Examining Online Instruction in Undergraduate Nursing Education

Distance Education, Vol. 23, No. 2, 2002

Examining Online Instruction in UndergraduateNursing Education

LuAnn Christianson, Drew Tiene & Pamela LuftKent State University, Ohio, USA

ABSTRACT Web-based courses have increased in number as one of the primary modes of distance

education in undergraduate nursing programs across the United States. An online survey of 171 nursing

faculty in the United States with experience teaching Web-based courses served as the primary data

source. Interviews and a review of course Web sites provided additional comparative information.

Results of this study indicated online faculty spent signi� cantly more time in planning and implementing

a Web course than they did a traditional course. Despite this time commitment respondents perceived the

teaching experience to be a successful and effective form of instruction that they felt could be used to

deliver any type of nursing course. The online teaching experience was described as both collaborative

and highly interactive. Most respondents indicated they preferred online teaching to traditional

face-to-face instruction. This positive reaction to teaching online supports the future viability of

Web-based instruction at colleges of nursing.

Introduction

By the end of the 1990s, online instruction had already become an important form of collegecourse delivery (Farrington, 1999; Katz, 1999; Rickard, 1999). As we begin this new century,colleges are providing Web-based instruction, not only to remain competitive, but becausetheir student population demands it as a means of distance education. The role of the universityis in a state of change. The manner in which students access information and the means bywhich faculty transmit knowledge are being altered dramatically (Furnell, Evans, & Bailey,2000; Noam, 1995). While a technical infrastructure has become well established in both smalland large higher education settings, the intellectual infrastructure necessary to re-conceptualizehow college courses are designed and taught has not been as fully developed (Hannah, 1998).

Purpose of the Study

This research explored how nursing college faculty perceived and evaluated their Web-basedteaching experiences, revealing a variety of ways in which online instruction was both rewardingand frustrating. The impact of transactional distance (Moore & Kearsley, 1996) and the use ofcomputer-mediated communication technologies on teaching undergraduate adult learners wereexamined. The perspectives of teaching gained from this study provide insights into what Goggin,Finkenberg & Morrow (1997) describe as the “pedagogical unknowns” of Web course organiza-tion, online teaching strategy, and the logistics of e-learning. Four research questions wereidenti� ed to guide the data collection and analysis of this study. The four questions were:

ISSN 0158-7919 print; 1475-0198 online/02/020213-17 Ó 2002 Open and Distance Learning Association of Australia, Inc.

DOI: 10.1080/0158791022000009213

214 L. Christianson et al.

(1) How do faculty compare their online teaching experiences with their experiences teachingthe similar subject matter in a conventional, face-to-face classroom?

(2) What strategies do faculty teaching online utilize in Web course design, delivery, andevaluation?

(3) What do online nursing faculty describe as their successes and failures in teaching aWeb-based course?

(4) What types of courses in an undergraduate nursing curriculum do online faculty considerbeing best suited to Web-based instruction?

Literature Review

A number of recent studies have explored the impact of the online environment on teaching(Daugherty & Funke, 1998). The perspectives of faculty as they design, develop and teachundergraduate Web courses can provide a basis for understanding processes involved in bothteaching and learning online. The reality that online teaching re� ects a cultural change forfaculty is beginning to be recognized (Cini & Vilic, 1999). The changes inherent in the onlineteacher’s role in the areas of course planning, lesson design, student–teacher interaction andassessment have been discussed in several studies (Halstead & Coudret, 2000; Navarro, 2000).Kearsley, Lynch, & Wizer (1995) highlighted key differences in classroom management styleand content presentation strategy. Many academics describing their experiences with onlinecourses stress the importance of a faculty member’s willingness to “learn a fundamentally newway of conveying the message and ensuring that the requisite learning takes place” (Kroder,Seuss, & Sachs, 1998, p. 69). Berge (1997), through the use of online teacher survey data,concluded that online teachers generally are learner-centered in their approach.

A number of authors have addressed speci� c issues associated with online instruction,including pre-planning strategies (Byun, Hallett, & Essex, 2000), preparation of materials(Landis, 2000), the incorporation of interactivity (Liaw & Huang, 2000) and other pedagogicalconsiderations (Bonk & Dennen, 1999; de Verneil & Berge, 2000). The nature of the hypertextenvironment seems to demand new teaching approaches that creatively utilize the capabilitiesand potential of the Internet, described by Duchastel (1997) as the unique requirements forlearning, information, interactivity, structure and communication.

Methodology

This nationwide study of undergraduate Web-based instruction explored the nature of theonline educational experience from the point of view of those most intimately involved withthe development and delivery of instruction, the teachers. Potential participants in this studywere identi� ed from 540 schools nationwide that were members of the American Associationof Colleges of Nursing (AACN). Of this number, 126 (about 25%) offered online nursingcourses at the undergraduate level. These were courses where students completed all course-work at a distance without face-to-face meetings.

