A recent trend in secondary education is the wide-spread adoption of online learning methods. Whether online learning is a buzzword or the new reality for educators remains to be determined. Online learning and technology have a clear intersection in nursing education. Increases in the use of online nursing programs and courses, in addition to advances in technology throughout health care, affect the nursing curriculum. To keep up with curricular trends, nurse educators must include technology and informatics themes and skills in their teaching (Rich & Nugent, 2010). Yet, nurse educators may not have the skills to teach online or to instruct others in the use of emerging health care technologies.
Technology assistance and workshops to enhance teaching skills are cited as specific continuing education needs for adjunct nursing faculty (Forbes, Hickey, & White, 2010). Faculty development must be flexible and respond to nurse educators’ need for convenience in earning continuing education units. Online learning addresses nurse educators’ time constraints by providing content in an easily accessible platform and format. Nurses consider online learning activities suitable for their working conditions and needs, and they report a positive perception of online learning (Karaman, 2011). Although online learning offers the advantages of convenience and flexibility for the learner, disadvantages and challenges associated with online learning include limitations of course management systems and online hosting services, nontraditional instructional design principles, and the need for new technology skills to develop and use online learning modalities.
To respond to the intersection of advances in online learning and educators’ need for technology skills, the University of Pittsburgh School of Nursing developed the Emerging Learning and Integrated Technologies Education (ELITE) Faculty Development Program in response to a call by the Health Resources and Services Administration. The call solicited initiatives to create a nursing collaborative “for faculty development in the use of information and other technologies in order to expand the capacity of collegiate schools of nursing to educate students for 21st century health care practice” (Health Resources and Services Administration, 2010). Five themes were selected as focus areas for ELITE offerings: learning technologies, distance education, informatics, telehealth technologies, and high-fidelity simulation. The University of Pittsburgh School of Nursing formed collaborations with the University of Pittsburgh School of Nursing’s Center for Innovation in Clinical Learning, Winter Institute for Simulation Education and Research (WISER), West Virginia University, the Center of Excellence for Remote and Medically Under-Served Areas (CERMUSA) at St. Francis University, and the University of Hawaii. These institutional partners brought content expertise in each of the five themes to the continuing education workshops of the ELITE program.
The University of Pittsburgh School of Nursing built on its success in implementing curricular changes supporting technology-based learning to design the ELITE program and continuing education workshops (Burns & Courtney, 2010). Using surveys of nurses, nursing deans, and chairs, as well as evaluations from the University of Pittsburgh School of Nursing’s previous continuing education offerings, barriers to nurse faculty development were identified. These barriers included scarce resources to travel to workshops, the need to disseminate information to faculty in rural locations, and the need to translate knowledge gained into practice (Burns & Courtney, 2010).
The ELITE program was created and designed to address these barriers, with the goal of providing nurse educators with the knowledge, skills, and abilities needed to apply, initiate, and integrate technology strategies into nursing education programs to address undergraduate and graduate learning needs. Targeted for nurse educators regionally and nationally, the ELITE program awarded continuing education units for all of its activities. ELITE workshops were offered on-site (face-to-face) and as online learning opportunities.
The collaborative partners planned to use a “module to workshop workflow” (Fig. 1) in which objectives and content remained consistent for on-site and online workshop offerings. The term “module” was used to describe the objectives, content, and evaluation for each of the five thematic technology focus areas (learning technologies, distance education, informatics, telehealth technologies, and high-fidelity simulation). For example, the project partners would brainstorm objectives for the informatics theme, create the associated content, and implement the evaluation plan for the on-site workshop. The on-site workshop would be videotaped and incorporated into an online course management system for presentation as an online learning opportunity for those who were unable to attend the on-site workshop. Therefore, the module, consisting of objectives, content, and evaluation, would stay consistent for on-site and online learning.
Figure 1. Anticipated module to workshop workflow.
Barriers and Implementation Strategies for Online Workshop Development
Barriers to the planned module to workshop work-flow (Fig. 1) included crafting objectives appropriate for online versus face-to-face learning, keeping pace with rapid changes in technology presented at on-site workshops, providing technical support in a course management system to host the online modules, tailoring the course management system to the needs of the program and the learner, and creating effective practice opportunities for the online learner. An important factor in successfully addressing these barriers was a structured workflow (Fig. 2) that was updated in practice and throughout project implementation.
Figure 2. Actual module to workshop workflow.
