Nursing Educator

What the new Apple iPhone 5 and iPod Touch mean for nurse educators

2012-09-12T16:28:00.000-04:00

Today Apple announced the new iPhone 5, an updated iPod Touch, a new iPod Nano, and a new OS for the iOS devices. What will be of most interest are the iPod Touch and iPhone 5. These now come with a larger, high quality display and faster processors. There are improvements to the inner workings for things such a lower power Bluetooth connection. On the outside they are thinner, lighter, and taller. The width is the same.

The iPod Touch has long been my favorite recommended device for nursing students who do not want the monthly cost of an iPhone. All smartphones require a monthly data fee. The iPhone 5 in the US will work with Verizon, AT&T, and Sprint but all require a minimum extra cost of $30 per month. However, for as price sensitive as students claim to be I find that nearly all of my students now have an iPhone or an Android smartphone.

For nursing faculty who want to recommend software that will work on any student's smartphone they will be limited to the major commercial reference titles. If you want to have students use the hundreds of other healthcare apps the best choice is the iOS line of devices. This includes the iPhone, the iPad, and the iPad Touch. Only the iPhone requires a monthly charge. The iPad and iPod Touch will work with WiFi access to the Internet.

Another advantage of the iOS system is that students only need to go to one place, the iTunes Store, to download apps. There are many free and low cost apps available.

Both the iPhone 5 and the new iPod Touch have a taller screen. Most apps will probably not take advantage of this increased real estate at first. I would expect that the developers of the major commercial apps will be updating their apps within a few months from now. All older apps will run fine but in a "letter-boxed" format so you won't see a stretched image.

I will post more ideas about how these devices affect nursing faculty as soon as I get my hands on one. I will be ordering one on Friday when preorders become available.

NPR addresses the Nursing Faculty shortage

2012-08-05T16:02:00.001-04:00

On August 3, 2012 the NPR radio program Morning Edition presented a balanced and informative story about the nursing faculty shortage. The story probably has nothing nursing faculty were not already aware of, but it is told with some real-life examples to illustrate the facts.

I also encourage you to see the comments section for that story. It has always made me angry at the number of people who believe the answer to a nursing shortage is to lower standards. We don't do that for any other profession but even nurses will denigrate the need for more education. I have always asked for where it says that less education is better than more education in any discipline?

Nurses' name tags have names on them, right?

2012-05-18T07:42:00.001-04:00

I have seen reports that some nursing programs are eliminating last names from student name tags for security purposes. This is troubling to me for several reasons. The purpose of the name tag is so patients and other staff can identify you. That is part of the openness necessary for patient praise or complaints. Nursing students are also new faces to the staff on a unit who also may need to identify a student. The other issue is one of professionalism. It is fine for my mechanic or waitress to display only first name because that is all the information I need in this transaction; but professionals should exhibit a little more formality. I really don't want my neurosurgeon to only be known as Doctor Phil. A physician-patient and nurse-patient relationship needs to be at a high level of trust. When a nurse refuses to reveal her last name then the message is sent to all patients that they are not trusted.

We give up much in the name of security even when it protects very little. Anecdotal stories of nurses being stalked are not enough to make decisions that diminish the role of nurses in patient care. A patient crazy enough to stalk a nurse or nursing student is probably also resourceful enough to find out her last name.

Nursing faculty need to be modeling a professional image for students. Cowering in fear over minimal risks sends the wrong message to students and patients.

Let's keep full names on the name tags of nursing students and faculty. Send a message to your students and patients that we are professionals engaged in mutual trust.

Now let me tell you what I think of the security measures of the TSA...

Calculators in Clinical? I sure hope so.

2012-05-09T10:42:00.001-04:00

Recently I heard about a nursing clinical faculty member who refuses to let students use a calculator in the clinical setting. I was stunned. Not knowing the rationale for this policy I will speculate that teacher thinks using a calculator will somehow soften students' thinking, or make them reliant on a machine that may not be available. Neither of these rationales have much merit.

Clinical education needs to focus on teaching students how to solve clinical problems. The overriding educational principle should be on how nurses would solve those problems and teach students that process. I cannot imagine a nurse refusing to use a calculator to check a dosage or other calculation.

We need to keep focusing on what skills students really need to function clinically. Calculators are ubiquitous. Even the NCLEX-RN exam has a pop-up calculator. Scenarios of blackouts or no calculators on a unit are too farfetched for faculty to be worrying about in our limited time with students.

