Exploring the influence of informatics in Nursing: The Filipino Student Nurses Perspective

Citation

Austria, P. (Summer, 2017). Exploring the influence of informatics in Nursing: The Filipino Student Nurses Perspective. Online Journal of Nursing Informatics (OJNI), 21(2), Available at http://www.himss.org/ojni

Abstract

Objective: The study explored the experiences of student nurses at a university in Baguio City with the impact of information and computer technology on appraising and developing their theoretical foundations and clinical competence in nursing.

Design: Qualitative descriptive phenomenological study using semi-structured interviews.

Setting: A university in the city of Baguio offering a Bachelor of Science in Nursing (BSN) program.

Participants: Six BSN students between the ages of 19 and 24.

Results: Two themes emerged from the data as being essential to the participants’ experiences with the use of informatics in their learning as student nurses in a developing country like the Philippines. These included: Todays’ learner in the light of informatics and technological advancement and emerging technology in today’s global health. Participants provided information on the advantages and disadvantages of information technology and the present situation of technology application and utilization among health care institutions which influences the learning outcomes for student nurses through reflecting on their own experiences.

Conclusion: These findings highlight the impact of information and computer technology advancement as applied to student learning in a developing country like the Philippines. The participants acknowledged the influence of informatics in their acquisition of learning in preparing them to become competent and competitive health care practitioners who meet global standards. To help support this, local health care agencies need to invest in systems and management upgrading for better patient care and the government needs to allocate proper funding for technology appraisal.

Introduction

Background of the Study

As the largest group of the health care workforce, nursing is at a pivotal junction of identifying and incorporating information technology to improve patient outcomes. Because health care delivery increasingly requires timely information for effective decision making, information technology must be integrated into nursing education curricula for all future nurse clinicians and educators (McNeil et.al. 2003).

The computer is the most powerful technological tool to transform the nursing profession prior to the 21st century (Saba & McCormick, 2006). Information and communication technology (ICT) has greatly impacted many parts of the world and has worked to change peoples’ daily lives, through provision of faster and more convenient communication, easier acquisition of information and its ability to support a better quality of life (Lee & Clarke, 2014). The emergence of computer technology and nursing informatics in the 21st century has brought huge impacts on academic institutions, health care sectors, other disciplines and society in general and has influenced people holistically in various aspects such as communication, transportation, education, social, economic, political and spiritual ways.

Philippine higher education has a historical tradition of serving student needs and meeting the demands of a developing country. Public and private colleges and universities in the 1990’s enrolled record numbers of students in spite of limited resources, and these students are now contributing to a modernized economy (Swinerton, 1999). This has led to continuing pressure on all educators to provide programs, teachers, and facilities to meet this growth. The nursing profession is seen as one of the “commodities” to help alleviate economic problems the country is facing, thus nurses are sent abroad to compete in the global health arena. Despite the enormous contribution of nurses in the country’s economic sustainability, educational preparation of student nurses still lack enough government support to improve preparation of these students to meet the demands of technological advancement.

Because nursing students within and across academic programs have such unique educational and nursing practice backgrounds, their preparation in informatics is apt to be varied, and nursing curricula needs to reflect this variation while advancing informatics competencies in  students (Choi & De Martinis, 2013). Educational institutions should ensure that the curriculum is properly designed to uphold the standards of the nursing profession by preparing students to become competent and innovative individuals, ready to face the growing challenges of technological advancement in nursing practice.   

Establishing a baseline of informatics competencies for nursing students is vital to planning an informatics curriculum and adequately preparing students to use information technologies to promote safe and evidence-based nursing care (Hebda & Calderone 2010). Chen, et.al. (2014) further emphasized that due to differing standards of nursing and cultural practice in various countries, it is also important to address the varied competency levels in nursing practice and in the use of information technology (IT). In the Philippines, an obvious lag in computer advancement is always an area of concern among nursing educators. Student nurses gain theoretical background in classrooms and their clinical experience in tertiary hospitals. Only a few tertiary hospitals offering affiliation to student nurses support computer technology in performing nursing functions. Most often, these students have to learn about technological appraisal through reading research journals and articles to gain some awareness that such modifications in health care delivery are available in highly productive countries.

