{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:57:24Z","timestamp":1773043044632,"version":"3.50.1"},"reference-count":62,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Nursing"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The current information and communication technologies, digital literacy, and ease of access to communication and information devices by nurses provide them with new ways and intention to access information for technical-scientific updating, ensuring the quality and safety of health care. Mobile learning (m-learning) offers a flexible and accessible alternative for continuing professional education, overcoming barriers such as time constraints and financial burden.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the effectiveness of m-learning in nurses\u2019 knowledge retention of chronic obstructive pulmonary disease self-management, using a Massive Open Online Course with integrated virtual clinical simulation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A quasi-experimental pre- and posttest study was conducted, with no control group, among 168 nurses from a Portuguese hospital. The intervention included an asynchronous online course with 13 modules. Knowledge retention was assessed by comparing the mean scores before and after the course.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The results indicated a significant increase in knowledge retention. The participants\u2019 average score increased from 59.97% in the initial assessment to 84.05% in the final assessment (P<\/jats:italic><.001). Nurses with a master\u2019s degree exhibited a higher level of basic knowledge than those with a bachelor\u2019s degree. The course completion rate was 93.45%, reflecting significant engagement attributed to gamification and clinically relevant content.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study confirms the effectiveness of m-learning in improving knowledge retention in nursing. This strategy is a valuable approach to lifelong learning, promoting quality and safety in delivering health care. m-learning is useful in nurses\u2019 lifelong learning, offering flexibility and more effective support for clinical practice. Integrating virtual simulation and gamification boosted motivation and reduced drop-out rates, highlighting the potential of m-learning in lifelong learning in health care.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/72957","type":"journal-article","created":{"date-parts":[[2025,5,18]],"date-time":"2025-05-18T18:05:06Z","timestamp":1747591506000},"page":"e72957-e72957","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of m-Learning in Enhancing Knowledge Retention for Nurses\u2019 Lifelong Learning: Quasi-Experimental Study"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2183-1586","authenticated-orcid":false,"given":"Daniel Jos\u00e9","family":"Cunha","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-6860","authenticated-orcid":false,"given":"Paulo","family":"Machado","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6631-776X","authenticated-orcid":false,"given":"Jos\u00e9 Miguel","family":"Padilha","sequence":"additional","affiliation":[]}],"member":"1010","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12707\/RVI22055","article-title":"Lifelong learning entre profissionais de enfermagem: desafios contempor\u00e2neos","volume":"VI S\u00e9rie","author":"Ornellas","journal-title":"Rev Enf Ref"},{"issue":"Supp.1","key":"R2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.21315\/eimj2024.16.s1.8","article-title":"Development of a risk communication in Massive Open Online Course (MOOC) module for nurses: a process description","volume":"16","author":"Aung","journal-title":"Educ Med J"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"79","DOI":"10.12738\/jestp.2020.1.006","article-title":"The effect of mobile learning on learning performance: a meta-analysis study","volume":"20","author":"Talan","journal-title":"EDUC SCI-THEOR PRACT"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Padilha JM Rosa JF Cunha DJ . Gamification in healthcare education: demystifying a trend. In: Bernardes O Amorim V Moreira A , editors. Handbook of Research on the Influence and Effectiveness of Gamification in Education IGI Global. 2022:46-62. [doi: 10.4018\/978-1-6684-4287-6.ch003]","DOI":"10.4018\/978-1-6684-4287-6.ch003"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2020.104509","article-title":"Northeastern Ontario nurses\u2019 perceptions of e-learning: an interpretive description","volume":"92","author":"Stevens","journal-title":"Nurse Educ Today"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2020.104705","article-title":"Easiness, usefulness and intention to use a MOOC in nursing","volume":"97","author":"Padilha","journal-title":"Nurse Educ Today"},{"issue":"C","key":"R7","doi-asserted-by":"publisher","first-page":"103721","DOI":"10.1016\/j.compedu.2019.103721","article-title":"Technological environment, virtual experience, and MOOC continuance: a stimulus\u2013organism\u2013response perspective","volume":"144","author":"Zhao","journal-title":"Comput Educ"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1111\/inr.12649","article-title":"Massive open online courses for nurses\u2019 and healthcare professionals\u2019 continuous education: a scoping review","volume":"68","author":"Longhini","journal-title":"Int Nurs Rev"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1058383","article-title":"A perspective of massive open online courses (MOOCs) and public health","volume":"10","author":"Bettiol","journal-title":"Front Public Health"},{"key":"R10","unstructured":"WHO guideline recommendations on digital interventions for health system strengthening. World Health Organization. 