My Major digital project

For my major digital project in eci831, I chose to develop a site for patients with congestive heart failure, their friends and family so that they could come together, support each other and learn how to deal with this chronic condition. My interest in this are began as I have worked in cardiology for over 10 years and during this time I have seen frequent hospitalizations due to heart failure. The projected number of hospitalization due to heart failure is expected to rise. In Saskatchewan, many people diagnosed with heart failure receive teaching and support primarily from their physician. With the development of the site, I wanted to provide factual and current information to patients and family members as well as a place where they can come together to share stories, ask questions and relate any concerns. I chose to develop a NING site. NING is a social networking site. I chose this as it would provide an opportunity for me as a nurse to give information on topics such as congestive heart failure, diet, medications, and exercise. Overall I found the tool quite easy to use given my experience with blogging as I was able to post discussions, provide teaching, attach pictures and videos in a relatively easy manner. As I chose the basic format, I was limited in the background choices however overall it is acceptable. One of the key areas that I wanted to address was the theoretical framework for the study which related to the nursing theory of online social support which describes how the patient seeks health related information online and how family members and nursing can support the patient. My NING site was also influenced by connectivism as learning can occur in a network or community where there may be a variety of opinions. Here learning occurs outside of ourselves as we learn from each other and our connections.

As we learn from each it was important to include the discussion boards so that patients can talk to each other or to family or to a health care provider. Patients and families can choose when they want to access the information, how much they want to share as well as how they want to participate. Ideally this site would be open to the public so that anyone can join.

At this time however, the only people who can access the site are those that I have granted permission. I chose to send the link out to registered nurses with experience in cardiology as patients could not access the site at this time. In order to have this site open to the public, I would require ethics approval. This is the next step that I am planning on doing. The reason that ethics is so important is due to HIPPA regulations as I cannot disclose patient names/medical conditions. I believe that I will be able to work around this if I can use other identifiers that will not give the person’s name out (like a combination of numbers and parent’s initials?). I was able to get some feedback from registered nurses. with experience in cardiology. I also had the opportunity to visit the heart failure clinic and discussed common issues/concerns that patients had so that I could address these on the site. I found these nurses to be very excited about the site due to need and requests of patients.

Overall, I did receive some valuable feedback for improvement of the site. Over the past two months I have made some changes. I will continue to further improve the site based upon current literature. I am also thinking of developing a section for children who may have a parent or grandparent with heart failure. I have made some initial strides with this as I developed a book using zooburst to introduce a young child to heart failure. I will continue to refine the book as I found the available images to be quite limiting when discussing heart failure. I am also planning on developing coloring book on heart failure as well.

There were many great videos available from YouTube on heart failure. I added a couple to the site and developed one of my own based on suggestions for improvement for the site. I used windows live movie maker to create the video. This was a quite the learning experience. For the video, I had to find pictures that would relate to heart health which was again challenging. I believe in the future I will buy or borrow a video camera so that I would have access to other images. The windows program itself was relatively easy to use. I found myself re-recording what I was saying as I did not like the tone of my voice. In the end, I am still not happy with my voice as it does not sound like I do in a regular conversation. This is definitely something that I am going to have to work on and revamp in following videos.

As I want the site to grow as learners take control and manage their own learning, I found that little discussion occurred on the site even from the nurses which is expected as they are familiar with the content. I was hoping for other suggestions on topics to add so that I can gain more experience adding to the site. Again this will have to wait until I have approval to open the site to the public.

Overall this platform will meet or exceed expectations for the site. I believe that the site will be valuable for patients and families. Ultimately I hope that other sites dealing with medical conditions will be made available online to support those patients living in remote and rural areas who do not have the opportunity to go to a face-to-face meeting.

My biggest learning to date is that I can manage to provide this information to patients and families as I have developed the skills to start a discussion, post videos, attach links to websites all of which are skills that I did not have prior to starting the course. Previously I was considering hiring someone with a computer science background but now I can manage this myself.

