Introduction and Background
Healthcare professionals are increasingly required to adopt information and communication technologies (ICTs) with the increase use of electronic health records (EHRs), decision support tools, and other digital technologies in the performance of their daily tasks [1]. Furthermore, emerging technologies, such as Big Data, artificial intelligence, robotics, and immersive health technologies, are increasingly part of daily nurse practice, urging nursing education to remain relevant [1‐3]. Graduating nurses should be competent in nursing informatics and it is imperative for nursing education institutions to prepare students for this practice [4]. In South Africa, progress has been slow, and it raises the question of whether nursing curricula sufficiently integrate informatics to address this.
Nursing informatics has evolved to encapsulate computer, information, and nursing sciences in support of nursing practice, administration, education, and research [5]. The International Medical Informatics Association (IMIA) describes NI as a sub-specialty of health informatics, that identifies, defines, manages, and communicates data, information, and knowledge to improve the health of people, families, and communities using ICTs [6]. To maintain nurses’ competency in nursing informatics, the Technology Informatics Guiding Education Reform (TIGER) initiative, established in 2006, developed a comprehensive list of nursing informatics competencies including the major components of basic computer, information literacy, and information management competencies [7].
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However, a lack of consensus exists regarding the specific knowledge and skills that need inclusion in nursing baccalaureate education [1]. Nursing students have consistently been found to be more competent in basic computer skills (searching the Internet, word processing, systems-operations skills, and graphical, and multimedia presentations), but less in applied computer skills for clinical informatics, such as extracting information from clinical data sets, or seeking available resources to help ethical decisions in computing [8]. Additionally, knowledge and skills regarding data analysis and information management has been found to be lacking [9]. Even in medical school curricula, research has shown differing levels of information literacy competencies and skills among first- and second-year medical students, requiring the need to formally include training in informatics competencies [10]. These findings emphasize the importance of assessing nursing student’s current level of informatics competency before presenting informatics-related content in a curriculum, and modifying teaching methods accordingly [11].
In South Africa, the broader field of digital health and more specifically informatics have been identified as areas that needs investment. The shortage of digital health skills experienced in South Africa’s public and private health sectors, has underscored the importance of developing a competent digital health workforce across all disciplines, and while South African-based universities have begun offering digital health short courses, these remain largely under-developed [12]. Furthermore, the South African Nursing Council (SANC), the statutory and regulatory body that sets preregistration (undergraduate) competencies to register as a nurse in South Africa, provided directives for new nursing programmes to ensure that nursing education matches changing needs and technological advancements. SANC stipulates incorporating health informatics and information technology into nursing curricula to support patient care and education providers are required to equip graduates with knowledge and skills for evidence-based practice and integrate novel technology in both classroom and clinical settings [13]. Even though a focus on computer literacy is emphasized, nursing informatics within curricula is not made explicit, hence the critical need for South African nursing schools to reform their curricula. Additionally, the South African health sector faces numerous challenges such as poor infrastructure, insufficient ICT literacy among educators and students, negative attitudes towards informatics tools in clinical practice, primarily academic use of ICT tools, a lack of standardized competencies [14], and nursing informatics content lacking in nursing curricula [15]. The global mandate for the integration of nursing informatics into nursing education urged the assessment of students’ nursing informatics competencies and evaluate the level at which it is integrated into curricula [6, 16].
Methods
Aim
The aim of this study was to examine the current integration of nursing informatics in the nursing undergraduate curriculum and the levels of nursing informatics competencies at a selected university in South Africa.
Setting
A school of nursing at a selected university in the Western Cape in South Africa. This School of Nursing was selected because it incorporates some of the innovative digital e-pedagogies within its undergraduate programme, such as the integration of a learning management system for blended learning, simulation exercises, and plans for future implementation of virtual reality in its skills labs.
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Design
A quantitative descriptive study, with a self-administered questionnaire to examine nursing student’s informatics competencies and a document review of the current nursing informatics content in the undergraduate curriculum.