Nursing education should be a key proponent in successfully preparing future nurses with technology and information capabilities (Simpson, 2007). The need to prepare nurses who are grounded both in nursing and computer science and information systems is reflected in all nursing practice areas (Kelly, 2006). It is important that nursing educators develop the IT skills necessary to fulfil their numerous responsibilities and provide learning opportunities to advance student knowledge and skills in information technology (Ragneskog & Gertnerd, 2006). To prepare student nurses to practice in an increasingly technological, data-rich health care system, faculty must determine effective teaching methods (Nelson, 2000). Neuman (2006) challenged nurse educators to develop designs that move nursing beyond the information age and to create innovative ways of thinking to influence the health care issues looming on the horizon. Clinical instructors and nurse educators should be keen in the application of informatics both in classroom and clinical areas. Continuing education for faculty provides opportunity to improve instructional delivery by integrating global trends necessary to provide a learning atmosphere grounded within technological advancement. 

As technology has advanced, the learning styles of students has changed a lot and the influence of computer technology is becoming critical to their formation as future professionals. Today’s students have their own perceptions on the influence of informatics in their learning styles and motivation. As partakers of computer technology advancement, exploring the experiences of these students enhances our understanding of how informatics influences learning and how it can improve the nursing profession in today’s world.

Researchers Background

As an educator in the tertiary level with a background in computers, my teaching was greatly influenced by technological advancement which has made teaching more dynamic and learning more sustained. Among my strengths as an educator and researcher include my being both a compassionate nurse and a committed educator; my ability to communicate therapeutically and effectively with any given group of individuals; my desire to discover and contribute new knowledge to the profession; my patience to work overtime; my honesty and sincerity to work with people; and above all my moral integrity as a person and as a professional.

My background in research has given me the confidence and motivation to fulfill the culmination of this academic requirement. Having passed the National Institutes of Health (NIH) certification which is a web-based training course on “Protecting Human Research Participants”, understanding of the moral and ethical principles became the foundation of this research activity that involved human participation. Subjectivity, conflict of interest, biases and prejudices never influenced in any way the congruence and validity of the data gathered and the integrity of the research in general.  

Research Objectives

To ensure that nursing graduates are competent in the era of electronic healthcare delivery, it is essential to integrate informatics into clinical nursing curricula (Gassert, 2008). Even in a third world country like the Philippines, student nurses are prepared to meet global technological advancement in health care system by continuously upgrading and enhancing the curriculum to meet their educational needs. To further understand the impact of ICT advancement on student nurses, this study explored their experiences with the impact of ICTs and informatics in appraising and developing their theoretical foundations and clinical competence in nursing.

Significance of the Study

In response to  the trending innovations nursing informatics has created in the profession, student nurses were given the opportunity to reflect and explore their experiences with the influence of nursing informatics on their academic preparation, economic and social growth as individuals. The study further explored the level of preparation of student nurses in meeting the ever advancing demands in global health care. Furthermore, professional nurses exposed to the findings may develop appreciation and value the enormous contributions of informatics in the nursing profession especially in the provision of safe, cost-effective and time-efficient patient care. School administrators of tertiary institutions of learning offering nursing curriculum in a developing country like the Philippines will obtain feedback from the identified effects of nursing informatics on the delivery of instruction by the faculty as well as the creation of policies deemed to influence the academic preparation of the students. Lastly, the government at some point will gain insight on the benefits of information technology in an attempt to meet the day to day challenges that technological advancement continuously offers.

