We developed a new interactive web-based teaching material to improve lung auscultation skills. Our objective was to investigate the effectiveness of the web-based teaching material on nurses with less than one-year work experience, using a prospective, open-label, stratified block randomized controlled trial. Of the 69 participants, 23, 22, and 24 participants were assigned to the web-based, paper-based, and control (with no intervention) groups, respectively. Using a simulator, a discrimination test on seven lung sounds, such as "normal," "wheeze," "rhonchi," "coarse crackles," "fine crackles," "left lung diminish," and "right lung absent," was conducted. Next, a post-test was conducted after one-week of training. Answers with formal names were considered "correct"; those with common names, misspellings, and without left and right parts were considered "insufficient"; and wrong answers were considered "incorrect." The control group showed no significant difference between the pre-test and post-test for any lung sounds. The paper-based group showed significant improvement in performance for "wheeze" (p=0.004) and "coarse crackles" (p=0.035). The web-based group showed a significant improvement in performance for "fine crackles" (p=0.026). The number of correct answers in the post-test was higher in the paper- and web-based groups than the control group (p=0.023). The web-based teaching materials that we had developed effectively improved the ability of new graduate nurses to auscultate lung sounds. Additionally, the results suggest that the combined use of web- and paper-based teaching materials may be more effective since the sounds that each method enhanced their ability to auscultate different lung sounds.
Keywords: lung auscultation; nursing education; physical assessment; web-based teaching material.