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Course development for web-based nursing education programs
Nurse Education in Practice xxx (2014) 1e6
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Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Course development for web-based nursing education programs Vicki A. Schnetter a, *, Darlene Lacy a, Melinda Mitchell Jones a, Khadija Bakrim a, 2, Patricia E. Allen a, 3, Cynthia O'Neal b, 1 a b
Texas Tech University Health Sciences Center School of Nursing, 3601 4th Street, Lubbock, TX 79430, USA Texas A & M University, Corpus Christi, College of Nursing & Health Sciences, 6300 Ocean Drive, Unit 5805, Corpus Christi, TX 78412, USA
a r t i c l e i n f o
a b s t r a c t
Article history: Accepted 16 June 2014
Developing and launching online programs requires nurse educators to reframe content and rethink traditional teaching methodologies. Creating a framework for course design and standardization of templates can result in online learning that is student centered while allowing the institution to scale up enrollment with quality education at the core. This article explores the considerations needed for effective, interactive online course delivery in nursing education. Working in conjunction with other university technology stakeholders, nurse educators can select the learning management system with the features that will work best for the program, develop the course structure and organization through adherence to template rules for both syllabi and course modules, and develop appropriate learning activities to assure student exposure to content identified in the course objectives. With these structure pieces in place process becomes the second focus for nurse educators in online programs. Process activities for active engagement are discussed. © 2014 Elsevier Ltd. All rights reserved.
Keywords: Course content Course development Nursing education Educational technology Learning environment
Online learning in nursing education is expanding rapidly and has been heralded as a panacea for being able to nimbly meet nursing shortage demands as well as to elevate the education level of nurses. The United States is expected to experience a shortage of nurses as Baby Boomers age and require more healthcare. Meanwhile nursing schools are struggling with capacity issues to produce nurses and meet the demand. The volume of employed nurses is predicted to grow 26% with the number of job openings resulting from growth and replacements of the nursing workforce reaching 1.2 million by 2020 (American Association of Colleges of Nursing, 2014). The United States is not alone in facing this crisis, healthcare worker shortages exist globally. The World Health Organization (WHO) indicates that in 57 countries there are less than 2.3 nurses, physicians, and midwives for every 1000 people (Callister, 2012). The International Council of Nurses cites numerous challenges for increasing supply to meet demand: gender-based discrimination, violence against healthcare workers, internal and international * Corresponding author. Tel.: þ1 702 375 2001. E-mail addresses: [email protected] (V.A. Schnetter), Darlene.lacy@ ttuhsc.edu (D. Lacy), [email protected] (M.M. Jones), khadija.bakrim@ ttuhsc.edu (K. Bakrim), [email protected] (P.E. Allen), cynthia.oneal@ tamucc.edu (C. O'Neal). 1 Tel.: þ1 361 825 2244. 2 Tel.: þ1 806 743 4248x227. 3 50 Silkbay Place, Woodlands, TX 77382, USA. Tel.: þ1 806 543 4760.
migration of nurses, and the ramifications of HIV/AIDS particularly in developing countries (Rosenkoetter and Nardi, 2007). The preparation of a highly educated workforce is essential in overcoming these challenges. The nursing shortage coupled with the movement to advance the education levels of the profession, has resulted in online expansion of nursing programs. In the United States, thousands of registered nurses are returning to school for bachelor's degrees and beyond. With the 2010 call for eighty percent of nurses to have baccalaureate preparation by 2020, the Institute of Medicine (IOM) has raised the bar for many states where only 40e50% of the nurses possess a Bachelor of Science in Nursing (BSN) degree. The IOM call for 80 by 2020, technology availability, and mobile learning have created a recent surge particularly amongst online programs targeted for associate degree nurses to obtain a baccalaureate degree. Additionally, the complexity, diversity, and global context of nursing require more nurses to be prepared at the master's and doctoral levels (Thorne, 2006). Thus, the growth in online programs for advanced degrees is also expanding exponentially. Globally, advancing nursing education is viewed as pivotal to meet the demands for quality healthcare through scientifically sound contributions. A well educated workforce has a crucial role in positive patient outcomes and decreasing mortality (Aiken et al., 2002, 2003; Daly et al., 2008). The Global Alliance for Nursing Education and Scholarship (GANES) was established by four nursing education organizations and strives to improve patient care by
http://dx.doi.org/10.1016/j.nepr.2014.06.007 1471-5953/© 2014 Elsevier Ltd. All rights reserved.
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ensuring highly educated nurses are in supply around the world. They are committed to expanding the educational opportunities of nurses and addressing student enrollment issues (Rukholm et al., 2009). This mission may be facilitated by the unique features of online education. Traditional education models have catered to local communities driven primarily by synchronous teaching and learning activities operating within specific time and space constraints. The birth and subsequent growth of online education programs has transcended geographic boundaries and has been spurred by asynchronous teaching and learning strategies without the same space and time restrictions commonplace with on campus course delivery. Online course delivery takes the education realm from that requiring physical presence or delayed transmission (in the case of correspondence courses) to expanding worldwide for instantaneous education delivery if desired. These driving forces have resulted in the proliferation of online nursing education programs. However, developing and launching online programs requires nurse educators to reframe content and rethink traditional teaching methodologies. Before moving into the essentials of course preparation, educators must first reflect on the faculty philosophy of learning. A frank discussion with the inclusion of all faculty centered on educational beliefs will enhance the success of course development and implementation thus improving learning effectiveness. Questions for discussion include the following: Are the faculty committed to creating student centered approaches to nursing education? As we enter what has been labeled the “Connected Age” we continue to create the pathways of communication (Ito et al., 2013). We now tweet, text and tag as well as provide massive open online courses (MOOC). One recent study of over 112,000 students noted no longer are desktops the predominant way to connect, 76% of students have smartphones, 89% have laptops, and 58% have three or more connective devices with the third device being a tablet (Dahlstrom et al., 2013). This new data has implications for “who” we are teaching and how we should engage with the student. Will the notion of what is best for the student be at the center of the philosophy? If so, then age old discussion of what is “academic freedom” and what is “quality” can be hammered out and courses can be designed based on optimizing student learning. The theme “it takes a team to educate a nurse” fits the underlying philosophy to course design described in this article. Creating an organizing framework for course design and standardization of course templates can result in a path to online learning that is student centered and allows the institution to scale up enrollment with quality education at the core thus expanding access and contributing to increasing the supply of highly educated nurses. This article explores the current considerations needed for effective, interactive online course delivery using the work of the Sloan Consortium on the “five pillars of online education”. These pillars speak to learner effectiveness, student satisfaction, faculty satisfaction, cost effectiveness and access (Lorenzo and Moore, 2002). Learner effectiveness According to the work of the Sloan Consortium, the pillar of learner effectiveness encompasses the notion that the quality of online learning should be comparable to the quality of traditional programs with emphasis on studentestudent interaction, facultyestudent interaction, methods of engagement, online course design, communication, learning outcomes and metric tracking (Moore, 2005). For online courses, the use of effective teaching principles has been rooted in theories such as behaviorism, cognitivism, constructivism or scaffolding to frame effective online learning. Theories such as these can provide a pivotal foundation
for the development of effective teaching strategies. Bangert and Easterby (2008) examined the design and launch of online courses. The authors cite the seven principles of effective teaching (Chickering and Gamson, 1991) as the lens through which the course development and delivery was explored. The designers used constructivist theory to evaluate the methodologies of course delivery and, through student evaluation, identified positive outcomes for student centered delivery. Foundational theories or frameworks such as cognitivism, behaviorism, constructivist theory, scaffolding theory and principles of effective online learning have been found to aid in understanding online course design (Gromley et al., 2012; Holtslander et al., 2012; Cooperman, 2007). Online course design begins with the choosing of a learning management system (LMS) application. LMS applications provide a platform to support distance education or supplement traditional way of teaching (Georgouli et al., 2008). LMS is defined as a webbased technology designed to support learning and teaching. Some of the main advantages of using LMS from the students' as well as instructors' point of view are: easy access to information e anywhere, anytime, keeping track of progress in a course, and ease of arranging off campus meetings with instructor and students in a virtual environment (Iqbal and Qureshi, 2011). LMS advantages for the instructor include: convenience in providing additional resources besides class lectures, providing timely feedback to students on their progress, monitoring and tracking students' participation. LMS provides a variety of tools and options to present instructional materials, directions to complete learning activities, and interactions with peers and instructors. For example, the file management feature allows flexibility to upload any multimedia file or documents as well as organize the release and display of the files. The communication tools facilitate interaction with the instructor, peers, and content. The assessment tools evaluate students' learning. Koszalka and Ganesan (2004) created a taxonomy that describes common LMS tools and categorizes them into information, instruction, and learning elements with examples of their value for teaching and learning. Each tool has unique characteristics that can be used to engage learners with course content in multiple ways. The intent is to prompt developers to think strategically and make decisions that will support the course and learning goals. The various tools in LMS are enticing to use, but they not equate to good design. Lack of knowledge of instructional design principles tend to lead to an ill-informed selection of features that are not aligned to course objectives (Gilbert and Moore, 1998; Kidney and Puckett, 2003). The tools do not however ensure that the learner will meet the learning expectations (Koszalka and Ganesan, 2004). The appropriate use of the tools, accompanied by sound pedagogy and relevant content help the learners achieve the specific goals of the course (Carmean and Haefner, 2002; Vrasidas, 2004). The automation of easy-to-populate templates and standardization appear to be an efficient method to build an online course, especially for instructors who are confused or uneducated about the effective use of features in the LMS (Gilbert and Moore, 1998; Kidney and Puckett, 2003). LMS support teaching and increase efficiency via various management features, assessment options, and communication tools. The file management feature allows flexibility to upload any multimedia file or documents, and organize the release and display of the files. LMS also offers ways to manage group communication. Consider a course with 30 students each submitting ten assignments, posting thirty messages, participating in two group projects, and uploading a final project. The number of e-mail interactions generated could be large. Techniques aimed at limiting the number of repetitive questions include encouraging students to answer each other's queries in the discussion board and posting a list of frequently asked questions.
