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F. Cornelius, E. Haslam, H. Michael Dreher

Drexel University (UNITED STATES)
This study investigated the benefits of introducing handheld computer technology into undergraduate nursing education as a means to enhance the development of clinical decision-making skills in undergraduate nursing students and evaluate the effectiveness of using the Gerontological Reasoning Informatics Project (GRIP), a PDA-based assessment tool, to accomplish this goal. Clinical faculty identified and recorded the top three nursing care priorities of all patients prior to giving student assignments. Students conducted assessments for assigned patients utilizing the GRIP tool and also identified the top three nursing care priorities. This data was analyzed to identify similarities between the three groups. Twenty-six senior nursing students and two clinical faculty participated in this study, assessing a total of 212 patients. Data collection also included in-depth interviews with 21 students and 2 faculty and field observation notes. The results suggest that handheld technology, equipped with a tool such as GRIP, effectively develops clinical competency and clinical decision-making skills in undergraduate nursing students.

Nursing students, while ever more computer and technically competent, continue to have “problems identifying, defining, analyzing and articulating the nature of their information needs”[1] This may be due in part to lack of hands-on experience accessing and utilizing relevant information in real-life, real-time clinical experiences. Nursing educators must identify strategies to provide structured learning activities that give students opportunities to practice accessing and utilizing information in clinical settings. This, in turn, can support the development of clinical competency and clinical decision-making skills. Mobile devices such as Personal Digital Assistants (PDAs) and more recently, Smartphones, having emerged as useful and often indispensable tools for healthcare providers, may be a means to provide these structured learning experiences to nursing students in clinical settings.

While the media has directed considerable attention at this exciting new technology and its utility in clinical practice, there has been limited research investigating the use of PDAs in health care and whether or not they contribute significantly to the quality of nursing care, medication error reduction and clinical decision-making. [2]This may well be the case, since information required for clinical decision-making is more readily available to the nurse with a PDA at the bedside, but there is no documented evidence supporting this belief. Clearly, a PDA is an effective tool for streamlining documentation and accessing information but there are no research studies that support the notion that it improves nursing practice and decision-making. Specifically, no studies to date have investigated the role of this technology in nursing education and development of clinical decision-making skills in undergraduate nursing students.

[1] Cheek, J & Doskatsch, I (1998) Information literacy: a resource for nurses as lifelong learners Nurse Education Today 18(3) 243-50
[2] VanDenKerkhof E; Goldstein D; Lane J; Rimmer M; Van Dijk J; (2003)Using a personal digital assistant enhances gathering of patient data on an acute pain management service: a pilot study: Canadian journal of anaesthesia = Journal canadien d’anesthesie.; 2003 Apr;50(4) p6811