Please keep checking back as I hope that in a future post you will have the link to the Saskatchewan Heart Failure Network.

Summary of learning

It is hard to believe that we are already at the end of the semester as it only seemed like yesterday that I spent hours upon hours editing and writing my first post. Over the course of the term, I have become more comfortable sharing my thoughts in the written word for all to see and the next hurdle is speaking for a video recording as no matter how hard I try it just sounds fake! There must be some kind of switch in brain that tells me to speak funny or at least I hope that I do not sound like that each day! I can’t do anything about my voice it just seems to be the tone. In fact I have had that issue the whole semester as I did podcasts for one of the nursing classes I was helping with. When I played back the recording it sounded like I was dragging out each word so I recorded it a hundred times and I think by the end I was speaking so fast no one understood. I think that I am going to have to continue to listen, record, re-record and yet again until I can find that happy medium.

For my final summary I chose to do a Shauna’s mindmap of learning. You can see a picture of a portion of it below or click on the pdf. The mindmap is a diagram used to represent words and ideas. I chose to so the mindmap as I will be using this next term with my clinical group to map out anything such as the pathophysiology of a disease process or why you would give one pain medication versus another. As these programs are freely available on the web, I think it will be good to try. The program I used was called FreeMind. Overall I found the program pretty easy to use but it seemed quite restrictive. You could continue to add on levels of headings (child nodes move you to the next level or a sibling node adds another piece to one common node) but once you continue to add what you learned it really becomes crowded. The advantage of using the mindmap is that all of this is centered around one topic which for this assignment was my learning. As the mindmap itself would not be that exciting to share in class on Tuesday I made a short video to accompany the mindmap. I have it attached below.

I will take many things away from the course. Looking back I believe that we really did develop our own personal learning network. We were able to connect with each other through the use of tools such as good reader and twitter (okay so I promise I will get better at this and making a video). I value sharism and throughout the semester I really tried to put myself out there so that I could get feedback and learn from my mistakes. I experimented with twitter, found tweet deck to be a wonderful tool to help me sort through all of the tweets. I also joined LinkedIn and started the technology nurse group on Facebook. As I wanted to continue to try new things in the classroom, my PowerPoint slides became only pictures. I tried various tools such as digital storytelling and introduced (yes introduced) the nursing students to twitter as they knew nothing about it.

I really began to put myself out there on the internet so I thought for the fun of it I would put my name in google alert and it alerted me once (but that is a start!).

We were asked if we put our best work out on the Internet and I would have to yes I have. My NING site that I have developed will hopefully be able to become public in the next few months (just have to work out the ethics). I am very excited about this site as it is a way for patients with heart failure, family members, friends and health care providers to come together to learn from each other and make connections. I will be talking more about this project in a later post.

With all of the this learning, the question becomes where can you learn from me? I hope to use Twitter more next term with my clinical group. My supervisor and I will be working on an open access journal for nursing which will be exciting. I also plan to continue with this blog so that others can learn from my success and my misses (again sorry for voice recordings).

I learned so much from all of you and hope that you too will continue with your blogs if not I will follow you on Twitter.

Reflections of the term…

  by  jkmallen 

I am working on finishing up my final summary for class and find myself amazed by how much I have learned (as well as how much I still have to learn). Taking this class has really opened doors for me that I would never have imagined at the beginning of the semester. I had an opportunity to share what I was doing in the classroom and clinical with nursing leaders across Canada- I did not think that opportunity would ever come about. As well I will be going to Awassa, Ethiopia to work on areas such as the use of simulation in the nursing program and the use of a variety of social media tools to improve communication.

I look forward to the many adventures ahead of me and I thank you all for helping me learn and grow throughout the term.

This will be the first time I will have traveled to Ethiopia- the only advice I have been given is to stay away from the hippos and watch out for hyenas at night. Living in Saskatchewan, I have not had to learn how to deal with an angry hippo- I guess I will just have to stay away.

Any other recommendations or advice?

