Enhancing nursing students’ skills in vital signs assessment by using multimedia computer-assisted learning with integrated content of anatomy and physiology
Introduction
In response to increasing economic constraints and number of nursing students, it is necessary to design and implement cost-effective teaching and learning strategies.This is especially important in clinical teaching which is an essential part of the undergraduate nursing programs.These strategies should provide opportunities for students to apply theories learned in the classroom to the real world of nursing practice.
Vital signs, which influence clinical decision-making and indicate a patient’s health status are always the first important basic clinical skills taught in the first or second year of the nursing school. In most Thai nursing schools, clinical skill teaching including vital signs assessment involves lecture and demonstration by limited members of multiple educators (Saksoomboon et al., 2002). The skills laboratory teaching system which provides students with valuable practicing experience is an essential part of the curriculum (Freeth and Fry, 2005). However, in spite of the fact that small group instruction is more educationally desirable (Dwyer et al., 2007) faculty are in short supply. Therefore, many skills laboratories have moved to the autotutorial model using computer-assisted learning (CAL) or interactive multimedia CAL (Beeson and Kring, 1999). The CAL multimedia requires the learners to participate actively in the lessons by themselves and immediate feedback is provided with instructions paced according to their needs. The advantages of the multimedia include more flexible class time, increased student autonomy, freedom to do more in-depth tutoring, and decreased course preparation time. However, some disadvantages exist, including cost, the need for electronic media technical specialists and probably lack of social contact of the learners.
Inaccuracies in measurement of the vital signs are quite often due to poor techniques and malfunctions of the equipment used (Tom, 1993). This is corroborated by the findings in a School of Nursing in Thailand that accuracies in vital signs measurements and interpretation by the second year nursing students were 66.7%, 71.9%, respectively. Thus, there is a recommendation to use multimedia tools to minimize such a problem (Fundamentals of Nursing Course report, Ramathibodi School of Nursing, Thailand, 2006).
The aim of this study is to develop a CAL multimedia with integrated anatomical and physiological content of vital signs to enhance understanding, retention and performance skills of nursing students.The effectiveness of CAL multimedia on students’ achievement will be investigated by supplementing the CAL to the traditional lecture either with or without faculty demonstration of vital signs measurement. The research questions are as follows:
- 1.
Does CAL multimedia affect nursing students’ scores on vital signs factual knowledge?
- 2.
Does CAL multimedia affect nursing students’ performance skills on vital signs measurement?
- 3.
What is the attitude of nursing students toward the use of CAL multimedia in the classroom?
Section snippets
Computer-assisted learning
Computer-assisted learning (CAL) is an individualized method of self-study using the computer to deliver an educational activity. It allows learners to proceed at their own pace with immediate and continuous feedback on their progress as a response to a software program. Multisensory learning with interactive CAL multimedia has been widely used and proved to be a successful educational tool to communicate the objectives and involves the student as an active participant in the learning process.
Study design
A randomized experimental design was used in this study (Shadish et al., 2001). The subjects were 117 second-year nursing students enrolled in a fundamental nursing course. They were from two nursing schools in Thailand, both of which had similar curricula and learning facilities such as computers, skill resource centers and other equipment. Most participants (93.2%) were female, with mean age of 19.39 ± 0.82 years and grade point average (GPA) of 2.56 ± 0.46. There was no significant difference in
Students’ achievement
The effectiveness of computer-assisted learning (CAL) multimedia was tested by comparing its effects on the three instructional intervention strategies, i.e., (1) CAL/lecture, (2) CAL/lecture/demonstration and (3) lecture/demonstration. The results in Table 1 show that the pretest on factual knowledge of nursing students in all three groups were significantly different from those of the posttest. Analysis of t-test on gain scores of factual knowledge showed a significant gain in knowledge in
Discussion
This study clearly demonstrated that supplementing CAL multimedia to the traditional lecture resulted in improvement of nursing students’ learning achievement in vital signs assessment. However, supplementation with the CAL multimedia only improved the performance skills but not the factual knowledge. Although a significant improvement of factual knowledge gained was seen in all groups, but there was no significant difference among groups, no matter whether the CAL multimedia was given or not.
Conclusions
We developed computer-assisted learning (CAL) multimedia which was tried on second-year undergraduate nursing students. The students were divided in groups which were exposed to CAL/lecture, CAL/lecture/ demonstration, and lecture/demonstration. It was found that this integrated (anatomy with physiology) interactive multimedia with animation and audio enhanced their performance skills. Our results suggested also that the CAL multimedia was comparable to faculty demonstration. However, this CAL
Acknowledgements
The authors are grateful to Dr.Ngamnit Ratananugool, Dr. Pragai Jirojanakul, Lecturer Ratanaporn Siriwatchaiporn for their valuable comments and suggestions, and to all participants for their cooperation. We thank the Mahidol Research Grant for financial support.
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