CD-ROM: Towards a strategy for teaching and learning Joan Aarvold and Graham Walton

Compact Disc Read Only Memory (CD-KOM) represents an exciting innovation in nurse education yet paradoxically has a potential to induce disillusionment and frustration. Purchasers of systems may well find that their investment does not bring the benefits they had been lead to expect. CD-KOM systems have the capacity to generate huge quantities of data on an equally large number of nursing topics. Arguably this very capability ensures certain ‘built-in’ problems. The purpose of this articles is to provide nurse teachers with information about CD-KOM, to highlight the resource implications of CD-ROM use and to consider the relative merits of various teaching and learning methods. To be worthwhile, strategies developed must be part of an information retrieval skills programme.

necessary and an effective

INTRODUCTION

strategy

Contemporary nurse education demands a research led curriculum. Information retrieval and analysis exercises educational

are part of the everyday

activity of both students

educationalists.

and nurse

These searches are typically per-

formed using card index systems, bibliographies although computer initiated and abstracts, searches are increasingly Disc Kead Only Memory

undertaken. Compact (CD-KOM) represents

such a system and appears to offer immense advantages in terms of access, speed, comprehensiveness

and

economy

However,

initial

investment

some

of

effort.

of time

is

Joan Aarvold BSc (Hans) SRN Cert Ed Lecturer, Institute of Health Sciences, University of Northumbria at Newcastle, Newcastle upon Tyne NE7 7XA, UK, Graham Walton BSc (Hans) MA FETC ALA Faculty Librarian (Social Sciences), University of Northumbria at Newcastle, Newcastle upon Tyne, UK (Requests for offprints to JAI Manuscript accepted 25 August 1992

458

is desirable,

maximum

benefit

teaching and learning

if not essential,

to ensure

from the system. The discri-

minate use of CD-KOM depends to a large extent on the user’s general understanding of the information been done

retrieval

process.

students

(Whitsed

reference

to the use of CD-KOM

1989)

this ‘use’ of the technology larly addressing provide

Studies

in the use of CD-KOM but

have

by medical

there

is little

by nurses. It is

which we are particu-

in this paper. The purpose

nurse educationalists

is to

with an overview

of the technology, the skills and resources required in its use and a review of several teaching

and learning

approaches.

THE TECHNOLOGY The

following

nursing)

CD-KOM

databases

are available at Newcastle

(relevant

to

Polytechnic:

MEDLINE - The major medical database produced by the US National Library of Medi-

NUKSE EDUL4TlON

tine.

It is available

from

per year. It includes

1966, with one disc

all references

from Inler-

-

This

approximately

contains

300

medical journals.

references

selected

from

nursing/para-

It is the CD equivalent

Cumulative Index to Nursing

of

and Allied Heallh

Literature. A single disc covers

from

1983 to

all the

developments chasers,

national Nursing Index and Index Medicus. CINAHL

changing

still

time

come

Dyer (1990)

not

discs

companies

products

market.

compatibility

and

drives.

produce

pur-

as there is

between

Several

CD-ROMs:

BRS and DIALOG known ones.

and

For

advises caution

complete

CD-ROM

as new

to the

459

TODAY

all

software

SilverPlatter,

are some of the more well

date. PsycLIT ture,

- Little coverage

of nursing

it is the CD equivalent

litera-

of Psychological

Abslracts. Two discs are used. !Sociofile -

Contains

and in-depth sources,

covering

ASSIA

-

issues.

bibliographic

abstracts

sociological

British

From

of articles

and

1987

citations from

1500

literature.

covers

available

June

1992. ERIC

- Database

developed

ment of Education. material

There

by US Departis a great deal of

on nurse education,

but poor British

coverage. With

able in the 196Os, whereas newer technology

between

cost, up-to-dateness

these

of information

space-saving

published

alternatives

to

On-line databases are accessed, usually by a trained intermediary, via a terminal connected to the main computer

files (the actual database)

or via a PC with a modem (telephone

connection)

to the main computer.

the variable costs (networking of on-line

searching.

added

MEDLINE

more recently, CD-ROM

the CD-ROM

discs belong

technology.

databases.

CD-ROM

to the new optical disc

Large amounts

of informa-

to

information

Some CD-ROM

disc can store the equivalent floppy discs or put another

and CD-ROM

pages of text. To read the CD-ROM be inserted into a special CD-ROM or linked to a microcomputer. including

printers.

Once

suitable

be able to either download disc) or print the records.

(199 1)

of a CD-ROM

information

been located on the CD-ROM,

drive integral

Nickerson

clearly the components

workstation,

disc it must

on monitors

information

has

the user needs to (save onto a floppy

are

whereas

can be 6 months behind.

