1153 Teaching Nursing Mediated by Computer: Students Evaluation Heloisa Helena Ciqueto Peres a, Karina Cardoso Meira b, Maria Madalena Januário Leite c, Grace T. M. Dal Sasso d, Denise Tofo Silveira e a,b c University of São Paulo (USP), São Paulo, Brazil d Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil e Federal University of Rio Grande do Sul (UFRGS), Rio Grande do Sul,Brazil Abstract It is an exploratory descriptive study. This study objective is to evaluate the educational site used to teach the subject Didactic in Nursing in the Nursing Graduation Course of the University of São Paulo. The results showed that the nursing students were ready to use the computer systems and they are favorable to the adoption of the new teaching methodologies, which amplifies the communication between teachers and students. Keywords: Nursing Education, Educational Technology; Medical Informatics. 1. Introduction The informatics introduces new possibilities of collective creation, cooperative learning and net cooperation. These new possibilities are raising questions about the working process in the educational.[1] The school was built based on the transmission of the knowledge and the memorization. Now it must change, the school is not the only privileged place for the education anymore. Education can be found through the mass means of communication, the companies and the computer system technologies. That is why, nowadays there is lots of questioning about the school as the only possible place to spread culture and acquire the social knowledge produced [2,3]. The teaching process mediated by the new communication technologies uses the Internet to store, recover and organize information, as well as, to evaluate the students progress and production. This settings with communication technologies giving at the students more flexibility, creativity, dynamism, interaction and communication in the teaching learning process. It is stimulates the active participation of the student based on a constructive concept. It is also helping the development of the distance learning, as a way to promote the continued education for the health professional while facing the fast technological development and its fast obsolescence[4,5]. In the nursing, the informatics is the focus are the largest in researches to identify and describe the abilities related to the use of a computer by the nurse, to define the content that has to be taught, as well as to evaluate the computer system disciplines in nursing.
1154 The main purpose of this subject is related to the use of the computer system technologies in nursing[6,7]. 2. Background The study was conducted in the school of nursing of the University of São Paulo, in Brazil. In this school, the content related to the health educational process and the themes connected to the pedagogical tendencies and their use in nursing and the planning as an instrument of health educational action are found in the discipline intituled Didactics in Nursing. We used an asynchronized communication with group of students by e-mail, discussion forums and by using other resources of the Internet as the hypermedia information (WWW), the virtual libraries and the electronic journals. A home page of the discipline was developed in HTML and it was available in the School site, which allowed the students to access the objectives, the content, the e-mail and the program of the discipline, interesting links and sites, on-line articles, e-groups and bibliographical references related to the discipline as well as the slides presented during the classes and the studies done by groups of students. These tools aimed to give the students conditions to communicate with the teachers and other students, to talk about the classes, to discuss theme related to the discipline, to send the teachers their production and to access important information in order to improve the their development. These tools also aimed to amplify and diversify the ways of communication and to bring more flexibility to the educational process. A student, holder of a scholarship from the Teaching Department participated in the development of this project and the collaboration of the Information System Department of the School was needed. The Information System Department is responsible for the technical support for the administrative, teaching, research and extension areas. The computer system classroom, with 12 computers connected to the net, was available at programmed hours for group works and in the pro-student room, with 14 computers, the graduation students had free access to the net. 2. Objectives To characterize the students profile according to their computer system knowledge; To evaluate the site of the discipline Didactic in Nursing, according to its form, content and use in the teaching process. 3. Material and Method This is a quantitative, exploratory and descriptive research. Eighty students enrolled in the discipline Didactic in Nursing of the Nursing Graduation Course of the School participated in the study. Thirty-six students answered the questionnaire. After the research project was approved by the Ethic Committee of the Institution, a meeting with the students who attended the discipline was appointed to explain them the aims and purposes of the research and to give them the questionnaires for data collection. The instrument used for data collection was a questionnaire divided in two parts. One of them was related to the students profile with 6 closed questions and the other part was about the evaluation of the site with 11 closed questions and 4 dissertation questions.
