@2024 Afarand., IRAN

---

ISSN: 2228-5468    Education Strategies in Medical Sciences 2015;7(6):369-375

Background
… [1-9] The current methods of training the nurses to increase their professional skills are not suitable [10-12]. … [13] 14.5% of the nurses participating in a study have not participated in any continuing education program and 61.8% of them have participated only in one continuing education program in one year [14]. Work-based learning or learning at work is one of the learning methods of different medical professions such as nursing that has been highly used in the recent years [15-18].
Previous Studies
In some studies, one of the critical care nurses has been invited to teach one of the main nursing articles such as ECG interpretation or arterial blood gas interpretation and related nursing cares [13, 19]. Nevertheless, there is no study about the preference of the method than the current methods of continuing educations, especially the workshop training method, for the critical care nurses. … [20]
Aim(s)
The aim of this study was to compare two methods of clinical teammate and workshop methods in teaching the arterial blood gas interpretation to the critical care nurses.
Research type
This is a pretest-posttest quasi-experimental study.
Research society, place and time
All critical care nurses of the Critical Units of Firoozgar Hospital, Tehran, Iran, were studied from April to November 2013.
Sampling method and number
Samples were selected, using convenience sampling method. All nurses working in two surgical intensive care units (workshop method) and one internal medicine intensive unit (clinical teammate method) were studied. The units were selected randomly. 12-16 nurses were working in each unit. Informed consent to participate in the study, having Bachelor of Science in Nursing, main membership in the units, and no attending a similar continuing education program during a year ago were the inclusion criteria.
Used devices&materials
Data was collected, using a two-part questionnaire. Demographic items and the educational background of the participants related to the training courses of arterial blood gas interpretation were included in the first part of the questionnaire. 25 questions of the second part of the questionnaire were about arterial blood gas interpretation in 5 domains that were acidosis, alkalosis, the complex disorders, foundations of arterial blood gas interpretation, and nursing care in the acid-base disorders. There were 5 questions for each domain and each question received 1 score. The test had no negative score. The received scores by each person might vary between zero and 25. To assess credibility of the questionnaire in a former study, viewpoints of some experts, who were familiar with the educational chart and had taught it, have been applied. To determine reliability of the questionnaire, 10 participants participated in a pilot study using the questionnaire in a two-week interval. Reliability of the questionnaire was 0.94 using test-retest method [13]. At first, the questionnaire was used to assess the information level of the nurses of two groups in arterial blood gas interpretation (Pre-test). After the primary test, one participant selected as educator of clinical teammate and did not participate in the final exam. Training length for each nurse in the clinical teammate method was the same as the training length of the workshop. The training length for each person was 4 hours up to maximum 2 months. An experienced graduate university teacher trained the nurses in the workshop plan. One-day 4-hour workshop was presented in the hospital. Re-test (post-test) was done in both groups and 2months after the end of the training course. Scores from zero to 5, from 6 to 10, from 11 to 15, from 16 to 20, and from 21 to 25 were considered as very poor, poor, average, good, and excellent, respectively. The scores and the demographic characteristics were analyzed, using SPSS 19 software. Independent T and Fisher analytical statistics were used to demonstrate the homogeneity of the groups. Independent T test was used to compare the groups in age, job history, and information level of arterial blood gas interpretation before interventions. Fisher test was used to compare the groups in gender and marital status. Paired-T test was used to interpret the difference between the mean scores before and after interventions in both groups.
Findings by Text
21 critical care nurses participated in pre-test and post-test. 11 nurses were in the clinical teammate group. 10 nurses were in the workshop method group. The mean ages of the critical care nurses in clinical teammate and workshop method groups were 29.91±4.76years and 30.60±4.11years, respectively. All participants in the clinical teammate group were female. There were 8 female and 2 male participants in the workshop method group. Mean job history rates of the nurses in clinical teammate and workshop method groups were 5.59±2.95 and 6.53±3.21 years, respectively. There were 3 unmarried and 8 married persons in the clinical teammate group. There were 5 unmarried and 5 married persons in the workshop method group. There were no significant correlation between the nurses’ age, gender, job history, and marital status and their information level of arterial blood gas interpretation and related nursing cares in both pre-test and post-test stages. In the pre-test stage, the nurses’ information levels in the clinical teammate group and workshop method group were 9.25±1.61 and 10.50±5.48, respectively. There was no significant difference between the values. Therefore, both groups were homogenized in the variables. There was no significant difference between the clinical teammate nurses’ mean scores in pre-test and post-test stages. However, there was a significant difference between the mean scores in the workshop method group (Table 1).
Main comparison to the similar studies
There was no significant correlation between the critical care nurses’ age and information level about arterial blood gas interpretation and related nursing cares in both groups. The result is confirmed by other studies [21, 22]. In both pre-test and post-test stages, there was no significant correlation between the nurses’ gender and information level about arterial blood gas interpretation and related nursing cares in the workshop method group. There is a significant difference between male and female persons’ awareness of the process of blood transfusion and blood products [22]. In pre-test and post-test stages, there was no significant correlation between job history of the understudied units and their information level of arterial blood gas interpretation and related nursing cares in both groups. The result is confirmed by other studies [23, 24]. Nevertheless, there is a significant correlation between the nurses’ information level in different domains and their years of service [25]. In the clinical teammate group, there was a significant difference between the nurses’ pre-test and post-test scores of the complex disorders only. Nevertheless, there was no significant difference in other domains (basic concepts, acidosis, alkalosis, and nursing care of patients with acid-base disorders) and in five understudied domains totally. There is a significant difference between the nurses’ scores before and after training via “The Unit’s Nurse Educator” method [13]. Participation of a clinical colleague in the lecture method has played a role in increasing the nurses’ information level [19]. The results of some other studies about increasing the nursing students’ information level are inconsistent with the result of the present study [21, 26]. Only few studies show that training has not resulted in increasing the learners’ information level. In the training method, the mean scores of the learners increased. However, the increase did not result in a significant statistical test. There was a significant difference between the scores of pre-tests and post-tests stages in other domains (alcalosis and complex disorders). Workshop method training in the continuing education programs for nurses has played a role in training the method of calculating and adjusting the medication dose by the nurses [27]. The workshop training metod has had an influence on information level, skills, and decision-making behavior of personnel of the health system [28]. The workshop training method has had an influence on the nurses’ time-management skill level [29].
Suggestions
More studies with different methodologies should be done to remove probable disadvantages of the method in the clinical environments. The clinical teammate method should be done in continuing education of the nurses of other units. In addition, more than one training domain should be investigated.
Limitations
Inequality of the scientific level of the instructors of two training methods was one of the limitations for the present study.
Conclusions
Utilization of the workshop method in training the arterial blood gas interpretation for the critical care nurses is more suitable than the clinical teammate method.
Acknowledgments
The researchers feel grateful to all nurses, who participated in the study.
Conflict of interest
Non-declared
Ethical Permissions
All procedures were approved by the Ethics Committee of Tehran University of Medical Sciences.
Funding Sources
The study was funded by Tehran University of Medical Sciences.

TABLES and CHARTS

Show attach file