Journal of Nursing Education

Major Article 

Opinions of Online Nursing Students Related to Working in Groups

Debra C. Hampton, PhD, RN, FACHE; Peggy El-Mallakh, PhD, RN, PMHNP-BC

Abstract

Background:

The purpose of this study was to examine nursing students' perceptions regarding the usefulness of group work in online nursing programs, to identify challenges with online group work, and to determine which factors contribute to successful completion of online group assignments.

Method:

An online survey was used to obtain data for this qualitative descriptive study. The sample consisted of 217 nursing students in RN-to-Bachelor of Science in Nursing, Master's of Science in Nursing, and Doctor of Nursing Practice programs.

Results:

The majority of online nursing students preferred not to work on assignments in groups due to the challenges but realized the importance and value of doing so. Participants stated that the greatest challenges to effective group work included time management and unequal contributions of individual group members. Strategies that facilitated effective group work included identification of compatible group members, communication, establishment of clear expectations for time lines and organization, and oversight from the course instructors.

Conclusion:

Faculty need to implement strategies to result in positive learning experiences for online nursing students because working effectively in groups is a critical nursing skill. [J Nurs Educ. 2017;56(10):611–616.]

Abstract

Background:

The purpose of this study was to examine nursing students' perceptions regarding the usefulness of group work in online nursing programs, to identify challenges with online group work, and to determine which factors contribute to successful completion of online group assignments.

Method:

An online survey was used to obtain data for this qualitative descriptive study. The sample consisted of 217 nursing students in RN-to-Bachelor of Science in Nursing, Master's of Science in Nursing, and Doctor of Nursing Practice programs.

Results:

The majority of online nursing students preferred not to work on assignments in groups due to the challenges but realized the importance and value of doing so. Participants stated that the greatest challenges to effective group work included time management and unequal contributions of individual group members. Strategies that facilitated effective group work included identification of compatible group members, communication, establishment of clear expectations for time lines and organization, and oversight from the course instructors.

Conclusion:

Faculty need to implement strategies to result in positive learning experiences for online nursing students because working effectively in groups is a critical nursing skill. [J Nurs Educ. 2017;56(10):611–616.]

Working together in groups or teams to solve problems and respond to complex issues is an essential skill. Nursing students need to obtain experience working in groups during their undergraduate and graduate education programs because being an effective team member is a requirement to work in any health care setting. As health care transitions from a fee-for-service model of payment to a value-based payment model, the need to combine skills and expertise to result in safe, effective, efficient care will become an even greater necessity. Students need to be comfortable working in a fast-paced, team-oriented environment and, further, in a flexible teaming model. Edmondson (2012) noted that in the current fast-moving, ultracompetitive, complex global business world, stable teams cannot be relied on to get things done, but instead need to take teamwork to a new level and facilitate the concept of flexible teaming. With teaming, experts from varied divisions or organizations and disciplines join together into temporary teams to tackle problems and capitalize on opportunities.

Evidence-based support exists for the benefits of learning and working in groups as students (Chiriac, 2014; Hall & Buzwell, 2012). Benefits of group work include social support during times of stress; more positive work attitudes; sharing knowledge and diverse perspectives; building on individual knowledge and skill to result in increased productivity, efficiency, and effectiveness; and, ultimately, better cooperation within the organization (Borrill et al., n.d.). Flexible teaming, as defined by Edmondson (2012), offers even further benefits to include innovation from combining skills and perspectives, boundary spanning skills, flexibility and agility, better interpersonal and team skills, and the ability to more effectively manage unexpected events. Organizations that have effective teams are more nimble and innovative. Edmondson (2012) stated:

They are able to solve complex, cross-disciplinary problems, align divisions and employees by developing stronger and more-unified corporate cultures, deliver a wide variety of products and services, and manage unexpected events.

Students in online courses gain the additional benefit of learning to work with others in technology-mediated settings. The skills learned from online collaboration will be useful in the work setting, especially if people work for multilocational organizations that rely on online communication tools, such as on Web conferencing, video calls, and instant messaging, to connect people across the nation (and world) (Strang, 2013). In addition, in an online course environment, social interaction and group activities can help learners avoid feelings of isolation and improve motivation and persistence (Shank, 2010).

