Skill Acquisition for System Administration of Nightingale TrackerTM System and Development of Web-based Tutorial for Student Instruction

Basic and Applied Sciences
Anita Crocket

The purpose of this proposal is to request support for me to learn, set up, and maintain the servers and trackers for the Nightingale TrackerTM System and design a web-based instructional tutorial on the Nightingale Tracker system. The Nightingale TrackerTM is a home-health-oriented personal digital assistant (PDA) that incorporates a standardized language as a framework for collecting and analyzing patient and nursing data at the point of care. This standardized language is a nationally recognized and extensively researched community clinical vocabulary and classification system referred to as the Omaha System. The MTSU School of Nursing obtained (with TAF funds) the Nightingale TrackerTM System in the form of two servers, 22 handheld DataRover 840 PDA's and all accompanying software. I attended a training session at FITNE, Inc. (formerly the Fuld Institute for Technology in Nursing Education) in Athens, Ohio to become familiar with teaching the technology, with the expectation that computer technician support would eventually be in place. In the meantime, the Tracker has been piloted and fully implemented (every student in the course learns this capability) into clinical teaching in the N3270 Educative/Supportive Course with limited utility.

The students have access to the Omaha System software and use wired capability through analog connection to fax their client data. The students either fax from the client's homes or more typically fax when they return home in the evenings. In this process, client data is retained on the Tracker and, although some functions can be used, full capability of the Tracker is not available. This process in some ways defeats the intended purpose of this technology.

The Tracker allows for internet access, email capability, storage and retrieval of client data, and wireless capability (with an addition of modem card and wireless phone service which may be feasible in the future). Student learning would be greatly enhanced with full capability, both in speed and effectiveness. Supervision could be synchronous as well as asynchronous, providing immediate feedback to students. In the future students will need point-of-care electronic information processing skills in our complex health care system. Objectives for this faculty member are:

Attend the technical training session provided by FITNE. Inc. with the purchase of the system. That training involves learning Linux System as well as troubleshooting and maintaining tracker hardware and software.

Complete setup of the two servers with accompanying internet access. One of the crucial aspects of this process is adhering to Health Insurance Portability and Accountability Act (HIPAA) guidelines in configuring the system. Since we deal with that aspect on a daily basis in the clinical settings, complete adherence will always be in the forefront of decision-making.

Establish the logistics of incorporating this aspect of the Tracker System for student learning and faculty supervision. I anticipate being able to implement it in the fall semester. Evaluation of this technology is an ongoing concern.

Design a web-based tutorial for the Nightingale Tracker System to be used in initially teaching students about it. When students learn from the Tracker itself, they get so involved with its capability and often miss key points in its operation. A tutorial initially before actually getting their hands on the Tracker will enhance their learning and reduce some frustration when they are alone with it. 


Basic and Applied Science
Pat O'Leary

This report will describe the progress made on the project undertaken for the Instructional Technologies Development Grant that I received in Fall 2001. The objectives of my project were:

(1) to learn a variety of multimedia applications; (2) to develop a variety of assessment simulations; and (3) to incorporate the developed assessment simulations into the online health assessment course to provide an interactive learning tool. Health Assessment is a required nursing course taught in the first semester of the nursing curriculum. It is a course where students learn how to conduct a health history and physical examination. This course requires the learning of psychomotor skills in order to properly perform a physical examination on a patient. Offering this course as a web-based course is a challenge because of the number of psychomotor skills that must be learned. Numerous hours were spent taking courses through OIT, working with OIT staff members, and working on my own to learn a variety of multimedia applications and then applying the knowledge to course content. I concentrated on working on two body systems-the heart and lungs.

FrontPage was used as the web-authoring tool in developing a web site to place the simulations for the students to access during the course. By incorporating Java Script, I developed pop-up windows so students would be able to review anatomy and physiology as well as new course material. One example is the review of the anatomy and physiology of the heart such as information on the heart valves, layers of the heart, and chambers of the heart.

Macromedia Flash 5 was used to incorporate animations into the course. Different types of movies were developed to show the students the correct sequence in the physical examination of a certain system. One example shows the student the correct sequence of moving the stethoscope on the chest while listening to the heart.