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Assessment tools are critical in the learning process and are an integral part of most LMS. Important features include: creating a quiz pulled at random from a pool of questions; allowing more than one opportunity to take the quiz while maintaining a record of all attempts; permitting selective release of quizzes based on factors such as date, completion of assignments, and score on a previous quiz; and permitting anonymous responses to surveys. Research indicates that frequent student-teacher and studentestudent communications are very important for effective online learning (Gunawardena et al., 1997). Common communication tools provided by LMS include discussion boards, chat rooms, and in course email. Some LMS platforms provide synchronous communication through audio, video, and/or chat rooms. Synchronous communication relies on students being online at the same time and may be used for group collaboration and for virtual office hours. Discussion boards are used for asynchronous interaction for the entire class or a specific group of individuals. It also includes the ability to record a log of conversations, which in turn helps tract participation. In course email is also asynchronous and allows a way to keep all communication within the system and tracked. The effectiveness of online courses will depend on the appropriate use of the tools, accompanied by sound pedagogy and relevant content (Carmean and Haefner, 2002; Vrasidas, 2004). There is not one correct way to teach, hence there is no single LMS solution. LMS are a tool that should be used to support rather than replace good teaching (Barron, 2003). Once the pathway for accessing the course has been determined, the development of the course content can be addressed. The Carnegie Mellon University website (Anonymous, 2012) identifies the importance of aligning objectives, assessments, and instructional strategies. Given that mastery of course objectives is the goal for courses, there should not be additional module objectives. Module objectives can create loss of focus and loss of the alignment of the three components. The process of content delivery is key to successful online courses. Thus, review of objective development and course learning activity inclusion is fundamental to the development of quality courses. Thompson (2008) identifies useful course objective components as audience, behavior, condition, and degree. The audience is the student; behavior is the overt, measurable behavior of the student; condition is how and under what conditions the student demonstrates mastery; and degree is the level of performance. Design of objectives and learning activities incorporates the process of online learning. Although structure of course design is pivotal to success; process of content delivery is also key to successful online courses. Therefore, review of objective development and course learning activity inclusion is fundamental to the development of quality courses. An objective is specific and measurable. An objective should focus on knowledge, skills and attributes students are expected to achieve and demonstrate as well as give students information regarding what they can expect and how they will be assessed. There should be no doubt in the student's mind what is expected in a course when reading the course objectives. Thompson (2008) identifies useful components of course objectives as audience, behavior, condition and degree. The audience is the student; behavior is the overt and measurable behavior of the student, condition is how the student demonstrates mastery and under what conditions and degree is level of performance. The selection of learning activities evolves from the course objectives. When considering learning activities, Benner et al. (2010) suggest effective strategies fostering the development of saliency: (1) build on what has already been learned, (2) guide thinking by posing questions relevant to patient situations, (3) allow for ideas related to approaches and possible complications to be expressed, (4) guide reflection on practice. Reflecting on subjective questions
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from case studies and interviews can provide insight and perspective transformation (Morris and Faulk, 2012). To allow students to express their ideas for, approaches to and possible complications empowers the students. The use of unfolding case studies, interview of patients and debriefing from simulation are ways to encourage students to express their ideas and approaches to safe patient care. Case studies help students reflect, asking about the nursing importance as well as what other information is needed to make decisions related to this case. Morris and Faulk (2012) suggest self-reflection/dialogue to explore value conflict and clarification to move students to having a sense of salience. Dialogue can take place on forum threads and allows for ideas to be shared and insight to be gained. The Penn State Learning Design Community Hub provides examples of activities by learning objective type. For objectives related to facts, activities may include self-check quizzes, trivia games, and matching terms with definitions. For concept focused objectives, sample activities are student generated flowcharts, concept maps, writing papers, discussion board postings, and journaling. When rules and principles are the emphasis, activities such as designing projects and prototypes or participating in simulation and debriefing of the simulation experience are appropriate. Activities such as case studies, small group discussion, debates, clinical reasoning exercises, and teamwork are examples of problem-solving level of learning as well as using computer-mediated activities. There are many examples of online learning activities that fall outside traditional learning activities, i.e. blogs, facebook, webx, online chats, etc. However, there are also many learning activities that are used in both traditional and online courses such as case studies, writing assignments, objective and subjective assessments and self-reflection are just a few. The development of critical thinking skills in online learning environments has also been an important subject of exploration and inquiry. Saade et al. (2012) found that the development of critical thinking skills in e-learning environments occurs in interactive courses focusing on high order thinking skills in virtual environments. To encourage critical thinking in new environments that embrace the web as a source for learning, Reynolds et al. (2012), found a Web 2.0 tool to be very beneficial. From the Web 2.0 tool, the investigators selected the Web Resource Appraisal Process (WRAP) software to facilitate critical review skills and question of the evidence by students. The findings noted participants found this tool to be instructive and useful (Reynolds et al., 2012). Evaluation of online courses is an integral part of establishing optimum learning environments and quality. The evolution of online education has resulted in a multi-pronged evaluation approach. Evaluation can support and provide evidence for ensuring institutional program and course quality. Spurred by the contention that online education may not deliver the equivalent quality as compared to traditional education delivery methods, various researcher, organizations, and accrediting bodies have generated standards, guidelines, and best practice recommendations for online course delivery (Little, 2009). Examples include the Sloan Consortium, the Commission of Collegiate Nursing Education, the American Federation of Teachers, the Council for High Education Accreditation, and the Council of Regional Accrediting Commissions. Scale (cost effectiveness and commitment) and access The pillars of scale and access focuses on the provision of continuously improving services while reducing cost and providing an array of courses (Moore, 2005). To this end, some nursing schools in the United States have embraced partnerships with companies utilizing a business model to scale up enrollments and deliver courses on a large scale. Academic Partnerships is one such
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company which partnered with University of Texas at Arlington. The partnership enabled the university to increase enrollment from just over 1900 in 2008 to over 6300 in 2012 (UT Arlington College of Nursing Honored for Increasing Bachelor Degree, 2013). The company uses marketing approaches to package the programs in an economically attractive fashion coupled with assisting the university to create short term courses offered more frequently than the semester or quarter system calendar. Some critics of the business model cite that the large volume of students decrease faculty interaction, lowers the quality of activities feasible with the volume, and diminishes the educational experience (Stripling, 2009). The demand for increasing volume while maintaining quality continues to be a consideration for balancing student enrollment numbers. Additionally, access to course content can now move beyond the LMS constraints thereby increasing access and flexibility. There are now options for eliminating use of the LMS through using various “cloud” computing options. Cloud computing is defined as a term for “networked computers that deliver IT services over the internet to many users in an on-demand environment” (Thomas, 2011, p.218). The type of services includes many types of consumer needs and has far reaching implications for higher education. Applications such as Softchalk offer the way to enhance the presentation of content and augment the interaction capabilities through innovative course design capabilities. Courses can be designed and accessed with a web link. The cloud also offers the sharing of content and peer review. Users no longer have to be concerned with configuring, purchasing and maintaining a system. The cloud is scalable and flexible (Thomas, 2011). Another version of high volume education access has been the development and innovation of massive open online courses commonly referred to as MOOCs which started populating the internet in 2008. Interest in MOOCs is high but the evaluation of the sustainability and value has yet to be determined (Skiba, 2013). Faculty satisfaction The faculty satisfaction pillar pertains to the ability of faculty to be pleased with teaching online and achieving success (Moore, 2005). The role of faculty development comprises an observed trend in the literature pertinent to online course delivery. The transition from a face to face delivery to a web-based style of teaching and learning has been explored (Zsohar and Smith, 2008; Cobb et al., 2001) especially in light of the challenges associated with the provision of adequate faculty development. The creation of meaningful courses where learners are actively engaged (and satisfied) is an important topic for faculty development (Murray et al.,, 2006; Vitale, 2010). Faculty proficiency with managing online learning platforms and utilizing appropriate techniques to engage learning is now being viewed as essential for online course delivery. Thus, faculty development opportunities are necessary in these areas. Evaluation of courses and faculty is an important aspect of teaching success. Entities such as Quality Matters, have developed rubrics for evaluation (Little, 2009). The rubrics may be used in the planning of a course, may be a source for faculty self-evaluation prior to the implementation of a course, and may be part of the peer review process for assessing compliance with best practice standards. At Texas Tech University Health Sciences Center, an evaluation matrix was developed specifically for online course delivery evaluation and serves as a guide for faculty to design courses consistent with quality standards. The areas addressed are: course introduction/information; course content; learning activities and assessment; interaction and communication; student support; and accessibility. See Appendix A for the matrix.
