Pre-registration nursing students' perceptions of their baseline digital literacy and what it means for education: A prospective COHORT survey study

Nursing faculty readiness to teach online: a survey of nursing educators from Saudi Arabia and the UK

BACKGROUND

Nursing Faculty's readiness to teach online has been recognized as a critical prerequisite for effective online teaching.

AIM

To examine the Nursing Faculty's level of readiness to teach online among a sample of nursing educators from Saudi Arabia and the UK.

METHODS

A convenient sample of 152 (46%) Nursing Faculty from five universities across Saudi Arabia and the UK completed Part 2 of The Faculty Readiness to Teach Online (FRTO)' survey between February - June 2021. Mann-Whitney U and Kruskal-Wallis One-Way Analysis of Variance tests were used to examine the differences in the average median scores of the participants' responses across selected independent variables.

RESULTS

Nursing Faculty from Saudi Arabia universities have scored significantly higher Median score than their British counterparts on the Course Design subscale (z=-2.6, p = 0.01) and Time Management subscale (z=-4.403, p = 0.001), and Nursing Faculty who completed a training course before they can teach online have also scored significantly higher median score than those who didn't on the same two subscales respectively (X2 = 6.15, df = 2, p = 0.05), (X2 = 12, df = 2, p = 0.002). Female Nursing Faculty scored significantly higher median score than male Nursing Faculty on the Course Communication subscale (z=-2.73,p = 0.006). Moreover, Nursing Faculty who mostly used asynchronous online teaching significantly scored the highest median score on the technical subscale (X2 = 8.64, df = 3, p = 0.03). The number of years of teaching online emerged as a key factor for defining the Nursing Faculty's level of readiness to teach online. For example, those Nursing Faculty with 6 years and longer of online teaching experience have scored significantly higher median scores on in Course Communication (X2 = 23.4, df = 4, p = 0.00), Time Management (X2 = 13.2, df = 4, p = 0.01) and Technical (X2 = 10.13, df = 4, p = 0.008) subscales compared with those with less than 6 year of online teaching experience. Nursing Faculty across Saudi and British universities who teach on MSc program have scored significantly higher median scores than those who teach on other programs on all four subscales.

CONCLUSION

The Nursing Faculty expressed a high level of competency in teaching online, with significant variations based on socio-demographic parameters. Future research needs to examine the factors that shape the Nursing Faculty's readiness to teach online.

Current status and associated factors of digital literacy among academic nurse educators: a cross-sectional study

BACKGROUND

In the backdrop of the ongoing global digital revolution in education, the digital literacy of teachers stands out as a pivotal determinant within the educational milieu. This study aims to explore the current status and associated factors of digital literacy among academic nurse educators.

METHODS

A cross-sectional design study utilizing an online questionnaire platform (Wenjuanxing) to collect data from August to October 2023. A total of 157 academic nurse educators members from 10 nursing colleges and universities across 5 provinces in China participated in the study. The digital literacy level of academic nurse educators was evaluated using the self-developed Teacher Digital Literacy Questionnaire. Multiple linear regression analysis was employed to examine the factors associated with the digital literacy of academic nurse educators.

RESULTS

The average digital literacy score was 125.27 ± 11.41, with the average scores for five dimensions from high to low by rank as follows: digital application (46.73 ± 5.38), digital social responsibility (27.22 ± 3.94), digital awareness (20.28 ± 3.17), professional development (19.88 ± 2.76), and digital technology knowledge and skills (11.16 ± 2.03). Multiple linear regression analysis revealed that age, years of teaching experience, awareness of digital advancements, and use of digital technologies (e.g. ChatGPT) (all p < 0.001) were significantly associated with the level of digital literacy among academic nurse educators.

CONCLUSION

Our findings suggest a need to design tailored digital education programs that address different age groups. For younger academic nurse educators, the focus should be on how to incorporate digital technology into their teaching practices to enhance educational diversity. For older academic nurse educators, training should prioritize building confidence in using digital tools and developing foundational digital skills to ensure they can effectively integrate technology into their instructional approaches. Therefore, supporting their needs and enhancing teaching competence towards sustainable nursing digital literacy.

The concept of capability in pre-registration nursing education: A scoping review

BACKGROUND

Capability in nursing education is an emerging concept that includes various requisites, which can be applied in complex or unfamiliar clinical settings. Despite growing research for practising nurses, the requisites of capability for pre-registration nursing students entering the workforce remain unclear.