Faculty teaching these courses was identi� ed in two ways, either directly from their courseWeb site, or through direct contact with the Nursing Department Dean or Department Head.This group of 316 faculty were sent an electronic message requesting participation anddirecting them to the research study Web site and survey location. All subjects were

Examining Online Instruction in Nursing Education 215

undergraduate nursing faculty who were either presently teaching an online course, or hadtaught one within the previous 2 years.

A total of 171 faculty (54%) completed the 76 item survey either online (165), or as a print(6) version. Follow-up of non-responders was again made through an e-mail, general mail, orby phone. The majority of survey items used a 5-point Likert scale, where 1 refers to “stronglydisagree” and 5 refers to “strongly agree.”

Web courses can vary widely in their design and degree of sophistication. Since thisvariation might be expected to in� uence how the course was both developed and implemented,this study asked each survey respondent to classify his or her Web course as one of fourdifferent types. Course development types were identi� ed as follows:

(a) A sites; hypertext mark-up language (HTML) authored sites;(b) B sites; Web page construction product sites (i.e., FrontPage, PageMill, etc.);(c) C sites; university designed template sites;(d) D sites; Web course development product sites (i.e., WebCT, Blackboard, etc.).

To ensure that these classi� cations were being accurately determined, 15 course Web siteswere accessed and analyzed using a Web site review instrument, developed by the researcher.These course sites were evaluated in terms of their structure, appearance, course overview, sitenavigation, content delivery, class communications systems and methods of evaluation.

At the end of the survey, there was an item asking if respondents would agree to participatein a phone interview. Two instructors were randomly selected from each of the four Webcourse development groups (A–D), so that instructors from each type of course would berepresented. These phone interviews were audio taped for later review. The interviews allowedfaculty to expand their responses to selected survey questions, to provide more detail abouttheir experiences, and to discuss some of the broader issues associated with teaching onlinesuch as course design, pedagogical decisions and teaching strategies.

Data from the online survey was analyzed using frequency counts, means, chi-squares, andpaired samples t tests. Frequency counts and means were used to help classify data responses.The chi-square test was used to identify relationships between selected survey items. Thepaired samples t test was utilized to identify statistical signi� cance of differences betweenfaculty allocation of time spent engaged in course planning and instruction in the online formatversus time spent in the traditional classroom setting. Interview data were analyzed byreviewing the audiotapes and transcribing the most relevant, interesting comments. Recurringthemes were identi� ed and later discussed in terms of the four research questions. Speci� cquotes were eventually excerpted for inclusion in the reporting of the study.

Findings

Faculty and Course Demographics

The faculty respondents in this study represented a range of online teaching experience fromone semester to nine, with a mean of two semesters. Total years of teaching experience rangedfrom 6 months to 40 years. These instructors taught a wide range of different types of classesacross all levels of the undergraduate-nursing curriculum. About half (88) of these courses


TABLE 1. Web courses classi� ed by development tool

No. of coursesType of Web development tool (n 5 165) % of courses

A tool: 17 10HTML authored siteB tool: 20 12Web page construction product siteC tool: 32 20University designed template siteD tool: 96 58Web course development product site

taught fell into eight general categories: research, leadership, assessment, community issues,concepts, informatics, pharmacology, and legal/ethical issues.

The majority of study participants utilized a commercial Web course development tool inthe construction of their course (D sites), with the other three approaches (A, B, and C sites)each representing between 10% and 20% of the overall sample (see Table 1).

Combinations of both synchronous and asynchronous computer tools were used to facilitatecommunication between faculty and students, as well as between students themselves. Allrespondents identi� ed e-mail as a primary means of communication, with about half of theinstructors offering online discussion group sessions and one-third including electronic bulletinboards in their courses (see Table 2). Synchronous communication tools were also popular,especially online chat, which was used in three out of every four courses. Interestingly, printmaterials continue to be incorporated into all but 5% of online courses.

TABLE 2. Computer-mediated communication in Web-based courses

No. of coursesTool type (n 5 169) % of courses

Asynchronous tools Course e-mail 169 100File sharing 126 75Discussion 83 49Course bulletin board 54 32

Asynchronous tools only 29 17Synchronous tools Course chat 124 73

Online work groups 66 39Shared whiteboard 19 11

Synchronous tools only 0 0Both asynchronous and 140 83synchronous tools


FIG. 1. Course planning time.

Research Question 1: Comparisons Between Online and Traditional InstructionCourse planning and implementation time. Insuf� cient time has been documented in theresearch literature as a major barrier to the development and implementation of online courses.Numerous authors (Gleydura, Michelman, & Wilson, 1995; Leggett & Persichitte, 1998)concur that lack of suf� cient time for online course planning and implementation is at the topof the list when identifying technology implementation obstacles. Halstead and Coudret (2000)have documented the importance of time and technology management for online nursingcourses. Navarro (2000) reported that 92% of his subjects took more time, and 73% said ittook over twice as long. In this study, online faculty spent signi� cantly more time in theplanning of a Web course than in planning a traditional classroom course. Over 80% ofrespondents devoted more than 30 hours to planning their online coursework, while less than50% of the same group devoted this much time to planning their traditional courses (see Fig.1).