Evaluation can also serve as a guide for faculty in identifying expectations about course delivery strategies and be a springboard for faculty development opportunities. The evaluation process can be utilized to support peer review processes and enhance collaboration between peers (Little, 2009). Student satisfaction The pillar of student satisfaction focuses on student pleasure related to their learning experience including interaction with instructors and peers, learning outcomes that match expectations, services, and orientation. Students are successful in learning online and are typically pleased with their experiences (Moore, 2005). Student satisfaction is often driven by the course appearance and navigation as well as by the expression of course expectations in the syllabus. The organizing framework and structure of the online course within LMS becomes pivotal, particularly for considering how to structure the “classroom” milieu. Rather than entering a classroom and passively listening to the teacher, students are required to actively seek, find, select, and interpret information primarily delivered in a written format. In a traditional setting, students may experience information that is verbal as well as written, with the student also scribing notes related to the content. While online settings often include video, podcasts, and other visual or verbal delivery methods, the information related to the syllabus and assignments tends to be presented only in the text format. Instructors need be able to select specific tools from a “tool set” that supports their particular pedagogical approach. Thus, the ease of navigation within the course is a necessary consideration. According to Jones (2002) and Ernst et al. (2005), students have little patience for courses which are difficult to navigate. Avery et al. (2008) support the ease of navigation and clear articulation of course mechanics as components of best practice for online education. Blood-Siegfried et al. (2008) developed a rubric for evaluating courses which includes the following criterion: “course is visually and functionally consistent, including consistent navigation.” The consideration of navigation ease supports the case for the use of templates as a way of organizing and structuring a course. Templates or preset formats improve navigation, enhance communication, streamline course maintenance, and can also assist with demonstration of meeting standards. Marin et al. (2003) discussed templates as an organizing framework to link evidence, terminology, and information models. Bachman and Steward (2011) developed a framework for a web course template based on psychological constructs pertaining to teaching and learning principles. According to Elbeck and Song (2011), the use of an email template improved the content delivered in student emails. To streamline course maintenance activities such as syllabus development and revision, M'Hammed and He (2008) created an online syllabus generated system. The aim was to improve communication through a well-designed syllabus thereby decreasing student anxiety and complaints. In online education, the syllabus will often be the first document the student sees and can set perception for the academic experience. In one study, the more detailed the syllabus, the higher the students rated the teacher along 12 qualities which included approachability, creativity, skill as a communicator, and fairness (Saville et al., 2010). The researchers concluded that students who reviewed the more detailed syllabus were more likely to “recommend the course to a friend and take another course from the [same] teacher” (Saville et al., 2010, p. 118). Norman Goodman, PhD, (Stonybrook University, 2010) shared that the syllabus is important because it includes “what the professor expects of the students and what students can expect of the professor” and serves as an offer of an agreement extended by the
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faculty to the student. So given the importance of the syllabus what should be included in the document? Slattery and Carlson (2010) recommend best practices for syllabus construction after review of relevant literature. Identifying information such as email addresses, web links, and phone numbers should be included. The instructor may also advise the students when live chats will be hosted as virtual office hours. A description of the course and course goals is helpful to the student so as to create the narrative road map to the destination (Passerini and Granger, 2000). Students may be involved in the evaluation process during a course by providing formative evaluation and at the end of the course through summative evaluation. Formative evaluation is primarily aimed at improving the instruction of the course during the development phase but can also occur as the course is progressing. Once the course is implemented, students are an important aspect of identifying the overall effectiveness of the instruction, thus providing summative evaluation. Key aspects of the media to capture in evaluation include the ease of navigation, screen design, information presentation, media integration and overall functionality (Passerini and Granger, 2000).
Conclusion This article has explored current considerations needed for effective, interactive online course delivery using the work of the Sloan Consortium on the “five pillars of online education”. These pillars speak to learner effectiveness, student satisfaction, faculty satisfaction, cost effectiveness and access (Lorenzo and Moore, 2002). Working in conjunction with university technology stakeholders, nurse educators can develop the course structure and organization through adherence to template rules for both syllabi and course modules, and development of appropriate learning activities to assure student exposure to content identified in the course objectives. With these structure pieces in place process becomes the second focus for nurse educators in online programs. Developing quality pedagogies that focus on the patient's experience, use of unfolding case studies, reflective journaling, debriefing following experiences in virtual learning environments and gaming are ways to encourage students to express their ideas and assure active learning. Creating processes for active engagement in courses built with standardized, evidence based components results in effective engagement of students and faculty in online learning. An appreciation of online education as well as the contribution of the delivery format to the production of a highly educated workforce around the globe is essential as nursing education navigates the innovations and ever changing landscape of technology and stakeholder expectations.
Appendix A. Evaluation matrix
Determine if each criteria is met, not met, or partially met with additional comments as relevant. I. Course introduction/information A. Course orientation A brief description on how to get started in the course is provided. How to move around the course is clearly stated. Course navigation is intuitive and easy to use. Self-introductions by the instructor and students are available.
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(continued ) Determine if each criteria is met, not met, or partially met with additional comments as relevant. B.
Syllabus
Syllabus is available in a printer-friendly format (pdf). Course objectives are clearly stated and measurable. Description of the activities, assignments, and resources are provided. Schedule of the course topics and activities is clearly identified. Assessment expectations are included. Information on how to communicate with course facilitator is stated. Academic integrity and netiquette expectations are stated. Layout of syllabus is visually organized.
II. Course content A. Modules
Course content is organized by modules. The organization of components in modules is consistent through the course. For example, each module has the following sections: introduction, objectives, readings/resources, and activities. Content is complete, accurate, current, and free of typographical errors. Readings/resources are provided for each module and relevant to content. Each module incorporates materials/resources, assignments, discussions needed to proceed through the module. The content/links under each module are organized in a logical manner for students to navigate. All links to content modules are current and functional. III. Learning activities & assessment A. Assignments Assignments are aligned with stated course learning objectives. Assignments are sufficient and appropriate to support learning. All assignments/activities are listed in order. Deadlines and time limits are identified clearly. Clear and concise instructions and expectations for the assignments are provided. Rubrics are provided as guidelines for the assignments (grading papers, projects). B. Assessments Assessments are consistent with course objectives. Instructions for online testing are provided. C. Discussions Discussion topics are organized into categories. Guidelines and expectations for posting and participating in discussion are provided. Deadlines are specified. Discussion questions encourage student participation. IV. Interaction/communication Communication among students is available (e.g., chat, discussions). Expectations and directions for communication among students and between students and faculty are defined. Instructor establishes methods to communicate with students through announcements, emails, and discussion postings. Expected time frame for instructor response/feedback to student queries or assignments is clearly stated. Students are provided an area in the discussion board to ask questions about the course. V. Student support Links to the technical or student support services are provided. Links to tutorials and resources to answer basic questions related to research, writing, technology, etc. VI. Accessibility Media content (Audio and video files) is accessible in all browsers. Alternatives to auditory and visual content are provided. The function of each icon or link is explained. Text is legible. There is adequate contrast between text and background.
