Are online ANP degrees destroying our credibility?

zenman · Feb 21, 2012

Me too psychonaut, me too!
lol
He sounds like a very cool guy! He's got the experience to back up his statements.

Ha, ha. However I think some of my religious family have un-friended me on FB! They don't think I'm cool since I'm apparently headed straight to the fire pit after our most recent discussion!

zenman · Feb 21, 2012

Too easy. My husbands friend is stationed there he will ask if there are NP's outside of psych. Odd that you were allowed to be a civilian student working on military patients. UCMJ is not the same as civilian law. I wonder what the commanders thought? Did they know an online student was taking care of their soldiers, sailors, marines. Highly troubling to even ponder.

I forgot to mention that many universities offer online courses to the military. The military is very familiar with online courses as often it's the only avenue for troops to obtain degrees. They have no trouble with the practice.

psychonaut · Feb 21, 2012

Ha, ha. However I think some of my religious family have un-friended me on FB! They don't think I'm cool since I'm apparently headed straight to the fire pit after our most recent discussion!

One dichotomy that has occurred to me is your embrace of DE and your Humanist style (is that fair to say of a shaman? Absolutely no mockery intended, serious). You of all people have to appreciate how much different it is to learn in someone's physical presence vs via technology.

I took one of the first on-line courses available at my U in 1998 or so (a psych class, believe it or not). I have taken many since. I loved my on-line English lit course so much I took the second semester, just for the joy of reading and participating with that professor. SO I am in NO way opposed to DE, I love it and feel it even has a place in nursing ed at the UG and Grad levels.

I am in a DE NP program now, and I don't think the format translates well. Our brief visits each semester are like manna from heaven to me. Discussing clinical cases IN PERSON with my peers and professors is just a whole 'nother beast. Of course, all of my clinical is in person, and while I can read and write all day about patho and pharm etc it just strikes me as more challenging and real when done with another person, asking and answering questions...

I try and know when to fish or cut bait. If DE is firmly entrenched in NP education, than I want to be part of making it as good as it can be. I know your feelings regarding standardized exams, and since I am getting into the education side of things myself I appreciate non-standard educational methods (mixed PBL/case studies with hands-on elements is my current passion), but we NEED objective, standardized judgements to make some level of rational decision regarding the competence of our students (and ourselves). That means exams with no looking up the answers, no "group input," just the student and a pencil and paper (or the electronic equivalent).

zenman · Feb 21, 2012

One dichotomy that has occurred to me is your embrace of DE and your Humanist style (is that fair to say of a shaman? Absolutely no mockery intended, serious). You of all people have to appreciate how much different it is to learn in someone's physical presence vs via technology.
I took one of the first on-line courses available at my U in 1998 or so (a psych class, believe it or not). I have taken many since. I loved my on-line English lit course so much I took the second semester, just for the joy of reading and participating with that professor. SO I am in NO way opposed to DE, I love it and feel it even has a place in nursing ed at the UG and Grad levels.
I am in a DE NP program now, and I don't think the format translates well. Our brief visits each semester are like manna from heaven to me. Discussing clinical cases IN PERSON with my peers and professors is just a whole 'nother beast. Of course, all of my clinical is in person, and while I can read and write all day about patho and pharm etc it just strikes me as more challenging and real when done with another person, asking and answering questions...
I try and know when to fish or cut bait. If DE is firmly entrenched in NP education, than I want to be part of making it as good as it can be. I know your feelings regarding standardized exams, and since I am getting into the education side of things myself I appreciate non-standard educational methods (mixed PBL/case studies with hands-on elements is my current passion), but we NEED objective, standardized judgements to make some level of rational decision regarding the competence of our students (and ourselves). That means exams with no looking up the answers, no "group input," just the student and a pencil and paper (or the electronic equivalent).

We're all different and have varying needs. I know DE is not for everyone so it's nice to have many approaches. I think multiple choice exams are poor way to test knowledge and anyone who knows how they are written could pass one in a subject they know nothing about.

I've even heard of a professor in a CRNA program who wanted to make sure ALL students came out of his course knowing everything he wanted them to know. So he gave them the answers before class and they had to answer all questions correctly. Was that wrong? They all came out knowing all objectives of the course.

