Advancing mobile learning in Australian healthcare environments: nursing profession organisation perspectives and leadership challenges

BMC Nursing - Tập 17 - Trang 1-13 - 2018
Carey Ann Mather1, Elizabeth Anne Cummings2, Fred Gale3
1School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
2School of Health Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
3School of Social Sciences, College of Arts, Law and Education, University of Tasmania, Launceston, Australia

Tóm tắt

Access to, and use of, mobile or portable devices for learning at point of care within Australian healthcare environments is poorly governed. An absence of clear direction at systems, organisation and individual levels has created a mobile learning paradox, whereby although nurses understand the benefits of seeking and retrieving discipline or patient-related knowledge and information in real-time, mobile learning is not an explicitly sanctioned nursing activity. The purpose of this study was to understand the factors influencing mobile learning policy development from the perspective of professional nursing organisations. Individual semi-structured interviews were undertaken with representatives from professional nursing organisations in December 2016 and January 2017. Recruitment was by email and telephone. Qualitative analysis was conducted to identify the key themes latent in the transcribed data. Risk management, perceived use of mobile technology, connectivity to information and real-time access were key themes that emerged from the analysis, collectively identifying the complexity of innovating within an established paradigm. Despite understanding the benefits and risks associated with using mobile technology at point of care, nursing representatives were reluctant to exert agency and challenge traditional work patterns to alter the status quo. The themes highlighted the complexity of accessing and using mobile technology for informal learning and continuing professional development. Mobile learning cannot occur at point of care until the factors identified are addressed. Additionally, a reluctance by nurses within professional organisations to advance protocols to govern digital professionalism needs to be overcome. For mobile learning to be perceived as a legitimate nursing function requires a more wholistic approach to risk management that includes all stakeholders, at all levels. The goal should be to develop revised protocols that establish a better balance between the costs and benefits of access to information technology in real-time by nurses.

