The PNWE, a measure of the work environment as perceived by nurses, represents the latest version of the Nursing Work Index-Revised based on current practice. In this study, it exhibited sound psychometric properties. Further application and testing of the PNWE in various patient care settings is recommended.

Purpose-Low health literacy has been associated with poor health-related outcomes. The purposes are to report the development of a website for low-literate parents in the Neonatal Intensive Care Unit (NICU), and the findings of heuristic evaluation and a usability testing of this website.Methods-To address low literacy of NICU parents, multimedia educational Website using visual aids (e.g., pictographs, photographs), voice-recorded text message in addition to a simplified text was developed. The text was created at the 5 th grade readability level. The heuristic evaluation was conducted by three usability experts using 10 heuristics. End-users' performance was measured by counting the time spent completing tasks and number of errors, as well as recording users' perception of ease of use and usefulness (PEUU) in a sample of 10 NICU parents.Results-Three evaluators identified 82 violations across the 10 heuristics. All violations, however, received scores <2, indicating minor usability problems. Participants' time to complete task varies from 81.2 seconds (SD=30.9) to 2.2 seconds (SD=1.3). Participants rated the Website as easy to use and useful (PEUU Mean= 4.52, SD=0.53). Based on the participants' comments, appropriate modifications were made.Discussion and Conclusions-Different types of visuals on the Website were well accepted by low-literate users and agreement of visuals with text improved understanding of the educational materials over that with text alone. The findings suggest that using concrete and realistic pictures and pictographs with clear captions would maximize the benefit of visuals. One emerging theme was "simplicity" in design (e.g., limited use of colors, one font type and size), content (e.g., avoid lengthy text), and technical features (e.g., limited use of pop-ups). The heuristic evaluation by usability experts and the usability test with actual users provided complementary expertise, which can give a richer assessment of a design for low literacy Website. These results facilitated design

Background: Digital education using immersive virtual reality (VR) technology is available in nursing. Evidence of its effectiveness is essential. Purpose: This review analyzed the effectiveness of and barriers to using immersive VR in nursing education. Methods: A structured search was performed in PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, PsycINFO, Web of Science, and ProQuest Nursing & Allied Health Database. The Medical Education Research Study Quality Instrument was used to assess the quality of studies. Results: The final review was composed of 9 studies of moderate to high quality published between 2018 and 2020. The review indicated that immersive VR increased learning, cognitive, and psychomotor performance. Most participants of the studies preferred using immersive VR in education and with a variety of experiential scenarios. Barriers were associated with technological hardware and software (eg, simulation sickness, lack of visual comfort). Conclusion: The review supports the viability of immersive VR technology in nursing education.

These results assist nurse educators in determining specific areas of informatics content that need greater focus and inclusion in the design of better nursing educational programmes. Examples of integrating competencies into existing curriculum or informatics courses are suggested.

An evidence-based e-health program, eCare We Care, was developed to disseminate information on diabetes management through web-based interactive tutorials. This study examined the effect of the eCare We Care program on diabetes knowledge development in African American adults with low diabetes literacy. Forty-six African American adults with type 1 or type 2 diabetes and low diabetes literacy were recruited from two health-care centres in eastern Winston Salem, North Carolina. The eCare We Care program included four weekly sessions: introduction to diabetes; eye complications; foot care; and meal planning. Significant differences in scores on the diabetes knowledge survey were demonstrated between the eCare We Care program participants and the comparison group. Study findings indicate the eCare We Care program is more effective in improving diabetes knowledge of African American adults with low diabetes literacy than paper-based, text-only tutorials. The eCare We Care program can be an effective educational strategy for improving diabetes knowledge and decreasing diabetes disparities among African American adults.

Healthcare education materials using pictographs provide effective strategies in improving discharge education for low-literate older adults in acute healthcare settings where nurses have primary responsibility as a first line of healthcare providers. It can also serve as an efficient tool to improve health education for immigrants speaking English as a second language.

This study investigated the psychometrics of the Self-Assessment of Nursing Informatics Competencies Scale for nursing students in undergraduate (n = 131) and graduate (n = 171) programs. The scale had a valid five-factor structure, accounting for 69.38% of the variance, high internal consistency reliabilities (0.96 for the total scale and 0.84 to 0.94 for subscales), and good responsiveness (standardized response mean = 0.99), as well as significantly improved scores in nursing students with diverse demographic and educational backgrounds after taking an informatics course. Our factor structure was similar to the original scale, differing slightly in four items' loadings. This difference may reflect current informatics practice or the greater diversity of our sample. Further research is needed on the factor, data/information management skills, and related item loadings. This scale could be used to assess informatics competencies and develop educational strategies that prepare nursing students as informatics-competent graduates in information technology-rich environments.

A pictograph-formatted approach may provide effective strategies to promote understanding of lengthy, complex action-based discharge instructions in rehabilitation facilities.