Effectiveness of a Small Private Online Course in Sexual Health Communication for Registered Nurses: A Randomized Controlled Trial.

BACKGROUND: Small Private Online Courses (SPOCs) apply a small-group, blended learning format to facilitate instructor-learner interactions. SPOCs are ideal for time-limited learners in clinical settings. PURPOSE: This study was designed to evaluate the effectiveness of using an SPOC-based course with a sample of nurses in terms of enhancing their knowledge and reducing their perceived barriers to sexual health communication. METHODS: This prospective randomized controlled trial was conducted at a teaching hospital in northern Taiwan. One hundred fifty in-service nurses were recruited and randomly assigned to either the control group (n = 75), which received the standard in-service nursing education program, or the intervention group (n = 75), which received the SPOC-based program in sexual health communication in addition to the standard education program. The intervention group completed five 15-minute online courses followed by a 2-hr offline course. Primary outcomes (sexual health care attitudes and perceived barriers to discussing sexuality) and a secondary outcome (frequency of engaging in sexual health communication with patients) were assessed at baseline (pretest, T1) and at 1 and 3 months after module completion (T2 and T3, respectively). Generalized estimating equations were used to analyze between-group differences in pretest-posttest changes. RESULTS: All 150 participants completed the baseline assessment; attrition occurred at the 1- and 3-month follow-ups. No participants were lost at baseline; however, follow-up attrition occurred at T2 and T3. Changes over time from baseline in attitudes toward sexual health communication and perceived barriers to discussing sexual health were significantly greater in the intervention group than in the control group. Importantly, the percentage of intervention group participants engaging in discussions with patients about sexual health increased from baseline to T2 and from T2 to T3, while no similar change over time was observed for the control group. CONCLUSIONS: The significant improvements reported for the intervention group demonstrate that cost-effective learning outcomes are achievable in spite of significant time and resource limitations. This was the first time SPOC-based learning has been used in the context of nursing education to improve sexual communication. The findings of this study suggest this format is suitable for a broader range of courses.