[논문]지역사회 간호사를 위한 건강검진 온라인 교육안 개발: Rapid prototyping method를 활용

김은하; 김계하; 배경의

doi:10.5762/kais.2019.20.8.250

[국내논문] 지역사회 간호사를 위한 건강검진 온라인 교육안 개발: Rapid prototyping method를 활용
Development of Online Continuing Education Courses on National Health Examination for Community Health Nurses: Using the Rapid Prototyping Method 원문보기

한국산학기술학회논문지 = Journal of the Korea Academia-Industrial cooperation Society, v.20 no.8, 2019년, pp.250 - 263

김은하 (부산가톨릭대학교 간호학과) , 김계하 (조선대학교 간호학과) , 배경의 (동서대학교 간호학과)

초록
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본 연구의 목적은 방문간호사를 위한 국가 건강검진에 관한 온라인 보수교육 프로그램을 개발하기 위함이다. 연구 기간은 2016년 11월부터 2017년 12월까지 시행되었다. 교육 프로그램은 래피드프로토타입 방법을 활용하여 단계적으로 개발하였다. : 1) 관련 문헌 검토와 이해관계자 및 전문가의 포커스그룹 면담(FGI)을 통해 학습자의 요구도를 확인하였다. 2) 방문 간호사의 건강 검진에 관한 상담 전략을 포함하는 교육내용의 개요를 작성하였다. 3) 온라인 교육자료 개발자와 연구자가 회의를 거쳐 온라인 교육 프로그램을 개발하여 학습자에게 모의 조사를 실시하였다. 4) 확정된 교육내용을 8개의 모듈로 구분하여 온라인 교육 자료 초안을 개발하여 파일롯 과정을 실행하였다. 5) 학습자의 피드백을 반영하여 교육 프로그램을 확정하여 지역사회 간호사를 위한 건강검진 온라인 보수교육 프로그램을 최종적으로 개발 및 운영하였다. 개발 된 온라인 보수교육 프로그램은 방문 간호사가 건강검진에 관한 상담을 수행하도록 돕는 데 효과적이었다. 따라서 온라인 보수교육 프로그램은 간호사의 실무역량을 향상하는데 효과적인 교육적 접근이라 할 수 있겠다.

Abstract ▼ AI-Helper

This study was conducted to develop an online education program for visiting health nurses on National Health Examination. The study period was from November 2016 to December 2017. The program was developed in stages using rapid prototyping methodology. 1) Learners' needs were identified through literature review and focus group interviews (FGIs) with visiting health nurses and stake-holders in the field. 2) The contents of the education program including counseling strategies regarding the heath of visiting health nurses were developed. 3) Online education materials were developed and piloted amongst learners. 4) The contents of educational programs were classified into eight learning modules, and online education drafts were pilot tested. 5) Based on feedback from learners, this program was revised and a web-based continuing education program for community nurses was developed. These education programs effectively assisted nurses with counseling regarding health examinations during visiting health nursing care. Therefore, the online continuing education program may be a very effective educational approach to improving nurses competency.

Keyword

표/그림 (7)

그림 Fig. 1. Rapid prototyping development methodology.
그림 Fig. 2. Stage of development applying rapid prototyping development methodology
표 Table 1. Learning plan for online educational material over two sessions
그림 Fig. 3. Course contents and main page
그림 Fig. 4. Sample screen –introduction page.
그림 Fig. 5. Sample screen 2-lecture page.
그림 Fig. 6. Sample screen 3-answer & expandation page.

