Original Investigation
Wound Care Nursing Education in the Acute Care Setting
Corey Heerschap, MScCH, BScN, RN, NSWOC, WOCC(C) and Samantha Wiesenfeld
ABSTRACT
OBJECTIVE: To assess the feasibility of a survey study exploring how nurses in
acute care prefer to be educated, particularly regarding wound management in the
acute care setting.
METHODS: This pilot study utilized a cross-sectional survey design that included
both open-ended and close-ended questions. Participants (N = 47) completed the
Index of Learning Styles Questionnaire and provided information regarding their
educational preferences related to wound management through use of an online
survey.
RESULTS: Participants described the importance of varying educational techniques
by topic, ensuring an appropriate time of day for education, and preferring smaller
educational sessions over time. Most participants preferred one-on-one bedside
education, and the most commonly reported learning styles were active, sensing,
visual, and a balanced approach to sequential and global learning. There were few
correlations between learning styles and choice of education method, only one of
which was expected.
CONCLUSIONS: It would be beneficial to conduct this study on a larger scale to
confirm results, improve understanding of the correlations, and determine further
potential correlations between study variables.
KEYWORDS: acute care, learning styles, nursing education, wound education,
wound management
ADV SKIN WOUND CARE 2023;36:370–6.
DOI: 10.1097/01.ASW.0000933988.18649.7c
Corey Heerschap, MScCH, BScN, RN, NSWOC, WOCC(C), is Wound/Ostomy Clinical Nurse Specialist, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada, and PhD student, Queens University,
Kingston, Ontario. Samantha Wiesenfeld is Undergraduate Nursing Student, McGill University, Montreal, Quebec. Acknowledgments: This work was supported by the RVH Foundation. A summer student
grant was provided by the foundation to support the coauthor’s time during the study period. The authors have disclosed no other financial relationships related to this article. Submitted July 14, 2022;
accepted in revised form August 19, 2022; published ahead of print May 8, 2023.
ADVANCES IN SKIN & WOUND CARE • JULY 2023
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
INTRODUCTION
Continuing education is an integral component of nursing
practice. Nurses are challenged to engage in continuous
learning depending on their place of work, experience,
and personal learning styles. Learning is complicated by
the fast pace at which healthcare knowledge is generated
and how practice is informed. McCrow et al1 explored
various learning styles among nurses, but stopped short
of defining the most effective educational methods in
practice. In a more recent study, Mangold et al2 reported
learning style preferences in nurses differed depending
on work satisfaction, years of experience, and gender.
To date, there is limited research pertaining to nurses’
preferred learning methods in general and even less that
focuses on wound care education in the practice setting.
In a literature review on wound care evidence, knowl-
edge, and education, Welsh3 concluded that there is an
inadequacy of wound care education at all levels of health-
care and recommended the development of more struc-
tured wound care education programs, including for
professional development. McCluskey and McCarthy4
also recommended increased wound care education for
nurses working in acute care hospitals. Wound care ed-
ucation is associated with improved self-assessed com-
petence and wound assessment knowledge.4 Understand-
ing nurses’ preferences for wound care education within
the acute care setting and the implications of different
learning styles on educational preferences may assist in
developing improved educational resources.
The aim of this pilot study was to assess the feasibility
of a survey study exploring how nurses in acute care pre-
fer to be educated and, specifically, how they prefer to be
educated in wound management. The authors sought to
address the following research questions:
1. What are the learning style preferences of nurses in
acute care?
2. How do nurses in acute care prefer to be educated re-
garding wound management?
3. Is there a relationship between learning style prefer-
ence and preferred method of wound education?
370 WWW.ASWCJOURNAL.COM
METHODS
Setting and Sampling
This pilot study utilized a cross-sectional survey design.5,6
The study was conducted at Royal Victoria Regional Health
Centre (RVH), a 388-bed regional acute care health
center in Ontario, Canada. Study participants were nurses
employed at RVH. Exclusion criteria included any em-
ployee who was not an RN or registered practice nurse
employed at RVH, including nurse managers and nurses
in a non-patient-facing role.