This principle needs to be applied to all of our faculty decisions. Ask yourself if your methods of teaching or your assignments are helping students to make good clinical decisions? If are they vestiges of teaching the way your were taught, or an attempt to "toughen them up" then please let me know why they are still used?

We must keep student access to handhelds in clinical

2012-04-23T10:24:00.000-04:00

I just got back from a great trip to speak with folks from the Florida League for Nursing. During our conversations about the use of handheld computers many nursing faculty in attendance relayed stories of being denied use of handheld computers in the clinical settings. The reasons given for such a ban by a hospital are always a little fuzzy but I believe they are based on a few fears. As we know fear usually comes from lack of knowledge. Each of these fears can be easily answered.

Here are some of the fears and how nursing faculty need to respond:
1. A smartphone/handheld computer could be used for a HIPAA violation.
Response: There have always been ways to violate privacy of patients. All nurses and students are expected to act ethically, and there should be consequences if they don't. We just need to make the privacy rules clear, and the consequences for violations clear and consistent.

2. Those devices will cause interference with equipment that will endanger patients.
Response: Hospitals are full of radio interferences from the telemetry devices themselves, security radios, cordless telephones, light dimmers, fax machines, floor buffer motors, elevators, nearby cell towers, and of course visitors' cellular telephones. There is little evidence of interference unless the transmitting device is right next to the receiving device. Some ultrasounds and telemetry devices can be affected but just stepping back a few feet will stop the effect.

3. Patient satisfaction scores will be hurt because patients will think the nurses/nursing students are playing on their phones.
Response: I would first want data to see if there is even merit to this concern. I have had students using handhelds in the clinical setting for over 12 years and found patients like to see nurses looking up information that helps their care. Nurses need to explain and show what they are doing on the handheld, and the hospital needs to engage in some education through signs or orientation brochures explaining this is how nurses and physicians practice now.

We nursing faculty must be assertive in speaking with the hospital administration about the importance of this access. In the 21st Century it is impossible, and not even desirable, for nurses to know all the facts about the drugs, surgeries, procedures, and test results of their patients. There are more facts available every day but our brains stay the same size.

Nurses are users not just recipients of knowledge. Handheld devices help nurses use the facts to make clinical decisions.

And as a final argument, it was pointed out that the administration says nothing about physician use but feels it is OK to single out nurses for these restrictions. If I was at such an institution I would really press the administration for their reasons for such a double standard.

Nursing faculty cannot just let this happen without a fight. We need to be assertive and press our points. It is not only helps nursing education but nursing practice as well.

Apple's New iPad: A Nursing Textbook Replacement Device?

2012-03-19T16:07:00.000-04:00

After a long day waiting for the FedEx truck I have trying out the new third generation iPad (or New iPad) from Apple. I have been a big fan of the first iPad that I have been using for nearly two years. As much as I enjoyed it I found that reading books from the iBooks app or Amazon Kindle app was a struggle. The first generation iPad is heavier and, like the iPad 2, has half the screen resolution of the newest iPad. This meant that using it as e-reader was a challenge after a few dozen pages. I found it hard to get used to the weight and the slight fuzziness of the fonts grew tiresome.

With the third generation iPad the lighter weight and crisp display make reading a pleasure. There are still issues with glare in very bright environments but the overall experience is a big improvement. I found myself able to read much longer without eye fatigue. Text is now as sharp as the Kindle and other e-ink style readers but with full color and the versatility of a laptop computer.

For nursing educators I think this new iPad would be an acceptable substitute for a paper textbook. This is the first time I have ever thought that. The increased clarity means that texts can have richer content and smaller text while still being legible and useful.

Of course the next step is up to the publishers. They will need to direct energies to exploring the best way to design texts for iPad use. Apple has already created a textbook store in its iBooks Store. These books are currently aimed at high schools students but I suggest you take a look at the free Biology text they offer. It shows off the capabilities of the iPad to do more than display text. It includes 3D models and videos embedded in the text. Just imagine what nursing faculty could do with such a tool.

Apple's New iPad: What it means to nursing education

2012-03-07T15:20:00.000-05:00

Apple has announced the third generation iPad which offers some implications for nurse educators. This blog has addressed the advantages and possibilities of the iPad before but there is one new feature that changes its utility in education: Resolution. The new iPad has a resolution near that of the iPhone 4/4S called a Retina Display. What this means is that the iPad now has a readability much closer to the sharpness of the Amazon Kindle and other e-readers but with the versatility of a PC. Despite speculation that this generation would be called iPad HD it is simply called iPad. Confusingly, the old iPad is still iPad 2.

