Development of Learning Using an Electronic Book Combined with Simulation-Based Learning on Nursing Care for Patients Receiving High-Flow Nasal Cannula Therapy on Learning Achievement, Satisfaction, and Self-Confidence Among Nursing Students

Abstract

     This research and development study aimed to develop and examine the effectiveness of an electronic book, as well as to evaluate the learning outcomes of using the electronic book combined with virtual simulation on nursing care for patients receiving high-flow oxygen therapy. The sample consisted of 76 fourth-year nursing students from Rangsit University. The study was conducted from September 2024 to January 2025 and was divided into two phases. Phase 1 involved developing and testing the effectiveness of the electronic book with 42 nursing students. Phase 2 examined the effectiveness of learning using the electronic book combined with virtual simulation on learning achievement, satisfaction, and self-confidence among 34 nursing students. Data were collected using a learning achievement test, a satisfaction questionnaire, and a self-confidence questionnaire administered before the learning session, after the session, and after the practice. The effectiveness of the electronic book was assessed using the E1/E2 efficiency index, and the effectiveness of the learning method was analyzed using descriptive statistics, Friedman Two-Way Analysis of Variance by Ranks, and the Wilcoxon Signed Ranks Test.

          The results of Phase 1 showed that the electronic book, which consisted of 5 chapters and corresponding end-of-chapter exercises, achieved an effectiveness score of 82.66/86.22, exceeding the standard criterion of 80/80. In Phase 2, it was found that after learning using the electronic book combined with virtual simulation, the nursing students' learning achievement differed significantly (p < 0.05); the highest average scores were observed after clinical practice, followed by after class and before class, respectively. The students reported a high level of satisfaction with the learning experience, and self-confidence was significantly higher after clinical practice than after class (p < 0.05). Therefore, the learning approach using the electronic book combined with virtual simulation is deemed appropriate for preparing nursing students prior to actual practice in caring for patients with oxygen deficiency who are receiving high-flow oxygen therapy.