Although working in groups can facilitate collaborative learning and knowledge development, group work also can interfere with learning (Chiriac, 2014). Jackson et al. (2014) reported experiencing “an episode of quite negative feedback” (p. 119) from a group of adult learners that was the catalyst for a study aimed to identify challenges and benefits associated with group work. Communication issues, language barriers, differing levels of knowledge and expertise, and time management issues were some of the challenges participants identified. Challenges of teaming include conflict among individuals with different experience levels, values and expertise, time zone differences, lack of time to form teams and build trust, and the requirement for constant communication and coordination (Edmondson, 2012).

Even more significant group problems may be experienced in online courses because facilitating opportunities to work in groups in online courses is more geographically challenging. Koh and Hill (2009) reported that students found online group work to be more difficult than face-to-face group work; they noted that difficulty with communication and a lack of a sense of community were two of the most significant challenges of online group assignments.

Some students fear that group work and online learning adds further uncertainty and apprehension (Calongne, 2010). Work equity issues, dependency on others, and lack of cooperation are other reported concerns of students when working in groups (Online Learning Insights, 2012; Piezon & Donaldson, 2005). An, Kim, and Kim (2008) found that the top seven impeding factors to successful online group work included: lack of individual student accountability, virtual communication challenges, technology problems, unclear assignment guidelines, time zone differences, lack of a group leader, and poor consensus building skills. Similarly, Roberts and McInnerney (2007) reported that the seven most common problems experienced when working in groups in the online learning environment included (a) student antipathy toward group work, (b) issues with the selection of the groups, (c) a lack of essential group-work skills, (d) the free-rider or student who does not do his or her own share of the work, (e) inequalities of student abilities, (f) withdrawal of group members, and (g) the assessment of grades for individuals within the group. Roberts and McInnerney (2007) noted that problems of online group learning may be interrelated. For example, they stated:

Student antipathy (#1) may lead to free-riders within groups (#4), and even the withdrawal of some group members (#6), and this in turn may cause problems for the assessment of individuals within the groups (#7).

As nursing faculty members who teach in online courses, the current authors have heard many of the same concerns about group work that are documented in the literature. However, few studies have focused on nursing students' perceptions of the effectiveness of group work in online nursing courses and the identification of factors that promote effective online team experiences. Because effective teamwork is so important in health care organizations, nursing faculty need to understand student opinions about group work so that can be developed strategies to help students be effective members and leaders of health care teams. Being a good team member requires nurses to effectively communicate with other members of the team, even when the staff are in different physical locations. Opinions of nursing students regarding the use of group assignments in online nursing programs, to include determining whether group assignments are considered to be useful for learning and to identify the challenges created by group assignments in online programs, are reported in this article. In addition, factors that help with successful completion of group assignments in online courses are discussed.

Method

An online survey was used to obtain data for this qualitative descriptive study. The goal of qualitative descriptive studies is the summarization of experiences of individuals or groups of individuals; the presentation of data from a qualitative descriptive study involves a logical summary of the information communicated by the participants (Lambert & Lambert, 2012). Qualitative descriptive research is grounded on naturalist inquiry, with the aim of understanding the “truth” from the participant's perspective (Colorafi & Evans, 2016, p. 17).

Eligible participants for the study included RN-to-Bachelor of Science in Nursing (BSN), Master's of Science in Nursing (MSN), and Doctor of Nursing Practice (DNP) students who were currently enrolled in online school of nursing programs in the southern United States or who had graduated during the previous calendar year. Both nursing programs that were the setting for this study admit students from across the United States. Approval for the study was received from the investigational review board for both schools.

An e-mail was sent to participants, inviting them to participate in the study. The e-mail included a link situated in survey software (SurveyMonkey®) that included items regarding demographic data and questions regarding students' opinions about group work in online courses. Participants completed an anonymous online survey; surveys were numbered automatically using the sequential numbering format within SurveyMonkey. The results discussed in this study include data from a survey that addresses student teaching methodology preferences in online courses; the survey also includes three open-ended questions about working together on group projects:

  • If you had your preference, would you use group projects in online courses?
  • What is the biggest challenge you have experienced when working in an online group project?
  • What factors have helped with successful completion of online group projects?