In addition to course planning time, Web course instructors spend more time deliveringcritical aspects of their online courses, including individual and small group discussion withstudents, answering questions, and assessment. Respondents were asked to consider Webcourse time and traditional course time allocations and record the percentage of time spent ineach of the following � ve course development and instructional activities, namely: planning,small group discussion, answering questions, assessing learning outcomes, and large groupdiscussion. The difference between the two sample means in the proportion of time spent wassigni� cant for all activities except for assessment of learning outcomes (see Table 3).

More than half of the surveyed faculty did receive some kind of compensation for thedevelopment of their online course, although there was no relationship between receivingcompensation and these subjects’ preference for either the online or the traditional teachingformat. Compensation took a variety of forms, with stipends mentioned as the most frequenttype. The amount of the stipend varied from $500 to $5,000 per course. Other types of


TABLE 3. Differences between time spent in Web courses and traditional courses

Course planning and development df 5 159 t 5 2 8.17, p , 0.0001X 23.6% 2 Y 33.6% 5 2 10%Small group discussion df 5 154 t 5 2 3.46, p , 0.0007X 12.2% 2 Y 5 16.1% 5 2 3.9%Answering questions df 5 159 t 5 2 5.8, p , 0.0001X 10.2% 2 Y 14.5% 5 2 4.3%Evaluation df 5 158 t 5 2 1.53, p , 0.11X 18.5% 2 Y 20.0% 5 2 1.5%Large group interaction df 5 152 t 5 12.6, p , 0.0001X 36.9% 2 Y 17.6% 5 19.3%

% time spent in traditional course activities (X) 2 % mean time spent in Webcourse activities (Y) 5 mean % difference.

compensation included tuition reimbursement, the hiring of administrative assistants, � nancialsupport for hardware purchases, and online provider service fees.

Teaching role. A number of researchers have addressed how the teaching roles associated withonline instruction may differ from those typically played by a traditional classroom teacher.Harasim, Hiltz, Teles, and Turoff (1995) refer to the online teacher as more of a facilitator.Online instructors will need to rede� ne their roles and become guides for students, helpingthem learn more independently. Shotsberger (1996) feels that the most critical role an onlineinstructor can play is in fostering a sense of community.

During their online teaching experiences, the eight interview respondents in this studyindicated that they were more “responsive to student needs” and more “� exible” than theywould tend to be in traditional courses. They described their role as one of “guide,” “coach,”or “mentor,” rather than being the person who “simply conveys information.” On the survey,69% of participants in this study agreed that the instructional approaches used in their onlinecourses were more “collaborative” than those used in their traditional classrooms. In addition,67% of those surveyed indicated they were better able to monitor individual student progressin the online environment (see Table 4).

According to Sherry and Wilson (1997), a primary responsibility in online instruction is todesign an active learning environment for students. Bonk and Reynolds (1997) emphasize theimportance of promoting student-centered activities in online instruction. In this study,however, learning activities did not necessarily become more student initiated. On the survey,the majority of subjects considered their instructional approach online to be more teacherinitiated than student initiated (see Table 4). Interviewees frequently mentioned the importanceof their role in “packaging information for students.”

This emphasis on developing a highly structured approach to Web course design was alsoidenti� ed in Halstead and Coudret’s study (2000). They identi� ed a structured approach as aneffective means for keeping students on track with the course. A number of other authors(McManus, 2000; Oliver, 1999; Revak, 2000) also addressed the issue of developing onlineteaching strategies designed to enhance students’ organizational abilities. Saba’s (2000)


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“migration” strategy for converting conventional courses to online courses acknowledges theimportance of helping students adjust to a more independent learning situation.

Interviewed faculty frequently mentioned the importance of creating structure for studentsto prevent them from becoming “overwhelmed or falling behind.” Comments included,“Things must be spelled out very clearly for online students,” “The requirements, due dates,and expectations need to be clearly spelled out since you are not there to clarify misunder-standings,” and “I add more structure to my online course to help students stay on track. It’stoo easy to fall behind when you don’t have to come to class each week.”

Most online instructors in this study seemed to assume a dual role, one that created speci� cboundaries and guidelines in the planning stage to assist students in their successful accom-plishment of course learning activities and another that was � exible and facilitative during theimplementation phase of the course. There was an effort to address the individual needs ofstudents, but within a pre-established framework.

Interactivity. Dialogue that facilitates learning may be effectively fostered online if facultydevelops learning activities that encourage collaboration (deVerneil & Berge, 2000). If avariety of interactive online tools are used to their full potential, opportunities to learn fromdiscussion in a Web-based learning environment can be signi� cant, and virtual communitiesof learners can effectively be established (Liaw & Huang, 2000). But what have studies shownthus far about the nature of interaction between participants in an online course?

