JMIR Publications

ABSTRACT

Background:

The introduction of ICT (information and communication technology) has drastically changed healthcare organizations and the way healthcare professionals work. A part of them is not able to cope efficiently with the demands of ICT. Lagging behind in digital knowledge and skills hampers them to adhere to professional standards regarding the use of ICT and may cause professional performance problems. It is important to get more insight into the reasons and motives why these professionals have problems in coping with the digital demands.

Objective:

Our aim was to identify the factors that influence competency in registered nurses digitally lagging behind, and identify ways to improve their digital skills.

Methods:

Ten face-to-face semi-structured interviews with registered nurses were performed within the setting of a Dutch university medical center. Based on the current literature and the FITT-framework of Ammenwerth et al., we identified possible themes to explore. Thematic analysis was used to analyze the data.

Results:

Five main categories and twelve subthemes were identified. The main categories were experience with digital working, perception and meaning, barriers, facilitators and future perspective. All respondents used electronic devices and digital systems including the electronic health record. The latter was mainly experienced as non-user-friendly, time-consuming and not supporting in daily professional practice. Most of the respondents described working digitally as ‘no fun at all’, ‘working in a fake world’, ‘stressful and annoying’, ‘feeling isolated, insecure, frustrated and ashamed’. There was a lack of common digital knowledge and very little or no formal digital training or education. This led to a downward spiral of feeling increasing incompetent and postponing or avoiding the use of ICT. The content, form and tempo of digital training and education did not meet personal learning needs and learning styles. It helped if (nurse) managers were aware and sensitive to the difficulties respondents experienced in developing digital skills.

Conclusions:

Nurses who are digitally lagging behind often have had insufficient and ineffective digital education. This results in stress and frustration and a downward spiral of feeling increasing incompetent, followed by postponing or avoiding the use of ICT. In order to prevent this, hospital management should be aware and informed about the importance of the fit between technology, task and individual. A formal digital training approach tailored to the learning needs and styles of these nurses is needed. The availability of a digital play environment combined with learning-on-the job guided by knowledgeable peers were experienced by respondents as helpful and motivating. Clinical Trial: not applicable