Pediatricians and Pediatric Nurses in the Delivery of Culturally Competent Care: A Scoping Literature Review to Investigate Progress and Issues around Culturally Diverse Care in Pediatrics

Joanne Reid, RGN, BSc, MSc, PhD

Reader in Cancer Nursing School of Nursing and Midwifery Queen’s University Belfast Medical Biology Centre 97 Lisburn Road Belfast BT9 7BL, UK; Tel. 00442890972459; E-mail: j.reid@qub.ac.uk

INTRODUCTION

Student response systems, sometime known as ‘class response systems’ or ‘clickers’ have been used in education for over 35 years.¹ Indeed in terms of health care education authors have reported their usefulness in nursing² dentistry³ radiology⁴ and medicine.⁵ In a University setting, they have been used with a variety of learners, from undergraduate to postgraduate students. Nonetheless, it has been noted that the majority of the existing literature in relation to their utility is anecdotal and there remains a clear need for rigorous exploration on the use of this technology.⁶ This is particularly true for the role of student response systems in summative assessments.

From the literature the advantages of using student response systems in teaching have been delineated.⁷ It has received a positive review from students and enhanced their learner engagement and participation.⁸ Within nursing education, student response systems have been shown to: increase classroom engagement¹ ; provide more effective and efficient nurse education⁸ ; and students themselves have highlighting that they help to improve acquisition and retention of knowledge.⁹ However, while positives have been described, there are limitations to using a student response system which have also been noted. These include the fact that the corresponding receiver must be connected to and recognised by the computer prior to the software being started, otherwise responses will not be collected. Additionally, there must be technical familiarisation with the system to ensure there is minimal distraction from the course of study.¹⁰

BACKGROUND

This is the first year that a novel module on Evidence Based Nursing (EBN1) has run in the current undergraduate nursing education curriculum within the recruiting University. What brought the authors to this topic was the need to select a useful format to conduct summative assessment. In this instance this refers to the summative year 1 EBN1 computer-based testing of a multiple choice question exam for undergraduate nurses (approximately 450 per year). The students are divided over two intakes per year, approximately 350 in October (including adult, children, mental health and learning disability specialism) and approximately 100 in February (adult specialism only). In some cases, due to the lack of a computer suite to accommodate the larger student numbers, all students cannot take a multiple choice question exam at one time and half must wait in a holding room until a computer is available, meaning the time is doubled for the exam. Module coordinators (JR and CL) sought an alternative, but prior to uptake recognised the importance of testing such a system as student response system. To this end they conducted two formative assessments (one using computer-based testing and one using a student response systems) and evaluated preferences for both from the students. The role of using student response systems to improve active teaching and learning and for formative assessments is well documented.^1,8-12 However, using student response systems for summative assessment is sparsely reported within the literature¹³ and there is a dearth of evidence on student preferences for computer-based testing versus student response systems for summative assessment.

Student Response Systems

1. Patterson B, Kilpatrick J, Woebkenberg E. Evidence for teaching practice: The impact of clickers in a large classroom environment. Nurse Educ Today. 2010; 30(7); 603-607. doi: 10.1016/j.nedt.2009.12.008

2. Fernandez-Alemán JL, Garcia AB, Montesinos MJ, Jimenez JJ. Examining the benefits of learning based on an audience response system when confronting emergency situations. Comput Inform Nurs. 2014; 32(5): 207-213. doi: 10.1097/ CIN.0000000000000053

3. Satheesh KM, Saylor-Boles CD, Rapley JW, Liu Y, GadburyAmyot CC. Student evaluation of clickers in a combined dental and dental hygiene periodontology course. J Den Educ. 2013; 77(10): 1321-1329. Web site. http://www.jdentaled.org/content/77/10/1321.long. Accessed May 9 2006

4. Millor M, Etxano J, Slon P, et al. Use of remote response devices: an effective interactive method in the long- term learning. Eur Radiol. 2015; 25(3): 894-900. doi: 10.1007/s00330-014- 3468-3

5. Tregonning AM, Doherty DA, Hornbuckle J, Dickinson JE. The audience response system and knowledge gain: a prospective study. Med Teach. 2012; 34: e269-e274. doi: 10.3109/0142159X.2012.660218

6. Fies C, Marshall J. Classroom Response Systems: A Review of the Literature. J Sci Educ Technol. 2006; 15(1): 101-109. doi: 10.1007/s10956-006-0360-1

7. Carroll JA, Rodgers J, Sankupellay M, Newcomb M, Cook R. Systematic evaluation of Go SoapBox in tertiary education: a student response system for improving learning experiences and outcomes. In INTED2014 Proceedings, IATED. Valencia, Spain; (2014). Available at: http://eprints.qut.edu.au/67262/

8. De Gagne JC. The impact of clickers in nursing education: A review of the literature. Nurse Educ Today. 2011; 31(8): e34- e40. doi: 10.1016/j.nedt.2010.12.007

9. Ibrahim RH. Nursing student’s attitudes towards clickers in the classroom. Kufa J Nursing Scie. 2015; 5(1): 1-7. Website. http://www.kuiraq.com/journals/index.php/kjns/article/view/ 3953. Accessed May 9, 2016

10. Lantz ME, Stawiski A. Effectiveness of clickers: Effect of feedback and the timing of questions on learning. Computer in Human Behaviour. 2014; 31: 280-286. doi: 10.1016/j. chb.2013.10.009

11. Bojinova ED, Oigara JN. Teaching and learning with clickers: are clickers good for students? Interdisciplinary j E-learning and learning objectives. 2011; 7: 169-184. Website. http://www.ijello.org/Volume7/IJELLOv7p169-184Bojinova772.pdf Accessed May 9, 2016

12. Klein K, Kientz M. A model for successful use of student response systems. Nursing Education Perspectives. 2013; 35(5): 334-338.doi: 10.5480/1536-5026-34.5.334

13. Hancock TM. Use of audience response system for summative assessment in large classes. Australia J Educational Technology. 2010; 26(2) 226-237. Website. http://citeseerx.ist.psu. edu/viewdoc/download?doi=10.1.1.366.9425&rep=rep1&type =pdf. Accessed May 9, 2016

14. Sprague EW, Dahl DW. Learning to Click: An Evaluation of the Personal Response System Clicker Technology in Introductory Marketing Courses. Journal of Marketing Education. 2010; 32: 93-103. doi: 10.1177/0273475309344806

15. FitzPatrick KA, Finn KE, Campisi J. Effect of personal response systems on students and academic performance in courses in a health science curriculum. Advances in Physiological Education. 2011; 35(3): 280-289. doi: 10.1152/advan.00036.2011