Article

Shaping the Future of Nursing Education

Today Using Distant Education and Technology

Abstract:

on Nursing" that provided the foundation for many curricula.

Today, nursing education is available through many diverse

settings and methodologies. One of the most evolving methods

is through distant education (DE). Evidence demonstrates

that the demand for DE is increasing across the United States

for students enrolling in DE classes to meet their personal

life style. In addition, the data reveal that more colleges and

universities are offering additional courses through DE. Today,

the Net Generation excels in the technological world with skills

that are easily adaptable to any form of technological device

or approach. Students desire teaching learning methods that

appeal to their cyber senses. Nursing faculty need to think

outside of the box regarding what type of learning environment

students prefer. Key concepts presented center on faculty

leadership, communication, organizational, collaborating and

problem solving skills needed within a DE program.

In 1860, Florence Nightingale, published "Notes

Key Words:

Synchronized and Asynchronized Learning

Distance Learning, Leaning Management System,

T

interest in colleges and universities, particularly among

nursing schools across the US. Nursing education

is available through many diverse settings using a variety

of methodologies. One of the most evolving methods is

through distance education. For purposes of this article the

authors applied the National League of Nursing Accrediting

Commission (NLNAC) 2008 definition of distance education

that states distance education can be defined as the educational

process that the majority of the instruction occurs when a

student and instructor are not in the same place utilizing audio,

video and/or computer technology (National League of Nursing

Accrediting Commission, 2008).

The Association of Pennsylvania State College and

University Faculties (APSCUF) that Slippery Rock University

is part of, defines distance education as instruction where

faculty members and students are separated geographically

oday, distance education (DE) has generated much

The ABNF Journal

so that face to face communication is absent; and where

communication is accomplished by one or more technological

media, allowing real time or delayed interactions using voice,

video, data, and/or text (Association of Pennsylvania State

College and University Faculty, 2007). Understanding how

various organizations define DE allows faculty the opportunity

to incorporate a variety of skills, ideas, innovative technology,

and software into the curriculum.

Recent research has demonstrated that the demand

for distance education among students in higher levels of

education is growing at a continuous rate. A study conducted

by Babson Survey Research Group in partnership with the

College Board completed their 5th annual report on the state of

online learning in U.S higher education entitled.

Five Years of Growth In Online Learning

2007). The surveyors received a 56% response rate from

colleges and universities across the U.S. (n = 4491), which

yielded a total of 2535 responses (Allen & Seaman, 2007). The

following five key questions were asked:

1. "How many students are learning on line?" The

researchers reported that 3.5 million students were

learning online and at least one online course was

taken during the fall semester of 2006, a 9.7%

increase from the previous year. Students enrolled

in at least one online course made up 20% of total

enrollment in U.S higher education system during

that same year (Allen & Seaman, 2007; p.l).

2. "Where has the growth in online learning occurred?"

Leading the way was the Associate degree

institutions, which had the highest growth rate for

students taking at least one online course during Fall,

2006. Conversely, baccalaureate institutions had

fewer enrollments (Allen & Seaman, 2007; p.l).

3. "Why do institutions provide online offerings?" The

majority of responses indicated that the number one

reason was to improve student access to educational

programs. An increased rate of degree completion,

and the high appeal to non-traditional students in the

area of continuing and professional education were

Online Nation(Alien & Seaman,

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the two other reasons given. To reduce or contain cost

was the least cited objective (Allen & Seaman, 2007;

p.2).

4. "What are the prospects for the future online

enrollment growth?" Sixty-nine percent of academic

leaders concur that the student demand for online

learning continues to occur. Resultantly, 83% of

current institutions plan to expand their existing

programs. On the other hand, past growth of online

enrollments resulting from new institutions initiating

programs academic leaders believe is nearing the end

(Allan & Seaman, 2007; p. 2).

5. "What are the barriers to widespread adoption of

online education?" The barriers cited were lack of

discipline by students, faculty acceptance, higher

costs for online development and delivery, and lack of

acceptance of online degrees by potential employers

(Allan &seaman, 2007; p. 3).

This paper will present characteristics of the nursing

faculty within a RN to BSN completion program identified as

essential for facilitating a web-based DE program.

TYPES OF INSTRUCTION/LEARNING IN A DE

PROGRAM

Instruction within a DE program may be synchronized

or asynchronized, meaning one may participate online

independently of other students, or simultaneously with

other students and faculty at prearranged times. There are

multiple advantages and disadvantages to either synchronized

or asynchronized learning via distance education (Denard-

Goldman, & Jahn-Schmalz , 2007). Zsohar & Smith (2008)

have identified three distinct benefits of asynchronized learning.