Participants were recruited using a convenience sam-
pling technique over a 2-month period from October to
November 2021. An estimated 1,290 RNs and registered
practice nurses eligible to participate in the study were
employed at RVH during this time. The authors performed
an initial sample size calculation using a 95% confidence
level with 5% margin of error and determined that 297
responses would be required. They emailed 942 of the
eligible nurses employed at RVH with an invitation to
participate in the study. The email invitation contained
informed consent and study information as well as a
link to the survey to be completed. Two reminder emails
were sent during the study period.
Ethical Considerations
This study was conducted in full conformance with prin-
ciples of the Declaration of Helsinki, good clinical prac-
tices, and within the laws and regulations of Canada. Re-
search ethics board approval was obtained from the RVH
Research Ethics Board.
Data Collection
Participants were asked to complete an anonymous on-
line survey using REDCap (Research Electronic Data Cap-
ture) electronic data-capturing software. Participants were
first asked to select their preferred methods of wound care
education in the acute care setting from a provided list of
options; they could also write other methods not listed.
Participants then completed the Index of Learning Styles
Questionnaire (ILS) and reported their results.7 Demo-
graphic data along with other wound care educational
preferences were then collected through a mix of closed-
ended questions, closed-ended questions with an oppor-
tunity to explain their answer, and open-ended questions.
The ILS is a 44-item questionnaire identifying learning
style preference with four subscales: active-reflective,
sensing-intuitive, visual-verbal, and sequential-global.2
Those with a preference for active learning tend to prefer
activities and group discussion, whereas those with a
preference for reflective learning prefer to work alone and
self-reflect.1 Individuals with a preference for sensing tend
to prefer data and facts and how they apply to their sur-
roundings, and intuitive learners tend to prefer theories
and ideas.1 Those with a preference for visual learning
WWW.ASWCJOURNAL.COM
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
prefer pictures and diagrams, whereas those who favor ver-
bal learning prefer speaking and listening.1 Finally, sequential
learners prefer a stepwise approach to tasks, whereas global
learners wish to understand the situation in its entirety.1
Scores on the ILS range from 1 to 11 on each of the four
subscales. Participants are considered to have a balanced
learning preference if they obtain a score of 1 to 3, mean-
ing only a mild preference for one side of the subscale.
They are considered to have a moderate preference with
a score of 5 to 7 and a strong preference with a score of 9
to 11.2 The ILS has acceptable test-retest reliability, factor
structure, internal consistency reliability, total-item cor-
relation, interscale correlation, and construct validity.2
The authors chose this tool for this study because it
was used in three recent nursing articles regarding learn-
ing style preferences.2
Data Analysis
Data analysis was conducted using the SPSS Statistics
software package version 27 (IBM Corp). The authors
analyzed open-ended questions through a qualitative con-
tent analysis approach with no preexisting codes for qual-
itative data.8 They used descriptive data analysis to evalu-
ate demographic data and educational preferences pre-
sented as closed-ended questions.
Each learning style scale was nominally grouped into
three groups, showing either a balanced preference or a
specific preference across each domain. Strong and mod-
erate preferences were combined; for example, in the
active-reflective subscale, participants were grouped as
either active, balanced, or reflective. Learning styles data
were excluded if the survey was not completed in full, or
if they did not match an appropriate response (eg, if the
respondent stated they fell within multiple learning styles
within the same domain).
Fisher exact tests were used to assess relationships be-
tween preferred learning styles and wound care educa-
tion preferences in the acute care setting. Fisher exact
was used when one cell was equal to zero, such as when
evaluating relationships between active/balanced/
reflective learners, because no reflective learners par-
ticipated in this study. When no cells were equal to
zero, such as when study members participated across
all learning styles within a domain (eg, sensing, balanced
sensing/intuitive, and intuitive learning styles), the Fisher-
Freeman-Halton exact test was used. Statistical significance
was considered P < .05. Cramer V was also calculated
to determine the effect size and how strongly each learn-
ing style and preference of wound care education was
associated. Effect size was interpreted based on values
presented by Rea and Parker.9 When one learning style
did not include a participant, leading to a 2  2 contingency
table, and demonstrated a statistically significant corre-
lation, the authors calculated an odds ratio (OR).
