Distant Education In Nursing and Potential Barriers Methodologies & Need
RN Needs for Online Education In Distant Learning
A study using focus groups of RNs at a military hospital identified five themes related to the need for professional development. The thematic groupings included:
(1) specific development needs for leadership, clinical/specialty practice, competence development, and maintenance
(2) methods to provide continuing education
(3) methods to evaluate the effectiveness and efficiency of continuing education
(4) barriers to development
(5) professional development issues affecting retention specific to military nurses (Bibb et al., 2003)
The themes described in the Bibb et al. (2003) study focus on professional development and continuing education. Specific needs for new clinical skills and current evidence-based practice information exists in all specialty areas of nursing.
Pharmaceutical updates can be provided via the Internet in online continuing education self-study modules. Unique case studies allow opportunities for collaboration and professional development. So, with the increasing needs for continuing education, why is obtaining it such a challenge for RNs?
Advantages Of Online Learning and Distant Education
For RNs, shift work, high patient acuity, and unpredictable patient flow all create barriers to continuing attending educational programs (Curran Smith & Best, 2004). Benefits of online education include its accessibility and flexibility. The opportunities for professional development include career advancement such as course work toward certification or to prepare for certification exams; contact hours for participation; or as a means for career advancement (RN to BSN clinical ladders).
Web based education can help RNs maintain evidence-based practice knowledge and skills. In addition, overburdened practitioners can realistically save more time for a 30 minute online course versus a full day or weekend conference. Another barrier of traditional continuing education involves the costs that can include travel, lodging, food, and registration.
Costs should be lower for a Web-based program, depending on who is offering the program. Web based instruction developed by pharmaceutical companies or as the result of a federal or private grant may be free to participants.
Nursing managers also have difficulty accessing continuing education. The development of educational resources and support for leadership and management is viable via online methods. Providing interactive workshops presenting information focused on enhancing knowledge and skills is feasible. Finally, creating an arena for discussion and support for practitioners via Web-based education can lead to interdisciplinary collaboration and knowledge development.
Finally, for some areas, continuing education is geographically inaccessible. Online education can reach rural areas that may lack resources and access to current continuing education. Clinics caring for under served populations may be more easily reached via the Internet, as long as they have Internet and computer resources.
Potential Barriers Of Online Continuing Education In Distant Education
Barriers unique to the Web-based education programs include access to computers and the Internet, especially in developing countries, and attitudes toward learning via the World Wide Web (Cragg, Edwards, Yue, Xin, & Hui, 2003; Curran Smith & Best , 2004). Another potential barrier is the need for new skill sets for online learning technologies for both learners and educators.
Computer literacy among faculty and staff is an important consideration when developing and implementing online education. Faculty must learn to present the content, assist students in applying the knowledge, establish a shared understanding, and identify opportunities for improved communication (Curran Smith & Best, 2004).
For continuing education, the administrative logistics are substantial, and online education is not an exception. Finding staff time to complete the programs or attend the live satellite teleconferencing programs is a management issue. How is time and money budgeted for staff to attend continuing education? Who is encouraged to participate in professional development programs and how frequently?
Are staff rewarded for attending continuing education? Hospitals have initiated programs to provide staff incentives, such as “accruing” points by taking advantage of self-directed learning opportunities, which will lead to off-site educational programs (Reed, 1999). Others have mandated continuing education by including it in job descriptions and performance appraisals (Postler-Slattery & Foley, 2003).
Similar techniques may be used to encourage online courses for staff development.With the busy lifestyles of nursing professionals, allocating a set day, time, and appropriate environment is important in maintaining to the commitment for professional development.
Utilizing the Internet in a library, private office, or meeting room would be more successful than using a computer in the middle of a busy workstation where phone, patient, and staff interruptions are likely. Having technology available is necessary, as well as less technically dependent back up methods for periodic system glitches or crashes. This includes technological support for those participating in the program.
As with any continuing education program, verifying the following is important: that the continuing education provider is accredited with a good reputation, the content describes expected outcomes and logical and attainable objectives are outlined, and the program fits RNs' needs (Jackson, 2004) . In the case of those supported by pharmaceutical or market-based companies, one should also evaluate the program for bias and examine the faculty disclosure statements.
It is suggested that the workload, attrition and failure rates for online courses are greater (Sapp & Simon, in press), but no one has examined continuing education programs in these areas. With proper computer skills, commitment of individual time, and evaluation of the online program, the learning environment can be as successful as any other.
Methodologies For Online Learning In Distant Education
The variety of settings and practice specialties in nursing creates a need for culturally appropriate, setting and specialty-focused information. Areas of concentration may include, but are not limited to, technology, clinical skills, and interventions for client symptoms and disease management, as well as issues related to administrative and leadership responsibilities. Web based education and online learning opportunities have the potential to meet this need.
An array of methods to provide this education exists, including varied materials, teaching formats, and techniques of presentation. Materials can be text based, in the form of Power Point slides or lecture dialogue. Pre and post tests can be used for the provision of continuing education units or contact hours and to evaluate participant learning.
Video clips can provide demonstration of specific assessments or skills and allow for vicarious experiences and participant learning through role modeling. Interactive exercises such as matching, short answer, or crossword puzzles can enhance learning by providing immediate feedback. Web based education can use simulations and progressive problem solving to improve critical thinking skills.
In addition to a variety of materials, teaching formats can vary as well. Teaching formats include a single presenter to an audience that may or may not be able to interact, the use of case studies to provide real-life scenarios for learning, or discussion threads that are recorded over time and used for learning. Case studies can be presented to provide clinically focused content; Internet resources of Web links can provide important information for future reference and use.
Presentation of information for professional development may be via teleconferencing in a myriad of formats. The teleconference may be live and displayed to a live audience; it may be presented in video or audio format, or both. In addition, the teleconference may be archived and available to participants in video and audio format with other presentation materials, for example, handouts, PowerPoint slides, and CD-ROMs.
Depending on the style of presentation, interaction may be live, such as a video conference where the presenter can see participants via cameras and answer questions while presenting. By contrast, in an audio format, where participants are also linked via the Internet in a meeting session, individuals are able to ask questions by typing or calling them into the live session.
Location of the attendees is determined by participant needs and technological availability. When participants attend at the current time the presentation is given, they can be gathered in a large auditorium, observing and participating in the presentation as a group. In contrast, a smaller group of attendees at a local clinic or physician's office can attend the live teleconference.
Finally, individuals may attend from the comfort of their own offices or homes, in live time or as part of the archived recording of the teleconference. Self study text based, case study based, or individual learning modules are usually done at the participant's convenience. However, reimbursement for time spent on continuing education remains an unresolved issue.
Web based education has the potential to provide a variety of materials, teaching formats, and methods of presentation. It can consider the values and beliefs of diverse under served populations cared for by local community and hospital health centers, federal and state health programs, and physician offices.
Programs may serve practitioners as well as students, academics, researchers, and administrators. The opportunities for professional development and career advancement using online education are limitless.
There are definitely challenges to be overcome in relation to online education. Increased demand from the new generation of health care professionals will need more options and increased availability of Web based continued education programs. Federal support is in place for the development of programs for distance education for many health professionals.
Issues of computer literacy and availability, technological support and consistency, and learner/educator attitude toward online educational methodology will determine the success and participant satisfaction with this form of continuing education.
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