title: Validating a Web-based Diabetes Education Program in continuing nursing education: knowledge and competency change and user perceptions on usability and quality.
abstract: BACKGROUND
  Nurses as the members of health care professionals need to improve their knowledge and competencies particularly in diabetes mellitus through continuing nursing education programs. E-learning is an indirect method of training that can meet nurses' educational needs. This study is aimed at validating a web-based diabetes education program through measurement of nurses' knowledge and clinical competency in diabetes and nurses' perception about its usability and quality.
  
  
  METHODS
  This Quasi-experimental research was conducted on a single group of 31 nurses employed in hospitals affiliated with Shiraz University of Medical Sciences. We used a 125 MCQ knowledge test and Objective Structured Clinical Exam (OSCE) to measure knowledge and clinical competency of nurses in diabetes before and after intervention. A Learning Management System (LMS) was designed to provide educational content in the form of 12 multimedia electronic modules, interactive tests; a forum and learning activities. Nurses were trained for two months in this system after which the post-test was administered. Each nurse completed two questionnaires for measurement of their perceptions on usability and quality. We used descriptive statistics for demographic and descriptive data analysis. Paired t-test was used to compare pre- and post-data using SPSS.
  
  
  RESULTS
  The findings showed significant differences in knowledge scores (p < 0.001), total score of clinical competencies (p < 0.001), and all ten assessed clinical competencies. The range of ratings given by participants varied on the six usability variables of Web-based training (2.96-4.23 from 5) and eight quality variables of Web-based training (3.58-4.37 from 5).
  
  
  CONCLUSIONS
  Web-based education increased nurses' knowledge and competencies in diabetes. They positively evaluated Web-based learning usability and quality. It is hoped that this course will have a positive clinical outcomes.
authors.affiliation: Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Moattari
authors.affiliation: Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Moosavinasab
authors.affiliation: Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dabbaghmanesh
authors.affiliation: Center of Excellence for Electronic Learning in Medical Sciences, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: ZarifSanaiey
keywords: Continuing Nursing Education; Diabetes; Evaluation; Nurses; Web-based Education