371 ADVANCES IN SKIN & WOUND CARE • JULY 2023
RESULTS
Of the 942 invitations sent, 47 participants submitted Table 1. PARTICIPANT DEMOGRAPHICS (N = 47)
Demographic Variables n (%)
survey responses (5% response rate). Demographic char-
Sex
acteristics of the participants can be seen in Table 1. The
population was primarily female (96%), with most nurses Female 44 (96)
being between 30 and 39 years of age. The largest propor- Male 2 (4)
tion of participants were within their first 4 years of nurs- Total 46a (98)
ing (28%), with the second largest group having worked Age groups, y
20 to 29 years (26%) and the third largest group having 20-29 9 (19)
worked 10 to 19 years (23%). A sizable portion of respon- 30-39 20 (43)
dents noted that their wound care education has come 40-49 10 (21)
from in-servicing (87%). Participants also noted taking
50+ 6 (13)
wound courses (30%) and obtaining certificates (20%).
Total 45a (96)
Nearly one-third of participants (32%) work in an inpa-
tient medical unit. Nursing experience, y
0–4 13 (28)
Preferred Learning Styles 5–9 11 (23)
Most participants identified as being an active learner 10–19 12 (26)
(60%). The remaining 40% of respondents were balanced 20–29 3 (6)
between active and reflective, with no participants identi- 30–39 6 (13)
fying as having a strong or moderate preference for reflec- Total 45a (96)
tive learning. Many participants preferred sensing (68%),
Educational experience in wound care
with the remainder of individuals identifying with either
In-services 40 (87)
a balanced approach (18%) or as intuitive learners (15%).
Certificates 9 (20)
Most participants identified as visual learners (78%), with
the remainder preferring a balanced approach between Degrees 1 (2)
visual and verbal (23%); no participants identified as Courses 14 (30)
having a moderate or strong preference for verbal learn- Other 5 (11)
ing. In contrast, participants were more spread out within Unit type
the sequential-global subscale, with 38% identifying as Surgical 7 (15)
sequential learners, 45% preferring a balanced approach, Medicine 15 (32)
and the remainder (18%) preferring global learning. Critical care 8 (17)
Emergency 3 (6)
Wound Care Educational Preferences
Mental health 2 (4)
Most respondents felt that educational practices should
differ by wound topic (70%). Participants discussed how Other 12 (26)
although some discussion can be beneficial, having a vi- Total 47 (100)
sual, a means to relate to past experience, or bedside ed- Believes education should differ by wound topic
ucation with hands-on experience can be necessary to Yes 33 (70)
understand the content. Participants felt that physical in- No 14 (30)
terventions such as complex dressing applications were Total 47 (100)
more appropriate for hands-on education, whereas other Time of day affects learning
interventions such as pressure injury staging were better Yes 32 (68)
suited for a nonclinical setting. They further noted that
No 13 (28)
more complex topics should be broken into a stepwise ap-
Total 45a (96)
proach with rationale provided to understand the content.
In addition, 68% of respondents felt that time of day Preference for small topics over time or large
review at once
affected learning. Participants discussed difficulties in
attending education while caring for their patients, in- Small topics over time 37 (79)
cluding nurse call bells, calls from family, and patient Multiple topics at once 9 (19)
care needs. Some respondents felt that non-patient-care Total 46a (98)
time would be most appropriate for education, provided a
Missing data.
in multiple sessions, whereas others thought that nurses
would not attend unless incentives were offered. Although

ADVANCES IN SKIN & WOUND CARE • JULY 2023 372 WWW.ASWCJOURNAL.COM

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

some respondents thought that knowledge retention may
be best during the day, others conjectured that afternoon
or evening education may be more appropriate because
nurses could complete their main tasks in the morning
and focus more on the education later in the day. Other
participants felt there was no best time of day for education
or noted that if education were provided in the evening,
they would not have the concentration or energy to par-
ticipate in learning.
A large majority of the population preferred small topics
provided over time rather than a large wound care review
at once (79%). Larger topics were felt to be overwhelming
by some who preferred to have education spread out over
time. Respondents reported that during smaller topic
discussions, content could be more focused on the nurses’
environment, explained in greater depth, and retained
more easily. However, some nurses felt that having larger
educational sessions would provide more time efficiency
and enable understanding of similarities and differences
between topics. Nurses who worked infrequently be-
lieved that they would miss content if it were provided
in small pieces over time.
Preferred Wound Care Education Method
A substantial portion of participants preferred one-on-one
wound care education at the bedside (83%; Figure). Group
in-servicing was also commonly preferred, with 57% of
respondents stating they preferred learning in a group.