In Donaldson and Thomson’s (1999) study, establishing effective communication with boththe teacher and fellow students was a concern for college students taking an online course.Some found that interaction seemed inhibited in the online environment (Schoenfeld-Tacher &Persichitte, 2000). But others have found higher levels of interaction (Halstead & Coudret,2000; Thiele, Allan, & Stucky, 1999) and more effective exchanges between participants(Leasure, Davis, & Thieron, 2000).

Contrary to what some might have expected, the majority of faculty surveyed in this studyfelt that the amount of “interactivity” was more pronounced in an online course than in aconventional face-to-face classroom (see Table 4). Survey responses showed that interactivitywas increased both between students (57%) and between students and their teachers (70%).Interviewed faculty described their online communication as more succinct and more egali-tarian. One commented, “It seemed in my regular classroom that I would always develop aconnection with certain students, students for whom I had more of a preference, for somereason. That doesn’t happen online. It’s easier for me to treat every student equally in my Webcourse.” Some felt the online learning environment demanded more participation, with oneinterviewee remarking, “Students have to communicate. They can’t just sit there and not sayanything.” The level of intellectual engagement was considered to be comparable to that insimilar courses taught in the traditional classroom environment by 67% of faculty surveyed(see Table 4).

Course participants were never actually face-to-face, so there was considerable potential forconfusion to develop due to possible communication gaps, a phenomenon that Moore andKearsley (1996) have de� ned as “transactional distance.” The high level of interactivity foundbetween participants in these online courses should help reduce transactional distance andmitigate the degree of possible misunderstanding. Online class participants communicated withone another on a consistent basis, and this degree of contact and connectedness should have


served to diminish the possible deleterious effects of physical distance. As one might haveexpected, the majority of faculty who considered interactivity to be enhanced also indicated onother survey items that Web-based instruction was an effective approach. But surprisingly,most respondents who did not think interactivity was enhanced still considered Web-basedinstruction to be an effective instructional format.

Teaching preference. Previous studies have indicated some reservations on the part of collegeinstructors who have taught online (Navarro, 2000). In the Halstead and Coudret (2000) study,some nursing faculty reported missing the face-to-face contact with students in their onlinecourses. Web-based courses also pose numerous design and implementation challenges forfaculty, which can be discouraging to some (Hill, 2000). How attractive is this online option?When asked “If you were to choose between teaching in the online environment or in thetraditional classroom, which would you prefer?,” 47% chose online, 27% traditional and 26%preferred a combination. Seventy-� ve percent also described their online teaching experienceas being a good � t with their individual teaching style. An overwhelming majority of 86%indicated that in the online environment they were able to teach in the way they preferred. Inaddition, a majority of faculty indicated they developed an increased interest in their ownsubject matter as a result of their online experiences (see Table 4).

These results indicate that the majority of faculty surveyed for this study preferred onlineinstruction to teaching in the traditional classroom setting. Interestingly, neither level oftechnological expertise nor the type of course development tool used in the creation of a courseWeb site was signi� cantly related to faculty preferences for online versus traditional teaching.Nor were variables such as faculty rank, years of teaching experience, or tenure status relatedto preference.

However, the online format was not the preferred mode of teaching for all faculty. Thoseindividuals who indicated a preference for the traditional classroom, or a combination ofenvironments, seemed to do so for what could be described as student/teacher relationshipissues. One respondent wrote, “I missed the students,” and another noted, “I miss theclassroom. I like the faces and the connection.”

Research Question 2: Design, Implementation and Evaluation Strategies

Strategies considered effective in the design and delivery of online instruction have beendescribed by a number of authors, based on their own online teaching experience (deVerneil& Berge, 2000; James & Voigt, 2001; Landis, 2000). Saba’s (2000) “migration” strategyinvolves a gradual approach to online course development, suggesting that instructors � rstexperiment with Web-based tools in a conventional course or incorporate Web-assistedelements in their curriculum, before moving the course entirely online. Collis (1997) points outthat Web conversion should be more than just pasting existing text into Web sites, but shouldinvolve redesigning materials to take advantage of the capabilities of the Web, a process shecalls “pedagogical engineering.”

One of the � rst design decisions to be made is the selection of a course development tool.Survey responses in this study indicated that the effectiveness of a Web course was not relatedto using any one of four types of course development tools highlighted in this study. Facultyratings of effectiveness were comparable, whether they had individually designed their own


FIG. 2. Instructional strategies.

course site or used a sophisticated, commercial course design tool. Nor was choice of coursedevelopment tool related to faculty impressions of ease in implementing a course, or thedegree of technological dif� culty experienced throughout the course. The majority of facultieswere able to obtain adequate technical support in planning and delivering their online courses.

