NUR 502 Module 6 Technology in Teaching Paper example

Five Minutes at a Time: Spaced Microlearning to Sustain High-Alert Medication Knowledge in Hospital Nurses

[Student Name]

Southern New Hampshire University

NUR 502: Teaching and Learning in Nursing

Module Six Technology in Teaching Paper

[Instructor Name]

[Date]

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Five Minutes at a Time: Spaced Microlearning to Sustain High-Alert Medication Knowledge in Hospital Nurses

The Learning Problem

Every nurse in a composite 280-bed hospital completes an annual online module on high-alert medications such as insulin, heparin, opioids and concentrated potassium. The module takes about an hour and ends with a quiz that nearly everyone passes. Yet medication event reports continue to show knowledge gaps: confusion about insulin correction scales, uncertainty about when to hold heparin and misunderstandings about opioid equivalence. A survey of 60 nurses asked to answer five questions on these topics three months after completing the annual module found that the average score had fallen from 94 percent at the end of the module to 68 percent.

The problem is not that nurses cannot learn the content. It is that knowledge taught once a year fades long before it is needed. The educational question is therefore not how to teach high-alert medication safety, but how to keep what was taught available on an ordinary Tuesday night in the eleventh month after the course.

The Learning Science

Two principles explain why a single annual module fails and what might work better. The first is the spacing effect: information studied in several sessions spread over time is retained better than the same information studied once. The second is the limited capacity of working memory. Cognitive load theory holds that learners can process only a small amount of new information at once, and that instruction overloading working memory reduces learning (Sweller, 1988). An hour-long module packed with drug facts is likely to exceed that capacity, while short units focused on one idea at a time are more manageable.

Microlearning combines these principles by delivering brief lessons, often a single question with explanation, repeated over days or weeks on a mobile device. It fits the way nurses already use phones for quick reference and can be completed during short breaks.

What the Evidence Shows

Research supports the approach but is still developing. A scoping review of microlearning in health professions education identified a growing number of studies, most reporting positive effects on knowledge, confidence or engagement, but noted that definitions of microlearning varied and that many studies were small or lacked comparison groups (De Gagne et al., 2019). Stronger evidence exists for spacing itself. In a randomized controlled trial, medical students who received spaced educational content by email, with questions and explanations repeated over time, retained significantly more clinical knowledge than those who did not (Kerfoot et al., 2007).

Taken together, the evidence suggests that brief, spaced content can improve retention, while the specific effect of mobile microlearning on nursing practice and patient outcomes has not yet been established. That gap argues for a careful pilot with evaluation rather than a hospital-wide mandate.

Program Design

The proposed pilot delivers one question every other day for four weeks through the hospital's secure learning app, followed by monthly booster questions for the rest of the year.

Table 1

Spaced Microlearning Pilot Design

Note. Content will be reviewed by pharmacy and matched to hospital protocols.

Writing Questions That Teach

The value of the program depends on the quality of each question. Every item will describe a short clinical situation drawn from real event themes on the hospital's units, such as a hypoglycemic patient due for a scheduled insulin dose, rather than asking for an isolated fact. Each answer, right or wrong, will be followed by a two or three sentence explanation and a link to the relevant hospital protocol, so that a wrong answer becomes a teaching moment rather than a mark against the nurse. Retrieval practice of this kind, in which learners must recall and apply information rather than reread it, is itself a strong driver of retention, and the spaced design gives nurses repeated opportunities to retrieve the same rules in slightly different situations.

A small content team of two clinical nurse specialists, a pharmacist and two staff nurses from night shift will write and review the items. Staff nurses will test every question for clarity before release. Items will be revised whenever a protocol changes, and any question that more than 70 percent of nurses answer correctly on the first attempt will be rewritten at a higher level so that the program keeps challenging experienced staff.

Access, Privacy and Equity

Technology introduces practical and ethical concerns. Not every nurse has a smartphone or wants to use a personal device for work, so the hospital will provide access through workstation computers and unit tablets as alternatives. Completing lessons should count as paid work time, not an expectation during breaks or at home, which is especially important for night-shift and part-time nurses who already have less access to education. The app will store only responses needed for feedback, will not be used for performance discipline and will comply with the hospital's privacy policies. Finally, content will be written in plain language and tested with nurses whose first language is not English.

Evaluating the Pilot

The pilot will run on four medical-surgical units, with four similar units continuing the usual annual module as a comparison. Knowledge will be measured with a 15-question test at baseline, at the end of four weeks and at six months. Engagement will be measured by completion rates and time spent. Practice will be assessed through high-alert medication event reports on pilot and comparison units over the year, while recognizing that event reporting is an imperfect measure. Nurses will be surveyed on usefulness and burden. If six-month knowledge retention is clearly higher on pilot units and nurses find the program acceptable, the hospital can expand it.

Conclusion

An annual hour-long module leaves nurses with fading knowledge of the medications most likely to cause harm. Spaced microlearning applies established principles of learning, spacing and manageable cognitive load, in a format that fits nursing work. Evidence for spacing is strong, while evidence specific to mobile microlearning is promising but limited, so a controlled pilot with attention to access, paid time and privacy is the responsible next step.

References

De Gagne, J. C., Park, H. K., Hall, K., Woodward, A., Yamane, S., & Kim, S. S. (2019). Microlearning in health professions education: Scoping review. JMIR Medical Education, 5(2), Article e13997. https://doi.org/10.2196/13997

Kerfoot, B. P., DeWolf, W. C., Masser, B. A., Church, P. A., & Federman, D. D. (2007). Spaced education improves the retention of clinical knowledge by medical students: A randomised controlled trial. Medical Education, 41(1), 23-31. https://doi.org/10.1111/j.1365-2929.2006.02644.x

Sweller, J. (1988). Cognitive load during problem solving: Effects on learning. Cognitive Science, 12(2), 257-285. https://doi.org/10.1207/s15516709cog1202_4