title: Using e-learning to support clinical skills acquisition: exploring the experiences and perceptions of graduate first-year pre-registration nursing students - a mixed method study.
abstract: BACKGROUND
  Clinical skills education must accommodate the different needs of nursing students, particularly in view of increasing numbers of graduate entrants. E-learning has been promoted for its ability to engage learners and customise the learning process and evidence supports its use for clinical skill acquisition. However, graduate nursing students have unique needs, and their perceptions and experiences of e-learning require exploration.
  
  
  OBJECTIVE
  The aim of the study was to explore graduate first year nursing students' perceptions and experiences of e-learning when used to supplement traditional methods to learn clinical skills.
  
  
  METHODS
  Mixed methods, employing qualitative and quantitative approaches, were used. Eighty-three (46%) participants were recruited from a cohort of graduate students (n=180) enrolled in an accelerated pre-registration nursing programme. Participants completed e-learning educational materials prior to attendance at clinical skills sessions. Focus groups (n=2) explored participants' (n=15) experiences and perceptions of e-learning and identified common issues. Discussions were transcribed verbatim and analysed using a thematic approach. Findings informed the development of a questionnaire which sought to confirm perceptions of e-learning and the perceived value for clinical skills acquisition in the larger student group. Data from questionnaires (n=83) were analysed using descriptive statistics.
  
  
  CONCLUSIONS
  Students found e-learning valuable for developing clinical skills and, although they viewed it positively, they did not want to relinquish conventional teaching methods, preferring both in combination. Video clips were perceived as the most useful feature while online readings were viewed as the least useful. An underestimate of time requirements, navigational issues and technical difficulties were reported frustrations.
  
  
  CONCLUSIONS
  Although limited by potential volunteer bias, findings contribute to the ongoing discourse on how e-learning can support clinical skills education and provides insights from the perspective of graduate nursing students. E-learning does not suit the needs of all learners. This must be recognised to enhance the learning experience.
authors.affiliation: Sydney Nursing School, University of Sydney, 88 Mallett Street, Camperdown, New South Wales 2050, Australia; Florence Nightingale School of Nursing and Midwifery, King's College London, 57 Waterloo Road, London SE1 8WA, United Kingdom. Electronic address: jacqueline.bloomfield@sydney.edu.au.
authors.forename: Jacqueline G
authors.initials: JG
authors.lastname: Bloomfield
authors.forename: Anne
authors.initials: A
authors.lastname: Jones
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D004511:Education, Nursing, Graduate / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D015402:Nursing Education Research; D011795:Surveys and Questionnaires; D014741:Video Recording
keywords: Clinical skills; E-learning; Education; Graduate; Nursing; Student experience