Journal of Nursing Education

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Inter-University Collaboration in the Development of a Distance Education Course in Community Health Nursing

Jacoba De Jonge, RN, BScN, MScN; Lorne McDougall, RN, BScN, MN

Abstract

In a period of expanding needs and limited funding, universities are pressured to meet changing education needs in a cost effective manner. In 1987, Laurentian University (serving northeastern Ontario) received provincial government funding support for its proposal for a distance education BScN program for RNs. These funds, however, were allocated to meet the needs of all of northern Ontario, and therefore were also apportioned to Lakehead University (serving northwestern Ontario) to offer its program by distance education. Because the funds were insufficient to develop two entirely independent sets of courses, the directors of the two schools of nursing developed a plan to share resources. Because of the complexity of the community health nursing content in each curriculum, the community health nursing course was co-authored by two faculty members, one from each university. This article describes the process of co-authoring a distance education course in community health nursing for post-dipioma baccalaureate nursing students. It will describe the necessary resources, existing constraints, development process, and pitfalls to avoid in the future.

Resources

Author Expertise. The faculty members involved in the course development had complementary education and experience in community health nursing. Each of the authors held master's degrees and had been in their current positions on faculty for 4 to 6 years, and were therefore familiar with their own school's curriculum, university resources, and community resources. Through previous work on a provincial committee of nurse educators, the authors had had the opportunity to exchange ideas about nursing education, particularly community health nursing education, prior to accepting this assignment.

Administrative Support. The coauthors were released from regular teaching commitments for one term to allow concentrated time for the course development work.

Course Development Team. The course development team, chaired by the Director of the Centre for Continuing Education (CCE), included the co-authors, an instructional design consultant, a course editor, a director of the instructional media department, a librarian, a distance education program coordinator, and a CCE staff member responsible for budget monitoring. The only team member released to devote full-time efforts to the course development process for three months was the Laurentian author.

Constraints

Budget. The Centre for Continuing Education at Laurentian University managed the course development budgets and had predetermined uniform ceilings for each course. The authors were responsible for developing a specific course development budget to cover anticipated costs of an editor, telephone calls, postage and courier services, photocopying, copyright costs, audiovisual materials production and duplication costs, library acquisitions costs, as well as airfare and hotel costs for working meetings. Fortunately, the Director of Continuing Education permitted us to be flexible in adjusting the budget proposal (but not the ceiling) as we worked and as needs changed. Airfare and hotel accommodations were the major unavoidable expenses, as the universities are 1,000 miles apart.

Content. Because the course had to satisfy two different curricula, each co-author had to become familiar with the other's curriculum. Also, because it was important for both authors to use consistent terminology, we needed to define terms and concepts and to clarify our beliefs about the concepts that would be addressed in the course. We also needed to consider course load issues in terms of credit value for the course and to be selective in the content covered, as this course essentially was to be a half-credit course (equivalent of three lecture hours per week for one term) including both a theory and a clinical component.

Delivery. The off-campus distance education courses were to have the same content and sequence as on-campus courses; only the course delivery methods were to differ in order to suit the distance education…

In a period of expanding needs and limited funding, universities are pressured to meet changing education needs in a cost effective manner. In 1987, Laurentian University (serving northeastern Ontario) received provincial government funding support for its proposal for a distance education BScN program for RNs. These funds, however, were allocated to meet the needs of all of northern Ontario, and therefore were also apportioned to Lakehead University (serving northwestern Ontario) to offer its program by distance education. Because the funds were insufficient to develop two entirely independent sets of courses, the directors of the two schools of nursing developed a plan to share resources. Because of the complexity of the community health nursing content in each curriculum, the community health nursing course was co-authored by two faculty members, one from each university. This article describes the process of co-authoring a distance education course in community health nursing for post-dipioma baccalaureate nursing students. It will describe the necessary resources, existing constraints, development process, and pitfalls to avoid in the future.

Resources

Author Expertise. The faculty members involved in the course development had complementary education and experience in community health nursing. Each of the authors held master's degrees and had been in their current positions on faculty for 4 to 6 years, and were therefore familiar with their own school's curriculum, university resources, and community resources. Through previous work on a provincial committee of nurse educators, the authors had had the opportunity to exchange ideas about nursing education, particularly community health nursing education, prior to accepting this assignment.

Administrative Support. The coauthors were released from regular teaching commitments for one term to allow concentrated time for the course development work.

Course Development Team. The course development team, chaired by the Director of the Centre for Continuing Education (CCE), included the co-authors, an instructional design consultant, a course editor, a director of the instructional media department, a librarian, a distance education program coordinator, and a CCE staff member responsible for budget monitoring. The only team member released to devote full-time efforts to the course development process for three months was the Laurentian author.