2019. URL: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK541902 [Accessed 20-06-2025]"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","DOI":"10.2196\/12913","article-title":"Digital education in health professions: the need for overarching evidence synthesis","volume":"21","author":"Car","journal-title":"J Med Internet Res"},{"key":"R12","unstructured":"Digital skills and competences and successful digital education and training: fit for the digital era. European Council. 2023. URL: https:\/\/www.consilium.europa.eu\/en\/press\/press-releases\/2023\/11\/23\/digital-skills-and-competences-and-successful-digital-education-and-training-fit-for-the-digital-era\/ [Accessed 07-02-2025]"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"123","DOI":"10.5152\/jern.2022.29053","article-title":"Change in nursing education: mobile-based learning approaches","volume":"18","author":"Masat Harbali","journal-title":"J Educ Res Nurs"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"79","DOI":"10.26650\/FNJN322556","article-title":"Reflections on nursing education of technological developments","volume":"27","author":"\u015eenyuva","journal-title":"Florence Nightingale Hemsire Derg"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Picciano AG . Theories and frameworks for online education: seeking an integrated model. In: A Guide to Administering Distance Learning. Brill; 2021:79-103. [doi: 10.1163\/9789004471382_005]","DOI":"10.1163\/9789004471382_005"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-023-04648-9","article-title":"Investigating the acceptance and use of massive open online courses (MOOCs) for health informatics education","volume":"23","author":"Alharbi","journal-title":"BMC Med Educ"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.im.2018.06.003","article-title":"Gamification: a key determinant of massive open online course (MOOC) success","volume":"56","author":"Aparicio","journal-title":"Inf Manag"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1007\/s11423-016-9500-3","article-title":"Disrupting and democratising higher education provision or entrenching academic elitism: towards a model of MOOCs adoption at African universities","volume":"65","author":"Rambe","journal-title":"Education Tech Research Dev"},{"issue":"4","key":"R19","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1007\/s11423-020-09798-x","article-title":"A comprehensive systematic review of MOOC research: research techniques, topics, and trends from 2009 to 2019","volume":"68","author":"Zhu","journal-title":"Education Tech Research Dev"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1007\/s12564-021-09692-y","article-title":"A bibliometric review on latent topics and trends of the empirical MOOC literature (2008\u20132019)","volume":"22","author":"Liu","journal-title":"Asia Pacific Educ Rev"},{"key":"R21","unstructured":"Shah D . Class central\u2019s best online courses of the year (2022 edition). The Report. 2021. URL: https:\/\/www.classcentral.com\/report\/best-free-online-courses-2022 [Accessed 20-06-2025]"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","first-page":"500","DOI":"10.6018\/eglobal.17.1.277841","article-title":"El uso de blog como estrategia de formaci\u00f3n continua en enfermer\u00eda: una revisi\u00f3n integradora de la literatura","volume":"17","author":"Almeida","journal-title":"Enferm Glob"},{"key":"R23","unstructured":"MOOCs market share, trend, growth, forecast research, 2032. Business Research Insights. 2024. URL: https:\/\/www.businessresearchinsights.com\/market-reports\/massive-open-online-course-mooc-market-122947 [Accessed 21-06-2025]"},{"issue":"3","key":"R24","doi-asserted-by":"publisher","first-page":"194","DOI":"10.5281\/zenodo.14576715","article-title":"Massive open online courses in nursing: a retrospective descriptive study","volume":"3","author":"Da\u011fc\u0131","journal-title":"Sa\u011fl\u0131k Bilimleri ve Klinik Ara\u015ft\u0131rmalar\u0131 Dergisi"},{"issue":"5-6","key":"R25","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1080\/10494820.2018.1465438","article-title":"Large-scale online education programmes and their potential to effect change in behaviour and practice of health and social care professionals: a rapid systematic review","volume":"27","author":"Zubala","journal-title":"Interact Learn Environ"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.33194\/rper.2024.395","article-title":"Aceita\u00e7\u00e3o pelos Enfermeiros da utiliza\u00e7\u00e3o de um Massive Open Online Course em contexto de forma\u00e7\u00e3o cont\u00ednua","volume":"7","author":"Cunha","journal-title":"Rev Port Enf