Methods and Procedures

Research Design

A qualitative descriptive phenomenological design was utilized to explore the roles of informatics in the lives of student nurses. A phenomenological approach was used since it is sutiable for answering experiential questions in the realm of nursing and the health sciences,. Phenomenology as a philosophy is seen as a way of returning to and exploring the reality of life and living (Dowling 2007). This rigorous, critical, systematic method of investigation allows researchers to explore perceptions of human experience with all types of phenomena (Streubert & Carpenter, 2011). As described by Spiegelberg (1975), descriptive phenomenology stimulates our perception of lived experience while emphasizing the richness, breadth, and depth of those experiences. It is the lived experience that gives meaning to each individual’s perception of a particular phenomenon and thus reflects to the individual what is true or real in his or her life (Giorgi, 1997). In this study, student nurses will describe the essence of informatics in their lives by exploring the significance of technological advancement in their evolution as students.

Participants

The participants in the study were student nurses who used computer technology as an aid in studying the science of nursing. A purposive sampling method was used in the recruitment process after identifying eligible participants who consented and confirmed willingness to participate in this research study. The number of participants was determined through saturation. A total of six students participated in the study where saturation of data was met on the fifth participant, making the sixth participant data a part of the disconfirming stage. Four of the students belonged to the fourth year while two were in the third year of the program. Inclusion criteria include third and fourth year student nurses regardless of age and sex as long as they already took nursing informatics as a program subject.

To further describe characteristics of each of the participants, a color coding approach was used. Participant Blue was a third year 21 year old student nurse, who claimed to be computer literate since high school. Participant Yellow was a 24 year old Fil-American student who prefered textbooks over reading internet-based information. Participant Red was the only female among the six students who were interviewed who was active in nursing research and claimed to have gained confidence and competence in the said field through her knowledge in computer and information technology. Participant Purple was a 20 year-old self-acclaimed computer gamer who relied on accessing information via the internet rather than the school library. Lastly, Participant Brown who was part of the disconfirming stage, was a 19 year-old internet dependent student who credited technology as the space where he worked on all scholarly activities.

Setting

The study was conducted in a tertiary educational institution in Cordillera Administrative Region (CAR) in the Philippines. The actual face-to-face interaction with the participants in the study was carried out in a non-threatening, quiet, and private part of the institution. This was done usually in a vacant classroom upon the approval of the College Dean to support trusting relationships that protected confidentiality of the information obtained. Personal preference of the participants in relation to the setting of the interview was taken into consideration as long as it was a suitable working environment, free from distractions and intimidation, fostering openness and supporting participant disclosure.

Data Gathering Method

Data was gathered through open exploratory unstructured interviews and observation of the non-verbal cues of the participants. It was set in an open time frame. Prior to the interview, rapport was established to set the tone and create an atmosphere that fostered quality interviews.  Identifying the dialect to be used to enhance articulation of ideas was also set based on the convenience of both parties involved. To maintain spontaneity of the conversation, open-ended questions were asked to encourage the participants to share freely and to give them sufficient time to internalize and construct their thoughts. An audio recording of the full length conversation was made upon approval of the participants. The initial research question was “What is your experience as a student nurse of the influence of computer technology in your studies?”

The use of field notes was of prime importance to the data gathering and analysis components of this research study. Streubert and Carpenter (2011) described field notes or notations as a tool intended to document observations, record assumptions about what is being heard or observed, or write a personal narrative about what is experienced by the researcher during a particular encounter. These notes are important additions during data analysis because they provide validation for important points made by the participants and facilitate appropriate emphasis on emerging themes.

Ethical Considerations

Informed consent was obtained before the initiation of the data gathering phase. The consent outlined important information about the study for the participants, especially the risks and benefits that could be obtained by participating in the study. Although the study did not pose major risk to the participants, discussion of possible risks was included.  It was emphasized that the data and information generated out of the study would be maintained for the sole purpose of research and not used for any other purpose.