In addition, some respondents preferred handouts (23%)
and virtual presentations (30%). In contrast, posters (15%),
online learning management system (LMS) modules
(19%), policies (6%), and other methods of education
(6%) were less frequently selected. Those who selected
“other” as a learning method preference identified pref-
erences for clinical placement, simulated learning, and
in-person workshops.
Figure. PREFERRED WOUND CARE EDUCATION METHOD
Abbreviation: LMS, learning management system.
WWW.ASWCJOURNAL.COM
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Relationship Between Learning Style Preference and Wound
Care Education Preference
Correlations between learning styles and wound care
education preference are described in Table 2. Three learn-
ing style domains were significantly correlated with a
method of preferred wound care education. The active/
reflective domain of learning correlated with LMS mod-
ule learning preferences with a relatively strong effect size
(P = .017, V = .421). Active learners were 8.9 times less
likely than balanced active/reflective learners to prefer
learning with an online LMS module (OR, 8.944; 95%
CI, 1.554-51.484). There was also a relatively strong effect
size and correlation between the visual/verbal domain
and wound care education by poster (P = .015, V = .447).
Visual learners were 12 times less likely than balanced
visual/verbal learners to choose posters as a preferred
form of wound care education (OR, 12.000; 95% CI,
1.718–83.803). Finally, a correlation was found between
the sensing/intuitive domain and other forms of education
with a relatively strong effect size (P = .015, V = .461).
Those with a sensing learning style never chose the “other”
category of wound care education methods.
Although there were no further statistically significant
correlations between learning styles and preferred method
of wound care education, there were six combinations of
learning styles and methods of education that showed a
moderate effect size. The active/reflective domain had
a moderate effect on education preference by poster
(P = .187, V = .235), as well as other forms of education
(P = .268, V = .225). A moderate effect was also found be-
tween the sensing/intuitive domain and poster education
preference (P = .525, V = .227). In addition, the visual/
verbal domain had a moderate effect on the choice of
wound learning through one-on-one bedside education
(P = .309, V = .220), handouts (P = .185, V = .248), and
LMS modules (P = .087, V = .228).
373 ADVANCES IN SKIN & WOUND CARE • JULY 2023
 Table 2. ASSOCIATIONS BETWEEN LEARNING STYLE AND WOUND CARE EDUCATION PREFERENCES
Learning Styles
Active-Reflective Sensing-Intuitive Visual-Verbal Sequential-Global

ADVANCES IN SKIN & WOUND CARE • JULY 2023

Methods of Wound Care Active Balanced Reflective Fisher Sensing Balanced Intuitive Fisher Visual Balanced Verbal Fisher Sequential Balanced Global Fisher
Education (n = 41)a Subgroups n (%) n (%) n (%) Exact V n (%) n (%) n (%) Exact V n (%) n (%) n (%) Exact V n (%) n (%) n (%) Exact V
Prefers group in-servicing (n = 25) 15 (60) 10 (40) 0 (0) 1.00 .025 18 (72) 3 (12) 4 (16) .621 .169 20 (80) 5 (20) 0 (0) .717 .059 8 (32) 12 (48) 5 (20) .580 .183
Does not prefer group in-servicing (n = 16) 10 (63) 6 (38) 0 (0) 10 (63) 4 (25) 2 (13) 12 (75) 4 (25) 0 (0) 8 (50) 6 (38) 2 (13)
Prefers one-on-one bedside (n = 35) 21 (60) 14 (40) 0 (0) 1.00 .048 23 (66) 7 (20) 5 (14) .656 .188 26 (74) 9 (26) 0 (0) .309 .220 13 (37) 15 (43) 7 (20) .714 .190
Does not prefer one-on-one bedside (n = 6) 4 (67) 2 (33) 0 (0) 5 (83) 0 (0) 1 (17) 6 (100) 0 (0) 0 (0) 3 (50) 3 (50) 0 (0)