Results

Demographic Data

Eligible participants in this study included 944 online current or recent nursing students, including 227 RN-to-BSN students, 561 MSN students, and 156 DNP students. An overall survey response rate of 23% was obtained (N = 217); the final sample consisted of 56 RN-to-BSN students, 118 MSN participants, and 43 DNP students. The average student age was 45 years, with little age diversity across the programs (RN-to-BSN = 44, MSN = 46, and DNP = 45). Ninety-five percent of the respondents were women. Participants had an average of 16.8 years of nursing experience, and the majority had been enrolled in the online programs for 2 years or less (0 to 12 months, 42%; 2 years, 45%; 3 years, 8%; and 4 years or more, 5%). Ethnic group participation was diverse and included African Americans (17%), Asian or Pacific Islanders (5%), Caucasians (71%) and Hispanics or Latinos (3%); 4% did not indicate an ethnic group.

Findings

Preferences: If You Had Your Preference, Would You Use Group Projects in Online Courses? The majority of participants indicated that their preference was to work independently due to the stress, “hassles,” and frustrations of having to work with others who have different skills, motivations, and time commitments. No significant differences existed regarding student opinions about working on group projects for the different programs; the majority of students in the RN-to-BSN, MSN, and DNP programs preferred to work independently instead of in assignment groups. Comments from those who preferred independent work included:

  • It is too much of a hassle getting it together and if you work and have a family it is already hard. In a group project some people care and others do not, so I am waiting around for everyone to respond to their part and it's always the last minute. If we were in a classroom and saw each other it would be different.
  • I work full time; this just causes added stress.
  • It hinders me from progress.

Despite the preference for individual work, participants stressed that group work was a valuable opportunity to interact with peers and learn collaboration and teamwork skills. One student stated, “I do see the benefit in some cases, especially to learn team work and leadership of teams.” Other students agreed, stating:

  • The goal of excellent patient care cannot be reached unless all team members actively participate in that care. I really want to do research and that, too, requires group effort.
  • Especially in nursing, one has to work with others all of the time, and learn to deal with the ways of others…. Some jobs I have looked into have had employees or management spread over several states. During my interviews, they seemed impressed that I had experience in distance-working.

Other participants related that group work introduced them to new concepts and practice guidelines that they would not have otherwise used. One student stated:

[I] learned a lot from peers about their experiences and their organizations. I actually got a protocol used at another peer's facility and brought it to ours. It has made a huge difference is CAUTI [catheter-associated urinary tract infection] prevention!

Other participants stressed that group work was beneficial in promoting collegiality: “I like a balance of group projects and individual projects. Group projects have been beneficial in helping me feel more engaged within my cohort; however, working in a group is not as convenient as individual projects.”

Challenges: What is the Biggest Challenge You Have Experienced When Working in an Online Group Project? Participants stated that the greatest challenges to effective group work included time management and unequal contributions of individual group members.

Time management issues were multifaceted, and mostly involved family obligations, work schedules, and coordination of group work across time zones. One participant stated:

I routinely partnered with people who worked full time and had a family. Living in different time zones also added to issues of time management. We always did what we needed to do and were successful, but it wasn't easy.

Several participants indicated that coordination of group work and communication were often compromised because group members worked different schedules and resided in different time zones, stating, “It takes extra time to communicate and collaborate…. For those of us with dramatic time differences, it is extremely difficult,” and “Being a nightshift worker, I sleep during the day…. [It is] hard to connect with people in different time zones.” One participant stated that “coordinating work, sleep, and school was difficult. Being the one in the earliest time zone, I would need to stay up very late to confer with the other participants.” Another student related, “I live in [a northwestern state]…. The time difference is usually between 3 [to] 4 hours…. By the time I am getting home from work, it is 9 [to] 10 p.m., which leaves me limited time to complete the discussion board.”