Students were assured that their identity would be kept confidential, anonymous and secure by keeping the data ecords in a secluded cabinet. Electronic audio recordings were deleted and transcribed conversation was kept in a sealed envelope. I ensured integrity as a researcher by consciously maintaining the confidentiality of all personal information and by avoiding disclosure of participant identities in every aspect of the rstudy and in day to day casual conversations with the people around me.

Data Management and Analysis

Data management was accomplished  through transcription of the audio recordedings. I read and re-read the transcribed conversation using three columns: the first column contained the  coded participant idenity, the second column presented the verbatim conversation that transpired during the interview ncluding notes about the non-verbal cues observed during the process, and the last column was used to write the themes that emerged from the data. A color-coding approach was used to ensure ease of identifying main themes for data analysis.. Printed results were cut with scissors to dissect the transcribed information and identify clustesrs of ideas to  generate the key themes through inductive thematic analysis.

To culminate the phenomenological investigation through data analysis, the nine steps presented by Colaizzi were applied since they are the most appropriate methodological interpretation fit to my study design (Streubert & Carpenter, 2011). The steps include (1) describing the phenomenon of interest, (2) collecting participants’ descriptions of the phenomenon, (3) reading participants’ description of the phenomenon, (4) returniing to the original transcripts and extract significant statements, (5) trying to spell out the meaning of each significant statement, (6) organizing the aggregate formalized meanings into cluster of themes, (7) writing an exhaustive description, (8) returning to the participants for the validation of the description, and (9) incorporating new data revealed during validation to the exhaustive description.

Establishing Trustworthiness

In establishing trustworthiness of the research study, the criteria used by Lincoln and Guba (1985) served as a basis for testing the internal validity to ensure precise, acceptable and transferable knowledge were generated in the results. The credibility of the study was maintained by consciously ensuring the congruence of the results generated to the reality. Setting aside personal overview and interpretation of respondent’s experiences and discounting any possibility of biases and subjectivity to influence results was maintained at all times. Transferability of the study was ensured by not limiting the discussion and applicability of the result to the target participants. The results obtained can impact and contribute to a wider population. The study targeted social, emotional and economic aspects of individuals thereby enhancing the transferability of the study to other disciplines.

For this study to be dependable, aspects of research design and the way it was implemented, the operational details of the gathered data, and a reflective appraisal of the topic was maintained. A strong methodological description was made to foster repetition of the study. Lastly, reducing investigator bias promoted confirmability of the study results by triangulation.  As a novice researcher on qualitative design, I developed the ability to recognize the shortcomings in my study methods and the possible potential effects and became receptive to feedback and critique to enhance the quality of my research paper.

Results and Discussion

A thorough and deliberate re-reading and clustering of the identified sub-themes was made that eventually led to the formulation of the major themes. There were two major themes identified which included “Todays’ learner in the light of informatics and technological advancement” and “Emerging technology in today’s global health.” The first major theme presented known benefits and disadvantages of computer information technology as applied to the lives of student nurses in the 21st century. The second major theme focused on the discussion of the implications, influences, and drawbacks of informatics and a picture of how informatics influences the Related Learning Experiences (RLE) of Filipino student nurses.

Todays’ learner in the light of informatics and technological advancement

As global technology continuously evolves, varied learning styles of students is becoming evident which affects their degree of preparation, confidence and competence to face the challenges of the computer world. Even as a third world country, the Philippines have been equipped with the necessary technology to prepare students to become competent and to provide a valuable contribution to the economic growth and stability of the nation. The nursing profession is a key part of the basic commodities of the country in response to global competence in health care services. All around the globe, Filipino nurses are known for their loyalty, dedication, and being skillful in fulfilling their nursing functions. A great deal of dilemma is faced by most of educators and educational institutions because computer technology is becoming influential in the delivery of instruction, yet the country still faces technological delay attributed to the cost of expenditure in its applicability and a lack of proper government support in the educational and health care sectors.

