Nursing Practice Today 2017. 4(1):11-20.

Effectiveness of virtual education on health care practitioners' self-efficacy in the neonatal unit
Maliheh Kadivar, Niama Seyedfatemi, Mitra Zolfaghari, Abbas Mehran, Tahereh Nikdel


Background & Aim: Caregivers’ education should be an active and dynamic process. Updated training programs are essential. This research was conducted to assess the effectiveness of virtual education on health care practitioners' self-efficacy in the neonatal unit.

Methods & Materials: In this quasi-experimental research, hospitals affiliated with Tehran University of Medical Sciences that had level one neonatal unit were divided into two intervention and control groups. Sampling was conducted based on the inclusion criteria from all the nurses and midwives who were employed at these units. The intervention group received two months of asynchronous virtual education using learning management system. The control group did not undergo any specific training program. Data of both groups were collected using demographic questionnaire and Schwarzer & Jerusalem' Generalized Self-Efficacy Scale (GSE10) at the first day of the study and two months after the start of the intervention in the form of pre-test and post-test and were statistically analyzed.

Results: Both of the intervention and control groups were similar regarding their demographic variables. Results showed that there was no significant difference between the mean score of self-efficacy of the two groups before the intervention (p=0.717); but there was a significant difference between the mean score of self-efficacy of two groups after the intervention (P <0.001). ANOVA test was used to eliminate the effect of pre-test score.

Conclusion: The results of this research demonstrated that virtual education programs are effective in increasing the health care practitioners' self-efficacy at level one neonate units. As a result, applying this method of education is recommended to managers and training planners.


distance education; e-learning; virtual training; self-efficacy

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Khezerloo S, SalehMoghaddam A, Mazloom S. Assessment of nurses professional roles in hospitals affiliated to Mashhad University of Medical Sciences. Hakim Res J. 2012;15:346-51 [ In Persian].

Heidari A, Mazloom SR, Ildarabadi E. Nursing's position in health care delivery system in Iran. IJNR.2012;7(25):37-44 [In Persian].

Fesharaki M, Islami M, Moghimian M, Azarbarzin M. The effect of lecture in comparison with lecture and problem based learning on nursing student’s self-efficacy in Najafabad Islamic Azad University. Iranian Journal of Medical Education. 2010;10(3): 262-268 [In Persian].

Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: guide to best practice.2 th.Lippincott Williams & Wilkins.2011.

Rochefort C, Lamothe L. Forcing the system: Aconfiguration analysis of a regionalized neonatal- perinatal health network. Health Care Manage Rev. 2011;36(3): 241 - 251.

Heydarzadeh M, et al. Healthy newborn care service package. Neonatal Health Department. Ideh Pardazan Fan va Honar. 2011;P:15&20.

Committee on fetus and newborn. Levels of Neonatal Care. American Academy of Pediatric.Available at: Accessed 2016; 587-594

Haslam B, Dreyzehner J. Tennessee perinatal care system, Guidelines for regionalization, hospital care levels, staffing and facilities.7thEd.Tennessee Department of Health, Division of Family Health and Wellness;2014.P:5-35.

Goudarzi Z, Tefagh M, Monjamed Z, Memari A, Kamali P. The effect of continuing education of neonatal intensive care nursing on knowledge and the practice of the nurses working in the children’s hospitals. Journal of hayat. 2004;10(1):25-31 [ In Persian[.

Yuksekdag Bb. The Importance of distance education in nursing. International Women Online Journal of Distance Education. 2015;4(1).

Richardson J, Ice P. Investigating students' level of critical thinking across instructional strategies in online discussions. The Internet and Higher Education. 2010;13(1):52-59.

Nourian A, Nourian A, Ebnahmadi A, Akbarzadeh Bagheban A, Khoshnevisan M H. Comparison of E-learning and Traditional Classroom Instruction ofDental Public Health for Dental Students of Shahid Beheshti Dental School during 2010-2011. J Dent Sch.2012;30(3):174-183[ In Persian[. 13. Rabiei M, Mohebi Amin S, Haji-Khawajelu SR. Internal quality assessment of the curriculum of virtual learning courses in Ferdowsi University of Mashhad. Horizons of Medical Education Development. 2010;4(1) [ In Persian[.

Khoshsima S, et al. Comparison of nurses learning level by multimedia and web - based methods in teaching nursing care of chemical accidents .Quarterly of Education Strategies in Medical Sciences. 2013; 6(3):129-134[ In Persian[.

Varzeshnejad M, Haghani F, Hashemi Jahromi M. Electronic learning and nursing education. Education and Ethics in Nursing. 2015;3(2) [ In Persian[. 16. Khatooni M, Alimoradi Z, Samiei-Seiboni F, Shafiei Z, Atashi V. The impact of an educational software designed about fundamental of nursing skills on nursing students' learning of practical skills. Journal of Clinical Nursing and Midwifery. 2014; 3 (1) :9-16[ In Persian[.

