Mobile device integration

1. The Integration of Mobile Devices into the Undergraduate Nursing Curriculum
Glynda J. Doyle, RN, MSN1, Bernie Garrett, RN, PhD2,
& Leanne M. Currie, RN, DNSc2
1British Columbia Institute of Technology, Nursing Program, Burnaby, BC
2University of British Columbia, School of Nursing, Vancouver, BC
Background
In this last decade there has been a significant shift in health education with the integration and
advancement of information technologies that are revolutionizing the delivery, design and
evaluation of nursing education. The incorporation of mobile computing devices (also known as
mobile devices, portable devices, personal digital assistants [PDAs], smartphones, or handheld
computers) has become a growing trend in nursing practice. Mobile devices have significant
potential to support nursing student‟s decision making and patient care planning as they can
quickly bring relevant and evidence-based resources to the point of care.1
Table 2. Strategies for Mobile Device Integration as per Rogers’ Five Phases of Innovation and Five Adopter GroupsPurpose
The goal of this project was to explore strategies that have been used for mobile device integration
into undergraduate nursing curricula as reported in the literature. Rogers‟ Diffusion of Innovation
model is used as a framework to identify appropriate strategies for the integration of mobile
computing devices into nursing curricula.
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2. Huffstutler, S., Wyatt, T., Wright, C. (2002). The use of handheld technology in nursing education. Nurse Educator, 27 (6), 271-275.
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5. White, A., Allen, P., Goodwin, L., Breckinridge, D., Dowell, J., Garvy, R. (2005). Infusing PDA technology into nursing education. Nurse Educator, 30 (4), 150-154.
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7. Rogers, E. M. (2003). Diffusion of Innovations (5th Edition ed.). New York: Free Press
8. Shankman, J. & Malcolm, C. (2002). Using organizational change to reach your technology goals. Healthcare Financial Management, 88-89.
9. Di Pietro, T., Coburn, G., Dharamshi, N., Doran, D., Mylopoulos, J., & Kushniruk, A. E. (2008). What nurses want: diffusion of an innovation. J Nurs Care Qual , 23 (2), 140-146.
10. Cornelius, F., Gordon, M. (2006). Introducing and using handheld technology in nursing education. Annual Review of Nursing Education, 4, 179-192.
11. McLeod, R. & Mays, M. (2008). Back to the future: personal digital assistants in nursing education. Nursing Clinics of North America, 43, 583-592.
12. George, L. & Davidson, L.(2005). PDA use in nursing education: prepared for today, poised for tomorrow. Online Journal of Nursing Informatics, 9 (2), 1-11.
13. Scollin, P., Callahan, J., Mehta, A., Garcia, E. (2006). The PDA as a reference tool: libraries' role in enhancing nursing education. Computers, Informatics, Nursing, 24 (4), 208-213.
14. Orr, G. (2003). Diffusion of Innovations, Everett Rogers (1995). Retrieved January 4, 2011 from Stanford University: http://www.stanford.edu
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16. Goldsworthy, S., Lawrence, N., & Goodman, W. (2006). The use of Personal Digital Assistants at the point of care in an Undergraduate Nursing Program. Computers, Informatics, Nursing, 24 (3), 138-
143.
Discussion & Limitations
Diffusion of Innovation Theory
Rogers‟ Diffusion of Innovation theory3 is a framework which characterizes people based on their
likelihood to adopt technology and which characterizes organizations based on their stage of
adoption of a new technology. Integration of mobile devices into the nursing curriculum is likely to
be seen as a new innovation to most faculty, and therefore we reviewed literature on the topic of
mobile computing in undergraduate nursing to identify activities that would promote the adoption
of these technologies based on type of adopter and stage of adoption (see Table 1).2
Rogers‟ “Diffusion of Innovation” model provides a useful framework for nursing schools that are
considering integrating mobile devices as a tool to enhance learning. This framework is useful to
support the planning and adoption of these new technologies because the integration of mobile
devices into the nursing curriculum represents a profoundly new innovation to many schools and
educators
Innovators Early Adopters Early Majority Late Majority Laggards
Knowledge
Exposure to the possibility of the
existence of the innovation
• Introduce to initiative before other faculty
• Organize orientation & training sessions that provide for
individual learning needs
• Integrate device into personal and work life1
• Join email distribution lists/listservs/ networking sites for
mobile device use & support2
• Introduce concept of mobile devices to other faculty and
stakeholders1,3
• Involve as „champions‟6
• Involve with process before, during and
after adoption8
• Introduce concept of mobile devices to
other faculty and stakeholders1,3
• Info sharing sessions from innovators and
early adopters12
• Peer mentoring and coaching from
innovators & early adopters2
• Provide personalized face to face
orientation sessions
• Determine and address concerns and
reasons for being reluctant to use devices
• Ensure aware of advantages and
disadvantages
• Address skepticism4
• Provide personalized face to face
orientation sessions
• Determine and address concerns and
reasons for being reluctant to use devices
• Ensure aware of advantages and
disadvantages
• Address skepticism4
Persuasion
Determination of:
• relative advantage
• compatibility
• complexity
• observability
• trialability
Ensure rapport with faculty4
Analyze and report on pilot studies
Address concerns that arise from surveys
