Point/counterpoint: Does "online" nursing education short change the RN to BSN student?

Georgia Nursing, Aug-Oct 2000 by Waddell, Donna L, Hayes, Jill M, Horne, Christina D, Camann, Mary Ann

Donna L. Waddell, EdD, RN, CS Jill M. Hayes, PhD, RN, C North Georgia College & State University

Online nursing courses, while convenient for the working RN, may not provide all of the advantages of participation in classes that meet face-to-face. Many studies have demonstrated that distance education results in the same knowledge increase for the RN to BSN student as campus-based courses (Billings, 2000). But, isn't education more than acquisition of facts or even critical thinking skills? Particularly in nursing education, don't role modeling and mentoring play a critical part in socializing students into the profession and teaching students to care? In this article we will examine some of the best practices in RN to BSN education, the effects of distance education on a variety of outcome measures for RN to BSN students, and the results of studies which focused on the best methods for faculty to promote professional socialization and caring. We will draw some conclusions about whether or not online education short changes the student.

Best Practices

Using Merzirow's theory of perspective transformation Callin (1996) examined the shift in perspective RN students experienced as a result of returning to school for their BSN. She noted the "ability to view familiar situations in new ways ... as they moved from RN to BSN (p. 28). She identified two teaching-learning models that foster this transformation: problem-based learning (PBL) and journaling. Others have demonstrated the positive effect PBL has on RN to BSN students (Murrell, Easton, & Thomsett, 1997; Edwards, et al., 1998; Ingram, Ray, Landeen, & Keane, 1998). Callin!s description of PBL assumed face-to-face small group discussions. To facilitate the discussion, tutors "need special skills in climate setting, team building, and promoting an accepting, supportive environment... to be experts in group process so that they can enable the students to recognize and label the dynamics in the group" (p. 31). Rogan (1997) described the challenges inherent in teaching an online course. Community building is the term he used for establishing a comfort level and trust as well as a high level of participation among the learners. The results of this initial study of the strategies which promote effective online learning indicate that while community building is not impossible, it is neither natural nor automatic; it is a skill which must be learned. Therefore, transferring the PBL or other active learning approaches will not automatically lend itself to an online environment. Faculty members choosing to implement PBL will have to develop cyberspace-specific strategies to ensure its usual effectiveness.

Thompson and Sheckley (1997) isolated the best teaching practices for BSN students who were adults, including RN to BSN students. Based on the "best" and "worst" traditional classroom experiences, a 45-item questionnaire with previously demonstrated reliability and validity was used. The RN to BSN students rated "cooperative learning" and "active learning" more highly than the other, even the older, non-licensed students. According to their definitions of these terms, cooperative learning involved encouraging students to help each other with difficult material, promoting learner interaction, and encouraging the learners to share their respective backgrounds with each other. Active learning involved using a variety of teaching-learning strategies, including role-playing, involving students in the planning of learning activities, and using interesting learning activities. To date, we do not know if these strategies will successfully transfer to the online learning environment. We can assume that since the lecture/discussion format did not fair well in this study, one cannot simply put one's lectures online and expect high levels of student satisfaction. Indeed, Schrum and Berge (1997) emphasized the need for faculty to change from lecturer to consultant, from an answerer to a questioner in the online environment.

Effects of Distance Education

According to a study by Reinert and Fryback (1997), the RN to BSN program is the most frequently offered nursing program via distance learning in the United States. This study surveyed all of the schools that were members of the American Association of Colleges of Nursing. According to the findings, a variety of delivery methods are in use, the most common being "one-- way and two-way video conferencing" (p. 422). Respondents cited as concerns student interaction with each other and with faculty. Technology, on-- site facilitators, and faculty visits were used to address these potential problems. All faculty members reported missing visual cues from the students and expressed concerns about the professional socialization of the students. All respondents expressed concerns about student isolation and their need for faculty contact.

Shomaker and Fairbanks (1997) evaluated a RN to BSN program delivered by satellite to nurses in rural New Mexico. Students expressed a preference for on-site classes. However, follow-up studies with graduates and their employers revealed improvement in leadership skills, critical thinking, and professional orientation. The grade point averages of the off-campus students were comparable to those of the on-campus students. The satellite program was, therefore, deemed a success, especially because it afforded access to an education, particularly for ethnic minority students, which otherwise would have been forgone.