Baccalaureate nursing students at the School of Nursing take 5 didactic lecture classes and one clinical experience class during their second semester. These classes are very rich in content and the students adjust their time present in class based on the requirements for all of their classes; at times only 50 or less of 155 students are present for the didactic lecture.
Currently, the course that contains the Human Immunodeficiency Virus (HIV) content, Adult and Older Adult Health Care II is taught by a face-to-face lecture with Powerpoint slides, for 4 hours during the second semester and is recorded. HIV is an important educational topic for BSN nursing students. The annual numbers of new HIV infections diagnosed worldwide in 2017 is estimated at 1.8 million while it is estimated that 36.9 million people are living with it (UNAIDS, 2018). Clinical trials, medications, treatment, practice guidelines, and research findings all change rapidly. Core competencies of nursing practice for HIV/AIDs care have been developed and evaluated by different agencies in different countries (Canadian Association of Nurses in AIDS Care (CANAC), 2013; Gagnon & Cator, 2015; Relf et al., 2009).
Nursing students need to learn about transmission and prevention of HIV, testing, collaborative management, the characteristics of opportunistic diseases associated with AIDS and nursing management of patients at risk for contracting HIV and those that are HIV positive (Gagnon & Cator, 2015; Relf et al., 2011).
In an online course, students have more responsibility for their own learning; the instructor is a facilitator of active learning (Passmore & Morrison-Beedy, 2013). Online education fits well within Knowles’ andragogical theory for education; adult learners need a reason to learn something, they are intrinsically motivated to learn, they are self-directed, task oriented, and bring different past experiences to their educational experience; adults have a problem centered focus (as opposed to the child’s subject centered focus) and learn more readily when the education will improve their ability to deal their life problems (Knowles, 1990; Passmore & Morrison-Beedy, 2013). Online learners may be better able to gather and evaluate relevant information, as online learning is self-directed. Continuing education and lifelong learning are necessary for nurses to maintain competencies and knowledge. Online HIV education for healthcare providers has been evaluated satisfactorily, (Wang & Luque, 2016) but an interactive online module for basic HIV education for nursing students has not been evaluated.
Purpose:
The purposes of this project were to 1) determine whether an interactive online module is at least as effective as lecture or recorded lectures for delivering the content, 2) determine whether the students prefer a recorded lecture or interactive online modules. We hypothesized that the average test scores on the 10 HIV questions would not differ between students who received the HIV content via lecture or lecture recording and those who used an online interactive module.
Methods:
With the assistance of an instructional developer, we constructed an interactive online module that comprised the previous semester’s PowerPoint presentations and lecture recordings with additional information. The previous semester Powerpoint slides were available on the learning management platform for all students to download. The interactive online module consisted of 8 separate lessons in 4 different formats: flip-book, tabbed index cards, videos with embedded slides, and voice-over Powerpoint slides. The 8 lesson module was posted on the learning management platform. The content learning objectives for the students were the same as those implemented in previous semesters.
At the end of the semester, students were tested on their HIV knowledge during their routine examination (10 questions), after which they completed an anonymous survey about the alternate module. The survey responses were evaluated and the examination scores were compared to those recorded in the previous semester.
Results:
The majority of the students were under age 35 (64 of 75 respondents). Many of those under 35 years old self-identified as visual learners, whereas the older group identified as visual or mixed learners. The majority of students accessed the previous semesters’ Powerpoint slides. More of those under age 35 ranked the alternate lessons highly, whereas the older group ranked them lower overall. Lecture recording was a clear preference for lesson format for both groups. Of the alternate formats, the video with embedded slides format was ranked highest for both the under and over age 35 groups.
More than 90% of the students correctly answered all 10 examination questions, consistent with previous semesters.
Conclusion:
Even those who ranked the alternate format highly preferred recorded lectures. This may be because they have been trained in this program to learn content this way, as almost all of their previous nursing courses presented content via in person lectures and the recordings of those lectures. As several noted, the alternate format may have required “too many clicks”. Others noted they were auditory learners. This was only one online module in a primarily didactic class, in which the majority of the students access content from the lectures or lecture recordings. The responses may differ in an all online course. Because much of nursing instruction is moving to an online format, understanding what works best for both the students and the faculty is important and necessary for effective education.