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The Emergence of Online Learning in PN Education

Sunday, November 30, 2008

For the fifth year in a row the online learning sector outpaced growth rates of the traditional classroom. Online learning continues to garner increasing levels of positive support from administrators, employers, and students who value the option of online education at increasingly greater levels. PN Education has largely remained on the sidelines of this revolution. However, with the nursing crisis growing, students, governments, and institutions are demanding more access and convenience to educational options. With the emergence of the Millennial Generation making up the majority of the students, the time has come for PN programs to embrace the potential of online learning. With its diverse mix of didactic, clinical, and lab requirements, PN education is ideally suited for the newest evolution of online delivery—Blended Learning 2.0. This paper will analyze in detail the overall state of affairs of online learning, especially as it pertains to educating the next generation of practical nurses, and finally provide an overview of the key components of a quality online program in PN Education.

Article Published in The Journal of Practical Nursing - Winter 2008 Edition

by David D. Hopkins, PhD

The popularity and growth in online education is redefining the student experience in all levels of higher education. Recently the Sloan-Consortium, one of the most respected online learning organizations in the nation, released its fifth annual State of the Union in online education. The expansion and acceptance of online education continues to improve. In 2007 there was a 9.7% growth rate for online enrollments, dramatically eclipsing the 1.5% increase of overall higher education student enrollments. This growth translates to nearly 3.5 million students taking at least one online course in 2007. En sum, nearly 20% of all higher education students are currently taking at least one of their courses online (Allen & Seamen, 2007). Numbers and statistics aside, it is safe to say that in the next two to five years online courses will be fully mainstreamed into the higher education student experience and the availability of such will be as common as meeting in the traditional classroom.

For the PN Program Director and PN Educator considering the introduction of online courses into their program, the data from Chief Academic Officers bodes well for PN programs to join the ranks of other programs online. The most recent research finds there is little lack of acceptance or resistance to the hiring of their graduates who earned all or part of their degree online (Allen & Seamen, 2007). Concurrently, it has been show that students perceive online courses of equal or higher quality as the traditional classroom. Students also perceive that online learning has significant advantages over traditional classroom methodologies (O’Malley, 1999). With institutional leaders, employers, and students in agreement on the efficacy of online learning, PN Educators are now faced with both the daunting task and exciting opportunity to transform the delivery of PN education for future generations of practical nursing students.

The Need for Change

The rationale for PN programs to go online can be reduced to three primary reasons. These three motivators are greater strains on institutions to produce more graduates due to the nursing shortage, to expand student access and convenience, and to address the changing demographics of the next generation of PN students. Changing student demographics and the drive for increased access and convenience are motivators for all institutions, whereas the nursing shortage is a problem that PN Educators are keenly aware. This added stressor on programs to produce high volumes of quality graduates is not seen in all fields and adds a greater sense of urgency to find innovative solutions to the nursing shortage.

It is common knowledge that there is a dire need to produce more quality nursing graduates. This is no exception in the LVN/LPN field. Statistics from the American Association of Colleges of Nurses most recently projected LPN growth to be 20.2% or approximately 142,000 jobs by 2012 (para. 2 “Facts About Licensed Practical Nurses” n.d.). Along with this new job growth, LPN turnover rates remain high, at 49.9%. Although nursing facility staff turnover rates fell moderately for most areas between 2002 and 2007, LPN turnover is the only sector of nursing that demonstrated an increased turnover rate (American Health Care Association, 2008). At the same time LVN/LPN schools nationwide produced 61,326 new LVN/LPNs in 2006 (Kenward, K., O’Neil, T.R., Eich, M., and White, E, 2008). When looking even more long-term, it is projected that the ratio of caregivers to people most likely to need it, the elderly, will decrease by 40% between 2010 and 2020 (para. 6 “Changing Demographics” n.d). This top-end number is creating a nearly perfect storm of insufficient number of graduates being produced, low overall retention, more people requiring care, and the final retirement of the baby-boom generation of LVN/LPNs. Online education can provide an alternative and pressure release valve to help increase the number of PN graduates.

