Student Nurses ' Perception of the Impact of Information Technology on the Quality of Teaching and Learning

The purpose of this paper was to investigate student nurses' perception of the impact of using information technology (IT) on the quality of teaching and learning of critical care nursing. This study was carried out at Faculty of Nursing, Mansoura University, Egypt. The sample included 163 of fourth year Bachelor of Nursing students enrolled in critical care nursing course (CCNC) during the academic year 2007-2008. Data were collected using a questionnaire sheet which gathered information about student nurses' IT skills and use, perception of the access to and use of IT at Faculty of Nursing, perception of the impact of using IT on teaching and perception of the impact of using IT on learning critical care nursing (CCN). Data were analyzed using the Statistical Package for Social Sciences version 9.0 for windows. The findings indicate that student nurses had positive perception of the impact of using IT on the quality of teaching and learning CCN. Students wanted access to IT at the Faculty and expressed their need for more training on using the Internet and Microsoft PowerPoint, and for IT resources in classrooms.


INTRODUCTION
The current revolution in technology plays a major role in recent transformation of nursing education.
IT raised the expectations of both students and teachers.Chalk and blackboard are no longer enough for nursing students' education.The traditional approach of education, which assumes that the teacher is the sole source of knowledge and deposits it into passive students, is no longer accepted. 1The Oxford Dictionary of English defined IT as "the branch of technology concerned with the dissemination, processing, and storage of Bull High Inst Public Health Vol.38 No. 4 [2008]   information using computers". 2 Technology is seen as a catalyst for teaching and learning, and a driving force of shifting towards a more eclectic set of learning activities. 3t affects the way teachers teach and students learn. 4IT creates new ways of thinking, learning and solving problems for students. 5It allows students to be more independent and responsible learners, and more interactive in communication with their colleagues. 6It also encourages teachers to develop their skills and use a variety of teaching styles.
Hence, IT is rapidly becoming an integral part of nursing education.
The literature highlighted the need for integrating IT into nursing education. 7,8 n fact, IT has been extensively used in nursing education in the United States of America and Europe. 7,9,10,11,12 In 992 the American Nursing Association (ANA) recognized nursing informatics as a distinct specialty area within nursing.In 1994 the ANA defined nursing informatics as "the specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing and managing data and information to support nursing practice, administration, education, research and the expansion of nursing knowledge". 13

Aim
The main aim of this study was to investigate student nurses' perception of the impact of using IT on the quality of teaching and learning of critical care nursing.

Study design
The study had a cross sectional descriptive design.

Setting
This refers to "strongly agree", 4 refers to "agree", 3 for "uncertain", 2 for "disagree" and 1 refers to "strongly disagree".For these three sections, students were asked to indicate the degree to which they agree or disagree with the proposed statements by checking one of five alternatives ranging from strongly disagree to strongly agree.
At the end of the questionnaire sheet, there was a free space for participants' free comments concerning the use of IT in teaching and learning CCNC.negative perception.Overall, the use of IT in teaching CCNC has a positive impact on the process of teaching and learning from student nurses' perspectives (with the total mean score X ± SD 89.4±8.9).

RESULTS
The results showed a positive correlation between students' years of IT experience, and their perception of the impact of IT on the process of teaching and learning (Table 5).Moreover, students' IT skills had a positive significant correlation with students' perception of the impact of IT on enhancing teaching, exchanging ideas and information with colleagues, preparing and presenting assignments, creativity in preparing assignments and enhancing students' confidence when presenting their work (Table 6).

DISCUSSION
The results of this study revealed that using IT in classroom has a positive impact on the quality of teaching and learning from student nurses' perspectives.Students The results showed the benefits of using IT from student nurses' perspective.Therefore, the Faculty must invest more money in increasing IT resources and developing teachers' as well as students' computer skills.

RECOMMENDATIONS
1.There is a need to improve IT resources at Faculty of Nursing to meet students' needs.
2. There is a need for more integration of IT in teaching and learning.
3.More attention must be given to computer courses aims, content and the practical applications.

Limitations of the study
This study used a self report questionnaire which is a strong tool for providing insight on individuals' perception, attitude, feelings and other information that can not easily be observed (Talbot, 1995).However, this method may limit participants' responses into specific choices, and may not give an opportunity to determine why people perceive things in a certain way.

