Introduction

COVID-19, a disease caused by SARS-CoV2 infection, caused a disruption in traditional teaching formats at the higher level, especially in Health Sciences careers, historically developed in face-to-face format, leading to an abrupt implementation of training modalities mediated by Information and Communication Technologies (ICT ).^1,2

Given the implementation of hybrid and remote modalities during training, it was essential that entrants and students have adequate management of different technological tools such as the use of virtual platforms, computer programs and tools for collaborative work, to mention a few. However, low competence has been reported for the management of these tools,³ understanding competence as the combination of knowledge, skills and attitudes, in this case related to the use of ICT.^4,5 Although the COVID-19 pandemic is behind us, many of the measures implemented, such as the inclusion of digital tools in teaching, prevail to this day.^6,7,8

The incorporation of ICT represented a challenge for teachers, management staff and students, ⁸ which not only reached the higher level but also elementary and high school education. Therefore, it is expected that those entering the university system come with experience in technology-mediated education as a result of their training during the period 2020-2022, and this could also be related to the emergence of difficulties for those who are older and trained prior to this period. For this study, “entrants” students are those students who are enrolled in their first academic year at a higher education institution, whether or not they have previously attended higher education.

Recent studies carried out in Argentina in both public ^(9,10 and private institutions,¹¹ involving nursing students, revealed a high level of satisfaction with the integration of ICT in higher education, despite challenges related to internet connectivity and the lack of familiarity with certain tools, such as institutional platforms, assessment software, and appropriate device connectivity. A further study conducted in Ecuador,⁽³⁾ which included participants from the Faculty of Health Sciences, revealed that the majority lacked the requisite knowledge and proficiency in ICT. This underscores the necessity for the early development of digital skills, starting from secondary school. A lack of digital proficiency is linked to suboptimal performance during training sessions¹¹ and an increased likelihood of abandoning the programme, ^(12,13 highlighting the urgency to address this issue.¹⁴

Based on the above, it is recommended that research be conducted to identify strengths and weaknesses in the use of resources and information technologies in higher education.¹⁵ The present work aims to determine the skills and knowledge about Information and Communication Technologies possessed by students entering the Bachelor's Degree in Nursing at a public higher-level institution in the city of Bahía Blanca, Province of Buenos Aires, Argentina. The information will enable the design of leveling activities to provide knowledge and skills for using digital tools to higher-level students in their first approach to the institution and before the start of the training section. This will help to reduce the risk of disintegration or academic failure due to inadequate use of the digital tools and platforms used by the institution, by focusing on the areas that have been identified as deficient.

Methodology

An observational, descriptive, quantitative and cross-sectional study was carried out. The population was made up of 422 entrants to cycles I (first year of the study plan to obtain the training of University Nurse - undergraduate degree) and II (fourth year of the study plan to obtain complementary training to obtain the Bachelor's degree in Nursing - degree) of the Bachelor's degree in Nursing. The sample was 386 entrants, equivalent to 91.46 % of the population, chosen through a non-probabilistic sample. Those entering cycles I and II of the Bachelor's Degree in Nursing enrolled during the 2022 academic year were included, who agreed to participate voluntarily by signing the informed consent.

An instrument was implemented consisting of 59 questions with closed response options aimed at sociodemographically characterizing the sample (4 questions), evaluating secondary level experience and training (5 questions), identifying the level of access to digital devices and the Internet (6 questions), use of applications, social networks and computer programs (15 questions), evaluation of digital skills (11 questions), perception of the importance of digital tools in education (1 question) and assessment of the training experience mediated by technology during admission to the race (17 questions). The questionnaire is designed to be answered in approximately 20 minutes.

The data collection instrument was uploaded to the Google Forms software and distributed via virtual campus and email. Once the information was collected, it was exported into a Microsoft Excel database and analyzed with the Infostat v/L program.

The descriptive analysis was carried out by calculating the mean and standard deviation for the quantitative variables and absolute and relative frequencies for the categorical variables. Chi2 (X ²) tests were implemented to evaluate the association between categorical variables and Student's T tests and ANOVA for comparison of means. A statistical significance level of p < 0.05 was set.