1155 By using the Excel computer program, the data obtained from the students were registered and put in tabular form. They were also presented in tables and graphics with absolute numbers and percentages. 4. Results and Discussion 4.1 Students profile concerning the use of the computer Most of the students (94.4%) who participated in the study were female, which reflects the predominance of women in the Nursing School and in the nursing field as well. Concerning the age, most students were young adults from 19 to 25 years old (94.4%), what makes this result compatible with the results found by some authors in their studies [6,8]. All the students interviewed (100%) use the computers and 34 students (94.4%) have a computer at home connected to the Internet. The students who do not have a computer at home access the Internet in the school where they study, in their families or friends houses or in commercial houses. The most frequent activities performed by the students on the computer are shown in the table 1. Table 1 The distribution of the computer activities performed by the graduation students of the Nursing School of São Paulo city, São Paulo, 2003. Activities performed on the computer * N % Typing papers 34 94.4 Internet 33 91.3 Presentation of papers 32 88.8 Bibliographical research 31 86.1 E-mail 11 30.5 Classes 4 11.1 Entertainment 3 8.3 Júpiter system** 2 5.5.* The students answered more than one activity. ** The Júpiter system is a computer system specially developed for the School. It allows the students to access their school reports and information related to the disciplines. It was noticed that the students frequently use the computer to do school works as typing (94.4%) and presentation of papers (91.3%) and it is less used for activities related to entertainment (8.3%). The programs for typing and paper presentation were the most used ones, which is similar to the findings by Peres[6]. It was observed that the development of the information technologies made the computer equipment necessary for the performance of several human activities, including the school activities. In this way, the use of new technological resources in the educational process of the professionals became a challenge for the Brazilian Nursing and these resources are not frequently explored by the Nursing Schools[9]. Then, it is defended the creation of the discipline Informatics in Nursing, aiming to develop the information system competences and abilities in nursing in order to make the students understand the use of these resources during their professional practice, contrary to the instruction of basic computer competences [7,10]. According to Luís [11] in order to make the students understand the use of the computer system resources in the nursing practice, the teaching of computer system has
1156 to promote an interdisciplinary net among the graduation disciplines and it should not be an isolated discipline. The computer systems discipline in nursing should not focus the basic computer training only (word processors, programs for presentation, chats, forums and etc), but it has to allow the students to sew the potentialities and limitations while using these resources in their professional practice. The students ability concerning the Internet resources, most students (55.5%) are able to use the e-mail and show from great to regular ability to use the Internet (44.4%). The students showed lower ability to download programs and to use the instruments that allow better communication and interactivity as the forums and chats. 47.2% of the students present a regular ability to download programs, 50% of them are not able to use forums, 33.3% of the students have regular ability to use the chats and 22.2% has no ability to communicate by chats. Associating these data with the activities performed by the graduation students on the computer, as shown in Table 1, it is observed that although the e-mail is not frequently used in the school activities, the students have great ability to use it. The same happens with the use of the resources to surf on the Internet. These findings show the importance and the need of the use of computer in the teaching of Nursing Graduation and aiming to build a new informatics in nursing conception, useful during the professional practice. 4.2 Students evaluation of the site The students evaluation concerning the form, the content and the use of the site in the learning environment can be seem in the graphic 2, below. Graphic 2: Distribution of the answers obtained from the evaluation of the following aspects related to the site: content, form and use in the learning environment. Answers given by the students of the Nursing School of São Paulo city, São Paulo, 2003. excellent very good good regular bad 36 30 24 18 12 6 0 Items in the site comnunication clearness objectivity quantity of information. colors vocabulary Images surfing teaching environment Desing Regarding the objectivity related to the content of the site, the students evaluated as good 33.3% and very good 41,6%; about clearness 30.5% said it was good and 36.1% very good; the quantity of information was evaluated as good 38.8% and as very good 27.7%; concerning the vocabulary used the students evaluated as good 41,6% and as very good 33.3%.