The second reason why PN Programs need to consider the move to online learning is increased access and convenience for the LPN student. For those institutions that moved their curriculum online, increasing student access was rated as the number one reason they offer programs online (Allen & Seamen, 2007). Online education offers the only viable solution for many adult
learners to transition into a new career or provides an alternative route for younger students to begin their first career. There surely are many LPN/LVN candidates who simply do not choose to go into nursing because of access to programs and the convenience of maintaining a home-work-school balance. In the technology-driven world of the 21st century, online education can open up another vast pool of potential PN students that could make wonderful nurses, if only they were given the opportunity for entry into an alternative format. Access and convenience are two of the most commanding characteristics of online learning.

The final reason for the paradigm shift is the changing demographics of the student population. The next generation of students is now entering our institutions of higher education. The Millennial Generation, coined by Neile Howe and William Straus, with its incessant communication and ‘always connected’ mentality will drastically alter the political, educational, and social landscape of our country (Shapira, 2006). There are profound differences in the psyche of this student body that PN Educators must factor into their teaching strategies. Whereas the Baby Boomers were the “family” generation, and the Generation Xers were the “me” generation, the Millennial Generation is considered the “we” generation. The “we” can be directly linked to the diverse modes of communication and the value that this generation puts on communication inclusive of how the individual interacts with the real and virtual world of technology.

The Millennial Generation is the first generation that entirely grew up with the internet and world-wide-web connectivity. This group has an “always connected” mentality. Cell phones, instant messaging, IPods, MP3 file sharing, Face book, blogging, and social interaction through technology are hallmarks of this new student. They can seemingly utilize all of the above devices simultaneously to the amazement of anyone outside of that generation. The millennial has extremely high expectations of technology, and their life experience both online and offline are highly integrated. The Millennial Generation does not simply choose a school or program for its curb appeal; rather, they factor in the web appeal as well. To recruit the millennial student into PN programs, schools must understand that they oftentimes prefer learning independently online over sitting in the traditional classroom. Programs and institutions must evolve to meet the new students’ needs or face reduction in both PN program interest and enrollment.

It is a daunting scenario for PN programs to face—a new generation, unlike any that has come before, coupled with a program of study that has strong traditional aspects. However, the Millennial Generation student will bring certain positive aspects to their educational experience when institutions properly leverage technology. Multiple studies have been conducted on this generation, and academically these students have highly developed skills in certain areas. They have ability to collaborate, as they do this daily through the internet via face book, blogging, and instant text messaging. They communicate incessantly and in the proper context in online classes this ability to communicate can lead to vibrant and meaningful dialogues. They multi-task incessantly and can juggle multiple assignments or tasks and absorb information quickly. Finally, they are very comfortable in standardized testing environments (Howe & Straus, 2000; Lancaster and Stillman 2002). Thus, properly channeled, in many ways, the millennial student will be better equipped to do more things, more effectively for the demanding PN Educator than prior generations. The daunting task at hand is how to create an online program model which includes a steady mix of didactic, clinical, and laboratory requirements that maintains the academic integrity required of each institution and board of nursing.

Developing a Quality Online PN Program

At first glance, PN programs are not the easiest to build in the online world. There is not a clearly defined national standard and as mentioned above the mix between didactic and traditional onsite work creates barriers to building an online environment for some courses. Coupled with the fact that for the near-term PN programs will still be challenged with inter-generational classrooms in which the 18 year old student is in the same cohort as a 40-something student who may not be as comfortable utilizing technology. Although these obstacles are real, technology in healthcare and all of industry invariably finds a way to adapt to meet the user’s needs. The same can be true with the introduction of online learning in PN education.

As an institution or educator considers online learning, one thing is certain—a one size fits all model that is employed in the mega-universities will not work in the highly specialized field of PN education. A more individualized approach to online course design will be necessary, thus leveraging the flexibility and limitless customization options of online learning modules for the individual institution or course will be key to online success in PN education.

