A Toolkit for Course Conversion to Online Formats

knarrindell

The concept of technostress will also be discussed, whereby technology-induced intimidation and anxiety may act as a barrier to faculty acceptance of course conversion. Throughout the article, this writer will also share insights gained through conversion of a nursing nutrition course.

Technostress and Faculty Development

Nurse educators have fallen victim to technostress. Technostress can skew attitudes and cause faculty to avoid adoption of web-based learning formats, even while praising the value of such (Tacy, Northam, & Wieck, 2016). Imagine saying that a certain textbook, if taught to nursing students, would greatly improve learning outcomes. Imagine if research consistently backed-up such claims, and students were asking for access to the text. And, despite all of this, imagine teachers resisting the textbook because the thought of having to master the material themselves was too intimidating. Online educational formats have successfully improved access to education for many nursing programs. Especially for adult learners, such flexible options can reduce barriers to education and offer courses which meet or exceed the quality of those taught within classroom settings (Keating, 2015). Internet-based educational programs can offer convenience, flexible scheduling, dynamic content, resource efficiency, and cost-saving through web-based access to the following: lectures, webinars and presentations, research articles, website links, photos and videos, audio recordings, simulations, white papers, discussion forums, testing, and library resources (Skiba, 2013). As such, many nursing programs have begun to incorporate online learning options. With most of the current nursing faculty in America projected to retire in the coming years, online courses may also help to alleviate the impact of faculty shortages.

The problem with technology, however, is that adoption of such involves change. Though a majority of nursing faculty believe that student learning outcomes are improved as a result of educational technologies, and thus warrant university spending on such, willingness to adopt online learning systems has been persistently low (Pereira & Wahi, 2017). What would cause so many educators to resist the very thing believed to improve learning? Many faculty are slow to adopt technology because of inadequate training. Unfamiliarity with online educational formats can lead to intimidation, low confidence levels, and resistance to change. Faculty development activities, however, have been shown to increase faculty adoption of web-based learning methods.

This article presents a step-by-step toolkit for nurse educators involved or interested in converting a traditional, classroom-based nursing course into a fully-online course format, utilizing a learning management system. Curriculum design principles and andragogical theory provide the foundation for toolkit strategies. Evidence-based active learning techniques and strategies to promote socialization are incorporated, as well. This author's experience of converting a classroom nursing nutrition course into an online course are discussed in order to share pertinent lessons learned, useful resources, and other helpful caveats. Much like a recipe for success, the toolkit consists of step-by-step recommendations for effective conversion of an existing traditional nursing course into an online course, based upon current research. The target audience is faculty and staff development personnel involved in course design for any level of nursing education. The incorporation of this toolkit into educator practice promotes excellence in accordance with the following core competencies for nurse educators: facilitating learning, facilitating the development and socialization of students, utilizing effective strategies to assess and evaluate, curriculum design and evaluation of outcomes, leading and facilitating change, continuous quality improvement and learning, scholarship, and mastery of the educational environment (National League for Nursing, 2012).

Tool #1- Use a Learning Management System

The first thing to do when converting a course for online use is to select a learning management system (LMS). This is what makes online classrooms user-friendly (and faculty-friendly). That being said, you want to take some time to find a system that works for your course needs. Studies have shown high success when tools, pedagogy, and content are consistent with program goals. No universal model has been identified as better than another. In fact, one study demonstrated that course models designed by individual program faculty were more effective than premade templates utilized by multiple organizations, especially when taught by the faculty whom had participated in the design (Wattenbarger Baker, Mitchell, & Scalf, 2017). LMS provide a supportive platform for course design and implementation of teaching strategies. Easy-to-populate templates and standardized formats are recommended, especially for faculty lacking extensive experience with LMS (Schnetter et al., 2014). Selection of the right LMS can compensate for online experience through easy, visually-appealing, navigation. Studies have shown that student success is higher when course design is easy to navigate, visually consistent, and perceived as functional (Scnetter et al., 2014; Zsohar & Smith, 2008). Course design which involves frequent student-faculty interaction has proven to be more effective in facilitating learning and student satisfaction. Course content is most effective when selected after a LMS has been established (Schnetter et al., 2014). The use of templates or preset fields streamlines course management and makes it easier to demonstrate how standards are being met. Syllabus design is paramount to student success and satisfaction. Detailed syllabi are associated with higher success and satisfaction. Clear expectations and adequate contact information allow students to focus on learning objectives, rather than waste time navigating the LMS. Standardized grading rubrics assist in defining expectations and incorporating feedback. Incorporating discussion forums promotes effective socialization, facilitates learning, and encourages collaboration (Farmer & Ramsdale, 2016; Floyd, Hughes, & Maydosz, 2012; Plante & Asselin, 2014; Schnetter et al., 2014; Woods & Bliss, 2016; Zsohar & Smith, 2008).