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References Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., Silber, J.H., 2002. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J. Am. Med. Assoc. 288, 1987e1993. Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., Siber, J.H., 2003. Educational levels of hospital nurses and surgical patient mortality. J. Am. Med. Assoc. 290 (12), 1617e1623. American Association of Colleges of Nursing, January, 2014. Nursing Shortage. Retrieved 2-28-2014 from: www.aacn.nche.edu/media-relations/nursingshortage. Anonymous, (2012). Retrieved 7-16-2012 from Carnegie Melon website: http:// www.cmu.edu/teaching/dsignteach/design/learningobjectives.html. Avery, M.D., Cohen, B.A., Walker, J.D., 2008. Evaluation of an online graduate nursing curriculum: examining standards of quality. Int. J. Nurs. Educ. Scholarsh. 5 (1), 1e17. Bachman, C.M., Stewart, C., 2011. Self-determination theory and web-enhanced course template development. Teach. Psychol. 38 (3), 180e188. Bangert, A.W., Easterby, L., 2008. Designing and delivering effective online nursing courses with the evolve electronic classroom. Comput. Inform. Nurs. 26 (5), 54Se60S. Barron, A.E., 2003. Course management systems and online teaching. J. Comput. High. Educ. 15 (1), 128e142. Benner, P., Sutphen, M., Leonard, V., Day, L., 2010. Educating Nurses a Call for Radical Transformation. Jossey-Bass, San Francisco, California. Blood-Siegfried, J.E., Short, N.M., Rapp, C.G., Hill, E., Talbert, S., Skinner, J., Goodwin, L., 2008. A rubric for improving the quality of online courses. Int. J. Nurs. Educ. Scholarsh. 5 (1), 1e16. Callister, L.C., 2012. Issues in global nursing education. MCN: Matern. Child. Nurs. 37 (6), 403. http://dx.doi.org/10.1097/NMC.0b013e318264e2e3. Carmean, C., Haefner, J., 2002. Mind over matter: transforming course management systems into effective learning environment. Educ. Rev. 37 (6), 26e34. Retrieved October 10, 2012 from: www.educause.edu. Chickering, A., Gamson, Z., 1991. Applying the Seven Principles for Good Practice in Undergraduate Education. Jossey-Bass, San Francisco. Cobb, K., Billings, D., Mays, R., Canty-Mitchell, J., 2001. Peer review of web-based courses in nursing. Nurse Educ. 26 (6), 274e279. Cooperman, L., 2007. Instructional design for online course development. J. Vet. Med. Educ. 34 (3), 238e242. Dahlstrom, E., Walker, J.D., Dziuban, C., 2013, September. ECAR Study of Undergraduate Students and Information Technology, 2013 [Research report]. EDUCAUSE Center for Analysis and Research, Louisville, CO. Retrieved from. https:// net.educause.edu/ir/library/pdf/ERS1302/ERS1302.pdf. Daly, J., Clark, J.M., Lancaster, J., Bednash, G., Orchard, C., 2008. The global alliance for nursing education and scholarship: delivering a vision for nursing education. Int. J. Nurs. Stud. 45, 1115e1117. Elbeck, M., Song, M., 2011. Improving instructor response to student e-mails using template and reminder interventions. J. Asynchr. Learn. Networks 15 (3), 54e67. Ernst, D., Jorn, L., Martyr-Wagner, M., McGlynn, N., Molgaard, L., Sonnack, J., Voelker, R., 2005. Student Technology Survey Executive Report. University of Minnesota Digital Media, Minneapolis. Georgouli, K., Skalkidis, I., Guerreiro, P., 2008. A framework for adopting LMS to introduce e-learning in a traditional course. J. Educ. Technol. Soc. 11 (2), 227e240. Gilbert, L., Moore, D., 1998. Building interactivity in web courses: tools for social and instructional interaction. Educ. Technol. 38, 29e35. Gromley, D.K., Colella, C., Shell, D.L., 2012. Motivating online learners using attention, relevance, confidence, satisfaction motivational theory and distributed scaffolding. Nurse Educ. 37 (4), 177e180. Gunawardena, L., Lowe, C., Anderson, T., 1997. Interaction analysis of a global online debate and the development of a constructivist interaction analysis model for computer conferencing. J. Educ. Comput. Res. 17 (4), 395e429. Holtslander, L.F., Racine, L., Furniss, S., Burles, M., Turner, H., 2012. Developing and piloting an online graduate nursing course focused on experiential learning of qualitative research methods. J. Nurs. Educ. 51 (6), 345e348. http://www. randybest.com/ut-arlington-college-of-nursing-honored-for-increasingbachelors-degree. Ito, M., Gutierrez, K., Livingstone, S., Penuel, B., Rhodes, J., Salen, K., Watkins, S., 2013. Connected Learning: An Agenda for Research and Design, 2013, January. Retrieved from: http://dmlhub.net/sites/default/files/Connected_Learning_ report.pdf Oblinger, D. G. Iqbal, S., Qureshi, I.A., 2011. Learning management systems (LMS): inside matters. Inf. Manag. Bus. Rev. 3 (4), 206e216.
Jones, S., 2002, September. The Internet Goes to College: How Students Are Living in the Future with Today’s Technology. Pew Internet & American Life Project, Washington. Retrieved from: http://www.pewinternet.org/~/media//Files/ Reports/2002/PIP_College_Report.pdf.pdf. Kidney, G., Puckett, E., 2003. Rediscovering the first principles through online learning. Q. Rev. Distance Educ. 4 (3), 203e212. Koszalka, T.A., Ganesan, R., 2004. Designing online courses: a taxonomy to guide strategic use of features in course management systems (CMS) in distance education. Distance Educ. 25 (2), 243e256. Little, B.B., 2009. Quality assurance for online nursing courses. J. Nurs. Educ. 48 (7) http://dx.doi.org/10.3928/01484834-20090615-05. Lorenzo, G., Moore, J., 2002. The Sloan Consortium Report to the Nation: Five Pillars of Quality Online Education. The Sloan Consortium. M'hammed, A., He, W., 2008. A design framework for syllabus generator. J. Interact. Learn. Res. 19 (4), 541e550. Marin, H.F., Marques, E.P., Hovenga, E., Gooseen, W., 2003. In e-health for all: designing nursing agenda for the future. In: Proceedings, 8th International Congress in Nursing Informatics, Rio de Janeiro, June 20e25. Moore, J., 2005. The Sloan Consortium Quality Framework and the Five Pillars. Retrieved 2-28-14 from: www.sloanconsortium.org/. Morris, A.H., Faulk, D.R., 2012. Transformative Learning in Nursing a Guide for Nurse Educators. New York: Springer, New York. Murray, T.L., Belgrave, L., Robinson, V.I., 2006. Nursing faculty members competence of web-based course development systems directly influences students' satisfaction. ABNF J. 17 (3), 100e102. Passerini, K., Granger, M.J., 2000. A developmental model for distance learning using the Internet. Comput. Educ. 34, 1e15. Penn State Learning Design Community Hub, (2012). Retrieved 7-16-2012 from: http://ets.tlt.psu.edu/learningdesign/objectives/activities. Reynolds, L., Gillham, D., Grech, C., Clark, C., Cornell, J., 2012. A study of the development of critical thinking skills using an innovative web 2.0 tool. May 17 Nurse Educ. Today, 1e5. Rukholm, E.E., Stamler, L.L., Talbot, L.R., Bednash, G., Raines, F., Potempa, K., Nugent, P., Clark, J.M., Bernhauser, S., Parfitt, B., 2009. Scaling up the global nursing health workforce: contributions of an international organization. Collegian 16, 41e45. Rosenkoetter, M.M., Nardi, D.A., 2007. American academy of nursing expert panel on global nursing and health: white paper on global nursing and health. J. Transcult. Nurs. 18 (4), 305e315. http://dx.doi.org/10.1177/ 1043659607305188. Saade, R.G., Morin, D., Thomas, J.D., 2012. Critical thinking in e-learning environments. Comput. Hum. Behav. 28, 1608e1617. Saville, B.K., Zinn, T.E., Brown, A.R., Marchuk, K.A., 2010. Syllabus detail and students' perceptions of teacher effectiveness. Teach. Psychol. 37 (3), 186e189. Skiba, D.J., 2013. On the horizon: the year of the MOOCs…massively open online courses. Nurs. Educ. Perspect. 34 (2), 136e137. Slattery, J.M., Carlson, J.F., 2010. Preparing an effective syllabus: current best practices. Coll. Teach. 53 (4), 159e164. Stony Brook University (Producer), 2010. An Interview of Norman Goodman, Ph.D., Importance of the Syllabus in Teaching (Video). Available from: https://tlt. stonybrook.edu/FacultyServices/IiE/Lists/Show%20List/DispForm.aspx?ID¼18. Stripling, J., 2009. So many students, so little time. Inside Higher Ed, Retrieved 2-2814 from: http://www.insidehighered.com/news/2009/03/24/heh. Thomas, P.Y., 2011. Cloud computer: a potential paradigm for practicing the scholarship of teaching and learning. Electron. Libr. 29 (2), 214e224. Thompson, D.M., 2008. Re: Education Grand Rounds University of Oklahoma Health Sciences Center the Apc through the Back Door: a Guide to the Suggested Guidelines for Course Syllabi. Retrieved from: ouhsc.edu/egr. ThompsonPresentation10-08-2.pps. Thorne, S.E., 2006. Nursing education: key issues for the 21st century. Nurs. Educ. Today 26, 614e621. UT Arlington College of Nursing Honored for Increasing Bachelor Degree, 2013. Retrieved 2-28-14 from: http://www.randybest.com/ut-arlington-college-ofnursing-honored-for-increasing-bachelors-degree. Vrasidas, C., 2004. Issues of pedagogy and design in e-learning systems. In: 2004 ACM Symposium on Applied Computing, pp. 911e914. Vitale, A., 2010. Faculty development and mentorship using selected online asynchronous teaching strategies. J. Contin. Educ. Nurs. 41 (12), 549e556. Zsohar, H., Smith, J.A., 2008. Transition from the classroom to the web: successful strategies for teaching online. Nurs. Educ. Perspect. 29 (1), 23e28.