The overwhelming majority of participants related that unequal contributions of the individual group members was a major challenge to effective group work. Participants noted that the most significant challenges included lack of accountability of group members, such as “getting everyone to do their fair share.” Participants related that “not everyone works equally on the project,” and that “usually, there are one or two members in the group who do all the work.” One participant stated that the online course format interfered with group members holding each other accountable to complete work in a timely fashion, stating, “[It was] difficult to hold anyone accountable; I ended up doing the majority of work.” Other participants agreed, stating that “the biggest challenge I have experienced in working in an online group project was other students often didn't complete projects or their portion of the assignment on time.” Participants further stated that the unequal contributions created undue stress and burden on those who were more motivated and committed to the project, with one student stating:

My biggest challenge is dealing with people who wait until the last minute or do not communicate often. It leaves me feeling as if I have the burden of completing the project on my own because I don't want it to affect my grade.

Facilitators: What Factors Have Helped with Successful Completion of Online Group Projects? Participants identified a variety of strategies that facilitated effective group work, including the identification of compatible group members, communication, establishment of clear expectations for time lines and organization, and oversight from the course instructors.

Participants stated that partnering with compatible classmates was essential to facilitate timely completion of high-quality group work. This involved identification of the right partners for group work, particularly classmates who were equally committed and invested in the project and to graduate education in general. One participant described “having classmates who are very much like yourself and dedicated to completing the degree.” Participants stated that “it truly depends on who your teammates are,” stressing the need to “[have] a greater percentage of go-getters than slackers.” Other comments underscored the importance of working with compatible group members, with one participant stating, “We really worked well as a team and ended up doing well on the project. It was very challenging, but I was lucky to have two great partners.” Equal motivation among all group members was identified as crucial; one participant stressed the need for “having good partners who were as motivated as you to accomplish the assignment.” Another participant stated:

I had two great partners, which was the first time a group project was a positive experience for me. It really demonstrated how a group project should work when all parties involved are hard workers and motivated.

Participants related that an effective strategy involved the identification of compatible classmates early in the program, with the intention of continuing work with these classmates throughout the program, with one stating, “Once I found someone that I worked in a group project with very well, we were able to get placed in the same classes and we chose each other as group members.” Another participant stated that she “made friends with someone first semester; she has personality traits like mine. I can trust that she will do her work on time and thoroughly.”

Participants identified several strategies to facilitate effective communication during group work; these included initial group brainstorming of suggestions, establishment of phone, text and e-mail trees, a private Facebook® page for group members, regular Skype or telephone conferences, file exchanges, and group discussion board updates. In addition, effective group work was facilitated by the group's ability to intervene with members who did not contribute equally, particularly with “persistent calling out of those with less accountability” and “staying on everyone's case until they respond.”

The establishment of clear expectations for group work was identified as essential. Expectations included identification of shared goals early in the project, assignment of different aspects of the project, and deadlines for completion of work. Expectations needed to be set at the beginning of the semester, with one participant stressing the need to “really know the time line and expectations on [the] first day so you could plan your schedule and work.” Other participants stressed the need for “collaboration, flexibility, feedback, and shared responsibility…understanding the bottom line and developing a plan to get to it,” and that “the rules of participation have to be very clear. I don't want to end up with a bad grade if someone disappears from the class and we submit incomplete work.” One participant indicated that lack of clear expectations among group members could interfere with progress in group work, stating, “we did not set ground rules so one student almost completely altered the work of another. As the third person involved, I did not think the changes were warranted…. We got through it.” Participants recommended establishing a time line in a signed contract among all members, stating:

[A] time frame is a must…drawing up an agreement that each student in the group had to sign. The group would make suggestions on what the laws would be for the project. They would agree on time frame, when an individual would be called, deadlines, respectful replies, and everyone had to contribute.

Participants stressed the need for the instructor to communicate clear guidelines for the group assignment at the beginning of the semester and provide ongoing oversight throughout the semester. One student expressed the opinion that group projects are effective “only with strong monitoring and support of the faculty. Time lines need to be established and faculty need to be present to enforce time lines…. People not pulling their weight should be dealt with immediately.” Another participant agreed, stating that “online group projects have been most successful when the instructions for the assignment are given ahead of time, [and] the guidelines for the assignment and grading are clear.” Another participant related that it was helpful when a “professor gave quick feedback… [and] had an open line of communication…. If there was any confusion, she would follow up with a phone call.”

Several participants indicated that group work could be facilitated through equitable grading policies. In particular, participants stressed the lack of fairness in grading individual contributions to group projects. One participant stated that “my partner, who did significantly less work, got the same grade as I, who did 90% of the work.” Other comments regarding lack of equitable grading indicated that “slackers get the same grade as all the others, with no substantive consequences to their failure to fairly or meaningfully participate” and “students who did not contribute should not receive the same grade as the ones who did.” Participants recommended that equitable grading in group projects requires “having each team member graded separately according to their participation.”

Discussion and Implications for Practice

Findings from this study demonstrate that the majority of online nursing students prefer not to work on assignments in groups due to the challenges but realize the importance and value of doing so. Together, teams can build on the skills of each member to achieve common goals (Chiriac, 2014) and accomplish far more than individual members. The issues experienced by participants in this study, including time management, unequal contributions by all team members, communication issues, and lack of clarity related to expectations, were also reported in other studies (An et al., 2008; Online Learning Insights, 2012; Piezon & Donaldson, 2005; Roberts & McInnerney, 2007).

One of the most significant online group project frustrations for students was colleagues not doing their share of the work, resulting in one or two students having to pick up the slack. One student noted that they did not want to be “at the mercy of someone I do not know.” In response to the question about factors that helped with successful completion of online group projects, several students mentioned that doing the work themselves is how they coped, stating,

  • Doing the work myself when my partner wasn't accomplishing what I expected.
  • Members who are committed to doing good and getting a good grade doing all of the work.
  • Usually [one to two] members take over and get the work done.
  • If I did not want half-way submitted projects, [I would] pick up the slack and help the other person complete their assigned portion.

Similar to the findings in this study, Hall and Buzwell (2012) reported that students related online course frustrations to free-riding team members and the lack of methods to hold student colleagues accountable; participants' main concern was the perceived inequality of others who did not do their share of the work getting the same grade.

The experience of working on assignments in online courses in a group can be made a more positive experience by making minimal changes that will have a significant impact.

First, online instructors need to provide mechanisms to ensure individual student accountability for their part of group assignments. Data from this study strongly supported the need for students to work with colleagues who had similar values and traits to their own (compatible team members), to include promptly responding to messages from student colleagues, meeting commitments, and doing their best to do outstanding work. Having students post information on an online discussion Web site about their values and expectations of team members may be one way for students to find more compatible group colleagues. On the basis of the posted information, students could choose group members who had like characteristics. Students also could post information about what time zone they live in, which could give colleagues the option to select group members who live in the same time zone. In addition, strategies to increase social interaction between online students or build familiarity among group members may enhance the feeling of compatibility with team members and enhance satisfaction and the learning experience (Koh & Hill, 2009).

Communication issues due to time zone differences, work schedules, and differing life priorities was a significant issue. Students recommended that online faculty use both synchronous and asynchronous communication methods, to include group discussion boards, e-mail and texting groups, and sharing of telephone contact information. An et al. (2008) also suggested that encouraging students to use synchronous communication tools, such as instant messaging, could reduce communication problems. Findings from this study, as well as those from other studies (An et al., 2008), also demonstrate the importance of having a group leader facilitate group communication. One student in this study stated he or she “took the lead on every group project I participated in” and that it “ensured the work was completed even if one student didn't do his or her part.” Another student stated that the “most effective factor that has helped with group projects is to have a lead person.”

Participants in this study also pointed out the importance of having detailed assignment guidelines for online courses, due to the challenges with communication. Instructors need to provide detailed assignment guidelines within the syllabus to include information about the grade influence consequences for late submission of assignments.

