Student Nurses Use of ICT by leader6


									  Conditions for the
development of student
nurses’ ICT capabilities
      Marian Willmer
                  Why ?
• Student nurses largest in number –
  frequency and number of ICT sessions
  and number of students in each group
  presenting particular ‘teaching’ challenges
• Own reflection and exploration of how to
  develop ICT teaching
• EdD presented opportunity to investigate
  and explore pedagogy involved
•   To contribute to the understanding of the
    use of ICT in one NHS Trust by providing
    a critical view of current ICT practice by
    ‘adult branch’ student nurses.
•   To critically examine the pedagogic and
    practical need for ICT in ‘adult branch’
    pre-registration nurse education.
                 The Literature
• We are in an era when information technology (IT) is
  being harnessed throughout society (Radovan 2001).
• The current Government has recognised (DoH,
  1997,1998, 2001) that appropriate use of information
  and technology is essential if the NHS is to be effective.
• The NHS needs to become part of the ‘information age’.
  The term ‘information age’ is characterised by
      ‘vast increases in knowledge, greatly improved
  access to that knowledge, and the widespread
  application of that knowledge in industrial and
  community contexts’ (George and Luke 1995, 3).
      The Literature continued
    Not only do nurses and educators therefore
    need to be competent in the use of ICT in order
    to become ‘information literate’, the 'real literacy
    of tomorrow' entails:
        ‘the ability to be your own personal reference
        librarian - to know how to navigate through
        confusing, complex information spaces and
        feel comfortable doing so’.
It is recognised that
        ‘technology will play an increasingly
        important role in the future development of
        health care’ (Rosow and Grimes 2003, 307).
“The bigger challenge is to learn
how to use new technology
well…..having the new systems is
just the start of a process of
                            (DOH 2005, 32)

DoH (2005) Creating a patient-led NHS: delivering the NHS
Improvement Plan. DH Publications.
        Research Questions
•   How does the nursing practice
    environment affect student nurses’ usage
    of ICT?
•   How do mentors influence student
    nurses’ engagement with the use of ICT?
•   How are ‘adult branch’ student nurses
    learning ICT in the nursing placement?
Case study methodology - the case
is ‘student nurses’ use of ICT’ the
context is ‘adult nursing practice’
       When, where and who?
• Data gathering took place in 2004
• Currently writing-up

• One local acute services NHS Trust

• Six student nurse volunteers; four mentors in
  practice; ‘significant others’ e.g. Information
  manager, R&D manager; observational visits;
  and nursing strategy document
What was found?

