Designing and delivering digital learning (e-Learning) interventions in nursing and midwifery education: A systematic review of theories.

AIMS /OBJECTIVES: To identify and synthesise theories that support the design and delivery of digital learning interventions in nursing and midwifery education. BACKGROUND: A range of educational and other theories are used to support nursing and midwifery education, including when e-learning interventions are being designed and delivered. However, there is a limited understanding of how theory is applied across the wide range of digital learning interventions to inform pedagogical research and practice. DESIGN: A systematic review. METHODS: CINAHL, ERIC, MEDLINE and PubMed were searched using key terms. Studies were screened by independent reviewers checking the title, abstract and full text against eligibility criteria. Due to the theoretical focus of the review, critical appraisal was not undertaken. Data were extracted and synthesised using a descriptive approach. RESULTS: Thirty-four studies were included. Twenty theories were identified from a range of scientific disciplines, with the Technology Acceptance Model and Theory of Self-Efficacy employed most often. Theoretical frameworks were used to inform and explain how the digital learning interventions were designed or implemented in nursing and midwifery education. The sample were mainly undergraduate nursing students and the digital learning interventions encompassed animation, blended approaches, general technologies, mobile, online, virtual simulation and virtual reality applications which were used mainly in university settings. CONCLUSIONS: This systematic review found a range of theories that support the design and delivery on digital learning interventions in nursing and midwifery education. While a single theory, the Technology Acceptance Model, tended to dominate the literature, the evidence base is peppered with numerous theoretical models that need to be examined more rigorously to ascertain their utility in improving the design or implementation of digital forms of learning to improve pedagogical research and practice in nursing and midwifery.

Theories informing technology enhanced learning in nursing and midwifery education: A systematic review and typological classification.

BACKGROUND: Learning is a complex process involving internal cognitive processes and external stimuli from curricula, pedagogical strategies, and the learning environment. Theories are used extensively in higher education to understand the intricacies of adult learning and improve student outcomes. Nursing and midwifery education uses a range of technology enhanced learning (e-learning) approaches, some of which are underpinned by theoretical frameworks. OBJECTIVE: Synthesise literature on theories that inform technology enhanced learning in nursing and midwifery education. DESIGN: A systematic review. DATA SOURCE: CINAHL, ERIC, MEDLINE and PubMed were searched for relevant studies (2000-2021). Reference lists of related literature reviews were hand searched. REVIEW METHODS: Title and abstract, followed by full texts were screened by two reviewers independently using predefined eligibility criteria. Quality appraisal was not undertaken. Data were extracted and Merriam and Bierema's typology of adult learning theories used to categorise theories in each study. RESULTS: Thirty-three studies were included, incorporating twenty-nine distinct learning theories from the behaviourist, cognitivist, constructivist, and social cognitivist domains, with constructivist being the most widely used. Kolb's Experiential Learning Theory and Driscoll's Constructivist Learning Theory were the most commonly reported theories. The population of learners were mainly undergraduate nursing students who used a range of online, mobile, blended or computerised learning, virtual reality, or digital forms of simulation, primarily in university settings. Theories were employed to inform the technology enhanced learning intervention or to help explain how these could improve student learning. CONCLUSION: This review highlighted a range of theories, particularly constructivist approaches, that underpin research on technology enhanced learning in nursing education, by informing or explaining how these digital interventions support learning. More rigorous research that examines the myriad of theoretical frameworks and their effectiveness in informing and explaining technology enhanced learning is needed to justify this approach to pedagogical nursing research and practice.

Dispose with dish soap: A simple and convenient method to increase proper opioid disposal in postoperative pediatric patients.

BACKGROUND: The opioid abuse crisis is rampant in the United States. Children and adolescents are unique risk groups in this crisis; age-specific concerns include accidental ingestion and association with high-risk behaviors. Studies aimed at disposal are limited in pediatric patients. Our study aimed to determine whether an educational brochure detailing a simple opioid disposal method using dish soap could enhance disposal in postoperative pediatric patients. METHODS: A prospective survey study of pediatric plastic surgery patients at the St. Louis Children's Hospital was performed from January to December 2020. Patients were assigned into two groups: those who received the educational brochure at the time of surgery and those who did not. In clinic, patient caretakers completed anonymous preoperative and/or postoperative surveys regarding opioid use and disposal. RESULTS: Surveys of 326 patients were analyzed (188 preoperative, 120 pre/postoperative, and 18 postoperative). Prescribed opioids were all consumed in 19% of patients. Receiving the educational brochure significantly increased the opioid disposal of leftover medications: 78% versus 35% (OR 6.52, 95% CI [2.03, 21.37], p < 0.001). Although not statistically significant owing to small sample size (p = 0.09), 71.4% of families with excess opioids in the home preoperatively retained unused postoperative opioids versus 31.6% without preoperative opioids. CONCLUSIONS: Postoperative opioids are overprescribed for most pediatric plastic surgery patients. A simple brochure significantly increases proper postoperative opioid disposal, representing a cost-effective, convenient, risk-free method to decrease opioid misuse and accumulation in our communities.