What types of instructional approaches were found to be most effective online (see Fig. 2)?Faculty respondents found the use of case studies an effective online instructional strategy.Individual work was also considered very appropriate for online courses. Both of theseapproaches involve independent work, so they are more convenient for online learners thanassignments requiring collaboration with others. In fact, cooperative work was considered theleast effective approach (although, surprisingly, small group work was considered quiteeffective). Large group discussion and lecture were not considered especially effective, nodoubt because they are not very practical to implement online.

The type of assessment used in an online course, as with a traditional course, may be heavilyin� uenced by the subject matter, teaching style, and the educational philosophy of theinstructor. However, the Web is a unique learning environment in which assessment of studentprogress is likely to differ from that of the conventional, face-to-face classroom situation(deVerneil & Berge, 2000).

A variety of assessment methods were identi� ed by survey participants to be potentially“suitable,” with papers and projects ranking highest and objective testing ranking lowest (seeFig. 3). Objective tests, although used by some faculty, were considered less suitable onlinethan in the traditional classroom. These responses stand to reason, because objective tests canbe more dif� cult to set up online, and it may be easier for students to cheat on an objectivetest that they take without supervision. There was no clear indication whether the respondents’methods of assessment and processes of grade determination signi� cantly differed between anonline environment and the traditional classroom setting. It must be noted that the methods of


FIG. 3. Assessment methods.

assessing student performance identi� ed in this study re� ected online class performanceexclusively. Clinical performance evaluation was not addressed by these strategies.

Research Question 3: Successes and Failures

Research question 3 examines faculty impressions of the degree of success they found in theironline instructional experience. Previous studies indicate a variety of successful outcomesassociated with online instruction, such as increased access to coursework (Leasure et al.,2000), availability of up-to-date instructional resources (Thiele et al., 1999), and increasedopportunities for collaboration (Zanglein & Stalcup, 1999) Online instruction seems tofacilitate active learning and encourages student initiative (Cini & Vilic, 1999).

The overwhelming success of the online teaching experience is apparent in the surveyresults of this study. Eighty-nine percent of faculty surveyed considered their teachingexperience to be either successful or very successful, while 76% of respondents also indicatedthat the online teaching experience fell above their expectations, or far above their expecta-tions. Eighty-three percent of faculty agreed or strongly agreed that Web courses are aneffective approach to undergraduate education. Probably the most important � nding of thisstudy is the considerable enthusiasm and approval for online instruction among theseundergraduate nursing instructors. Even though the majority of faculty surveyed in this studyfelt they were not given suf� cient time to develop their Web-based courses, most remainedpositive about the online format. So strong was this positive reaction to online teaching thateven those instructors who were not sure it was a good � t with their own personal teachingstyle still felt Web-based instruction was a legitimate method of delivering college coursework.Furthermore, those faculty who did consider online instruction to suit their personal teachingstyle were likely to describe their online experience as not only successful, but “falling abovetheir expectations.”


Research Question 4: Nursing Course Suitabilit y

At the start of the new millennium, online coursework began proliferating in nursing collegesacross the country (Halstead & Coudret, 2000; Leasure et al., 2000). One of the questionsraised in a 1999 White Paper on Distance Technology in Nursing Education, published by theAmerican Association of Colleges of Nursing, asked whether technology-based learningexperiences can effectively prepare students for a practice-based discipline like nursing whichdeals so directly with critical human needs. This question suggests that faculty designingonline instruction must look carefully at the suitability of courses for inclusion in anundergraduate-nursing curriculum.

When asked in the online survey to choose the types of nursing courses they considered tobe appropriate for online instruction, those mentioned most frequently were nursing informat-ics by 82% of respondents, followed closely by nursing research with 80%. It is not surprisingthat nursing informatics was considered to be the most appropriate type of online nursingcourse since the focus of course content in this area is on the multitude of ways in whichprofessional nursing activities may utilize various computer applications. There was consensuson the feeling that many different types of courses and topics could be effectively addressedover the Web. In fact, the entire group interviewed thought that any course could be taughtonline. However, it was felt that skills development was still best facilitated by hands-onactivities in a face-to face setting.

Discussion

Web-based instruction in baccalaureate nursing education is expanding in colleges anduniversities across the United States and around the world. In many cases, this trend has beendriven by administrative initiatives. However, it is a trend that apparently is also beingsustained by faculty, many of whom � nd the online learning environment both potentiallydynamic and well suited to their individual teaching style. The purpose of this study was toelucidate and describe these faculty perspectives. The results of this study indicate that manyfaculty teaching online courses in undergraduate nursing programs feel that Web-basedinstruction is a successful educational endeavor.

Research question 1 focused on comparing the online teaching experience to that of teachingin a conventional classroom. Comparisons were made in the areas of course planning andimplementation time, teaching role, interactivity, and teaching preference. Nursing facultyrespondents overwhelmingly agreed that additional time was required for teaching online. This� nding supports the research of numerous authors (Gleydura et al., 1995; Leggett &Persichitte, 1998; Mangan, 1999; Navarro, 2000) and highlights the need for the developmentof time-sensitive planning strategies and design approaches that facilitate ease in coursedevelopment and delivery.