Tài liệu tham khảo

Mather C, Cummings E. Empowering learners: using a triad model to promote eHealth literacy and transform learning at point of care. Knowl Manag ELearn: Int J. 2015;7(4):629–45. Mather CA, Cummings E. Unveiling the mobile learning paradox. Stud Health Technol Inform. 2015;218:126–31. Mather C, Cummings E. Issues for deployment of Mobile learning by nurses in Australian healthcare settings. Stud Health Technol Inform. 2016;225:277–81. Mather C, Cummings E. Moving past exploration and adoption: considering priorities for implementing Mobile learning by nurses. Stud Health Technol Inform. 2017;241:63. Mather C, Cummings E, Allen P. Nurses' use of mobile devices to access information in health care environments in Australia: a survey of undergraduate students. JMIR mHealth and uHealth. 2013;2(4):e56 e. Nursing and Midwifery Board of Australia. Registered Nurse Standards for Practice 2016. [Available from: https://www.nursingmidwiferyboard.gov.au/news/2016-02-01-revised-standards.aspx]. Accessed 23 Jan 2018. Nursing and Midwifery Board of Australia. Code of Professional Boundaries 2013. [Available from: https://www.nursingmidwiferyboard.gov.au/news/2016-02-01-revised-standards.aspx]. Accessed 23 Jan 2018. Nursing and Midwifery Board of Australia. Code of Ethics Canberra 2013. [Available from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx]. Accessed 23 Jan 2018. Lluch M. Healthcare professionals’ organisational barriers to health information technologies—a literature review. Int J Med Inform. 2011;80(12):849–62. Mickan S, Tilson JK, Atherton H, Roberts NW, Heneghan C. Evidence of effectiveness of health care professionals using handheld computers: a scoping review of systematic reviews. J Med Internet Res. 2013;15(10):e212. O'Connor S, Andrews T. Mobile technology and its use in clinical nursing education: a literature review. J Nurs Educ. 2015;54(3):137–44. Raman J. Mobile technology in nursing education: where do we go from here? A review of the literature. Nurse Educ Today. 2015;35(5):663–72. Mather C, Cummings E. Modelling digital knowledge transfer: nurse supervisors transforming learning at point of care to advance nursing practice. Informatics. 2017;4(12):1–14. McBride D, LeVasseur SA, Li D. Nursing performance and mobile phone use: are nurses aware of their performance decrements? JMIR Hum Factors. 2015;2(1):e6. McBride DL, LeVasseur SA, Li D. Non-work-related use of personal mobile phones by hospital registered nurses. JMIR mHealth and uHealth. 2015;3(1):e3. Mather C, Gale F, Cummings E. Governing Mobile technology use for continuing professional development in the Australian nursing profession. BMC Nurs. 2017;16(1–11). https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-017-0212-8. Nursing and Midwifery Board of Australia. Guidelines for Continuing Professional Development 2016. [Available from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/codes-guidelines/guidelines-cpd.aspx]. Accessed 8 Dec 2017. Australian Nursing and Midwifery Accreditation Council. Australian Nursing and Midwifery Accreditation Council Registered Nurse Accreditation Standards: Australian Nursing and Midwifery Accreditation Council; 2012. [Available from: https://www.anmac.org.au/sites/default/files/documents/ANMAC_RN_Accreditation_Standards_2012.pdf. Accessed 8 Dec 2017. Australian Nursing and Midwifery Accreditation Council. Health informatics and health technology - an explanatory note 2014, : ANMAC; 2014. [Available from: https://www.anmac.org.au/sites/default/files/documents/20150130_Health_Informatics_Technology_Explanatory_Note.pdf. Accessed 8 Dec 2017. Green J. Nurses’ online behavior: lessons for the nursing profession. Contemp Nurse. 2017;53(3):355–67. Morgan R. Roy Morgan Image of Professions Survey 2016: Nurses still most highly regarded – followed by Doctors, Pharmacists & Engineers, Article 6797, 2016. Ferguson C. It's time for the nursing profession to leverage social media. J Adv Nurs. 2013;69(4):745–7. Health Workforce Australia. Nurses in Focus 2013. Adelaide: South Australia Health Workforce Australia; 2013. Cummings E, Shin EH, Mather C, Hovenga E. Embedding nursing informatics education into an Australian undergraduate nursing degree. Stud Health Technol Inform. 2016;225:329–33. Mather C, Cummings E. Mobile learning: a workforce development strategy for nurse supervisors. Stud Health Technol Inform. 2014;204:98–103. O'Connor S, Hubner U, Shaw T, Blake R, Ball M. Time for TIGER to ROAR! Technology informatics guiding education reform. Nurse Educ Today. 2017;58:78–81. Skiba DJ. Digital wisdom: a necessary faculty competency? Nurs Educ Perspect. 2010;31(4):251–3. Skiba DJ, Barton AJ. Adapting your teaching to accommodate the net generation of learners. Online J Issues Nurs. 2006;11(2):15. Brunetto Y, Farr-Wharton R, Shacklock K. Communication, training, well-being, and commitment across nurse generations. Nurs Outlook. 2012;60(1):7–15. Christopher SA, Fethney J, Chiarella M, Waters D. Factors influencing turnover in GenX nurses: results of an Australian survey. Collegian. 