Constraints

Budget. The Centre for Continuing Education at Laurentian University managed the course development budgets and had predetermined uniform ceilings for each course. The authors were responsible for developing a specific course development budget to cover anticipated costs of an editor, telephone calls, postage and courier services, photocopying, copyright costs, audiovisual materials production and duplication costs, library acquisitions costs, as well as airfare and hotel costs for working meetings. Fortunately, the Director of Continuing Education permitted us to be flexible in adjusting the budget proposal (but not the ceiling) as we worked and as needs changed. Airfare and hotel accommodations were the major unavoidable expenses, as the universities are 1,000 miles apart.

Content. Because the course had to satisfy two different curricula, each co-author had to become familiar with the other's curriculum. Also, because it was important for both authors to use consistent terminology, we needed to define terms and concepts and to clarify our beliefs about the concepts that would be addressed in the course. We also needed to consider course load issues in terms of credit value for the course and to be selective in the content covered, as this course essentially was to be a half-credit course (equivalent of three lecture hours per week for one term) including both a theory and a clinical component.

Delivery. The off-campus distance education courses were to have the same content and sequence as on-campus courses; only the course delivery methods were to differ in order to suit the distance education requirements and resources. The selection of course delivery methods were validated by an instructional design consultant at one of the two distance education network centers. These centers were established in 1986 through government funding to promote access to educational opportunities throughout northern Ontario.

Course Development Process

Although the course development time was officially September to December 1987, the authors met once in early July to prepare for a meeting with the course development team at the end of August. Preparation included discussion of curriculum structures, anticipated course objectives, possible course structure, and division of the workload between the two authors, including a schedule of target dates. The schedule allowed time for primary writing, review by the co-author, editing, and revisions for each section. We planned for catchup weeks, anticipating that we would fall behind schedule at some point. The final draft was approved early in March 1988.

As authors, we examined the community health nursing objectives for each school and determined which objectives should be addressed in the course to be developed. These objectives were then grouped into units that could be sequenced as necessary to fit each curriculum. Because the two curricula were structured differently, each unit was designed so it could stand alone; this would allow for the material to be reorganized or distributed across different courses if necessary. We then developed an outline of all of the content areas and clinical expectations arising from the objectives that was realistic and feasible for both the course deliverer and student workload. The objectives were re-examined and readjusted throughout the course development process as necessary to distili a succinct set of essential, specific objectives for the course.

Since this was to be a multimedia course, we explored a variety of media forms suitable for the objectives. Dutton and Lievrouw (1982) warn that media selection should be content-driven rather than technology-driven. Although we were introduced to a vast array of new computer technology and software, we opted for media forms that were accessible to all students, mainly including texts, reports, journal articles, teleconferencing, and videotape recordings.

A well-organized course manual was essential to spell out the course objectives and to guide students to the recommended text and reference readings, videotapes, teleconferencing schedule, child-development assessment kits, and required clinical field experiences. As co-authors working at a distance, we each took primary responsibility for developing selected units in our respective areas of interest and expertise. We then requested input and critique from the other co-author to avoid redundancies and unexplained discrepancies in content. We agreed that the units must all have a similar structural format and a similar approach to the use of readings and audiovisual resources. Each unit was therefore organized to include required readings, review readings, videotapes, an overview of the unit, learning objectives, discussion, learning activities, supplementary readings, references, and an appendix. The overview set the boundaries for the topics covered in a particular unit and described the relationship of each unit to others in the course manual. The discussion section was designed te augment and illuminate key ideas in the assigned readings. The students were introduced to the material and shown how it interconnected with a larger body of knowledge. Key concepts and theories were also illustrated so that the readings would have a focus.

Resource Persons. The assistance of a course editor was invaluable. She helped set target dates for the submission of first and revised drafts of each unit and had the monumental task of reconciling two very different writing styles into a manual that would be consistent enough in style not to be disconcerting to and inefficient for students. Because she was not familiar with nursing jargon, she challenged the use of words and phrases to ensure that the manual was self-explanatory and enlightening.

The distance education program coordinator in the Centre for Continuing Education informed us of policies and potential pitfalls (especially around the use of copyrighted materials). A library assistent looked after the acquisition of the books, articles, documents, and reports necessary for the course development. Staff at the instructional media department were helpful to us in identifying possible audiovisual materials to help us meet specific course objectives. They assisted by ordering preview materials, advising us on copyright costs and requirements, and ultimately purchasing and duplicating items needed. All their admonitions about the time required to obtain desired materials (up to six months for some items) and the need to order materials as early as possible were well-founded.

Computers. Both authors had access to IBM-compatible microcomputers but neither had experience with them. Because we had virtually no secretarial support available in either school, we were strongly urged by our faculty colleagues to use computers for word processing and communication efficiency. However, we lost enormous amounts of time exploring mechanisms to have work downloaded to the university mainframe computer and transmitted to the co-authors and editor. Inaccurate information about the compatibility of our word processing software programs also resulted in frustration and lost time.

Communications Technology. We tried to send materials from one university to the other by means of computer mainframes, FAX machine, mailed diskettes, and courier, but found none of these methods to work satisfactorily. The cheapest and most efficient form of communication was to send a hard copy by bus parcel express. The documents sent this way usually arrived the same day.