I prefer doing for testing. Take physical exams for example. We had to videotape some with family or friends. That was low level anxiety. I got it down pat quickly because I could look over DVD's and online videos from medical schools over and over, then grab a friend and perform that part of the exam. Then we did some with classmates in person. Then our preceptors were present for exams in clinical. My preceptor told me he liked mine but that I could scale it back for the "real world." (I currently do an abbreviated one, except for neuro, for psych.) My preceptor was a funny guy. When I griped about some of my homework he said medical school was the same way but not to let education get in the way of my learning. I think it was Mark Twain who said that originally.

We could have tests about patient interviewing but wouldn't it be better to put you in front of a patient and see how you do?

But I do see your point. I just want you to come up with something more creative and spread it around! Be a consultant and make $$!

And if you want to test me at range firing, we go to the range and "do it."

Trauma Columnist · Feb 21, 2012

I did my first degree, an AA in general studies in 1988 - did it via videotapes while we were stationed in Korea and Alaska (interior Alaska not a city).

The military has long had a grasp on distance learning.

Annaiya, NP · Feb 21, 2012

a lot of good points have been covered in this thread already (in pointing out the opinions here are not supported by any facts), but i wanted to add a couple of things. i did my nursing school pre-reqs online, which was my only option, because i had to still work full-time as an attorney while i was doing them. there was no time for me to go to class. this means i did a&p and micro online. my labs were very different. i had agar plate equivalents growing stuff in my fridge that i had swabbed from tooth brushes, litter boxes and other stuff around the house. i had to physically draw all of the different anatomical structures and mail them to my professor. it was a completely different style of labs than i would have gotten on campus, but i learned the content just the same. my knowledge of the content was the same as my peers during nursing school.

i went to a well respected absn program with a traditional classroom format. and i am now doing an online np degree from a non-profit school. and it is not easy to get into my program. just look at the pre-np student forums and you'll see all the posts of people with good gre and gpa scores not getting in.

there are advantages and disadvantages to both online and in person programs. many of these points have already been covered by other posts. as for exams, the difficulty of the exam and how much you need to know for it is based on the person writing the exam, not whether it is open book or closed book. all of my patho exams were open book exams and were 75 to 100 questions each. very few people at my school get an a in patho. if you did not know the content extremely well, you would not pass the exam. there was maybe time to look up a couple of answers, but if you hadn't read the content carefully, there was no way you had time to figure out the answer. it isn't like they ask a straight forward question that you can just pull out of the book. the questions required an understanding of the content and critical thinking to figure out the answer. an open book exam does not equal an easy a.

all online programs are set up differently, and i think this format is still learning a lot about what methods work the best. but that doesn't mean the content can't be learned as well as in a traditional program. as it is, everyone comes out of school only knowing enough to be safe to practice and get a job where they will actually learn what they are doing. it was the same with nclex. the certification exam is a enough to make sure you meet a minimum standard for safety, but the real learning starts when you start working. the online programs have proven with their pass rates that they are producing graduates that meet the minimum standards. exact quality will always vary between schools, whether they are online or in person.

lastly, i have a great amount of respect for the people teaching my program. they work much harder trying to teach online classes. they have to answer tons of e-mails and be available all day almost every day, because of the students having a varieties of schedules. it is obvious that they have dedicated themselves to producing well-educated, competent new np grads. it is insulting to say that all of these phd nurses with decades of years of experience in their field and in nursing education are simply doing their jobs to make money and produce a bunch of unqualified np graduate students. especially since we all know they aren't paid what they are worth. to say their work and dedication to what they do is degrading the profession of nursing is absurd. maybe the people who feel so strongly about this need to start working on their phd, and they can study the quality of online np graduates for their dissertation.

nomadcrna, DNP, CRNA, NP · Feb 22, 2012

Until you can show me a peer reviewed, scientific study that says distance education NPs practice is not as good as brick and mortor NPs then it is an OPINION. Thats it, just an OPINION.

Come on people, you practice evidenced based medicine. Try using that in more than just talking about it.

Esme12, ASN, BSN, RN · Feb 22, 2012

True......isn't that what the OP was looking for?

chris_at_lucas_RN, RN · Feb 22, 2012

Plenty of errors and poor care have come from people out of traditional programs.

Accreditation is by national organizations, and it's consistently applied.