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문제 정의

The purpose of this study was to identify visiting nurses’ professional education needs with respect to implementing nursing care for health checkup patients and develop education materials to reinforce their professional competency.
This study attempted to comprehensively examine educational demand on medical checkups and develop education materials that could enhance nurses’ capabilities to encourage the examines in a nursing service field of the local community.
Through analysis of demand for the development of educational material, contents provided key standards for competency, and enhanced learners’ satisfaction[7]. This study utilized interviews with stakeholders and expert reviews as well as focus group interviews in order to reflect how medical checkup agencies, experts on healthcare policy and nurses think about medical inspection. The focus group interview results suggested that the opinions of the examinees could be taken into account prior to intervention, and be a potential data in addition to extensive practical information from the health examination[17].
As these materials are focused on health promotion activities, they haven’t been used to make medical judgment and establish nursing goals based on professional knowledge on diseases, as an attempt to identify patients’ nursing demand for a certain disorder and prevent progression or complications of the disease.
This study was used rapid prototyping method to develop the online education program. Rapid prototyping method is an instructional design approach that combines the design, developmental and evaluation phases.
To sum up, this study confirmed that nurses’ demand to be educated on medical checkups reflects the demand from checkup subjects, and comprehensive information on the purpose of inspection items, judgment of results, risk regarding examination tools as well as follow-up checkup should be available for the subjects. The significance of this study lies in the fact that it investigated such demand of visiting nurses by focusing on education materials necessary for medical checkup counseling at the actual local community settings from the perspective of beneficiaries of such education. Meanwhile, this study failed to separate visiting nurses’ experience of providing visiting care from their entire professional life, thereby being unable to check different educational needs depending on their past experience, something future research should look into.
In this study, an educational material was developed to enable nurses to provide nursing intervention efficiently to those undergoing health checkups. Educational contents were developed based on the results of the investigation and analysis of the educational needs of nurses in the community nursing field.

가설 설정

They formulated 10 questions to assess the appropriateness of the educational goal, educational construct, evaluation, effectiveness of the process, and suitability of the learning materials. The main questions were as follows: Is there an educational goal that includes educational topics and contents? Is the curriculum effective for nursing practice? Is the amount of educational content appropriate to achieve the educational goals? Is there a plan for various forms of evaluation tools (such as true-false type, multiple choice type, and essay type) in consideration of the educational goals and contents? Is the source of the learning materials clearly presented? The panel members were then asked to rate the course description draft based on these questions on a self-report three-point Likert-type scale, where 1 = disagree, 2 = partially agree, and 3 = completely agree.