Equally important, the objectives and content were designed to remain consistent in on-site and online offerings (Fig. 1). However, during development of the online workshops, the content experts advised that the objectives needed to be tailored to provide appropriate theme-specific learning opportunities for the online format. The Table lists objectives from on-site workshops and their modification for use in the online workshop format.
Table: Comparison of Objectives from On-Site and Online Workshops
The core concept of the ELITE program was to improve the knowledge, skills, and attitudes of nursing faculty in the application of technology into nursing education and practice. Because of rapid advances in technology over the course of several months, cutting-edge technology presented at on-site workshops was obsolete by the time the online workshops were developed and deployed. For example, the ELITE program delivered an on-site workshop called Introduction to Learning Technologies in project year 1, with plans to offer the online version of the workshop in project year 2. The on-site workshop showcased technologies such as electromagnetic panels, audience response systems, copy stands, SMART Board interactive whiteboards, and iTV. However, these technologies were outdated by project year 2. To remedy this recurring issue, the project partners developed web-based activities to highlight enduring themes in technology use (including best practices in online communication and online evaluation) and resources to assist with integration of technology from the on-site workshop (e.g., tips for using an audience response system and examples of a distance education syllabus), rather than focusing on specific technologies.
In the Introduction to Learning Technologies workshop, on-site-to-online carryover topics included strategies for developing an online workshop and the use of wikis and blogs to focus on collaborative writing skills in nursing courses. The carryover topics from each on-site workshop were divided into three or four distinct modules. The development of specific and measurable learning objectives for the overall online workshop and for each individual module helped content experts to organize and focus the online material into manageable segments. These segments included assessment and online activities that allowed participants to track the achievement of objectives in meeting the overall course outcomes. To supplement the online text and interactive materials, audio clips with questions for the learner to consider and short, role-played vignettes were recorded with free online software. The use of high-quality microphones was key because these audio clips provided the primary delivery pathway for these materials. Embedding of the audio clips also helped to break up text-heavy reading material. Content experts created voice-over PowerPoint presentations using e-learning software and authoring tools. Voice-over PowerPoint presentations added visual and audio learning elements and allowed concepts to be demonstrated through the use of graphs, pictures, and charts. Finally, each online workshop design incorporated a short quiz and an evaluation that allowed individuals to assess the attainment of objectives and provided useful feedback to the course designers.
Course Management System
Course management systems, or learning management systems, are the systems or software platforms used to deliver course content and track course engagement. These management systems are used for online and blended (online and face-to-face) courses. The ELITE program deployed its web-based workshops using the course management system that was already in place at the university. This tactic ensured that the workshops could be converted to a new, supported system if the university changed course management system vendors. It also defrayed the cost of securing a new web service to host the workshop content and guaranteed that technical support would be available because the system was already in place and in use at the university. This approach was used during online workshop development.
The use of the course management system for continuing education was new to the university. The ELITE program pioneered the online workshops as self-paced learning experiences for continuing education programs. This prompted many meetings and collaborations among instructional design, technology support, and continuing education staff because each entity needed to make adjustments to their standard operating procedures to develop the ELITE online learning activities. Instructional designers worked directly with content experts from the ELITE collaborative partners in reviewing on-site workshop agendas and learning objectives to craft course outlines with alignment between learning objectives and content. Technology support staff developed new protocols for storing course content on servers where information could be accessed by ELITE participants external to the university. The University of Pittsburgh School of Nursing’s office of continuing education worked with technical support and instructional designers to set course management system codes and rules for the ordered release of workshop content, quizzes, evaluations, and customized continuing education completion certificates, thereby providing users with a seamless self-paced learning experience. Continuing education staff developed graphics and design protocols to give the activities a uniform, professional aesthetic and created sample standardized language to meet continuing education accreditation requirements. The University of Pittsburgh School of Nursing’s advancement and external relations department offered design expertise in creating an online registration portal to capture participants’ demographic data needed for grant reporting to the Health Resources and Services Administration.