In addition to time management issues that are potentiated by time zone differences, the second most significant frustration for students was lack of accountability to complete well-done work in a timely manner. One accountability strategy would be to have the group set deadlines for each part of the assignment and require students to individually report to the instructor about the status of their assigned task at applicable project milestone times (or submit each part of the assignment to the instructor as individual students); this will allow for the monitoring of each group member's level of commitment, responsibility, and participation for the assignment. To increase student accountability, collaborative assignments should include both group and individual performance-based tasks (An et al., 2008). Another strategy to address unfair workload distribution in an online setting would be to assign individual grades to students instead of stating that all students will receive the same grade on the assignment (Piezon & Donaldson, 2005; Roberts & McInnerney, 2007). Individual student grades could be determined by combining points for group participation, individual contributions to the final assignment, and timely submission of the student's part of the assignment. Roberts and McInnerney (2007) noted that the best method to monitor the quantity and quality of an individual student's contribution is to obtain feedback from other students within the group. Clearly, it is important to obtain feedback from the students, their individual group peers, and all members of the group as a team.

Instructor visibility and close oversight of the work being conducted by online groups of students is critically important. Having synchronous group member sessions with use of Adobe® Connect, Zoom, Skype, or other online methodologies is one way for instructors to monitor work within groups. Whether talking to students individually or in groups, it is important to listen to both sides of the story when students complain about the contribution of group members. Sometimes, the student who is the most verbal may not be doing his or her share of the workload or may not be cooperative, resulting in group dissension.

Once project assignment teams are formed, a wise strategy is to require students to create a project team charter (Engle, 2010; Shank, 2010) that outlines the work to be completed and addresses questions such as:

  • Who will do what work?
  • When and how will the group meet and communicate during the project term?
  • What are the group expectations for communication with each other?
  • How and when will members submit their part of the assignment to the group?
  • Who will be responsible for editing the final document?
  • Who will submit the final group assignment for the group?

Finally, even though an important part of education is to provide an environment for students to learn effective team collaboration, some assignments may result in more positive learning experiences if conducted by individual students instead of as a group assignment. Group assignments in online programs need to be limited to those that will be maximally effective for learning when completed in a group. When class sizes are large, assigning projects in groups may result in less grading work for faculty; however, this should not be the reason for use of group projects. Online assignments that require students to communicate with each other several times a week may not work well for distance education, where students from across the United States need to work together on the project.

Limitations

A limitation of this study included having participants from only two schools of nursing in the southern part of the United States; however, because students in these programs were from across the United States, this was not considered a significant limitation to the study. Participants included students who had recently completed the program, in addition to students who were currently enrolled in the program; retrospection may have influenced the opinions of students who already had graduated from the program to result in an opinion that might be different than the one they had when they were a current student. Further, some students did not have enough experience as an online student to offer an opinion regarding working on group projects in online courses or to offer suggestions about factors that would improve the experience of doing group assignments; this was evident from statements from some students who noted they did not have enough experience to comment. In addition, some participants answered the question about a preference for working in groups but did not provide information about challenges of working in a group or suggestions for improved online group effectiveness.

Conclusion

More than ever before in the current complex health care environment, working effectively in groups, including virtual teams to solve problems and ensure safe care for patients and a positive workplace for staff, is essential. Faculty who teach in online courses need to be effective boundary spanning leaders (Ernst & Chrobot-Mason, 2011) to maximize creativity, innovation, and potential of diverse online student groups. As stated by Ernst and Chrobot-Mason (2011), “In navigating today's unfamiliar terrain, we are all challenged to think and act beyond the current borders that confine us, our teams, and our organizations as a whole” (p. 3). Reciprocity and group collaboration among students should be maintained in the classroom education environment to result in continued student engagement, effective learning, and students who are prepared and ready to face the challenges of the current work setting; the online learning setting is no different.

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Authors

Dr. Hampton is Academic Coordinator, Executive Nursing Leadership and MSN-to-DNP Programs, and Assistant Professor, and Dr. El-Mallakh is Associate Professor, University of Kentucky College of Nursing, Lexington, Kentucky.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Debra C. Hampton, PhD, RN, FACHE, Academic Coordinator, Executive Nursing Leadership and MSN-to-DNP Programs, and Assistant Professor, University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536; e-mail: dhamp0@uky.edu.

Received: February 09, 2017
Accepted: April 25, 2017

10.3928/01484834-20170918-06

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