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IADIS International Conference WWW/Internet 2010learning of nursing skills (hereinafter designated as the system) based on results of the interviews.3. RESULTS3.1 Characteristics of how Nurses and Nursing Students Perceive Knacks ofIntravenous InjectionResults of the interviews revealed that the knack of intravenous injections most often perceived by nursingstudents was “selection of a blood vessel” (14 people), followed by “feeling and sense at needle insertion” (8people), “syringe fixation” (5 people), and “arrangement of articles and procedures” overall (5 people). Onthe other hand, the contents of knacks perceived by nurses were “selection of a blood vessel” (17 people),“feeling and sense” (3 people), and “image simulation” (3 people). Linguistic expressions differ from nurseto nurse in terms of the sensation of fingers at selecting a blood vessel or inserting an injection needle. Forexample, it was expressed as “smoothly” or “without hesitation” at needle insertion, which indicates thatsuch a sense of speed is important.Many nursing students and nurses recognize“selection of a blood vessel” as a knack. However,regarding selection methods, nurses answered visualinspection or feeling by touch based on their own realfeelings, whereas students gave answers such as“engorging (or tying) sufficiently” and “understandinganatomy”. Furthermore, regarding “feeling and sense”,they recognized others’ experiences that would beknacks in the future, such as “It is better to capture asense of entering a blood vessel”, as knacks, but nottheir own real, experienced feelings. It would be goodfor nursing students to be able to learn knowledge (tacitknowledge) that experts have gained throughexperience.On the other point, the differences of intravenousinjection skill between nurses and nursing students were “how to hold the syringe”, “angle of needle prick”,“how to stretch the skin”, and so on(Figure 2).3.2 Overview and e-Learning System CharacteristicsLinguistic expressions differed among nurses in termsof the sensation of fingers that nurses recognize atperceiving blood vessels by touch or inserting aninjection needle. This suggests that formal knowledgeby visualization would be better than that byverbalization to share and use know-how of nursingskills which cannot be verbalized.Consequently, the developed e-learning systemdescribed herein assigns importance to handling imagesto enable visual learning. In addition, because manynursing students consider precise implementation ofprocedures as technical “knacks”, the instructionaldesign consists of the following four phases:Figure 3. The screen of technical procedures check1. Identification of one’s own technical procedures;2. Comparison of model images with one’s own technical images;3. Comparison of each image in one’s own practice progressions; and4. Output and identification of learning results.A NurseA Nursing Student< Difference between nurses and nursing students ># How to hold the syringe# Angle of needle prick# How to stretch the skinFigure 2. The differences of intravenous injection skillbetween nurses and nursing students401