Internet-generation nursing students' view of technology-based health care

BACKGROUND: Today's nursing school applicants are considered “digital natives.” This study investigated students' views of new health care technologies. METHOD: In a cross-sectional survey among first-year nursing students, 23 common nursing activities and five telehealth nursing activities were presented along with three statements: “I consider this a core task of nursing,” “I look forward to becoming trained in this task,” and “I think I will do very well in performing this task.” RESULTS: Internet-generation nursing students (n = 1,113) reported a significantly (p ⩽ .001) less positive view of telehealth activities than of common nursing activities. Median differences were 0.7 (effect size [ES], −0.54), 0.4 (ES, −0.48), and 0.3 (ES, −0.39), measured on a 7-point scale. CONCLUSION: Internet-generation nursing students do not naturally have a positive view of technology-based health care provision. The results emphasize that adequate technology and telehealth education is still needed for nursing students. [J Nurs Educ. 2017;56(12):717–724.] Nursing curricula are regularly updated to respond to changes in society and health care practice. Current nurse educators must respond to an increasing use of health care technology in nursing practice. Health care technologies, such as telehealth care (i.e., the remote provision of health care using technologies such as videoconferencing or equipment to monitor vital signs), typically do not provide direct, face-to-face contact (Shea & Chamoff, 2012). This limits the possibility to observe patients and their environments directly and requires additional digital competencies for contact through technology. Inadequately trained professionals are considered a barrier to the effective provision of telehealth care (Brewster, Mountain, Wessels, Kelly, & Hawley, 2014; Kort & van Hoof, 2012; Sharma & Clarke, 2014; van Houwelingen et al., 2015). An earlier study identified 14 distinct nursing telehealth activities (van Houwelingen, Moerman, Ettema, Kort, & ten Cate, 2016) or professional activities that can be performed by nurses to support patients using technologies (e.g., triaging incoming calls and alarms, or independently double-checking high-risk medication via videoconferencing). All of the telehealth activities required a specific set of knowledge, skills, and attitudes. Nurses cannot be entrusted with these activities without receiving adequate training in these additional required competencies. Specific competencies for health care technologies have become a significant part of published nursing curriculum guides (e.g., American Nurses Association, 2010; Australian Qualifications Framework, 2013; Steeringgroup Bachelor of Nursing 2020, 2015; Tuning Project, 2011). These curricular adjustments contribute to overcoming barriers caused by inadequately trained nurses in telehealth care. Nurses currently working in this domain need additional skills to be able to integrate technology applications in practice. However, today's applicants for nursing education are part of a generation known as “digital natives” (Prensky, 2001). This generation, referred to as Generation Z by Glass (2007), knows no world without the Internet, and its members commonly are characterized by their wide experience with and skills in using the Internet and communication technologies. For these students, the use of health care technology may feel normal because they are already immersed in a world of technology through the use of smartphones, tablets, and social media, both privately and at primary and secondary schools. The question that is being asked by schools of nursing is, “How much technology-based nursing education is necessary for the current new generation of future nurses to provide telehealth care?