At present not included,

providers

publish both on-line

versions of databases. the full text of the references although

some

CD versions

are of

large printed volumes are available in the science held. The information from cover the bibliographical

the CD-ROM

references

or key words that

and the headings

have been used to identify Some

references

also

details

of

will the

each reference. include

an

abstract

summarising the contents of individual articles. This is a significant development as it allows the of the information.

Although,

as Nickerson

us, the

of CD-ROM

databases

CD-ROM

hardware

that is

America.

target

can

citations

monthly)

the relevance

is a moving

databases

25000

CD-ROM drives are becoming a usual feature of the contemporary personal computer (PC). (199 1) reminds

to

Dyer (1990) claims that CD-ROM databases can never be a serious competitor to on-line services.

tion can be stored on optical discs; one CD-ROM of 400, 3.5 inch way 120000 A4

(some

compared

and/or telephone)

The on-line

followed by on-line bibliographic

and,

version is the

fixed costs (discs and subscription)

daily,

and

them is largely one of

does the searching.

be updated

databases

is a much

in the mid 1980s.

of material and who actually

printed bibliographies become increasingly attractice. Microfilms were one such method,

explains

CD-ROM

appearing

A major benefit of the CD-ROM

the amount

worldwide,

storage

Database

There is some confusion over on-line databases and CD-ROM. On-line databases became avail-

The difference

psycho/social

onwards,

CD-ROM and On-Line

searcher

to establish

with much more accuracy originate

Some cover British

The

majority

from

nursing

North

literature

460

NURSE EDUCATION

effectively

but others concentrate

ial. Most CD-KOM journals

TODAY

databases

but references

and conference

on US mater-

are compiled

to reports,

proceedings

from

dissertations

are included.

commands

as they type them, and be able to edit

typed text. The concepts of ‘booting’, ‘loading’, ‘downloading’ and ‘menus’ for example, will all need careful literate concept

EDUCATIONAL Becoming CD-KOM

RELEVANCE

Some users new to CD-KOM

have an assumption

that all they have to do is type their essay/dissertation

title into the computer

to be given

return an appropriate list of references. tunately it is not that simple. Whitaker surveyed

38 American

rated the following

academic

in

Unfor(1990)

libraries

who

needs of users in order

of

importance. 1. Basic search commands,

thesaurus

terms

terms 4. How tojudge

between

using

to free

text

appropriateness

of CD-KOM

several

different

computer

research learning.

Computer

All nursing students need to develop methods of time

management,

note

keeping,

awareness

study

and

of

be assessed

perspectives.

literacy,

essay

and

report writing, literature searching and critical reading. Information retrieval skills are increasingly important as nurses are now expected to examine, test, support and justify their practice. amount

of

available

material

grows, informa-

The skills learned should

become an integral part of a nurse’s working life. The

need to be informed

stronger.

priate

and importance

can therefore

too

Study skills and research awareness

about

in nursing

new develophas never been

Nurses on basic and post-registration

essays, theses and projects.

is structured

relevance

the use of CD-KOM

where

at the same

1982).

courses have to carry out literature

6. How to limit a search by date 7. Understanding CD-KOM technology The educational

198 1; Kowntree

ments and research

5. How the database

include:

are introducted

tion retrieval methods.

logic

as a search tool

from

many new concepts

nurses must be able to use appropriate

e.g. Find

as opposed

This will take time as

is jeopardised

As the

2. Some concept of Boolean 3. Knowing the difference

to the non-computer-

attainment

time (Child

a competent and discriminate user of involves a range of complex skills.

explanation

user of CD-KOM.

CD-KOM

search

searches

for

By using the approstrategies

nurses

not

only save time, but also increase their study skills and their awareness of relevant and related literature.

These

skills

and

student-centred

Student-centred Increasingly,

learning

adults are expected

to take control

of their own learning. Student-centred methods encourage participation and are more likely to lead to more

literacy

As computer literacy components as part of information technology

(Kogers are appearing (IT) courses in

meaningful

and lasting

learning

1986). To develop from novice to profi-

cient as described by Dreyfus & Dreyfus (1986) a user will need to progress from supervised and

nurse education, learning how to use CD-KOM databases is a natural development. Computer

supported a danger,

keyboards are now standard and students who have used wordprocessing or other PC packages

instruction, resources and support the learner is abandoned at a critical stage in his learning of CD-KOM. This can be anxiety making and may discourage further use of the technology. Achieving a successful search, however, can be

will be able to identify the appropriate keys necessary for CD-KOM searching with relative ease. They will also understand the need to enter

practice to independent use. There is however, that due to lack of guided

NURSE EDUCATION

very rewarding Working other

and increase student motivation.

personal

Group instruction

in pairs enables students to ‘teach’ each

and also helps the development

of inter-

skills.