Creating summaries for each module of instruction can provide a predictable, centralized, source of information. When courses feel segmented and disorganized, students experience frustration and paranoia about what will be expected of them. Clear module summaries are a great way to identify module readings, objectives, required assignments and due dates, and priorities. A sample summary has been attached to this article, and provided this writer with an easy starting-point for lesson development. Operational links imbedded within the summary will enhance the navigation of online courses, and promote both student and faculty satisfaction. When things are easy to find, and to post, less time is wasted.

Tool #2- Re-examine Learning Objectives

At times, objectives should be customized for the online course, rather than applied directly from an existing classroom-based course (Schnetter et al., 2014). Objectives should be relevant to the tools utilized within the LMS and easily understood by students. Course revision or redesign of any nature presents an excellent opportunity for quality improvement of learning objectives. So, before getting into curriculum elements, take time to assess the existing course learning objectives. Update, as needed, to reflect current practice guidelines and standards for excellence. Also consider any accreditation requirements for distance learning formats. Some states have established benchmarks and expectations when it comes to online higher education. When wording objectives, communicate clearly and unmistakably, to promote student understanding. Many objectives can be directly applied from a traditional classroom to an online teaching environment. In this writer's experience, every existing objective was directly applicable. You simply need to ensure that achievement can be demonstrated through existing online avenues.

Tool #3- Redesign Lectures and Assignments for Online Use

Before getting into lectures and assignments, it is important to note that adult learners have specific learning needs. According to Knowles' theory of andragogy, adults progressively seek greater independence and autonomy, gain resources through life experience, value knowledge which serves a practical purpose with regard to social roles, and recognize immediate benefits from learning problem-centered content (Bastable, 2014; Billings & Halstead, 2012; Keating, 2015). While external factors typically motivate child learners, adult learners are motivated by intrinsic goals (Utley, 2012). The advantages of applying Knowles' theory to adult nursing students include increased student motivation, greater readiness to learn, enhanced understanding through building upon previous knowledge, and effective preparation for specific social roles. Rather than fight the natural tendencies of adult learning principles, andragogy incorporates such in order to enhance the learning experience, improve professional training, and promote student success (Draganov, Andrade, Neves, & Sanna, 2013). Shifting from a pedagogical approach to one of adult learning requires a shift in control and responsibility; whereby adult students assume personal responsibility for learning, prefer an active learning environment in which student input is respected, and appreciate when educators assume a more facilitative role (Utley, 2012). Content which is perceived as irrelevant to actual life application will often result in resistance, poor participation, and dissatisfaction. In order to fully engage student interest, and thereby motivate, educators should value the needs of adult learners, and facilitate student success through provision of useful content, active learning opportunities, and building upon life experience. Additionally, assignments should be due on the same predictable schedule each week (Zsohar & Smith, 2008). Standardized due dates aid in organization and time management within an online environment. Based upon Knowles' theory, knowledge transfer increases when educators facilitate greater independence and autonomy, prepare students for success in new social roles, and provide problem-centered knowledge (Bastable, 2014; Billings & Halstead, 2012; Curran, 2014). Adult learning theory is fundamental to effective online education, as distance education methods depend upon learner motivation and autonomy (Decelle, 2016). Self-directed learners have enabled the effective use of online course offerings in nursing. Within the online learning environment, active engagement and reflection promote retention among adults.

