Realia and models

Realia are actual objects such as medical equipment that provide the learner with the most concrete learning experiences, whereas models “are three-dimensional representations of real objects . . . [that] may be larger, smaller, or the same size as the object it represents” (Smaldino, Russel, Heinich, & Molenda, 2005, p. 215). Models have some advantages over realia in that they can be modified to accentuate certain details or disassembled to provide interior views. Realia and models are used in classroom demonstrations or in learning resource centers to provide students with an opportunity to practice nursing skills and simulate patient care. Models can also be displayed in digital formats and manipulated in virtual reality environments.

Whether they are using realia or models, students should be encouraged to handle and manipulate each object. To facilitate easy student access, the instructor may need to provide more than one of the same item to a group of students. Another suggestion is for the instructor to place a series of different objects, with their supportive texts and instructions, around the classroom and have learners visit each station in turn. Learning resource centers that house realia and models provide students with opportunities for individual or group learning during scheduled class periods or at other times convenient for the students (for additional discussion, see Chapter 19).

Still visuals

Moving visuals, video, and animation

Moving visuals add motion to the projected visual image and present a process more effectively than do other media. Moving visuals permit safe observation of phenomena that might be hazardous to view directly. Faculty can also use moving visuals to dramatize events and situations, explore personal and social attitudes, enhance problem-solving instructional situations, and teach the subtleties of unfamiliar cultures. Finally, moving visuals serve as a method of gaining student attention to the topic and cue the learner to the most relevant components of instruction. Moving visuals are commonly stored and made available through technologies such as the World Wide Web, compact discs (CDs), USB flash drives, digital versatile disks (DVDs), and Blu-ray discs.

It was the medium of film that was first to contribute the attributes of changing space and time. Spatial perspectives could be modified by “zooming in” or “zooming out.” Time compression or expansion could be realized though time-lapse photography or filming in slow motion.

The limitations of film (size, weight, expense, and technical complexities) have been overcome by the adoption of newer video-related technologies, but its positive attributes continue to provide unique features for teaching.

Audio media

Audio media include the use of sound for instructional purposes. Audio media tend to be inexpensive, simple to use, easily adapted, and portable. Audio media can be used in nursing education for self-paced instruction, mastery learning, drill and practice, interview skills, or performance evaluation.

Computer-based instruction

Computer-based instruction, computer-assisted instruction, computer-assisted learning, and computer-based training refer to the use of the computer to guide learning and create learning communities. The computer programs (software) can be used as tutorials, simulations, and tests or to enrich or remediate learning. In a computing environment in which students work on a network that provides access to software, files, and electronic mail, computer-mediated learning promotes dialogue, inquiry, collaboration, and shared interactive learning experiences. These networks create virtual classrooms and knowledge communities that can be accessed at any time and any place.

Tutorials teach new concepts to students. A tutorial program assumes that the student has little or no prior knowledge of the particular subject matter. Generally, tutorials present facts and principles; ask the student to interact with the content by answering questions; and then, on the basis of the student’s response, provide feedback and move on to the next component of the lesson.

Testing by computers gives the faculty member the opportunity to develop, administer, grade, and perform statistical measurements of an examination (item analysis, standard deviation, mean, median, and mode) with ease. A wide variety of computerized test development software programs is available to facilitate the development and administration of tests and is included in most learning management systems (see Chapter 22). Computer-based testing can also be used to assess learning needs and learning styles, administer pretests and posttests to determine mastery, or simply to provide the student with an opportunity to practice taking tests related to specific content areas for self-evaluation of learning. A variety of commercial computer-based testing services are available for use by nursing programs to assess nursing program applicants or current students for such characteristics as learning readiness, critical thinking abilities, and learning styles. Computer-based testing services are also used throughout the curriculum to assess student’s mastery of course concepts and readiness for taking the licensing exam and for predicting student success.

A combination of previously mentioned methods can come together in a “learning management system,” or LMS. The University of New Orleans online glossary for distance education defines an LMS as

Most LMS solutions support the standard SCORM for their stored learning content, materials that would be made available to learners in online courses. SCORM (sharable content object reference model) is a collection of specifications that enables interoperability, accessibility, and reusability of web-based learning content (Advanced Distributed Learning, n.d.). In short, SCORM-compliant courses can be accessed and shared by different LMSs without need for modification. Through the use of SCORM-compliant courses, faculty across different schools of nursing can collaborate and share in course development and distribution, though the costs per student remains prohibitive for many institutions.

Virtual reality and virtual worlds

In virtual reality, learners immerse themselves in multimedia, computer-based, three-dimensional simulated environments in which they can interact, demonstrate professional behaviors, practice skills, manipulate equipment, and learn teamwork and collaboration. Virtual worlds in nursing and health care (Second Life is one common virtual reality space) are simulated health care environments such as a clinical agency (Skiba, 2009), an operating room, or a community (Curran, Elfrink, & Mays, 2009; Giddens, Shuster, & Roehrig, 2010) that also include the patients, families, groups, and health care team who are members of the virtual world being portrayed. The student, using an avatar that can be either created by the student or precreated by the developer of the virtual world, enters the three-dimensional environment, assumes the role of the nurse, and participates in solving clinical problems.

Virtual worlds can also be designed as classrooms and meeting spaces for students and faculty (Schmidt & Stewart, 2009). Here, students and faculty conduct discussions, ask and answer questions, show media, and share or develop documents such as creating a database or executing statistical analyses. Experiences in virtual worlds can be used as adjuncts to online courses, experiences with high-fidelity manikins, or actual clinical experience (Schmidt & Stewart, 2009).

Participation in the virtual worlds can occur individually or in groups during a synchronous role play. The faculty can assume roles of facilitator, instructor, and coach or take part in the role play as a patient or health team member.

The advantages of using virtual reality include providing a replicable learning experience for each student, creating the opportunity to manipulate equipment and perform procedures in a safe environment, and simulating a clinical experience when it is difficult or not possible for a student to have that experience. Net Generation students find learning in a virtual reality environment appealing due to their experience with online games that use a similar approach (Skiba, 2009).

There are also disadvantages to using virtual reality, the most significant one being expense. The cost of purchasing or creating the virtual world can be prohibitive; other costs include development time and orientation for students and faculty to learn to work within the environment (Schmidt & Stewart, 2009). Using virtual reality also requires the use of a computer offering graphic processing capability not available on entry-level computers affordable to some students. Faculty have a choice to develop or employ existing case studies and scenarios for the student to use and plan the debriefing and evaluation that follows participation in the virtual world. For some users there is a sense of discomfort and invasion of privacy while in the virtual world (Skiba, 2009).