Using iPads on nursing student clinical placements

1 November 2012

BEV MacKAY and JANE ANDERSON report on an action research project exploring using iPads to enhance teaching support for NorthTec nursing students on clinical placements.

New technologies are now available to enhance student learning.

The use of mobile learning resources such as etxt and blended learning (using Northnet a web-based learning platform) have changed the way we teach at NorthTec and the way our students learn and access resources.

We felt that the use of mobile devices such as the iPad also offered the potential to enhance our teaching in clinical settings through access to students’ work, resources on NorthNet, the Internet, and mobile applications.

We implemented an action research project to explore the ways our lecturers use mobile technology while out on hospital and community placements. Following an initial cycle of action research, the iPad was chosen as our preferred technology because of the ease of inputting data and its screen size. Our project commenced in February this year and will finish in November. We plan to release a report in 2013.

There is a growing body of evidence around the use of mobile devices. Overseas research suggests these devices put the student at the centre of learning, moving the focus from teaching to learning, and they are increasingly being used by nurse educators in other countries. Personal Digital Assistants (PDAs) such as iPads and iPhones also provide the hardware for using mobile applications (or apps). Apps that can teach drug calculations, look up drugs and interactions, explore nursing management decisions, and interpret laboratory result guides are just a few of the apps now available. Using a device like an iPad also allowed us to extend the m-learning (mobile learning) support we already give our students in clinical.

In clinical, keeping connected with students is particularly relevant, especially in community settings where there is no immediate access to computers. Once again, experience overseas suggests that with mobile technology you can connect with the student and reinforce their learning when and where they need it.

Currently at NorthTec, we use eTXT to communicate and support students in primary healthcare nursing settings across Northland. The problem is that eTXT replies from students go into our email accounts, which can result in communication and time management issues when we’re out on clinical and unable to access email. Also, even though students are advised to use the clinical phone number, they still use existing eTXTs in their phone to text when they are sick, to change appointments, or to ask questions. Access to email accounts through a smart phone or device like an iPad minimises this problem.

This project follows action research methodology that enables practitioners to describe, interpret, and explain their practice whilst trying to improve it. Validity and reliability in action research is supported by collaboration and agreement between the researcher and participants to ensure that their findings are an accurate depiction of reality. In an initial cycle, one of us used both an iPhone and an iPad in clinical practice. We chose the iPad for the second cycle of research because of its superior ability for data input and its larger screen size, which made shared viewing with students easier. The decision was made, with management support, to fund five devices with 3G connections. The Information Computer and Technology Department and management support were also crucial in enabling the project to progress.

We are now in the project’s second cycle of action with six researcher participants (clinical lecturers) using iPads in clinical teaching across the three years of the nursing programme. We have regular meetings with other members of our research group to plan, discuss findings, and to make decisions regarding the progress of the project. In addition, the clinical lecturers are keeping blogs and we have had an initial focus group with another planned for November. The research literature, meeting summaries, blogs, and focus groups will be used to guide the development of the final report.

Initial findings from an interpretive analysis of blogs and a focus group demonstrate a range of indicative themes currently still under development. These initial themes suggest that this technology has the potential to enhance teaching practice in the right situation. Major positive themes include immediate and portable access to a range of resources (applications, internet sites, YouTube, NorthNet) and student formative work and files (these could be edited on the iPad). The ability to respond immediately to student cues for learning and engage with the student was another theme. Other positive themes were the ability to cater for learning styles through audio (auditory), video (visual), manipulation (kinesthetic), and connectivity (being able to connect via email).

However, introduction of this technology also had the ability to constrain teaching practice where technology interfered with the quality of the student-teacher interaction or interaction with staff at the placement. Other constraining themes included: lack of technological skills; unfamiliarity with the iPad and applications; connection issues; and concern about clinical staff perceptions regarding the use of the iPad. Experience with an iPad and knowledge of suitable applications were factors in setting up the devices, and applications were found and tested through trial and error. There appeared to be no substantive list to refer to in the literature or on the Internet.

These early findings suggest that iPads do have the potential to enhance our teaching in clinical settings; however, teaching can be impaired by lack of experience with an iPad, lack of knowledge of resources and applications, and perceptions. A second focus group planned for later this year will enable us to build on earlier findings. In addition, it will be necessary to look at resource issues, training, and support if these devices are adopted as standard resources in our clinical practice.

About authors: Dr Bev MacKay is a principal lecturer and Jane Anderson is the nursing programme leader at Whangarei’s NorthTec nursing school.