Quality and Safety Education for Nurses (QSEN) has asserted the preparation of future nurses must include experiences that increase knowledge, teach skills, and address attitudes related to informatics. Many students do not perceive that they are receiving sufficient formal education about information technology in health care (Maag, 2006). At the same time, surveys of nursing faculty reveal uncertainty about what to and how to teach in this area (Smith, Cronenwett, & Sherwood, 2007).
Assessment of Informatics Competencies
Prior to attending a classroom presentation about information technology in health care, first-semester nursing students completed a 35-item self-assessment of informatics competencies. The survey was intended to raise awareness about informatics concepts and to explore student preferences among information sources.
Survey items were developed from a research-based, master list of informatics competencies for the beginning-level nurse, as defined by Staggers, Gassert, and Curran (2002). Their list outlined how nurses relate to technology in their workplace for purposes of administration, communication, data access, documentation, client education, monitoring, quality improvement, and research. In addition, it identified a nurse’s obligation to keep protected health information secure. We believed students would be more likely to engage with this topic if given an opportunity to connect it to their own experience.
The survey was reviewed and given exemption status by the campus institutional review board. All students enrolled in the course participated (n = 129).
First, students rated their knowledge, skill, and access to each computer application using a 5-point scale (1 = very little, 5 = very much). Next, students were asked how often they accessed various information sources, using a 5-point scale (1 = never, 5 = often/daily). Some information sources replicated those named in a national survey that examined the readiness of practicing nurses to access evidence-based information sources for best clinical practices (Pravikoff, Tanner, & Pierce, 2005).
Students rated their knowledge, skill, and access highest (M > 4.75) on basic desktop software and e-mail applications. They also rated themselves high (M > 3.75) on items that pertained to attitudes (recognizing impact of data on quality of care, importance of privacy, and significance of nurses’ role in design of computer applications). Self-ratings were lowest (M < 2.5) on items referring to clinical functions (administrative, data access, documentation, monitoring, and peripheral devices).
When asked how they sought information needed for clinical practice, many nursing students indicated a preference for using popular Internet sources over bibliographic databases. In contrast, our library instruction emphasized how to search the latter.
The survey also revealed students often reached out to colleagues versus other resources when seeking information. When these findings were discussed in class, one student stated she felt highly encouraged by her clinical instructor to ask questions, noting that an item on our clinical evaluation tool credits “asking for help.” We discovered it is as important to help students differentiate when it is best to consult an information source as it is to teach them how to access such sources.
Teaching Strategies for Classroom, Laboratory, and Clinical Settings
In addition to valuable classroom discussion, the survey also stimulated nursing faculty to integrate examples of information technology in laboratory and clinical settings. In the laboratory, an electronic record and handheld peripheral devices for medication administration now accompany all clinical simulations. In addition, embedded in all simulation scenarios is a need to consult the hospital Intranet for information, such as checking the laboratory test directory or nursing policies.
Based on our data, we developed an online tutorial to address the wide variety of information sources that may be useful to students in clinical settings. It explains how to access health portals that serve consumers and decision support tools that serve providers, in addition to searching within bibliographic databases. Tips for assessing the credibility of information from online sources are provided. In a follow-up assignment, students compared results after searching a single term within each of these sources.
Clinical information sources have changed over time. Future nurses must be equipped to navigate the sources commonly accessed by patients and be prepared to evaluate their credibility. An assessment of informatics competencies prompted actions that have moved our nursing curriculum toward adherence to this QSEN competency.