Learners to be included in this study were all clinical nurses, with a bachelor’s degree or master’s degree, having more than one-year of working experience, and were capable of using smartphones and laptops. Based on the results of the data collected in a literature review and a focus group interview of clinical nurses, the common types, limitations of previous nursing research training programs and corresponding solutions are listed in Table S1. All solutions proposed were considered during the development of the training program. Based on the corresponding solutions, a blended emergent research training for clinical nurses based on the needs assessment and related theoretical framework was proposed as a potentially effective way to improve the research competence of clinical nurses.
In order to provide theoretical guidance for the program development, a theoretical framework of blended emergent teaching was constructed based on a scoping and critical review of the literature related to emergent teaching (e.g., [18, 23–25]) and blended learning (e.g., [19, 26]). In the framework (Fig. 2), “Predefined Contents” refers to the contents predefined and developed based on the literature review and the learners’ needs (i.e., the results of the nominal technique group session). After the Predefined Contents are presented to the learners, there would be interactions among learners, learning resources, peers, and teachers . During the interaction process, emergent resources (predictable and unpredictable) would emerge as the output of these interactions . Predictable emergence refers to the emerging process which could be predicted. For example, after learners master pre-defined knowledge content about quantitative and qualitative research, we could predict that the learners could differentiate between these two types of studies. Unpredictable emergence involves the emerging processes which cannot be predicted before they happen. For example, after the discussion of an after-class assignment, some unexpected questions were proposed by learners. The analysis, identification, and use of valuable emergent resources (e.g., common mistakes made by learners, good examples provided by learners in the discussions, and good questions deserving in-depth discussion) are crucial to emergent teaching . Emergent resources could, in turn, be used as the predefined contents in further trainings.
Training needs and priorities identified are shown in Table S2 and were considered during the D (Design) stage. The purpose of this training program was to improve the research competence of clinical nurses. Learning goals are shown in Table S3. Resources identified as being required for the training program were: Content Resources (e.g., textbooks, literature), Technology Resources (e.g., smartphones, laptops, interactive online platforms), Instructional Facilities (e.g., rooms), and Human Resources (e.g., video makers, professionals, training assistants).
The task inventory of every unit guided our systematic instructional design. A copy of the task inventory for every unit was also provided to all participants for better learning. One example of the task inventory designed is shown in Figure S2. Learning goals, performance objectives, and corresponding assignments were designed for every unit. One example is shown in Table S5 in additional file. Learning materials of every unit were designed based on the task inventory of the unit. The specific training program’s process model (Figure S3) and the planned training schedule (Table S4) were provided in the additional file.
The interactive online platform was developed for online learning, communication, and interaction. The platform included front-end and back-end management. Every learner had a unique username and password (these inputs were set by the user and were confidential) to log on to the front-end (i.e., the user interface) of the platform. Every member of the research group had a unique account to log on to the front-end display and to have access to back-end management of the platform. The front-end of the platform included a “course” module (for learning files provided to learners), a “comments” module (for learners to post their comments on this research training and learning materials), a “questions” module (for learners to propose and discuss their questions related to the learning materials), a “notes” module (for learners to make synchronous notes while learning the “course” module), and a “community” module (that allowed: (1) for trainers to post lead-in questions and after-class assignments; (2) for learners to post their responses to the questions and assignments; and (3) for learners to discuss and interact with others). On the back-end of the platform, teachers could adjust the front-end display of the platform, post notices, upload learning materials, and track every learner’s learning behaviors and process.
Learning materials (videos, handouts, and literature) were developed or selected and improved by the research group. The formative evaluation questionnaire was developed by the research group. This questionnaire was used to evaluate each learner’s satisfaction regarding the training contents, methods, and time schedule of the units after each face-to-face emergent seminar in the training program. For summative evaluation, the Research Competence Scale for Clinical Nurses (RCSCN), Chinese Version of Critical Thinking Disposition Inventory (CTDI-CV), and a training satisfaction questionnaire were selected or developed as the instruments. More specific information about these study materials will be found in the other evaluation paper.
The three-month training program was implemented according to the training process model, the planned training schedule (Table S4 in additional file), and formative evaluation feedbacks. The actual training schedule (Table S6 in additional file) included four types of training activities: online courses, practice modules, emergent seminars, and a simulation project. (1) Predefined Contents of the unit were uploaded as the online course for learners. After learning the online course module of the unit, the learners would respond to the unit’s open-ended assignments, propose concerned questions, and discuss with trainers and peers in the online “community” module. (2) Practice modules were completed in a room with computers and a campus internet connection in order to train clinical nurses to use databases and software commonly used in nursing research. (3) Emergent seminars were used for group learning and discussion activities organized based on emergent topics. The emergent topics were identified and proposed by the research group through the review and analysis of the interaction records in the online “community”. There were valuable emergent resources (e.g. common mistakes made by learners and good examples and questions related to nursing practice and research) emerging from the interaction in the training. Trainers identified and used these emergent resources as learning materials in the training. (4) The incorporation of the simulation project was proposed and developed based on the learners’ feedback (collected at the fourth week of the training program), when learners shared that it was “easy to forget the contents learned before and we cannot make all learned contents concrete”. A two-day simulation project at the end of the training program (Table S6 in the additional file) was implemented to simulate all steps of the research process, in order to review the key knowledge and skills learned in the training and make them concrete. The simulation project is also an output of emergent teaching which is learner-centered and flexible.
The data for formative evaluation were analyzed and were used for improving the training before and during the I (Implement) stage. For example: feedback provided by the users after using the trial version of online platform were used to improve the online platform before the I (Implement) stage; the simulation project was proposed and developed based on the feedback from the formative evaluation during the I (Implement) stage, in order to improve the training. By the end of the study, the training program showed positive effects on nursing research competence and critical thinking of the clinical nurse participants. The summative evaluation will be explained in more detail in the separate evaluation research paper.