OBJECTIVE

The objective was to identify the requisites that constitute capability for practice among pre-registration nursing students as well as the enablers to develop capabilities.

DESIGN

A scoping review was performed using the Joanna Briggs Institute methodology.

DATA SOURCES

Records published without date restriction were searched using MEDLINE, Embase, Emcare, CINAHL, and Scopus databases. Grey literature and reference list searching was conducted.

REVIEW METHODS

Sources explicitly reporting requisites of capability or enablers of capability development in pre-registration nursing education were eligible. All global sources written in English and available in full text were included. Data were extracted and synthesised using a specifically designed extraction tool.

RESULTS

The number of records reviewed totalled 896. Twenty-three studies met the criteria for inclusion in the synthesis. Nineteen capability requisites for practice were reported. Whilst various enablers to support development of capability requisites were reported, some challenges were also identified.

CONCLUSION

This study identified requisites of capability for practice and enablers that may support development of capability in pre-registration nursing education. This holistic set of capabilities has previously not been reported. Given the emerging nature of the concept, this collective set of requisites may not be indicative of all required capabilities of nursing students upon graduation. Efforts to develop a definitive set of requisites and explore strategies to support and enable capability development are needed to advance this concept in the pre-registration nursing education context.

Pre-Registration Nursing Students' Perceptions of Digital Health Technology on the Future of Nursing: A Qualitative Exploratory Study

BACKGROUND

Health informatics competencies, digital health education, and nursing students' perceptions of technology are critical to ensure a future digitally capable health care workforce.

PURPOSE

To explore preregistration students' perceptions of digital health technology impact on their role as nurses.

METHODS

Using a qualitative exploratory approach, students from 2 Australian universities were purposively sampled. Data were collected through photo-elicitation from 3 focus groups and thematically analyzed. Photo-elicitation provided reference points to encourage more in-depth exploration.

RESULTS

Themes included fear of the unknown and who am I? Nursing in a digital world . Human interaction was fundamental to their nursing role and digital health technology could depersonalize care, creating tension around their reason for choosing a nursing career.

CONCLUSIONS

Educators should prepare students to redefine their nursing identity by exploring how digital health technology augments their practice and critical thinking skills, while addressing fear of a perceived threat to the future of nursing.

Nursing students' perspectives on being work-ready with electronic medical records: Intersections of rurality and health workforce capacity

AIM

To explore nursing students' views on being prepared for using electronic medical records during clinical placement.

BACKGROUND

The need for an undergraduate nursing curriculum to include electronic medical record training has been internationally recognised, however successful implementation has been inconsistent worldwide and limited in Australia. Many nursing students are unprepared to effectively provide care during clinical placement using electronic medical records and are therefore not work-ready as registered nurses.

DESIGN

Online survey.

METHODS

Third-year nursing students from two multi-campus universities were invited to complete the survey.

RESULTS

Most students believed that learning electronic medical records during simulations would be extremely or very useful. Student confidence levels correlate with the amount and type of exposure to electronic medical records prior to clinical placement. Four themes emerged from qualitative analysis: Don't throw out the baby with the bathwater; Prepare us for practice; Mistakes - hardly any; and Universities need to catch up and put out.

CONCLUSION

Students receiving hospital-based education on eMR and eObs can improve student confidence in preparation for clinical practice. First-year optional eMR university education had a limited impact on students' perception of preparedness for clinical practice. Shared responsibility between both the universities and health services on eMR education would provide improved student confidence and preparedness for clinical practice. This study supports the international research that eMR education needs to be scaffolded over the three years of study with increasing complexity of real-life scenarios.

A cross-sectional study of discipline-based self-perceived digital literacy competencies of nursing students

AIMS

This study offers an empirical exploration of self-assessed digital competencies of students, most of whom studied in nursing courses, using a discipline-based self-assessment survey tool. A range of digital competencies were explored: information and communication technology proficiency and productivity, information literacy, digital creation, digital research, digital communication, digital learning and development, digital innovation, digital identity management and digital well-being.

DESIGN

A cross-sectional empirical study.

