ReviewInteractive, technology-enhanced self-regulated learning tools in healthcare education: A literature review
Introduction
In both higher and health education, the place for learning technology has become increasingly widespread and rapidly growing. The body of related literature to support technology enabled (TE) education such as computer assisted and online tools within health is expanding (Ray and Berger, 2010). In addition, there has been in recent years, a growing emphasis on the importance of self-directed study in nursing and health (Cason et al., 2009, Fisher and King, 2010) particularly for post-registration study where classroom time has become much more limited. The ‘blended’ approach to learning (Brandt et al., 2010) combines traditional face-to-face classroom teaching with self directed online/TE learning tools. Provision of TE tools enabling interaction and informal self-testing in a non-threatening way using a range of multimedia formats has been shown to be beneficial by engaging the learner actively. This has been shown to help learners follow a clear structure and allows them to pace their own learning (Nichol, 2007) highlighting an important link between self-directed learning and TE tools to structure engagement (Schneiderman and Corbridge, 2009, Dennison, 2011).
There is a focus here on guided learning; i.e. facilitation of, rather than, simply giving information for the learner to assimilate passively. This is fitting with the Learning theory of Knowles (1980) based on the premise that learning should occur when learners are self-directed and motivated with a need to know as relevant to their own area of experience, in this case post-basic nursing specialities.
Therefore, tools that engage the user in quizzes particularly those involving feedback challenge them to actively participate in and self-regulate their learning (Nicol and Macfarlane-Dick, 2006, Sandahl, 2010). Such interactive, self-testing is seen as a mode of ‘low stakes assessment’; in other words, as a self-regulated learning strategy rather than for ‘high stakes’ summative assessment where there is a pass/fail criteria (Nichol, 2007, JISC, 2007).
The primary focus of this paper is to identify and critique current literature exploring the implementation and potential effectiveness of TE learning within healthcare with a focus on learning by interaction and self-regulation or testing as applicable to post-registration nurse education.
Section snippets
Background
The recognition of the need for appropriately trained, educated nurses within health specialities who are proficient in their skills and knowledge base is widely agreed in post-registration nursing. The post-basic learner is distinguished from those at pre-registration level in that they are starting at a different knowledge base. Having a set of generic skills and knowledge underlying practice, the nurse decides which area to work in and can then be faced with a new set of skills and knowledge
Aims
By reviewing the literature into the implementation of TE tools, one may get closer to a better understanding of their wider use within healthcare and explore their potential value in the continuing education of nurses. With the increased demands for post-basic education in the light of the resource and time limitations identified, is there a place for TE education? In line with this, the aims of this literature review are;
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To critically analyse selected literature on TE interactive learning
Review Method and Search Strategy
The STARLITE approach was applied to the methodology for this Literature review as proposed by Booth (2006). The mnemonic includes the essential elements for reporting literature searches and the final output from them can be seen in Table 1 with the relevant element underlined in relation to the present review.
Findings
The paper will now discuss the findings and relevant aspects of this critique in relation to the selected studies using designated common themes from the work; namely, improvement in knowledge and skills, learner satisfaction and blended learning using TE tools. The reader should refer to Table 3 for specific detail of each study.
Discussion
The literature discussed highlights how learning technologies have been used in specific areas to enhance knowledge and scaffold direct contact teaching by engaging learners in self-directed study. While not all of the studies focus on the post-basic learner, the messages from the findings can now be applied to the discussion of post-registration nurse education.
Interactive TE learning tools have been shown to impart some benefits. In relation to knowledge acquisition, improvements in some
Conclusion
Interactive TE self-regulated tools can be incorporated into self-directed programmes of study and have been shown to have some value and benefit in certain areas of healthcare. TE learning however is not embraced by everyone and engagement can be variable. In addition, one must acknowledge whether the impact on learning can be measured accurately. However, whilst considering study limitations and confounding influences on learning, the positive outcomes from the work discussed can be applied
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