The
purpose of this three-phase study was to describe the use of mobile devices in
nursing student–nurse teacher cooperation during the clinical practicum, to
develop a novel alternative called mobile cooperation intervention (MCI) for this
cooperation and to evaluate its effectiveness on the students’ clinical
learning outcomes and acceptability from the perspective of nursing students.
The ultimate goal is to improve
the quality of nursing education and thus the outcomes of patient care.

In Phase
I, an integrative review of use of the mobile devices in nursing student–nurse
teacher cooperation during the clinical practicum was conducted. In Phase II, the CLES+T scale was
further developed. Additionally, a mobile application called Study@CampusPro
(App) and a mobile cooperation intervention (MCI) were developed. In Phase III,
a randomised controlled trial design was used to evaluate the effectiveness of
the MCI on nursing students’ clinical learning outcomes, i.e. the individual
outcomes (competence and self-efficacy) and contextual outcomes (quality of the
clinical learning environment). Data were collected using three instruments (1)
the Nurse Competence Scale (NCS), (2) the Self-efficacy in Clinical Performance
instrument (SECP) and (3) the
Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T₂).
Eligible nursing students (n=102) were randomly allocated to an intervention
group (n=52) with mobile cooperation and a control group (n=50) with standard
cooperation. The congruence
between the nursing students’ self-assessed competence and the mentors’
assessments of the students’ competence was examined by comparing the nursing
students’ self-assessments and their mentors’ (n=95) assessments.
Moreover, a process evaluation was conducted by examining the students’ acceptability of the MCI by using
a process evaluation questionnaire (Peq) developed for this study and the
System Usability Scale (SUS) and student essays. The methods of analysis used
in this study were critical appraisal, thematic and content analysis as well as
descriptive statistics and statistical modelling.

There have been only
a few studies (n=17) on nursing student–nurse teacher mobile cooperation and
their methodological weaknesses are evident. The MCI was found to be
significantly effective in facilitating nursing student–nurse teacher
cooperation and as effective as standard cooperation in improving the clinical
learning outcomes of nursing students. The older age was shown to be
significantly associated with improvements in the competence in the whole study
population. Students’ self-assessed theoretical knowledge and practical skills
prior to the clinical practicum were also shown to be significantly associated
with the quality experienced of the clinical learning environment. In the
control group, the students’ self-assessed competence showed a weak but
significant congruence with their mentors’ assessments. The MCI was given a
high degree of acceptance among students and the App’s usability was rated as rather
good. The items developed for the T -subscale of the CLES+T scale, on which the
CLES+T₂ scale were based, demonstrated an appropriate level of
content validity and good internal consistency.

This study suggests
there is potential in the MCI to improve the quality of the nurse teacher’s
pedagogical cooperation with students and for being used as an alternative
cooperation method in supporting students’ clinical learning outcomes.