Regarding ethical precautions, the study had the approval of the Bioethics Committee of the Dr. Leónidas Lucero Municipal Acute Hospital of Bahía Blanca, Argentina. Informed consent was obtained after data collection and participation was voluntary. This constitutes a risk-free investigation and the ethical requirements for studies in human beings expressed in the Declaration of Helsinki, Belmont Report, Personal Data Protection Law of the Argentine Republic and the standards of Good Clinical Practices were respected.¹⁶

Results

The sample contained 386 entrants to the Bachelor's Degree in Nursing, who were mostly 20 years old or younger (47.15 %) and were female (85.49 %), residing in the city of Bahía Blanca (67.36 %). and entered Cycle I of the degree (74.35 %) (Table 1).

Table 1: Characterization of the sample 

Most of the entrants completed their high school studies two years ago or less (52.07 %), had access to the internet during that training period (72.28 %) and activities mediated by technology (61.14 %). In those who responded that they did not have access to the Internet, they stated that they supplied it by going to libraries (10.10 %), phone shops/cyber cafes (4.40 %), consulting books and copies (5.96 %) and using mobile data (4.15 %) (Table 2).

Table 2: Characterization of and use of ICT during secondary education 

^Note: * Includes only those who stated they did not have internet access.

When asked about current Internet access, entrants reported having Internet at their homes (98.19 %), logging in mostly from their laptop and desktop computers (79.27 %) and spending between four and six hours a day surfing the Internet (42.23). %), the most used website or application being WhatsApp (97.15 %), followed by email (94.30 %) (Table 3). Furthermore, it was found that 83.16 % of the entrants consider the use of ICT in training to be important.

Table 3: Access to and use of the Internet by nursing career entrants 

^Note: * Includes only those who stated they did not have internet access.

When asked to self-assess their skills in using the tools of the Microsoft (MS) Office program on a scale from 0 (least skill) to 10 (highest skill), it was found that MS Word was the best rated with an average of 7.15 (SD = 2.00), followed by MS PowerPoint with a mean of 5.90 (SD = 2.84) and to a lesser extent, MS Excel with a mean of 4.12 (SD = 2.78). When asked about the use of collaborative work applications, it was found that 88.6 % of respondents used Google Drive and 10.88 % did not use any.

The entrants were consulted about their skills to carry out various activities mediated by ICT, finding that 97.15 % reported knowing how to navigate the Internet, 95.34 % can download files from the Internet and 89.38 % perform basic text editing, in contrast, 26.94 % reported knowing how to design videos and 29.02 % knew how to design and publish personal web pages (Figure 1).

Figure 1: Skills to carry out ICT-mediated activities 

100 % of the entrants reported using Moodle during the admission activities and the use given to the platform was to access virtual classes and take exams and questionnaires (100 %), download class files (96.37 %), reproduce videos (95.34 %) and communicate with teachers (89.38 %). When asked to evaluate the platform, 97.41 % consider it practical and useful and 95.60 % believe it is friendly and easy to use.

Regarding the use of platforms for video conferences (synchronous classes), 73.06 % of respondents mentioned using Zoom in some activities, and Google Meet (68.13 %). They also reported that Adobe Connect and Jitsi were impractical.

Regarding the institution's resources, only 16.32 % of the entrants knew the available resources of the institutional virtual library and 75.91 % stated that they had received advice for carrying out computerized administrative procedures; the remaining students obtained information from their classmates or other students (9.59 %), friends and family (1.81 %), autonomously (1.81 %), through social networks (1.55 %) and from teachers and tutors (1.30 %), among others.

When performing the inferential analysis, it was found that age (X ² = 15.79, p= 0.007) and gender (X ² = 4.90, p = 0.026) were shown to be related to the importance given to the use of ICT in education; in this regard, younger and female respondents considered this aspect more important.

It was identified that younger entrants had fewer skills in using MS Excel (p = 0.036), in contrast, those of older age had greater mastery of MS Word (p = 0.047). It was also found that male respondents had greater competence in the use of MS Excel (3.89 vs. 5.52, p< 0.001) and MS Word (7.06 vs. 7.63, p = 0.034), who reported spending more than six hours on the Internet per day had better proficiency in the use of MS Word (p = 0.004) and MS PowerPoint (p = 0.048), and those entering Cycle II had greater proficiency in the use of MS Excel (3.90 vs. 4.75, p = 0.006) and MS PowerPoint (5.73 vs. 6.38, p = 0.047). Entrants who had completed high school education more than nine years ago had greater mastery of MS Excel (p = 0.016).

