E-learning within a blended clinical skills module: the experiences of first year BSc/Dip HE (adult nursing) students

E-learning is an increasingly popular method in providing educational material and educational support within higher education (Farrell 2006). Farrell (2006) suggests that e-learning widens access to education and provides flexible, student centred cost-effective education. E-learning however, is not without its critics. Muirhead (2007) recommends prudence over such teaching methods without research to ascertain its use and expressed concern that it is prescriptive, does not promote critical thinking and is promoted purely to meet the needs of the institution. The acquisition of clinical nursing skills is an essential component of nursing programmes. The Quality Assurance Agency for Higher Education (2008) identifies student nurses should develop these skills both at university and in the clinical practice setting. In 2009 the University of the West of Scotland (UWS) commenced a newly validated programme BSc/ Dip HE Adult nursing. The clinical skills module (Essential Nursing Skills), in year one, of this programme adopted a blended learning approach utilising e-learning through a Blackboard © site for the theory of the nursing skill, with some face to face tutorials to support learning and practice within the simulated skills laboratory. Aims of the Study The aim of this study was to explore the first year, BSc/DipHE (Adult Nursing) student experience of e-learning within a blended learning clinical skills module in order to ascertain if this method of teaching met the student’s learning needs and aimed to answer:•What difficulties do students experience using e-learning?•Does age affect students learning preferences in relation to e-learning?•What is the effect of e-learning on social interaction and class discussion? •What mechanisms do students currently access for support with e-learning?•What support do students perceive would enhance the experience of e-learning? MethodologyA descriptive quantitative study using triangulation of methods of data collection was adopted for this study. The study consisted of two phases. Phase-one comprised of an on-line survey via SurveyMonkey ©. Descriptive statistics were used to analyse the survey data.A focus group interview was used in phase-two of the study to explore and clarify the results of the survey (Denzin and Lincoln 1998). The quantitative and qualitative data were then triangulated to provide a holistic overview of the students’ experience.Population, Sample and Recruitment StrategyA non-probability, convenience sample of first year nursing students (n = 101) based at a single university campus was invited to participate. Students were allocated to 2 groups: age 17-24 and >25. Ethical approval was gained prior to the commencement of the study.ResultsA high response rate of 58.4% (Punch 2003) was obtained from the on-line survey. The flexibility of e-learning was viewed positively by participants of both age groups as it allowed them to study at a place and time that suited them, and helped those with children organise childcare. However, the majority of participants (84.7%) of all ages, preferred to print the e-learning material and then complete it. This was further explored in the focus group where it was identified that it was the paper copies that gave flexibility allowing participants to complete their work without competing for computer access and enabling them to complete it anywhere. Flexibility was impinged for some students by a lack of computer confidence and difficulties using computer passwords. Statistically significant survey results demonstrated that participants aged 17-24 enjoyed working on the computer more than those aged 25 and over (95% CI for difference between +7.1% to +50.7%; p = 0.009). The majority of the participants (84.7%) indicated that they enjoyed working on their own with 83% indicating that the knowledge they gained from e-learning gave them confidence for the skills laboratory practice and 79.7% indicating that it will help them to nurse patients. Comments provided via the on-line survey and the focus group identified that some participants felt that the e-learning motivated them to learn, promotes self-discipline and responsibility for learning.The majority of participants (93.2%) identified that it was important to gain computer skills as part of their nursing programme. Participants valued lectures with 71.2% of participants identifying that they missed class discussion when the theory is taught by e-learning. Students were reluctant to contact the University IT support services preferring to depend on friends and family for support. The majority of students (55.6%) aged 17-24 wanted extra time at the start of the module to get on with the e-learning, compared to 20.5% of those aged 25 and over. Over fifty percent of those students aged 25 and over wanted extra computer sessions compared to 7.4% of those aged 17-24. Drop in support sessions was viewed as a potentially valuable support. Contribution to Knowledge•E-learning can promote the development of self-directed learning and skills for life-long learning. •Whilst e-learning provides a degree of flexibility, students value contact and discussion with both peers and lecturers, suggesting a blended approach is most beneficial. •Different age groups of students have different support needs and these need to be identified and addressed by HE providers if students are to fully benefit from e-learning provision. ReferencesDenzin NK and Lincoln Y (Eds) (1998) Strategies of Qualitative Inquiry London Sage PublicationsFarrell M (2006) Learning differently: e-learning in nurse education Nursing Management 13 (6) p14-17Muirhead RJ (2007) E-learning: Is this teaching at students or teaching with students? Nursing Forum 42(4) p178-184.NHS Education for Scotland (2004) Themes and Issues 2002-2004 Quality Assurance and Professional regulation: Programme Approval and Monitoring Edinburgh NHS Education for Scotland Available: http://www.nes.scot.nhs.ukPunch KF (2003) Survey Research the Basics London Sage PublicationsThe Quality Assurance Agency for Higher Education (2008) Outcomes from institutional audit. Institutions’ support for E-learning Second series Gloucester QAA Available qaa.ac.ukAuthors:Main Correspondent: Elaine Gifford MSc, B.N, R.G.N, PGC TLHELecturer, School of Health, Nursing and Midwifery, University of the West of Scotland, A722 Barbour Building, High Street Paisley PA12BEAnn Marie Rice MSc, PGC(HE), RGN, RNTLecturer in Nursing, Nursing & Health Care School, College of Veterinary, Medical & Life Sciences, University of Glasgow