The signi� cance of this time factor might be exaggerated with regard to planning Web-basedcourses, for the extra time taken to develop an online course might be much reduced when itis taught repeatedly online. However, the time associated with delivering an online coursemight be expected to remain more consistent over time, given that the demands of studentswould likely be similar from semester to semester.

Hopefully more sophisticated “user friendly” course development tools that become avail-


able will ultimately streamline the planning and implementation of online courses. However,in this study, there did not appear to be a relationship between the course delivery tool utilizedby participants and ease of course delivery. It should be noted that, despite the extra time andeffort involved, the vast majority of faculty participating in this study still considered theironline teaching experience to be a success. Nursing faculty participants did not see theadditional time demands inherent in the online course format as obstacles to a successfulteaching experience.

The primary teaching roles identi� ed by the majority of respondents in this study werefacilitator, guide and mentor. The instructional approach used by nursing faculty in their onlinecourses was considered to be more collaborative than that used in their traditional classroom.This � nding is consistent with the work of authors such as Shotsberger (1996). It is importantto look more closely at this role shift, because it not only tells us how online faculty conducttheir classes, but it also may reveal their pedagogical preferences. Interestingly, respondents’approaches to teaching online were also characterized as primarily teacher initiated and highlystructured. These instructors may have considered this emphasis on structure in online coursesespecially important because their students were undergraduates, who might not have beenused to working so independently and for whom online study was an entirely new type oflearning experience. There almost seems to be a paradox here, but these � ndings make senseif the most effective way to structure a new learning experience for students is to � rst establishclear course guidelines, so that students do not lose focus as they work on their own at adistance from faculty and other students.

While instructor reactions to teaching a Web-based course versus teaching traditionally havebeen previously examined (Halstead & Coudret, 2000), direct comparison of nursing facultypreferences between the two formats had apparently not yet been the subject of formalinvestigation, before this study was conducted. Findings show that the majority of surveyrespondents preferred online teaching, mainly because of the collaborative environment thatexisted in their online courses. For many, teaching online was also a suitable match with theirpersonal teaching style. Given these positive perspectives, it appears that online instructionmay well have a promising future, at least in the � eld of nursing.

The results of this study indicate that interactivity is not inhibited in an online learningenvironment, but can actually be fostered by it. Earlier concerns about computer-mediatedcommunication summarized by Bates (1995) that predicted potentially low levels of studentparticipation appear unfounded. In fact, respondents found overall levels of interactivitybetween students, and between students and teachers, actually to be enhanced in the onlinelearning environment. Again, this � nding strongly supports the learning potential of onlineinstruction in nursing. As college instructors � nd that online teaching can include interestingdialogue and dynamic intellectual exchanges, they will be increasingly likely to supportWeb-based instruction as a legitimate approach to course delivery.

Interestingly, neither technological expertise nor type of course development tool used bythe instructor was found to be related to nursing faculty teaching preference. The majority offaculty in this study taught online for only one or two semesters/quarters and they utilized acommercially available development tool requiring minimal technological expertise. The levelof experience with technology necessary for online teaching appears to be modest, as indicatedby the increasing numbers of faculty who are getting involved in Web-based teaching.

The identi� cation of what teaching strategies nursing faculty use in their online course was


the focus of research question 2. Faculty indicated that they stressed individual, independentstudent work, rather than whole-group activities, with small group work also being important.In addition, there was an emphasis upon problem-solving activities, with a preference for casestudies. Clearly these responses show the kinds of adjustments that nursing instructors need tomake when they teach in a virtual learning environment. Many college instructors areaccustomed to lecturing, but this approach is not likely to be effective on the Web. If theseprofessors are asked to teach online, they will need to develop other approaches that encourageindividual, independent projects. Such changes in teaching style may be dif� cult for some,although this did not appear to be the case for most of the subjects in this study.

In terms of evaluation strategies, the majority of surveyed faculty felt they were better ableto monitor individual student progress in the online course environment. They felt that papersand projects were the most suitable ways to evaluate student learning. Interviewed facultyreported using the online quiz functions available more often as a learning self-study tool thanas a means of evaluating progress. Concerns about supervision during objective tests probablymade this approach the least attractive to these online nursing instructors. Normative objectivetesting may become less commonplace in college courses as online education becomes morewidespread. Web-based instruction is likely to rely more upon student projects, which somehave described as “authentic assessment” because it may better indicate what an individualpupil has learned.