These benefits include the following, that students: a) have an

increased amount of time to prepare responses, b) do not have

the ability to interrupt other students when speaking, and c)

have access to a written record of all discussions for future use

(Zsohar & Smith, 2008). Disadvantages of using asynchronized

learning include: a) the loss of personal direct contact, b) the

loss of spontaneity in responding to questions, and c) limitations

to the type of discussion faculty can pose (Zsohar & Smith,

2008 and Anderson, 2009).

Similarly, the literature also reflects disadvantages and

advantages within synchronized learning. The advantages

cited included: a) increased communication; and b) increased

savings in time and money due to ability to meet on line versus

traveling to a designated location . Disadvantages include

technological issues with initial setup, and difficulty in the use

of audio functionality (Little, Passmore, & Schullo, 2006).

Although literature provides various views on the advantages

and disadvantages of synchronized versus asynchronized

learning, the authors believe the course content, type of

technology/software used, and skill level of the faculty leading

the course will determine how the student or faculty will view

what is or is not an advantage or disadvantage.

TRANSITIONING CURRICULUM

In 1974, Slippery Rock University Department of

Nursing began its first RN to BSN completion program, which

was approved by the National League of Nursing Accrediting

Commission in 1981 (National League of Nursing Accreditation

Commission, n.d.). Later, in 1998, responding to the needs of

registered nurses returning to school for a bachelor's degree, the

visionary academic leaders began curriculum redesign and use

of technological advancement to develop the first DE program

on campus. In the early stages of development, DE at Slippery

Rock University offered only a few courses via a web-based

learning management system called Blackboard (BB). This

form of instruction meant that students would only receive a

portion of the course content through online instruction, while

the remaining content was delivered face- to- face via teacher

led instruction in the traditional classroom format. This method

of content delivery is known as a hybrid web-base course.

CURRENT STATE

Today at Slippery Rock University, through a series of

curriculum revision and course redevelopment all nursing

courses/programs (including the RN to BSN, the School Nurse

Certification program, and the RN to MSN Program) are

offered entirely online using some form of web-based advance

technology. Students can access the course any time of the

day or night at their convenience and be actively involved

in learning. In addition, students from various geographical

locations throughout the United States have the ability to

interconnect through discussion board assignments and group

activities, to further discuss issues that may impact multiple

states within the United States.

Since the inception of the RN to BSN program at Slippery

Rock University, there has been continued growth in student

enrollments. Since 2001, Slippery Rock University has seen a

steady increase in student enrollment across all programs, with

an approximate 55% growth in the RN to BSN program (Figure

1). Currently, all nursing programs utilize Black Board version

7.3, a web-based learning management system. The authors

need to note that the RN to MSN program was placed on hold

in December, 2008, until a feasibility study can be completed to

further expand the program. Presently, nursing faculty continue

to critically evaluate the current distance education curriculum

in an effort to expand existing programs and meet the needs of

society, such as offering continuing education units for nurses

online.

ROLE OF FACULTY

Faculty Certification

At present, all nursing faculty are required to complete a

certification program for online instructors. This requirement

was mandated by administration at the university level, in an

effort to validate that all faculty teaching online possess the

skills needed to deliver educational instruction successfully.

Requiring faculty to be certificated as distant educators has been

well received by other institutions that offer distance education (

Lorenzetti, 2009).

Faculty as Leaders

There are certain attributes that faculty must possess

when teaching within a distance education program. Faculty

leadership is one of the critical components for directing courses

via DE. Faculty leadership is essential for: a) high quality

teaching and learning, b) innovative curriculum development,

c) facilitation of student interaction online, and d) promotion of

student engagement in DE activities.

Teaching at a distance requires extensive preparation

and organizational skills. Faculty can exercise a great deal of

leadership through organizing innovative and intellectually

challenging courses while at the same time supporting student

self directed learning. Faculty's organizational skills must have

the flexibility to be proactive in anticipating student questions

in order to address similar questions from multiple students in

a consistent manner; to manage information in an electronic

format, from storing emails, to saving original assignments

versus graded assignments; and, to create opportunities for

students to socialize via the internet, such as group assignments.

Faculty as Resource

The faculty leader acts a resource person for the distant

learner and provides support and ensures quality learning. One

of the critical resource responsibilities faculty have in a DE

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program is the ability to be visible to their students supporting

the traditional accessibility of faculty in person on a weekly

basis, as well as the visual comfort of seeing and hearing an

instructor. As an instructor who is well organized and manages

his or her time wisely, there are many ways in which comfort

through visualization can occur for students. Examples include

prerecording welcoming videos, using various software, such as

Wimba for synchronized audio/visual communication for office

hours, or using the latest technology such as Sonic Foundry for

videotaping of weekly lectures or study guide reviews. Faculty

often becomes the technological resource for helping students

with any technologic problems.