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Contents lists available at ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Course development for web-based nursing education programs Vicki A. Schnetter a, *, Darlene Lacy a, Melinda Mitchell Jones a, Khadija Bakrim a, 2, Patricia E. Allen a, 3, Cynthia O'Neal b, 1 a b
Texas Tech University Health Sciences Center School of Nursing, 3601 4th Street, Lubbock, TX 79430, USA Texas A & M University, Corpus Christi, College of Nursing & Health Sciences, 6300 Ocean Drive, Unit 5805, Corpus Christi, TX 78412, USA
a r t i c l e i n f o
a b s t r a c t
Article history: Accepted 16 June 2014
Developing and launching online programs requires nurse educators to reframe content and rethink traditional teaching methodologies. Creating a framework for course design and standardization of templates can result in online learning that is student centered while allowing the institution to scale up enrollment with quality education at the core. This article explores the considerations needed for effective, interactive online course delivery in nursing education. Working in conjunction with other university technology stakeholders, nurse educators can select the learning management system with the features that will work best for the program, develop the course structure and organization through adherence to template rules for both syllabi and course modules, and develop appropriate learning activities to assure student exposure to content identified in the course objectives. With these structure pieces in place process becomes the second focus for nurse educators in online programs. Process activities for active engagement are discussed. © 2014 Elsevier Ltd. All rights reserved.
Keywords: Course content Course development Nursing education Educational technology Learning environment
Online learning in nursing education is expanding rapidly and has been heralded as a panacea for being able to nimbly meet nursing shortage demands as well as to elevate the education level of nurses. The United States is expected to experience a shortage of nurses as Baby Boomers age and require more healthcare. Meanwhile nursing schools are struggling with capacity issues to produce nurses and meet the demand. The volume of employed nurses is predicted to grow 26% with the number of job openings resulting from growth and replacements of the nursing workforce reaching 1.2 million by 2020 (American Association of Colleges of Nursing, 2014). The United States is not alone in facing this crisis, healthcare worker shortages exist globally. The World Health Organization (WHO) indicates that in 57 countries there are less than 2.3 nurses, physicians, and midwives for every 1000 people (Callister, 2012). The International Council of Nurses cites numerous challenges for increasing supply to meet demand: gender-based discrimination, violence against healthcare workers, internal and international * Corresponding author. Tel.: þ1 702 375 2001. E-mail addresses: [email protected] (V.A. Schnetter), Darlene.lacy@ ttuhsc.edu (D. Lacy), [email protected] (M.M. Jones), khadija.bakrim@ ttuhsc.edu (K. Bakrim), [email protected] (P.E. Allen), cynthia.oneal@ tamucc.edu (C. O'Neal). 1 Tel.: þ1 361 825 2244. 2 Tel.: þ1 806 743 4248x227. 3 50 Silkbay Place, Woodlands, TX 77382, USA. Tel.: þ1 806 543 4760.
migration of nurses, and the ramifications of HIV/AIDS particularly in developing countries (Rosenkoetter and Nardi, 2007). The preparation of a highly educated workforce is essential in overcoming these challenges. The nursing shortage coupled with the movement to advance the education levels of the profession, has resulted in online expansion of nursing programs. In the United States, thousands of registered nurses are returning to school for bachelor's degrees and beyond. With the 2010 call for eighty percent of nurses to have baccalaureate preparation by 2020, the Institute of Medicine (IOM) has raised the bar for many states where only 40e50% of the nurses possess a Bachelor of Science in Nursing (BSN) degree. The IOM call for 80 by 2020, technology availability, and mobile learning have created a recent surge particularly amongst online programs targeted for associate degree nurses to obtain a baccalaureate degree. Additionally, the complexity, diversity, and global context of nursing require more nurses to be prepared at the master's and doctoral levels (Thorne, 2006). Thus, the growth in online programs for advanced degrees is also expanding exponentially. Globally, advancing nursing education is viewed as pivotal to meet the demands for quality healthcare through scientifically sound contributions. A well educated workforce has a crucial role in positive patient outcomes and decreasing mortality (Aiken et al., 2002, 2003; Daly et al., 2008). The Global Alliance for Nursing Education and Scholarship (GANES) was established by four nursing education organizations and strives to improve patient care by
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ensuring highly educated nurses are in supply around the world. They are committed to expanding the educational opportunities of nurses and addressing student enrollment issues (Rukholm et al., 2009). This mission may be facilitated by the unique features of online education. Traditional education models have catered to local communities driven primarily by synchronous teaching and learning activities operating within specific time and space constraints. The birth and subsequent growth of online education programs has transcended geographic boundaries and has been spurred by asynchronous teaching and learning strategies without the same space and time restrictions commonplace with on campus course delivery. Online course delivery takes the education realm from that requiring physical presence or delayed transmission (in the case of correspondence courses) to expanding worldwide for instantaneous education delivery if desired. These driving forces have resulted in the proliferation of online nursing education programs. However, developing and launching online programs requires nurse educators to reframe content and rethink traditional teaching methodologies. Before moving into the essentials of course preparation, educators must first reflect on the faculty philosophy of learning. A frank discussion with the inclusion of all faculty centered on educational beliefs will enhance the success of course development and implementation thus improving learning effectiveness. Questions for discussion include the following: Are the faculty committed to creating student centered approaches to nursing education? As we enter what has been labeled the “Connected Age” we continue to create the pathways of communication (Ito et al., 2013). We now tweet, text and tag as well as provide massive open online courses (MOOC). One recent study of over 112,000 students noted no longer are desktops the predominant way to connect, 76% of students have smartphones, 89% have laptops, and 58% have three or more connective devices with the third device being a tablet (Dahlstrom et al., 2013). This new data has implications for “who” we are teaching and how we should engage with the student. Will the notion of what is best for the student be at the center of the philosophy? If so, then age old discussion of what is “academic freedom” and what is “quality” can be hammered out and courses can be designed based on optimizing student learning. The theme “it takes a team to educate a nurse” fits the underlying philosophy to course design described in this article. Creating an organizing framework for course design and standardization of course templates can result in a path to online learning that is student centered and allows the institution to scale up enrollment with quality education at the core thus expanding access and contributing to increasing the supply of highly educated nurses. This article explores the current considerations needed for effective, interactive online course delivery using the work of the Sloan Consortium on the “five pillars of online education”. These pillars speak to learner effectiveness, student satisfaction, faculty satisfaction, cost effectiveness and access (Lorenzo and Moore, 2002). Learner effectiveness According to the work of the Sloan Consortium, the pillar of learner effectiveness encompasses the notion that the quality of online learning should be comparable to the quality of traditional programs with emphasis on studentestudent interaction, facultyestudent interaction, methods of engagement, online course design, communication, learning outcomes and metric tracking (Moore, 2005). For online courses, the use of effective teaching principles has been rooted in theories such as behaviorism, cognitivism, constructivism or scaffolding to frame effective online learning. Theories such as these can provide a pivotal foundation
for the development of effective teaching strategies. Bangert and Easterby (2008) examined the design and launch of online courses. The authors cite the seven principles of effective teaching (Chickering and Gamson, 1991) as the lens through which the course development and delivery was explored. The designers used constructivist theory to evaluate the methodologies of course delivery and, through student evaluation, identified positive outcomes for student centered delivery. Foundational theories or frameworks such as cognitivism, behaviorism, constructivist theory, scaffolding theory and principles of effective online learning have been found to aid in understanding online course design (Gromley et al., 2012; Holtslander et al., 2012; Cooperman, 2007). Online course design begins with the choosing of a learning management system (LMS) application. LMS applications provide a platform to support distance education or supplement traditional way of teaching (Georgouli et al., 2008). LMS is defined as a webbased technology designed to support learning and teaching. Some of the main advantages of using LMS from the students' as well as instructors' point of view are: easy access to information e anywhere, anytime, keeping track of progress in a course, and ease of arranging off campus meetings with instructor and students in a virtual environment (Iqbal and Qureshi, 2011). LMS advantages for the instructor include: convenience in providing additional resources besides class lectures, providing timely feedback to students on their progress, monitoring and tracking students' participation. LMS provides a variety of tools and options to present instructional materials, directions to complete learning activities, and interactions with peers and instructors. For example, the file management feature allows flexibility to upload any multimedia file or documents as well as organize the release and display of the files. The communication tools facilitate interaction with the instructor, peers, and content. The assessment tools evaluate students' learning. Koszalka and Ganesan (2004) created a taxonomy that describes common LMS tools and categorizes them into information, instruction, and learning elements with examples of their value for teaching and learning. Each tool has unique characteristics that can be used to engage learners with course content in multiple ways. The intent is to prompt developers to think strategically and make decisions that will support the course and learning goals. The various tools in LMS are enticing to use, but they not equate to good design. Lack of knowledge of instructional design principles tend to lead to an ill-informed selection of features that are not aligned to course objectives (Gilbert and Moore, 1998; Kidney and Puckett, 2003). The tools do not however ensure that the learner will meet the learning expectations (Koszalka and Ganesan, 2004). The appropriate use of the tools, accompanied by sound pedagogy and relevant content help the learners achieve the specific goals of the course (Carmean and Haefner, 2002; Vrasidas, 2004). The automation of easy-to-populate templates and standardization appear to be an efficient method to build an online course, especially for instructors who are confused or uneducated about the effective use of features in the LMS (Gilbert and Moore, 1998; Kidney and Puckett, 2003). LMS support teaching and increase efficiency via various management features, assessment options, and communication tools. The file management feature allows flexibility to upload any multimedia file or documents, and organize the release and display of the files. LMS also offers ways to manage group communication. Consider a course with 30 students each submitting ten assignments, posting thirty messages, participating in two group projects, and uploading a final project. The number of e-mail interactions generated could be large. Techniques aimed at limiting the number of repetitive questions include encouraging students to answer each other's queries in the discussion board and posting a list of frequently asked questions.