Analyzing how corporate America has leveraged technology provides a template on how PN education should approach online learning. JCPenney has been one of the largest traditional retailers in America since 1902. From inception, their hallmark has been in store quality products and services. However, if you look at the JCPenney of today, they have managed to fully ingrain technology and online components into their retail culture. The company now has all their products available to purchase online, customers can have advertisements and promos sent to PDAs or cell phones via text message, customers can track their purchases online, customers can e-mail for assistance 24 hours a day, 7 days a week through the web, or if customers prefer, they can find their nearest JCPenney store outlet online, complete with local store hours and phone numbers. JCPenney is not unique, but it does provide a framework and a peek into the potential that exists in PN education by properly leveraging technology to expand and improve the student experience.

In the leading edge education institutions in America for the 21st century, a student will consume (acquire knowledge) through products (courseware and learning modules) that provide the greatest quality and results (superior educational experience) that allows the student to effectively transition in their role from learner to competent and qualified working professional. Educational institutions that are willing to analyze technology within the context of how it has benefitted industries outside of education will soon realize that implementing online learning will improve their students overall academic experience. Just as a JCPenney shopper isn’t an exclusive online buyer or in-store buyer, students of the 21st century, are looking for a holistic quality academic purchase in choosing a program or institution. By opening the opportunity to online course offerings and meeting the students’ needs in ways that encourage success will separate the quality innovators that will promote the long-term change and viability of PN education from those who will maintain the status quo.

One short-sighted argument that is quickly becoming passé in higher education circles is the debate over which are ‘better’ online classes or traditional classes. Each delivery channel has its own inherent strengths and weaknesses, just as a comparison of two A&P textbooks will yield inherent strengths and weaknesses. Online learning will not supplant brick and mortar institutions anymore than JCPenney’s online store will completely supplant going to the mall or outlet. For the 21st century student, it is more about a holistic learning experience that integrates people and technology into a seamless and fulfilling program of study. The very good institutions that off er online learning use technology to leverage personal relationships with their students, but they do not eliminate the human touch with their students, but rather enhance human touch through leveraging technology.

Blended Learning 2.0

With the continued evolution of online learning technology and a greater understanding of the shortfalls of online education, the new, leading edge institutions will not fall prey to the old model of online education. The earlier online models were often characterized by poorly designed courseware; a lack of student feedback mechanisms, nonexistent academic support services, untrained or poorly trained online Instructors, and regurgitated textbook or faculty lecture notes ill-suited for online delivery. The results of many of these institutions were mediocre at best. As the old saying goes, every dog has its own fleas and online education surely had and continues to have problems just as traditional courses.

For all the problems in online learning, the traditional classroom struggles with quality and student satisfaction as well. Studies are showing a continued disengagement from the traditional classroom, as a record-high 39.9 percent of freshmen report feeling frequently “bored in class.” Also a reported 62.6% of students reported that they “came late to class” frequently or occasionally, and “overslept and missed class” 36.2% of the time (Sax, L.J., Astin, A.W., Korn, W.S., & Mahoney, K.M., 1999). Of course student disengagement from the traditional classroom has a multitude of causes; however, students perceived value of the classroom as being stagnant or boring compared to their ‘connected’ world outside the classroom surely is a contributing factor to student’s positive receptivity, engagement, and increased enrollment in online classes.

In response to many of the shortfalls in online education, an emerging conversation, perfectly suited to the dynamic nature of PN programs is a concept that we shall call Blended Learning 2.0. This new version of the blended learning approach will be the next wave of online innovation. Blended learning’s traditional definition, appearing around the early part of 1999 was defined as “the integration of instructional media into a traditional classroom or into a distance learning environment.” (Holden, J.T. & Phillip, J.L., 29). Blended learning 2.0 is not simply about having asynchronous online experiences coupled with synchronous live events in the traditional classroom, but rather, it is an approach to program and course design which unites four distinct aspects of the student educational experience: academic support, social learning, cognitive interactions, and instructor engagement. By combining all four of these into a seamless experience which leverages the most effective aspects of core academic quality, a new and improved blended learning environment emerges.