1157 They also said the resource facilitated the access to the information related to the theme Didactics, to the articles from magazines and journals and to the papers of other students, besides reducing the costs with paper copies. Some students talked about problems with the Internet connection. The students evaluated the form of the site as good 33.3% and as very good 41.6%; the use of colors was evaluated as good 27.7%, as very good 22.2% and as excellent 27.7%; about the images they said good 19.4%, very good 38.8% and excellent 27.7%; the design was seem as good 19.4% and very good 58.3%; the means of communication were good and very good 33.3%; the surfing on the site was evaluated as good 19.4% and very good 50%. The use of the site as a teaching environment was evaluated by the students as good 22.2% and very good 36.1%. They site structure and its means of communication were pointed out as positive aspects, once it permits a bigger and diversified interaction among the teachers, the students and groups of students. They also suggested that this instrument should be used in other disciplines, because it facilitated the learning process. It was verified that the students pointed out as positive aspects: the possibility of getting information out of the classroom, which facilitates the learning process and the following process of the discipline as well as the organization of activities and the communication between the students and the teachers. The students suggest the use of this resource in other disciplines, and the same kind of suggestion was observed in studies done by Santos [12], by Zem Mascarenhas [13] and by Maio and Ferreira [14]. The students believe this is an important instrument to acquire knowledge and it allows them to review the subjects, clear doubts, and establish communication between students and teachers, besides helping to memorize the theoretical contents. The students evaluated the availability of information as an unfavorable aspect, because it was not easy to access and it suggests that the communication among the students should be intensified and they should be more motivated to use the site. As the discipline used only the e-mail as the communication resource, it was noticed the need to intensify the use of tools like forums and chats, because as it can be observed in the Graphic 1, the students have low abilities to use this resource and it is important to develop these abilities, so the students can identify the potentialities and the limitations of these resources in their professional practice. Nowadays it is possible to see the fast development and use of the technological information resources. In this way, it is very important for the Nursing Schools to be involved in this context, so the nursing professionals will be able to use the new technologies and will not be used by them only. 5. Conclusion It was noticed that the students frequently use the word processor and the presentation programs: typing (94.4%) and presentation of papers (91.3%) and it is less used for activities related to entertainment (8.3%). Most students 55.5% had a great ability to use the e-mail program and 44.4% of the students an excellent ability to use the surfing programs and 47.2% had regular ability to download programs. Concerning the resources that allow greater communication and interactivity like the forums and the chats, the students showed lower ability to use them. 50% of the students
1158 did not have the ability to use the forums and 33.3% had regular ability to use the chats and 22.2% had no ability at all. The students evaluated the form, the content and the use of the site as a teaching environment as good and very good, because they amplify and diversify the means of communication between the students and teachers, they also allows the students to acquire new contents and they facilitate the learning process. The students pointed out the possibility of getting more information out of the classroom and a greater communication among the students and between students and teachers as favorable aspects. They suggested the use of this resource in other disciplines. It was also noticed that some students did not consider the resource very important for the learning process. They only made use of it to get access to material related to the discipline. We conclude that the use of new technological resources in nursing is a challenge to be faced. The students and teachers attitude towards the educational process must be changed. 6. References [1] Lévy P. As Tecnologias da Inteligência: o futuro do pensamento na era da informática, Rio de Janeiro: Editora 34; 1999. [2] Peres HHC, Kurcgant P. O ser docente de enfermagem frente à informática. Rev Lat-Am Enferm [periódicos on-line] 2004; 12(1).Disponível em: < http://www.scielo.org>. [3] Tiramonti G. Los imperativos de las políticas educativas de los 90. Rev Fac Educ [periódicos on-line] 1997; 23(1/2).Disponível em: < http://www.scielo.org>. [4] Bastos, MAR, Guimarães EMP. Educação á distância na área de enfermagem:relato de uma experiência. Rev Lat-Am Enferm [periódicos on-line] 2003;11(2).Disponível em: <http://www.scielo.org> (20 jul de 2004). [5] Christiane L, Ramos MP, Bessa R, Sigulem D. O papel do ensino á distância na educação médica continuada: uma análise crítica. Rev Assoc Méd Brás [periódicos on-line] 2003;49(3).Disponível em: <http://www.scielo.org> (20 jul de 2004). [6] Peres HHC, Duarte YAO, Maeda ST, Colvero LA. Estudo Exploratório sobre a Utilização dos Recursos de Informática por Alunos de Graduação em Enfermagem. Rev Esc Enferm, São Paulo 200;35(1): 88-94. [7] American Nurses Association (ANA).The Scope of Pratice for Nursing Informatics. American Nurse Publishing: Washington 1994: p.1-15. [8] Santos SR. Análise das Atitudes de Enfermeiros e Estudantes de Enfermagem na Paraíba-BR quanto á Utilização do Computador. Rev Lat-Am Enferm 2001;6(9): 56-61. [9] Marques IR, Marin HF. Enfermagem na WEB: O processo de criação e validação de um site da WEB site sobre doença arterial coronariana. Rev Lat-Am Enferm [ periódicos on line] 2002;10(3).Disponível em: <http://www.scielo.org>(20 de jul de 2004). [10] Marin HF. Nursing Informatics in Brazil : a Brazilian Experience. Comput Nurs 1998; 16(6): 327-32. [11] Luis MA, Moala FA, Évora YDM, Scochi CGS, Rodrigues RAPR. Avaliação de uma Disciplina de Informática por Graduandos de Enfermagem.Rev Lat-Am.Enferm 1995; 3(2):59-69. [12] Santos BRL, Funcke LB, Ribeiro NRR, Uebel WS. Percepção dos Alunos de Graduação sobre a Informática no Ensino de Enfermagem. Rev. Gaúcha. Enferm 1993;14(1): 40-44. [13] Zem-Mascarenhas SH, Cassiani SHB. Desenvolvimento de um Software Educacional para o Ensino de Enfermagem Pediátrica. Rev. Lat-Am Enferm 2001; 6(9):13-8. [14] Maio M, Ferreira MC. Experience with the first Internet-based course at Faculity of Medicine, University of São Paulo. Rev Hosp Clin. São Paulo.2001; 56(3) :69-74.