I am back from Toronto

  by  St Stev 

I was in Toronto this week for a CASN–Infoway symposium discussing nursing informatics. I had the opportunity to not only listen and participate in the discussion with the deans of many nursing programs across Canada, but share with them tools that I have learned in eci831 and tried in both the classroom and clinical settings. In clinical I shared how I use a variety of apps to help students understand more about the body and pathophysiology, how I use you tube to help students learn to interpret ECGs and how QR codes can be used in the clinical settings. The discussion was a very important first step as we begin to develop competencies and discuss issues around this area for nursing. It was definitely a start in beginning a discussion around nursing informatics. Many stated that the using the words nursing informatics implied something difficult? What do you think when you hear the words nursing informatics?

I tried out digital storytelling in one of the classes I taught on Monday

  by  ssh 

For me, some of the most powerful tools that I have been introduced to this semester all centered around the use of photographs. At the beginning of the semester in our eci831 class, Alec introduced us to the site  Dear Photograph and I have not stopped talking about it since. I spent hours reading and looking at all of the photographs. I have told many to check it our. I keep going back to the site as well. When I went to link the website here, I spent more time looking at the latest photos. I am trying to figure out how I can use this in clinical…still trying to figure it out. I think it is a great option for those dealing with change, death or dying. It is a great site to help work through those emotions (for some).

So I Monday, I had the opportunity to teach a fourth year nursing class. This class came about right after my introduction to digital story-telling so I had to try one in class. The topic of the class was on nurse fatigue and patient safety. I had the students chose 5 photos that told their story of fatigue (from clinical, school, life etc) which is a bit of a variation. The students loved it and had such a great time. This class came together, shared stories, laughed and I do believe learned much more than the use of another more traditional method. I would definitely use this again as it introduced the students to another teaching tool that they can use in their clinical practice, opened the door to a rich discussion on fatigue, helped them learn more about copyright and they really did come together to support one another.

And I did tell them to check out the dear photograph site….

My 5 card Flickr story..

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Five Card Story: Where am I going after my comps?

a Five Card Flickr story created by Shauna Davies

flickr photo by Serenae

flickr photo by Serenae

flickr photo by Choconancy1

flickr photo by krutscjo

flickr photo by krutscjo

As I am sitting her sorting through all of the articles that I have read for my PhD classes, I wonder where my path will take me. After my classes, I will have the opportunity to go to Ethiopia for a three month internship where I will be working with other students around the issue of food security. My role will not only be nursing but trying out social media tools learned in class. I can see that these tools will not only be useful for those in Canada but all over the world!

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As with many stories, mine is yet unfinished

So today I had a discussion about ethics…

  by  justinbaeder 

Today in another class we had a guest speaker talk about ethics in relation to our research interests. The guest was from the Behavioral Ethics Research Board and we reviewed changes to TCPS2. It was a very interesting discussion as we began to explore issues related to the Internet and the use of chat rooms. The focus on the discussion was around confidentiality and privacy on public forums. Basically it came down to the following:

• if the chat room is open to the public and does not require log-in you probably can do the research without seeking a consent
• if you are required to sign in to the chat room, you are required to obtain ethics approval and will need a consent by the participant.
• the interesting point (which was new to me) was that in order to receive ethics approval, you must first have the permission from the web host to see if they allow researchers to conduct any type of research on their site.

I would like to further expand on my final project by using this in my PhD program. So I will contact the NING executive and find out if that is a possibility…wish me luck!

This seems to not be that easy of a process as there is no information on the terms of service or in the help section so I will send in a request to the help desk.