Practice Opportunities in an Online Format
The on-site version of the ELITE workshops featured hands-on use of emerging learning and health care technologies, including audience response systems for student engagement and polling, web-based tools for assessment, spreadsheet software for informatics practice, mobile applications for clinical learning, sound and video recording applications for building podcasts, sensors to monitor patient vital signs remotely, and tablet computers that simulated an electronic health record. The ELITE partners wanted to incorporate similar hands-on opportunities for learners to practice or reflect on the content provided in the online workshops. This was a challenge because the ELITE online learning activities were designed as self-paced individual learning experiences. Instructional designers assisted ELITE content experts with reviewing the content and learning objectives for each online workshop to develop practice points. Practice points, short content-based exercises, were built into the online activity to give learners a break from reading or viewing online materials and an opportunity to apply knowledge gained. Examples of practice points used in the ELITE online activities included a critique of mobile applications based on best practices in mobile health, creation of a database to track students’ progression and attainment of baccalaureate degree essentials throughout a 4-year nursing program, worksheets and sample rubrics to guide educational evaluation and assessment, checklists for faculty considerations in using technology, key questions to guide the creation of a course outline, and directions to access online learning object collections to find multimedia elements to accompany workshop content.
Adjusting Workshop Content to Fit the Online Format
Each ELITE workshop was adjusted to accommodate the barriers and realities of on-site-to-online workshop conversion while using core concepts of each technology theme. For example, the informatics content expert developed spreadsheets for hands-on practice during the on-site workshops. The spreadsheets were easily uploaded into an online workshop as an interactive practice opportunity. For the distance education theme, on-site workshop topics such as “effective online teaching” and “enhancing the delivery of online courses with mixed media” inspired web-based workshops on best practices for evaluating online learning and communication strategies. Although specific telehealth technologies and delivery systems were highlighted in the on-site workshop, the telehealth online workshops focused on broader implementation themes, such as reimbursement for services and operating telehealth systems effectively.
Conclusion and Implications
The ELITE program produced a total of eight online workshops to address learning and emerging health care technologies. Participants can register and enroll in the workshops at the following website: www.nursing.pitt.edu/academics/ce/online.jsp. Providing opportunities for faculty development and continuing education ensures quality in nursing education, promotes job satisfaction, and supports retention of nursing faculty (Forbes et al., 2010). With the many opportunities that are available for health care professionals to obtain continuing education, the ELITE program responded to the specific niche of nurse educators wanting to improve the use of technology in their teaching. Although nurses with more frequent computer use rate their perception of online learning more positively, nurses of all ages, at all experience levels, and in all geographic areas should be provided with continuing education through online learning modalities (Karaman, 2011). Today’s nurse educators may be asked to teach a nursing course online without any previous knowledge or experience in online teaching and learning. Experiencing an online learning course, such as the ELITE program, provides nurse educators the opportunity to assume the role of student in the course, increasing their awareness of the challenges and benefits of online learning.
- Burns, H. K. & Courtney, K. L. (2010). University of Pittsburgh—Faculty development program: Emerging, learning, and integrated technologies education (ELITE) case study 7A. In Weaver, C., Delaney, C. W., Weber, P. & Carr, R. L. (Eds.), Nursing and informatics for the 21st century: An international look at practice, education and EHR trends (2nd ed.). Chicago, IL: Healthcare Information and Management Systems Society.
- Forbes, M. O., Hickey, M. T. & White, J. (2010). Adjunct faculty development: Reported needs and innovative solutions. Journal of Professional Nursing, 26(2), 116–124 doi:10.1016/j.profnurs.2009.08.001 [CrossRef] .
- Health Resources and Services Administration. (2010). Faculty development: Integrated Technology into Nursing Education and Practice (ITNEP). Retrieved from http://bhpr.hrsa.gov/nursing/grants/itnep.html
- Karaman, S. (2011). Nurses’ perceptions of online continuing education. BMC Medical Education. Retrieved from www.biomedcentral.com/1472-6920/11/86 doi:10.1186/1472-6920-11-86 [CrossRef]
- Rich, K. L. & Nugent, K. E. (2010). A United States perspective on the challenges in nursing education. Nurse Education Today, 30(3), 228–232 doi:10.1016/j.nedt.2009.10.015 [CrossRef] .
Comparison of Objectives from On-Site and Online Workshops
||Objective From On-site Workshop
||Objective From Online Workshop
||Demonstrate how integrated mobile software can be used in the clinical setting.
||Explain how mobile devices, eBooks, and virtual worlds can be used in adult learning settings.
||Develop an online or hybrid syllabus that prevents common communication problems.
||Conduct a review to confirm effective communication throughout the online course.
||Apply software tools for data visualization.
||Demonstrate basic skills in building a simple database.
||Consider specific examples of telehealth technology as solutions to health care needs.
||Compare factors related to patients, providers, and technology that determine the success of telemedicine.