The digital camera was used to take pictures of manikins to use with some of the simulations. Photo editing was necessary and Adobe Photoshop and Microsoft PhotoDraw were used. Sounds (i.e. heart sounds, lung sounds) were edited using Sound Forge XP and Real [Media] Player. Image maps were developed incorporating the edited sounds and manikin pictures. This will allow students to listen to normal and abnormal heart and lung sounds.

The digital video camera was used to take videos of some of the psychomotor skills used in the course. I videotaped a fellow faculty member as she assessed the manikin "patient". I then edited the videos and added text and transitions using Imovie. Short video clips were completed for the student to view the actual assessment of the lungs and heart.

This material will be added to the web-based course starting in spring semester 2002 and will be presented during the Mid-South Technology Conference on April 9, 2002. An evaluation of the effectiveness of the assessment simulations for students will be done starting at the end of spring 2002 semester.

In the coming months, I plan to I continue making other body system assessments interactive as well as adding more to the heart and lung assessments. I want to continue to learn more using Flash 5 animation. I want to develop a movie to help students review the physiology of the heart (i.e. show the movement of blood as it flows through the heart). I also want to learn how to use the drag and drop feature of Flash 5 so that I can develop study materials for the students to review course material.

I want to thank the OIT department staff (Barbara Draude, Brenda Kerr, and Sherry Thorup) for their time, support, and encouragement in working with me on this project. I feel that I learned a variety of different multimedia applications and can now utilize this knowledge to integrate the technology into teaching.


CASE (Computer Application for Student Enhancement) Project for Nursing 460: Compensatory Health Care

Basic and Applied Sciences
Maria Antoinette Smith

Smith will develop an enhanced web component for Nursing 460: Compensatory Health Care. This information will include graphics and audio as well as text. Smith also plans to design two interactive cases that will allow students to safely develop patient management skills for patients with possible life threatening health care problems. This will facilitate student understanding regarding management of patient in high acuity (critical care) settings.

There were three objectives for this project, which were met upon its completion. Each will be addressed individually. The first stated objective was to - Enhance the current web based course information to include graphics and audio as well as text. Courseinfo was utilized as the foundation for accomplishing this objective. Not only was the didactic course NUR460: Compensatory Health Care placed in this format but its companion clinical course as well. A custom banner was developed for both courses. All student information was integrated into appropriate headings for student use. Information was entered in text and HTML format in order to set up tables and utilize other text enhancements. Many hours were spent searching the web for healthcare information related to Critical Care Nursing, Respiratory Alterations, Dysrhythmias, Hemodynamics, Cardiovascular Alterations, Endocrine Alterations, Renal Alterations and Neurological Alterations. Hundreds of pieces of information were critiqued but only 43 were identified as sufficient to enhance student learning and therefore hyper linked to Courseinfo in folders for ease of student use.

Project Objective #2

The second objective was to - Design two (2) interactive cases that will allow students to safely develop patient management skills for patients with possible life-threatening health care problems. This objective was very time intensive. The two cases developed were: (a) Rick a 65 year-old homeless gentleman with acute respiratory and cardiovascular problems, and (b) Herbert a 50 year old overweight gentleman with Acute Coronary Syndrome. The first step (step 1) was to develop the cases in text. After this step was completed, a system had to be developed that would allow me to logically connect pieces of information including correct and incorrect responses (step 2). I developed an initial flowchart that allowed me to visualize linkages. From here, I diverted to a practical format of printing the pages and laying them out on the floor in order to trace the flow of information. Step 3 involved locating graphics and audio for the web pages. This was an interesting step. This required finding pictures that would allow the student to actually view anatomical body parts for hyper linked audio and information access. This was the most frustrating of all the steps, as there were few sites that afford these types of graphic images for healthcare education. Step 4 involved putting everything together to work from the web. Hyperlinks and hotspot links within the interactive case had to carry a web address in order to work correctly. This is a final step as these case-specific links cannot be previewed in the desktop FrontPage program after this step is completed. Cases were not posted until students completed sufficient information to afford them the possibility of success.