NURS 453 Professional Practice IV - Smith

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About This Article

This article describes how mobile computing, specifically tablets, was piloted in Prof. Linda Smith's NURS 453 - Professional Practice IV to transform teaching and learning.

Intended Audience

WSU instructors interested in past faculty experience with tablet devices in the classroom.

Fall 2012 iPad Pilot

Students in this course had access to an iPad tablet to use throughout the fall semester along with several apps selected by Dr. Smith for use in class and in the field.

How the iPads are Used in NURS 453

Dr. Smith used the iPad to accomplish several key objectives of the course that would be difficult or impossible utilizing only traditional educational methods. The iPad and the associated application enabled Dr. Smith to transform the learning in ways that were impossible before.

Students learn to conduct mental health assessments through role play. A student playing the role of nurse visits the home and interviews classmates playing a husband and wife, the wife having just come home from the hospital after an unsuccessful suicide attempt. The nurse interviews the couple to determine the mental state of the wife, how to keep her safe, and how to help her progress along the road to recovery.

As part of the assessment, the nurse completes a standardized form. The form serves two purposes - guiding questions for the interview and documentation of the responses. The paper assessment form completed by the nurse is approximately 14 pages in length.

As part of the iPad Prototype, a PDF of the form was loaded onto an iPad. Rather than the nurse completing the 14-page form in pen, a PDF-editing application was installed on the iPad and a stylus was used to annotate the form.

Professor Smith used the iPads to accomplish several key objectives of the course that would be difficult or impossible utilizing only traditional educational methods. The iPad and its associated application enable Dr. Smith to:

  • Increase student engagement. Adding the iPad to the exercise increased the interest in the interview process, the form content, and the steps in documenting the interview.
  • Eliminate the stress produced by the 14-page document. Fourteen pages are quite intimidating. By using an electronic form, the physical presence of the document is hidden from the role players eliminating a stressor from the exercise.
  • Expose students to technology. As many clinics and hospitals are moving toward electronic records, it is important for students to be prepared for the workplace.


Changes in the classroom

  • Notability includes a sidebar that shows a visual table of contents of the document, enabling the interviewer to move about more easily within the document during the conversation. Because there is less time spent shuffling paper, more time is invested in conversing with the interviewee. The conversation runs deeper, increasing engagement on both sides.
  • Placing the document on an iPad eliminates both the physical and the visual presence of the 14-page document. The sheer size of the document causes stress to both parties. The interviewer must flip through the pages to find specific information and the interviewee sees the size of the document and passes judgement on the time and effort it will take to complete the process.
  • The use of technology is prevalent within the medical community. Exposing students to the tablets in the laboratory setting decreases the stress of encountering the same or similar technology in the field. 

Students adapted quickly to the technology. Each interviewer was given about 20 minutes of tablet instruction before the simulation. This was ample for most students, even the students that had never used a tablet prior to this experience. For all students, the tablet posed some level of challenge at the outset, but all adapted and succeeded in the simulation.
  • Because the tablet is smaller than a laptop, there was little or no need to lay the tablet on the furniture. This decreased to possibilities of spreading germs between interviewee homes. Cleaning the tablets between visits is also easier as there is no physical keyboard to sanitize.
  • The upright nature of a laptop screen presents a physical obstacle between the interviewer and the interviewee, impacting conversation. By using a tablet, the screen has a more horizontal aspect and the obstacle of the laptop is minimized.


  • The results of the fall pilot were quite positive. The interview process was streamlined because of the tablets and conversations were less distracted by the paper copy of the form.
  • Professor Smith recommends continuing the pilot for the spring term. Improvements to the next iteration of the pilot include exposing the students to the form and the tablet earlier in the process. This would decrease the learning curve at the time of the simulation and increase the comfort with the process. Professor Smith will also include more thorough training on the use of tablets in the simulation and in the classroom.

Changes Made in Follow-Up Pilots - Spring 2013 & Fall 2013

Professor Smith has rerun the NURS 453 pilot several times. Changes she made to subsequent iterations of the pilot include:

  • Recording the audio of the conversation rather than taking notes during the conversation: Students commented that the action of taking notes was detrimental to the development of a therapeutic conversation. So, instead of actively taking notes during the conversation, Dr. Smith had her students use the form on the iPad as a guide during the questioning, record the audio of the conversation on the iPad, and then analyze the interview for content after the fact. Students reported a higher level of therapeutic conversation when they did not have to actively take notes.

iPad Applications Employed in NURS 453

Professor Smith used the following applications in her NURS 453 iPad pilot:

  • Notability

Descriptions, pricing, and links to iTunes for each of these applications is available on the iPad Pilot Applications page.

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