Digital Health and Informatics Innovations for Sustainable Health Care Systems 1043

J. Mantas et al. (Eds.)

© 2024 The Authors.
This article is published online with Open Access by IOS Press and distributed under the terms
of the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0).
doi:10.3233/SHTI240589

Continuing Educational Program in

Nursing Informatics for Greek Nurses
Joseph LIASKOS a,1, Sotirios ANAGNOSTOPOULOS a, Spyros ZOGAS a
and John MANTAS a
a
Health Informatics Laboratory, Faculty of Nursing, National and Kapodistrian
University of Athens, Greece
ORCiD ID: Joseph Liaskos https://orcid.org/0009-0007-1706-1714

Abstract. Nurses are required to adapt to a complex and rapidly evolving

environment that incorporates new IT technologies. Continuing, lifelong learning,
especially in the fast-growing fields of Nursing Informatics, eHealth and related
Information and Communication Technologies, is vital to the professionalism of
nurses. The study presents the curriculum development and implementation of the
educational project entitled “Training of Nurses in Nursing Informatics and
Information and Communication Technologies (ICT)” which has been designed and
offered to Greek nurses as a continuing – lifelong online educational program by the
Health Informatics Laboratory of the National and Kapodistrian University of
Athens. The training material was created in three modules and 29 sub-modules,
considering the new advancements and recommended competencies, necessary for
the nurse, in the fields of Nursing Informatics and ICT. So far, eight training cycle
courses have been offered to 1388 nurses, free of charge. Each course integrates
synchronous and asynchronous distance learning methods and requires a workload
of 70 hours over 10 weeks. The initial evaluation of the course by the participants,
concerning its effectiveness, usefulness, and innovation are very encouraging.

Keywords. Nursing Informatics, Continuing Nursing Education, Distance Learning

1. Introduction

Within the complex and ever-changing healthcare environment, guided by the

technological innovations (e.g. new devices, social networks for healthcare, new
healthcare services through eHealth methods and applications, etc.), the human factor
remains one of the stable constraints, which owe to respond and adapt to new
technological developments [1]. In Greece, especially after the COVID-19 pandemic,
nurses and other health care professionals are required to adopt and use in their routine
IT-based tools, such as, among others, patient data management systems, electronic
medical records, the paperless prescription, the e-prescription system, the e-appointment,
telemedicine tools [2]. In the following years, significant reform is expected towards
digital processes in the health system, to address long-term weaknesses. Upgrading e-
health infrastructures at health service points, with the aim of providing quality services,
and promotion of innovation in eHealth, through the introduction of new innovative

1
Corresponding Author: Joseph Liaskos, Health Informatics Laboratory, Faculty of Nursing, National
and Kapodistrian Univeristy of Athens, Papadiamantopoulou 123 Athens Greece; E-mail:
[email protected].
1044 J. Liaskos et al. / Continuing Educational Program in Nursing Informatics for Greek Nurses

technologies into the national health system are a strategic priority [3]. Nurses, the bulk
of health professionals, and the "core" of the health system, with a multilevel and
multidimensional role in the hospital, community care and education, are called upon to
update and upgrade their knowledge and skills in new developments of technological
innovations in the context of continuing education.
Continuing education includes learning experiences that lead to improving the
knowledge, skills, competencies, and behavior of professional nurses [4]. Seminars,
workshops, conferences, tutorials are traditional examples of the means that provide
opportunities for continuous professional development and empowerment. Recently,
online learning and massive open online courses (MOOCs) has offered new
opportunities and an increased interest in continuing education. Nurses and other health
professionals have the possibility to attend MOOCs offered by universities and
instructors around the world [5-6].
The aim of this study is to present the curriculum development and implementation
of the educational project entitled “Training of Nurses in Nursing Informatics and
Information and Communication Technologies (ICT)” which has been designed as a
continuing – lifelong online educational course for Greek nurses by the Health
Informatics Laboratory of the Faculty of Nursing of the National and Kapodistrian
University of Athens (NKUA).