제안 방법

The researchers set three learning goals: (1) understand the purposes of the general health examination, life transition health examination, and cancer screening; (2) explain the NHE’s specific items and methods; and (3) solve questions about NHE outcomes.
(4) Development phase: After confirming the prototype, images were not previously secured. After the development is completed, a pilot test is conducted for a small group of learners, and a final revision is made based on the advice of expert reviewers. (5) Deliver phase: The lecture is implemented in practice and is assessed according to learners’ satisfaction level.
The material was presented across eight modules (for a total of eight contact hours) with the aim of assessing the program delivery procedures, estimating the time required to administer the program, and obtaining participants’ feedback and suggestions.
5 hours each. In order to develop the FGI question, the researchers should be able to clarify the research problem in the first research meeting and then draft the question after reviewing the research question and finally review the contents of the question. The question was structured.
(1) What recent information should nurses have about health examinations? (2) What knowledge and skills do nurses need to provide health screening counseling? (3) What knowledge have you considered necessary when counseling health examination patients? We analyzed the data collected from the FGIs using the content analysis method, based on the audio recordings and transcripts. The transcripts were read repeatedly to find meaningful words, sentences, and paragraphs and to classify and categorize data according to the aspects of health examinations (periods, methods, and diseases). To increase the validity and reliability of data analysis, we held regular meetings to discuss the data analysis results.
They formulated 10 questions to assess the appropriateness of the educational goal, educational construct, evaluation, effectiveness of the process, and suitability of the learning materials. The main questions were as follows: Is there an educational goal that includes educational topics and contents? Is the curriculum effective for nursing practice? Is the amount of educational content appropriate to achieve the educational goals? Is there a plan for various forms of evaluation tools (such as true-false type, multiple choice type, and essay type) in consideration of the educational goals and contents? Is the source of the learning materials clearly presented? The panel members were then asked to rate the course description draft based on these questions on a self-report three-point Likert-type scale, where 1 = disagree, 2 = partially agree, and 3 = completely agree.
The revised educational materials were then pilot-tested using a sample of Korean public health centers. It was conducted at the education bureau of the Korean Nurses Association with around 4,000 nurses for a period of 10 months.
The second area, “ask any questions,” comprised three topics, which were presented in Modules 6–8, during which questions were answered based on real-life cases, in relation to the diagnostic tests conducted in health examinations, various imaging examinations, and diagnostics in life transition periods.
The second area, “ask any questions,” comprised three topics, which were presented in Modules 6–8, during which questions were answered based on real-life cases, in relation to the diagnostic tests conducted in health examinations, various imaging examinations, and diagnostics in life transition periods. Based on the questions asked by actual patients, Module 6 answered questions in relation to liver function tests, tests for lipid metabolism, and renal function tests, while Module 7 comprised the purpose, methods, preparations, precautions, and photographs related to the interpretation of ultrasonography, computed tomography (CT), magnetic resonance imaging, and positron emission tomography-computed tomography (PET-CT) results.
With the existing limited data on the status and demand of education on medical examination, it’s essential to comprehend health issues in which the examinees have interest and difficulties in acting on healthy life habits and form an educational program to address such issues for the development of educational material tailored to learners. Also, this study adopted a methodology that could embrace requests from users in the field of education, and clients (organizations). By doing so, it measured nurses’ educational demand on medical checkup both qualitatively and quantitatively, specified contents formation, and reflected it on learning strategies.
Online education, especially, allows for flexibility in promoting learner-focused self-directed learning away from instructor-centered standardized education[18]. Educational materials developed in this study were made up of pre-test, content learning and post-test to engineer interactions between learners and content. Also, conversational explanation between learners and instructor and questions and answers were utilized in order to boost efficiency of the learning methods in line with the previous study[19] and expert review was performed after the program was developed to improve content validity and overall compositional quality.
Given that the use of pictographs and visual materials has been suggested as an effective strategy for an educational material friendly to the subjects’ culture[25], this study presented cases from the TV show ‘Medical checkup, ask whatever you want’ in the form of animated illustration, provided constant images of nurse and checkup subject’s personal information, and offered health information in figures and tables.
In addition, it added experts’ explanation with a focus on diagnostic imaging from ‘Medical checkup, complete mastery’ and on video clips of cancer inspection, thereby enhanced visual efficiency.

대상 데이터

Because Korean is one of the world’s most internet-accessible nations, the educational team constructed on online on national health examination course for the visiting health nurse that followed the commonly used rapid prototyping method[9]. This research describes the development of this educational materials during a 1-years period from May 2016 to May 2017. The needs of visiting nurses for the NHE were identified by focus group interviews with visiting nurses in Community Health Centers, health teachers, and those eligible for the NHE.
Participants comprised 24 full-time female nurses. Following recommendations that focus groups should comprise 6 to 10 participants, we divided the participants into four groups of six participants each.
The revised educational materials were then pilot-tested using a sample of Korean public health centers. It was conducted at the education bureau of the Korean Nurses Association with around 4,000 nurses for a period of 10 months. The material was presented across eight modules (for a total of eight contact hours) with the aim of assessing the program delivery procedures, estimating the time required to administer the program, and obtaining participants’ feedback and suggestions.

이론/모형

This study applied the method from Jones and Ricky[9] which is “rapid prototyping development methodology” to the process of developing education material by using developmental research method.

성능/효과

First, during the focus group interview of nurses, or learners, a sub-category of understanding of general health examination results was added by reflecting the finding that “While consulting with subjects, explaining liver or kidney dysfunction with physical symptoms caused by changes in examination results was more persuasive than comparing their results with normal measures.
First, the nurses’ experience of visiting nursing care part was not separated in the case therefore, it was difficult to check the difference between nurses who have more or less knowledge of visiting nursing care.

후속연구

Meanwhile, this study failed to separate visiting nurses’ experience of providing visiting care from their entire professional life, thereby being unable to check different educational needs depending on their past experience, something future research should look into.
A web-based education program is better for nurses who work in various fields as a small unit as they can access it selectively without time or space restrictions[25]. As this study developed educational materials for the online platform for greater and more efficient access, it is expected to make considerable contributions to improving quality of nursing.

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