by Caitlyn Huddle RN Master of Nursing Student, Athabasca University

Abstract

Technology has been integrated into our healthcare system with continued advancement and modernization. The heightened use and rising implementation of technology within educational settings ensures students are adequately prepared for entering the workforce. Educational facilities have increased their technological equipment and are continuously integrating innovative teaching platforms. Nurse educators are provided with many forms of technology to advance learning and better support students for graduation. Technology has improved accessibility to learning for students in remote locations who may not be able to physically attend educational facilities. Modes of technology utilized within nursing education may include simulation learning, mobile phones, e-books, personal laptops or tablets such as iPads. The topic of technology is broad and poses some challenges; nevertheless, is an essential tool used in today’s learning environment. This article provides an informative and reflective overview of the benefits, concerns, yet optimistic and innovative prospects technology holds for the future of nursing education.

Keywords: learning, educational, facilities, healthcare, technology, nursing, educators, students

Introduction

Technology has become more popular as a medium for teaching and is imperative to today’s learning environment (Merrill, 2015). There are numerous modes of technology utilized in nursing education today, for example high- and low- fidelity simulation provides students with case-based scenarios and the opportunity to practice hands-on skills (Tosterud, Hedelin, & Hall-Lord, 2013). Technological advancements, such as e-learning, have been incorporated into many nursing programs, enabling students in remote locations to learn in a more cost-effective and accommodating manner (Sheikhaboumasoudi, Bagheri, Hosseini, Ashouri, & Elahi, 2018). Many educational facilities have concentrated on embracing educational delivery changes through reconstruction projects, budgetary amendments, and improving support to educators (Benjamin & Ostrow, 2008). The topic of technology is multifaceted and has brought many positive contributions to today’s nursing education. Thinking of the future generation of nursing students, it is imperative that as it continues to advance, technology does not supersede the importance of providing excellent patient care (Mahon, 2017).

This article explores the role of technology and its value to educational facilities, nurse educators, and nursing students. Further expansion on these areas will identify the benefits, concerns, and prospective outlook of technology. As the incorporation of technology into learning environments is inevitable, these impending advancements will be most impactful on the forthcoming generation of nursing students (Revell & McCurry, 2010). It is hoped that by reflecting on the various components of technology and its role within nursing education, ongoing support for educators and students alike will be provided.

Synopsis of Technological Use Within Educational Facilities

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Benefits of Utilizing Technology

There is great pressure on educational facilities to ensure that technology is properly introduced and integrated into learning environments (Gonen & Lev-Ari, 2016). Reflecting on the last decade, there is an evident increase and numerous enhancements made to the technology utilized within educational facilities (Damewood, 2016). Of significant change is the rise of web-based or e-learning modes for delivering education. The primary reason for this shift in education delivery is the need for increased accessibility and higher demand coming from students wanting to learn from their own home environments (Damewood, 2016).

Distance programming

The concept of electronic distance learning has been a major evolution for educational facilities (Sowan & Jenkins, 2013). With the ease of access to computers and internet for students and educators, this uptake has been an easy transition for most facilities (Sowan & Jenkins, 2013). By definition, distance programming involves using multiple modes of technology to deliver pre-developed course curriculum to students, who are not in physical contact with their educators (Griffiths, 2016). Programming can be taught via synchronous methods, including virtual chat or video streaming activities, or through asynchronous activities, such as posting to a forum or sending an e-mail (Sowan & Jenkins, 2013). Distance learning has also allowed students to participate on a part-time basis, which provides greater program flexibility, ultimately optimizing enrollment amongst the facilities (Griffiths, 2016).

Learn where you live

One example of integrating distance learning into curricula comes from the University of Saskatchewan, with the implementation of the nursing program Learn Where You Live in 2012 (Butler, Bullin, Bally, Tomtene, & Neuls, 2016). The goal of this program focused on better supporting the indigenous population, with set objectives aiming to satisfy demographical preferences of this community and reach individuals who cannot physically attend programs due to their isolated location (Butler et al., 2016). Students within the program were taught within their home environment and connected with educators virtually by means of online or telephone connections (Butler et al., 2016). Upon review of this project and once the initial group of participants had graduated, success was evident as the whole class received their registered nursing certifications (Butler et al., 2016). Criterion that determined program effectiveness included the provision of satisfactory education in a remote method and most impactfully improved northern health care (Butler et al., 2016). Beyond simply a means to learning, distance education supports social equality, as it provides the same access to education for all (Smith, 2008).

