December 28, 2006: 3:37 pm: Conference - general, Miscellaneous

This blog is now ‘frozen’ and will not be further updated. Due to moving to a new hosting provider, some of the ‘bells and whistles’ we used are no longer available – but we will add them, and more, for the Rutgers2007 25th anniversary conference blog.

The 25th anniversary event – the Annual International Nursing Computer and technology Conference, organised and presented by the Rutgers College of Nursing Center for Professional Development – will take place on June 14-17, 2007 at the San Francisco Marriott.

Watch out for the Rutgers2007 blog site and other exciting developments.

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May 28, 2006: 2:16 pm: Saturday activities, Social events

On Saturday, many of the confernece particpants attendeed the traditional networking dinner event. This year, we had a cruise on Lake Ontario, which provieded a good opportunity for photos of the Toronto skyline and the sunset.

Margaret Maag provided champagne to celebrate her birthday.

Toronto

Toronto

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: 2:08 pm: Conference - general, Sunday activities

Ann Henderson and Alison Merrill, from the University of Northern Colorado School of Nursing, today (Sunday) gave an introduction to podcasting and its use within education. They began by describing the basic nature of podcasts, describes mp3 files and the kinds of players available for mp3 files.

They described some of the reasons for using podcasts within the School; they felt it would be a useful way to give information to students, as most students have computers and some kind of mp3 player, or iPod. Simplicity of the solution was a rationale behind using podcasts – users can listen to what they want, where and when they want. They then moved on to cover some of the basics of creating podcasts, including not only the technical aspects, but also issues such as the educational objectives, tone and structure of the files, including the use of scripts and the need to break the materials to be covered into smaller files.

The presenters did a small pilot study to see if the students were accepting the podcasts and whether it was effective as a teaching strategy. A survey was developed to assess student satisfaction, the effect of different degrees of technical experience among students, and the number of times the podcasts were used by the students. Two content-driven podcasts were developed specifically for the study. The study is based in sensory stimulation theory, which suggests that in adults, 75% of knewledge is held by adults when learned through seeing, and 13% through hearing. A group of 72 students were invited, but only 20 participated; 8 listened exclusively through mp3 players or iPods, and 10 listened just through their computers. 45% of the 20 students felt the podcast was helpful to their course content, while 70% found them interesting and enjoyable, and 80% would like to see more podcasting used in classes. A comparison on scores for students on the exams to which the podcast content related showed no real differences between the groups using the podcasts and those not using them, but the study numbers were very low and this was an early pilot to explore the possibilities.

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May 27, 2006: 8:57 pm: Conference - general, Saturday activities

Carolyn Fong, from California State University, presented a session on ‘Support and learning from online clinical journals’, describing a pilot project with nursing students. The context was the problem of students being tired after long shifts and being unhappy about having to share their learning experiences and reflect on their clinical activities in group discussions after their shifts. The project aimed to evaluate whether online clinical journalling could help students to reflect and learn. Nineteen students, split into smaller groups of 4-5, submitted clinical journals to Blackboard LMS and interacted at the end of each clinical day.

Students in the project found that reflecting on learning outcomes was a cathartic experience, that they reviewed textbooks based in issues that arose from their reading of their peers’ journals, and they expanded on theoretical concepts in explaining the care of their patients. Initially, students were reluctant to share mistakes made in clinical settings, but began to share experiences and problems once they got to know each other.

The students found that this type of online journalling and sharing was accessible and convenient, and a good way to connect with colleagues without significant extra time commitment (eg travelling to face-to-face meetings). Some suggested that they would have liked more immediate feedback than was received or they would get in face-to-face meetings, while others found the reading of other comments was time consuming.

Carolyn found that her students learned through teaching one another in their journals, and that they socially supported one another in their mistakes and triumphs.

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: 8:56 pm: Conference - general, Saturday activities

Dr Diane Duff and Dr Mina Singh, both of the University of York, Toronto, Canada introduced the partners in the project, which include local health and community service providers for homecare patients, as well as local hospitals that refer patients due for discharge. The telehomecare equipment includes provider and patient workstations with video cameras. The project is a video-based programme for patients with chronic illnesses that aims to improve health outcomes. The project collects research data on the patient experiences, including quality of life surveys.

The project has 120 patients in total over the 3 years, with over 3100 ‘visits’ (of which 80% are telehomecare visits, and a few tlephone visits and a few physical home visits); patients have been aged from 28 to 98 years, with an average age of 70 years. 32% live alone, and most patients have a primary diagnosis of COPD, and many have multiple health problems.

Qualitative research, based in in-depth interviews with patients and care providers, have been used to explore the patient experiences. The main theme that emerged was that telehomecare helped them live with confidence in their homes with their illnesses. Four phases were identified, moving from making an initial connection between patient and care provider, then a focus on vital signs, before moving into understanding the illness and finally patients taking control of their situations and becoming proactive. 78% of the participants felt that it was just as easy to communicate with health care providers as is face-to-face communication, although 45% also noted some technical problems with the equipment.

The nurses who acted as telehomecare providers were positive about the project, seeing patients as becoming empowered, and the service as being convenient and time-saving, and having positive effects on patients’ health.

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: 6:21 pm: Conference - general, Saturday activities

Scott Erdley and Margaret Maag took the opportunity to conduct three brief participant interviews at the Rutgers 2006 conference in Toronto. Oral consent was obtained from each interview participant. Listen for some emerging themes! More to follow! Thank you participants for taking a moment to share your ideas!

The vodcast can be accessed from the following url:http://www.maagnursing.com/mp3personal/rutgers06 vcast2.mov

Note that if you have Quicktime plug-in you will be able to see this live in your browser – otherwise you will need to save the file to disk and then view it.