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Assessment tools are critical in the learning process and are an integral part of most LMS. Important features include: creating a quiz pulled at random from a pool of questions; allowing more than one opportunity to take the quiz while maintaining a record of all attempts; permitting selective release of quizzes based on factors such as date, completion of assignments, and score on a previous quiz; and permitting anonymous responses to surveys. Research indicates that frequent student-teacher and studentestudent communications are very important for effective online learning (Gunawardena et al., 1997). Common communication tools provided by LMS include discussion boards, chat rooms, and in course email. Some LMS platforms provide synchronous communication through audio, video, and/or chat rooms. Synchronous communication relies on students being online at the same time and may be used for group collaboration and for virtual office hours. Discussion boards are used for asynchronous interaction for the entire class or a specific group of individuals. It also includes the ability to record a log of conversations, which in turn helps tract participation. In course email is also asynchronous and allows a way to keep all communication within the system and tracked. The effectiveness of online courses will depend on the appropriate use of the tools, accompanied by sound pedagogy and relevant content (Carmean and Haefner, 2002; Vrasidas, 2004). There is not one correct way to teach, hence there is no single LMS solution. LMS are a tool that should be used to support rather than replace good teaching (Barron, 2003). Once the pathway for accessing the course has been determined, the development of the course content can be addressed. The Carnegie Mellon University website (Anonymous, 2012) identifies the importance of aligning objectives, assessments, and instructional strategies. Given that mastery of course objectives is the goal for courses, there should not be additional module objectives. Module objectives can create loss of focus and loss of the alignment of the three components. The process of content delivery is key to successful online courses. Thus, review of objective development and course learning activity inclusion is fundamental to the development of quality courses. Thompson (2008) identifies useful course objective components as audience, behavior, condition, and degree. The audience is the student; behavior is the overt, measurable behavior of the student; condition is how and under what conditions the student demonstrates mastery; and degree is the level of performance. Design of objectives and learning activities incorporates the process of online learning. Although structure of course design is pivotal to success; process of content delivery is also key to successful online courses. Therefore, review of objective development and course learning activity inclusion is fundamental to the development of quality courses. An objective is specific and measurable. An objective should focus on knowledge, skills and attributes students are expected to achieve and demonstrate as well as give students information regarding what they can expect and how they will be assessed. There should be no doubt in the student's mind what is expected in a course when reading the course objectives. Thompson (2008) identifies useful components of course objectives as audience, behavior, condition and degree. The audience is the student; behavior is the overt and measurable behavior of the student, condition is how the student demonstrates mastery and under what conditions and degree is level of performance. The selection of learning activities evolves from the course objectives. When considering learning activities, Benner et al. (2010) suggest effective strategies fostering the development of saliency: (1) build on what has already been learned, (2) guide thinking by posing questions relevant to patient situations, (3) allow for ideas related to approaches and possible complications to be expressed, (4) guide reflection on practice. Reflecting on subjective questions
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from case studies and interviews can provide insight and perspective transformation (Morris and Faulk, 2012). To allow students to express their ideas for, approaches to and possible complications empowers the students. The use of unfolding case studies, interview of patients and debriefing from simulation are ways to encourage students to express their ideas and approaches to safe patient care. Case studies help students reflect, asking about the nursing importance as well as what other information is needed to make decisions related to this case. Morris and Faulk (2012) suggest self-reflection/dialogue to explore value conflict and clarification to move students to having a sense of salience. Dialogue can take place on forum threads and allows for ideas to be shared and insight to be gained. The Penn State Learning Design Community Hub provides examples of activities by learning objective type. For objectives related to facts, activities may include self-check quizzes, trivia games, and matching terms with definitions. For concept focused objectives, sample activities are student generated flowcharts, concept maps, writing papers, discussion board postings, and journaling. When rules and principles are the emphasis, activities such as designing projects and prototypes or participating in simulation and debriefing of the simulation experience are appropriate. Activities such as case studies, small group discussion, debates, clinical reasoning exercises, and teamwork are examples of problem-solving level of learning as well as using computer-mediated activities. There are many examples of online learning activities that fall outside traditional learning activities, i.e. blogs, facebook, webx, online chats, etc. However, there are also many learning activities that are used in both traditional and online courses such as case studies, writing assignments, objective and subjective assessments and self-reflection are just a few. The development of critical thinking skills in online learning environments has also been an important subject of exploration and inquiry. Saade et al. (2012) found that the development of critical thinking skills in e-learning environments occurs in interactive courses focusing on high order thinking skills in virtual environments. To encourage critical thinking in new environments that embrace the web as a source for learning, Reynolds et al. (2012), found a Web 2.0 tool to be very beneficial. From the Web 2.0 tool, the investigators selected the Web Resource Appraisal Process (WRAP) software to facilitate critical review skills and question of the evidence by students. The findings noted participants found this tool to be instructive and useful (Reynolds et al., 2012). Evaluation of online courses is an integral part of establishing optimum learning environments and quality. The evolution of online education has resulted in a multi-pronged evaluation approach. Evaluation can support and provide evidence for ensuring institutional program and course quality. Spurred by the contention that online education may not deliver the equivalent quality as compared to traditional education delivery methods, various researcher, organizations, and accrediting bodies have generated standards, guidelines, and best practice recommendations for online course delivery (Little, 2009). Examples include the Sloan Consortium, the Commission of Collegiate Nursing Education, the American Federation of Teachers, the Council for High Education Accreditation, and the Council of Regional Accrediting Commissions. Scale (cost effectiveness and commitment) and access The pillars of scale and access focuses on the provision of continuously improving services while reducing cost and providing an array of courses (Moore, 2005). To this end, some nursing schools in the United States have embraced partnerships with companies utilizing a business model to scale up enrollments and deliver courses on a large scale. Academic Partnerships is one such
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company which partnered with University of Texas at Arlington. The partnership enabled the university to increase enrollment from just over 1900 in 2008 to over 6300 in 2012 (UT Arlington College of Nursing Honored for Increasing Bachelor Degree, 2013). The company uses marketing approaches to package the programs in an economically attractive fashion coupled with assisting the university to create short term courses offered more frequently than the semester or quarter system calendar. Some critics of the business model cite that the large volume of students decrease faculty interaction, lowers the quality of activities feasible with the volume, and diminishes the educational experience (Stripling, 2009). The demand for increasing volume while maintaining quality continues to be a consideration for balancing student enrollment numbers. Additionally, access to course content can now move beyond the LMS constraints thereby increasing access and flexibility. There are now options for eliminating use of the LMS through using various “cloud” computing options. Cloud computing is defined as a term for “networked computers that deliver IT services over the internet to many users in an on-demand environment” (Thomas, 2011, p.218). The type of services includes many types of consumer needs and has far reaching implications for higher education. Applications such as Softchalk offer the way to enhance the presentation of content and augment the interaction capabilities through innovative course design capabilities. Courses can be designed and accessed with a web link. The cloud also offers the sharing of content and peer review. Users no longer have to be concerned with configuring, purchasing and maintaining a system. The cloud is scalable and flexible (Thomas, 2011). Another version of high volume education access has been the development and innovation of massive open online courses commonly referred to as MOOCs which started populating the internet in 2008. Interest in MOOCs is high but the evaluation of the sustainability and value has yet to be determined (Skiba, 2013). Faculty satisfaction The faculty satisfaction pillar pertains to the ability of faculty to be pleased with teaching online and achieving success (Moore, 2005). The role of faculty development comprises an observed trend in the literature pertinent to online course delivery. The transition from a face to face delivery to a web-based style of teaching and learning has been explored (Zsohar and Smith, 2008; Cobb et al., 2001) especially in light of the challenges associated with the provision of adequate faculty development. The creation of meaningful courses where learners are actively engaged (and satisfied) is an important topic for faculty development (Murray et al.,, 2006; Vitale, 2010). Faculty proficiency with managing online learning platforms and utilizing appropriate techniques to engage learning is now being viewed as essential for online course delivery. Thus, faculty development opportunities are necessary in these areas. Evaluation of courses and faculty is an important aspect of teaching success. Entities such as Quality Matters, have developed rubrics for evaluation (Little, 2009). The rubrics may be used in the planning of a course, may be a source for faculty self-evaluation prior to the implementation of a course, and may be part of the peer review process for assessing compliance with best practice standards. At Texas Tech University Health Sciences Center, an evaluation matrix was developed specifically for online course delivery evaluation and serves as a guide for faculty to design courses consistent with quality standards. The areas addressed are: course introduction/information; course content; learning activities and assessment; interaction and communication; student support; and accessibility. See Appendix A for the matrix.