Lectures can still be utilized within online classrooms, though may be augmented or delivered through alternative methods. For example, lectures can be videotaped, voice-recorded, and offered in print. Studies have shown that podcasts, for example, lead to enhanced recall and understanding of lecture material, especially for auditory learners and students whom commute (Abate, 2013; Marrocco, Wallace Kazer, & Neal-Boylan, 2014). Podcasts can also be used to provide walk-through assessment examples, interviews, and case studies. The main concerns when converting lectures and assignments for online use are to cater to adult learners through relevant, useful information, and avoid overloading the student with extra work. For example, multiple lecture formats can be made available, though students should not be required to use all of them. Provide students with the means to facilitate learning, and allow them to choose what works best for them. When slide presentations are utilized, embed videos which augment the print. This type of design capitalizes on the benefits of online learning, whereby so many resources are available with the click of a mouse. Even lectures or slide presentations can then become more interactive or dynamic. Within slides, create prompts which ask the reader to stop and answer a question. Then, provide an answer, with rationale, on the next slide. Assignments should incorporate active learning techniques whenever possible. Those are discussed as Tool #4.

Tool #4- Use Active Learning Strategies

Active learning and constructivist teaching strategies are widely applied to online nursing education due to consistency with adult learning theory and improved learning outcomes when compared to more traditional pedagogies (Feng et al., 2013; Kerrick, Miller, & Ziegler, 2015; Keating, 2015). Many classroom techniques for incorporating active learning can also be applied within online environments. Common forms of active learning used within online classrooms include case studies, games, service learning projects, WebQuests, and simulation. Simulations range from low-fidelity to high-fidelity. Case studies are a form of simulation, as are role-play activities and virtual scenarios. Virtual simulation, or e-simulation, is now widely available for use within online course formats, and offers interactive scenarios which can be tailored to fit individual course needs (Leibold & Schwarz, 2017; Perry, Woodland, & Brunero, 2015). Studies have demonstrated high levels of learning and student satisfaction when internet-based virtual simulations have been used to teach the following: cultural competence, empathy, critical care nursing, operative nursing, nursing assessment, interprofessional communication, patient interviews, conflict management, medication administration, delegation, nursing management skills, and various clinical skills. E-simulation is based in adult learning theory and constructivism, and promotes self-efficacy through immersion in highly interactive, realistic scenarios (Perry, Woodland, & Brunero, 2015). Learners have reported improved knowledge, skills, and attitudes at higher levels than with traditional instruction methods. Scenario-based simulation requires that learners make choices, and then reflect on the effects of such. Feedback is received throughout the scenario, prompting real-time integration of knowledge and enhancing critical thinking skills.

Case studies promote critical thinking skills for the same reasons as other forms of simulation (Hagedorn Wonder & Otte, 2015; Kaddoura, 2011; Singh, Modi, Patel, & Pathak, 2017). Case-based learning has been shown to facilitate engagement and active participation in learning. Analytical thought and problem-solving is promoted through the use of complex, unfolding case scenarios. However, case studies offer a unique benefit, in that case assignments can allow more time for research and application of new knowledge, as well as time to consider the case specifics. More time for thought allows for reflection and assimilation of new information. Case studies are highly compatible with adult learning theory, as such cases represent real-life nursing problems and likely scenarios. Rather than passively receive instruction, students involved in case studies are actively participating in a nursing problem. Studies have shown cased-based learning to be significantly more effective than traditional lecture methods in developing critical thinking and decision-making skills (Kaddoura, 2011). And, the higher level of cognition promoted through cased-based learning has been associated with longer recall (Dutra, 2013).

WebQuests are another popular form of active learning which can easily be incorporated into online design (Sanford, Townsend-Rocchiccioli, Trimm & Jacobs, 2010). WebQuests are rooted in constructivist theory and compatible with adult learning principles. According to Bloom's Taxonomy, WebQuest assignments promote learning at the highest level, and can be highly customized for any course. Effective use of WebQuest assignments involves providing students with online resources which are to be accessed and utilized to construct some sort of project. Common examples include development of slide presentations, posters, reports, brochures, podcasts, or videos. Rubric-based evaluations have been shown to improve student success by providing clear expectations. However, rubrics are only effective when tailored to evaluate aspects of the individual project.