2. Methods

The educational project started on 1/9/2021 and has a three-year duration. The first six
months were the design and development phase of the curriculum (educational material)
while the implementation phase started in the 7th month. Until the end of the
implementation phase, the program is planned to be offered in nine consecutive course
cycles. In each course cycle participate about 150-180 trainees, and it is estimated that
the approximate number of benefitted nurses will be more than 1600. Both distance and
continuous – lifelong learning methods have been applied. Each course cycle is designed
to last 10 weeks with the workload in hours being 70, corresponding to both synchronous
and asynchronous distance learning. Asynchronous e-learning is designed to include
electronic educational material, such as documents, multimedia presentations, and other
external resources. Synchronous e-learning is designed to consist of 10 hours (five two-
hour meetings – lectures) in which instructors, in groups of 30-35 trainees, demonstrate,
and analyze selected topics in the field of Nursing Informatics, as well as solve related
laboratory exercises. For the design of the curriculum and subsequently the development
of the educational material, we relied on the relevant literature [7-11]. A proper design
of the online course, and interaction between trainees and instructors, have been proved
to facilitate distance learning [12]. Thus, trainees are encouraged to virtually
communicate with their instructors to resolve questions on the material, exercises, and
assignments, and participate in discussion groups and forums.
Applying the methods of lifelong learning, the program is designed to: a) respond to
every age and different levels of knowledge or skill in the fields of ICT and Nursing
Informatics; b) provide access to participants to a wide range of educational resources;
c) engage participants in self-directed learning; d) encourage experiential learning
through assignments that integrate hands-on learning opportunities; and e) promote
coaching and guidance from experienced instructors – professionals in the fields of ICT
and Nursing Informatics.
 J. Liaskos et al. / Continuing Educational Program in Nursing Informatics for Greek Nurses 1045

3. Results

3.1. Development of curriculum (educational material)

Educational material was developed, in accordance with the content and learning
objectives of the program. In addition, exercises and assignments were created for the
evaluation of the trainees in the various teaching units of the program. The training
material was divided into three (3) basic modules (module 1: Knowledge and skills in
ICT, module 2: Knowledge and skills in accessing information, module 3: Knowledge
and skills in clinical information management) and 29 sub-modules. Eight sub-modules
were created for module 1, ten for module 2 and eleven for module 3. In addition to the
essential competency topics suggested in the literature for nurses, it was deemed
appropriate to include new technological developments in eHealth (e.g., mHealth, Big
Data, Internet of Things, Ambient Assisted Living). The total number of slides generated
with multimedia material, in Greek language, was more than 1500. In addition to the
educational material, four assignments and a database of more than 500 closed-ended
questions or small exercises related to the educational content were created. The list of
the learning outcomes in terms of knowledge, skills, and attitudes/ behaviors the
attendants are expected to gain after completing the program are presented in Table 1.
Table 1. Learning outcomes of the educational program.
Key component: The nurse who successfully attends the program:
1. Recognizes the structure of computers.
2. Distinguish between software categories and functions of operating systems
and application software.
3. Defines the operating principles of communication networks and the Internet.
4. Lists the concepts, methods, tools, and applications of the field of nursing
informatics.
5. Defines and analyzes the concepts, applications, and systems of electronic/
digital and mobile health.
Knowledge 6. Identifies issues related to the quality of health information.
7. Distinguish the security issues arising from data management in the health
sector.
8. Defines the basic concepts and functions of Hospital Information Systems and
Nursing Information Systems.
9. Analyzes the basic concepts, structure and functions of databases and
Electronic Health Records.
10. Describes the communication standards, and terminology standards used in
nursing and the health sector.
1. Fluently operates the Windows operating system.
2. Handles simple and specialized functions of office software applications.
3. Creates integrated multimedia presentations related to nursing.
4. Locates reliable and quality health and nursing information on the world wide
Skills web.
5. Organizes and classifies data, information and knowledge collected in the
health and nursing sector.
6. Compares, selects, and utilizes electronic applications related to nursing and
health care.
7. Uses database and electronic health record applications.
1. Utilizes appropriate software tools to perform specific functions.
2. Applies the principles of security and ergonomics of information technology in
daily life.
Attitudes /
3. Promotes the use of electronic applications in nursing and the provision of
Behaviors
health services.
4. Implements good practices for the effective management of information
contained in the Electronic Health Record.
1046 J. Liaskos et al. / Continuing Educational Program in Nursing Informatics for Greek Nurses

