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Abstract
Introduction Digital textbooks (DTs), in which students read dozens of paragraph clips and systematise their level of knowledge through new questions, can be an alternative for digital natives to consider. Developing DTs is required when teaching digital natives at undergraduate nursing schools. A scoping review is required to understand the current status of DTs in nursing education.
Methods and analysis The preliminary search has been conducted to check whether the results produced by PubMed (NCBI) were published in English within 10 years and related to DTs. This study includes research targeting undergraduate nursing students. Literature will be further searched using Embase (Elsevier), Cochrane Library and Cumulative Index to Nursing and Allied Health (CINAHL) databases. This scoping review will also consider quantitative, qualitative, and mixed research methods, texts and opinion documents; review studies; and pilot tests. The chosen studies will first be extracted based on the scoping review data extraction section of Joanna Briggs Institute to identify their general characteristics. DTs will be analysed based on the e-textbook framework: information goods, technology and stakeholders.
Ethics and dissemination The Institutional Review Board of Nambu University, South Korea, approved this study for review exemption (approval number: 1041478-2022-HR-009). The results of this study will be disseminated through research results to nursing education institutions and hospitals.
Open Science Framework https://doi.org/10.17605/OSF.IO/QS6WH.
- Protocols & guidelines
- Information technology
- EDUCATION & TRAINING (see Medical Education & Training)
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STRENGTHS AND LIMITATIONS OF THIS STUDY
This review will provide a future direction for the form of digital textbooks in nursing education.
In this review, we will highlight the types of digital textbooks developed in the field of nursing education and the important requirements for their development.
While this review focuses on digital textbooks in nursing education, it will attract international attention in many areas of education, given the changes in the form of educational materials for healthcare workers around the world.
This study does not perform a quality evaluation on the selected literature; thus, low-quality literature may be included, and digital-based educational materials in the clinical field are excluded because the scope is limited to undergraduate nursing education.
Introduction
Digital natives have grown up with information technology and the internet and are familiar with using new communication devices and social media.1 They use new ways of perception, such as visual perception, immersion in learning processes or situations, and gamification.2 The older generation, ‘book people’, learn through recognising provided information for comprehension, comparison, analysis and criticism, while digital natives, ‘screen people’, are rather inclined towards the dynamic and mosaic ‘clip’ and receiving, processing and generating visual information.3 To ensure optimal learning for students, students’ preferences and needs, as well as technology, support and self-management strategies, must be identified.4 However, all educational methods are still developed for book people, not digital native students. Digital natives’ perception has been developed with the expansion of the amount of information, diversification of the type of information, expansion of multitasking and increased conversations with various social classes,5 adding dynamism to educational activities and allowing necessary tasks to be completed in a minimal form; solving problems with multidimensionality, diversity and ambiguity; and providing a positive mental reaction to information overload. It also has negative aspects such as pixelation of fragmented information, quick consumption of information like fast food and difficulties in situational analysis.3 Therefore, an educational strategy that reflects the learning features of digital natives and the strengths and weaknesses of their way of perception is needed.
Digital textbooks (DTs), such as digital books or e-books intended to serve as texts for classes, can be a part of the strategy. DTs may also be known as e-textbooks or e-texts.6 DTs, a major component of technology-based education reform, provide education services based on diverse and rich science and technology (learning support functions such as animation and 3D, additional functions such as search provision of new learning resources through updates, interaction between synchronisation and desynchronisation, etc) without temporal and spatial constraints.7 As DT’s effectiveness in quality education was proved,8 the recent growth of electronic textbooks has been highlighted in the field of education.9 This situation was accelerated by the growing demand for the development of innovative educational methods,10 along with the COVID-19 pandemic. Educators of the non-digital generation also became aware that web-based education is replacing face-to-face education, and it is becoming unavoidable that education should be designed in an online-based environment.11 In particular, DTs, in which students read dozens of paragraph clips and systematise their level of knowledge through new questions, can be an alternative for digital natives.4 In this situation, teachers who educate digital natives are faced with the task of developing DTs that fit their ways of perception.