METHODS

Quantitative data were collected from November to December 2021 via a questionnaire survey administered to students. Quantitative results were reported through descriptive statistical analysis. Mann-Whitney (U-test) and Kruskal-Wallis non-parametric statistical tests were used to identify statistically significant differences based on age demographics and pre- or post-registration course. Thematic analysis was utilized for survey open-ended questions data.

RESULTS

Students reported low competencies in the following digital literacy dimensions, all of which were imperative for their studies and for their future professional careers: information literacy, digital research, digital innovation. Significant statistical subgroup differences were found between age demographics and pre/post-registration within most of the digital competence dimensions. The survey open-ended comments revealed that students encountered challenges around digital skills they had mostly developed via everyday life experiences and trial-and-error approaches.

CONCLUSION

Increasing awareness of existing digital gaps and offering tailored digital skills enhancement can empower students as future-proof evidence-based practitioners in an evolving digital healthcare landscape.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Highlights the importance of embedding digital literacy within nursing study programmes, as preparation for comprehensive patient healthcare.

IMPACT

Offers insights into digital competencies gaps of nursing students. Proposes targeted educational digital skills training interventions. Stresses the value of academic staff supporting nursing students to develop digital skills in important areas of professional practice.

REPORTING METHOD

JBI critical appraisal checklist. No patient or public contribution.

Nursing students' preparedness for the digitalised clinical environment in Australia: An integrative review

AIM

The aim of this integtrative review is to examine the literature on nursing students preparedness for the digitalised clinical setting.

BACKGROUND

Digital literacy skills ensure nursing students can provide quality and safe care to patients in a digitalised clinical setting.

DESIGN

Integrative review of the literature.

METHODS

The integrative review of the literature incorporated Whittemore and Knafl's (2005) framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2021 statement. A review of the literature comprised of a search of the following databases: ERIC, Scopus, CINAHL, Medline, Cochrane Library and Google Scholar from 2010-2022. Data were critically appraised using the Critical Appraisal Skills Programme (CASP), the Mixed Method Tool (MMAT) and Joanna Biggs Institute (JBI).

RESULTS

The literature reported on nine studies from 2010 to 2022. The four themes identified using Braun and Clarke's thematic analysis were curriculum design, education and training, digital literacy level and professional digital literacy competency standard framework. Major findings include the need for the development and integration of a professional digital literacy competency standard framework embedded into nursing curricula to equip nursing students with appropriate digital literacy skills to navigate digitalised healthcare settings.

CONCLUSION

Current registered nurses and preregistration nurses are required to be upskilled with the understanding and knowledge of health informatics and its role in the clinical setting. This will enable future registered nurses to keep up with the rapidly evolving technological clinical environment.

Influence of technical, cognitive and socio-emotional factors on digital literacy in nursing students assessed using structural equation modeling

BACKGROUND

Digital literacy is one of the 21st-century skills that nursing students should develop and acquire. Several factors influencing digital literacy have been identified, but the predictive role of technical, cognitive, and socio-emotional factors in digital literacy remains unexplored in nursing students.

OBJECTIVE

This study aimed to explore the digital literacy level and determine the predictive role of technical, cognitive, and socio-emotional factors in digital literacy among nursing students in Turkey using a structural equation modeling (SEM)-based approach.

DESIGN

A web-based, predictive, cross-sectional study.

SETTINGS

This study was conducted among first-, second-, third- and fourth-year students in a nursing faculty located in the capital of Turkey in the academic year 2021-2022.

PARTICIPANTS

Overall, 210 nursing students were recruited for this study.

METHODS

The use of a digital literacy model guided data collection. Data were collected between 8 and 28 June 2022 using online Google Forms. The data were analyzed using descriptive statistics and SEM.

RESULTS

Nursing students' digital literacy mean score was 67.29 (13.60). Internet self-efficacy (β = 0.31, p < 0.001), online information search strategies (β = 0.20, p = 0.003), and online privacy concerns (β = 0.14, p = 0.024) were positive predictors, whereas social media use (β = -0.13, p = 0.032) was a negative predictor of digital literacy. Among these variables, Internet self-efficacy had the most significant influence on the digital literacy level. The four variables contributed to 22 % of variance in the digital literacy level.

CONCLUSIONS

This study shows nursing students' digital literacy level is above average. Our findings suggest that technical, cognitive, and socio-emotional factors influence digital literacy.