Synthesize evidence from literature5
Document and share benefits and challenges with
others
• Increase critical mass by involving early
adopters8
• Demonstrate how devices can be
integrated into clinical and classroom2,6
• Provide opportunity to gain comfort with
devices in „safe‟ setting such as simulation
lab9,10
• Address fears, anxiety, concerns
• Provide with examples of case studies,
models of use11
• Share analysis of literature
• Involve with pilot studies13
• Provide opportunity to gain comfort with
devices in „safe‟ setting such as simulation
lab9,10
• Allow time for process of integration2
• Address fears, anxiety, concerns
• Provide with examples of case studies,
models of use11
• Share analysis of literature14
• Provide opportunity to gain comfort with
devices in „safe‟ setting such as simulation
lab9,10
• May need more time with devices,
likelihood of feelings of fear and anxiety
due to unfamiliarity
• Share analysis of literature14
• Remind of professional responsibility to
stay current15
• Provide opportunity to gain comfort with
devices in „safe‟ setting such as simulation
lab9,10
• May need more time with devices,
likelihood of feelings of fear and anxiety
due to unfamiliarity
• Share analysis of literature14
• Remind of professional responsibility to
stay current15
Decision
Commitment to the adoption of the
innovation
• Involve with maintaining resources through website
• Implement pilot studies or small scale trials7
• Provide with orientation and
troubleshooting sessions
• Share stories and examples of mobile
device use11
• Involve with pilot studies7
• Allow time for process of integration2
• Provide with orientation and
troubleshooting sessions
• Share stories and examples of mobile
device use11
• Provide with ongoing personalized
orientation sessions available as needed
• Share stories and examples of mobile
device use11
• Provide with ongoing personalized
orientation sessions available as needed
• Share stories and examples of mobile
device use11
Implementation
Implementing the innovation
• Provide ongoing support and info sharing6
• Develop policies of use that include patient
confidentiality, professional etiquette and infection
control
• Continue with training and troubleshooting
sessions2
• Continue to share stories and examples of
mobile device use
• Continue with training and troubleshooting
sessions2
• Continue to share stories and examples of
mobile device use11
• Continue with training and troubleshooting
sessions as needed2
• Continue to share stories and examples of
mobile device use11
• Continue with training and troubleshooting
sessions2
• Continue to share stories and examples of
mobile device use11
Confirmation
Continued implementation of the
innovation
Ensure ongoing evaluation and adaptation in
accordance with results of evaluation2
Explore opportunities for research
• Involve with research/evaluation
• Continue to share stories and examples of
use2
• Share results of evaluations
• Offer opportunity to be involved with
research studies
• Continue to share stories and examples of
use2
• Share results of evaluations
• Offer opportunity to be involved with
research studies
• Continue to share stories and examples of
use2
• Share results of evaluations
• Offer opportunity to be involved with
research studies
• Continue to share stories and examples of
use2
• Share results of evaluations
• Offer opportunity to be involved with
research studies
Adopter Group Description
Innovators Venturesome types who are typically well educated, more likely to take risks, enjoy being on the cutting edge, and
are motivated by the idea of being a change agent (Rogers, 2003).
The depth to which the innovators implement and confirm a new innovation will particularly influence subsequent
decisions of other potential adopters (Orr, 2003; Scollin et al., 2007).
Play a gatekeeping role in the introduction of new ideas into a system (Rogers, 2003)
Early Adopters Use the data provided by the innovators to make their own adoption decisions (Rogers, 2003).
Usually respected social leaders, visionaries in their field, often considered as key decision makers (Rogers, 2003).
Ultimately help with triggering the critical mass when approving an innovation (Orr, 2003).
Early Majority Will adopt an innovation before the average individual (Rogers, 2003).
Make up about one third of all members of a system (Rogers, 2003).
Tend to be slower with the adoption process than the early adopters (Rogers, 2003).
Typically not leaders per se, but are willing to adopt change (Barr, 2002).
Late Majority Adopt an innovation after the average member of a system (Rogers, 2003).
Approach new innovations with a high degree of skepticism and are slow in adopting the innovation (Rogers, 2003)
Tend to need intense encouragement (Barr, 2002).
Laggards The last to adopt an innovation (Rogers, 2003).
Are typically focused on tradition with a strong aversion to change (Orr, 2003).
• Laggards and late adopters may need more time to assimilate information and make their decision to adopt.
• Although the table appears linear, the process may be iterative, and individuals may appear to be „laggards‟
when in fact, they might be „early majority‟ types who will engage in the technology when they are offered
the opportunity at the right time.
• Continual assessment and evaluation of the integration process must be maintained and budgeted for, to
ensure that the use of mobile devices improves patient care without detriment to the patient nurse
relationship.
• Implementing technological change in an organization is likely to be a challenge, understanding change
management and applying evidence-informed strategies to diffuse new technology will support the process
of integration.
Table 1. Description of Adopter Groups
References