Tool #5- Promote Socialization

Our final tool addresses socialization and sense of community within online classrooms. Online nursing education presents a unique challenge for creating social presence and promoting nursing values such as caring (Plante & Asselin, 2014). Studies have consistently shown that social presence within online learning environments is promoted through the following: incorporating introductions which include photos and personal information, discussion participation, timely and adequate faculty feedback, faculty use of caring words and expressions, respectful dialogue, scholarly communications, supportive communications, and consistency with expectations and evaluation criteria. Personal touches to communications, such as video messages, voice messages, and sharing of personal interests have all been shown to promote a sense of community and social presence. Socialization to the nursing role is similarly supported, through professional modeling and inclusion of nursing valued throughout case studies. Discussion practices have proven to be critical in dictating social presence and role socialization (Woods & Bliss, 2016). Face-to-face discussions incorporate body language and hidden curriculum aspects which are not obvious within the online teaching environment. As such, communications must be deliberate and clear, so as not to send the wrong message. One benefit to online discussion, however, is that introverted learners have an equal platform, and time to prepare careful statements. To promote effective social presence and enhance learning, discussion expectations should be communicated clearly and enforced consistently. Netiquette refers to an expected set of behavior for online communications, whereby acceptable and inacceptable practices are outlined (Farmer & Ramsdale, 2016; Woods & Bliss, 2016). Studies show that learners prefer, and thus participate more actively in, discussions which involve real-life nursing scenarios or relevant local issues. This type of topic is also consistent with adult learning theory, which has shown to facilitate more effective learning. Reflective elements within discussion assignments and prompts have also been shown to promote higher level thinking and improve long-term recall. Discussion need not be synchronous to be effective. Asynchronous discussion can be just as effective when rules are clearly defined and enforced, faculty take on a facilitative mode through prompting, professional communication is modeled, and students receive clear expectations for participation and posting deadlines.

Conclusion

This article has offered five evidence-based tools for effective conversion of a traditional nursing course into online formats. These tools can help nurse educators overcome technostress by simplifying the process and highlighting key aspects of course conversion. Course layout within a learning management system, conversion of learning objectives, redesigning lectures and assignments for online use, active-learning strategies, and promotion of socialization were addressed. The incorporation of this toolkit into educator practice promotes excellence in accordance with the following core competencies for nurse educators: facilitating learning, facilitating the development and socialization of students, utilizing effective strategies to assess and evaluate, curriculum design and evaluation of outcomes, leading and facilitating change, continuous quality improvement and learning, scholarship, and mastery of the educational environment (National League for Nursing, 2012).

Please leave a comment regarding the following: whether you feel better prepared for participation in online course design after having read this article, what two things have you learned as a result of the toolkit, and how the toolkit could be improved. Thank you!

References

Abate, K. S. (2013). The effect of podcast lectures on nursing students' knowledge retention and application. Nursing Education Perspectives (National League For Nursing), 34(3), 182-185.

Bastable, S. B. (2014). Nurse as educator: Principles of teaching and learning for nursing practice (4th ed.). Boston: Jones & Bartlett.

Billings, D. M. & J. A. Halstead. (2012). Teaching in nursing: A guide for faculty (4th ed.). St. Louis: Saunders.

Curran, M. K. (2014). Examination of the teaching styles of nursing professional development specialists, part II: Correlational study on teaching styles and use of adult learning theory. The Journal of Continuing Education in Nursing, 45(8), 353-359. doi: Examination of the Teaching Styles of Nursing Professional Development Specialists, Part II: Correlational Study on Teaching Styles and Use of Adult Learning Theory

Decelle, G. (2016). Andragogy: A fundamental principle of online education for nursing. Journal of Best Practices in Health Professions Diversity, 9(2), 1263-1273.

Draganov, P. B., Andrade, A. D. C., Neves, V. R., & Sanna, M. C. (2013). Andragogy in nursing: A literature review. Investigacian y Educacian En Enfermera, 31(1), 86-94.

Dutra, D. K. (2013). Implementation of case studies in undergraduate didactic nursing courses: a qualitative study. BMC Nursing, 12(1), 15-23. doi:10.1186/1472-6955-12-15

Farmer, H. M., & Ramsdale, J. (2016). Teaching competencies for the online environment. Canadian Journal of Learning and Technology, 42(3), 1-17. Retrieved from ERIC - Teaching Competencies for the Online Environment, Canadian Journal of Learning and Technology

Feng, J., Chang, Y., Chang, H., Erdley, W. S., Lin, C., & Chang, Y. (2013). Systematic review of effectiveness of situated e-learning on medical and nursing education. Worldviews On Evidence-Based Nursing, 10(3), 174-183. doi:10.1111/wvn.12005

Floyd, K., Hughes, K., & Maydosz, A. (2012). A toolkit for web-based course creation and conversion. Rural Special Education Quarterly, 30(4), 32-39.