For educators this level of resolution brings the day that paper nursing textbooks can be replaced with electronic versions. The monochrome Kindle-type reader cannot be seriously considered as textbook replacements due to their lack of color, video, and audio capability. The new iPad will allow books to appear as clear as paper but with the portability of an e-reader and the versatility of a laptop computer. I look forward to seeing how nursing textbooks will look on this screen. The other step will be to incorporate high resolution video into texts.

Other cool features of the new iPad are new 4G-LTE support for high speed data connections when out of Wi-Fi, a processor that runs 4X faster than the original iPad, voice dictation whenever the keyboard is displayed, and an improved camera, all at the old price for an iPad 2 starting a $499 (up to $829 for a 64GB 4G-LTE version). The iPad 2 will still be available but is now $100 cheaper.

I will be ordering one as soon as the Apple Store goes back on line. I will report on it soon after it arrives. Rumors are that it should be delivered around March 16th.

How to Present iOS Nursing Applications to a Classroom

2012-02-27T15:00:00.000-05:00

I previously discussed the technical aspects of how to display the output of an iOS device but now it's time to look at what to teach students in the use of an iPad or iPod Touch or iPhone (all using the iOS operating system).

1. The Hardware: Buttons and Switches. The first thing to do is to be sure everyone knows how to turn on the device at the Power button or by pressing the Home button if it is asleep. The next most important control is the volume toggle. Finally, show students the Lock switch. The Lock switch can be used to lock the orientation or as a Mute switch. It is best on this step and the rest to have students practice on their own devices as you teach.

2. Basic Gestures. The nice thing about iOS devices is that they are pretty intuitive but there a few gestures you should demonstrate. First, the swipe. From the Home screen show how to swipe back and forth through the home pages. Second, the pinch gesture. Open a Safari web page and demonstrate how to navigate with swipe and then pinch in or pinch out for zooming in and out.

3. Basis Settings. If you are teaching first time owners of an iPad they should know how to open Settings and adjust WiFi and General settings. The others can wait until later.

4. The Healthcare Apps. I recommend that all nurses have reference apps. My favorite is Nursing Central from Unbound Medicine but there are others from Skyscape and PEPID that many nursing schools use. Students should first be given a walkthrough the dictionary, drug guide, diseases, and lab guides. Be prepared with some initial search terms to demonstrate. Ask a student to give you a term, drug, or lab test and then show how you would look it up. Finally, give the class some terms to look up. Discuss and difficulties they are finding and solutions you or their colleagues found.

5. App Management. This is a good time to show how Apps can be moved around the home screen, be put into folders, and deleted. Also, go to the App Store app and show how an application can be purchased or reinstalled. Also show how to search the App Store for healthcare-related apps.

6. The Variety Show. At this point in the instruction it is good to give quick exposure to some of the other healthcare apps you recommend. Explain why you would use them, then show how they work. There are around 1000 free and inexpensive apps of in the App Store so there are plenty of examples to prepare for your particular teaching needs.

These are my recommended steps for students' first introduction to the iOS device. As they become more familiar you can add future classes on troubleshooting, backing up, and more specific clinical uses of the apps.

"Situated Caring": An Integration of Nursing and the Environment

2012-02-15T14:39:00.000-05:00

Olga Jarrin PhD RN (who was a student of mine during her undergraduate days) has posted a very interesting presentation on her work on the concept of Situated Caring. Situated Caring is nursing care that is highly cognizant of the context, or situation, of the care. The context includes the external environmental influences as well as the internal influences of both nurse and patient (of course "patient" can be individuals, families, groups, and communities who interact with nurses). What I particularly like is her attempt to bring together what are often presented as competing worldviews of subjective and objective perspectives of health. She presents this as "left brain" and right brain" views. I never liked this dichotomy as most of us have two working hemispheres, and we approach the world with both. Her work really emphasizes that nursing care does not take place in a vacuum. As nursing educators we need to examine how we include context into our teaching of nursing concepts.

If your department is considering changes to the curriculum or philosophical framework I urge you to read her paper in Advances in Nursing Science: 35(1) 14-24. For a short time you can download a pdf of the paper here.

How to use an iPad 2 to teach handheld nursing applications

2012-01-30T09:45:00.000-05:00

I have been a long time advocate of using handheld computers as a reference resource during nursing clinical all the way back to the days of the Palm computer. Ever since then one of the most difficult tasks has been how to teach using the software with students. The difficulty is that it is hard to display to a group what is appearing on a small screen such as an Apple iPod Touch.

