Effects of competitive computer-assisted learning versus conventional teaching methods on the acquisition and retention of knowledge in medical surgical nursing students José Luis Fernández Alemán a, ⁎, Juan Manuel Carrillo de Gea a,1 , Juan José Rodríguez Mondéjar b a University of Murcia, Departamento de Informática y Sistemas, Facultad de Informática, Campus de Espinardo, 30071- Espinardo, Murcia, Spain b University of Murcia, Hospital General Universitario Reina Sofia, Comunidad Autónoma de la Región de Murcia, Spain summary article info Article history: Accepted 23 December 2010 Keywords: Computer-assisted learning Medical–surgical nursing Nurse education Purpose: This paper presents a novel approach of computer-assisted learning for nursing education in university undergraduate courses. Background: The most innovative aspect of the proposal is the design of nursing assignments as on-line competitions. The effects of competitive e-learning versus conventional teaching methods on the acquisition and retention of knowledge were compared in a course on medical–surgical nursing. Method: A total of 116 students of mixed gender, age, computer experience and educational background in a second-year course on medical–surgical nursing participated in the study. Data were collected from nursing students at four time points. The on-line activities were carried out using a web-based automatic evaluation system. Results: The study revealed that the competitive e-learning method produced significant cognitive gains for the experimental group students in the immediate follow-up test. Nevertheless, both teaching methods resulted in similar knowledge retention in the 10-week follow-up test. Conclusion: Significant benefits were found following our approach. The work of the students could be evaluated along the course, the workload of instructors was reduced and students received immediate feedback by the on-line judge, which promoted both independent learning and reflective thinking. The approach is applicable to any other nursing educational institution. © 2011 Elsevier Ltd. All rights reserved. Introduction Nowadays, the impact of the ICTs (Information and Communications Technologies) on nursing education is widely recognized (Ainsley and Brown, 2009). In the last decade, a large number of studies related to computer-assisted nursing learning have been published. Innovative learning methods are gaining popularity as an alternative way of delivering clinical skills education, but they require solid, effective research (Bloomfield et al., 2008). Many benefits are attributed to the use of computer technology in nursing learning (Simpson, 2006; Sheridan et al., 2008; Carroll et al., 2009). Computer-assisted learning (CAL) provides temporal flexibility, spatial decentralizing and both collaboration and communication between students; it allows computer-literacy skills to be developed; it promotes self-direction and active learning; it creates safe environ- ments; and it accommodates different styles of learning and reduces instructional time. CAL has also demonstrated a high capacity to generate motivation and enthusiasm among students. Studies usually report high levels of students' satisfaction with e-learning (Gerdprasert et al., 2010; Kaveevivitchai et al., 2009; Lu et al., 2009), and students feel very motivated to learn by using CAL (Reime et al., 2008; Gerdprasert et al., 2010; Lu et al., 2009; Kelly et al., 2009). On the other hand, there are barriers which can lead to failure of the on-line learning process: loss of social process of learning, provision of technical and educational support and proficiency in certain essential skills for computer use. Glasgow and Cornelius (2005) states that there are costs and strategic planning activities associated with implementing these projects. Qualified material, methodological and human resources (Fernández Alemán and Carrillo de Gea, 2010; Atack and Rankin, 2002) are required for success. Particularly, there is a need for continued research to identify best practices in web-based education (Billings et al., 2005). Currently, several models, standards, bench- mark and peer review processes can be found in the literature that assure the quality of online education and provide documentation for evaluation and accreditation processes (Little, 2009). The rest of the paper is organized as follows. Section 2 justifies the importance of this research by reviewing the related literature. Section 3 presents Mooshak, the web based application used for e-learning. Section 4 introduces the method of the experiment that can be applied Nurse Education Today 31 (2011) 866–871 ⁎ Corresponding author. Tel.: + 34 868 884621; fax: + 34 868 884151. E-mail addresses: aleman@um.es (J.L. Fernández Alemán), jmcdg1@um.es (J.M. Carrillo de Gea), juanjose.rodriguez@um.es (J.J. Rodríguez Mondéjar). 1 Fax: + 34 868 884151. 0260-6917/$ – see front matter © 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2010.12.026 Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/nedt