Online Education, Required or Optional

I attended a national nursing meeting on the development of online associate degree nursing programs today. The conference was a phone one, which has definite disadvantages. While this delivery method may have helped those educators attending but who are still transitioning into online, it did little to role model technology uses in education. My involvement was further hindered by the lack of a budget to pay for the hour long phone call, so I first tried my cell, my main communication tool with all of my colleagues and students. When I could not figure out if it had a mute button, I suddenly realized my Skype account had calling out privileges to land lines, which worked perfectly.

From Dolores Fidishun’s Integrated Adult Learning Theory as We Teach with Technology, she refers to Knowles, Holton, and Swanson’s six assumptions of andragogy. In the nursing and other medical fields, the first assumption, The Learner Needs to Know, is well evident, for these are training courses for professions needing student graduates. Some reflection is used in the courses already, but more could be done. The learner’s self concept is not usually fostered towards a self directed learner, but rather as a dependent one. Most courses in traditional as well as in many online ones, provide the information, which is then internalized, and regurgitated, if not forgotten, on a multiple choice examination, both in the college programs and in the state licensing examination. Multiple ways of learning are usually provided and an almost exclusive emphasis is on the textbooks, rather than other educational sources, even in partially online courses. This is particularly a problem because the medical profession requires lifelong learning, most of which will be done in a independent format.

Little emphasis has been made about andragogy in nursing education. All of the educational structure seemed to be more pedagogical, following the less effective learning model of providing the information for the students to memorize, without experiencing it before they moved onto the lab and clinical. Using teaching resources like Eluminate, Articulate, blogging, games, web videos and animations, 3D online environments, text messaging, and clinical cases are not very common place in traditional or online nursing education.

Not much in nursing and medical education uses the next assumption, the role of the learner’s experience, to encourage reexamination of previous learning. Critical thinking requires that practitioners reexamine interventions based on the complex variables presented in each unique medical scenario on the job. Therefore it is imperative that learning occur with a more reflective and prioritizing manner. Through media and activities using the web and real patient cases, students can learn better in both the online and all face to face environments. At this meeting, a huge emphasis was placed on attrition and licensing rates, as compared with all face to face classes. The real test of whether online learning using current, complex situations not available in textbooks, should come from the medical facilities and employers themselves, as long as they are too entrenched in the old ways of teaching. Clearly, as the graduates move into practice in a job, reexamination comes quickly and can be very traumatic for the novice.

A strong argument can be made for all classes in the medical area needing to be at least partially online, with a heavy emphasis on the current state of the medical fields as well as real patient situations. Medications and treatments change frequently because much of medicine is not based on evidence, but rather it is just the way it has been done, and as new research comes forth, these assumptions are questioned. Equipment changes very fast and the manufacturers have detailed educational resources, which are extremely valuable, even with the negative of their corporative spins. The links to these changes need to be at front of any educational program, providing the real examples for students to analyze and react to.

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