With increasing

student

smaller

TEACHING METHODS are clearly constrained

and skills available

to the institution.

Various

sessions,

structured

teacher-lead

programmes.

advantages

and

disadvantages

are discussed

through of

followed

groups.

to

The different

2000 students Data

the

screen

Units

on to a larger

poor quality. Croup

in patient

reasons) and educationally

care

(for

it

obvious

it is flawed. With this

approach

to CD-KOM

successful

stage in the search has been reached,

the user seldom Frustrations permanent

use,

however,

remembers

emerge

not so fruitful.

screen.

once

a

how he got there.

when further

The learning

attempts

is random,

and this strategy

are

seldom

can be very time-

of the features use

successful

in conveying

to set up the equip-

The

sucesss

depends during

upon a course.

when

place

By linking the CD-KOM

input

can see the technology

or dissertations as being

Workbooks

for health

skills have already

at Newcastle

Polytechnic

its broadest not

sense,

encourage

one-to-one

development

to the

is considered instruction of

in does

independent

learning or enhance group communication skills. This approach may amount to nothing more than a demonstration area, we are reminded must involve hands-on.

and learning

in this

by Wallace et al (1991), Whitsed (1989) remarks

O’Brien, are

Proctor

synonymous

relevant

users and

workbooks

information

can be tailored

also

take

to specific essays, projects

sessions

teaching

needs. If education

very

of the indi-

demonstrations

the

This is a method usually beyond the remit of any as the sessions

in CD-ROM

however,

the purpose

of group

Student-centred

individual’s

does allow most

vidual key on the keyboard.

One-to-one

effective,

this will that have

from the DDU can be of

It is not,

consuming.

it may be the most

to

computer

Although

instruction

useful to their studies.

team. Educationally

the

and skills involved

to be covered.

Project activity.

can be used

from

of demonstrations

ment and the resolution

Most of us, at some time, adopt this approach, is not advocated

(DDU)

information

to be done, time is needed

Trial and error of success. However,

to

by how

last 15 minutes,

is still a time-consuming

Display

project

below.

with a degree

demonstrations

size is dictated

then showing one intake of, for example,

reduce the numbers

sometimes

by

Croup

of six. If each demonstration

staff, ranging

from ad hoc self-directed

to groups.

is to give an initial lecture on the

many bodies can cluster around a single microcomputer. In our experience this is a maximum

by the resources

are open to the teaching

approaches

(100 students

there is a need to provide instruction technology

methods

numbers

three times a year on some Project 2000 courses) One approach

These

46 1

TODAY

students

on traditional been developed

(Lyne & Walton

1991;

& Walton 1991). Workbooks with current androgogical

approaches in adult education (Knowles 1984). They reduce the need for formal instruction and allow

students

Workbooks

to

work

at

their

have other advantages:

own

pace.

they can be

tailored towards specific groups, they can reflect local teaching and learning strategies and be part of an institutions’ corporate image.

that although this approach is labour intensive, a thorough training of key personnel could facilitate a cascade teaching method. However, it is

However, this inductive approach needs some introduction. For novice users, even the most

time-consuming and does not solve the problem of pressure on the resources.

well planned student workbook only when generic computing

will confuse, not terms are used,

NURSE EDUCATION

462

TODAY

but also when are devised

the specific The mentioned. at Newcastle

CD-KOM CD-KOM

Polytechnic

search terms workbook

for a variety

of

students on health related courses combines a basic user guide with practical exercises. We found

that

involved

including

together

during

an

student

explanations

with

actual

of the steps

self-answered

search

process

facilitates

learning.

Learning

outcomes

workbook, students

after should

Search

are clearly

completion

stated

of

the

language

Search

using

control

language

Search

by subject,

Search

by age grouping search

records sets

and download

references

Another useful inclusion effective, is the ‘deliberate error’. the exact taking

and panic,

road

the

to their

students

using

found Often

seldom

distress.

down

the words

tal’ as key search able,

but

terminology and

terms in

to be students

remembering By deliberately

an erroneous

references

would

evaluation

expressions

not

using find

further

how For

not be unreason-

A student

can inform

sheet

is a useful subsequent

impenetrable

are sometimes

and

a

Manuals to be very

for the casual

supplied

which

can be

customised to produce a poster display to be placed near the workstation. Tutorials stored on floppy

discs

are also available,

only a microcomputer Some

CD-KOM

screen

help.

but

alongside with

discs

CD-KOM

technology

of several

resources

some have

require

not

the CD-KOM, computing

very

skills.

effective

on-

of CD-KOM

(1990).