Survey population and sampling
The population included student nurses enrolled in a 4-year undergraduate nursing programme, at the selected school (N = 995). Inclusion criteria were undergraduate students registered at the stated university whether first-time or repeating students. Student nurses were chosen using a stratified random sampling method, wherein students were grouped by their respective year level (Table 1). Using the Raosoft sample size calculator, a sample of n = 278 was calculated (5% margin of error, a 95% confidence interval, and a proportion of 50%) and proportionally distributed across the four-year level strata (Table 1).
Table 1
Sample size and population
Year level | Target population | Sample size |
|---|---|---|
Year level 1 | 211 | 137 (65%) |
Year level 2 | 184 | 125 (68%) |
Year level 3 | 305 | 171 (56%) |
Year level 4 | 295 | 168 (57%) |
Survey instrument
A structured self-administered questionnaire which included the TIGER-based self-assessment of Nursing Informatics Competencies (TANIC©) scale, with permission, was used to assess nursing informatics competencies of student nurses. The scale was selected as the nursing students survey was complemented with a professional nurse survey, using the same scale [17]. The scale includes three domains, namely, computer literacy, information literacy, and clinical information management [18]. The instrument comprises 85 skills, with competence rated on a numerical scale ranging from 1 to 4, representing novice (1), advanced beginner (2), comfortable (3), and proficient (4) levels. The TANIC© scale is reliable, with a Cronbach’s alpha test of α = 0.948 for computer skills, α = 0.980 for information literacy, and α = 0.944 for information management (18). The three main domains are further categorised into subdomains and skills [7].
Computer literacy involves fundamental skills required to effectively use computers, including navigating operating systems, managing files, and utilizing essential applications for tasks such as word processing, spreadsheets, and internet communication. Information literacy involves the ability to identify required information for a specific purpose, locating, evaluating, and applying information correctly, an important skill for incorporating evidence-based practice. Clinical information management involves data collection, processing and presentation, and communication of the processed data as information or knowledge, managed by nurses through the use of information systems, including electronic health records [7]. In the computer literacy domain, there were fifty-one (51) skills organized into twelve (12) subdomains, while clinical information management included nine (9) skills divided among two (2) subdomains (Table 2). Additionally, the information literacy domain comprised (25) skills distributed across five (5) subdomains (Table 2). Skills are rated from 1 to 4, representing novice (1), advanced beginner (2), comfortable (3), and proficient (4) levels. The TANIC scale effectively assessed graduate-level nursing informatics competencies [19].
Table 2
Mean subdomain scores by year level
B1 N = 53 | B2 N = 48 | B3 N = 53 | B4 N = 68 | Total N = 222 | U | p-value | |
|---|---|---|---|---|---|---|---|
Mean/4 (sd) | Mean/4 (sd) | Mean/4 (sd) | Mean/4 (sd) | Total mean (sd) | |||
Computer literacy | 3.18(0.49) | 3.35(0.47) | 3.34(0.48 | 3.41(0.47 | 3.33(0.48) | 9.27 | 0.026 |
