"Nurses don't learn to be nurses without active participation," says Sarah Beckman, an associate professor of nursing at Indiana University-Purdue University Fort Wayne. Because of this, Beckman and her collegues Linda Meyer and Carol Sternberger both associate professors of nursing at IPFW, have been instrumental in integrating interactive multimedia teaching and learning tools, including computer-assisted instruction (CAI) and interactive video discs (similar to CD ROMs, but able to hold much more information), into IPFW's nursing curriculum over the past several years. "Multimedia allows students to be exposed to situations or scenarios or experiences that they might not have otherwise" due to trends in heath care such as hospital downsizing and shorter hospital stays, Meyer says. "They no longer have the availability of long-term, repetitive experience, so they may only experience something in a lifelike situation via computers."
There is another obvious benefit to using multimedia simulations in nursing education: the imaginary patient can come to no harm. "With multimedia, students can make decisions on the computer and not hurt anybody," Meyer says. "A student can try different things and be told whether an action caused the patient to be rushed off to surgery, remain in stable condition, or die," Beckman adds. Nursing is complex and requires practitioners to make many decisions, sometimes very quickly. Allowing students to explore, take risks, and make decisions on their own, even decisions that would lead to patient death, is important to the education process, "but it can't happen in real life," Meyer points out. "Critical thinking is very much a part of making decisions--nursing is not a black-and-white type of thing--and scenarios help students develop their critical thinking skills."
Understandably, students who can practice procedures on the computer before they practice them on real patients are more sure of themselves and suffer less anxiety when faced with a live human being. "I find that when students use the CAIs or the other multimedia, it really helps their self-confidence," Sternberger says. Meyer explains, "In nursing, we teach a lot of psychomotor skills, such as catheter insertion, sterile techniques, changing beds, and bed baths, particularly in the basic nursing courses. Multimedia allows for repetition, so the student can review and review without repetition by the instructor. If a student wants to go back over a particular procedure, he or she doesn't have to feel uncomfortable raising a hand in class and saying, ÔI really didn't get this.'"
Beckman points out that using multimedia also enhances the effectiveness of classroom teaching. "Multimedia is not the only teaching method we use; it is one of many and it complements traditional lecture and discussion, videos, and overheads," she says. "Multimedia should not replace human interaction. Students can do repetitive types of exercises as often as they want with multimedia. The human portion that faculty can offer in class can then build on what students have learned using multimedia tools." Besides CAIs and interactive video discs, Beckman, Meyer, and Sternberger all regularly use in their teaching the World Wide Web, presentation software, and videos that they have made themselves. Two of Sternberger's videos are being marketed throughout the country, and most of the royalties from the sales of those videos are being used to buy computer equipment and other high-tech items for the nursing department. With the help of a $25,000 grant from the Purdue Research Foundation's TRASK Fund, Meyer and Sternberger are tackling yet another multimedia medium. They are developing an interactive CD-ROM on the adult cardiovascular system. They have completed several chapters, and a couple of companies have already expressed interest in publishing the disc.
Although IPFW students and faculty are now generally positive about using multimedia tools, Beckman, Meyer, and Sternberger say it wasn't always that way. "We really struggled not only with the students, but with the other faculty members trying to get them computer literate," Sternberger says. However, when the state licensing exam for nurses was computerized three years ago, faculty resistance all but disappeared. "Change is difficult," Meyer states. "I think students are very accustomed to having things handed to them through lecture, and many times they don't value using learning discovery, being the initiator and the professor being the facilitator. . . . On student evaluations, we see things like, 'I paid money for this course; I expect to be lectured to.'" Yet, overall, students seem to accept, and appreciate, the new methods. In Sternberger's classes, where use of CAIs is encouraged but not required, 95 percent of the students use them.
By the year 2000, a mere three years away, the state licensing exam is slated to be an interactive clinical simulation, and virtual reality tests may not be far away, Meyer says. Already, virtual reality teaching tools are available that allow students to experience the actual sensation of performing a nursing procedure such as inserting an IV. While these types of programs are exorbitantly expensive now, as the technology becomes cheaper and more widely available, they will become more accessible. Innovations such as these clearly excite Beckman, Meyer, and Sternberger, and inspire them to get ahead, or at least stay with the flow, of the technological curve. "If we keep putting out the fires and are crisis oriented and wait for a dictate like nursing state board exams are now on computer and we better catch up, we're always going to be in the catch-up mode," Beckman says. Clearly, as they take classes on using technology in teaching, coach colleagues, and cheer each other on, that is not where these three energetic women plan to be.
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