Evaluation can also serve as a guide for faculty in identifying expectations about course delivery strategies and be a springboard for faculty development opportunities. The evaluation process can be utilized to support peer review processes and enhance collaboration between peers (Little, 2009). Student satisfaction The pillar of student satisfaction focuses on student pleasure related to their learning experience including interaction with instructors and peers, learning outcomes that match expectations, services, and orientation. Students are successful in learning online and are typically pleased with their experiences (Moore, 2005). Student satisfaction is often driven by the course appearance and navigation as well as by the expression of course expectations in the syllabus. The organizing framework and structure of the online course within LMS becomes pivotal, particularly for considering how to structure the “classroom” milieu. Rather than entering a classroom and passively listening to the teacher, students are required to actively seek, find, select, and interpret information primarily delivered in a written format. In a traditional setting, students may experience information that is verbal as well as written, with the student also scribing notes related to the content. While online settings often include video, podcasts, and other visual or verbal delivery methods, the information related to the syllabus and assignments tends to be presented only in the text format. Instructors need be able to select specific tools from a “tool set” that supports their particular pedagogical approach. Thus, the ease of navigation within the course is a necessary consideration. According to Jones (2002) and Ernst et al. (2005), students have little patience for courses which are difficult to navigate. Avery et al. (2008) support the ease of navigation and clear articulation of course mechanics as components of best practice for online education. Blood-Siegfried et al. (2008) developed a rubric for evaluating courses which includes the following criterion: “course is visually and functionally consistent, including consistent navigation.” The consideration of navigation ease supports the case for the use of templates as a way of organizing and structuring a course. Templates or preset formats improve navigation, enhance communication, streamline course maintenance, and can also assist with demonstration of meeting standards. Marin et al. (2003) discussed templates as an organizing framework to link evidence, terminology, and information models. Bachman and Steward (2011) developed a framework for a web course template based on psychological constructs pertaining to teaching and learning principles. According to Elbeck and Song (2011), the use of an email template improved the content delivered in student emails. To streamline course maintenance activities such as syllabus development and revision, M'Hammed and He (2008) created an online syllabus generated system. The aim was to improve communication through a well-designed syllabus thereby decreasing student anxiety and complaints. In online education, the syllabus will often be the first document the student sees and can set perception for the academic experience. In one study, the more detailed the syllabus, the higher the students rated the teacher along 12 qualities which included approachability, creativity, skill as a communicator, and fairness (Saville et al., 2010). The researchers concluded that students who reviewed the more detailed syllabus were more likely to “recommend the course to a friend and take another course from the [same] teacher” (Saville et al., 2010, p. 118). Norman Goodman, PhD, (Stonybrook University, 2010) shared that the syllabus is important because it includes “what the professor expects of the students and what students can expect of the professor” and serves as an offer of an agreement extended by the
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faculty to the student. So given the importance of the syllabus what should be included in the document? Slattery and Carlson (2010) recommend best practices for syllabus construction after review of relevant literature. Identifying information such as email addresses, web links, and phone numbers should be included. The instructor may also advise the students when live chats will be hosted as virtual office hours. A description of the course and course goals is helpful to the student so as to create the narrative road map to the destination (Passerini and Granger, 2000). Students may be involved in the evaluation process during a course by providing formative evaluation and at the end of the course through summative evaluation. Formative evaluation is primarily aimed at improving the instruction of the course during the development phase but can also occur as the course is progressing. Once the course is implemented, students are an important aspect of identifying the overall effectiveness of the instruction, thus providing summative evaluation. Key aspects of the media to capture in evaluation include the ease of navigation, screen design, information presentation, media integration and overall functionality (Passerini and Granger, 2000).
Conclusion This article has explored current considerations needed for effective, interactive online course delivery using the work of the Sloan Consortium on the “five pillars of online education”. These pillars speak to learner effectiveness, student satisfaction, faculty satisfaction, cost effectiveness and access (Lorenzo and Moore, 2002). Working in conjunction with university technology stakeholders, nurse educators can develop the course structure and organization through adherence to template rules for both syllabi and course modules, and development of appropriate learning activities to assure student exposure to content identified in the course objectives. With these structure pieces in place process becomes the second focus for nurse educators in online programs. Developing quality pedagogies that focus on the patient's experience, use of unfolding case studies, reflective journaling, debriefing following experiences in virtual learning environments and gaming are ways to encourage students to express their ideas and assure active learning. Creating processes for active engagement in courses built with standardized, evidence based components results in effective engagement of students and faculty in online learning. An appreciation of online education as well as the contribution of the delivery format to the production of a highly educated workforce around the globe is essential as nursing education navigates the innovations and ever changing landscape of technology and stakeholder expectations.
Appendix A. Evaluation matrix
Determine if each criteria is met, not met, or partially met with additional comments as relevant. I. Course introduction/information A. Course orientation A brief description on how to get started in the course is provided. How to move around the course is clearly stated. Course navigation is intuitive and easy to use. Self-introductions by the instructor and students are available.
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(continued ) Determine if each criteria is met, not met, or partially met with additional comments as relevant. B.
Syllabus
Syllabus is available in a printer-friendly format (pdf). Course objectives are clearly stated and measurable. Description of the activities, assignments, and resources are provided. Schedule of the course topics and activities is clearly identified. Assessment expectations are included. Information on how to communicate with course facilitator is stated. Academic integrity and netiquette expectations are stated. Layout of syllabus is visually organized.
II. Course content A. Modules
Course content is organized by modules. The organization of components in modules is consistent through the course. For example, each module has the following sections: introduction, objectives, readings/resources, and activities. Content is complete, accurate, current, and free of typographical errors. Readings/resources are provided for each module and relevant to content. Each module incorporates materials/resources, assignments, discussions needed to proceed through the module. The content/links under each module are organized in a logical manner for students to navigate. All links to content modules are current and functional. III. Learning activities & assessment A. Assignments Assignments are aligned with stated course learning objectives. Assignments are sufficient and appropriate to support learning. All assignments/activities are listed in order. Deadlines and time limits are identified clearly. Clear and concise instructions and expectations for the assignments are provided. Rubrics are provided as guidelines for the assignments (grading papers, projects). B. Assessments Assessments are consistent with course objectives. Instructions for online testing are provided. C. Discussions Discussion topics are organized into categories. Guidelines and expectations for posting and participating in discussion are provided. Deadlines are specified. Discussion questions encourage student participation. IV. Interaction/communication Communication among students is available (e.g., chat, discussions). Expectations and directions for communication among students and between students and faculty are defined. Instructor establishes methods to communicate with students through announcements, emails, and discussion postings. Expected time frame for instructor response/feedback to student queries or assignments is clearly stated. Students are provided an area in the discussion board to ask questions about the course. V. Student support Links to the technical or student support services are provided. Links to tutorials and resources to answer basic questions related to research, writing, technology, etc. VI. Accessibility Media content (Audio and video files) is accessible in all browsers. Alternatives to auditory and visual content are provided. The function of each icon or link is explained. Text is legible. There is adequate contrast between text and background.