Network | 3.26(0.79) | 3.60(0.54) | 3.38(0.60) | 3.35(0.75) | 3.39(0.69) | 5.73 | 0.125 |
Using the browser | 2.76(0.64) | 3.07(0.56) | 3.18(0.56) | 3.20(0.65) | 3.06(0.63) | 17.83 | < 0.001 |
ICT in everyday life | 2.66(0.73) | 2.81(0.73) | 2.87(0.71) | 2.90(0.78) | 2.82(0.74) | 3.36 | 0.339 |
Internet security considerations | 2.74(0.93) | 3.05(0.74) | 3.06(0.62) | 3.13(0.78) | 3.00(0.79) | 6.44 | 0.092 |
Security | 3.85(0.36) | 3.71(0.62) | 3.58(0.63) | 3.71(0.60) | 3.71(0.57) | 5.53 | 0.137 |
Operating system | 3.41(0.50) | 3.55(0.54) | 3.44(0.50) | 3.52(0.54) | 3.48(0.52) | 4.84 | 0.184 |
Utilities | 2.56(1.02) | 3.02(1.02) | 3.08(0.92) | 3.09(0.99) | 2.95(1.00) | 10.28 | 0.016 |
Print management | 2.25(1.12) | 2.75(1.08) | 3.08(0.90) | 3.13(0.96) | 2.82(1.07) | 22.21 | < 0.001 |
Using the application | 3.65(0.50) | 3.58(0.59) | 3.57(0.52) | 3.61(0.64) | 3.61(0.57) | 2.11 | 0.550 |
Electronic communication | 2.69(0.67) | 2.85(0.75) | 3.11(0.62) | 3.17(0.67) | 2.97(0.70) | 15.97 | 0.001 |
Using email | 3.32(0.81) | 3.49(0.51) | 3.45(0.57) | 3.52(0.47) | 3.45(0.60) | 9.03 | 0.029 |
Email management | 3.11(0.68) | 3.35(0.80) | 3.31(0.82) | 3.44(0.69) | 3.31(0.75) | 9.57 | 0.023 |
Information literacy | 2.63(0.62) | 2.82(0.71) | 2.85(0.58) | 2.91(0.71) | 2.81(0.68) | 7.15 | 0.067 |
Determine the nature and extent of the information needed | 2,87(0,73) | 3,07(0,79) | 3,00(0,60) | 3,14(0,68) | 3,03(0,70) | 6.05 | 0.109 |
Access needed information effectively and efficiently | 2,34(0,74) | 2,81(0,83) | 2,78(0,65) | 2,77(0,78) | 2,68(0,77) | 13.69 | 0.003 |
Evaluate information and its sources | 2,66(0,69) | 2,72(0,76) | 2,81(0,63) | 2,87(0,82) | 2,77(0,73) | 4.38 | 0.224 |
Use info effectively for a purpose | 2,83(0,78) | 2,83(0,76) | 2,86(0,67) | 2,98(0,86) | 2,88(0,77) | 2.61 | 0.455 |
Evaluate outcomes of the use of information | 2,62(0,67) | 2,82(0,83) | 2,88(0,64) | 2,92(0,91) | 2,82(0,78) | 6.85 | 0.077 |
Clinical information management | 2.37(0.75) | 2.67(0.78) | 2.79(0.75) | 3.01(0.67) | 2.73(0.77) | 21.21 | < 0.001 |
Using an EHR | 2,49(0,76) | 2,79(0,78) | 2,84(0,74) | 3,13(0,67) | 2,83(0,77) | 20.18 | < 0.001 |
Confidentiality_ Access_Control_ Security | 2,13(0,87) | 2,42(0,90) | 2,69(0,88) | 2,76(0,81) | 2,52(0,89) | 15.86 | 0.001 |
Survey procedure
Following ethics approval from the university ethics committee (Ethics ref. BM19/10/21) and permission to conduct the study, data collection was conducted from July to September 2022. After making email and/or personal contact, the researcher visited classes before the start of class sessions to explain the study to students and to recruit students willing to partake in the study. Each student received a self-administered anonymous questionnaire, together with an information sheet and consent form. Informed consent was obtained from all the participants. Students were informed that they could withdraw their consent at any time during the survey process. The researcher remained present in the venue during questionnaire completion to answer any questions participants may have had. For students who did not complete the questionnaires on the day it was distributed, an opportunity was given to complete the questionnaire at a later time that suited them, with the expectation of returning the completed questionnaire the following day. Completion of the questionnaire took place towards the end of classroom sessions, taking between 20 and 25 min, and was submitted in a box as students exited the classroom.