Reflections on roles

  by  owlana 

On Tuesday,  we had a thought-provoking conversation on roles of the educator in a networked world by Stephen Downes. If you missed this discussion, you may still  access it on the course website ECI831.  There was a emphasis on open learning and learner autonomy. Downes discussed that course content is merely a tool to support learning rather than the object of learning. Learning occurs by engagement and activity within an authentic learning community. Given this perspective, the role of the educator will change. The discussion focused on a variety of roles such as:

• the learner
• the collector
• the alchemist
• the programmer
• the salesperson
• the convener
• the co-ordinator
• the designer
• the coach
• the agitator
• the facilitator
• tech support
• the moderator
• the critic
• the lecturer
• the demonstrator
• the mentor
• the connector
• the theorizer
• the sharer
• the evaluator
• the bureaucrat

During the discussion I could see myself in these roles at various times. In the role of the learner, as a co-creator of knowledge, learning through sharing of ideas– as a Registered Nurse and clinical instructor I see this as a life-long role as one cannot know everything in healthcare. Since this class has started, I have become a collector. I now live by google reader, have downloaded Evernote on the iPad, and now cannot live without delicious. I am  a coach as I see myself raising the bar and encouraging the third year nursing students to practice at the new graduate level, with this I take the role of facilitator as I keep pushing the students to take on a bit more responsibility as they move up to caring for 4 patients. Each week I am a critic as I take their assignments and review if they have completed all of their research, if they have come up with appropriate nursing diagnoses, understand the reason why the patient is receiving a particular medication or why a specific lab value is out of range. I am becoming better at being a sharer as I am passing links to other sites with nurses on my Facebook group, TechnologyNurse or on Twitter.

As the picture shows above, as nurses we do wear many hats and as nurse educators we seem to just add to that number. Stephen stated that these roles are being blown up and that the role of the teacher will not be the same in ten years…I think that as nurses we are looking and trying to figure out what exactly that will look like. It will definitely be interesting to see what changes come about. A person can always find someone who does not welcome change but I think given the acuity of patients, how much information students need to know to practice safely in our healthcare environment we need people to take on each of these roles and excel. So which role will I focus on? I feel most comfortable as the coach.

So I sent the link out for my final project…

  by  lastquest 

I have been working on my final project for a while. During this time I have received wonderful support. Nurses from the heart failure clinic will be reviewing and commenting on the site- the only problem is that one is not able to sign in to NING. I phoned her and went over how to sign in to the platform over the phone but it did not work. I was thinking that maybe it would have to do with the firewall at her place of employment?? She is going to try to access the NING site from home to see if that works. Has anyone else had this experience? If so what have you done to correct this? One other participant has signed on and they do work at the same place. Any suggestions would be greatly appreciated! Thanks in advance…

As my final project is developing a site where patients, family members, friends and health care providers could come together to discuss issues, questions, treatments about heart failure as well as a place where patients and family members could share stories if they wish, I focused the health related information to someone newly diagnosed with heart failure. Topics included describing what heart failure is, managing symptoms, how to track symptoms, diet considerations (low sodium/salt), taking medications, emotional health of living with a chronic condition. I will also include topics such as losing weight, weight loss procedures, advanced health care directives. If you knew someone with heart failure- what information would like to know?

Based on research, signs and symptoms was ranked the most important topic for learning followed by prognosis, risk factors, medications, general information, diet, psychological factors and activity (Boyde et al., 2009b). These findings were supported by Nahm et al. (2008) who found the heart failure patients wanted to have up-to-date information on research findings, medications and laboratory tests, rather than general information about heart failure. Patients liked to have immediate access to information in order to verify if they are still following the recommendations as prescribed (Boyde et al., 2009a) and found it useful to continue web-based communication over long periods (Delgado et al., 2003). Caregivers want equal access to web-based information to help their loved ones and to provide better care (Nahm et al., 2008; Piette et al., 2008). When given access the Web-based applications, caregivers reported that the program was helpful in providing assistance and additional information about heart failure (Piette et al., 2008).