The original iPad released in 2010 had some video out capability but it was limited by the software. Developers needed to add code to software to let it be displayed, and very few did. The iPad 2 eliminated this restriction by providing a mirror display capability. In a mirror display whatever you see on the iPad will also be displayed on the external monitor. Unfortunately, there are still some considerations for nursing faculty hoping to show their students software in operation.

The iPad 2 mirror display requires a HDMI-capable monitor, an iPod-to-HDMI adapter (called the Apple Digital AV Adapter), and a HDMI cable. The adapter is available in the Apple Store and HDMI cables are easy to find, but many nursing programs do not yet have HDMI-capable displays.

Apple Digital AV Adapter

Most computer monitors and LCD projectors that are now ubiquitous in classrooms do not have HDMI capability. HDMI creates a digital "handshake" between the monitor and the device to limit copying. It is on every flat screen screen television sold in the last few years.

For nursing faculty this means we must push for the acquisition of HDMI-capable displays. They are a good investment as we migrate to high-definition instructional videos using Blu-Ray players it will be useful more than just handheld computer teaching.

When hooking up the iPad 2 to the adapter be sure to also plug in the power connector as you will run out of battery power very quickly without it. I also recommend you get a very long HDMI cable. They are available in many lengths but I suggest at least 12-foot. The most common 6-foot cords will not leave you much room to get into an area appropriate for pointing out what students will see on the monitor.

Some other tips:
• Software designed for the iPhone will display as an iPhone shaped rectangular screen. Use the 2X button to enlarge the display.

• Use the Orientation Lock next to the volume button to keep the screen from shifting from vertical to horizontal as you move the iPad.

• Have students follow along as you demonstrate a capability of the software. Then ask them to call out something they would like to do and then demonstrate that. Give students other tasks to do, such a look up a med or procedure, then see who is having difficulty. Ask a student who is able to do the task come up and demonstrate to the class.

• This advice will also work with the Apple iPhone 4S released in the summer of 2011.

Do you have any other tips or advice?

Apple's Education Initiative and Nursing Education

2012-01-20T10:25:00.001-05:00

Apple's Education Event announced yesterday brings some exciting opportunities to nursing educators. The event introduced three new things:

iTunes U: A course management system that works through iTunes. It lets faculty manage courses and post content.
iBooks 2: The next generation of iBooks for the iOS devices (iPod Touch, iPhone, and iPad). It adds new navigation, highlighting, interactivity, study cards, tap word glossary.
iBooks Author: Mac software that enables educators to write their own interactive textbooks.

The addition of iBooks Author has the greatest potential effect for nursing faculty. Imagine writing and publishing your own textbook that your students can download directly to an iPad. Self-publishing has not been a big factor in nursing academia but the advent of e-books is stimulating a change. I can foresee faculty creating their own books that will illustrate important concepts in nursing using video, audio, and links to Internet resources.

This new option also creates new questions about student purchases of technology and e-books, who owns the book, and who gets paid for the work. I recommend you view the Apple video and see where you think nursing education can go with this.

NLN Webinar on Curricula Implications of Informatics and Social Networking

2012-01-16T10:43:00.003-05:00

Here's a blatant advertisement for an upcoming webinar series by the NLN called Curricula Implications: Informatics and Social Networking. This is a three-part series on teaching electronic health records, integrating informatics into the curriculum, and the implications of social networking in nursing education.
A webinar is a one-hour audio/video conference you watch from any computer connected to the Internet. There is a question and answer period at the end. This webinar consists of three one-hour sessions held on Monday afternoons in February.
I am going to be teaching part of the session on the curricular implications of social networking. I hope you can join in.

4 Technology Issues for Nursing Educators in 2012

2012-01-09T09:45:00.000-05:00

As we begin a new year nursing educators face many challenges. What are some of the technology issues of interest to all those who teach nurses?

Need to incorporate electronic health records (EHR) into the curriculum. Documentation has long been taught but faculty now need to address how EHRs affect assessment and evaluation of patients. Additionally, students are entering clinical sites with a need to quickly adapt to various EHRs. Faculty must consider how to teach the principles of EHRs.
Need to assure access to EHRs by students and faculty. In the past, no hospital would think to deny student access to the patient charts but with the advent of EHRs some hospitals are now doing that. Nursing administrators or staff development people who are faculty liaisons must understand that they must push back when an IT person declines student access to an EHR. Faculty must be clear about learning needs, how they fit the mission of the hospital, and that IT should not be in charge of nursing education.
Need to plan how social media fits into your nursing program. While nursing students are heavily involved with Facebook and Twitter, how many nursing faculty even understand what they are? Remember when e-mail arrived and some faculty struggled to change the way they communicated? That is happening again with social networking. Nursing programs will need clear guidelines on how to use these media for external marketing and internal communication.
Need to evaluate your nursing program's use of technology to enhance learning. Technologies that have strong pedagogical advantages are available to faculty at lower cost and are easier to use. Make 2012 the year you investigate how to use Wikis, Blogs, Podcasts, Photo sharing, and Social networking.