Survey data analysis
Data were cleaned and entered manually into the Statistical Package for Social Science (SPSS) version 28. Missing data was minimal and included in the analysis as it did not significantly affect the overall results. Descriptive statistics was used to summarize respondent’s demographic variables and the different domain skills related to nursing informatics. Confidence intervals were computed at a 95% level for all nursing informatics competencies in the domains of computer literacy, clinical information management, and information literacy, including their respective sub-domains. Mean scores were interpreted as follows: novice (1.50–2.12), advanced beginner (2.13–2.75), comfortable (2.76–3.38), and proficient (3.39–4.00). Chi-square tests and Independent Samples Wilcoxon U Tests were conducted to compare the differences in demographics per domain. Statistical significance was set at p < .05.
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Curriculum mapping process
Curriculum mapping was conducted to examine course content, to determine when and what nursing informatics related content was taught, and to highlight strengths and weaknesses regarding the current inclusion of nursing informatics [20, 21]. A document review was conducted using the module/unit guides and the clinical practice placements for each year level to determine the vertical and horizontal integration of nursing informatics throughout the undergraduate nursing degree [22]. Specifically, nursing informatics was assessed in terms of computer literacy, information management and information literacy.
Information presented in module guides was collated and entered into tables, quantifying how frequently certain concepts appeared based on key search terms: technology, computer, information, electronic, literacy, data, learning management system, blended learning, and skills lab. As no blueprint exists for accepted nursing informatics competencies in South Africa, the selected school’s curriculum content was mapped against the nursing informatics competencies found in the literature, after which it was reviewed by the research team [3, 15, 23].
Results
A total of 222 students completed the questionnaire (response rate of 222/278), 79,9%). This included n = 53 (24%) first-year students, n = 48 (21.6%) second-year students, n = 53 (24%) third-year students, and n = 68 (30.6%) fourth-year students. Most of the respondents were female (90%, n = 198), with the average age of all respondents being 21.9 years (± 3.43), ranging from 17 to 42 years (Table 3). Only 15.2% (n = 34) reported training in nursing informatics/health care technology, such as general training on technological devices and computerized information systems used in clinical settings (Table 3).
Table 3
Demographic data
Age group | Mean 21.9, SD 3.43 Age range 17–42 |
|---|---|
Gender | |
Male | 23(10%) |
Female | 198(90%) |
Missing | 1(0.5%) |
Year 1 nursing students | 53 (24%) |
Year 2 nursing students | 48 (21.6%) |
Year 3 nursing students | 53 (24%) |
Year 4 nursing students | 68 (30.6%) |
Training in nursing informatics / health technology | 34(15.3%) |
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Overall nursing informatics competencies
Nursing informatics competence was measured out of a possible rating of 4 for perceived level of competence in each of the 85 skills in the three domains, computer literacy, clinical information management, and information literacy. Within all three domains, competence levels increased per year levels with significant differences existing among the year levels for computer literacy and information management (Table 4). Computer literacy was rated significantly higher than the other two domains (3.32/4 [95%CI 3.26–3.39]). Among the domains, computer literacy competency had the highest score (3.33, ± 0.48) of all domains, approaching proficient competency levels across all year levels (3.18, ± 0.49–3.35, ± 0.47), except for respondents from Year 4, who had ratings at the proficiency in competency level (3.41, ± 0.47) (Table 4). Information literacy had the second highest score (2.81, ± 0.68), falling within the comfortable competency range, again gradually increased from advanced beginner levels in Year 1 (2.63, ± 0.62) to comfortable competency ranges in Year 2 to Year 4 (2.82, ± 0.71–2.91, ± 0.71). Lastly, the clinical information management domain had the lowest score (2.73, ± 0.77), indicating competence levels within the advanced beginner range. Similar year level patterns were seen with Year 3 and 4 students having the highest mean scores, within the comfortable competency range (2.79, ± 0.75–3.01, ± 0.67), while the lowest scores, situated within the advanced beginner competency range in Years 1 and 2 (2.37, ± 0.75–2.67, ± 0.78) (Table 4).