Faculty as Collaborators

Faculty have a responsibility to seek peer collaboration

within a DE program, which can be challenging, as well

as rewarding. Faculty need to work closely with various

departments that are associated with Information Systems,

instructional curriculum design, and technology integration.

Through faculty development, opportunities can be created

for faculty and various department to learn together to provide

.the best services possible, highlight and address organizational

issues that may impact success, and create an atmosphere that

empowers teams while offering rewards for collaborative efforts

(Steinert, 2005),

Today, the Net Generation excels in the technological

world with skills that are easily adaptable to any form of

technological device or approach> Faculty need to embrace

the functionality of recent technology and incorporate

the technology into the DE class room (Skiba, & Barton,

2006), Incorporating functionality such as Blogs, WIKIS, or

TWEAKS would strongly support student collaboration in a

positive manner, by providing the source/platform for sharing

documents, revisions, or just information in general.

Another source of collaboration that is critical for the

distant learning environment especially within a nursing

academic program is with the support from the institution's

library (Lee, 1999), The ability of'having students access

electronic materials such as data bases, electronic journals,

and/or electronic books is essential to support the concepts of

evidence-based practice or evidence-based research. Faculty

need to work closely with librarians to establish a well defined

list of "distant learning library services" that will be available

to students once enrolled (Barron, 2002, pg, 27) Understanding

how to navigate a web browser to complete a literature search

or how to request paper materials from a library located

thousands of miles away is vital to a student's success.

Faculty as Communicator

Effective communication skills, both oral and written are

necessary for a faculty leader to be an effective communicator.

The DE faculty develops and encourages good interpersonal

relationships among students enrolled in the online program.

These relationships will help facilitate cooperation among all

students. There are a variety of methods and tools available

to promote student communication and discussions within a

DE program, VandeVusse and Hanson (2000) conducted a

study that identified six categories that describe how nursing

faculty can communicate effectively to facilitate student

involvement online. These categories include a) assist student

with navigation, b) explain expectations of students, c) clarify

the role of faculty, d) stimulate critical thinking, e) share

one's expertise, and f) offer encouragement. To help make the

distance learning environment a pleasant, comfortable and

inviting place, faculty need to introduce good communication

skills, such as netiquette rules of behavior for communicating

online, Netiquette is defined as network etiquette that provides

direction for applying common courtesy when communicating

online (Netiquette Home Page, 2006), Various guidelines can

be followed to ensure proper communication. Shea (1994)

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has identified 10 core rules of etiquette that one should follow

when communicating via the internet. Three of these rules

include: a) "respect other people's time and bandwidth", b)

"make yourself look good online", and c) "be forgiving of other

people's mistakes" (Shea, 1994, p 39-45), Netiquette guidelines

need to be available for student use when sending emails; when

engaging in dialogue via discussion board postings, an online

forum for sharing written communication; and, when working

collaboratively on group assignments.

Students within a DE program are not able to see

body language and facial expressions as typically used

within a traditional classroom setting. Students and faculty

must be concerned with the tone of the written text or risk

misinterpretation of the written content. For example, use of

bold capital letter may be interpreted as anger, A good practice

is to inform students of the established netiquette rules in order

to help decrease miscommunication among distance education

users.

In addition to communicating with students, it is important

to communicate with other faculty members teaching online

courses. For example, tools used to evaluate websites that are

introduced to students in one DE course may be useful to other

faculty who may want to incorporate the tool into courses. This

sharing of ideas will promote the use of consistent teaching

methods building a stronger foundation of resources for students

reducing the potential for confusion and frustration.

Faculty as Manager of Time

As nursing faculty within a DE classroom, the traditional

role of educator becomes expanded to include additional

responsibilities. For example, how one manages his or her time

must incorporate the time needed to review and respond to

discussion board questions on a weekly basis; to assess student's

ability to access exams or posted weekly course content; and to

respond to student communication in a timely manner whether

through discussion board forums, email, voicemail or phone

conversations.

Within an asynchronized DE program, students attend

class independently of each other at various hours of the day or

week. Within these varied times students may have questions

that require immediate feedback, or experience issues that

require immediate resolution, such as inability to complete

exams. Common reasons for student's inability to complete

exams are the result of being "locked put of the test bank,"

Other problems students may experience include inability to

view information posted within a weekly class, due to sorhe

technical issues in the platform used to deliver the class content/

material. As DE faculty we need to alter the way that we deliver

educational content using the skills described above, but more

importantly we need to change the process and manner that we

assess and evaluate student outcomes.