2018;25(2):217–25. Carroll CL, Bruno K. Social media and free open access medical education: the future of medical and nursing education? Am J Crit Care. 2016;25(1):93–6. Farr-Wharton R, Brunetto Y, Shacklock K. The impact of intuition and supervisor–nurse relationships on empowerment and affective commitment by generation. J Adv Nurs. 2012;68(6):1391–401. Senge PM. The fifth discipline. New York: Doubleday/Currency; 1990. Cader R, Campbell S, Watson D. Judging nursing information on the WWW: a theoretical understanding. J Adv Nurs. 2009;65(9):1916–25. Kim Y. Trust in health information websites: a systematic literature review on the antecedents of trust. Health informatics journal. 2016;22(2):355–69. Westbrook JI, Duffield C, Li L, Creswick NJ. How much time do nurses have for patients? A longitudinal study quantifying hospital nurses' patterns of task time distribution and interactions with health professionals. BMC Health Serv Res. 2011;11(1):319. Thorne S. Interpretive description: qualitative research for applied practice. Routledge; 2016. Creswell JW, Plano Clark VL, Gutmann ML, Hanson WE. Advanced mixed methods research designs. Handbook of mixed methods in social and behavioral research. 2003;209:240. Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory, 3rd ed. Los Angeles: Sage Publications; 2008. Elliott R, Timulak L. Descriptive and interpretive approaches to qualitative research. A handbook of research methods for clinical and. Health Psychol. 2005;1:147–59. Alshenqeeti H. Interviewing as a data collection method: a critical review. English Linguistics Research. 2014;3(1):39. https://doi.org/10.5430/elr.v3n1p39. Australian Government. National Health and Medical Research Council, Australian Research Council and Australian Vice-Chancellors’ Committee. National statement on ethical conduct in human research. Canberra: Australian Government; 2007. Fixsen DL, Naoom SF, Blase KA, Friedman RM. Implementation research: a synthesis of the literature. 2005. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, National Implementation Research Network; 2005. p. 125. Nursing and Midwifery Board of Australia. Professional Standards: NMBA; 2017. [Available from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx]. Accessed 23 Jan 2018. Australian Government. Australia's National Digital Health Strategy, Safe, seamless and secure: evolving health and care to meet the needs of modern Australia, Australian Digital Health Agency Executive Team Canberra, 2017. [Available from: https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board]. Accessed 8 Dec 2017. Australian Nursing and Midwifery Accreditation Council. Review of registered nurse accreditation standards consultation paper 1. Canberra: Australian nursing and midwifery accreditation council; 2017. Australian Nursing and Midwifery Accreditation Council. Review of registered nurse accreditation standards consultation paper 2. Canberra: Australian nursing and midwifery accreditation council; 2018. Mackay B, Anderson J, Harding T. Mobile technology in clinical teaching. Nurse Educ Pract. 2017;22:1–6. White J, Kirwan P, Lai K, Walton J, Ross S. ‘Have you seen what is on Facebook?‘the use of social networking software by healthcare professions students. BMJ Open. 2013;3(7):e003013. Mansfield SJ, Morrison SG, Stephens HO, Bonning MA, Wang S-H, Withers A, et al. Social media and the medical profession. Med J Aust. 2011;194(12):642–4. Jones C, Hayter M. Social media use by nurses and midwives: a ‘recipe for disaster’or a ‘force for good’? J Clin Nurs. 2013;22(11–12):1495–6. Wilson R, Ranse J, Cashin A, McNamara P. Nurses and twitter: the good, the bad, and the reluctant. Collegian. 2014;21(2):111–9. Lim VK, Chen DJ. Cyberloafing at the workplace: gain or drain on work? Behav Inf Technol. 2012;31(4):343–53. Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res. 2013;15(4). Alt D. Students’ wellbeing, fear of missing out, and social media engagement for leisure in higher education learning environments. Current Psychology. 2018;37(1):128–38. Risling T. Educating the nurses of 2025: technology trends of the next decade. Nurse Educ Pract. 2017;22:89–92. Roberts D, Williams A. The potential of mobile technology (# MoTech) to close the theory practice gap. Nurse Educ Today. 2017;53:26–8. Buresh B, Gordon S. From silence to voice: what nurses know and must communicate to the public. United States of America: Cornell University Press; 2006. May C, Sibley A, Hunt K. The nursing work of hospital-based clinical practice guideline implementation: an explanatory systematic review using normalisation process theory. Int J Nurs Stud. 2014;51(2):289–99. Australian Government. Australian Digital Health Agency Executive Team, 2017 [Available from: https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-executive. Horstmanshof L, Moore K. Understanding the needs of all the stakeholders: issues of training and preparation for health work students and their clinical educators. Asia-Pacific Journal of Cooperative Education. 2016;17(2):93–100. Moorley C, Chinn T. Using social media for continuous professional development. J Adv Nurs. 2015;71(4):713–7. Duke VJ, Anstey A, Carter S, Gosse N, Hutchens KM, Marsh JA. Social media in nurse education: utilization and E-professionalism. Nurse Educ Today. 2017;57:8–13. Australian Government. Australia's National Digital Health Strategy, safe, seamless and secure: evolving health and care to meet the needs of modern Australia. Canberra: ADHA; 2017. Huryk LA. Factors influencing nurses’ attitudes towards healthcare information technology. J Nurs Manag. 2010;18(5):606–12.