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References Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., Silber, J.H., 2002. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J. Am. Med. Assoc. 288, 1987e1993. Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., Siber, J.H., 2003. Educational levels of hospital nurses and surgical patient mortality. J. Am. Med. Assoc. 290 (12), 1617e1623. American Association of Colleges of Nursing, January, 2014. Nursing Shortage. Retrieved 2-28-2014 from: www.aacn.nche.edu/media-relations/nursingshortage. Anonymous, (2012). Retrieved 7-16-2012 from Carnegie Melon website: http:// www.cmu.edu/teaching/dsignteach/design/learningobjectives.html. Avery, M.D., Cohen, B.A., Walker, J.D., 2008. Evaluation of an online graduate nursing curriculum: examining standards of quality. Int. J. Nurs. Educ. Scholarsh. 5 (1), 1e17. Bachman, C.M., Stewart, C., 2011. Self-determination theory and web-enhanced course template development. Teach. Psychol. 38 (3), 180e188. Bangert, A.W., Easterby, L., 2008. Designing and delivering effective online nursing courses with the evolve electronic classroom. Comput. Inform. Nurs. 26 (5), 54Se60S. Barron, A.E., 2003. Course management systems and online teaching. J. Comput. High. Educ. 15 (1), 128e142. Benner, P., Sutphen, M., Leonard, V., Day, L., 2010. Educating Nurses a Call for Radical Transformation. Jossey-Bass, San Francisco, California. Blood-Siegfried, J.E., Short, N.M., Rapp, C.G., Hill, E., Talbert, S., Skinner, J., Goodwin, L., 2008. A rubric for improving the quality of online courses. Int. J. Nurs. Educ. Scholarsh. 5 (1), 1e16. Callister, L.C., 2012. Issues in global nursing education. MCN: Matern. Child. Nurs. 37 (6), 403. http://dx.doi.org/10.1097/NMC.0b013e318264e2e3. Carmean, C., Haefner, J., 2002. Mind over matter: transforming course management systems into effective learning environment. Educ. Rev. 37 (6), 26e34. Retrieved October 10, 2012 from: www.educause.edu. Chickering, A., Gamson, Z., 1991. Applying the Seven Principles for Good Practice in Undergraduate Education. Jossey-Bass, San Francisco. Cobb, K., Billings, D., Mays, R., Canty-Mitchell, J., 2001. Peer review of web-based courses in nursing. Nurse Educ. 26 (6), 274e279. Cooperman, L., 2007. Instructional design for online course development. J. Vet. Med. Educ. 34 (3), 238e242. Dahlstrom, E., Walker, J.D., Dziuban, C., 2013, September. ECAR Study of Undergraduate Students and Information Technology, 2013 [Research report]. EDUCAUSE Center for Analysis and Research, Louisville, CO. Retrieved from. https:// net.educause.edu/ir/library/pdf/ERS1302/ERS1302.pdf. Daly, J., Clark, J.M., Lancaster, J., Bednash, G., Orchard, C., 2008. The global alliance for nursing education and scholarship: delivering a vision for nursing education. Int. J. Nurs. Stud. 45, 1115e1117. Elbeck, M., Song, M., 2011. Improving instructor response to student e-mails using template and reminder interventions. J. Asynchr. Learn. Networks 15 (3), 54e67. Ernst, D., Jorn, L., Martyr-Wagner, M., McGlynn, N., Molgaard, L., Sonnack, J., Voelker, R., 2005. Student Technology Survey Executive Report. University of Minnesota Digital Media, Minneapolis. Georgouli, K., Skalkidis, I., Guerreiro, P., 2008. A framework for adopting LMS to introduce e-learning in a traditional course. J. Educ. Technol. Soc. 11 (2), 227e240. Gilbert, L., Moore, D., 1998. Building interactivity in web courses: tools for social and instructional interaction. Educ. Technol. 38, 29e35. Gromley, D.K., Colella, C., Shell, D.L., 2012. Motivating online learners using attention, relevance, confidence, satisfaction motivational theory and distributed scaffolding. Nurse Educ. 37 (4), 177e180. Gunawardena, L., Lowe, C., Anderson, T., 1997. Interaction analysis of a global online debate and the development of a constructivist interaction analysis model for computer conferencing. J. Educ. Comput. Res. 17 (4), 395e429. Holtslander, L.F., Racine, L., Furniss, S., Burles, M., Turner, H., 2012. Developing and piloting an online graduate nursing course focused on experiential learning of qualitative research methods. J. Nurs. Educ. 51 (6), 345e348. http://www. randybest.com/ut-arlington-college-of-nursing-honored-for-increasingbachelors-degree. Ito, M., Gutierrez, K., Livingstone, S., Penuel, B., Rhodes, J., Salen, K., Watkins, S., 2013. Connected Learning: An Agenda for Research and Design, 2013, January. Retrieved from: http://dmlhub.net/sites/default/files/Connected_Learning_ report.pdf Oblinger, D. G. Iqbal, S., Qureshi, I.A., 2011. Learning management systems (LMS): inside matters. Inf. Manag. Bus. Rev. 3 (4), 206e216.
Jones, S., 2002, September. The Internet Goes to College: How Students Are Living in the Future with Today’s Technology. Pew Internet & American Life Project, Washington. Retrieved from: http://www.pewinternet.org/~/media//Files/ Reports/2002/PIP_College_Report.pdf.pdf. Kidney, G., Puckett, E., 2003. Rediscovering the first principles through online learning. Q. Rev. Distance Educ. 4 (3), 203e212. Koszalka, T.A., Ganesan, R., 2004. Designing online courses: a taxonomy to guide strategic use of features in course management systems (CMS) in distance education. Distance Educ. 25 (2), 243e256. Little, B.B., 2009. Quality assurance for online nursing courses. J. Nurs. Educ. 48 (7) http://dx.doi.org/10.3928/01484834-20090615-05. Lorenzo, G., Moore, J., 2002. The Sloan Consortium Report to the Nation: Five Pillars of Quality Online Education. The Sloan Consortium. M'hammed, A., He, W., 2008. A design framework for syllabus generator. J. Interact. Learn. Res. 19 (4), 541e550. Marin, H.F., Marques, E.P., Hovenga, E., Gooseen, W., 2003. In e-health for all: designing nursing agenda for the future. In: Proceedings, 8th International Congress in Nursing Informatics, Rio de Janeiro, June 20e25. Moore, J., 2005. The Sloan Consortium Quality Framework and the Five Pillars. Retrieved 2-28-14 from: www.sloanconsortium.org/. Morris, A.H., Faulk, D.R., 2012. Transformative Learning in Nursing a Guide for Nurse Educators. New York: Springer, New York. Murray, T.L., Belgrave, L., Robinson, V.I., 2006. Nursing faculty members competence of web-based course development systems directly influences students' satisfaction. ABNF J. 17 (3), 100e102. Passerini, K., Granger, M.J., 2000. A developmental model for distance learning using the Internet. Comput. Educ. 34, 1e15. Penn State Learning Design Community Hub, (2012). Retrieved 7-16-2012 from: http://ets.tlt.psu.edu/learningdesign/objectives/activities. Reynolds, L., Gillham, D., Grech, C., Clark, C., Cornell, J., 2012. A study of the development of critical thinking skills using an innovative web 2.0 tool. May 17 Nurse Educ. Today, 1e5. Rukholm, E.E., Stamler, L.L., Talbot, L.R., Bednash, G., Raines, F., Potempa, K., Nugent, P., Clark, J.M., Bernhauser, S., Parfitt, B., 2009. Scaling up the global nursing health workforce: contributions of an international organization. Collegian 16, 41e45. Rosenkoetter, M.M., Nardi, D.A., 2007. American academy of nursing expert panel on global nursing and health: white paper on global nursing and health. J. Transcult. Nurs. 18 (4), 305e315. http://dx.doi.org/10.1177/ 1043659607305188. Saade, R.G., Morin, D., Thomas, J.D., 2012. Critical thinking in e-learning environments. Comput. Hum. Behav. 28, 1608e1617. Saville, B.K., Zinn, T.E., Brown, A.R., Marchuk, K.A., 2010. Syllabus detail and students' perceptions of teacher effectiveness. Teach. Psychol. 37 (3), 186e189. Skiba, D.J., 2013. On the horizon: the year of the MOOCs…massively open online courses. Nurs. Educ. Perspect. 34 (2), 136e137. Slattery, J.M., Carlson, J.F., 2010. Preparing an effective syllabus: current best practices. Coll. Teach. 53 (4), 159e164. Stony Brook University (Producer), 2010. An Interview of Norman Goodman, Ph.D., Importance of the Syllabus in Teaching (Video). Available from: https://tlt. stonybrook.edu/FacultyServices/IiE/Lists/Show%20List/DispForm.aspx?ID¼18. Stripling, J., 2009. So many students, so little time. Inside Higher Ed, Retrieved 2-2814 from: http://www.insidehighered.com/news/2009/03/24/heh. Thomas, P.Y., 2011. Cloud computer: a potential paradigm for practicing the scholarship of teaching and learning. Electron. Libr. 29 (2), 214e224. Thompson, D.M., 2008. Re: Education Grand Rounds University of Oklahoma Health Sciences Center the Apc through the Back Door: a Guide to the Suggested Guidelines for Course Syllabi. Retrieved from: ouhsc.edu/egr. ThompsonPresentation10-08-2.pps. Thorne, S.E., 2006. Nursing education: key issues for the 21st century. Nurs. Educ. Today 26, 614e621. UT Arlington College of Nursing Honored for Increasing Bachelor Degree, 2013. Retrieved 2-28-14 from: http://www.randybest.com/ut-arlington-college-ofnursing-honored-for-increasing-bachelors-degree. Vrasidas, C., 2004. Issues of pedagogy and design in e-learning systems. In: 2004 ACM Symposium on Applied Computing, pp. 911e914. Vitale, A., 2010. Faculty development and mentorship using selected online asynchronous teaching strategies. J. Contin. Educ. Nurs. 41 (12), 549e556. Zsohar, H., Smith, J.A., 2008. Transition from the classroom to the web: successful strategies for teaching online. Nurs. Educ. Perspect. 29 (1), 23e28.
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