Nursing graduate competencies in technology in 2012

2011-12-05T13:17:00.001-05:00

While it's obvious our graduates are entering a practice world that increasingly uses technology, it is less clear how students are being prepared for such practice. Nearly all nursing faculty had their basic education at a time without desktop computers, electronic health records, and handheld computers. Faculty are expected to have clinical expertise in their specialty but how many nursing schools expect their faculty to have technological expertise? Most faculty develop their skills through experiences in their clinical sites or by attending conferences, but is that enough?

Accrediting agencies at both the nursing level and the general higher education level are expecting graduates to have skills in technology. Nursing has a long history of constant revision with curriculum. You curriculum revisions of 2012 need to focus on these areas:

1. What are the expected technology competencies of our graduates?

2. Are our faculty prepared to teach students how to use these technologies?

The answers to those questions will require debate, a commitment to financial resources, and faculty development. Those questions will not be quickly answered. It will take a great deal of short and long term planning. What is your department doing to answer these questions?

4 Gift Ideas for Nursing Students this Holiday Season

2011-11-27T13:39:00.001-05:00

Nursing educators are heading into the final days of the fall semester at most schools. I like to give my students gift ideas that they could use to make their student lives easier. I suggest they pass them on to their parents and relatives. Here are my top 3 suggestion for the 2011 holiday season:

1. Monochrome Laser Printer: So many students tell me their printer is broken or out of ink, or that the school's printer is broken or being used by too many others. A black and white laser printer can be had for under $100. Even though toner cartridges cost around $60 students fail to realize that the cost per pages is only pennies, print quality is superior to inkjet, they're fast, and the toner never goes dry like an inkjet cartridge.

2. Apple iPod Touch: At $200 this is a great tool for students. No monthly fees, hundreds of healthcare applications (with many of them free), and lots of other non-academic uses including a camera, calendar, calculator, and iPod make it the best deal in the electronics store.

3. Apple iPad 2: If their parents have a bigger budget the iPad WiFi has all the benefits of the Touch and works well as an e-reader. The 3G model has monthly fees to access the Internet but has no contract.

4. All those too rich for your blood? How about a LED Penlight? They are very bright and last hours longer than the old-fashioned lights. They start around $7.

I hope you all have a good end of the semester. Stay calm. It will be all over soon.

Is the Amazon Kindle Fire useful to nursing educators?

2011-11-15T14:13:00.001-05:00

This week Amazon releases its latest member of the Kindle e-reader family, the Kindle Fire. On its surface it looks like smaller (7" vs 10") and cheaper ($200 vs $500) Apple iPad but there are differences that nursing educators need to consider.

First, some details about the Fire. It is tablet computer running an Amazon version of the Android operating system. It's primary purpose is to connect with the Amazon universe of books and shopping. It also has a web browser, an e-mail reader, and built-in links to Amazon's Android App Store. Early reports are that it does these things well and has an easy-to-read screen not unlike the iPad's. Unlike the iPad, the Fire has no Bluetooth, microphone, camera, or GPS. The Fire also has no automatic ability to read PDF files unless you first e-mail them to the device.

For nursing educators the Fire still may be an option. Before committing to the Fire be sure that the applications you want are available. While many Android healthcare apps are available many are not yet on the Amazon App Store. There are also far fewer healthcare apps for Android than for the iOS devices (i.e., iPhone, iPad, & iPod Touch). This means more support issue for faculty who are want students to get specific applications. To me, the inability to directly read PDF files is also a killer. Getting students to e-mail themselves a PDF you've assigned seems like a tech support nightmare.

So the Fire may have some specific applications for educators, and its price is attractive, but its limitations seem too great for use in a nursing classroom or clinical setting.

5 Tips for Poster Presenters

2011-11-08T16:16:00.005-05:00

I just got back from a conference and enjoyed many of the posters but I also was frustrated that so many educators fail to meet the needs of their audience. Here are some tips:

1. Minimize the text, Maximize the images. Why are so many posters practically a copy of their manuscript? Pick out the most important points and print only those. Use images, flowcharts, or charts to illustrate concepts. I should be able to tell what you did in a few seconds, remember there are lots of other posters I have yet to see.

