Access to clinical supervision is an enduring enigma to many nurses and other healthcare professionals. The aim of this action research study was to bring about the potential for a change in the practice of clinical supervision (CS) by developing a solution to the problem of access. This was achieved in collaboration with community nurses and a range of other staff from one NHS Primary Care Trust. The solution proposed was the development of a new mode of delivery: online clinical supervision. Holter and Schwartz-Barcott’s (1993) Technical Collaborative Approach was used to identify potential user (Supervisee, Supervisors and Management) requirements for an online environment for CS. The research was conducted in three stages. The first stage ‘Conceptualisation’ involved the identification and exploration of the problem as well as the initial steps in discovering how the problem could be addressed. Central to this was the engagement with the stakeholders. The second stage ‘Designing the Solution’ was a synthesis of activities undertaken by focus groups in order to determine what a potential online environment might look and feel like, as well as how it might function. Analysis was through a continuous, iterative, cyclical process of member checking. Schach’s (1999) Life Cycle Model (adapted) and Lengel’s (2001) Website Design Principles were used as a theoretical frame to guide the solicitation of the required design and build criteria. The final stage was ‘Evaluation’, participants evaluated the design and build criteria they had developed using a SWOT analysis, and finally the experience of undertaking action research was captured through a self completion questionnaire. In conclusion, this research has identified what an online environment for CS could look like, as well as how it might function, thus opening up the possibility of improving access to CS. The research also highlighted a potential tension between the users’ desire for privacy and the employers’ desire for access to information. Future negotiations are required to determine how this tension could be managed. The likely impact of this development, if implemented, will be more community nurses and others undertaking CS at a time and place that is convenient to them, potentially making CS available (via a user-centred design) 24 hours-a-day, seven days-a-week a reality.

Students learning in blended learning and classroom environments benefit from social interaction and vicarious learning experience with their peers and tutors. In comparison, students learning via self-directed Web-based learning cannot benefit from these advantages and may feel isolated. This research investigates if the presence of virtual persuasive agents presented as avatars, happy images and encouraging text can provide social support similar to real peers and improve students’ Web-based learning self-efficacy (WBLSE). This research also examines if low and high fidelity virtual persuasive agents can provide social support in a similar way. This study uses Bandura’s (1982) self-efficacy theory as a framework for changing nursing students’ beliefs in using the Web for learning. The basis for including virtual persuasive agents in this research stems from the media equation theory (Reeves & Nass, 1996) which holds that Computers are Social Actors (CASA) and that people respond to Web-based media as if they were social actors. Adopting the User-Centred Design approach, a bespoke Web-based training package was developed for changing pre-registration and post-registration nursing students’ WBLSE. In a quasi-experimental design, the package was delivered in three separate studies to different groups of pre-registration and post-registration nursing students. Several important findings contributed to the WBLSE body of knowledge. Overall, the training package was found to be effective with the nursing students’ WBLSE improving equally in the intervention groups in all studies. Pre-registration students showed the greatest improvement when learning by self-direction supported by virtual persuasive agents, whereas post-registration students improved when learning in a blended setting without their support. Low-fidelity virtual persuasive agents were sufficient in providing social support for pre-registration students in self-directed settings. The implications for Web-based learning in nurse education, research and practice are discussed.

Introdução: O desenvolvimento e a aplicação das Tecnologias de Informação e Comunicação associadas à internet exercem mudanças no processo de ensino aprendizagem e podem contribuir para a educação permanente em enfermagem, favorecendo a capacitação de enfermeiros, para reconhecer imediatamente a situação de parada cardiorrespiratória (PCR) de adultos e sistematizar as intervenções de suporte avançado de vida (SAV), a fim de que colaborem para o sucesso da reanimação cardiopulmonar e maior sobrevida dos pacientes. Objetivos: Desenvolver e avaliar a qualidade do curso on-line para enfermeiros sobre suporte avançado de vida nos casos de parada cardiorrespiratória em adultos. Método: Pesquisa metodológica aplicada, na modalidade de produção tecnológica de natureza quantitativa, exploratória e descritiva. Para o desenvolvimento do curso on-line, utilizou-se o modelo de Design Instrucional Contextualizado (DIC). A seleção dos participantes foi aleatória, intencional e não probabilística. Participaram do estudo dezesseis enfermeiros especialistas na área de urgência e emergência adultos e/ou de educação on-line. A coleta de dados ocorreu no período de novembro a dezembro de 2016. A avaliação do curso on-line foi baseada em critérios validados de Avaliação da Qualidade de Objetos de Aprendizagem. Resultados: O curso on-line foi implementado no ambiente virtual de aprendizagem (AVA) Moodle®, em nove unidades de aprendizagem e obtiveram índices de alta e boa qualidade em quinze (75%) critérios referentes à pertinência, contextualização, qualidade da informação, navegação, referências, portabilidade, correção de conteúdo, clareza das informações, facilidade de aprendizagem na interação e de localização das informações, interatividade, eficiência de utilização, utilização de recursos audiovisuais, ergonomia e estética. Foram avaliados cinco (25%) critérios como qualidade mediana relacionados à facilidade de retorno, uso de marcas especiais, gestão de erros, múltiplas janelas, ajuda aos usuários. Conclusões: os resultados mostraram que os referenciais teórico-metodológicos e pedagógicos adotados possibilitaram o desenvolvimento do curso on-line sobre SAV em PCR de adultos conferindo-lhe viabilidade de integrar tecnologias e estratégias educacionais inovadoras na implementação de capacitação e atualização de enfermeiros nas situações de emergência utilizando AVA. / Introduction: The development and application of Information and Communication Technologies associated to internet bring evidence-based changes in the processes of teaching and learning and may contribute for permanent education in nursing, promoting the training and the qualification of nurses on recognition of situations of cardiorespiratory arrest (CPR) in adults and on the systematization of advanced life-support interventions, in order to collaborate for the success of cardiopulmonary resuscitation and longer survival of adult patients. Objectives: Develop and evaluate the quality of the on-line course on advanced life support in adult cardiorespiratory arrest for nurses. Method: Applied methodological research, in the form of technological production based on quantitative, exploratory and descriptive research. For the development of the on-line course the Contextualized Instrumental Design (DIC) model was used. The selection of participants was random, intentional and non-probabilistic. Sixteen nurses specialists in the area of urgency and emergency to adult and/or on-line education participated in the study. Data collection has taken place from November to December 2016. The evaluation of the on-line course was based on assessed criteria of Learning Object Quality Assessment. Results: The on-line course was implemented in the Moodle® virtual learning environment in nine learning units and obtained high quality indexes in fifteen (75%) criteria regarding pertinence, contextualization, information quality, navigation, references, portability, content correction, technical information, ease of learning in interaction and location of information, interactivity, efficiency of use, use of audiovisual resources, ergonomics and aesthetics. Five (25%) criteria were evaluated a median quality related to ease of return, use of special brands, error management, multiple windows, and user assistance were also evaluated. Conclusions: The results showed that the theoretical, methodological and pedagogical frameworks adopted allowed the development of the on-line course on life-support interventions in adult CPR focused on adult learning, making it possible to integrate innovative educational technologies in the implementation of training and professional updating for nurses in the emergency situations using virtual learning environment.