Chiu Y-L, Tsai C-C. The Roles of social factor and internet self-efficacy in nurses' web-based continuing learning. Nurse education today. 2014;34(3):446-450

Bandura A. Health promotion by socio cognitive means health education behavior. Journal of Health Education & Behavior.2004; 31(2): 143-164. 19. Hosseini M, Azimzadeh E. Correlation between self-efficacy and nurses’ conflict management strategies. JHPM. 2013; 2 (4) :16-23[ In Persian[.

Tsai C-C, Chuang S-C, Liang J-C, Tsai M-J. Self-efficacy in internet-based learning environments: A literature review. Educational Technology & Society.2011; 14(4):222-240. 21. Hassani P, Cheraghi F, Yaghmaei F. Self-efficacy and Self-regulated Learning in Clinical Performance of Nursing Students: A Qualitative Research. Iranian Journal of Medical Education. 2008; 8 (1) :33-42[ In Persian[. 22. Habibzadeh H, Khajeali N, Khalkhali H R, Mohammadpour Y. Effect of Evidence-Based Education on Nursing Students' Self-Efficacy. Strides Dev Med Educ. 2015; 11 (4) :500-507[ In Persian[.

Schwarzer R, Jerusalem M. Generalized Self-Efficacy Scale. In J. Weinman, S. Wright & M. Johnston. Measures in health psychology: A user’s portfolio. Causal and control beliefs. Windsor, UK: NFER-NELSON. 1995;35-7. Available online at

Rajabi GH. Validity and reliability of Generalized Self-Efficacy Scale in psychology students of the Faculty of Education and Psychology of Shahid Chamran University of Ahvaz and Marvdasht Azad University. Journal of New Thoughts on Education. 2006;2(1&2):111-122.

Available at:

Mirzaei A, Shabani Nia F.Review of e-learning modern systems. Interdisciplinary Journal of Virtual Learning in Medical Sciences. 2013;4(2):62-74.

Verklan T, Walden M. Core curriculum for neonatal intensive care nursing.4th Ed. Elsevier Health Sciences St.Louis; USA; 2014.

Cloherty JP, Eichenwald EC, Stark AR. Manual of Neonatal Care.7th Ed. Wolters Kluwer, Lippincott Williams & Wilkins; USA; 2012.

Gleason CA, Juul SE. Avery's Diseases of the Newborn.9th Ed. Elsevier Health Sciences; Philadelphia; USA; 2011. 30. Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, et al. Part 15: neonatal resuscitation. Circulation. 2010;122(18 suppl 3):S909-S19. 31. Ravanipour M, Ahmadian A, Yazdanpanah A, Soltanian A R. Assessing the relationship between self-efficacy and clinical decision-making in hospital nurse. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2015; 23 (4) :77-86. 32. Roh YS, Lee WS, Chung HS, Park YM.The effects of simulation-based resuscitation training on nurses' self-efficacy and satisfaction. Nurse Educ Today. 2013 Feb;33(2):123-128. 33. Purfarzad Z, Vanaki Z, Ghamari Zare Z, Farmahini Farahani M, Ghorbani M. Assessment charge nurses' managerial self-efficacy. Quarterly Journal of Nursing Management. 2014;2(4):8-16. 34. Mclaughlin K,Moutray M, Muldoon OT. The role of personality and self-efficacy in the slection and retention of successful nursing students: A Longitudinal Study. Journal of Advanced Nursing. 2008;61(2):211-221. 35. Bolton KM. Effects of an online education program on self-efficacy and knowledge of the clinical teacher role: a study with nursing clinical instructors. Ontario: Queen's University (Canada); 2012. 36. Hosseini T, Torabi S S, Shayan N, Ismaeel Poor M, Ashoori J. Comparing the effects of web-based teaching and cognitive and metacognitive learning strategies on nursing students' academic achievement and self-efficacy, Islamic Azad University, Pishva Branch. Interdisciplinary Journal of Virtual Learning in Medical Sciences. 2015;6(2):1-10[ In Persian[. 37. Smith AR, Cavanaugh C, Moore WA.Instructional multimedia: an investigation of student and instructor attitudes and student study behavior.BMC Med Educ.2011;11(38):1-13.

Du S, Liu Z, Liu S, Yin H, Xu G, Zhang H, et al. Web‐based distance learning for nurse education: a systematic review. International nursing review. 2013;60(2):167-177.

Poddar KH, Hosig KW, Anderson ES, Nickols-Richardson SM, Duncan SE. Web-based nutrition education intervention improves self-efficacy and self-regulation related to increased dairy intake in college students. Journal of the American Dietetic Association. 2010;110(11):1723-1727.

McMullan M, Jones R, Lea S. The effect of an interactive e-drug calculations package on nursing students’ drug calculation ability and self-efficacy. international journal of medical informatics. 2011;80(6):421-430.


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