References
Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning for heart failure patient (The L-HF patient study). Journal of Clinical Nursing, 18, 2030-2039. doi:10.1111/j.1365-2702.2008.02716.x
Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning style and learning needs of heart failure patients (The Need2Know-HF patient study). European Journal of Cardiovascular Nursing, 8, 316-322. doi:10.1016/j.ejcnurse.2009.05.003
Delgado, D., Costigan, J., Wu, R., & Ross, H. J. (2003). An interactive Internet site for the management of patients with congestive heart failure. Canadian Journal of Cardiology, 19(12), 1381-1385.
Heart failure. (n.d.). In heart and stroke foundation. Retrieved September 29, 2010, from the World Wide Web: http://www.heartandstroke.com
Heo, S., Moser, D. K., Lennie, T. A., Riegel, B., Chung, M. L. (2008). Gender differences in and factors related to self-care behaviors: A cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies, 45, 1807-1815. doi:10.1016/j.ijnurstu.2008.05.008
Munhall, P. L. (2007). Nursing research: A qualitative perspective. Sudbury, MA: Jones and Bartlett Publishers.
Nahm, E., Blum, K., Scharf, B., Friedmann, E., Thomas, S., Jones, D., & Gottlieb, S. S. (2008). Exploration of patients’ readiness for an eHealth management program for chronic heart failure: A preliminary study. Journal of Cardiovascular Nursing, 23(6), 463-470.
Piette, J. D., Gregor, M. Share, D., Heisler, M., Bernstein, S. J., Koelling, T., & Chan, P. (2008). Improving heart failure self-management support by actively engaging out-of-home caregivers: Results of a feasibility study. Congestive Heart Failure, January February, 12-18.
Strömberg, A., Dahlström, U., & Fridlund, B. (2006). Computer-based education for patients with chronic heart failure: A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life. Patient Education and Counseling, 64, 128-135. doi:10.1016/j.pec.2005.12.007
Westlake, C., Evangelista, L. S., Strömberg, A., Ter-Galstanyan, A., Vazirani, S., & Dracup, K. (2007). Evaluation of a web-based education and counseling pilot program for older heart failure patients. Progress in Cardiovascular Nursing, Winter, 20-26.

My NING site

  by  ….Tim 

For my final project, I am working on developing a NING site for patients with congestive heart failure. It has been an exciting week- first I will share with you my experiences with NING . It was really easy setting up the account. You do have 3 options to choose from- I went with the basic format but added other features such as the ability to set up groups. My first hurdle was choosing the name of the network. I would never have guessed how difficult this could be as I wanted it to be easy to find, as it is hard to have anybody participate if they cannot find you. At the same time I did not want it to be too restrictive so that others would not want to check it out. The other issue was that I did not want it to be too similar to groups already in existence so that patients and family members would not think that I am receiving support from a particular association. In the end I chose the name Saskatchewan Heart Failure Network.  It is limiting from the standpoint of will others who live outside of Saskatchewan want to participate? I am not sure but hope to find out eventually. I would ultimately like to have this site up and running but will require ethics approval first.

Now back to the site- as I had access to the basic format (and no programming skills) I chose one of the available backgrounds which happens to be a cork board. It is okay, would not be my preferred choice for a background but given the other selections it is the easiest to read and follow. Attaching videos is really easy and similar to what you do on wordpress.

I have started two groups- one for patients with heart failure, the other for family members and friends who also may want to share their story. A third group was also set up for just general questions. As well I started several discussion postings on various topics such as what is heart failure, medications, diet, monitoring etc. In each of these discussion postings I have provided an overview of the topic with links to websites. I have tried to keep with as many Canadian resources as possible and particularly Saskatchewan based for relevancy. I also started a forum on medications- this was started as so many patients do not take medications as scheduled due to side effects.

I met with the nurses at the Congestive Heart Failure Clinic in the Regina Qu’ Appelle Health Region and they are very excited about this project as there is such a need. I was told that patients last week were asking if such a site exists. These nurses will be given access to the site and I look forward to their comments and how I can improve it. I will be continuing to develop it throughout the month- ultimately I would like the site to become a place where patients, family members and friends can seek advice, share experiences and stories, support one another and have access to current and relevant information monitored by a nurse.

I have also been asked to share this with the Canadian Council of Cardiovascular Nurses in one of their webinars when I am further along. I will continue to blog about what content I chose for the site as well as about the feedback I receive so I will keep you posted.