Journal of Nursing Education

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Change: Introducing Computer-Assisted Instruction (CAI) to a College of Nursing Faculty

Kathleen Kadner, RN, MSN

Abstract

Introduction

In July 1979, a Microcomputer Lab was established by the Educational Media Center at the University óf Texas at El Paso College of Nursing under the sponsorship of DHHS Grant DIO NU26019-01. One of the purposes of this lab has been to explore microcomputer applications in nursing education, including computer-assisted instruction (CAI). This purpose led to the following goals: dissemination of computer-based instruction into the curriculum and participation of faculty in development of software as authors. For these goals to be accomplished, orientation and attitudinal change among a 30-member faculty were necessary. Fifteen instructional modules have since been completed in-house, and several individual and group faculty authoring projects are in development. The completed modules are being assigned within a 243 upper division undergraduate and 74 graduate nursing student population. The reeducative and persuasive strategies used with faculty at the College of Nursing have facilitated the transition from non-computerized instruction to active faculty participation in the development and use of CAI.

Rationale

Instructional computing has become more affordable on individual and institutional levels with the development of microcomputer technology. Not only is the hardware less costly but the complexity of designing suitable software for instruction has also decreased. Individual departments on the university level can realistically approach intradepartmental development of CAI material which will match the needs of their curriculum. By developing a computer program to work within a specific course, an instructor can have better control of how instructional time is spent in that course. Additionally, CAI programs are being increasingly looked upon as publications, with all the incentives that publishing holds in the academic community.

Microcomputers have made feasible intradepartmental acquisition and development of CAI systems. The problem remains; addressing an indifferent population on whose support the success of CAI implementation depends. Attitudes toward computers in general, and CAI in particular, mayrange from enthusiastic receptivity to downright resistance. The traditionally conservative academic community is not exempt from negative attitudes, often related to fear of the unknown. Applying reeducative and persuasive strategies in orienting our faculty to CAI were found to be useful in effecting change.

Strategies

* Inviting individual iaeulty members to participate in accessing computer assisted instructional programs via remote hook-ups with computer networks.

Surveying the computer networks available, the Ohio State University (OSU) Health Science Network seemed to have the most comprehensive and relevant array of programs. A month-long demonstration hook-up was arranged, which would allow evaluation of the network for possible membership. Although membership was eventually declined due to cost considerations, the short hook-up provided invaluable assistance in the planned change process.

Invitations to faculty to access a CAI program on the network were handled informally on a person-to-person basis. For most who accepted the invitation, it was their first experience interacting with a computer. Hands-on experience reduced unfamiliarity with a computer keyboard. Additionally, faculty projected themselves as potential authors of similar programs. They were able to critique the work of colleagues in their own profession who had authored the OSU programs and speculate how they might handle similar subject matter. This introduction to computer simulation, problem solving, and drill and practice strategies enabled identification of some preliminary elements of these techniques. Direct experience with what CAI looked like, how it worked, and where it applied was obtained.

* Developing demonstration CAI programs in nursing education exemplifying the content, formatting, and graphic potentials of the microcomputer system in use.

"SALIC," a 15-minute decision-making program involving emergency management of a pediatric salicylate poisoning, was initially produced. A low level of difficulty was chosen to avoid exposure of lack of subject matter knowledge when the program was…

Introduction

In July 1979, a Microcomputer Lab was established by the Educational Media Center at the University óf Texas at El Paso College of Nursing under the sponsorship of DHHS Grant DIO NU26019-01. One of the purposes of this lab has been to explore microcomputer applications in nursing education, including computer-assisted instruction (CAI). This purpose led to the following goals: dissemination of computer-based instruction into the curriculum and participation of faculty in development of software as authors. For these goals to be accomplished, orientation and attitudinal change among a 30-member faculty were necessary. Fifteen instructional modules have since been completed in-house, and several individual and group faculty authoring projects are in development. The completed modules are being assigned within a 243 upper division undergraduate and 74 graduate nursing student population. The reeducative and persuasive strategies used with faculty at the College of Nursing have facilitated the transition from non-computerized instruction to active faculty participation in the development and use of CAI.

