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This document reports a study that aimed to develop and assess the performance of a virtual learning environment (VLE) named 'Tele-education in Malignant Hyperthermia' to promote health education for nursing teams in surgery centers. The document reveals the process of creation and assessment of the educational multimedia program as a VLE website for nursing professionals and experts in health informatics. The developed virtual learning environment is shown to be an effective tool to support teaching on malignant hyperthermia for nursing teams.
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| ORIGINAL ARTICLE | | 180 |
(^1) Nurse, Central Sterile Supply Department of Hospital da Restauração ; Surgery PhD student, Graduation Program in Surgery, Universidade Federal de Pernambuco (FENSG/UPE); assistant professor at Nossa Senhora das Graças Nursing School, 2 Universidade de Pernambuco (FENSG/UPE) – Recife (PE), Brazil. Email: emanuela.pereira@upe.br 3 Nurse, FENSG/UPE – Recife (PE), Brazil. Nurse in the Commission of Hospital Infection Control, Pronto-Socorro Cardiológico Universitário de Pernambuco Professor Luiz Tavares (PROCAPE), UPE; Master’s and PhD degree in Health Sciences, School of Medical Sciences (FCM) at UPE; assistant professor of FENSG/UPE – Recife (PE), Brazil. 4 Bachelor’s Degree in Visual Communication; Master’s degree in Technology and Management in Distance Learning; specialist in system analysis; assistant professor of FENSG/UPE, system analyst and instructional designer of distance learning courses at UPE – Recife (PE), Brazil. 5 Nurse; PhD in Surgery, Graduation Program in Surgery, UFPE; adjunct professor at FENSG/UPE – Recife (PE), Brazil. Rua Marechal Deodoro, 340 – Encruzilhada – Zip Code: 52030-172 – Recife (PE), Brazil. Received: 29 Apr. 2017 – Approved: 23 Aug. 2017 DOI: 10.5327/Z1414- ABSTRACT: Objective: To develop and assess the performance of a virtual learning environment (VLE) called “Tele-education in Malignant Hyperthermia” to promote health education for surgery nursing teams. Method: This is a technology validation study of methodological development research with quantitative and qualitative approach. It revealed the process of creation and assessment of an educational multimedia program as a VLE website for nursing professionals of surgery centers and for experts in health informatics. Results: The experts’ assessment showed great acceptability of the pro- gram and received a classification of “very good” in most of the assessed items. Conclusion: The developed virtual learning environment is an effective tool to support teaching on malignant hyperthermia for nursing teams of surgery centers. Keywords: Malignant hyperthermia. Surgicenters. Perioperative nursing. Health education. Nursing informatics. RESUMO: Objetivo: Desenvolver e avaliar a execução de um ambiente virtual de aprendizagem (AVA) intitulado “Teleducação em Hipertermia Maligna”, visando a promover educação em saúde para equipes de enfermagem em centro cirúrgico. Método: Estudo de validação de tecnologia do tipo pesquisa de desenvol- vimento metodológico com abordagem quanti-qualitativa, revelando o processo de criação e avaliação de um programa multimídia educacional no formato website como AVA para profissionais de enfermagem em centro cirúrgico e especialistas em informática em saúde. Resultados: A avaliação dos especialistas mostrou grande aceitabilidade do programa, recebendo classificação de “muito bom” para a maioria dos itens avaliados. Conclusão: O ambiente virtual de aprendizagem desenvolvido mostrou-se uma ferramenta eficaz para apoiar o ensino sobre hipertermia maligna a equipes de enfermagem em centro cirúrgico. Palavras-chave: Hipertermia maligna. Centros cirúrgicos. Enfermagem perioperatória. Educação em saúde. Informática em enfermagem. RESUMEN: Objetivo: Desarrollar y evaluar la ejecución de un entorno virtual de aprendizaje (EVA) llamado “Teleeducación en Hipertermia Maligna”, con el propósito de promover la educación en salud para equipos de enfermería en centros quirúrgicos. Método: Estudio de validación de la tecnología de la pesquisa del desarrollo metodológico, con abordaje cuantitativo y cualitativo, que reveló un proceso de creación y evaluación de un programa de multimedia educacional en formato de sitio electrónico como EVA para profesionales de enfermería en centros quirúrgicos y expertos en informática aplicada a la salud. Resultados: La evaluación de los expertos mostró una gran aceptabilidad del programa con el recibimiento de la clasificación “muy bueno” para la mayoría de los ítems evaluados. Conclusión: El entorno virtual de aprendizaje desarrollado se mostró una herramienta eficaz para apoyar la enseñanza de la hipertermia maligna a los equipos de enfermería en centros quirúrgicos. Palabras clave: Hipertermia maligna. Centros quirúrgicos. Enfermería perioperatoria. Educación en salud. Informática aplicada a la enfermería.