Hagedorn Wonder, A. & Otte, J. L. (2015). Active learning strategies to teach undergraduate nursing statistics: Connecting class and clinical to prepare students for evidence-based practice. Worldviews On Evidence-Based Nursing, 12(2), 126-127. doi:10.1111/wvn.12075

Kaddoura, M. A. (2011). Critical thinking skills of nursing students in lecture-based teaching and case-based learning. International Journal for the Scholarship of Teaching and Learning, 5(2), Article 20. Retrieved from ERIC - Critical Thinking Skills of Nursing Students in Lecture-Based Teaching and Case-Based Learning, International Journal for the Scholarship of Teaching and Learning

Keating, S. B. (2015). Curriculum development and evaluation in nursing (3rd ed.). New York: Springer.

Kerrick, S. A., Miller, K. H., & Ziegler, C. (2015). Using continuous quality improvement (CQI) to sustain success in faculty development for online teaching. The Journal of Faculty Development, 29(1), 33-40.

Leibold, N., & Schwarz, L. (2017). Virtual simulations: A creative, evidence-based approach to develop and educate nurses. Creative Nursing, 23(1), 29-34. doi: Virtual Simulations: A Creative, Evidence-Based Approach to Devel...: Ingenta Connect

Marrocco, G. F., Wallace Kazer, M., & Neal-Boylan, L. (2014). Transformational learning in graduate nurse education through podcasting. Nursing Education Perspectives (National League for Nursing), 35(1), 49-53. doi:10.5480/10-421.1

National League for Nursing. (2012). The scope of practice for academic nurse educators, 2012 revision. Washington DC: NLN Publishers.

Pereira, A. S., & Wahi, M. M. (2017). Strategic approaches to increase course management system adoption by higher education faculty. Journal of Higher Education Theory and Practice, 17(2), 61-69.

Perry, A., Woodland, L., & Brunero, S. (2015). eSimulation: A novel approach to enhancing cultural competence within a health care organisation. Nurse Education in Practice, 15(3), 218-224.

Plante, K., & Asselin, M. E. (2014). Best practices for creating social presence and caring behaviors online. Nursing Education Perspectives, 35(4), 219-23.

Sanford, J., Townsend-Rocchiccioli, J., Trimm, D., & Jacobs, M. (2010). The WebQuest: Constructing creative learning. Journal Of Continuing Education In Nursing, 41(10), 473-479. doi:10.3928/00220124-20100503-04

Schnetter, V. A., Lacy, D., Jones, M. M., Bakrim, K., Allen, P. E., & O'Neal, C. (2014). Course development for web-based nursing education programs. Nurse Education in Practice, 14(6), 635-640. doi:http://dx.doi.org/10.1016/j.nepr.2014.06.007

Singh, S. P., Modi, C. M., Patel, C. P., & Pathak, A. G. (2017). Low-fidelity simulation to enhance understanding of infection control among undergraduate medical students. The National Medical Journal of India, 30(4), 215-218.

Skiba, D. J. (2013). Back to school: TIGER and the VLE. Why faculty need to access this site. Nursing Education Perspectives, 34(5), 356-9.

Tacy, J. W., Northam, S., & Wieck, K. L. (2016). Understanding the effects of technology acceptance in nursing faculty: A hierarchical regression. On - Line Journal of Nursing Informatics, 20(2).

Utley, R. (2012). Theory and research for academic nurse educators: Application to practice. Boston: Jones & Bartlett.

Education Perspectives (National League For Nursing), 35(6), 392-400. doi:10.5480/13-1168

Wattenbarger Baker, C., Mitchell, C., & Scalf, Y. (2017). Creating positive impact on nursing education in an online RN-BSN program through curriculum development. Kentucky Nurse, 65(2), 17.

A Toolkit for Course Conversion to Online Formats

Do you now feel better prepared for participating in online course design?