Self-Reported eHealth literacy among nursing students in Sweden and Poland: The cross-sectional multicentre study

This study aimed to provide an understanding of nursing students' self-reported eHealth literacy in Sweden and Poland. This cross-sectional multicentre study collected data via a questionnaire in three universities in Sweden and Poland. Descriptive statistics, the Spearman's Rank Correlation Coefficient, Mann-Whitney U, and Kruskal-Wallis tests were used to analyse different data types. Age (in the Polish sample), semester, perceived computer or laptop skills, and frequency of health-related Internet searches were associated with eHealth literacy. No gender differences were evidenced in regard to the eHealth literacy. Regarding attitudes about eHealth, students generally agreed on the importance of eHealth and technical aspects of their education. The importance of integrating eHealth literacy skills in the curricula and the need to encourage the improvement of these skills for both students and personnel are highlighted, as is the importance of identifying students with lacking computer skills.

Developing online simulated practice placements: a case study

The Nursing and Midwifery Council recognises that using simulated practice learning within the pre-registration nursing curriculum is a valuable way for students to develop nursing knowledge and skills. The University of Huddersfield developed simulated placements in the pre-registration nursing curriculum in 2021. Simulated placements are now embedded within all fields of the BSc and MSc programmes, providing structured, innovative learning experiences that embrace online technology in supporting the development of skills and knowledge relevant to all fields of nursing. Developing these placements has provided an opportunity for faculty staff to work collaboratively with clinical colleagues, service users and carers, academics and technologists. This article offers an overview of that work, addressing challenges, operational issues, and insight into some of the activities developed to support students' learning.

Lessons Learned from Natural Disasters around Digital Health Technologies and Delivering Quality Healthcare

As climate change drives increased intensity, duration and severity of weather-related events that can lead to natural disasters and mass casualties, innovative approaches are needed to develop climate-resilient healthcare systems that can deliver safe, quality healthcare under non-optimal conditions, especially in remote or underserved areas. Digital health technologies are touted as a potential contributor to healthcare climate change adaptation and mitigation, through improved access to healthcare, reduced inefficiencies, reduced costs, and increased portability of patient information. Under normal operating conditions, these systems are employed to deliver personalised healthcare and better patient and consumer involvement in their health and well-being. During the COVID-19 pandemic, digital health technologies were rapidly implemented on a mass scale in many settings to deliver healthcare in compliance with public health interventions, including lockdowns. However, the resilience and effectiveness of digital health technologies in the face of the increasing frequency and severity of natural disasters remain to be determined. In this review, using the mixed-methods review methodology, we seek to map what is known about digital health resilience in the context of natural disasters using case studies to demonstrate what works and what does not and to propose future directions to build climate-resilient digital health interventions.

The Psychometric Properties of Version 2 of the Canadian Nurse Informatics Competency Assessment Scale

In 2020, we conducted a mixed methods study comprised of a cross-sectional survey in which we applied a modified version of the 21-item Canadian Nurse Informatics Competency Assessment Scale and one-on-one interviews to explore self-perceived nursing informatics competency and readiness for future digital health practice. A total of 221 senior-level students in BScN programs in western Canada participated. This article reports on results related to the factor structure and internal consistency reliability of the 26-item (version 2) of the Canadian Nurse Informatics Competency Assessment Scale. Exploratory principal component analysis with the varimax rotation revealed a four-component structure, explaining 55.10% of the variance. All items on the Canadian Nurse Informatics Competency Assessment Scale 2 had good loadings, except item 7, which did not load to any domain but was retained based on an evaluation of the α value and item relevance to nursing practice. A few items shifted to different domains. The overall reliability of the Canadian Nurse Informatics Competency Assessment Scale 2 was ( α = .916) and its subscales: information and knowledge management ( α = .814), professional and regulatory accountability ( α = .741), and use of information and communication technology ( α = .895). This study provided preliminary evidence for the factor structure and reliability of the Canadian Nurse Informatics Competency Assessment Scale 2 among nursing students. Further testing is recommended.

Integrating interprofessional electronic medical record teaching in preregistration healthcare degrees: A case study

BACKGROUND

Electronic medical record (EMR) adoption across healthcare necessitates a purposeful curriculum design to prepare graduates for the delivery of safe and effective patient care in digitally-enabled environments.

OBJECTIVE

To describe the design and development of an Interprofessional Electronic Medical Record (iEMR) subject that introduces healthcare students to its utility in clinical settings.