Web streaming

Another positive technological contribution is the use of web-based streaming and real-time TV interactions employed through educational programming (Smith, 2008). This method of technology allows educational facilities to increase their outreach to a larger number of scholars, while avoiding physically changing their structure. It also ensures that students feel connected and build valuable relationships with one another (Smith, 2008). Overall, students support this type of technology use since it connects them with their educators, strengthens feelings of caring, and emulates being present without physically attending lectures (Smith, 2008).

Simulation learning

Simulation learning is another trending technological mode utilized within educational programming (Damewood, 2016). Whether it is high- or low- fidelity simulation, either approach presents students with more hands-on practice, allows them to mimic case situations, and further develops nursing expertise in an environment that is out of harm’s way (Tosterud et al., 2013). High-fidelity simulation involves mannequins that replicate human systems and includes features such as respiratory, cardiac, and verbal tones (Przybyl, Androwich, & Evans, 2015). Software is provided with each mannequin to deliver realistic case situations, which can be altered depending on desired learning outcomes (Przbyl et al., 2015). Low-fidelity simulation is more simplistic; this form involves a torso to practice cardiopulmonary respirations, or an arm for inserting an intravenous needle (Przbyl et al., 2015). By practicing various nursing skills within educational settings, students can offer one another suggestions and reconsider approaches to previously practiced case scenarios (Berragan, 2014). The use of simulation has become more prevalent, is sought-after, and is now well accredited among numerous nursing programs (Sanko, 2017). While the equipment may have initially been quite costly, over time it has become more reasonably priced, further supporting the integration and operation of simulation by educational facilities (Sanko, 2017).

Concerns Associated with Utilizing Technology

As technology use has grown amongst nursing educators and their student body, educational facilities have experienced concerns with its’ increased implementation and operation. Hurdles that have arisen are largely due to the greater work pressure reported by staff, along with increased monetary strains experienced amongst several educational facilities (Damewood, 2016).

Burden on staff

Damewood (2016) noted that with increased use of technology it is essential that educational facilities have adequate repair and support personnel to attend to the increased maintenance, operational, and reparation work resulting from the various equipment. While in the past these employees may have only been accountable for fixing computers, they are now in charge of all related technology that comes along with incorporating new equipment (Damewood, 2016). Outside of routine repair work, educational facilities must uphold predetermined criteria, which necessitates that these employees are adequately trained to operate and maintain various technologies (Dudding & Nottingham, 2018).

Financial pressure

As educational facilities consider implementing or advancing technology, varying expenses may occur depending on the type of equipment to be incorporated (Dudding & Nottingham, 2018). Even if these fees are now more manageable, many organizations still recognize these escalated prices to be an ongoing barrier (Benjamin & Ostrow, 2008). Factors such as continuous repairs, equipment renovations or replacing broken parts pose added economic stress, which could ultimately require facilities to increase tuition rates; not lightening the stressful monetary expenses already felt by the students (Benjamin & Ostrow, 2008). These obstacles noted are currently inevitable and will remain present with the prolonged use of technology amongst educational facilities.

Prospective Technological Use

The prospective use of technology within educational facilities is full of opportunity and new modernized approaches (Glauser, 2017). Many educational facilities seek partnerships with global institutes to expand current technologies, improve schooling, and deliver an enhanced learning setting for future students (Goldsworthy, 2012). Regardless of the way students are taught or how technology is integrated into lessons, the use of technology within educational facilities is vast (Goldsworthy, 2012).

Gaming

One future prospect for technology is the possibility of employing gaming activities within nursing curricula. Gaming in health care settings has become increasingly popular as it holds the interest of students and is a fun approach to learning (Ferguson, Davidson, Scott, Jackson, & Hickman, 2015). The gaming platform itself may be used on personal technological devices such as a cell phone or tablet, providing students with the ability to configure as well as control patient variables (Ferguson et al., 2015). For instance, the game may mimic a reality-based scenario where the student is giving patients their medications (Glauser, 2017; Ferguson et al., 2015). If a step was missed or mistake was noted the game would alert the student immediately, and offer constructive feedback (Glauser, 2017). Glauser (2017) noted the game would have different levels for students to advance to, and most importantly would allow for learning wherever whenever.