Students participating in a Blended Learning 2.0 programs encounter a dynamic and multi-modal learning environment. Students are always active in this academic world, as courseware is available 24/7, any event (or non-event) can be recorded, tracked, and provide on the spot feedback when necessary through the system. The system spoon feeds data on student progress to the instructor and academic advisors. This allows them to proactively use data to engage students through various communication tools to best support the student’s needs. The design strategies of a Blended Learning 2.0 system requires collaboration of the entire institution to ensure that the multiple inputs, outputs, and learning modules (online and offline) engage the students in a manner that creates a holistic learning and support environment. Although integrating all four quadrants requires detailed sequencing, what is fairly easy to demonstrate is that by surrounding the student with quality inputs and outputs from the four quadrants surely blends the best of online and traditional educational components. Below is a brief overview and their impact on the entire blended learning process.

The teaching presence quadrant is the ever present student interaction with the instructor. This interaction is a daily process involving the threaded discussion forums or online office hours that are monitored by and responded to by the Instructor. Inside each module of learning there is interaction online that may or may not be reinforced by face-to-face engagements during labs, testing events, or clinical rotations. A key ancillary component is an instructive and supportive online instructor training program and faculty support system to ensure all Instructors are as comfortable in delivering their courses online.

Another key aspect of the learning environment for the millennial generation student is creating a strong social presence in which there is always an opportunity for student interaction with peers. Social learning has both intrinsic and extrinsic value to the student’s educational experience. This interaction, a daily facet in the blended program model, is executed through open threaded discussion forums as well as team or group assignments and live chat sessions. All of these are handled and moderated by the Instructor to ensure groups stay on-task. Ultimately the student learns with the group while discussing topical issues, case studies, or project work just as they would in the traditional classroom. This avails all students with mutual learning initiatives.

Probably the most often ignored aspect of online learning is the vital role a quality academic advisor can play in online learning. The support services quadrant, may in fact, be the missing link in helping online learning realize its true potential. A quality support presence, not as an ancillary service, but as a primary facet for motivation, guidance, and student encouragement is important in the Blended Learning 2.0 model. Leveraging a steady flow of student input and output data from the system and into the hands of qualified academic advisors gives the student a well informed mentor that can help the learner with proactive advisory services at the point of need. This quadrant of Blended Learning 2.0 is more than a helping hand that makes a once-a-semester phone call or helps with basic technology questions, but rather becomes a ‘go to’ resource for students to help them traverse the obstacles of becoming a successful student.

Finally, the cognitive presence is focused on the building of quality courseware, and the design of the student engagements and feedback mechanisms that impact the student’s interaction with the online content and system. The courses should be based on effective materials by publishers or instructors that are implemented into the learning modules to create a dynamic student learning experience. Special attention is paid to ensuring all the learning styles are satisfied. The learning modules should have clearly defined objectives that can be assessed through activities and assignments in the platform to ensure all student outcomes are properly measured.

The full surround-sound experience of Blended Learning 2.0 is ultimately solidified by the inclusion of Instructor lead skill based labs and clinical experiences integral in all PN programs. The skill labs give the students a hands-on approach to the procedures and an interpersonal time period for didactic learning to occur with the individual student and the group. At these scheduled time periods the Instructor can also spend some time evaluating the individual learners for their personal learning styles and any particular learning idiosyncrasies that the instructor can evaluate to enhance the individuals’ overall learning experience. The Clinical experiences are generated to give the student practical understanding and a knowledge base for working in the field and a time period for the student to demonstrate their learned procedures and knowledge.

Ultimately, this integrated approach works by building online courseware and programs to engage all aspects of the student’s experience. This new blended approach is going to be key for online PN education to break into the next plateau of student success. “The emerging conversations about big blend strategies involve exploring how we fully plan for and implement blended learning: strong in-class, online, and hybrid instruction and services” (Milliron, M.D, Plinske, K., & Noonan-Terry, C., 2008). The support presence is one that has been grossly neglected in online education. The proper infusion through quality courseware design to give skilled academic advisors tools and feedback from the system to proactively serve as a support mechanism as the student navigates the social-cognitive and instructional challenges of colleges may be the final piece of the puzzle to a consistent, quality online (and offline) experience.