Figure 1 outlines the emerging sub-themes identified in the study leading to the identification of the major theme entitled “Today’s learner in the light of informatics and technological advancement.

As a need, the students perceived the internet as a tool that was very influential to their learning. It made information accessible and readily available at any given time and place, which gave them more time to accomplish school related and personal activities. In the advent of computer advancement, gadgets such as iPads, tablets and smart phones are technological tools commonly seen as educational aid for students used to access internet information. Various applications on these devices facilitate learning by making information available at any time.

In our generation nowadays, if you know how to use technology like gadgets, it makes work easier
Green

The electronic book or commonly known as e-book is a commonly used applications in these electronic gadgets where pdf files of textbooks are saved and can be accessed anytime it is needed without the students carrying heavy textbooks to access information they need during classes for case analyses and other assignments where references are needed to facilitate their learning.

As a student nurse, e-books provided us practical, cheapest, fastest and easiest way to obtain information
Blue

Innovative teaching strategies also affected student ability to assimilate information shared during class. In contrast to a chalk-board approach, the use of Powerpoint presentations support the need of today’s generation of visual learners. Video presentations do as well, perceived by students as important for boosting learning dynamics through vivid description of the subject matter (such as basic nursing skills during return demonstrations). Soft copies of Powerpoint presentations given to students helped them to focus their concentration and were less tiresome since an outline of the classroom discussion was available and accessible. This dynamic approach to learning through the use of computer technology favors more meaningful learning.

I can say 80% of the time. Projectors or computers are used. As well as tablets for research and other stuff. That’s the one thing I find quite more enjoyable about lectures.
Yellow

Accessible research development and utilization in nursing became possible through the use of electronic devices such as personal computers and laptops and the proliferation of different software available online to help students analyze and interpret statistical data. Students access journals and research studies for updates regarding patient care through the search engines available for any scholarly activities such as the EBSCO Host which the university subscribes to so students can maximize involvement and awareness of research. In the tertiary institution where this study was conducted, junior and senior student nurses acknowledged the valuable contribution of computer technology in generating their research related outputs.

Technological advancement is not only focused purely on educational enhancement. Individuals belonging to the computer generation have witnessed the encompassing influence of technology to their daily lives. The birth of social media has intensified social linkages through tools like Facebook which is used by many students. This social media modified learning approaches for most of the students through the use of group pages where announcements, homework and other school related activities are made accessible to all its members.

All hand-outs and announcements are made available in our group page where we can view topics to review and some home works.
Red

Also, Facebook became a source of information among students through the links and articles made open for public awareness such as global news pertaining to health, politics, entertainment, business and the like. It fosters re-connection among family and friends and an avenue for group chat for the discussion of homework and school requirements. Computer games on the other hand if viewed by a majority can become a social menace turning addiction to failure in class performance. Three of the six students who participated in the study shared they often played computer games but never reached the point of getting addicted. They viewed computer games as a stress reliever to the heavy load they experienced both in their lecture and clinical duties.

In contrast to the identified benefits student nurses achieved, they were able to identify some possible drawback with the use of computer technology that included internet dependence, learning distractions, social media abuse, theft and piracy and early sexual curiosity. All of these points had major influences in their physical, social, emotional and spiritual growth as individuals and as student nurses.
Since the internet offers a diverse amount of information that can be obtained at a click of a finger, students claimed to have less frequent library visitation which becomes beneficial at some point but it teaches students to rely more on the internet than immersing self into the wide array of references the library offers.

It makes it harder to fulfil requirements without technology, because we were assigned to look on journals, updates, this and that.
Yellow

Because of too much dependence to internet, students become lazy and may neglect exhausting all possible references and become content to what is being offered in internet sites where even scredibility of information is somtimes at stake. The students added that access to the university internet services is not adequate considering that they pay for internet fees. They are aware that the university is serviced by internet connection but issues of connection speed are becoming a growing concern so many students provide their own internet connections through pocket wifi’s.