The questionnaire was reviewed by three experts in the filed of
comments and feedback, some items were revised and rephrased to improve clarity.The tool was developed in English, and then translated into Arabic version by the researchers.To ensure the validity of the translation, back translation technique was used.27, 28 The questionnaire was translated from English into Arabic and then from Arabic into English.The two versions of translation were compared and modifications were done accordingly.Then, the translated questionnaire was reviewed by a lecturer from Faculty of Education, English Department, Mansoura University.Alpha Crombach test was used to test the reliability of the tool.29, 30 The closer the alpha is to 1.0, the more reliable the test is.Coefficients ranging from 0.70 to 0.94 are acceptable for most instruments.31In this study, Alpha score for the 22 items of the tool (sections 2, 3 & 4) was 0.80 which confirms the tool reliability.METHODSA permission to conduct the study was obtained from the Dean of Faculty of Nursing.For the purpose of this study, IT Bull High Inst Public Health Vol.38 No.4 [2008] was used in teaching CCNC in a form of PowerPoint presentations in the classroom, videos of CCN procedures, access to the Faculty Electronic lab, and access to relevant web sites.Students were divided into fourteen groups, each group included from 12 to 13 students.Each group was assigned to prepare a project relevant to critical care procedures or topics using IT.The proposed activities involved developing a Maquette, providing a PowerPoint presentation or designing a Poster presentation.Considering the fact that not all students were familiar with using computers and Internet, a facilitator from critical care faculty staff was assigned to supervise and instruct each group.Students were given 5 weeks to complete the assignments and provide a presentation for their product.Each project was evaluated by a three member committee from CCND.The questionnaire was piloted on 10 students from the first, second, third and fourth year Faculty of Nursing students, Mansoura University.The aim of the pilot study was to assess the clarity of the statements and make necessary amendments prior to the main study.The students of the piloting group were asked to read the statements carefully, complete the questionnaire and highlight statements that require more clarification.Based upon students' comments, some of the statements were rephrased.The questionnaire was administered to the students at the end of the course in January 2008.Participants were asked to fill in the questionnaire in the teaching hall during the last lecture in critical care course.They were assured that participation in the study was voluntary, and that those who declined involvement in the study would not be penalized or affected in any way.Data were collected anonymously.Data analysis Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 9.0 for windows.Statistical methods used included frequency, percentage, mean and standard deviation.
strongly expressed the need to access computers and Internet at the Faculty for preparing their assignments.They demanded training programs on using the Internet and Microsoft PowerPoint.This could indicate that the current computer classes at Faculty of Nursing are inadequate for developing students' IT skills.Student nurses also emphasized the need for IT resources in all classrooms.The data pointed to an important fact, that is, the ability of teachers to master technology made IT a useful teaching tool.This is in the same line with Fetter's (2009) findings which illustrated student nurses' belief that faculty should possess IT skills to be proficient teachers and role models. 16This actually reflects the importance of developing teachers' IT skills on the outcome of students' learning.This supports Fabry and Higgs (1997) suggestion of investing time, money and resources in teachers who have greatest impact on students, 32 and Ornes and Gassert, (2007) who highlighted the need to increase faculty knowledge and understanding of the nursing informatics competencies that relate to beginning nurses. 17

Using
IT enhanced teaching CCNC, allowed teachers to present information in a variety of formats and made CCNC more interesting.Besides, it attracted students' attention in classroom, enhanced their reception of information; stimulated their critical thinking and imagination, and provided them with a variety of learning style.IT was also a useful tool for students in preparing their assignments and presenting them confidently.These findings are congruent with the results of other studies which examined students' perceptions and attitude towards computer technology and Internet in education. 6, 33,34, 35, 36 In Turkey, Sagin Simsek (2008) found that students were satisfied with the application of information and communication technologies in their reading courses and had positive attitudes towards online courses. 34It was also found that on line courses helped students to be more independent and responsible learners and using the Internet made them more interactive with their colleagues. 6Interestingly, the primary source for students' access to IT was the internet Café and only 13.5% of students used the college IT resources.This actually explains why half of students considered IT costly.This could be partly due to the limited IT resources located for students at Faculty which made them pay to use the IT in internet Café.Unexpectedly, 26.4% of students had no computer skills at all, only 12.3% gained computer skills from attending computer class at the Faculty and 21.5% were self taught.These are very interesting findings considering the fact that Faculty of Nursing students study computer sciences in the first, second and third year for four semesters.CONCLUSIONS In summary, the findings showed that student nurses have positive perception of the impact of using IT on the quality of teaching and learning CCNC.Students' inadequate access to IT at Faculty of nursing is a very important concern that needs to be dealt with.Computer courses should be designed to develop students' IT skills and meet their needs.The successful use of IT in classroom can not only be achieved by students' positive perception of the IT, but also by teachers' mastery of technology, and the availability of computer technology in classrooms.

4 .
While this study investigated the impact of IT on the quality of teaching Bull High Inst Public Health Vol.38 No.4 [2008] and learning from the perspectives of students, future research could consider adoption of IT from the perspectives of teachers.