Usage of Distance Learning in Nursing Education Term Paper

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Nursing Online

The nursing shortage in the United States is expected to get worse as baby boomers age and their health care needs grow. To make matters worse, nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care. Technology-driven answers, including online learning, are being studied and utilized increasingly to meet these needs. However, a number of difficulties continue to exist with such technology approaches, including hands-on clinical class work, which is an essential aspect of nursing curriculum. In the future, some of these issues will better be resolved as the need for nurses continues to grow.

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In 2006, officials with the Health Resources and Services Administration projected that the nation's nursing shortage would grow to more than one million nurses by the year 2020 (Fact sheet). Such shortages are not consistent from one state to another, or even across states. For example, Michigan (Center for Nursing) conducted a study of its schools to determine the status of its nursing programs. In some cases, qualified applicants are not enrolled even though there are unfilled admission slots. Programs may have difficulty filling slots if they lack faculty, facilities, or clinical placement sites. Openings may also go unfilled if there are too few qualified applicants, if admitted applicants do not enroll due to financial or personal reasons or are accepted to other programs. Yet, while some programs report that they do not have enough qualified applicants, most say they have more qualified applicants than the number of approved admission slots. Overall, for the 40 institutions studied, 4,298 qualified applicants were not enrolled.

Term Paper on Usage of Distance Learning in Nursing Education Assignment

The American Association of Colleges of Nursing (AACN) recognizes that technological advances are increasing opportunities to improve the quality of and access to nursing education. In Washington State (Department of Health), for example, several programs use Blackboard and other technologies as a communication assistant. Seven nursing programs identified portions of specific courses that are available online, one program has all course syllabi and course materials available online, five programs are using interactive television, two report web-based/web-enhanced courses, and one is video-streaming selected courses. The AACN states that the idea that students and faculty are aligned with one institution for their academic life is no longer the case. Further, the potential of students taking core coursework at multiple institutions for credit through online learning is now feasible and the ability of faculty to work for a traditional university and also teach in "virtual universities" is also possible.

Utilizing distance learning for obtaining a degree as a registered nurse is becoming increasingly common. At Indiana University, for instance, with the RN-BS, all required courses in the nursing major are offered via the Internet. Clinical courses are arranged in the student's community, and general education requirements can be fulfilled by a combination of course work earned through distance learning, the Indiana College Network, and the local college or university. on-campus visits are not required.

In 2005, Karen Brown conducted a qualitative research study of the RN from LPN education program at Central Michigan University, which was the first online RN completion degree on its kind. Overall, the graduates were satisfied with the program, but noted specific improvement areas, including student preparation, faculty and student communication, and testing. Four themes emerged from the data: (a) the students took the program with some unrealistic expectations on rigor and flexibility; (b) the student cohort provided learner bonding and support, which positively affected learning; - students faced several barriers to success; and (d) it provided access and career advancement to those who might not be able to attend a traditional program. Online programs thus provide a way to increase the number of RNs by increasing access, if barriers are minimized. According to Bird, another distance learning example is Rio Salado College in Tempe, which includes online coursework that is supplemented by a 900-hour clinical component at one of a dozen partner medical centers. Upon successful completion, students receive the associate in applied science degree and are ready to enter a lucrative career in a field faced with widespread shortages of trained personnel.

However, where distance learning works well across varied degree programs, their deployment is based on school preference and culture. The University of Phoenix, for instance, offers online programs only for full-time RN-to-Bachelor's of Science in nursing degree (BSN) students, with one immersion course at a time for five to six weeks. The University of Nebraska Medical Center College of Nursing's distance learning program teaches a doctoral track for masters-prepared faculty at sites in South Dakota, and for others in Nevada and Kansas; master's students at the University of South Dakota take graduate courses for the psychiatric nursing specialty remotely in Nebraska's program, and will take core courses and earn the degree from USD (AACN Bulletin). Because of the need for clinical coursework, the ability to obtain an entry-level, LPN degree online is much more difficult. For example, for the degree at Northwestern Michigan (NMC Frequently asked questions), clinical classes are based on regional studies and must be taken in Traverse City. The school states, "While in the future we hope we can come up with cooperative solutions between states and between nursing programs, we are not there yet."

Most online programs in nursing require students to arrange for their own clinical training locally. This can be difficult, according to one study

Segal-Isaacson). Says one student, "We were responsible for setting up our own [preceptors], and I'm not sure that this is the best way to facilitate learning. It was difficult to find clinicians willing to take on students, and, if they were willing, they may not have been good teachers." Some students felt that online programs could be effective at any level of study, others believed that a solid grounding in clinical skills was needed before pursuing distance nursing education. "I think it wouldn't work well for someone starting out as an NP student. You really need that monitoring and feedback to get down your physical assessment skills," noted one student. "Leaving that to the discretion of a preceptor is iffy. If you don't get the basics down, you have a shaky foundation." Others saw this more positively: "Finding our own clinical sites allowed us to find potential employment sites, which helped many of my colleagues get jobs after we graduated."

One technology-based middle ground that may help in this area of entry-level coursework is simulations (Curl et al.,). Clinical simulations offer opportunities for faculty to extend the number of years their knowledge is shared with students and may attract younger nurses who enjoy technology to the field of education. Costly simulation equipment can be shared among nursing programs through a central simulation laboratory. Collaborative simulation partnerships with other nursing programs allow for the sharing of faculty expertise in clinical specialty areas.

MacFarlane et. al find that in several Canadian provinces, funding has been provided for schools of nursing to equip simulation labs. Ontario announced a clinical simulation initiative through which the government provided $20 million over two years to colleges and universities. Likewise, the British Columbia Academic Health Council created the Practice Education Innovation Fund that supports many simulation projects.

Specifically, what will be the future of distance education? Answering this question can help develop more effective teaching and learning strategies to provide higher quality online programs. Mancuso-Murphy reviewed nursing literature to ascertain the student perspective of online education. She found that the use of distance education will continue to grow in the future as technology becomes more developed and accessible. Growing demands in the healthcare workforce will mandate programs that are effective, accessible and convenient and that offer a sound theoretical basis, consistency, and standardization. Tomorrow's learners will come from a variety of backgrounds with different needs that must be addressed. "However, if it is done in a systematic and orderly way, with the incorporation of a theory of learning, teaching strategies that address multiple learning styles, use of technology with multiple capabilities, and a focus on creating an interactive, collaborative community of learners, course redesign for the Web can result in a high-quality educational experience with pleasing results for both faculty and students."


American Association of Colleges of Nursing (AACN). March 2007. Fact Sheet. Nursing shortage. 24, July 2007.

American Association of Colleges of Nursing (AACN). January 2000. Distance Learning is Changing and Challenging Nursing Education. 24 July, 2007.

Bird, Linda.

Nontraditional Approach to Educating Tomorrow's Workforce

Community College Journal. (Dec 2006/Jan 2007). 77.3; 48-52

Brown, Karen.

A case study of the first year of a new online RN from LPN program: Evaluation of program and student outcomes. Central Michigan University (2005), 157

Curl, Eileen Deges, Smith, Sheila, Chisholm, LeAnn, Hamilton, Janet and McGee, Leah Anne

Multidimensional Approaches to Extending Nurse Faculty Resources Without Testing Faculty's Patience, Journal of Nursing Education. (2007) 46. 4; 193-196

Indiana State University. Distance Learning. 24, July 2007.

MacFarlane, Ellen, Milliken, Jane, L Ouellet, Louiselle, Thrasher, Christine et al.… [END OF PREVIEW] . . . READ MORE

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