The connection is very slow and most of the time we can’t avail of the internet services that’s why we bring our own pocket wifi during class hours.
Red

The complexity of technology sometimes creates some degree of distraction as claimed by the students. Multitasking with the use of computers and other electronic gadgets offers a variety of tasks a student can avail while trying to search the internet. Instead of focusing on a specific task, distractions from social media, Youtube and other websites interfere and make fulfilment of the task less manageable.

I get lost and lose track of time for more important things. It’s like a stress reliever to me. I always tell myself, I watch this first before I do my requirements.
Green

Even during lecture periods, students claimed that the use of electronic gadgets is restricted since it distracts attention from the topic at hand and affects retention of learning. As learners in the era of computer technology, they claimed that restrictions on the use of all these gadgets limits their learning experience. Participant Blue added that students should develop a deep sense of personal accountability and responsibility when using electronic gadgets especially during lecture hours to maximize its ability to enhance learning during class discussions.

Before, almost all instructors allowed the use of gadgets during class hours, but because others use their gadgets the wrong way it became restricted. So students should learn to use technology appropriately during class hours.
Blue

The use of social media has become commonplace among students, professionals, and the general public. For example, Facebook, Twitter, Myspace, YouTube, Linkedin, and Instagram are popular sites with millions of users. The potential misuse of electronic communication and social media platforms by nursing students is of growing concern in nursing education (Westrick, 2013). Being an influential tool in establishing social connections, social media can influence students learning. Social media can be an avenue for students to express their thoughts, emotions, achievements, and even personal information putting them at risk for cybercrime and cyberbullying.

There are things I post in social media that are not supposed to be, as an effect people get to know easily thoughts that are not supposed to be shared.
Green
Some of my friends post personal matters like money. With that they are prone to be robbed.
Purple

Social media is so accessible that the risk of identity theft is possible which heightens the probability of being bullied. As victims of such crimes, students learning are affected by causing insecurities and intimidation that can lead to social isolation and poor academic performance. With such concerns, parental guidance and restrictions must be set to ensure a better and safe learning environment for the learner.

Another risk in using information technology to student nurses learning is the issue of early sexual curiosity. It is a known fact that adolescent and early adult individuals have the innate curiosity about sexual issues. With proper parental guidance, this curiosity is handled in a mature manner. But because of the prolific influence of social media which offers diverse and complex information and mass media availability anytime of the day which can somehow influence emotional development. Two of the six participants admitted habitual access to adult sites about three to four times a week. One claimed that it is a normal activity which is done mostly by males. Its effects on learning as identified by the participants included a lack of sleep at night because of the enjoyment and pleasure the explicit materials offer. It also caused distraction to student learning if they spend more time with it over doing homework.

I think for the opposite sex it becomes shameful and awkward, but for the same sex its ok since most do it. So it’s like a normal thing.
Purple

Emerging technology in today’s global health

We live in an era when information technology (IT) is being harnessed throughout society (Radovan 2001). Insofar as ICT devices have been widely adopted in global healthcare settings, it is important to pay adequate attention to them in education (Lee & Clarke, 2014). However, Stronge and Brodt (1985) argued that the influence of user factors should not be underestimated and ignored since it is imperative that health care providers have adequate training and preparation for the integration of technology in health care delivery. This major theme from the data showcases both the influences information technology has on student nurses bedside care competence and their viewpoints on information technology as applied to health in a third-world country (Figure 2).

Participating student nurses acknowledged how information technology provided opportunities to maximize their learning and influence their competence in providing quality patient care. As a result, student nurses are developing clinical competence that provides a competitive advantage in the global health market thus improving quality outcomes in bedside care.

 

The exposure to various equipment and electronic generated machines available in the affiliating hospitals have helped to develop a significant degree of competence in these student nurses. The opportunity to manipulate equipment such as ECG machines, cardiac monitors, electronic beds, infusion pumps and so on has an impact on their level of competence by allowing them to begin to take part in patient care using technology.