Personality. Besides experts and technological resources, other important sustaining elements were the personalities of the participants. Mutual respect, honesty (tempered with patience and politeness!, flexibility, endurance, and commitment were all vital. The most important element probably was a sense of humor.

Two major frustrations in which personality was a critical factor included labor disputes and transportation problems. During the course development time, there was a threatened strike at one university and a two-week strike at the other three months later, each of which raised issues of divided allegiance to our own faculty group versus the co-author. Needless to say, these labor disputes added considerably to the challenge and stress of co-authoring a course. Since the two universities are about 1,000 miles apart and only one had the key support staff for the project, the Lakehead author did all of the traveling, using air travel as the quickest mode. Travel delays and cancellations caused by a lengthy air strike and inclement weather demanded flexibility, endurance, and commitment from both authors and editor.

Pitfalls to Avoid

Many of the difficulties encountered in the development of this course were unforeseeable and beyond our control. Others, however, could be avoided in future.

Conditions imposed on the funding must not obstruct the possibility of developing a course or program according to academically sound principles. For instance, the ceiling on the course development budget should have been adjusted to reflect the communication costs necessary for two authors situated at such distant locations. Furthermore, it was extremely difficult to develop one course to be used in two curricula with significantly different course structures and sequences.

Requiring a distance education course to conform to the same expectations as an oncampus course may be unrealistic. This was particularly apparent as we strove to design meaningful and efficient learning activities, and ultimately assignments, that would be appropriate for the dispersed student body. We were constantly aware of the wide variations in learning circumstances that the off-campus student population would experience. Although the oncampus RN-BScN students had many of the characteristics profiled by Green (1987 ), the off-campus students were likely to carry even more roles and responsibilities and were likely to have more interruptions to their studying. Tbey would also have less in-person access to resource materials and faculty. The course needed to reflect these realities.

Faculty time for course development and release from other responsibilities must be clearly negotiated prior to the commencement of the course development process. It is important to guard this time carefully to avoid erosion by committee work, crisis relief, or administrative obligations. One author was pressured to accept some of these tasks and was then forced to work many late nights and weekends to meet deadlines. The process of researching a topic, writing a unit to be reviewed critically by a colleague and an editor, and then moving on to a new topic the next week can be stressful. The size of the project that was undertaken was such that a three-month release from teaching and other duties would be the minimum expected for both authors. Adequate administrative support is essential throughout the course development time.

Computer support systems should be available to both authors from the outset. Such support should include ready access to microcomputers, compatible word processing software for use by both authors, a mechanism for transferring computer files from microcomputer diskettes to a mainframe computer, and efficient computer support service personnel readily available to assist in trouble-shooting when necessary.

The Outcome

The final outcome of the process described in this brief was a multimedia community health nursing course using a course manual to guide student learning. The course manual was structured into nine units that do not require a particular sequence. These units could not only be offered intact by Laurentian University as one course, but they also could be integrated where appropriate into the nursing courses with community health content being developed by Lakehead University. Reference books and journal articles, videotapes, and other essential equipment were selected to be made available to students at designated off campus learning centers. Relevant informative brochures and guidelines specific for clinical practice were collated into a learning resource package, tailored for each student's site, to accompany the course manual.

Although the course manual was designed to provide students with clear directions for proceeding through the course, students are not expected to be as independent in learning as were those in the program described by Lethbridge (1988). This course is designed to be offered at various satellite locations during the same term: students are expected to meet in groups at those satellites for scheduled teleconferences with the course professor at the university and for seminars with local clinical teachers. These teachers are responsible for supervision of the home visiting clinical experience of students registered at each satellite.

The clinical experience component was not included in its entirety in the course manual because the specifics are expected to require restructuring each time the course is offered; moreover, the exact clinical experience is dependent on the clinical resources available in students' home communities. Clinical objectives were, however, integrated into the learning objectives for each unit.

Summary

Collaboration between faculty members from two university nursing programs has successfully produced an introductory community health nursing course for RNBScN distance education students. The course has integrated theoretical and clinical components organized into a coherent whole via a detailed course manual. The course is designed to be flexible so that individual units of the course manual can be reorganized as needed to fit the curriculum requirements of the co-authoring university.

The process of collaboration was both frustrating and satisfying. The frustrations included unavoidable difficulties as well as problems that, now that they have been identified, could be avoided in future. The greatest satisfaction, of course, was that of actually achieving a worthwhile goal despite the obstacles that presented themselves during the course development process.

References

  • Button. W. & Lievrouw, L. (1982). leleconferencing as an educational medium. In L.A. Parker & C. H. Olgren (Eds. teleconferencing and electronic communications (pp. 108-114). Madison. WI; University of Wisconsin-Extension Centre for Interactive Programs.
  • Green. C.P. (1987) Multiple role women: The real world of the mature RN learner. JNurs Educ, 26(71,266-271.
  • Lethbridge. D.J, U988). Independent study: A strategy for providing baccalaureate education for RNs in rural settings. J Nurs Educ. 27(4), 183-185.

10.3928/0148-4834-19890901-11

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