Stay tuned for interviews from NI2006 (Seoul, Korea) in a few weeks! Please submit some questions for us to ask of participants attending the NI2006 conference by commenting on this blog spot.

Cheers, Scott and Margaret

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: 3:28 pm: Conference - general, Miscellaneous

Some members of the hi-blogs.info ‘crew’ who are responsible for this blog and for creating the podcasts and other files:

blogcrew01.jpg

From left to right – Peter Murray, Bill Perry, Scott Erdley and Margaret Maag.

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: 3:16 pm: Conference - general, Saturday activities

A full room of people turned up to hear Bill Perry talk about using mp3 files within developing learning. Bill started by describing mp3 files and th4e many ways in which they can be accessed, inlcuding direct access over the Internet and being burned to CD or played on mp3 players. He says that one of the advantages of mp3 files is their small size, but still with good quality.

He asked why we might wish to create mp3 files and referenced Marc Prensky’s (www.marcprensky.com) work on digital natives and the nature of use of different media by today’s young people. Today’s students seem to be audio-oriented, and spend much less time reading – so one of the advantages is portability of the mp3 files. Many people are using mp3 files, including education, business and government; Bill demonstrated some of the work he has done with Nursing Spectrum on creating mp3 files for creating continuing education materials (nursingspectrum.netstation.us). Users can play the files online or download them to mp3 player.

For creating mp3 files, one needs some content appropriate for audio, a microphone and recorder, and suitable software, such as Audacity to record and manipulate the recording to mp3 files. He discussed the differing nature of file size and quality, and issues of download times that may influence students’ ability to access materials, with CD quality files being around 4 times as large as AM radio quality.

Bill moves on to creating podcasts. A podcast as different from a posted mp3 file in that one can subscribe via RSS files to a resource and download new content automatically. RSS file subscriptions can be automatic via an aggregator or by copying the RSS file into a feed reader. He discussed a range of ways to access feeds, including iTunes, Juice (open source, formerly called iPodder), GoogleReader, and others.

In looking to integrating audio into continuing education, Bill suggests the use of a combination approach that features the audio version, some text readings, supplemental websites, illustrations, etc., and some online testing or other means of validating the learning.

In relation to some of the issues on developing mp3 files for continuing education, Bill suggests that small file size can be an advantage (perhaps by chunking a larger file into smaller segments), especially if nurses do not have time to listen to all of a larger file at once.

The session generated a lot of interest among the audience, with many questions about practical elements of developing and using mp3 files.

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: 3:12 pm: Conference - general, Saturday activities

Wendy Nehring, Associate Dean for Academic Affairs at Rutgers The State University of New Jersey’s School of Nursing, gave the day’s opening keynote presentation on ‘The state of the art of the use of simulation’. Her talk was focused on high-fidelity patient simulation, covering the rationale for proliferation of its use in nursing and other healthcare disciplines, the paradigm changes in nursing education, opportunities for professional development and the related research literature, before closing in looking at some future directions.

Part of the impetus is Institute of Medicine publications focusing on patient safety, in conjunction with technological advances influencing healthcare, such as pharmacogenetics, treatment options including robotics, telemedicine and advances in assessment technology. Much of the work on these developments has been lead by work from the military, such as PDA-based monitors (as per Star Trek) for monitoring patients and underwater telemedicine.

Education changes such as the knowledge explosion, choices in what to teach from the plethora available, the faculty shortage, decreasing numbers of clinical sites and the costs of using clinical sites, the need for students to develop clinical thinking and assessment skills all have an impact. Students need to be fit to practice in wireless, paperless hospitals, and to be able to develop active learning techniques within multidisciplinary group learning.

High fidelity patient simulation can address areas such as increased patient acuity and problems of students being able to access real patients within real clinical environments. The nursing literature has shown for several years the advantages and disadvantages of using simulators (often from within critical care courses, such as nurse anaesthesia), in how critical thinking can be increased within critical incidents, and the role of debriefing following on from the use of simulations on performance and student feelings about the experiences.

There is now a journal titled ‘Simulation in Healthcare’ and new organisations are emerging for people working in the field. In recent years, several US nursing organisations have suggested the need to explore simulations and virtual reality within clinical education. A recent survey of Boards of Nursing in the US states (Nehring, 2006) showed that a only small number of states (5, plus Puerto Rico) have made changes to regulations for the percentage of clinical time that can be spent with simulations. 16 states give permission for use of simulators within clinical hours, while in many others, regulations are silent on the issues, thus probably leaving the door open for potential use of simulators and other technology.

A range of simulations exist, including full-body, low-tech mannequins, task trainers, role playing and standardised patients, computer patient models, and high-fidelity patient simulators. Research into simulation as a teaching strategy and in knowledge acquisition have shown positive benefits to learning and retention of knowledge from simulations. Nehring suggests a model and new strategies are needed for research into the field, perhaps with a focus on patient safety.

In looking at future directions, she suggests that patient simulation will be increasingly used throughout all levels of nursing education, there will be standardised clinical evaluation, further development of standardised scenario development, and videostreaming on the Internet for virtual learning and debriefing.

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: 11:32 am: Conference - general, Saturday activities

Today provides a packed programme of events from the conference. Starting at 8:00am with exhibits and poster sessions, the formal part of the day will open with a keynote speech on the use of simulation from Wendy Nehring from Rutgers. Several sessions of simultaneous papers throughout the day will cover issues such as critical thinking in web-based courses, anytime/anywhere learning using mp3 files, use of PDAs for learning, the Toronto telehomecare project, blogs as online clinical journals – and much more. The closing keynote of the day is Joyce Sensemeier from HIMSS. The day closes with a networking dinner cruis on Lake Ontario.

Oh, and for the eagle-eyed ones out there – yes, my computer clock is still set to UK time, which is why some of the posts seem to be from the future ;-))

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