Social Networking

The expression Free Open Access Medical Education (FOAM) is another major development and pertains to the utilization of social networks (Carroll, Bruno, & vonTschudi, 2016). FOAM is described as an online network for students to operate and associate with each other via web apps including Twitter, blogs, or YouTube. Social networking is being increasingly accepted as a beneficial tool for learning and many educational facilities are supporting its rising popularity (Carroll et al., 2016). Some encouraging elements that support the ongoing implementation of FOAM include affordability, as several social networking apps come without a fee, open accessibility for students and educators, and simplicity of implementation within facilities (Carroll et al., 2016).

One disadvantage to FOAM involves the merit of material, as there is a limit to what can be monitored online by facilities, as they hold restricted power in controlling web discussions and deliberations (Carroll et al., 2016). The topic of social networking is popular, and with further progression of technologies and applications, ongoing execution for this means of learning is inevitable (Carroll et al., 2016).

Synopsis of Technological Use by Nursing Educators

Benefits of Utilizing Technology

Present day classroom settings include a higher percentage of students to educators and lessons that are held in large rooms, which is often daunting for many individuals (Revell & McCurry, 2010). Technology has been incorporated into the classroom to help overcome these barriers, as well as better support the relationship between educators and students (Revell & McCurry, 2010). The Canadian Association of Schools of Nursing have made it a requirement that nurse educators teach their students about the foundations and ability to properly utilize technology prior to graduating (Canadian Association of Schools of Nursing and Canada Health Infoway [CASN/CHI], 2012). This is to certify that all students have developed the same level of understanding for operating technology, while it also ensures graduates are able to work knowledgeably and safely in diverse healthcare settings (CASN/CHI, 2012).

Incorporating technology successfully

Nurse educators are viewed as important by their students, as they are role models and ultimately mould the future generation of nurses. It is important that educators are accepting and competent when operating technology. This ensures students maximize their learning experiences and properly employ technology themselves. To support the incorporation of technology within their teachings, educators should be provided with a constructive work environment, helpful information and technology staff, and remain inventive with their teachings. Altogether, these undertakings will help improve their acceptance and support ongoing technology use (Gonen & Lev-Ari, 2016).

The norm of education

Technology has provided nurse educators with the opportunity to further develop lessons, associate with more students, incorporate new modalities into their lessons, and is now recognized as the norm of education (Jones & Wolf, 2010). Kuhn (2017) identified that despite previous hurdles, nurse educators are open to including innovative technologies within their courses. Most educators acknowledge these tools to enhance existing approaches and support the growing demands from their students. This openness has resulted in technological use to prosper by nurse educators and allowed them to appreciate how technology further advances opportunities for current and forthcoming students (Kuhn, 2017). Present day technology use is valuable, enhances teaching opportunities, and its continued use will further support current and future nurse educators.

Concerns associated with Utilizing Technology

Technology has brought about many benefits and enhances the role of a nurse educator, yet there are evident challenges associated with integrating technology. World-wide there is an insufficient number of accessible educators and those that are qualified identify concerns with regards to professional development activities in relation to technology use (Oprescu, McAllister, Duncan, & Jones, 2017). It is expected that educators are equipped with a basic knowledge and understanding for operating technology, but most are not experts in using computers nor do they possess technological proficiency (Rajalahti, Heinonen, & Saranto, 2014). Many educators identify technology as a source of hindrance, and simply lack time to learn how to properly utilize it to its full potential (Oprescu et al., 2017).

Technology stressors

Realities of today’s working environment for nurse educators include increasing workloads and rising apprehension, since it is an expectation that technology is incorporated into their lessons (Burke, 2009). While the term technostress was primarily recognized around 1980, it is a prevalent feeling amongst many nurse educators (Burke, 2009). Technostress is defined as sensations of worry and apprehension due to the general incorporation or operation of technology during a lesson, as well as regular duties involved with being an educator (Tacy, Northam, & Wieck, 2016). Educators frequently express being weighed down by having to respond to many modes of technology, for instance checking e-mail while also leading an online lesson. There is an evident overabundance of technology, which has subsequently led to a decreased desire to use technology and declining job satisfaction (Tacy et al., 2016). Educators note that technology can be tiresome and often creates the most amount of pressure within their role (Burke, 2009). Evidently, technology is a topic that requires attention for faculty, as educational facilities are faced with a dwindling quantity of qualified educators (Revell & McCurry, 2010).