The biggest change in society caused by the pandemic is digitalisation and smartisation; therefore, a paradigm shift in nursing education is inevitable in line with the great flow of social change. In nursing education, it is necessary to establish a smart learning environment based on advanced technology to provide a variety of student-oriented education.12 Demand for DTs is becoming inevitable. In 2016, only 15% of students said they preferred DTs,13 but 5 years later, in 2021, it was found that teachers and students preferred DTs between DTs and general textbooks.14 Thus, developing DTs is required when teaching digital natives at undergraduate nursing schools.
Scoping review maps available evidence conceptually and can represent commonalities and differences between literature with a specified scope.15 Therefore, a scoping review of related literature before developing DTs will be very useful for preparing for future education. A scoping review is required to understand the current status of DTs in the field of nursing education that has been developed so far and to suggest directions for DT development.
Among DT-related studies, a scoping review of studies on digital media, as a type of DT, in the public health sector was made,16 and a scoping review on predicting population health through machine learning17 was done. In nursing education, a study was conducted on developing a digital nursing dictionary uploaded on a terminal tablet to provide educational material contents as a part of the learning support system,18 while another study was conducted on the effects of using DTs in nursing education.19 However, all of them are about DTs that have already been developed, and in line with the trend of the times, scoping review research has not yet been conducted to develop DTs to ensure optimal learning in consideration of the learning characteristics and cognition methods of digital natives. A preliminary search of articles in Joanna Briggs Institute (JBI) Evidence Synthesis, Cochrane Database of Systematic Reviews and International Prospective Register of Systematic Reviews (PROSPERO) was conducted until June 2022. This study confirmed that no current or ongoing systematic review of DTs used in nursing education exists.
Therefore, to provide a basis for developing DTs for future nursing education, this study will review the range of evidence generated by a mixed methods of qualitative and quantitative research. Specifically, the proposed scoping review aims to establish a comprehensive understanding of how DTs have been implemented at undergraduate nursing schools and present a direction for developing DTs as a part of undergraduate nursing education.
Scoping review questions
This scoping review aims to address the following questions:
What are the features of DTs included in undergraduate nursing education?
What are the challenges of using DTs for future undergraduate nursing education?
Methods and analysis
The methodological approach of this study is a scoping review, and its protocol process follows the JBI manual for Evidence Synthesis.20 All procedures will be reported according to Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and PRISMA Extension for Scoping Reviews (PRISMA-ScR).21 22
Inclusion criteria
Participants
This study aims to present the rationale for the development of DTs for undergraduate students at nursing schools and investigates studies on DTs for undergraduate nursing school curricula. The suggestion terms selected as P from patient/population, intervention, comparison and outcomes (PICO) are ‘nursing’, ‘nursing student’ and ‘undergraduate nursing education’, while the related control words are ‘nursing’, ‘students, nursing’ and ‘education, nursing’.
Concept
In this study, the suggestion term selected as I from PICO is ‘digital textbook’, and the related control words are ‘books’, ‘textbook’, ‘monograph’, ‘dictionary’, ‘textbooks as topic’, ‘encyclopedia’, ‘reference books’, ‘teaching materials’, ‘internet’, ‘smartphone’, ‘mobile applications’ and ‘digital technology’.
Context
This study includes research targeting undergraduate nursing students. Programmes for graduate students, nursing assistants, nursing training institutions and obstetrics and gynaecology nursing courses are excluded. However, it is not geographically limited.
Types of sources
This scoping review will also consider quantitative, qualitative, and mixed research methods, texts and opinion documents; review studies; and pilot tests. In the quantitative study, time series analyses, such as randomised controlled trials, non-randomised controlled trials, before-and-after studies, prospective and retrospective cohort studies, case–control studies and longitudinal and cross-sectional technical observational studies, will be considered. Meanwhile, the qualitative study will include phenomenology, qualitative explanation and behavioural research. Cited references of the systematic review will also be included if they are appropriate to the research topic.