Table 4
Nursing Informatics competency domains
Year 1 N = 53 | Year 2 N = 48 | Year 3 N = 53 | Year 4 N = 68 | Total N = 222 | U | p-value | |
|---|---|---|---|---|---|---|---|
Mean/4 (sd) | Mean/4 (sd) | Mean/4 (sd) | Mean/4 (sd) | Mean/4 (sd) | |||
Computer literacy | 3.18(0.49) | 3.35(0.47) | 3.34(0.48) | 3.41(0.47 | 3.33(0.48) | 9.27 | 0.026 |
Information literacy | 2.63(0.62) | 2.82(0.71) | 2.85(0.58) | 2.91(0.71) | 2.81(0.68) | 7.15 | 0.067 |
Clinical Information management | 2.37(0.75) | 2.67(0.78) | 2.79(0.75) | 3.01(0.67) | 2.73(0.77) | 21.21 | < 0.001 |
Computer literacy competency domain
Computer literacy was the highest rated nursing informatics domain. Within this domain, the highest rated level of competence in skills was for Security (3.71, ± 0.57), with the highest competence level being in Year 1 (3.85, ± 0.36). Using the Application (3.61, ± 0.57) also with a high rate of competence with again Year 1 having the highest mean score (3.65, ± 0.50). Significant differences across year levels were found in skills related to Print Management (2.82, ± 1.07) the lowest rated competence skill (Table 2).
Information literacy competency domain
Information literacy was the second highest rated nursing informatics domain. Within this domain, the skill focusing on Determine the nature and extent of the information needed, had the highest competency ratings (3,03, ± 0,70), with the highest ratings achieved in Year 4 (3,14, ± 0,68). Access needed information effectively and efficiently was rated overall as least competent (2,68, ± 0,77), with Year 1 rating this the lowest (2,34, ± 0,74) (Table 2).
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Clinical information management competency domain
The Clinical information management domain was rated with two skills, significant differences were shown across the year levels for skills related to EHR use (2,83, ± 0,77), with EHR use showing the highest competence levels in Year 4 (3,13, ± 0,67) (Table 2).
Nursing informatics integration in the nursing curriculum
Within the computer literacy domain, skills implemented across all year levels (Table 5) integrate basic content content such as computer operating systems, hardware and software fundamentals, word processing, email management, file management, and security measures.
Table 5
Curriculum mapping of nursing informatics integration
Year 1 | Year 2 | Year 3 | Year 4 | Description | |
|---|---|---|---|---|---|
Computer literacy | |||||
Computer Operating systems & Cloud systems (navigating World Wide Web, Windows) | ✓ | ✓ | ✓ | ✓ | Integrated |
Components of hardware and software | ✓ | ✓ | ✓ | ✓ | Integrated |
Fundamental applications (Word processing, PowerPoint media, spreadsheets) | ✓ | ✓ | ✓ | ✓ | Integrated |
Electronic communication (email management) | ✓ | ✓ | ✓ | ✓ | Integrated |
File management | ✓ | ✓ | ✓ | ✓ | Integrated |
Security measures to protect data and devices | ✓ | ✓ | ✓ | ✓ | Integrated |
Information literacy | |||||
Scholarly database management | ✓ | ✓ | ✓ | ✓ | Integrated |
Navigating the digital library | ✓ | ✓ | ✓ | ✓ | Integrated |
Information resources for nurses and clients | – | – | ✓ | ✓ | Integrate certain health care apps, e.g. MomConnect, and other online sources, e.g. PACK, EM |
Information management | |||||
Health information systems | ✓ | – | – | ✓ | Theoretical coverage |
Electronic Health Records (EHR) | ✓ | – | – | – | Theoretical coverage |
Electronic medical record (EMR) | ✓ | – | – | – | Theoretical coverage |
Protection of personal electronic health Information | – | – | – | – | |
Clinical use of information systems | – | – | – | – | |
Electronic monitoring | ✓ | ✓ | ✓ | ✓ | Dynamaps, Infusion pumps, CPAP, AEDs |
Administrative management systems | – | – | – | – | |
Health data storage and exchange | – | – | – | – | |
Ethics and legal aspects of informatics | – | – | – | – | |
Data analytics | – | – | – | – | Some statistical procedures in quantitative analysis |
Clinical decision support | ✓ | – | – | – | Theoretical coverage |
Understanding of Big data | – | – | – | – | |
Concepts and components of interoperability of ICTs | – | – | – | ✓ | Lecturer presentation from Department of Health |
Other technological applications | |||||
Uses web-based learning management systems (LMS) (digital education) | ✓ | ✓ | ✓ | ✓ | Integrated |
Simulation | ✓ | ✓ | ✓ | ✓ | Skills Lab activities (high and low-fidelity mannequins) |
Telehealth and mobile health | ✓ | – | – | – | Theoretical coverage |
Advanced technologies | |||||
Virtual reality | – | – | – | – | Future integration in progress |
Robotics | – | – | – | – | |
Artificial intelligence (AI) | – | – | – | – | |
In terms of the information literacy domain, search database management, access and evaluation of information, and sources of information are integrated into academic tasks in modules and explicitly taught in the research modules in the curriculum. Students in year levels 2–4 engage with information sources such as South African electronic health resources such as PACK (Practical Approach to Care Kit) and EM (Emergency Medicine Guidance) (Table 5).