Connecting to students

Another common barrier reported by nursing educators pertains to their interactions with students and satisfying all unique requests. Reaching all students is not straightforward, as they have a range of learning requirements and past technological experience (Bowen et al., 2010). Educators note that it is an ongoing struggle to adjust and establish improved approaches for incorporating technology, while also trying to connect with their students. Nursing educators are also of varying generations, differing in past skills, and bring forth many different areas of expertise and know-how (Rajalahti et al., 2014). There is an expectation for nurse educators to possess a similar understanding and ability to operate various modes of technology, similarly to their often-younger students; consequentially these differences have resulted in noteworthy predicaments. As nurse educators continue to utilize technology, a baseline education must be offered to ensure they are able to operate and integrate it successfully. Doing so would not only overcome obstacles, but also enhance future job performance, as technology is projected to remain an integral element for nurse educators.

Prospective Technological Use

Once a novelty, hand-held devices have now become customary tools amongst educators and are rarely viewed as a newer mode of technology (Risling, 2017). Technology has brought forth many incredible and inventive ways in which educators teach their students, and it is forecasted that the next decade will be full of even more novel technological platforms. One newer mode of technology predicted to surface within nursing curricula includes more practice with Electronic Medical Records equipment, and nurse educators must support students with the trial and errors these tools may bring. The notion of wearable technology, such as sleep monitoring or caloric counting devices, are other novel tools that educators may wish to incorporate within their lessons, as upcoming student cohorts become the future workforce employing these tools in their daily practice (Risling, 2017).

The resetting process

A prospective notion for technology use includes nursing educators offering their students options as to what technology is incorporated into lessons (Bassendowski & Petrucka, 2016). This notion has been identified as the resetting process and is based on the thought that providing choices and letting students decide upon the means of learning enhances resourcefulness and innovation. To ensure this continued uptake of technology, it is important that educators remain encouraging and confident when employing various technologies within program courses. Additionally, educational facilities can support this notion by providing ample numbers of information technology personnel, deliver enough training sessions, and envision technology as being beneficial to students (Gonen & Lev-Ari, 2016).

Many nursing experts are persuading recent graduates to become nurse educators themselves, as they believe this role to be well recognized during this technological revolution (Risling, 2017). Nurse educators must continue to support the future generation of nursing students and ensure they develop the same knowledge, competence, and abilities to utilize technology to its full capacity. While taking these points into consideration, it is evident that the future use of technology for nurse educators is broad, continuously growing, and an encouraging improvement to the current approaches to teaching.

Synopsis of Nursing Students Technological Use

Benefits of Utilizing Technology

Nurses are expected to have basic competence to incorporate technology within their practice, as technology supports optimal decision making and critical thought processing (Kaur & Rawat, 2015). Having pre-exposure and an opportunity to practice operating technology prior to entering the workforce ensures professional development needs are met. Many modes of technology are incorporated into today’s nursing education outside the traditional use of computers, including e-books, video conferencing, simulation, and mobile devices (Bristol, 2019; Tutticci, Ryan, Coyer, & Lewis, 2018). Having direct access to technology allows nursing students to research questions as they encounter various problems during clinical practice, which supports learning needs and reduces errors (Iverson et al., 2016).

Fortify optimistic feelings

Technology has impacted students by enhancing feelings of humanity and understanding, in addition to bettering relations among students and teachers (Smith, 2008). By implementing technology, students have the chance to study in an environment that is equal in opportunity, improves self-awareness, supports better understanding of educational subject matter, and promotes a virtual being. Nursing students have profited significantly since technology has been incorporated into their programs (Kaur & Rawat, 2015). Technology provides an opportunity to practice simulated scenarios, boosts their capability for operating electronic charting, and replicates the realities of their future work setting.

Accessibility

A second characteristic technology has improved upon is accessibility, as students in remote areas can engage in educational opportunities without changing their geographical location (Butler et al., 2016).  Physically attending university level programs typically involves high travel and moving expenses, which may be major barriers. Contemporary technology provides students worldwide with the chance to study and interact virtually, and without these technological enhancements, learning might not have been an option.  