Search strategy
Since this review study has to capture various studies related to DTs, an extensive search should be conducted. Therefore, before conducting a full-scale search, a preliminary search was performed in PubMed (National Center for Biotechnology Information, NCBI) on 11 August 2022. After the protocol is published, the overall search will be updated with the latest data. In the preliminary search, natural terms will be identified in related studies and used in the final search in addition to the suggested terms, control words, MeSH terms, Emtree and Emtree synoyms of PICO related to the research topic. In addition, the scope of the search is limited to text words to prevent important research from being omitted. The preliminary search will be conducted to check whether the results produced by PubMed (NCBI) were published in English within 10 years and related to DTs. Online supplemental appendix I shows the detailed results of the preliminary search. In the preliminary search of the protocol, the deadline for searching the literature was limited to 10 years, but in review, it can be revised from 2016, when the Fourth Industrial Revolution was mentioned.23
Supplemental material
After the initial preliminary search is completed an overall search strategy will be established. In the full-scale process of the scoping review, the process of identifying potentially relevant studies will be made in three steps. During the first step, as the primary search, literature will be further searched using Embase (Elsevier), Cochrane Library and Cumulative Index to Nursing and Allied Health (CINAHL) databases. They are chosen because researchers can freely access them and have the most information in nursing research. In the second step, reference mining of studies identified during the primary search will be performed, including a systematic review of previous studies and retrieval of references cited in the chosen studies. Then, in the third step, grey literature will be identified.24 Grey literature identifying searches will be conducted in ProQuest Dissertations & Theses, Google, Google Scholar, OpenGrey and Semantic Scholar. Two reviewers will conduct this three-step process independently, and if there are differences, they will be resolved by mutual consultation. If an agreement cannot be reached, it will be resolved by reconsideration with one additional reviewer.
Study/source of evidence selection
All identified studies will be primarily encoded with EndNote V.20.0 (Clarivate Analytics, Pennsylvania, USA), and duplicate studies will be removed. One reviewer will then evaluate titles and abstracts according to the inclusion criteria. The two reviewers will search and screen the entire text of the studies to ensure that the subjects and research questions contain appropriate concepts. Finally, a full-text review of all selected studies will be done by one reviewer based on inclusion criteria. At this stage, issues that need to be resolved will be settled through discussion with the other reviewer, and excluded literature will be reported in the final report. The series of search processes will be reported in the final report in full detail, along with the PRISMA flow diagram.25
Data extraction
Basic descriptive data such as author, title, publication year, etc, and data to be extracted such as research questions will be extracted using the data extraction tool (online supplemental appendix II) developed by the reviewer(AJ). The data extraction process will be independently conducted by two reviewers, and if there is a conflict of opinion during the data collection process, data will be extracted through a process of review and consultation. The data extraction tool may be modified according to relevant content during the review process, and modifications will be specifically explained during the overall review. The chosen studies will first be extracted based on the scoping review data extraction section20 of the JBI to identify their general characteristics (authors, year of publication, origin, aim, population, methodology, intervention type). Also, in order to confirm the form of DTs in the field of undergraduate nursing education, analysis will be conducted on nursing field, contents, outcome variable, technology and stakeholders (elements used by instructors and students). Then, digital resources will be analysed using reliability indicators that can evaluate the quality and educational usefulness to identify the characteristics of the DTs suitable for undergraduate nursing schools in the future (limitations, recommendations).26 Therefore, in this study, DTs will be analysed based on the three core elements of the e-textbook framework (information goods, technology and stakeholders) devised by Chen et al.27 For the qualitative research, literature will be analysed based on the modified grounded theory,28 which recognises the ‘structural process’ through context, process and condition consequence matrix, rather than focusing on concept derivation.
Supplemental material
During the review process, analysis frameworks can be modified to achieve the research purpose, and the modifications will be described in detail in the full review paper. If important parts are missing or additional data are required for analysis, the request can be made to the author of the selected papers.
Data analysis and synthesis
The search results for the selected literature will be presented in a table according to the extraction tool, which will include the general characteristics of the selected studies, the theoretical and methodological characteristics of DTs and the barriers presented in the studies. In particular, a narrative synthesis will be used to present the barriers, challenges and facilitating factors of developing DTs for future use at undergraduate nursing schools.
Patient and public involvement
No patient was involved.
Ethics statements
Patient consent for publication
Acknowledgments
We would like to thank those who conducted the study for the DTs so that this study could be conducted.
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Contributors AJ conducted the conceptualisation, methodology, software, formal analysis writing, funding acquisition and project administration. HP contributed to the investigation, data curation, writing review and supervision. AJ is responsible for the overall content as the guarantor.
Funding This study was supported by the National Research Foundation of Korea (2021R1I1A3046198).
Competing interests None declared.
Patient and public involvement Patient and public involvement are excluded from this protocol’s design and execution.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.