A study of evaluation methods for individual
contribution in group work using a online tool for
creating nursing care plan and pathological related
diagramMoe Fujii1 , Akiko Williamson2 and Munehiko Sasajima112

University of Hyogo, 8-2-1, Gakuennishimachi, Nishi-ku, Kobe-shi, Hyogo, 651-2103, Japan
Kobe University Hospital’s Department of Nursing, 7-5-2 Kusunokicho Chuo-ku, Kobe-shi, Hyogo, 650-0017, Japan

Abstract

Those who become nurses need to acquire the ability to develop the nursing process, and to this end, theyare conducting an exercise in which they work in groups to create a nursing care plan and pathologicalrelated diagram. In this study, we address the issue that it is difficult for teachers to properly evaluate
individuals when grading this exercise. We use an online tool for group work to create a nursing careplan and pathological related diagram, and to measure the contribution of each individual from the tool’slog. Currently we are evaluating the model using log data from real nursing learners.

Keywords

nursing care plan and pathological related diagrams, group work, evaluation of learners,

1. Introduction
Nurses are required to carry out a series of nursing processes, such as collecting patient
information, clarification of assessment and problem, developing a nursing plan, implementing
and evaluating the plan. In nursing education, in order to acquire this ability, nursing students
and new nurses practice making a nursing care plan and pathological related diagram, whichrepresents the nursing process in a graphical structure, individually or in groups. An example
of a description of a nursing care plan and pathological related diagram is shown in Fig. 1.
This study focuses on an exercise in which learners work in groups to create a nursing careplan and pathological related diagram. In this case, it is not easy for the instructor to grasp
all the efforts of each learner during the exercise and to provide appropriate guidance andevaluation for each individual. Appropriate evaluation of individuals in group work, not only inexercises of creating a nursing care plan and pathological related diagram, is considered to berelated to the motivation of the learners to work. In addition to marking exercises, the instructor
also has other tasks to perform, so it is important for the instructor to be able to evaluate thework of the learners. A method is needed to appropriately evaluate the individuals in the group
without increasing their workload as much as possible. In this study, with the aim of supportingIJCKG 2023 Poster and Demo track$ ad23w062@guh.u-hyogo.ac.jp (M. Fujii); wakiko75@med.kobe-u.ac.jp (A. Williamson);sasajima@sis.u-hyogo.ac.jp (M. Sasajima)© 2023 Copyright for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
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サードスペースに移動し循環血液量増加た体液が血管内に戻る

術後酸素投与＃肺合併症＃ダンピング症候群

尿量減少
尿量増加

呼吸数増加

気道内分泌増早期ダンピング
気道内分泌貯留＃皮膚統合性障害

加

腎血流量低下下痢

組織の酸素欠乏

抗利尿ホルモン亢進

心拍出量低下気管内挿管による機械的刺激

後期ダンピング

気 道内分 泌の粘稠化
腸蠕動亢進

褥瘡発生

低血糖

酸素消費量増加人工呼吸器管理

心拍数増加

血圧低下

脱水

1000

不感蒸泄

血管透過性亢進

血 漿 成 分が サ ード ス ペ

プロポフォール

ロクロニウム炎症サイトカイン産生

侵襲

胃癌

高齢

熱生産低下の摩擦

血行障害

慣れない環境全身麻酔

せん妄（筋弛緩薬使用）

腸管内容のインスリン

高浸透圧

過剰分泌

中枢性の体温調節機食物が小腸へ食後血糖の急激急速に流入な上昇＃術後出血
食物貯留機能低下

転倒
術後食事再開腹腔鏡下胃全摘術
術中低体温＃膵液瘻膵臓損傷

術中操作ースに移動

覚醒時シバリング

移動・移乗時女性、61 歳循環血液量減少

体温上昇

調整中枢の抑制解除

ブリンクマン指数：

神戸花子

代謝亢進

麻酔薬が切れると体温

乾燥刺激

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筋力低下＃身体損傷リスクADL 低下術後疼痛

（R-Y 再建）

＃縫合不全

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ドレーン留置
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腸蠕動低下

気腹消化管機能低下

ﾌｪﾝﾀﾆﾙ入り硬膜外カテーテル

浸出液貯留

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感染菌の増殖＃感染予定外抜去

血中 CO2 濃度上昇

留置物多数
DVT

ADL 介助＃セルフケア不足

Figure 1: A nursing care plan and pathological related diagram of gastric cancer.(in Japanese)

instructors in appropriately guiding and evaluating individual learners, we investigate a method
for measuring the contribution of individuals in a group in the creation of nursing care plan andpathological related diagrams using an online tool, with which jointly developed with the Kobe
University Hospital’s Department of Nursing. Specifically, we developed a model to measure
the contribution of individuals in group work, and calculated the contribution of each individualfrom the log data generated by the online tool. By calculating from the log data, we contributeto avoid increasing the burden on the instructor in the evaluation process.

