resources

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Resources cont.

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Resources cont.