2. Provide a handout with more detail. You're frustrated that you have so little on the poster? Make copies of the detailed description of your presentation. Use a small font and two columns and you can fit all the text onto one page.

3. Give clear contact information. Put your more than your name on the poster. Give us your email address so we can contact you for more information later. Put contact information on your handouts too.

4. Put the title of your study on a sticker and put it on the back of your business cards. If you want more people interested in your work a business card is great, but when I get home how will I remember what you did? If I have the title on the back of your business card I will remember what you did and know how to get in touch with you.

5. When you are standing by the poster during the poster session, engage those who walk by. The purpose of a research conference is to share research. This is not the time to avoid eye contact with people walking by. We all came from far distances to be there, engage us with some small talk, ask about our interests. We both may learn something.

The iPad at 1 year old: Its Effect on Nursing Education

2011-04-04T10:45:00.000-04:00

The Apple iPad was released a year ago today. I waited in a line and bought one sight unseen. In that time it has changed the computing in ways that are well documented. It is, as Steve Jobs described, a Post-PC device. Its ability to bring multimedia to your hand in a small form factor but with a large screen and a touch interface brought new opportunities to nurse educators. So where do we stand a year later?

As of today the App Store lists 1001 paid and 435 free iPad apps in their Medical category. Also keep in mind that nearly all the other thousands of apps written for the iPod Touch and iPhone will also run on the iPad (although in a enlarged display of the iPhone screen). Just as in the early days of the Palm handheld computers the majority of apps are geared to physicians, although many can be of interest to nursing students. For example, there are many apps to help learn anatomy. The iPad is particularly well suited to this with its big bright screen.

A search of "nursing" in the iPad Medical category shows 37 applications. The modal type in this list are NCLEX-RN preparation apps. Also available are some reference texts such as dictionaries. Among the major nursing suite apps none have been released for the iPad yet. It is a big investment for organizations such as Skyscape and Unbound Medicine to expand into the iPad market, and it is a scary prospect for them when there is little evidence of many nursing schools requiring an iPad. This chicken and egg dilemma has been at the heart of every technological advance.

Another area I am waiting for is the availability of nursing textbooks in iBooks form. This will be the "killer app" for the iPad in nursing education. My students tell me if they would love to carry all their books in an iPad. One of the biggest hassles of being a nursing student is the nearly one hundred pounds of textbooks they need to study. Being able to take their books to any place on campus and to the clinical area would be a big advance.

Keep in mind that the iPad is currently great at viewing pdf files in the iBooks app. I have been distributing my handouts in pdf form. They can be viewed on many platforms but the iPad is a great way to carry and read them.

So one year later the iPad has yet to fulfill its promise for nursing education but things are improving. The availability of the second generation, greater awareness of what the iPad can do, and the availability of thousands of apps that didn't even exist a year ago point to a bright future.

Educational Technology is expensive, but can we afford NOT to use it?

2011-04-01T09:45:00.001-04:00

I have been talking with nurse educators for years about different technologies that enhance learning. In the 1980s just having access to a computer was considered an achievement. Later I spoke about the uses of applications such as PowerPoint and how they helped organize a lecture. In the 1990s we talked about the coming of the Internet and how we could use it in nursing education. At all these phases there was always the complaint that it was 1) too expensive for the nursing school, 2) too expensive for students to buy, and 3) was not necessary because the old way of teaching was just fine. In all those cases the arguments were forgotten and now the technologies are considered a required part of nursing education.

Today I hear the same arguments about the use of handheld technologies; and my answer is the same. If the technologies have advantages over the old methods, and can help us create better nurses, then we can't afford not use the new tools.

Of course the reality is that money can be scarce with a nursing department, students will complain about spending anything on their education, and faculty are reluctant to spend money on new technology for themselves. Here are some points to consider:

1. Education is, and has always, been expensive. I am sure many nursing faculty reading this feel they are paid less than they are worth. Does anyone think that if we hired cheaper but less qualified faculty that the quality of the graduate would improve? There is an expression "you get what you pay for". If faculty sit still and not incorporate technologies that would improve the quality of the graduate then we will get what we pay for.

2. Students will always complain about spending money. Nursing textbooks cost thousands of dollars over the course of a curriculum but we don't tell students "that's OK, these books are optional". All of the healthcare-related reference texts are available in electronic form. If it is to the students' advantage to have the references wherever they are clinically then we should not feel bad about complaints of having to buy an iPod Touch to carry them.

