Department of Nursing, MacKay Junior College of Medicine, Nursing, and Management, ROC, No. 92, Shengjing Rd., Beitou Dist., Taipei 112, Taiwan.
Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, ROC, 365, Ming-Te Rd., Peitou District, Taipei 11219, Taiwan.
Nurse Educ Today. 2021 Jun;101:104870. doi: 10.1016/j.nedt.2021.104870. Epub 2021 Mar 20.
Tube dislodgment has been ranked as the top three medical accidents for five years consecutively in Taiwan. Chest tube care accidents affect patient's health and life significantly. Typically, education on chest tube care focuses on the knowledge transmission with limited guiding nursing students in learning clinical reasoning. The Generation Z students prefer mobile devices. It is crucial to incorporate mobile applications to learning.
The purpose of this study was to evaluate effectiveness of the teaching intervention program ("iLearning app for chest tube care") in improving nursing students' clinical reasoning ability and self-directed learning.
A quasi-experimental study with a cluster sample was used. A total of 107 nursing students were recruited with the intervention group (n = 53) using the "iLearning app" to learn chest tube care, and the comparison group (n = 54) using the "traditional teaching". Data were collected before the intervention, one week and one month after the intervention.
The result showed that there was no difference in clinical reasoning and self-directed learning between groups before the intervention. However, the intervention group showed significantly higher clinical reasoning and self-directed learning scores than the comparison group (p < .05) one week and one month after the intervention. It indicated that the students' clinical reasoning abilities and self-directed learning improved with implementation of the intervention.
The results indicated that the "iLearning app" intervention improved the clinical reasoning and self-directed learning in nursing students. This intervention used situated learning with concept mapping to guide student learning and demonstrated effectiveness in improving their clinical reasoning ability. Immediate feedback of the course instructor might trigger deeper learning and self-correction of clinical reasoning. The "iLearning app" could be used as a tool to improve students' clinical reasoning and self-directed learning, and thus enhance lifelong learning.
在台湾，管腔脱落已连续五年位居前三大医疗事故之列。胸管护理事故显著影响患者的健康和生活。通常，胸管护理教育侧重于知识传播，对指导护理学生学习临床推理的关注有限。Z 世代学生更喜欢移动设备。将移动应用程序纳入学习至关重要。
本研究旨在评估教学干预计划（“iLearning 胸管护理应用程序”）在提高护理学生临床推理能力和自主学习能力方面的效果。
采用准实验研究，采用整群抽样法，共招募 107 名护理学生，干预组（n=53）使用“iLearning 应用程序”学习胸管护理，对照组（n=54）使用“传统教学”。在干预前、干预后一周和一个月收集数据。
结果显示，干预前两组在临床推理和自主学习方面无差异。然而，干预组在干预后一周和一个月的临床推理和自主学习得分均显著高于对照组（p<.05）。这表明，学生的临床推理能力和自主学习能力随着干预的实施而提高。
结果表明，“iLearning 应用程序”干预提高了护理学生的临床推理和自主学习能力。该干预使用情境学习和概念图来指导学生学习，并证明在提高他们的临床推理能力方面是有效的。课程教师的即时反馈可能会引发更深入的学习和临床推理的自我纠正。“iLearning 应用程序”可作为提高学生临床推理和自主学习能力的工具，从而增强终身学习能力。