Prefers posters (n = 6) 2 (33) 4 (67) 0 (0) .187 .235 4 (67) 2 (33) 0 (0) .525 .227 2 (33) 4 (67) 0 (0) .015 .447 2 (33) 3 (50) 1 (17) 1.00 .054
Does not prefer posters (n = 35) 23 (66) 12 (34) 0 (0) 24 (69) 5 (14) 6 (17) 30 (86) 5 (14) 0 (0) 14 (40) 15 (43) 6 (17)
Prefers handouts (n = 10) 5 (50) 5 (50) 0 (0) .472 .128 6 (60) 2 (20) 2 (20) .640 .106 6 (60) 4 (40) 0 (0) .185 .248 4 (40) 4 (40) 2 (20) 1.00 .053

374
Does not prefer handouts (n = 31) 20 (65) 11 (36) 0 (0) 22 (71) 5 (16) 4 (13) 26 (84) 5 (16) 0 (0) 12 (39) 14 (45) 5 (16)
Prefers LMS modules (n = 9) 2 (22) 7 (78) 0 (0) .017 .421 6 (67) 2 (22) 1 (11) .858 .083 5 (56) 4 (44) 0 (0) .087 .288 4 (44) 4 (44) 1 (11) 1.00 .089
Does not prefer LMS modules (n = 32) 23 (72) 9 (28) 0 (0) 22 (69) 5 (16) 5 (16) 27 (84) 5 (16) 0 (0) 12 (38) 14 (44) 6 (19)
Prefers policy (n = 3) 2 (67) 1 (33) 0 (0) 1.00 .033 2 (67) 0 (0) 1 (33) .444 .180 2 (67) 1 (33) 0 (0) .535 .077 2 (67) 1 (33) 0 (0) .770 .176
Does not prefer policy (n = 38) 23 (61) 15 (40) 0 (0) 26 (69) 7 (18) 5 (13) 30 (79) 8 (21) 0 (0) 14 (37) 17 (45) 7 (18)
Prefers virtual presentation (n = 12) 7 (58) 5 (42) 0 (0) 1.00 .035 9 (75) 1 (8) 2 (17) .766 .150 9 (75) 3 (25) 0 (0) 1.00 .047 6 (50) 4 (33) 2 (17) .670 .153
Does not prefer virtual presentation (n = 29) 18 (62) 11 (38) 0 (0) 19 (66) 6 (21) 4 (14) 23 (79) 6 (21) 0 (0) 10 (35) 14 (48) 5 (17)
Prefers other methods of education (n = 3) 3 (100) 0 (0) 0 (0) .268 .225 0 (0) 1 (33) 2 (67) .015 .461 3 (100) 0 (0) 0 (0) 1.00 .149 1 (33) 1 (33) 1 (33) .568 .122

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Does not prefer other methods of education 22 (58) 16 (42) 0 (0) 28 (74) 6 (16) 4 (11) 29 (76) 9 (24) 0 (0) 15 (40) 17 (45) 6 (16)
(n = 38)
a
Missing data
Abbreviation: LMS, learning management system.

WWW.ASWCJOURNAL.COM
Challenges to Learning in Acute Care
Nurses noted that time felt limited during each shift,
leading to difficulties with attending wound care educa-
tion, completing documentation, and remaining consis-
tent in care provision. Respondents described a lack of
certainty as to wound product availability and reported
that wound care products and resources can be difficult
to access in acute care settings with fewer options avail-
able compared with the community setting.
Participants felt that they would benefit more from
hands-on one-on-one bedside education and case-based
study than from group sessions and posters, which they
reported were more commonly used for education in
acute care. Some respondents also felt they would benefit
from specific wound condition learning modules, whereas
others thought wound modules would not be beneficial.
When learning a new skill, respondents noted that not
implementing the skill regularly would lead to a lack
of knowledge when it came time to put the theoretical
knowledge into practice. They also mentioned limitations
to accessing full interprofessional team support because
of individual task requirements, leading to reduced oppor-
tunity for bedside education among providers. Nurses also
reported that communication among staff members
related to wound management was a challenge, with
documentation being a potential area for improvement.
Although respondents described colleagues as a source of
wound care information, they observed that it was not al-
ways possible to obtain support from peers because of
time constraints. Participants also recognized that informa-
tion gathered from peer sources may not always be correct,
and with practices constantly changing, it is difficult to re-
main knowledgeable on topics related to wound care.