Research question 3 addressed what nursing faculty considered to be the perceivedsuccesses and failures of the online teaching experience overall. Some challenges werementioned. Technical problems continue to be an issue for some faculty, although mostrespondents referred to these as occurring infrequently and easily � xed. Staying connectedwith students was considered by some to be dif� cult, and online teaching can become tiring,because it can be a 24-hour a day, 7 days a week proposition. However, most of the responseswere positive. Many faculty seemed to be genuinely surprised that the format was assuccessful for them as it was, agreeing that the online instructional format enabled them toprovide more interesting and effective learning activities for their students. They also agreedthat teaching online increased their level of interest in the subject material they taught.

Research question 4 examined what types of nursing courses might most effectively betaught online. Many different types of courses were felt to be suitable. A majority felt thateven introductory courses and basic foundational courses in a nursing program couldsuccessfully be taught as Web based, provided a structured approach to implementation wasbuilt into the course. As with several other � ndings here, it seems that this reaction is a voteof con� dence in Web-based education. It was not considered an approach that might beappropriate only for speci� c types of subject matter, certain students, or particular ways oflearning. On the contrary, it was viewed as a widely applicable instructional deliverymechanism.

Conclusions

The � ndings of this study support the viability of online instruction in baccalaureate nursingeducation. Faculty generally characterized Web-based courses as highly interactive, student-centered learning experiences. Instructors generally felt the online approach was successful,and they enjoyed this type of teaching. The success of online instruction indicated in this study


should encourage universities to incorporate more Web-based instruction into their currentnursing study programs.

This study documents the extensive time needed initially to plan a course and communicatewith students during course delivery. If online teaching demands more time and effort, shouldit not deserve additional reimbursement or release from other responsibilities? The potential ofthis new teaching methodology may only be fully realized if faculty are given � nancialincentives or granted release time to develop and implement pedagogically sound onlinecourses.

While most respondents in this study actually preferred online teaching, academic adminis-trators must also recognize that not all faculty are inclined or well suited to teach in the onlineformat. Teaching online does not � t every instructor’s individual teaching style. The character-istics of the teacher must be taken into consideration in planning the delivery of Web-basedinstruction. There needs to be a recognition that the quality of online courses will be injeopardy unless faculty with interest and skill in online instruction are matched with thosecourses.

Nursing faculty who teach online must identify strategies that enhance collaboration whilerecognizing the value of individual student work. While facilitating independent student work,instructors also need to provide suf� cient structure for those students who need it. Finally,Web course instructors will need to continue to devise ways to evaluate pupils carefully andfairly, despite constraints associated with testing in an online environment.

Web-based instruction in nursing education can no longer be considered an emergingendeavor or instructional experiment. The perceived success of online courses, from theperspective of nursing faculty across the country, indicates that the pedagogical challengespresented by computer-mediated course delivery are being addressed effectively. Severalcritical indicators support the continued development and proliferation of Web-based coursesin Colleges of Nursing, including the adoption of Internet technology into existing nursingcourses, general support for technology initiatives, and the endorsement of this approach bythe majority of nursing faculty This enthusiasm for online instruction was typi� ed in the wordsof one faculty respondent who said “My attitude has completely changed. At � rst I wasskeptical, but now I’m excited by it. My students have deeper insights, work harder, and aboveall else, learn more.”

REFERENCES

American Association of Colleges of Nursing. (1999). AACN white paper: Distance technol-ogy in nursing education. Washington, DC: AACN Publications.

Bates, A. W. (1995). Technology, open learning and distance education. London: RoutledgePress.

Berge, Z. (1997). Characteristics of online teaching in post-secondary formal education.Educational Technology, 37(3), 38–47.

Bonk, C., & Dennen, V. (1999). Teaching on the Web: With a little help from my pedagogicalfriends. Journal of Computing in Higher Education, 11(1), 3–28.

Bonk, C., & Reynolds, T. (1997). Learner-centered Web instruction for higher-order thinking,teamwork, and apprenticeship. In B. H. Khan (Ed.), Web-based instruction. EnglewoodCliffs: Educational Technology Publications.


Byun, H., Hallett, K., & Essex, C. (2000). Supporting instructors in the creation of onlinedistance education courses: Lessons learned. Educational Technology, 40(5), 57–60.

Cini, M., & Vilic, B. (1999). Online teaching: Moving from risk to challenge. Syllabus, 12(10),38–40.

Collis, B. (1997). Pedagogical reengineering: A pedagogical approach to course enrichmentand redesign with the WWW. Educational Technology Review, 8, 11–15.

Daugherty, M., & Funke, B. (1998). University faculty and student perceptions of Web-basedinstruction. Journal of Distance Education, 13(1), 8–36.

deVerneil, M., & Berge, V. (2000). Going online: Guidelines for faculty in higher education.Educational Technology Review, 32(13), 13–18.

Donaldson, J., & Thomson, V. (1999). Interpersonal communication strengthens Web-basedinstruction. Journal of Applied Communications, 83(3), 23–32.

Duchastel, P. (1997). A web-based model for university teaching. Journal of EducationalTechnology Systems, 25(3), 221–229.