2. Related Works
Not only nursing care plan and pathological related diagrams exercises, but also other nursing
exercises are often conducted in a group format[1]. There are two main reasons for this. The
first is that through group learning, students can acquire the skills necessary for future teamnursing. The second reason is that nurses work in groups in actual nursing practice, and this has
attracted attention as an educational method[2][3]. Group work has also been widely introduced
outside the field of nursing education, but there are various discussions about the method ofindividual evaluation in group work. For example, there is mutual evaluation within the group,
submission of work reports, final reports and comprehension tests, etc., and instructors evaluate
individuals based on an evaluation model that combines these methods[4][5][6]. In addition,some studies have developed their own group work support systems and monitor learners’
activities based on the use of these systems[6][7].
However, these methods place an additional burden on learners and instructors in terms ofcreating and scoring evaluation materials other than group work products.

3. Methods
In this study, a tool to support the creation of nursing care plan and pathological related diagrams
called "CO-LAB NOTE" is used. The area where nursing care plan and pathological related
diagrams are created is called a canvas, where nodes and node links are combined. A node is arectangle that describes a condition or disease name, while a node link is an arrow line in asingle direction that represents the causal relationship between nodes. The tool allows multiple
learners to edit at the same time. In addition, each time an operation is performed on the tool,log data is stored to show who performed what operation and when.
The flow of a nursing care plan and pathological related diagram exercise is as following:(STEP1)The instructor sets up a patient situation as a task for the exercise and gives it to
the learners, (STEP2)Learners work in groups to create a nursing care plan and pathologicalrelated diagram using CO-LAB NOTE in response to the set task, (STEP3) When the learners
have completed the nursing care plan and pathological related diagram, they submit it to theinstructor as a PDF file, and (STEP4)The instructor evaluates the learner based on the submitted
the nursing care plan and pathological related diagram and the learner’s efforts observed by theinstructor during the exercise.
In this study, an approach is made to step4. Specifically, the work log of the learner’s creationof nursing care plan and pathological related diagrams using CO-LAB NOTE is passed to theindividual contribution evaluation module. The module calculates the individual contribution byreferring to the contribution model that has been created in advance. The instructor evaluates
the learner based on these results.
In developing the contribution model, a definition of contribution needs to be considered. In
this study, two definitions were used, which are described below. In definition 1, learners who
performed many operations in the process of making the diagram were considered to have ahigh contribution, and the contribution was defined as the percentage of operations performedin the process of making it. In Definition 2, learners who were involved in the creation of
the completed nursing care plan and pathological related diagram a lot were considered tohave a high contribution, and the contribution was the percentage of the nursing care plan andpathological related diagram that was finally submitted by the individual. When Definition 1 wasadopted, if a learner repeatedly performed meaningless operations, he or she would be placedat the top of the contribution level. To prevent this, we considered Definition 2. Meaningless
operations here refer to those that are not directly related to the instructor’s grading of thecontent of nursing care plan and pathological related diagrams, such as changing the displayposition of a node to improve its appearance.

4. Results and Discussion
To evaluate the proposed model, we analysed log data from real nursing learners. We asked 20
groups of nursing students to use the tool in an in-class exercise at a nursing college in Japanand used their work logs as input data for the module. Table1 shows a result of one of the 20
groups, consisting of 6 members.
Table 1
Contribution results in Experiment.
userID
261
265
260

contrib. model1
0.491
0.121
0.097

contrib. model2
0.351
0.245
0.139

userID
264
262
259

contrib. model10.172
0.117
0.001

contrib. model2
0.171
0.090
0.004

As a result of the analysis, it can be read that there is a large difference in the level ofcontribution. This is thought to be because the CO-LAB NOTE used in this study was only
available for PCs, and not all of the nursing learners who participated in the experiment had PCs,
so the roles were divided between them. Therefore, in the future, it will be necessary to organize
the environment in which students can use PCs, to make the tool compatible with iPads andother devices in addition to PCs, and to improve the fact that the level of contribution cannot bemeasured correctly when the person who initiated the idea and the person who filled in the tool
are different. In addition, the results of the evaluation of the model are currently being presented
to the instructors, and we are waiting for feedback on the instructors’ conventional evaluation
criteria, the usefulness of the model, and the differences from the actual evaluation. Furthermore,
as we were only able to measure contribution in terms of workload in this experiment, it isnecessary to consider a model that also takes into account the content of the nursing care planand pathological related diagram. For example, we are considering giving points to learners
who created important keywords, or to the creators of the process of arriving at the correct
nursing diagnosis name.

5. Conclusion
As a method of individual evaluation in group work, we proposed to measure individualcontribution by creating group products using an online tool and analyzing their log data.
Now, we have created a module for measuring individual contribution, verified that the module
performs the expected behavior, and are analyzing the actual data. In the future, we will improvethe module by organizing the evaluation criteria of the instructor and having the instructor
check the results of the analysis.
Acknowledgment Part of this work was supported by the New Energy and Industrial Technology
Development Organization (NEDO) JPNP18002.

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