Evaluation of an interactive multimedia learning environment designed to enable graduate nurses to think critically on clinical decision making: A case based reasoning architecture

A patient experiencing an anaphylactic reaction is used as the precipitating event to engage users in making critical decisions. An anaphylactic reaction has the potential to cause a chain of events but as a contrived learning situation, users within this learning environment are not constrained by the pressure of time and they can make mistakes if necessary, without causing injury to real patients. Support for users is given in the form of feedback and rationales are provided for each decision that is made. Users also have the opportunity to review relevant documents and consult the experts when making decisions. Making mistakes and learning from experience is one of the goals of this environment, which is not obviously possible in real life threatening situations.

The formative evaluation of the learning environment, with embedded activities involved structured and open ended question types with individual and small groups of practicing nurses and subject matter experts. A semi-structured questionnaire was employed to ascertain user perceptions and this enabled us to evaluate the utility and the efficacy of the product from the perspective of graduates. The results show that the user acceptance of this learning environment was very high and the overall impressions of this product and the approach to learning adopted have been positive. We regard formative evaluation as an ongoing feature of this work, which is necessary to meet the changes and growing needs of practising nurses. These processes will be explicitly addressed in the paper.