Faculty as Evaluators

Grading papers and assessing outcomes can be conducted

in the traditional fashion through the use of quizzes and

exams that incorporate multiple choice questions, matching,

fill in the blank, essays, and project assignments requiring

PowerPoint presentations. But with DE, faculty need to

consider other variables that may impact their role or ability to

view documents. Standard software must be approved by the

institution and communicated to all students, so that multiple

files or attachments can be shared among students and faculty.

Difficulty in opening the documents occur as a result of students

attempting to use software programs such as Word Perfect, and

Microsoft Works versus the institutional approved software such

as Microsoft Word,

Another situation that may arise occurs when students

purchase a different type of computer system with distinct

operating software, such as an Apple Computer that requires the

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conversion of documents if not saved correctly, which often

necessitates using the university-approved software applications

to make the conversion. This incompatibility results in an

increased amount of time for faculty to resolve. Faculty must

attempt to open the files using various applications, initiate

additional communication to students to resend documents in

different format or file type, or delete a student's initial attempt

to submit original files for resubmission in the DE course

management system.

Developing quizzes or exams requires some basic

understanding of how a DE or online course management

system operates, such as BlackBoard. Some technical skills are

required mainly to navigate various screens which consist of

unique functionality that allows faculty to have control on what

students can view, the format in which they see content, the

time period when content becomes visible to students, and the

amount of time they have to take exams. Having control within

the online management system allows faculty to become more

organized and efficient in managing course content.

Although DE requires faculty to become experienced

with these technical sldlls, there are many positive factors

that DE and an online course management system offers. For

example, when administering tests that have multiple choice

or matching questions, the system automatically grades the

questions, provides feedback (if entered by faculty member)

and provides students with a instant grade (if faculty permits).

Documents completed by students can be easily submitted and

viewed within the online system allowing the organization of

information to be conducted electronically. Most Information

Systems Departments have a process in which online

management systems are backed up and saved for future needs,

allowing easy retrieval.

Another positive outcome DE offers faculty is the ability

to work from any location, state or country as long as internet

services are accessible. Teaching in a DE program allows

faculty the freedom to work from home and take time to travel

for scholarly activities.

CONCLUSION

Over the past 5 years, the concept of teaching online

has gained attention and acceptance at various universities or

academic institutions due to student demand, has improved

student access to the internet, has greater appeal for nontraditional

students, has increased flexibility of class schedules

due to expansion/growth of online programs, and has increased

rates of degree completions (Allen & Seaman, 2007). Today

at Slippery Rock University, we are shaping the future of

nursing education through the use of innovative technology.

As nursing continues to change and grow as a profession and

as a discipline, so must the manner in which we prepare our

nurses for today's healthcare challenges. The integration and

utilization of technology within the educational classroom, as

well as the home environment, has become widely available

and accessible. Technology within healthcare organizations has

become so widely accepted that academia must incorporate it as

part of the educational curriculum and academic preparation.

The use of technological tools is rapidly becoming

the norm and expectation of individuals seeking the most

sophisticated functionality and accessibility, in the performance

of every aspect of daily living. From cell phones, to

blackberries, to text messaging, to blue tooth technology has

touched all of our lives personally, as well as professionally.

Leading with technology through the use of distant education

is an alternative that may appeal to nursing faculty, in an

effort to keep the spark alive within the teaching and learning

environment of professional nurses.

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Diana P. Jones, EdD,

the Department of Nursing at Slippery Rock University in

Slippery Rock, PA, where she teaches in a RN-BSN distance

education program. She received her EdD from Northern

Illinois University in DeKalb, Illinois in Adult and Higher

Education, her MS and BSN from Purdue University Calumet,

Hammond, Indiana; Dr. Jones' scholarship focuses on breast

cancer among, African American women, and teaching with

technology. Dr. Jones may be reached at: diana .jones @sru.

edu or 724-738-2505.

Professor of Nursing at Slippery Rock University and adjunct

Professor at Robert Morris University. Her academic

curriculum focuses on healthcare informatics and delivery of

nursing care in a managed care environment. Her primary

research focuses on patient centeredness and how nurses can

utilize a new model of care to address the individual needs of

patients.

CNS, is an Assistant Professor inDebra M. Wolf, PhD, is AssociateThe ABNF Journal Spring 2010

Diana P. Jones, EdD, CNS and Debra M. Wolf, PhD