Rationale

Instructional computing has become more affordable on individual and institutional levels with the development of microcomputer technology. Not only is the hardware less costly but the complexity of designing suitable software for instruction has also decreased. Individual departments on the university level can realistically approach intradepartmental development of CAI material which will match the needs of their curriculum. By developing a computer program to work within a specific course, an instructor can have better control of how instructional time is spent in that course. Additionally, CAI programs are being increasingly looked upon as publications, with all the incentives that publishing holds in the academic community.

Microcomputers have made feasible intradepartmental acquisition and development of CAI systems. The problem remains; addressing an indifferent population on whose support the success of CAI implementation depends. Attitudes toward computers in general, and CAI in particular, mayrange from enthusiastic receptivity to downright resistance. The traditionally conservative academic community is not exempt from negative attitudes, often related to fear of the unknown. Applying reeducative and persuasive strategies in orienting our faculty to CAI were found to be useful in effecting change.

Strategies

* Inviting individual iaeulty members to participate in accessing computer assisted instructional programs via remote hook-ups with computer networks.

Surveying the computer networks available, the Ohio State University (OSU) Health Science Network seemed to have the most comprehensive and relevant array of programs. A month-long demonstration hook-up was arranged, which would allow evaluation of the network for possible membership. Although membership was eventually declined due to cost considerations, the short hook-up provided invaluable assistance in the planned change process.

Invitations to faculty to access a CAI program on the network were handled informally on a person-to-person basis. For most who accepted the invitation, it was their first experience interacting with a computer. Hands-on experience reduced unfamiliarity with a computer keyboard. Additionally, faculty projected themselves as potential authors of similar programs. They were able to critique the work of colleagues in their own profession who had authored the OSU programs and speculate how they might handle similar subject matter. This introduction to computer simulation, problem solving, and drill and practice strategies enabled identification of some preliminary elements of these techniques. Direct experience with what CAI looked like, how it worked, and where it applied was obtained.

* Developing demonstration CAI programs in nursing education exemplifying the content, formatting, and graphic potentials of the microcomputer system in use.

"SALIC," a 15-minute decision-making program involving emergency management of a pediatric salicylate poisoning, was initially produced. A low level of difficulty was chosen to avoid exposure of lack of subject matter knowledge when the program was worked on by faculty in the presence of peers or students. Since the SALIC program took one person two months to produce from review of the literature to summative evaluation, more rapid development of demonstration programs was deemed necessary. A second demonstration program was developed from a nursing clinical simulation text with the author's permission. This second program completed as a demonstration involved a clinical simulation of a patient with impending myocardial infarction in an industrial setting,

A clinical simulation was chosen for demonstration since this strategy provides a bridge between nursing theory and practice. One of the problems in nursing education is the difficulty of transferring didactic material to clinical practice. Not only is skill acquisition difficult to provide and evaluate in a bona-fide clinical area, but consumer safety must also be considered. By demonstrating a computer-based simulation application, it was hoped that faculty would recognize a new learning strategem which would assist in meeting this transfer of learning need,

* Scheduling bimonthly displays of the Microcomputer Lab's activities at faculty meetings with opportunities for hands-on experience at computer terminals.

At first, only the demonstration programs provided by the corporation that manufactured the microcomputer were available. By the second display, the two demonstration programs which were developed by the Micro Lab were shown. The third display created the most interest since some faculty members had by then authored completed programs and other faculty members were anxious to see their colleagues' creations.

There was mixed enthusiasm about the displays. Individual reactions ranged from completely bypassing the display to stating an intention to use the modules developed within courses being taught. The two authors on faculty were already committed to using their CAI material within courses they were teaching. Most faculty politely sat at the keyboard and ran through the programs, manifesting an interestedly restrained attitude.

* Ongoing communications with individual faculty members about specific applications of CAI within their courses.

