Development of a smartphone application and its evaluation on its usability in facilitating self-directed learning of clinical skills among undergraduate nursing students

Abstract

Introduction: Self-directed learning (SDL) has been proven effective to enhance learning experience and it is essential for the effectiveness of mobile learning interventions. Although a lot mobile-based interventions have been implemented in nursing education, it did not provide a consistent result on the improvement of knowledge and skill among nursing students. Many mobile learning interventions were built without implying the important elements of use behaviour of a technology. Objectives: This study aimed to explore the important factors of perceived behavioral intention to use smartphone application, develop and evaluate the usability of a smartphone application prototype that facilitate SDL of clinical skills among undergraduate nursing students. Methods: A sequential exploratory mixed-method design was used and adapted in this study. Phase 1 includes the qualitative aspect using in-depth, semi-structured interview to investigate the challenges of SDL of clinical skills among nursing students, at the same time, to explore the perception of using smartphone application to cope with the challenges. In Phase 2, a quantitative aspect utilizing survey instrument based on Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) was used to identify the significant factors that give positive effect on behavioural intention to use the smartphone application. In Phase 3, the relevant smartphone features were identified and mapped with its significant behavioral determinant using methodological triangulation followed by the development of smartphone application prototype. In Phase 4, usability studies and end-user perception were carried out to evaluate the prototype using observation, in-depth interview, and survey. Qualitative data was analyzed using thematic analysis meanwhile quantitative data was analyzed by performing PLS-SEM analysis. Findings: The first interview findings suggested that undergraduate nursing student were lack of self-management skill, lack of desire of learning and lack of self-control skill. Meanwhile, in assessing their perception for adopting smartphone application for SDL of clinical skills, an additional factor which is self-management of learning was found. On larger scale study, the most significant factors that give positive effect on behavioural intention to use the smartphone application were habit, facilitating condition and social influence. On analysis of usability and end-user perception of the prototype, tasks completion rate, usability score and perceptions were good. But there is still a need of improvement in terms of navigability, flow process and interface design of the app. Likewise, the mobile features’ improvement such as profile personalization, content credibility, interface design, and app notification, were indeed necessary. Conclusion: This finding proves that the smartphone application developed based on UTAUT2 is useful in exploring needed mobile apps features and requirements in facilitating SDL of clinical skills among undergraduate nursing students.