Improved Attentiveness to Education
Respondents felt that providing multiple learning periods
throughout the day, on more frequent occasions, and at
set times would enable improved time management when
planning a day to ensure educational attendance. The
ability to be hands-on with products and techniques was
discussed as a way to increase interest in education, as well
as using case studies to improve connections with past
nursing experience. Respondents discussed increasing
staffing on education days as a way to increase focus and
availability for education. Specific educational interests
were mentioned, including advanced wound dressings,
theoretical principles of wound management, wound in-
fection, and vascular wounds.
DISCUSSION
Most participants in this study had an active learning
style, in contrast with previous studies by McCrow et al1
and Mangold et al,2 which found that acute care RNs
tended to have a balanced active/reflective learning style.
WWW.ASWCJOURNAL.COM
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
However, in line with previous findings,1,2 the majority of
study participants preferred sensing, visual, and balanced
sequential/global learning styles. Thus, overall, the pres-
ent study findings support those of previous literature on
common learning styles among nurses.
According to Rea and Parker,9 most significant relation-
ships are either moderately or relatively strong, an effect
size of .2 to .6. The moderate effect size yet nonsignificant
results of six findings within this study may be related to
the study being underpowered, supporting the need for
further research with a larger study population.10 Consid-
ering the lack of statistically significant correlations found
within this study and that one of the three significant
correlations demonstrated an unexpected connection be-
tween learning style and wound care education prefer-
ence, there is an increased probability that learning styles
do not impact the way in which nurses prefer to learn
within the acute care setting. Visual learners, for example,
were 12 times less likely to select posters as a preferred
method of wound education, but Felder and Soloman7
describe visual learners as those who prefer pictures, di-
agrams, flowcharts, timelines, films, and demonstrations.
The lack of preference for posters for wound education
would appear to contradict the ILS definitions. However,
81% of visual learners demonstrated a preference for one-
on-one bedside education, which would meet the prefer-
ence for demonstration-based education. The visual/verbal
domain of learning was not significantly correlated with
one-on-one bedside education, though.
One statistically significant result that was expected
given learning style definitions was that active learners
were 8.9 times less likely than balanced learners to prefer
online LMS modules for wound education. Felder and
Soloman7 describe active learners as those who retain in-
formation through actively participating in learning and
trialing an activity, often in groups. It is therefore not sur-
prising that active learners are less likely to prefer online
learning module-based education.
Participants reported that a lack of time to attend edu-
cational in-services was a challenge, and the majority
expressed a preference for one-on-one bedside education.
This is in line with education preferences for shorter edu-
cation sessions over time rather than a single longer ses-
sion. This is similar to the findings of Norushe et al,11
who, in a qualitative study with RNs, found that in-
services may conflict with patient care needs. Those study
participants preferred education through teachable mo-
ments rather than through an in-service approach.11 In
the present study, participants discussed how learning
from colleagues in acute care may be a challenge because
information may not always be accurate or evidence
based. Although providers gathering knowledge through
discussion with peers has been reported in the wound
care literature,12 clinicians often make clinical judgments
375 ADVANCES IN SKIN & WOUND CARE • JULY 2023
based on previous knowledge and experience, which can
contrast with current and best practices.13 Participants
reported that communication was a challenge within the
acute care setting. Previously, Heerschap et al12 found that
staff thought communication and documentation could be
improved in the acute care setting and that poor com-
munication could lead to poor patient outcomes.
Study participants reported that to improve education
attentiveness, it is important to consider the timing of ed-
ucation and ensure staff can participate in case-based dis-
cussion or get hands-on with products and resources.
This finding is similar to that of Yektatalab et al.14 In their
article on intensive care nurses’ perceptions of the barriers
to effective in-service education, participants discussed
the importance of appropriate timing of education and
issues with lecture-based education formats. Providing
multiple learning opportunities in the form of short edu-
cation sessions may improve access to education within
the acute care setting.
Limitations and Gaps to Address in Future Research
Although this study offers insight into nursing educational
preferences, challenges to learning, and potential interven-
tions to improve attentiveness related to wound manage-
ment education, the study survey obtained a low response
rate of 5%. At the time of the initial survey dissemination,
Ontario was within the fourth wave of COVID-19, increas-
ing nursing stress and workload, which may have im-
pacted the response rate to the emailed survey. It is also
possible that the length of the survey, which included both
the ILS questionnaire and additional education ques-
tions related to wound care, was a deterrent to comple-
tion. Given the valuable information obtained from this
survey, further research on nursing wound care learning
preferences and learning styles would be beneficial through
distribution to a wider acute care nursing audience to
ensure an appropriate sample size is obtained.