3. Commitment to spending has to come from the top. Nursing schools that have most successfully incorporated technologies such as high-fidelity simulation or handheld computers had administrators who were committed to using the technologies. It takes administration support to help find the financing, commit a portion of the budget to such spending, and bring the more reluctant faculty along into new ways of teaching.

In upcoming blogs I will discuss some ways to pragmatically address these points in nursing education. I welcome your opinions.

3 Reasons Nurse Educators should require iPads and iPod Touch devices

2011-03-28T11:55:00.000-04:00

A commenter to an older post just asked a very good question about the cost of incorporating devices such as an Apple iPad into nursing education. So is it a good idea to add an additional expense to nursing education by requiring the use of a handheld device such as an iPhone, iPod Touch, or iPad? This is a question I hear a lot when speaking about the advantages of these technologies. Here is why I think it is worth it to have students use these technologies today:

1. They change the way students learn and apply information. Traditionally students learned nursing by buying textbooks, listening to lectures, and taking a multiple-choice exam. Moving to a handheld delivery system is not just making books available in electronic form. The change brings a change to the way students learn. In the classroom the teacher can move from presenting facts to giving lessons on how to apply knowledge. There is too much information to know it all but knowing how to find and use information quickly is really what nurses need to do in the 21st Century.

2. They provide a media delivery device directly to the student. Currently most students have to go to a library or a computer lab to view media that contribute to their learning. For example, to learn a procedure students once had to view a film strip or 16 mm film, later they watched a video tape or DVD. With a handheld device the video can be viewed wherever the student is. Right now there are nursing programs developing mini-videos of procedures that students can review just before going into a client's room.

3. They help faculty use proven pedagogies to improve learning. Educators have known for years that multi-media enhances learning. Steve Jobs calls the iPad a "post-PC" device. It gives students the ability to have audio, video, web-based apps, and clinical apps all in one device. This means that it is more than just a portable media delivery system but a whole new way to teach students how to use information p.r.n.

Apple iPad 2 Digital AV Adapter biggest advance for educators

2011-03-03T09:13:00.003-05:00

The announcement of the iPad 2 brought improvements in speed and weight and adds cameras. Those are great but lost in most accounts is the biggest feature for nurse educators, the ability to display apps on an external display. Apple is now offering a Digital AV Adapter for $39. On the iPad 2 this adapter creates a mirror output of the iPad's screen on a flat screen TV that has HDMI. This is a huge step for educators because now all apps can be shown to a classroom in real time on a real iOS device. Nurse educators can teach how to use clinical software in a way never before possible. Up until now only applications with the external-output code could be displayed. Faculty can now walk students through the options of their clinical applications.

Apple Digital AV Adapter

This adapter is not just for the new iPad. It will work with the iPod Touch 4th generation, the iPhone 4, and the original iPad (in 720p not 1080i).

Some caveats: The mirroring capability will only work with the new iPad 2. It is not yet clear what can be displayed on the other devices (my guess is just software with the external-output code). You will also need either an HDMI display or a way to convert your HDMI signal to DVI or VGA. DVI, which is used by most modern computer monitors can be displayed with a simple converter/adapter. To use VGA, which most projection LCDs use, requires an additional adapter such as the one available from HP. The reason for the HDMI requirement is due to the ability of HDMI to retain copy protection for videos.

Apple is promoting the iPad as a tool for educators at all levels. The AV adapter will really help nurse educators teach students how to use any of the hundreds of healthcare-related apps that are available for the iPhone and iPad. The adapter should be available on March 11 in the USA.

How iPhone 4 Affects Nursing Education

2010-06-29T12:49:00.000-04:00

The iPhone and iPod Touch have now been available with downloadable healthcare software for two years. The number of applications of interest to nursing faculty has expanded to nearly 1000 applications (out of the over 200,000 applications) in the Apple App Store. Apple has now combined the operating system for iPads, iPhones, and iPod Touches into the iOS. This will help developers create software for all the devices, all of which have nursing education implications.

The introduction of the iPhone 4 adds to the versatility of the Apple devices in education. The biggest change to the phone from an educators perspective is the much improved display. The iPhone 4 has the twice the resolution of the old phone. It is now much easier to read even very tiny text on the screen. For nursing educators this means students can read health-related texts and web pages with much more ease. The free iBooks app allows the importation of pdf files. Faculty could distribute course syllabi, class notes, or supplemental readings in an easily transportable form.

In addition to the great display the iPhone 4 has improved still and video camera capability, a front facing camera for video chat, and a much faster processor. I recommend you get a demonstration of the new phone if you are in the market. I predict that Apple will also be updating their iPod Touch in the coming months to take advantage of the display and processing improvements. All the more reason to consider adding a handheld computer to the nursing curriculum.