Introdução: O desenvolvimento e a aplicação das Tecnologias de Informação e Comunicação associadas à internet exercem mudanças no processo de ensino aprendizagem e podem contribuir para a educação permanente em enfermagem, favorecendo a capacitação de enfermeiros, para reconhecer imediatamente a situação de parada cardiorrespiratória (PCR) de adultos e sistematizar as intervenções de suporte avançado de vida (SAV), a fim de que colaborem para o sucesso da reanimação cardiopulmonar e maior sobrevida dos pacientes. Objetivos: Desenvolver e avaliar a qualidade do curso on-line para enfermeiros sobre suporte avançado de vida nos casos de parada cardiorrespiratória em adultos. Método: Pesquisa metodológica aplicada, na modalidade de produção tecnológica de natureza quantitativa, exploratória e descritiva. Para o desenvolvimento do curso on-line, utilizou-se o modelo de Design Instrucional Contextualizado (DIC). A seleção dos participantes foi aleatória, intencional e não probabilística. Participaram do estudo dezesseis enfermeiros especialistas na área de urgência e emergência adultos e/ou de educação on-line. A coleta de dados ocorreu no período de novembro a dezembro de 2016. A avaliação do curso on-line foi baseada em critérios validados de Avaliação da Qualidade de Objetos de Aprendizagem. Resultados: O curso on-line foi implementado no ambiente virtual de aprendizagem (AVA) Moodle®, em nove unidades de aprendizagem e obtiveram índices de alta e boa qualidade em quinze (75%) critérios referentes à pertinência, contextualização, qualidade da informação, navegação, referências, portabilidade, correção de conteúdo, clareza das informações, facilidade de aprendizagem na interação e de localização das informações, interatividade, eficiência de utilização, utilização de recursos audiovisuais, ergonomia e estética. Foram avaliados cinco (25%) critérios como qualidade mediana relacionados à facilidade de retorno, uso de marcas especiais, gestão de erros, múltiplas janelas, ajuda aos usuários. Conclusões: os resultados mostraram que os referenciais teórico-metodológicos e pedagógicos adotados possibilitaram o desenvolvimento do curso on-line sobre SAV em PCR de adultos conferindo-lhe viabilidade de integrar tecnologias e estratégias educacionais inovadoras na implementação de capacitação e atualização de enfermeiros nas situações de emergência utilizando AVA. / Introduction: The development and application of Information and Communication Technologies associated to internet bring evidence-based changes in the processes of teaching and learning and may contribute for permanent education in nursing, promoting the training and the qualification of nurses on recognition of situations of cardiorespiratory arrest (CPR) in adults and on the systematization of advanced life-support interventions, in order to collaborate for the success of cardiopulmonary resuscitation and longer survival of adult patients. Objectives: Develop and evaluate the quality of the on-line course on advanced life support in adult cardiorespiratory arrest for nurses. Method: Applied methodological research, in the form of technological production based on quantitative, exploratory and descriptive research. For the development of the on-line course the Contextualized Instrumental Design (DIC) model was used. The selection of participants was random, intentional and non-probabilistic. Sixteen nurses specialists in the area of urgency and emergency to adult and/or on-line education participated in the study. Data collection has taken place from November to December 2016. The evaluation of the on-line course was based on assessed criteria of Learning Object Quality Assessment. Results: The on-line course was implemented in the Moodle® virtual learning environment in nine learning units and obtained high quality indexes in fifteen (75%) criteria regarding pertinence, contextualization, information quality, navigation, references, portability, content correction, technical information, ease of learning in interaction and location of information, interactivity, efficiency of use, use of audiovisual resources, ergonomics and aesthetics. Five (25%) criteria were evaluated a median quality related to ease of return, use of special brands, error management, multiple windows, and user assistance were also evaluated. Conclusions: The results showed that the theoretical, methodological and pedagogical frameworks adopted allowed the development of the on-line course on life-support interventions in adult CPR focused on adult learning, making it possible to integrate innovative educational technologies in the implementation of training and professional updating for nurses in the emergency situations using virtual learning environment.