           Hard Factors                            Soft Factors
 Number and position of computer                    Support (d)
         terminals (e)
   What accessed and used (i, j)                Others’ ICT skills (g)
Time when used or difficult to use (f)          Others’ attitudes (h)
       Security/passwords (k)                      Confidence (a)
     Reliability of equipment (l)        Ways of learning (b) and ownership
                                            of teaching and learning (c)
• The findings indicated that student nurses’
  approach to their learning of ICT had a
  number of facets indicating that the
  instrumental approach to teaching was
  only an initial trigger for what was required
  with regard to ICT.
          Back to the literature
•   Management Map
•   CoP
•   Information ecologies
•   Digital Bricoleur
  Information, Communication and
         Technology (ICT)
• IT is not just a new tool with which to do
  traditional tasks
• It changes the way people perceive their
  world and introduces new dilemmas in
  terms of information for decision making
          Management Map
        (Knight and Silk 1990)
• Provides an over-arching framework that
  guided the overall approach to the
  literature review
• Seeks to link the individual student nurse
  and her role context within education and
  clinical practice, to the overall strategic
  environment driving her support systems
  and how these interact to affect her
  behaviour and attitudes.
• Wenger argues a ‘practice’ is
  ‘in order to be able their job and have a
  satisfying experience at work. It is doing
  in an historical and social context that
  gives structure and meaning to what we
  do.’ (Wenger 1998, 47).
• Lave and Wenger (1991, 101-103) explained
  that becoming a 'full participant' in the CoP
  includes engaging with 'technologies of
  everyday practice'. They used the concept of
  ''fields of transparency" to understand how
  technology becomes useful within the CoP.
• 'transparency of technology always exists with
  respect to some purpose and is intricately tied to
  the cultural practice and social organisation
  within which the technology is meant to function'.
         Information ecology
       (Nardi and O’Day 1999)
An information ecology is:
 'a system of people, practices, values, and
 technologies in a particular local
 environment….the spotlight is on human
 activities that are served by technology'
 (Nardi and O'Day 1999, 49)
      Locality of technology
The locality of the technology, which for Nardi
and O'Day (1999, 54-55) is the key to becoming
'active participant in technological change
as….only the participants of an information
ecology can establish the identity and place of
the technologies that are found there….. As
users of tools, we are responsible for integrating
them into settings of use in such a way that they
make sense for us'.
             Digital bricoleur
           (Seely Brown 2002).
• In the future, when today's young become adult,
  a different learning ecology will have evolved
• Today's young people tend to 'multiprocess' -
  'they listen to music, talk on the phone, use the
  computer, all at the same time' (Seely Brown
  2002, 4).
• This together with four sets of dimensions
  (finding, building, judgement and action) may
  form a new way of creating knowledge. With
  'information navigation' comes 'discovery-based
• Fostering of personal knowledge and
  development of ICT capability.
• Integrate ICT into curriculum
• Range of both practical ICT skills
  development sessions and information
  management sessions
• Explicit links between the use of ICT as a
  tool and module content
• Be summatively assessed.
  Where do we need/want to be with
       studentcentral VLE?
  Integrating the continual learning of ICT
  through informal, incidental and formal
  learning, we can not only become
  competent with ICT, but we can develop
  ICT capability:
  “the integration of ICT knowledge, skills and
  attitudes, used appropriately and effectively, in
  response to new and changing contexts, tools
  and methods for leveraging knowledge for
(my definition from the adaptation of Stephenson 1992 and PÓr 2001).
 Conditions for the development of
  student nurses’ ICT capability
• Realising ICT skills are needed
• Overcoming fear and increasing willingness to try new
  software and new ways of using ICT
• Adopting a termless approach to learning and wanting to
• Engagement in the use of ICT in an unrestricted way,
  with unrestricted computer access
• Knowing what is doable and meaningful in relation to ICT
  – understanding the legal and ethical considerations
  related to the use of ICT
Findings mapped to CoP and Information Ecologies

         External factors                     Internal factors
Hard factors          Soft factors     Engagement, Imagination and
influencing           influencing             Alignment
 learning –       learning – Mutual
  Locality        engagement, joint
                  enterprise, shared
   Practise          Support from       An approach to learning and
  requiring          others with a     wanting to learn– Engagement.
 continuous        positive attitude   Overcoming fear and increasing
    access          towards use of     willingness to try, engendering
                     ICT - Mutual        confidence – Imagination.
                  engagement, joint
Sitting next to   Others’ ICT skills    Realisation that ICT skills are
someone who        good enough to           needed– Alignment.
can show you         demonstrate
 how to use        appropriate and
     ICT –          effective use -
  Keystone        shared repertoire.
      Findings mapped to Management Map, CoP, Information Ecologies
     Trajectory of participation (ICT use in terms of
                                                                                               Inbound Trajectory
                                                                                               Past history e.g. ICT stories
       Membership of                          Mind
       CoP through
       Negotiation of                         Engagement    - A termless
       meaning                                approach to learning and
                                              wanting to learn

                                                 Self of
                                                 Nurse                     Spirit
                                                 Imagination –             Alignment –
             Body                                what is doable,           realizing ICT
             Participation /                                               skills are needed
                                                 meaningful -
             Reification                         overcoming fear
                                                                                               Part of something
                                              Share ICT stories,                               bigger
Engage in use of ICT in                       simulations
unrestricted way, with
unrestricted computer access                                                                        Legal/ethical
                                                    Try new ways,                                   considerations
                                                    new software
ICT - use as Legitimate part of
                                                  ICT - Capability                             Using ICT - ‘Right’
                Recipe for ICT education for Student nurses

                        ICT capability across a range of domains

                       Quantitative skills and        Qualitative skills and
                       competence, e.g. application   competence, e.g. confidence
                       software, information

                  Assessed by scenario/case                  Assessed by self assessment
                  study based group work                     questionnaire on confidence

Learning ‘with’ ICT in clinical                                           Learning ‘through’ ICT using WWW,
practice using CRS and other                                              EBP etc. applied to clinical practice

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