Blended Learning Was Integrated into the Clinical Skills of Nurses (1090-003599) (Research Abstract Professor Rounds: Group 5)
Start time: Friday, January 29, 2021, 10:00 AM End time: Friday, January 29, 2021, 11:00 AM Session Type: Research Abstracts (Completed Studies)
In the context of the diversification and increasing sophistication in healthcare, and the transition to home care in Japan, training has been under way to improve the clinical skills of nurses in physical examination, medical interviewing, clinical reasoning, and IPW to shift and share tasks. Among such training programs, the "specified medical acts training for nurses" was launched in 2015 (1). One training method to improve clinical skills is blended learning, where knowledge is acquired through e-learning, and simulation is used to integrate knowledge, skills, and attitudes. Blended learning has been shown to improve physical examination (2) and communication skills (3), but acquiring more integrated clinical skills has not been examined in relation to blended learning. Therefore, in this study, to test the hypothesis that blended learning improves the clinical skills of nurses, a blended learning program was designed and evaluated from multiple perspectives.
The study participants comprised a total of 188 nurses aged between 28 and 58 (145 females and 43 males), all of whom were working full-time as registered nurses and had joined the “specified medical acts training for nurses” program in A center. For the design of blended learning, we used the Five Specific Blended Learning Models by Bersin (4). A five-day blended-learning program was designed consisting of two days of e-learning, two days of simulation, and one day of OSCE to enable students to learn through e-learning as much as possible. The learning task was to acquire clinical skills and the target population was employed in this study. After blended learning, the participants joined bedside training for a week. The 10-item, 10-step self-evaluation and OSCE evaluations were used for the program evaluation. Self-evaluation was conducted before and after blended learning and after bedside training. The analysis was performed on SPSS with a paired t-test.
In the OSCE evaluation using Mini-CEX by the supervising physicians, all 188 participants passed both after blended learning and bedside learning. A total of 178 participants responded to all three self-evaluations. In the self-evaluation, "Understand team medicine and medical ethics," "Understand the differences between the roles of nurses and doctors," and "Understand how to work with multiple occupations" scored more than 6.5 points from before the blended learning and tended to be higher than the other 7 items. Additionally, seven items other than "Understand team medicine and medical ethics," "Understand the differences between the roles of nurses and doctors," and "Understand how to work with multiple occupations" significantly increased their ratings by an average of 1 to 1.5 points after blended learning. Ratings for all 10 items were significantly increased by 0.8 to 1.5 points after bedside learning than after blended learning.
In this study, ability acquisition was assessed by Mini-CEX and self-evaluation. Although self-evaluation is unreliable as an outcome evaluation, it is important as a process of reflection, leading to metacognition by learners. Participants were able to perceive an improvement in their abilities in seven items through blended learning. Further, we found that more integrated tasks such as medical ethics, the difference in roles between doctors and nurses, and interprofessional work were self-evaluated highly before blended learning, and that they were aware of the improvement in their abilities through bedside learning rather than blended learning. This is because awareness of integrative issues is greater during normal working hours and a more authentic learning environment is necessary to become aware of ability acquisition. In order to promote learning by blended learning, it is necessary to design programs that seek to enhance authenticity and clarify the role of bedside learning.