Developing nursing ethical competences online versus in the traditional classroom.

BACKGROUND: The development of society and science, especially medical science, gives rise to new moral and ethical challenges in healthcare. RESEARCH QUESTION/OBJECTIVES/HYPOTHESIS: In order to respond to the contemporary challenges that require autonomous decision-making in different work contexts, a pedagogical experiment was conducted to identify the readiness and responsiveness of current organisation of nursing higher education in Slovenia. It compared the successfulness of active learning methods online (experimental group) and in the traditional classroom (control group) and their impact on the ethical competences of nursing students. The hypothesis set in the experiment, hypothesis 1 (the experimental group will be successful and will have good achievements in comprehension and application of ethical principles) was confirmed based on pre-tests and post-tests. The hypothesis tested by the questionnaire, hypothesis 2 (according to the students, the active learning methods online in the experimental group have a positive impact on the development of ethical competences) was confirmed. RESEARCH DESIGN: The pedagogical experiment was supported by a multiple-case study that enabled the in-depth analysis of the students' attitudes towards the active learning methods in both settings. PARTICIPANTS AND RESEARCH CONTEXT: The study included Slovenian first-year nursing students (N = 211) of all the enrolled students (N = 225) at the University of Ljubljana and University of Primorska in the academic year 2010/2011. ETHICAL CONSIDERATIONS: Before the study ethical permission was obtained from the managements of both participating faculties. The students were given all the necessary information of the experiment before the tutorials. FINDINGS: No significant difference was found between the two learning settings and both had a positive impact upon learning. The results of the content analysis show that the students' active engagement with the active learning methods in the group enables the development of ethical competences and the related communicative competences, interpersonal skills, collaboration and critical thinking. DISCUSSION: Active learning methods in the settings compared, online and the traditional classroom, enabled the development of a higher level of knowledge defined by the ability of critical thinking and reflective response, the core of ethical competences. Students develop ethical competence through active engagement in a group work, role play and discussion, and there is no difference between online or traditional learning settings. CONCLUSION: In the healthcare, it is crucial for providers to be capable of making autonomous decisions and managing various communication situations and contexts in which the moral attitudes and ethical sensibility are essential.

An information communication technology based approach for the acquisition of critical thinking skills.

BACKGROUND: Both academics and practitioners agree that critical thinking skills are necessary to provide safe and comprehensive nursing care. In order to promote the development of critical thinking, nurse educators need to keep the teaching/learning process captivating and interesting using active learning environments. These can be implemented by using modern information and communication technologies that are simple, fun, and time and cost effective. OBJECTIVES: The goal of our study was to design and test an approach, which allows individual and fast acquisition of critical thinking skills with the use of information and communication technology. DESIGN: A combination of qualitative and quantitative research design was implemented. The study consisted of a quasi-experiment (phases 1-3): (1) pre-test discussion board, (2) use of e-contents based on the presented approach, and (3) post-test discussion board. The participants' opinion about the presented approach was identified in phase 4. SETTINGS: The study was performed in May 2012 during the course "Ethics and Philosophy in Nursing" at the Faculty of Health Sciences, University of Primorska, Slovenia. PARTICIPANTS: Forty first-year undergraduate nursing students. METHODS: Qualitative analysis of the discussion boards (phases 1, 3) and an anonymous survey with open- and closed-ended questions (phase 4). RESULTS: Qualitative analysis of the discussion boards showed a significant (p<0.001) improvement in the percentage of posts (12.2%) for which the opinions and conclusions of the participants were justified with valid arguments. The survey results indicated that participants perceived the e-contents based on the presented approach as useful, and that they improved their critical thinking skills. CONCLUSIONS: Repeated confirmation of the validity of the presented approach through methodological triangulation represents a strong indication that the presented approach is a valuable tool to develop nursing students' critical thinking skills.

The effect of voluntariness on the acceptance of e-learning by nursing students.

Although e-learning is an innovation that is worth making generally available, it is not always accepted by nursing students. Many researchers state that voluntariness is closely related to the individual level of adoption of innovations. Hence, we hypothesized that voluntariness moderates the effect of perceived attributes of innovations (e.g. relative advantage, compatibility, complexity, trialability, and observability), which determines the acceptance of e-learning. To test the hypothesis a survey involving two groups of nursing students was carried out. For the first group the usage of e-learning was mandatory, for the second group it was optional. The results confirm our hypothesis. Institutions, interested in e-learning initiatives, should consider the effect of voluntariness when implementing e-learning. This paper provides a useful reference that can help e-learning providers to develop guidelines that can improve the acceptance of e-learning.

Differentiating between rights-based and relational ethical approaches.

When forced treatment in mental health care is under consideration, two approaches guide clinicians in their actions: the dominant rights-based approach and the relational ethical approach. We hypothesized that nurses with bachelor's degrees differentiate better between the two approaches than nurses without a degree. To test this hypothesis a survey was performed in major Slovenian health institutions. We found that nurses emphasize the importance of ethics and personal values, but 55.4% of all the nurse participants confused the two approaches. The results confirmed our hypothesis and indicate the importance of nurses' formal education, especially when caring for patients with mental illness.