3.2. Nurses’ recruitment and training

The program has been announced to interested nurses through the website
(https://www.snf-nurs.cce.uoa.gr/) of the Center of Continuing Education and Lifelong
Learning of NKUA and on social media for nursing professionals. The prerequisites for
their participation, apart from being graduated nurses, are to own a computer with
internet connection, to have basic knowledge on computer operation and to have
moderate reading and writing skills in English language. The criteria for the trainees to
complete the program and receive the training certificate, are to attend at least the 8 (from
10) hours of synchronous e-learning and be graded successfully in all 14 exercises and 4
assignments. The educational program is offered free of charge.
Up to date, eight educational cycles of the online educational program
(https://cce.uoa.gr/courses-detailed/4d5ddbf4-86c6-42b4-8a94-6d6a4d95784f) have
been completed. Eight instructors have participated, all of them being experts in ICT and
have a master’s degree in health informatics. The total number of trainees attended the
course cycles are 1388 (87.97% women). The average age of the participants is 39.93
years (min: 22, max: 66). Most of the participants (>95%) are employed and work mainly
in the clinical environment. The participants who have successfully completed the
program and received the training certificate are 848 (87.38% women), which
corresponds to 61.10% of the participants. Due to the distance learning methods
incorporated into the program, the participants come from all over Greece. An evaluation
of the educational program by the participants who successfully complete the program
is also being conducted. The initial results indicate that most of the participants believe
that the knowledge and skills acquired meet their expectations and requirements, and
evaluate the training program as understandable, innovative, and useful for their work.

4. Discussion and Conclusions

Trying to support the limited informatics competencies of Greek nurses [13,14], we

designed and implemented an online educational program in the fields of ICT and
Nursing Informatics, addressed to Greek nursing graduates. The program is offered in
consecutive course cycles and integrates both distance and lifelong learning methods.
We developed the curricula of the course considering the new advancements and
recommended competencies, necessary for the nurse, in the fields of Nursing Informatics
and ICT. The structure and content of the curriculum are deemed comprehensive and
adequate, keeping in mind the limited duration of the educational program (70 hours in
10 weeks) and the fact that it addresses different levels of knowledge in Nursing
Informatics and ICT from the participants. The large number of nurses who participated
in the training program demonstrate its acceptance and indicates a strong interest in
continuing education in digital literacy, IT skills, and nursing informatics among nurses.
The percentage of the participants who successfully completed the course and received
the training certificate is considered satisfactory, taking into account on the one hand the
requirements of the program in terms of consistency, on the part of the trainees, both in
attending the online meetings and the educational material, as well as in the preparation
of the exercises and assignments, and on the other hand the busy daily schedule of
working nurses.
The preliminary results, concerning the effectiveness, usefulness, and innovation of
the educational program are very encouraging. The positive initial evaluation of the
 J. Liaskos et al. / Continuing Educational Program in Nursing Informatics for Greek Nurses 1047

program by the participants prompts its improvement and future redesign with different
learning objects in the fields of eHealth and Nursing Informatics. At the end of the project,
the final evaluation results are expected. Overall, Nursing Informatics courses designed
and implemented through distance learning methods and technologies, such as those
offered in this program, can: a) achieve a variety of learning outcomes; b) address
different levels of educational needs; and c) recruit nurses from remote areas who would
otherwise not be able to participate.

Acknowledgements

The educational project entitled “Training of Nurses in Nursing Informatics and

Information and Communication Technologies (ICT)” is funded by the Stavros Niarchos
Foundation (SNF). It is implemented by the Health Informatics Laboratory through the
Center of Continuing Education and Lifelong Learning of NKUA.

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