One Month as a Nurse Educator with an iPad

2010-05-03T11:26:00.000-04:00

One month ago I stood in line to pick up my reserved 16-gig WiFi iPad. So what is the state of the iPad as it pertains to nursing education? How does it compare clinically and educationally to the iPhone? I have taken both the iPad and the 3G iPhone to my clinical site, and the University where I work, and found that each has its advantages and disadvantages. Here they are:

Internet Access: Winner- iPad. As long as you are within WiFi, and I am at the hospital, the University, and most other public places I visit, the Internet browsing experience is much faster and easier to use than on an iPhone. I have long been unable to use Flash on the iPhone and it hasn't made much difference in my browsing.

E-Mail: Winner- iPad. The mail application is especially nice in the landscape mode. I can see my e-mail accounts, easily and quickly open messages, and manage those messages much faster than on the iPhone.

Reading: Winner- iPad. I never owned an e-reader such as a Kindle so reading e-books has been a new experience. So far I love it. The ability to change font size, bookmark, and see full color illustrations has been very helpful. I am reading more now than before as I can quickly read a few pages without having to carry every book.

Clinical Applications: Winner- iPhone. While the iPad's size makes for easy viewing it is also too big to carry around in an inpatient hospital setting. The iPad doesn't fit in a scrub pocket or lab coat so that means carrying around with my other papers. Another issue is that there are few clinical apps so far that take advantage of the iPad's features. Most of my iPad apps are just iPhone apps at 2X size. The iPhone is still the fastest way to quickly find clinical information. On the other hand, finding and reading a journal article is far better on the iPad.

So my final grade for the iPad is: Incomplete but showing great potential. It does a lot of things very well right now. When nursing textbooks designed for the iPad become available it will really make the use of paper texts a thing of the past. We also need to see clinical applications that can really take advantage of the larger screen.

5 Must Haves for Apple iPad Nursing e-books

2010-03-25T20:26:00.001-04:00

With release of the Apple iPad around the corner there have yet been any announcements about the availability of nursing texts. The iPad has great potential as a replacement for paper textbooks, but iPad nursing texts need to be more than electronic versions of the old. Here are some features that publishers need to include to make e-reader books better learning tools for nursing students:
1. Hypertext within the book. Keywords and links to other portions of the text would enable the reader to jump around the book and find the other relevant sections with ease. For example, in a section on care of a patient in a cast could link to another section on neurovascular assessment. Additionally, every word in the index should link to the respective section.

2. Large images. Currently, images in textbooks are limited in size due to space limitations. E-Books have no space limitations. Images should be enlargeable to the size of the e-reader screen. This would allow students to get much better images to study. Thinks of the detail for skin conditions, retinas, or cell images.

3. Embedded video. Textbooks have been limited to still images, until now. Procedures, communication examples, or animated processes should be embedded within the text.

4. Relevant Internet Links. While recent texts have included websites, e-books can actually link to those sites. The Apple iPad has Wi-Fi or, in some models, 3G network access. Nursing students should be able to instantly visit any sites listed. Links could also go to data that changes frequently such as daily morbidity statistics.

5. Embedded audio. Like images and video there are also sounds such as lung, heart, and bowel sounds that could be included. Additionally, image great lecturers including audio to help students learn difficult subjects.

It is time for nursing publishers, and nurse authors, to begin to think "outside the covers". What other things do you think nursing e-books should have?

Clinical guidelines for use of electronic devices

2010-03-18T08:42:00.001-04:00

Any of you teaching clinical have seen that nearly every student comes to clinical with at least a cell phone. Many now have iPhones or Blackberry devices loaded with clinical software. It has long been standard practice that students are not to engage in personal business while functioning as a nursing student in the clinical setting. New technologies now obligate nursing faculty to be more explicit in directing the proper use of these devices.

Some agencies and nursing schools have proposed banning mobile devices altogether. This is unwise as important clinical software is now available for these devices. Faculty should be encouraging the use of new technologies and applying the latest information when conducting patient care.

Here are some guidelines to establish with students. These should be put into your syllabus to clarify your expectations:

1. Protect patient privacy: Students may not use cameras to take pictures of patients. Healthcare data that identifies a patient is not to be removed, or transmitted, from the clinical site. Lab values and other assessments can be stored as long as no patient names or identifying numbers are connected to the data.

2. Professional conduct: Students are not permitted to engage in personal business while performing as a clinical student without faculty permission. This includes voice calls, texting, or Internet browsing for nonclinical information.