Clinical information management content is not formally included in the four-year degree programme, however, concepts of the Electronic Health Record (EHR), the Electronic Medical Record (EMR), Health Information Systems, and Clinical decision support systems are theoretically introduced in Year 4 and a lecture presentation on the health information systems used in the public facilities in the Western Cape Department of Health (Table 5).
The use of a web-based learning management system is implemented across year levels. Applications of virtual reality, robotics, and artificial intelligence (AI) are not formally implemented in the curriculum, even though some elements may be integrated, such as large language models such as ChatGPT (Table 5).
Discussion
The study looked at both the nursing informatics competencies in undergraduate nursing students and the current content in the nursing curriculum. The survey found low nursing informatics competencies, except for skills around computer literacy. However, there was a gradual increase in nursing informatics competence across the year levels, with significant differences (computer literacy p = .026 and information management p < .001), or near significant for information literacy (p = .067) difference across the years. This finding is expected as students are increasingly exposed to technology across the nursing programme, in alignment with their training in preparation for students entering the profession as professional nurses [24, 25].
Computer literacy
Significantly higher ratings were found for skills in the computer literacy domain, with competence ratings ranging from ‘comfortable’ to ‘proficient’ levels across all year levels. Computer literacy extends beyond managing computers and common software applications, such as e-mail, and word processing, to also involve understanding computer and information systems and their functionalities and basic applications such as Microsoft Word and PowerPoint applications, e-mail management, and Internet use, amongst others [26], and have always been integrated in the teaching and learning activities across all modules in this curriculum. Various other studies support this finding, as higher confidence levels in basic computer knowledge and skills were reported among baccalaureate-nursing students, associated with frequent computer use during the learning process [27‐29]. [30] opined that most nursing students entering nursing programmes are computer literate, and mainly use technology for academic purposes, with a correlation between the emphasis on development of basic computer skills in undergraduate curricula and low nursing informatics implementation in African nursing schools [14, 31].
These findings were also supported in the curriculum mapping with several skills focusing on this domain. This finding was supported by a study in Iran which found that teaching informatics in curricula was only at the level of basic computer skills, and not including any knowledge and skills in informatics [9]. In addition, with the advent of the COVID-19 pandemic in 2020, the rapid change to an online teaching and digital learning environment (learning management systems) emerged, forcing students and nurse educators in this study to engage in blended learning.
Information literacy
Information literacy skills help students to critically appraise and apply the best available evidence, to inform decision-making and support their nursing care and technology implementation in practice [32]. Respondents across all year levels in this study displayed comfortable competence levels in information literacy skills.