Moral distress in critical care nursing practice: A concept analysis.

AIM: To provide a critical analysis of the concept of moral distress (MD) in critical care (CC) nursing. BACKGROUND: Despite extensive inquiry pertaining to the legitimacy of MD within nursing discourse, some authors still question its relevancy to the profession. However, amid the global COVID-19 pandemic, MD is generating a significant amount of discussion anew, warranting the further exploration of the concept within CC nursing to provide clarity and expand on the definition. DESIGN: Rodger's Evolutionary Concept Analysis method was used to guide this analysis. METHODS: Related terms, attributes, antecedents, and consequences of MD were identified using current literature. RESULTS: The results of this analysis demonstrate strong congruence between the attributes, antecedents, and negative consequences pertaining to MD. However, a new theme has emerged from this review of the contemporary literature, highlighting the potential unexpected positive outcomes perceived by nurses who experience MD, including the provision of better care, increased levels of empathy, and enhanced opportunities for ethical reflection.

Pathophysiology of Pediatric Traumatic Brain Injury.

The national incidence of traumatic brain injury (TBI) exceeds that of any other disease in the pediatric population. In the United States the Centers for Disease Control and Prevention (CDC) reports 697,347 annual TBIs in children ages 0-19 that result in emergency room visits, hospitalization or deaths. There is a bimodal distribution within the pediatric TBI population, with peaks in both toddlers and adolescents. Preclinical TBI research provides evidence for age differences in acute pathophysiology that likely contribute to long-term outcome differences between age groups. This review will examine the timecourse of acute pathophysiological processes during cerebral maturation, including calcium accumulation, glucose metabolism and cerebral blood flow. Consequences of pediatric TBI are complicated by the ongoing maturational changes allowing for substantial plasticity and windows of vulnerabilities. This review will also examine the timecourse of later outcomes after mild, repeat mild and more severe TBI to establish developmental windows of susceptibility and altered maturational trajectories. Research progress for pediatric TBI is critically important to reveal age-associated mechanisms and to determine knowledge gaps for future studies.

Slipping through the cracks: the taxonomic impediment conceals the origin and dispersal of Haminoea japonica, an invasive species with impacts to human health.

Haminoea japonica is a species of opisthobranch sea slug native to Japan and Korea. Non-native populations have spread unnoticed for decades due to difficulties in the taxonomy of Haminoea species. Haminoea japonica is associated with a schistosome parasite in San Francisco Bay, thus further spread could have consequence to human health and economies. Anecdotal evidence suggests that H. japonica has displaced native species of Haminoea in North America and Europe, becoming locally dominant in estuaries and coastal lagoons. In this paper we study the population genetics of native and non-native populations of H. japonica based on mt-DNA data including newly discovered populations in Italy and France. The conclusions of this study further corroborate a Northeastern Japan origin for the non-native populations and suggest possible independent introductions into North America and Europe. Additionally, the data obtained revealed possible secondary introductions within Japan. Although non-native populations have experienced severe genetic bottlenecks they have colonized different regions with a broad range of water temperatures and other environmental conditions. The environmental tolerance of this species, along with its ability to become dominant in invaded areas and its association with a schistosome parasite, suggest H. japonica could be a dangerous invasive species.

Alien molluscan species established along the Italian shores: an update, with discussions on some Mediterranean "alien species" categories.

The state of knowledge of the alien marine Mollusca in Italy is reviewed and updated. Littorina saxatilis (Olivi, 1792), Polycera hedgpethi Er. Marcus, 1964 and Haminoea japonica Pilsbry, 1895are here considered as established on the basis of published and unpublished data, and recent records of the latter considerably expand its known Mediterranean range to the Tyrrhenian Sea. COI sequences obtained indicate that a comprehensive survey of additional European localities is needed to elucidate the dispersal pathways of Haminoea japonica.Recent records and interpretation of several molluscan taxa as alien are discussed both in light of new Mediterranean (published and unpublished) records and of four categories previously excluded from alien species lists. Within this framework, ten taxa are no longer considered as alien species, or their records from Italy are refuted. Furthermore, Trochocochlea castriotae Bellini, 1903 is considered a new synonym for Gibbula albida (Gmelin, 1791). Data provided here leave unchanged as 35 the number of alien molluscan taxa recorded from Italy as well as the percentage of the most plausible vectors of introduction, but raise to 22 the number of established species along the Italian shores during the 2005-2010 period, and backdate to 1792 the first introduction of an alien molluscan species (Littorina saxatilis) to the Italian shores.