| 181 | VLE IN MALIGNANT HYPERTHERMIA INTRODUCTION The current high-level connectivity is a gift given by the internet. It may promote information sharing, improvement of didactic maneuvers, and develop- ment of health studies not only in education, but in all areas of knowledge^1. The learning-teaching process does not currently focus only on one physical and traditional environment, it is inter- posed between informatics and technologies. It is not dif- ferent in health. Tele-education, for instance, works as an important resource for the education of health profession- als, not only for practical activities, but also for knowledge transmission and research2,3. Society is changing, and so is nursing. Every day, nursing teams are challenged to present new knowl- edge and competences that respond to such changes. Therefore, the internet, together with tele-education, works as a source of information that enables develop- ing new knowledge, achieving new skills, training pro- fessionals, and facing challenges that are determined by technological advances4,5. The virtual learning environment (VLE) aims to support technology-related activities. It enables adapting and adding different kinds of media with distinct purposes, besides pro- viding teaching-learning news2,5,6. For instance, in surgicenter nursing, several subjects may serve as an object of training according to specific needs or service updating, such as malig- nant hyperthermia (MH), which is a rare dominant autoso- mal genetic disorder of the skeletal muscle that is potentially fatal and related to an uncontrolled release of calcium from the sarcoplasmic reticulum^7. MH is traditionally characterized by an abnormal hypermetabolic reaction to anesthetic inhalator agents of the halogenate group, to depolarizing neuromuscu- lar blocking agents (such as succinylcholine) or, even more rarely, to stress (like extreme physical exercises in warm environments)7-9. In Brazil, the first report on this syndrome was published in 1975 and there are no current data about it, but estimates show an occurrence from 500 to 1,000 MH cases per year only in the state of São Paulo9,10. The number of deaths due to MH is high not only due to the syndrome complexity, but also because of the lack of knowledge by the professionals. The mortality index per MH decreased from 80%, in 1970, to 5% in 2007. The treatment of disease reactions should result in 100% survival, but we need quick and qualified care to achieve it, which can only happen with proper training of the surgical center professionals^10. Based on the relevance and severity of MH, we noticed the need for training teams in surgical centers so that they can provide early diagnosis and deal with MH crisis. Therefore, we considered the following question: can the VLE provide a conceptual and technological contribution to nursing education? OBJECTIVE This study aimed to develop and assess the performance of a virtual learning environment (VLE) named “Tele- education in Malignant Hyperthermia”, with the objec- tive of promoting health education for nursing teams in surgery centers. METHOD This is a technology validation study of methodological development research with quantitative and qualitative approach. This paper reports the elaboration and reveals the result of the assessment process provided by surgical center nursing professionals and health informatics experts about an educational multimedia program in the website format as VLE. The elaboration and development of a VLE comprise a group of activities that include structural organization of essential elements, such as the chance of reviewing and redoing them in undetermined moments^5. We based our methodology on Struchiner^11 concepts, which establish basic principles for developing educational material and articulate the structural development stages in a proposal with different criteria^5. The preceding variables that formed and defined the environment were: establishment of theme; choice of scenario to be composed; educational purposes; video and text formatting; and experts’ assessment after using the VLE. We divided the VLE production in two stages: the first one comprised theme definition and VLE creation; the sec- ond corresponded to environment assessment by a group of experts.
| 183 | VLE IN MALIGNANT HYPERTHERMIA The tab “About the course” [ Sobre o Curso ] shows the course stages and how each one works. In addition, it also provides information such as methodology, study place, population, eligibility criteria, and research purposes. The link “How to Participate” [ Como Participar ] provides a step-by-step on how to first access the entire course and then access the “Course” [ Curso ] link. It has two options: “Evaluator” [ Avaliador ] and “Participant” [ Participante ]. To take the course, the user must choose the option “Participant” [ Participante ] and complete all the steps, as described in Figure 2. With the aim of validating the interactivity, we asked for a feedback from professionals invited to assess the VLE. After taking the activities in the “Participant” [ Participante ] link, they needed to go to the “Evaluator” [ Avaliador ] link, where they would find a questionnaire about the VLE functioning and the provided educational purposes. The assessment page also provides a blank Figure 1. First page of the website that shows the course “Tele-education in Malignant Hyperthermia”. Recife, Pernambuco, Brazil, 2016.
| 184 | PEREIRA EBF, MODESTO BCM, VALENÇA MP, SILVA JUNIOR WS, SOUZA CFQ space where experts may leave suggestions and com- ments for improvements. In general, the website “Tele-education in Malignant Hyperthermia” was very well accepted by the evaluators, who provided suggestions for improvement and com- ments, which were mostly positive about the performed work. The assessed items were scored according to the scale: very good (VG), good (G), regular (Re), poor (P), and very poor (VP). The first three questions of the assessment were about the way content is transmitted. These questions approach: didactics, clarity and objectivity; amount and quality; consis- tence and pertinence of the presented material. Table 1 presents the distribution of answers obtained in the assessment made by experts on the content. The con- tent was considered “good” by most of the experts (five) in “didactics, clarity, and objectivity”. “Quantity and quality” of the content and “consistence and pertinence” received “very good” in most of the answers (five). Questions four and five of the assessment form discussed about the course objective regarding the established educa- tional purposes and the pertinence of the proposed learning assessment (pre- and post-test). We observed, in Table 2, that most of the evaluations (five) considered the course objective regarding the proposed educational purposes in the VLE as “very good”. Regarding the “learning assessment (pre- and post-test)” and its pertinence to the VLE content, most of the evaluations were positive, consid- ering the item as “very good” (seven). Also regarding the pre- and Figure 2. Structure of the course in the VLE on “Tele-education in Malignant Hyperthermia”. Recife, PE, Brazil, 2016.
TCLE Registration form Pre-test
| 186 | PEREIRA EBF, MODESTO BCM, VALENÇA MP, SILVA JUNIOR WS, SOUZA CFQ REFERENCES
| 187 | VLE IN MALIGNANT HYPERTHERMIA