Reab"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.hrmr.2018.06.004","article-title":"Revolutionizing training and education? Three questions regarding massive open online courses (MOOCs)","volume":"29","author":"Weinhardt","journal-title":"Hum Resour Manag Rev"},{"issue":"10","key":"R28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239766","article-title":"Identifying course characteristics associated with sociodemographic variation in enrollments across 159 online courses from 20 institutions","volume":"15","author":"Kizilcec","journal-title":"PLoS ONE"},{"key":"R29","unstructured":"Korn M Levitz J . Online courses look for a business model. The Wall Street Journal. URL: https:\/\/www.wsj.com\/articles\/SB10001424127887324339204578173421673664106 [Accessed 20-06-2025]"},{"key":"R30","volume":"8","author":"Breslow","journal-title":"Res Pract Assess"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-018-1215-1","article-title":"A MOOC as an immediate strategy to train health personnel in the cholera outbreak in Mexico","volume":"18","author":"Maga\u00f1a-Valladares","journal-title":"BMC Med Educ"},{"issue":"6","key":"R32","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1080\/0144929X.2018.1549595","article-title":"Effects of social-interactive engagement on the dropout ratio in online learning: insights from MOOC","volume":"38","author":"Wang","journal-title":"Behav Inform Technol"},{"issue":"7","key":"R33","doi-asserted-by":"publisher","DOI":"10.2196\/17318","article-title":"Benefits of massive open online course participation: deductive thematic analysis","volume":"22","author":"Blum","journal-title":"J Med Internet Res"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012209.pub2","article-title":"Serious gaming and gamification interventions for health professional education","author":"Gentry","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-024-05154-2","article-title":"Clinical virtual simulation: predictors of user acceptance in nursing education","volume":"24","author":"Padilha","journal-title":"BMC Med Educ"},{"issue":"6","key":"R36","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1080\/10494820.2014.964263","article-title":"Gamification and student motivation","volume":"24","author":"Buckley","journal-title":"Interact Learn Environ"},{"key":"R37","doi-asserted-by":"crossref","unstructured":"Khalil M Wong J de Koning B Ebner M Paas F . Gamification in MOOCs: a review of the state of the art. Presented at: 2018 IEEE Global Engineering Education Conference (EDUCON); Apr 17-20, 2018:1629-1638; Tenerife, Spain. [doi: 10.1109\/EDUCON.2018.8363430]","DOI":"10.1109\/EDUCON.2018.8363430"},{"issue":"4","key":"R38","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023","article-title":"Global initiative for chronic obstructive lung disease 2023 Report: GOLD executive summary","volume":"61","author":"Agust\u00ed","journal-title":"Eur Respir J"},{"issue":"2","key":"R39","doi-asserted-by":"publisher","DOI":"10.38087\/2595.8801.166","article-title":"ANDRAGOGIA: INSTRUMENTO DE EDUCA\u00c7\u00c3O E ORIENTA\u00c7\u00c3O AOS ADULTOS","volume":"5","author":"Val\u00easka Ara\u00fajo Costa Lima","journal-title":"COGNITIONIS"},{"issue":"SPE1","key":"R40","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1590\/S0103-21002012000800010","article-title":"An\u00e1lise do uso de suportes tecnol\u00f3gicos e conte\u00fados informacionais pelos pacientes com doen\u00e7a pulmonar obstrutiva cr\u00f3nica","volume":"25","author":"Padilha","journal-title":"Acta Paul Enferm"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2017.09.005","article-title":"Clinical virtual simulation in nursing education","volume":"15","author":"Padilha","journal-title":"Clin Simul Nurs"},{"issue":"3","key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/11529","article-title":"Clinical virtual simulation in nursing education: randomized controlled trial","volume":"21","author":"Padilha","journal-title":"J Med Internet Res"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecns.2020.06.012","article-title":"Clinical virtual simulation as lifelong learning strategy\u2014nurse\u2019s verdict","volume":"47","author":"Padilha","journal-title":"Clin Simul Nurs"},{"issue":"6","key":"R44","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1097\/SIH.0000000000000186","article-title":"Improving nurses\u2019 peripheral intravenous catheter insertion knowledge, confidence, and skills using a simulation-based blended learning program: a randomized trial","volume":"11","author":"Keleekai","journal-title":"Simul Healthc"},{"issue":"4","key":"R45","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/SIH.0000000000000168","article-title":"Multisite single-blinded randomized control study of transfer and retention of knowledge and skill between nurses using simulation and online self-study module","volume":"11","author":"Rutherford-Hemming","journal-title":"Simul Healthc"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2023.105741","article-title":"Development and evaluation of a Massive Open Online Course (MOOC) for healthcare professionals on malnutrition in older adults","volume":"123","author":"Eglseer","journal-title":"Nurse Educ Today"},{"issue":"8","key":"R47","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.44152","article-title":"The effect of simulation training on enhancing nursing students\u2019 perceptions to incorporate patients\u2019 families into treatment plans: a randomized experimental study","volume":"15","author":"Khalil","journal-title":"Cureus"},{"issue":"13-14","key":"R48","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1111\/jocn.15701","article-title":"Virtual reality teaching in chemotherapy administration: randomised controlled trial","volume":"30","author":"Chan","journal-title":"J Clin Nurs"},{"issue":"1","key":"R49","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.rdc.2019.09.001","article-title":"Active learning strategies to improve progression from knowledge to action","volume":"46","author":"Torralba","journal-title":"Rheum Dis Clin North Am"},{"issue":"3","key":"R50","doi-asserted-by":"publisher","first-page":"e566","DOI":"10.1016\/j.teln.2024.04.003","article-title":"Comparative impact of active participation and observation in simulation-based emergency care education on knowledge, learning effectiveness, and satisfaction among undergraduate nursing students","volume":"19","author":"Jiang","journal-title":"Teach Learn Nurs"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2019.05.008","article-title":"MOOCs, an innovative alternative to teach first aid and emergency treatment: a practical study","volume":"79","author":"Chan","journal-title":"Nurse Educ Today"},{"issue":"2","key":"R52","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1177\/00178969231225060","article-title":"Motivations of learners enrolled on a Massive Open Online Course \u2013 \u2018The Science of Weight Loss: Dispelling diet myths\u2019","volume":"83","author":"Lim","journal-title":"Health Educ J"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.1016\/j.compedu.2018.04.012","article-title":"Exploring the impacts of interactions, social presence and emotional engagement on active collaborative learning in a social web-based environment","volume":"123","author":"Molinillo","journal-title":"Comput Educ"},{"key":"R54","unstructured":"Aydin CH . MOOCs as change agents. The 2018 OpenupEd Trend Report on MOOCs. 2018. URL: https:\/\/www.openuped.eu\/images\/Publications\/The_2018_OpenupEd_trend_report_on_MOOCs.pdf [Accessed 20-06-2025]"},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2019.02.004","article-title":"Who can benefit more from massive open online courses? A prospective cohort study","volume":"76","author":"Jia","journal-title":"Nurse Educ Today"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2020.104662","article-title":"The use of virtual reality simulation among nursing students and registered nurses: a systematic review","volume":"98","author":"Shorey","journal-title":"Nurse Educ Today"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2020.102818","article-title":"High fidelity simulation evaluation studies in nursing education: a review of the literature","volume":"46","author":"Hanshaw","journal-title":"Nurse Educ Pract"},{"issue":"3","key":"R58","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.anr.2020.07.001","article-title":"Examining knowledge, skill, stress, satisfaction, and self-confidence levels of nursing students in three different simulation modalities","volume":"14","author":"\u00dczen Cura","journal-title":"Asian Nurs Res (Korean Soc Nurs Sci)"},{"issue":"3","key":"R59","doi-asserted-by":"publisher","first-page":"227","DOI":"10.14235\/bas.galenos.2019.3416","article-title":"The effect of simulation-based training on the self-confidence and self-satisfaction of nursing students dealing with patients under isolation","volume":"8","author":"Karata\u015f","journal-title":"Bezmialem Science"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","first-page":"e176","DOI":"10.1016\/j.teln.2023.10.009","article-title":"Effect of a high-fidelity simulation-based teaching-learning experience (SBTLE) on maternal health nursing students\u2019 knowledge of postpartum hemorrhage, confidence, and satisfaction","volume":"19","author":"Alsaraireh","journal-title":"Teach Learn Nurs"},{"issue":"1","key":"R61","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/SIH.0000000000000411","article-title":"Virtual simulation in nursing education: a systematic review spanning 1996 to 2018","volume":"15","author":"Foronda","journal-title":"Simul Healthc"},{"key":"R62","doi-asserted-by":"publisher","DOI":"10.1016\/j.cedpsych.2019.101827","article-title":"Mobile technology, learning, and achievement: advances in understanding and measuring the role of mobile technology in education","volume":"60","author":"Bernacki","journal-title":"Contemp Educ Psychol"}],"container-title":["JMIR Nursing"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T20:42:13Z","timestamp":1752784933000},"score":1,"resource":{"primary":{"URL":"https:\/\/nursing.jmir.org\/2025\/1\/e72957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,17]]},"references-count":62,"URL":"https:\/\/doi.org\/10.2196\/72957","relation":{},"ISSN":["2562-7600"],"issn-type":[{"value":"2562-7600","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,17]]},"article-number":"v8i2e72957"}}