METHODS

A six-stage design-based educational research framework (Focus, Formulation, Contextualisation, Definition, Implementation, Evaluation) was used to instigate the iEMR design and development in nursing and five allied health graduate entry to practice (preregistration) degrees at an Australian university.

RESULTS

In the Focus process, the concept and interdisciplinary partnerships were developed. The Formulation process secured grant support for subject design and development, including a rapid literature review to accommodate various course and curriculum structures. Discipline-specific subject themes were created through the Contextualisation process. During the Definition process, learning objectives and content resources were built. The Implementation process describes the pilot implementation in the nursing program, where assessment tasks were refined, and interdisciplinary clinical case studies originated.

DISCUSSION

The design and development of an iEMR subject is underpinned by internal support for educational innovation and in alignment with digital health strategies in employer organisations. Identified barriers include faculty-level changes in strategic support for teaching innovation, managerial expectations of workload, the scope of work required by academics and learning designers, and the gap between the technology platform required to support online learning and the infrastructure needed to support simulated EMR use. A key discovery was the difficulty of finding EMR software, whether designed for teaching purposes or for clinical use, that could be adapted to meet the needs of this project.

CONCLUSION

The lessons learned are relevant to educators and learning designers attempting a similar process. Issues remain surrounding the sustainability of the iEMR subject and maintaining academic responsibility for ongoing curriculum management.

Baseline evaluation of nursing students' informatics competency for digital health practice: A descriptive exploratory study

Introduction

The healthcare system is increasingly technology-dependent and proficiency in informatics skills is essential for health professionals to efficiently operate in the contemporary clinical environment. Nurses are major users of digital health technologies and graduates need to be well-prepared and confident to use the different available clinical systems competently as they transition from education to practice.

Aim

To explore undergraduate nursing students' self-perceptions of informatics competence, set within a larger research project.

Method

Descriptive, exploratory cross-sectional research design, with online self-assessment survey of undergraduate nursing students (n  =  142). Data were analysed with descriptive, correlation and comparative statistics.

Results

Participants' perceived overall mean informatics competency was at the level of somewhat competent, with only 40.84% (n  =  58) at the level of competent. The highest mean value was in foundational information and communication skills and the lowest in information and knowledge management. Formal informatics education within curriculum was limited and lacked uniformity, as was prior exposure to important simulated informatics tools in preparation for practice. Factors including academic year level, computer experience and previous experience using clinical systems had a significant impact on participants' perceived informatics competency.

Conclusion

Even though informatics competence is vital for clinical practice, with technology becoming pervasive within healthcare, nursing students' preparedness for digital health was sub-optimal. There were gaps in students' critical informatics practice knowledge with implications for work readiness of future graduates and nurse education practice.

Factors in integrating academic electronic medical records in nursing curricula: A qualitative multiple case studies approach

BACKGROUND

Academic electronic medical records are useful simulation-based educational tools that assist health professional students develop their skill sets for digital health practice. Despite this, their utilisation in pre-registration nursing curricula is uncommon in Australia and New Zealand.

AIM

To explore factors surrounding integration of academic electronic medical records into pre-registration nursing curricula in Australia and New Zealand.

DESIGN

Exploratory qualitative multiple case studies approach with purposive sampling set within a larger research project.

METHODS

Semi-structured interviews conducted with course leaders from six nursing schools. Data were analysed in an iterative content-driven deductive and inductive process using open-coding and categories. Case analysis involved within case and cross-case analysis.

RESULTS

Findings revealed different factors that impacted the utilisation of academic electronic medical records in nursing curricula including factors influencing adoption, barriers and challenges with implementation, enablers for integration and perceived benefits for students' clinical practice preparation. Reasons for not using academic electronic medical records, barriers for implementation, and preparation of students for clinical practice in the absence of these simulation tools were also highlighted.

CONCLUSION

Our findings suggest that use of academic electronic medical records in nursing curricula is still evolving and that their adoption and application within programs is not straightforward. While there are many factors unique to the schools using such resources, factors including decisions around curriculum incorporation, optimising available resources to support students' learning, and developing faculty capability to teach with academic electronic medical records were common considerations. Lack of funding and access to local educational tools were ongoing barriers for adoption. Further research examining curriculum timing and preparation, possibilities of partnerships to share resources, and evaluation in meeting students' needs is necessary.