Farrington, G. (1999). The new technologies and the future of residential undergraduateeducation. In R. Katz. (Ed.), Dancing with the devil: Information technology and the newcompetition in higher education. San Francisco: Jossey-Bass.

Furnell, S., Evans, M., & Bailey, P. (2000). The promise of online distance learning:Addressing academic and institutional concerns. Quarterly Review of Distance Education,1(4), 281–291.

Gleydura, A., Michelman, J., & Wilson, C. N. (1995). Multimedia training in nursingeducation. Computers in Nursing, 13(4), 169–175.

Goggin, N., Finkenberg, M., & Morrow, J. (1997). Instructional technology in highereducation teaching. Quest, 49, 280–290.

Halstead, J., & Coudret, N. (2000). Implementing Web-based instruction in a school ofnursing: Implications for faculty and students. Journal of Professional Nursing, 16(5),273–281.

Hannah, R. (1998). Merging the intellectual and technical infrastructures in higher education:The Internet example. The Internet and Higher Education, 1(1), 7–20.

Harasim, L., Hiltz, S., Teles, L., & Turoff, M. (1995). Networks for higher education, training,and informal learning: Exemplars and experiences. In Learning networks: A � eld guide toteaching and learning online. Cambridge, MA: MIT Press.

Hill, J. (2000). Web-based instruction: Prospects and challenges. Educational Media andTechnology Yearbook, 25, 141–155.

James, M., & Voigt, M. (2001). Tips from the trenches: Delivering online courses effectively.Business Education Forum, 55(3), 56–57.

Katz, R. (1999). Competitive strategies for higher education in the information age. In R. Katz(Ed.), Dancing with the devil: Information technology and the new competition in highereducation. San Francisco: Jossey-Bass.

Kearsley, G., Lynch, W., & Wizer, D. (1995). The effectiveness and impact of computerconferencing in graduate education. Retrieved from http:/gwis.circ.gwu.edu/ , etl/cmc.html

Kroder, S., Seuss, J., & Sachs, D. (1998). Lessons in launching web-based graduate courses.T.H.E. Journal, 25(10), 66–69.

Landis, M. (2000). Faculty strategies for distance teaching. Educational Technology, 40(6),55–57.


Leasure, A., Davis, L., & Thievon, S. (2000). Comparison of student outcomes and preferencesin a tradition vs. World Wide Web-based baccalaureate nursing research course. Journal ofNursing Education, 39(4), 149–154.

Leggett, W., & Persichitte, K. (1998). Blood, sweat, and tears: 50 years of technologyimplementation obstacles. TechTrends, 43(3), 33–36.

Liaw, S., & Huang, H. (2000). Enhancing interactivity in Web-based instruction: A review ofthe literature. Educational Technology, 40(3), 41–45.

Mangan, K. (1999, April 21). Online programs face faculty resistance, management educatorssay. Chronicle of Higher Education, p. 1.

McManus, T. F. (2000). Individualizing instruction in a Web-based hypermedia learningenvironment: Nonlinearity, advance organizers, and self-regulated learners. Journal ofInteractive Learning Research, 11(2), 219–251.

Moore, M., & Kearsley, G. (1996). Distance education: A systems view. Belmont, CA:Wadsworth.

Navarro, P. (2000). Economics in the cyber classroom. Journal of Economic Perspectives,14(2), 119–132.

Noam, E. M. (1995). Electronics and the dim future of the university. Science, 270.Oliver, R. (1999). Exploring strategies for online teaching and learning. Distance Education,

20(2), 240–254.Revak, M. (2000). If technology is the hammer, where’s the nail? Journal of Cooperation and

Collaboration in College Teaching, 10(1), 21–23.Rickard, W. (1999). Technology, education, and the changing nature of resistance. Educom

Review, 34(1), 42–45.Saba, F. (2000). Migration: A comfortable strategy to help faculty move online. Distance

Education Report, 4(12), 3–4.Schoenfeld-Tacher, R., & Persichitte, K. (2000). Differential skills and competencies required

of faculty teaching distance education courses. International Journal of Educational Tech-nology, 2(1), 1–16.

Sherry, L., & Wilson, B. (1997). Transformative communication as a stimulus to Webinnovations. In B. H. Khan (Ed.), Web-based instruction. Englewood Cliffs: EducationalTechnology Publications.

Shotsberger, P. (1996). Instructional uses of the World Wide Web: Exemplars and precautions.Educational Technology, 36(2), 47–50.

Thiele, J., Allen, C., & Stucky, M. (1999). Effects of Web-based instruction on learningbehaviors of undergraduate and graduate students. Nursing and Health Care Perspectives,20(4), 199–203.

Zanglein, J., & Stalcup, K. (1999). Technology: Web-based instruction in legal skills courses.Journal of Legal Education, 49(4), 480–503.

Correspondence. Pamela Luft, 405 White Hall, Kent State University, Kent, OH 44242-0001 ,USA.

Documents

Examining Online Instruction in Undergraduate Nursing Education