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It is necessary to acquire not only specialized knowledge but also appropriate nursing skills in nursing education. In this paper, we propose an e-learning system model to support a high level of technique learning, such as “tacit knowledge” and “proficient art” in nursing skills, which have been heretofore learned only from experience. This e-learning system enables self-learning in addition to intellectual learning, thereby enhancing knowledge of procedures and understanding of nursing skills. The results of evaluation experiments showed that each system had learning effects. However, simultaneously, they indicated the importance of the capability of self-training with actual trial-and-error to acquire skills. For that reason, adding “check point learning” to the already developed cognitive learning support system as a new function, we made improvements to provide nursing skills training covering detailed items. Based on this, we propose step-by-step learning after completing learning in the cognitive domain through spiral learning, which is the first step (from intellectual learning support to skill learning support again to intellectual learning support), learners move on to the second step (technique learning support) in a phased manner. We think that other evaluation given by instructors by checking between the first and second steps, as well as checking self-leaning, reduces the sense of loneliness, which is a common pitfall an e-learning, and which provides satisfaction with self-learning outcomes and a motivation for additional learning development.

A Proposal of the New System Model for Nursing Skill Learning Based on Cognition and Technique