Having Internet access at home was not related to the perception of competence in the use of MS Word, PowerPoint and Excel. Likewise, no relationship was found between the importance given to the use of ICT in training and the entrance cycle (p = 0.134) nor with current access to the internet (p = 0.852).

Discussion

The importance for health professionals of developing digital skills is indisputable, which must be considered when planning the education curriculum. ^17,18 During and once the COVID-19 pandemic was overcome, a transformation of higher education was evident, giving greater relevance to the use of digital tools, remote training and the need to have students trained to cope with the challenges of the 21st century.^19,20

It is to be expected that the implementation of virtual training at the high school level of education, as well as remote work (teleworking) during the pandemic - considering that many of the entrants to the Bachelor of Nursing degree are professionally active-, would have contributed positively to the development of digital skills. However, the deficits regarding Internet access, the lack of adequate devices for the full exploration of digital tools (computer or electronic tablets) and the exclusively face-to-face dynamics of some jobs, showed a negative impact on the learning process and autonomous management of technological resources and tools.^6,9,10

In Argentina, the Bachelor's degree in Nursing is divided into two cycles, the first being intended for the training of the University Nurse and the second, for complementary training to obtain the title of Bachelor of Nursing, which is why it is expected that greater digital competence will be identified in the latter as a result of their previous education.²⁰ This data was corroborated in the present work where those entering cycle II reported better handling of MS Excel and PowerPoint.

Likewise, age was shown to be linked to the level of development of digital skills. Although it was expected to identify more competencies linked to this area in younger students, as a result of greater exposure to technology, it is described that this is only related to greater use of social networks, but not with collaborative work tools and text editing programs, data management or presentation design such as those of the MS Office package.²¹ This data could also be related to the frequent and obligatory use of these tools in workspaces, explaining the associations between competence in the second cycle of edition.

The study revealed a high level of proficiency in competencies related to browsing and downloading documents from the Internet, editing text documents, and converting file formats. Conversely, video design and web page design and publication were identified as areas with the lowest level of development. These findings align with the observations of multiple authors who have noted that students and new entrants tend to lack the necessary skills to create content.^22,23,24,25

Regarding the association between the male gender and higher levels of competence for the use of computer programs such as MS Excel and Word, a study carried out by Cabezas González et al.²⁶ found, in a sample of 70 students, better knowledge and management of technological resources in male students. In this work, a positive attitude towards ICT was also identified, evidenced in the perception of these as useful and necessary for the future professional (score 8.43 out of 10), similar to the findings of the present study where more than three quarters consider them useful. This finding is relevant because attitudes towards the development of digital skills have been linked to a greater commitment to learning them.²⁷

From a practical standpoint, the findings of this study can serve as a preliminary diagnostic tool for assessing the low level of digital competencies among new students and those pursuing a Bachelor's Degree in Nursing. This information can inform the design and implementation of interventions to address this issue and reduce its impact on students' academic trajectories and potential dropout rates.

As potential limitations, we note the type of sampling employed and the use of an instrument developed ad hoc for the study, which may affect the representativeness of the sample and the comparability of the findings with those of other studies.

Conclusion

Upon analysis of the level of digital competence among the incoming Bachelor of Nursing students, it was observed that they exhibited a positive self-assessment of their proficiency in the use of MS Word. In contrast, they indicated less proficiency in MS Excel. A notable deficiency in knowledge and a scarcity of skill development in content generation are apparent, while the utilization of skills for information search and download from the web is pervasive.

Furthermore, it was established that younger age groups and females ascribe greater importance to ICT in higher education. Male, older, male entrants who reported using the Internet for more than six hours per day and who were entering Cycle II demonstrated superior command of digital tools applied to education.

It can be inferred that the entrants demonstrate an intermediate level of digital competencies applied to education, with a notable proficiency in the use of social networks. It is recommended that leveling programs be implemented during the entry process or training to impart skills in the use of devices, programs, and digital tools. Furthermore, the integration of content pertaining to the advancement of computer competencies in an educational and professional context into the curriculum represents a potential avenue for consideration.