Determining the nature and extent of the information needed seemed to be the most competent skill, rated highest in Year 4, and lowest in Year 1. This is supported by other studies that found that senior students had higher literacy levels than those in junior levels due to the higher academic experiences of senior students [33, 34]. The lower ratings for evaluating information were also consistent with other studies. [34‐36] found that students were unable to evaluate the reliability of searched sites and identify the scientific merit of resources. A study by [35], during which students achieved intermediate levels of competence, revealed that students required extra support in domain skills such as organizing and evaluating information [36]. also reported undergraduate nursing student’s difficulty in discerning between high- and low-quality resources, despite being knowledgeable about accessing online health information and locating it.
The higher competence levels in information literacy skills among students in year level-two to year-four in this study may be a result of teaching specific information literacy skills in research modules and library sessions on information literacy. These skills include reviewing research, assessing the quality of research, and doing actual research. This is also applied in the nursing modules with students expected to actively engage with departmental electronic information, namely, PACK (Practical Approach to Care Kit), IMCI (Integrated Management of Childhood Illness), and EM (Emergency Medicine) guidance used to support their practice. Additionally, library sessions are held during orientation periods at the beginning of every year, assisting in the acquiring of information literacy skills.
Clinical information management
Clinical information management skills were rated the lowest, fluctuating between ‘advanced beginner’ to ‘comfortable’ competence ranges. Other studies also confirmed the lowest mean scores in the information management domain [37, 38]. Nurses need sound data management skills, extending beyond just efficient operation of data systems and tools, to access and manage data, such as the use of electronic health records [39]. Even though this school employs innovative educational technologies, beyond simulation, this has not translated to the clinical environment in areas such as clinical nursing documentation. Even though the senior students in this study may encounter hospital and clinical information systems during clinical placements, no theoretical content about electronic information management is done, leaving students to learn mostly from their experiences during clinical placement [40]. This may also relate to poor access in clinical settings with reports on limited access to digital systems hindering student’s competence [41], mainly because permission is reserved for hospital staff only [40, 42].
One of the programme outcomes with the nursing curriculum in this study, states that students should exit the programme with the ability to access, produce and manage information effectively to a range of audiences, including health information systems, however, in practice, the school falls short of fully achieving this outcome [13]. The mapping of the current curriculum supported this with information management covering only patient confidentiality issues, but lacks the application of real-time computerised information in practice, focusing primarily on ethics-related content in clinical care. According to [39], curriculum coverage should focus on how data is accessed and used, including the ethical-legal concerns of clinical electronic information to equip future nurses with literacy in health information legislation and protective laws regulating health data exchange.
This has revealed the need for the school to create simulated learning opportunities in their skills labs for students to navigate electronic health records, and to expose them to computerized information systems during clinical placement.
Recommendations
There is a need for nursing departments and nursing programme accrediting bodies in South Africa to rethink curriculum reform to keep pace with global technological advancements. This is essential to prevent the stagnation of nurse education in Africa compared to international standards and to ensure that the development of nursing informatics content within curricula is tailored to and aligned with healthcare in a South African context.
Limitations
In the absence of an existing nursing informatics module at this particular school, the curriculum in the study was mapped to identify possible nursing informatics content for integration across the nursing curriculum, with the aim to identify nursing informatics competence among undergraduate nursing students and indicate areas where specific informatics training and support are needed.
Conclusion
This study highlighted the need for increased integration of NI into the nursing curriculum to adequately prepare nurses for future practice in a technologically-infused healthcare environment. Important implications emerging from the results of the current study, are to find ways to increase nursing informatics integration in the curriculum and the need for nurse educator proficiency in nursing informatics. Nurse educators play an indispensable role in leading future nurses in an ever-changing profession infused with technological advancements, and should therefore aim to find a balance in teaching for present needs in anticipation of future demands [39]. In addition, partnering with practice and technology partners to enhance interprofessional education and providing opportunities for context-specific clinical encounters through the use of technology and simulation should be encouraged [3].
Acknowledgements
The authors would like to acknowledge the support of Mr Isaiah Owoeye, as well as the study participants.
Declarations
Ethics approval and consent to participate
Ethical approval (Ethics ref. BM19/10/21) was obtained from the Biomedical Research Ethics Committee (BMREC) of the University of the Western Cape.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
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