Effects of an Interactive E-book to Enhance Nursing Skill

Study Overview
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Brief Summary
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It is necessary for nursing students to have sufficient knowledge and correct nursing skill before clinical practicum to provide patients appropriate care and improve nursing quality. The learning materials of nursing skills are mainly paper textbooks and handouts, which are one-way knowledge transmissions having limitations and deficiencies in nursing skill learning. Interactive e-books integrate multimedia such as text, images, and videos, which are more suitable for learning nursing skill and maximize the effectiveness of the learning materials. The present study aimed to develop a nasogastric tube feeding interactive e-book based on Information Processing Theory (IPT) and Attention, Relevance, Confidence, and Satisfaction Motivational Model (ARCS), hoping to improve students' learning motivation and learning effectiveness. This is a randomized controlled trial study. Convenience sampling will be applied. The participants will be recruited and randomly assigned into the experimental group and comparison group. The experimental group will read an interactive e-book to learn nasogastric tube feeding, while the comparison group will read a paper textbook.

Detailed Description
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It is necessary for nursing students to have sufficient knowledge and correct nursing skill before clinical practicum to provide patients appropriate care and improve nursing quality. The learning materials of nursing skills are mainly paper textbooks and handouts, which are one-way knowledge transmissions having limitations and deficiencies in nursing skill learning. Interactive e-books integrate multimedia such as text, images, and videos, which are more suitable for learning nursing skill and maximize the effectiveness of the learning materials. In addition, the learning content can be updated at any time, in order that students can learn the latest skills and connect with clinical. The present study aimed to develop a nasogastric tube feeding interactive e-book based on Information Processing Theory (IPT) and Attention, Relevance, Confidence, and Satisfaction Motivational Model (ARCS), hoping to improve students' learning motivation and learning effectiveness. Therefore, the purpose of this study is to examine the effectiveness of using interactive e-book to enhance nursing students' knowledge and learning self-efficacy of nursing skill. This is a randomized controlled trial study. Convenience sampling will be applied at a university in Northern Taiwan. It is expected that 60-100 participants will be recruited and randomly assigned into the experimental group and comparison group. The experimental group will read an interactive e-book to learn nasogastric tube feeding, while the comparison group will read a paper textbook. The questionnaires will be collected before the intervention, after the intervention, and after one month of the intervention. The questionnaires include demographic information, nasogastric tube feeding knowledge questionnaire, nasogastric tube feeding confidence scale, learning self-efficacy scale, nasogastric tube feeding skill test, and learning satisfaction questionnaire. This study will use SPSS 19.0 software for data analysis, including percentage, mean, standard deviation, t-test, chi-square test, and generalized estimation equation (GEE).

Official Title
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Effects of an Interactive E-book to Enhance Nursing Students' Knowledge and Self-efficacy of Nursing Skill

Conditions
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Healthy

Intervention / Treatment
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* Other: Interactive e-book
* Other: paper textbook


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: students who major in nursing students have not yet learned nasogastric tube feeding skill. Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: interactive e-book<br>The experimental group will read an interactive e-book for 90 minutes to learn nasogastric tube feeding. | Other: Interactive e-book<br>* The nasogastric tube feeding interactive e-book has a lot of elements such as text content, videos, pictures, links, and other interactive content with which the students can interact. The participants can use the interactive e-book to learn nasogastric tube feeding.<br>|
| Active Comparator: comparison group<br>The comparison group will read a paper textbook for 90 minutes to learn nasogastric tube feeding. | Other: paper textbook<br>* The paper textbook has text content and pictures. The participants can use the paper textbook to learn nasogastric tube feeding.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nasogastric Tube Feeding Quiz | The Nasogastric Tube Feeding Quiz is a 15-item true/false questions with three responses (true, false, and not sure). Participants score 1 point for a correct answer and 0 for an incorrect answer or not sure. The total score ranged 0-15 points. A higher score indicating a better knowledge of NG tube feeding. | Baseline, before the intervention(T0) | 
| Nasogastric Tube Feeding Quiz | The Nasogastric Tube Feeding Quiz is a 15-item true/false questions with three responses (true, false, and not sure). Participants score 1 point for a correct answer and 0 for an incorrect answer or not sure. The total score ranged 0-15 points. A higher score indicating a better knowledge of NG tube feeding. | Immediately following after the intervention(T1) | 
| Nasogastric Tube Feeding Quiz | The Nasogastric Tube Feeding Quiz is a 15-item true/false questions with three responses (true, false, and not sure). Participants score 1 point for a correct answer and 0 for an incorrect answer or not sure. The total score ranged 0-15 points. A higher score indicating a better knowledge of NG tube feeding. | one month after the intervention(T2) | 
| Confidence scale (C-scale) | A 5-item scale designed to measure participant's confidence level in performing a nursing skill. Each item had five responses and the total score ranged 5-25 points. A higher score indicating that nursing students felt more confident in performing the nursing skill. | Baseline, before the intervention(T0) | 
| Confidence scale (C-scale) | A 5-item scale designed to measure participant's confidence level in performing a nursing skill. Each item had five responses and the total score ranged 5-25 points. A higher score indicating that nursing students felt more confident in performing the nursing skill. | Immediately following after the intervention(T1) | 
| Confidence scale (C-scale) | A 5-item scale designed to measure participant's confidence level in performing a nursing skill. Each item had five responses and the total score ranged 5-25 points. A higher score indicating that nursing students felt more confident in performing the nursing skill. | one month after the intervention(T2) | 
| Learning Self-Efficacy Scale (L-SES) | A 12-item scale designed to measure student's learning self-efficacy for nasogastric tube feeding. Participants rate each item on a scale from 1 to 5. The total score ranged 12-60 points. A higher score indicating the nursing students have more confidence in their capability to learn nasogastric tube feeding. | Baseline, before the intervention(T0) | 
| Learning Self-Efficacy Scale (L-SES) | A 12-item scale designed to measure student's learning self-efficacy for nasogastric tube feeding. Participants rate each item on a scale from 1 to 5. The total score ranged 12-60 points. A higher score indicating the nursing students have more confidence in their capability to learn nasogastric tube feeding. | Immediately following after the intervention(T1) | 
| Learning Self-Efficacy Scale (L-SES) | A 12-item scale designed to measure student's learning self-efficacy for nasogastric tube feeding. Participants rate each item on a scale from 1 to 5. The total score ranged 12-60 points. A higher score indicating the nursing students have more confidence in their capability to learn nasogastric tube feeding. | one month after the intervention(T2) | 
| Nasogastric tube feeding skill test | The Nasogastric tube feeding skill test is designed to test nasogastric tube feeding skill performance and competence. It requires participants to perform NG tube feeding in front of an examiner. The participants will be asked to demonstrate NG tube feeding in 10 minutes. The total score ranged 0-100 points. A higher score indicating the nursing students have a better ability of NG tube feeding. | three months after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Satisfaction questionnaire | A 10-item scale designed to measure participant's level of satisfaction in learning materials. Participants rate each item on a scale from 1 (very dissatisfied) to 5 (very satisfied). The total score ranged 10-50. A higher score indicating high level of satisfaction in the learning materials. | Immediately following after the intervention(T1) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nursing students, Skill performance