Kesources

and manpower Financial

the

search

at

inclusion.

the

printings

vide library and lecturing staff particular learning difficulties.

end

Student and

of

the

feedback also pro-

with insight Workbooks

into are,

however, very time-consuming for staff to produce and require access to wordprocessing and or desktop publishing facilities.

Software supplier help Most software suppliers provide documentation to assist users. This should not be seen as an

by Dyer

maintenance

and replacement

considered.

Kecurring

rather

than

a

costs

costs

discs are also significant: to CINAHL

for

(up to f2000).

In addition

scription

time

needed

workstation

must

discs are rented

British

provided

of a financial,

hardware

CD-KOM be

is not

of the impli-

have first to be committed

the

‘prenatal’ relevant

has been are those

resources

American the

exercise

analysis

nature.

purchasing

dedicated

consumer

of ways. Bring-

as a cost-saving

cations

in

is a considerable in a variety

A comprehensive

CD-KOM

all

refining

feasible.

for

in many cases

purchased.

on CD-KOM

A sub-

can cost f700

per annum. Another library

workbook

and hence

user. Leaflets

route

or ‘postna-

problematic.

the

would without

‘antenatal’

fact,

favours

‘postpartum’.

terminology terms. An

are

detailed,

as its

assistance

record of what is covered elsewhere. provided by software companies tend

ing in CD-KOM

and back out again, we are demonstrating mistakes can be made and corrected. example

of instruction

both

RESOURCE ISSUES

by time period

different

mistakes

forms

is to provide

title, author

Mark and display Print

exercises

to other

purpose

but also a student

natural

Combine

in the

be able to:

using

Narrow

make

questions

alternative

impact

staff

effectively,

upon

time. college

resources

If CD-KOM librarians

is that

of

is to be used

must

be prepared

to invest much time and thought into its functioning and implementation. The workstation has to be set up and maintained, documentation has to be written and group/individual instruction given.

This will take the librarian

other responsibilities In many instances

away from

and duties. colleges of nursing

will not

be able to supply students with the articles requested from its own collection. The library may wish to increase the number of journals it receives as well as fund the many more requests from

the

inter-library

loans.

Both

these

con-

NUKSE EDUCATION

sequences of CD-ROM can be very costly, consuming resources not previously identified. If a college

of nursing

is thinking

about

CD-ROM.

Multi-media

463

discs

have

CD-ROM

been recently released which will be able to store moving

pictures,

sound

and text on the same

providing CD-ROM in its library, the extra resources need to be anticipated and estimated

disc. A recent

from the outset.

available on-line databases

In many instances the existing

TODAY

experiment

(Law

1991)

has made

free at the point of

book collection and/or journal holdings will be inadequate. It could be that the college would do

use. This negates the major advantage CD-ROM has over traditional on-line databases. Indeed

better to use funding identified for CD-ROM

McSean

improve

to

its basic collection.

CD-ROM

& Law (1990) is a transient

given the potential not

Advances in computer

technology

challenges

for the nursing

particular,

nurse

1990;

present many

profession

educationalists

Ronald

& Skiba 1987).

will provide

&

As nurses

retrieval skills,

many advantages

when

looking for material to support study, research and practice. Nursing students will have increased

flexibility and power when research-

ing for essays and projects. on the CD-ROM

As many references

have abstracts,

students

are

more likely to be able to identify if the information is relevant or not. Students are also learning skills that will enhance their participation in an increasingly Various

technological teaching

be adopted.

Each

approach

careful consideration needs

of the

implications

world.

and learning

student

strategies

can

however

requires

of the particular

learning

group,

and a recognition

the

resourcing

of the role of

CD-ROM within the whole range of information sources. Despite the advantages

the intention

article has been to highlight

of this

some of the prob-

lems that must be confronted if the technology is introduced. With nursing students being expected

to be able

student-centred

to locate methods

research,

learn

by

and take on the con-

cept of life-long learning they will need flexible and effective information sources like those provided

by CD-ROM.

Developments to CD-ROM have significant potential. It is now possible to network CD-ROM so that the databse can be accessed by more than one user at the same time. It is also possible to have the full text of research

preclude

that

However,

benefits from its intelligent

its integration

should

into nurse

edu-

cation.

and in

(Chambers

develop their IT and information CD-ROM

persuasively

technology.

use, the dubious shelf life of CD-ROM

CONCLUSION

Coates

argue

articles

on the

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