critical care, orientation, computer learning


Purpose: Education of the novice critical care nurse has traditionally been conducted by critical care educators in face-to-face classes in an orientation or internship. A shortage of qualified educators and growth in electronic modes of course delivery has led organizations to explore electronic learning (e-learning) to provide orientation to critical care nursing concepts. Equivalence of e-learning versus traditional critical care orientation has not been studied. The primary aim of this study was to examine the equivalency of knowledge attainment in the cardiovascular module of the Essentials of Critical Care Orientation (ECCO) e-learning program to traditional face-to-face critical care orientation classes covering the same content. Additional aims were to determine if learning style is associated with a preference for type of learning method, and to determine any difference in learning satisfaction between the two modalities. Methods: The study was conducted using a two-group pretest-posttest experimental design. Forty-one practicing volunteer nurses with no current critical care experience living in southwest Florida were randomly assigned to either the ECCO (n=19) or face-to-face (n=22) group. Those in the face-to-face group attended 20 hours of classroom instruction taught by an expert educator. Those in the ECCO group completed the lessons on line and had an optional 2 hour face-to-face discussion component. Pre-test measures included the Basic Knowledge Assessment Test (BKAT-7), modified ECCO Cardiovascular (CV) Examination, and Kolb Learning Style Inventory (LSI). Post-tests included the BKAT-7, modified CV Examination, and Affective Measures Survey. Results: The majority of subjects were female, married, and educated at the associate degree level. Their mean age was 39.5 + 12 years, and they averaged 9.9 + 11.7 years of nursing experience. The diverging learning style was assessed in 37% of subjects. Classroom instruction was preferred by 61% of participants. No statistical differences were noted between groups on any demographic variables or baseline knowledge. Learning outcomes were compared by repeated measures analysis of variance. Mean scores of subjects in both groups increased statistically on both the BKAT-7 and modified CV Examination (p= < .01); however, no significant differences (p > .05) were found between groups. Preference for online versus classroom instruction was not associated with learning style (X2 = 3.39, p = .34). Satisfaction with learning modality was significantly greater for those in the classroom group (t=4.25, p=.000). Discussion/Implications: This is the first study to evaluate the ECCO orientation program and contributes to the growing body of knowledge exploring e-learning versus traditional education. The results of this study provide evidence that the ECCO critical care education produces learning outcomes at least equivalent to traditional classroom instruction, regardless of the learning style of the student. As participant satisfaction was more favorable toward the classroom learning modality, consideration should be given to providing blended learning if using computer-based orientation programs. Replication of this study with a variety of instructors in varied geographic locations, expanded populations, larger samples, and different subject matter is recommended.


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Graduation Date



Sole, Mary Lou


Doctor of Philosophy (Ph.D.)


College of Health and Public Affairs



Degree Program









Release Date

August 2013

Length of Campus-only Access


Access Status

Doctoral Dissertation (Open Access)

Included in

Nursing Commons