Concerns Associated with Utilizing Technology 

Seeing that technology is incorporated into nearly all nursing education, this change has resulted in unavoidable concerns. The emotion of caring is a key value intrinsic to nursing, and the use of technology has created a loss of individual bonds impacting student’s ability to care (Jelec, Sukalic, & Friganocic, 2016). Recent nurse graduates are most commonly impacted by this, as they have a substantial exposure to technology in their learning environment, instead of practicing in a clinical setting with actual patients. As the amount of technology increases, it is essential that students continue to understand the value of empathy and caring.

mLearning

A concept that has been around since the 1970’s is mobile learning, (mLearning), defined as accessing subject matter through mobile devices (Garrett, Jackson, & Wilson, 2015). Present-day use of mLearning allows students to utilize their own devices, such as a mobile phone, tablet, or laptop for educational purposes, which enhances accessibility and makes learning more accommodating (Garrett et al., 2015; Pereira & Rodrigues, 2013). Students have noted some downsides since this technological initiation, including reduced display dimensions, unreliable battery, more diversion from other applications, and system delays (Pereira & Rodrigues, 2013). To add to this, technical problems such as slower uploading of videos or difficulty accessing materials has caused many frustrations, thus interfering with the students’ ability to learn (Garrett et al., 2015). While mLearning is merely a singular representation of technology used within nursing schools, the prime message is that these barriers could be applicable to many different technological modalities. As faculty continue to incorporate many different modes of technology, there are unavoidable problems and obstacles that students will have to overcome.

Prospective Technological Use

The forthcoming generation of students are often recognized differently than past generations. Not only do they present themselves as being privileged, but they have a major affinity and attachment to technology (Erlam, 2014). It has been acknowledged that technology is an essential component to learning, better prepares students, and ensures students can operate effectively within their future working environment (Skiba, 2010). As a great variety of learning modalities, equipment, and web-based applications are being continuously developed, the possibilities remain limitless for the ongoing advancement and prospective application creation (Au-Yong-Oliveira et al., 2017).

Millennial generation

Current students are referred to as millennials, and it is forecasted that they will enter educational settings with an increased abundance of technology (Au-Yong-Oliveira et al., 2017). Not only will they have greater exposure and accessibility to technology, but many educational facilities and health care settings forecast their environments to be entirely web-based (Skiba, 2010). Ongoing evolvement of already utilized technological modes, such as mobile devices and tablets will be continuously integrated into programming which will further equip graduates to care for patients with more chronic conditions. With the flexibility that simulation learning provides, scenarios can be adjusted to meet the changing requirements of the health care system and reduce the inconveniences that clinical placements may create (Erlam, 2017). The future cohorts of nursing students will have greater access to advanced methods of learning, complete with diverse technical modalities.

Artificial intelligence

Glauser (2017) identified that robotics are an innovative technology being introduced to the health care industry which will have an impact on prospective nursing students. A robot equipped with artificial intelligence has been trialed to connect with seniors in assisted living homes and help monitor symptoms alongside nurses, as well as note possible indications of dementia. As technology such as this is being continuously developed, students will play a role in its’ creation and uptake within healthcare environments. Students will also be required to provide critical evaluations of these novel technologies, as robotics will ultimately impact future responsibilities and role requirements of a nurse (Glauser, 2017).

Conclusion

Technology provides endless opportunities for growth and evolvement within nursing education (Sanko, 2017). This includes the expansion of distance learning into educational facilities, nursing educators incorporating more technology in their teaching, or nursing students operating new technological modes. The topic of technology is broad and there are many new innovative modes to explore. Technology is recognized as a key component and is intrinsic to providing excellent patient care, reinforcing its importance within nursing education (Archibald & Barnard, 2018). Reflecting on the prospective use of technology, it is imperative that it remains effective, accessible, and satisfies the demands of the future generation of nursing faculty and students (Dudding & Nottingham, 2018).

Author Bio

Caitlyn Huddle is a RN and is currently working in an occupational-health role with WellPoint. Past experience includes public health, mental health, and community positions. She graduated from the University of Ottawa in 2011, and shortly after began her Master of Nursing with Athabasca University. Future pursuits include expanding on occupational health nursing.

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