As far as monitoring vital signs, we have things like cardiac monitors, pulse oximeters, we have mechanical ventilators to treat and assess which is more practical way than doing it the manual way
Yellow

Not all affiliating hospitals offer sophisticated equipment for student learning and even in their return demonstration classes, but the students still claimed that exposure to basic equipment is more than enough to provide a competitive advantage given the necessary background in information technology acquired in their lower years. Even in technologically advanced countries where health care delivery is becoming technology dependent, the student nurses believed that everything is learned through constant exposure and adequate training. 

It is advantageous that we’re exposed to such technology while still students so that when we work somewhere else later on we know already how to operate basic equipment.
Green

With the qualities Filipino nurses tend to have in terms of patient care, the participants believed that care should not be fully dependent on machines. Instead constant and caring nurse-patient interactions must be developed in order to ensure quality outcomes. Too much dependence on technology can influence the caring essence of the nursing profession.

In a private tertiary hospital where students are affiliated, they observed that use of informatics is not well appreciated. Except for the available equipment and machines, the management information system for filing and provision of pertinent data regarding patient care is not observed. Charting is still traditionally done on paper and procurement of supplies and drugs or medications is done manually which takes away from time allotted for bedside care.

Charting alone, we still do it manually. So, more time is spent on records management than patient care.
Blue

Even in return demonstration classes where students learn basic skills, the university is not equipped with up-to-date equipment essential to enhance learning and mastery of basic skills before actual performance in the clinical area. Students are taught to use Mcgyver at times where ideal performance of the skill is compromised. Video presentation of skills should be done at all times and return demonstrations should be aligned to the actual skill performance in the clinical area to prevent confusion and mistakes.  

Obviously everyone complains about the equipment that we utilize during return demonstrations. I believe the way to utilize technology further increase the knowledge of students would be to create video presentations of these skills. So at least in that manner they won’t be able to say you do this and that to reduce the confusion of students, because the way that we practice our RD in a way that is actually practiced in the hospitals are two completely different things. Sometimes we often mistake what we do here to what is supposed to be done.
Yellow

The students believed that there is nothing wrong with how Filipino nurses deliver care to patients. It may not be ideal patient care, but given the lack of proper government support to hospitals in upgrading services through the use of information and technology, patient care is not optimized as much as it could be.

The government should allocate funds for technology.
Green
The Philippines have money, we do have funds it’s just on the way they are spending it. It’s not beneficial to people but only beneficial to a specific group of people or at least a specific individual. This selfishness I guess gives the lag in information technology and health care system.
Yellow

Because of poor funding and insufficient technology upgrading, students have a hard time acquiring the best exposure to enhance the way they fulfil their functions in patient care. Some claimed that the lack of exposure in the clinical area taught them to learn independently through watching Youtube and other learning aids to fill the gap in learning they obtain in school.

If I find performance of skills inadequate, I usually watch it over the Youtube so the next time I will be exposed I already have an idea.
Blue

Lastly, too much dependence on technology is viewed as a drawback since it leads to poor assessment and dependence on machines for taking vital signs recording through the use of cardiac monitors, pulse oximeters and the like which limits the development and enhancement of hands-on skills.

It shortens everything and it leads to poor assessment
Yellow

This finding suggests students should not rely too much on machines and equipment, but instead they should work on developing a concise clinical eye and judgement to better improve outcomes in nursing care.  

Conclusion

The findings of this study indicated that all students who participated acknowledged the roles and influence of informatics in their academic formation. As verbalized, learning became simple and the acquisition of information is readily available through the World Wide Web making the internet an influential tool in students learning. In order to improve the delivery of instruction, educators should intensify the integration of informatics in developing the curriculum and aim to improve learning outcomes both in the classroom setting and the clinical areas. Similarly, educational institutions need to provide the necessary technological advancement together with affiliating hospitals to enable students to develop confidence and competence in carrying out their roles as care providers.

