An Exploration of Online Learning as a Medium to Alter Decison Making in Care Giving by Nurses
Attitudes have been shown to be important within the field of continence care where incontinence is often perceived by practitioners as an inevitable consequence of aging. Research literature has demonstrated that education alone cannot change practice but rather attitudes need to be challenged in order to effect change. In order to confront practitioners about attitudes they need to feel comfortable in expressing views in a safe environment. Using technology the medium of online learning can create such an environment. A twelve week online course which addresses nurses' knowledge, attitudes and practice regarding incontinence was evaluated in relation to its impact in altering the attitudinal decisions nurses make regarding continence care. A factorial survey design was employed, augmented by a content analysis of qualitative data, collected to explore the knowledge and practices of nurses who undertook the course (n = 39) before and after the intervention. In the factorial survey the unit of analysis is the vignette, which included nine independent variables, presenting patient characteristics related to incontinence, each with a number of levels which were randomly selected within each unique vignette. The total vignette population was 82,944, of which 1794 were randomly selected. The dependent variables measured the judgement of nurses and were related to knowledge, attitudes and practice. The utilisation of the factorial survey to establish the effectiveness of the educational intervention expands its usage as a research methodology. This online course resulted in nurses' altered decision making in continence care. For example prior to the educational intervention the provision of pads explained 21.7% of the variance, after the intervention this reduced to 11.2%. This study demonstrates that the online environment provides a suitable medium with which to alter attitudinal decision-making.
Keywords: On-line learning, Attitudes, Nursing, Decision-making
Dr Carol Curran
Head of Nursing, Faculty of Life and Health Sciences, University of Ulster