If an instructor could be shown specific instances where CAI would assist in learning some aspects of course content, the realizability of authoring and using CAI became less remote. For example, undergraduate students have had difficulty in converting measurement systems. The cognitive skills involved must be mastered for safe medication administration. While this material is taught in a preliminary course, the skill must be checked and evaluated throughout the undergraduate program.

The first faculty member to become interested in authoring a CAI program wanted to address this problem. Her solution was a three- part drill and practice program. Although drill and practice has generally been advocated for elementary and secondary educational applications, the project was accepted. An easy initial authoring process might encourage an "experienced" author to later attempt more challenging techniques, such as simulation. This approach was successful in producing a satisfactory programming solution for the problem at hand and a favorable author attitude toward future CAI projects.

* Developing a tutorial CAI program on coursewriting guidelines available as a direct computer access or hard-copy version.

This 20-minute tutorial was divided into four sections:

1. Deciding on CAI as the teaching strategy of choice for a specific teaching module. This section apprises the learner of appropriate and inappropriate uses of CAI.

2. Planning the evaluation/revision process. Possible evaluation and revision processes are suggested.

3. Determining the style of presentation for the CAI module to be developed. Four models are suggested and summarized . . . drill and practice, tutorial, problem-solving, and simulation. Excerpts from programs exhibiting the model are displayed after each summary.

4. Developing CAI module design. This section addresses techniques for displaying text, balance of information and learner responses, evaluation of learner responses, and graphics integration.

Faculty who expressed an interest in authoring were invited to access this program as an initial step in the coordination process. Usually a member of the Micro Lab was in attendance during the computer interaction to expand on the material and to assist with the computer's operation.

* Informally assessing each faculty member's level of readiness for participation in CAI projects.

As expected, there was a wide divergence of opinion about the advisability of using CAI. In conversation, resistance was expressed in a variety of ways. Some individuals objected to the entire project as money wasted. Others objected to specific drawbacks about the system, such as having to use a keyboard for response entry. Some were enthusiastic about the prospect of having microcomputers. Although support from all segments of this group was sought, the individuals who expressed enthusiasm initially were the first to attempt authoring projects.

* Coordinating preliminary efforts of faculty members to author new material.

The Micro Lab offered the assistance of a support person knowledgeable in subject matter, sequencing techniques, and available programming languages. One of the major difficulties in CAI development is that the subject matter experts are not conversant with programming languages or formatting techniques. The availability of someone possessing a basic knowledge of these three areas permits better coordination of program development. This nurse possessed additional credibility by being qualified to serve on faculty. Because the nurse who was responsible for programming the material could communicate with the authors in their terminology, and with a knowledge of the concepts they wanted to write about, there was less misunderstanding during the coordination process. Less misunderstanding contributes to less frustration. The authors are more confident that their goals in presenting material are understood and valued.

* The Dean of the College of Nursing suggesting at a faculty meeting that at least one CAI module be included in each course offered at the College.

This statement encouraged faculty who may have been reluctant to experiment with the new media. The implication of this statement is that new attitudes and behaviors would be rewarded. Top administrative support for old attitudes was being removed.

* Installing microcomputers in the Independent Learning Center at the College of Nursing for student use.

Approximately 10 modules were completed prior to this installation. The installation was timed to coincide with faculty readiness to assign CAI modules as part of course requirements.

* Compiling and distributing the "Microcomputer Reference List," a booklet describing available programs, computer operation instructions, and a glossary of computer terminology.

A booklet was initially distributed by mail to every faculty member. Later, when faculty started assigning modules to students, copies were given out to each student in the Independent Learning Center.

The material in the booklet was kept at an elementary level, so that new users would not be overloaded with superfluous information.

Conclusion

We have been encouraged by the growing support and participation among faculty that the Microcomputer Lab is now enjoying. Integrating CAI within the College of Nursing curriculum has been facilitated by sensitivity to the concerns, fears, and needs of the target population, including recognition of the value of their professional expertise and communicating that recognition interpersonally during the change process. We believe that the foregoing reeducative and persuasive strategies have contributed heavily to the successful introduction of CAI to our College of Nursing faculty.

10.3928/0148-4834-19841001-09

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