Students achieve extensive access to varied data and information and even share personal thoughts, information and insights through social media accounts putting them at risk for cybercrime, cyberbullying and exposure to unsavory adult sites. In this regard, the use of technology can become detrimental and influential in the emotional, physical, psychosocial, spiritual and intellectual development of learners. Hence, dependence on technology is sometimes not advantageous to learning, therefore, students should be taught to protect themselves online, especially when using social media.

Finally, the advancement of technology in a third world country like the Philippines poses a great challenge to the quality of education being offered. This is attributed to poor funding and outdated programs provided by the government for computer and technology advancement. If this is not dealt with appropriately, our potential contribution to improve areas of education, health, and research will forever remain a vision that is always out of reach. As such, the educational preparation of Filipino learners, including nursing students will not be at par to international educational standards.

Recommendations

Computer evolution has provided favorable changes and improvements in all aspects of society, especially in business, education, and health care sectors. Learning and patient outcomes have steadily improved since the advent of computer technology. ICTs support effective data management, processing and acquisition of relevant information. At present, technology has advanced significantly in developed countries, but reality tells us that the Philippines still has a long way to go to provide a globally competent educational system to train professionals such as nurses. It is a growing challenge and concern that demands multi-disciplinary partnership to address the issues and create a solution.  

With the ever changing structure and context in any given educational curriculum, colleges and universities in the Philippines should be adaptive and responsive to the evolving challenges of technology in influencing student learning. To support this, educational institutions should embrace the constantly changing demand for technological appraisal deemed to uplift educational standards. Every institution should support the significant influence of the internet by investing in wifi connected campuses.  The provision and utilization of technology in any given institution should be updated and should correspond to set global standards. Schools should ensure that every learner is equipped with the necessary knowledge, skills and attitude necessary to support attainment and fulfilment of professional, social, and economic stability within the nation. 

Educational institutions that offer nursing program partner with staff nurses, hospital administrators and health care institutions to provide practice opportunities where students learn the art of nursing in a world where technology is becoming an influential tool for learning. Staff nurses should continue to undergo professional advancement through trainings and seminars relevant to the area of specialty. Hospital administrators on the other hand should be receptive to change by way of integrating technology into management structures. It is high time we move beyond traditional ways of nursing and begin to acknowledge and embrace the favorable influences of technology in patient care. These ideas can be realized if healthcare agencies begin to appraise the quality of health services aligned with the challenges of technological advancement. By doing so, Filipino student nurses will ultimately achieve quality learning experiences.

Numerous Filipino professionals have attained international recognition for their valuable contribution to certain fields in Health, Education, Entertainment, and Science and Technology. With this in mind, the Philippine government should reflect and appraise our educational standards by creating policies, budgets, and projects directed toward a balanced appropriation of funds to all sectors. A need for aggressive programs that meet technological demands starting with centralized computer literacy programs in grade school should be initiated. In the health care sector, allocation of funds should support the integration of technology to enhance safe and high quality health services. All tertiary government and training hospitals should be equipped with advanced technology and the funds for research should be intensified to support advanced knowledge in applying these technologies to support wellness and health in all citizens.

In conclusion, follow-up studies utilizing other research designs should be undertaken to identify other areas of concern regarding technology advancement in nursing education and healthcare, particularly in developing countries like the Philippines. Further study can give direction on how to proceed to incorporate ICTs into healthcare, and draw attention to the influence of information technology in today’s modern world in all sectors of everyday life.  

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Author Bio

Phildon Jonar Austria is a faculty member for the School of Nursing of Saint Louis University Baguio City, Philippines. He is a graduate of the Masters of Science in Nursing Major in Adult Health at Saint Paul University Philippines School of Health Sciences and at present is completing a Doctor of Philosophy in Nursing at Saint Louis University.