Conclusion

The Millennial Generation with their ‘we’ mentality does not want community isolation in a barren and boring online world anymore than they want to be burdened with sitting in a stagnant traditional classroom. This next generation of LVN/LPN will demand connectivity and technology ingrained in their learning just as it is ingrained in the world they live outside of the classroom. They are online collaborators and communicators; they are multi-taskers; they absorb information quickly; they know and appreciate the internet intimately; and they will engage through any medium that engages them mentally. PN programs can evolve to build on these strengths to create a higher-caliber PN graduate through proper deployment of online technology.

Blended Learning 2.0 takes the best of ‘old school’ and ‘new school’ pedagogical practices to create a vibrant and engaging world of education that transcends the quality and potential that the PN schools of earlier generations could ever dream of creating. Properly deployed online PN courseware and programs will be successful for generations to come by simply embracing the potential of online learning and evolving the program to constantly meet new demands and improve the student experience. Technology has crept into all aspects of life, and the proper combination of live human interaction with online learning and alternative delivery channels will greatly enhance a student’s educational experience. PN Education has a place in the new frontier of online learning, with its power to penetrate student’s lives 24 hours a day, 7 days a week. There is vast potential for the PN Educator to reach their students and create a better prepared LPN and in the long run improve the number and quality of nurses in America.

David D. Hopkins, Ph.D., is the Chief Learning officer of Rue Education, he has developed, taught, and launched multiple online programs since 2000 in the educational services arena as well as online university programs. Dr. Hopkins has focused almost exclusively on providing quality distance education experiences to the non-traditional adult learner. Educators may contact Dr. Hopkins at 727.725.0005 ext. 1012 or .

References

• Allen, E.I. and Seamen, J. (2007). Online Nation: Five Years of Growth in Online Learning. (Sloan-C, The Sloan Consortium). Needham, MA: The Alfred P. Sloan Foundation.
• American Association of Colleges of Nurses. n.d. “Changing Demographics.” Retrieved March 22, 2008 from http://www.aacc.nche.edu.
• American Association of Colleges of Nurses. n.d. “Facts About Licensed Practical Nurses.” Retrieved March 22, 2008 from http://www.aacc.nche.edu.
• American Health Care Association. (2007). 2007 AHCA Survey: Nursing Staff Vacancy and Turnover In Nursing Facilities. (AMHCA Department of Research). Washington DC: American Health Care Association.
• Decker, F.H., Gruhn, P., Mathews-Martin, L., Dollard, K.J., Tucker, A.M., and Bizette, L. (2003). AHCA Survey of Nursing Staff Vacancy and Turnover in Nursing Homes. (Health Services Research and Evaluation). Washington DC: The American Health Care Association.
• Holden, J.T. and Westfall, P.J.L. (2005). An Instructional Media Selection Guide for Distance Learning. Boston, MA: The United States Distance Learning Association.
• Howe, N. and Strauss, W. (2000). Millennial Rising: The Next Great Generation. New York: Vintage Books.
• Lancaster, L.C. and Stillman, D. (2002). When Generations Collide. Who They Are. Why They Clash. How to Solve the Generational Puzzle at Work. New York: Harper Business.
• Kenward, K., O’Neil, T.R., Eich, M., and White, E. (2008). 2006 Nurse Licensee Volume and NCLEX Examination Statistics. (Report: NCSBN Research Brief ). Chicago, IL: National Council on State Boards of Nursing.
• O’Malley, J. and McGraw, H. (1999) Student Perceptions of Distance Learning, Online Learning and the Traditional Classroom. Online Journal of Distance Education Administration. 2 (4). Retrieved September 18, 2008, from http://www.westga.edu/~distance/omalley24.html.
• Sax, L.J., Astin, A.W., Korn, W.S., and Mahoney, K.M. (1999). The American Freshman: National Norms for Fall 1999. (UCLA Graduate School of Education & Information Studies). Los Angeles, CA: Higher Education Research Institute.
• Shapira, Ian (2008). What Comes Next After Generation X?, The Washington Post Online. Retrieved on September 19, 2008, from http://www.washingtonpost.com/wp-dyn/content/story/2008/07/.