Given the challenges identified, some of which related
specifically to wound management, such as product
knowledge and resource availability, future research should
focus on identifying further opportunities to strengthen
wound care education in acute care and methods to im-
prove attentiveness and knowledge retention. The authors
identified only three statistically significant correlations be-
tween learning styles and education preferences in wound
care. However, given the low response rate, there may still
be further correlations between learning styles and edu-
cation preferences to be uncovered.
CONCLUSIONS
Obtaining data related to wound care education prefer-
ences can provide valuable insight into the needs and
challenges of nurses in the acute care setting. This pilot
ADVANCES IN SKIN & WOUND CARE • JULY 2023
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
study demonstrated the feasibility of conducting this
type of research on a larger scale to confirm results. Par-
ticipants discussed a preference for one-on-one bedside
education with greater options for hands-on learning.
They also reported various challenges, including a lack
of time for education and difficulty obtaining resources
and staying up to date with wound care products and
practices, among others. The most common learning styles
within this cohort included active, sensing, visual, and a
balanced approach to sequential and global learning.
The authors observed three correlations between learning
styles and educational preferences: the active/reflective
domain of learning correlated with a preference for or
against LMS module learning, the visual/verbal domain
correlated with a preference for or against poster learn-
ing, and the sensing/intuitive domain correlated with
a preference for or against other forms of education.
The statistically significant result between active learners
and the lack of preference for online module wound edu-
cation was an expected outcome given the definitions of
that ILS learning style. Although further research with a
larger study population is needed to confirm the results,
it is likely that there is a lack of correlation between learn-
ing style and preferred method of wound care education
in the acute care setting. Confirming the findings regard-
ing the overall lack of significant effect of learning styles
on the preferred method of wound education as well as
educational preferences of timing, technique, and depth
of topic would be beneficial to ensure effective nursing
wound care education. •
REFERENCES
1. McCrow J, Yevchak A, Lewis P. A prospective cohort study examining the preferred learning styles
of acute care registered nurses. Nurse Educ Pract 2014;14:170-5.
2. Mangold K, Kunze K, Quinonez M, et al. Learning style preferences of practicing nurses. J Nurses
Prof Dev 2018;34:212-8.
3. Welsh L. Wound care evidence, knowledge and education amongst nurses: a semi-systematic
literature review. Int Wound J 2018;15:53-61.
4. McCluskey P, McCarthy G. Nurses’ knowledge and competence in wound management. Wounds UK
2012;8:37-47.
5. Cresswell J. Survey designs. In: Creswell J. ed. Educational Research: Planning, Conducting, and
Evaluating Quantitative and Qualitative Research. 4th ed. Pearson; 2012:384-432.
6. Wang X, Cheng Z. Cross-sectional studies: strengths, weaknesses, and recommendations. Chest
2020;158:S65-71.
7. Felder R, Soloman B. Learning styles and strategies. https://www.engr.ncsu.edu/wp-content/
uploads/drive/1WPAfj3j5o5OuJMiHorJ-lv6fON1C8kCN/styles.pdf. Last accessed April 13, 2023.
8. Sandelowski M. Whatever happened to qualitative description? Res Nurs Health 2000;23:334-40.
9. Rea L, Parker R. Designing and Conducting Survey Research. Jossey-Bass; 1992.
10. Visentin D, Cleary M, Hunt G. The earnestness of being important: reporting non-significant statistical
results. J Adv Nurs 2020;76:917-9.
11. Norushe T, van Rooyen D, Strumpher J. In-service education and training as experienced by
registered nurses. Curationis 2004;27:63-72.
12. Heerschap C, Nicholas A, Whitehead M. Wound management: investigating the interprofessional
decision-making process. Int Wound J 2019;16:233-42.
13. Gillespie B, Chaboyer W, St John W, et al. Health professionals’ decision-making in wound
management: a grounded theory. J Adv Nurs 2015;71:1238-48.
14. Yektatalab S, Momennasab M, Parvizy S, Mousazadeh N. Intensive care unit nurses’ perception of
the barriers to effective in-service education: a qualitative study. J Nurs Midwifery Sci 2020;7:241-7.
376 WWW.ASWCJOURNAL.COM