There will always be reasons for MD's to prefer PA's (who cannot practice independently and therefore will always be under the MD's control). They are not nurses, for one thing.

Nurses, incidentally (and this would include APN's and did not differentiate brick and mortar versus community based educated providers), are consistently perceived as the most trusted profession and are rarely sued or complained against. It might be because we give better care and make fewer mistakes.

I wouldn't make assumptions based on the ideas of a few individuals. After all, racial minorities didn't suddenly become competent and intelligent when our society developed a level of acceptance that minimized prejudice.

studentdrtobe · Feb 22, 2012

Until you can show me a peer reviewed, scientific study that says distance education NPs practice is not as good as brick and mortor NPs then it is an OPINION. Thats it, just an OPINION.
Come on people, you practice evidenced based medicine. Try using that in more than just talking about it.

I understand what you're saying but, to be nitpicky, the way science works, it up to the proponents of online education to show that it's just as effective or better than traditional methods. It's not up to the rest of the world to disprove that idea. That's not how EBM works.

Plenty of errors and poor care have come from people out of traditional programs.
Accreditation is by national organizations, and it's consistently applied.
There will always be reasons for MD's to prefer PA's (who cannot practice independently and therefore will always be under the MD's control). They are not nurses, for one thing.

A big reason why physicians might prefer PAs is not because they want someone they can "control." It's because PAs receive standardized training and the perception is that PAs receive better basic science and clinical training.

Looking at the non-standardized curricula of NP and DNP programs as well as the few hours of clinical training they receive along with the fact that the curricula is filled with more leadership and MPH-ish courses rather than courses on advanced physio/pathophys/pharm/etc, it's easy to see why physicians might prefer PAs over NPs. Believe me when I say we don't "control" PAs any more than we do our NPs. They function in equivalent roles in the hospitals I'm in.

Nurses, incidentally (and this would include APN's and did not differentiate brick and mortar versus community based educated providers), are consistently perceived as the most trusted profession and are rarely sued or complained against. It might be because we give better care and make fewer mistakes.
I wouldn't make assumptions based on the ideas of a few individuals. After all, racial minorities didn't suddenly become competent and intelligent when our society developed a level of acceptance that minimized prejudice.

:rolleyes:

Of course, the reason nurses get sued less frequently because they're better than physicians. It has nothing to do with the fact that physicians have deeper pockets that lawyers can go after. It also has nothing to do with the fact that the attending physician is the ultimate decision-maker regarding patient care and thus, is also going to be blamed for any errors (kind of like how QBs on an NFL team get too much credit when the team wins and too much blame when the team loses).

Patti_RN · Feb 22, 2012

Some for-profit online college programs have hurt the reputations of all online educational experiences. Schools like University of Phoenix have terrible reputations and have tainted all online programs. This is as crazy as saying Michael Jackson's physician is typical of the medical profession and all doctors should be barred from practicing medicine.

Schools like Georgetown University offer online NP programs that are as rigorous as any traditional classroom. I am currently enrolled in Georgetown after beginning an NP program at a 'brick and mortar' university. The online delivery makes no difference in the quality of the education. Georgetown's classes are held via real-time 'skype' type format; you interact with your professor and other classmates (usually 8 to 10 in each class--a ratio unheard of in other schools). The program is demanding, the other students are smart and engaged. This was not my experience at the NP program where I was previously enrolled, and was the reason I switched to Georgetown. Schools like Georgetown are not going to hurt their own reputations by 'churning out' graduates who are ill-prepared or not worthy of acceptance. Georgetown's online program has the same stringent requirements their residential program has. The only difference is the online program is two-dimensional, while the residential program is in 3D.

While Georgetown may not be typical of all online programs, University of Phoenix isn't either--there are many mediocre schools in between and many schools ranging in quality from excellent to poor. I'd rather attend an online program where the rest of the students are high achievers, have significant experiences both in nursing and in other fields, and contribute to the value of the class. I'd also rather have professors who are at the top of their field, respected and are good educators. My experience at the local college was far inferior in all these ways.

The doctor who dismissed all NPs in favor of PAs because there are online NP schools might be as dumb as Michael Jackson's physician--he may be the exception to my previous analogy.

nomadcrna, DNP, CRNA, NP · Feb 22, 2012

LOL, no it can work either way. It does not have to be online educator who do the study. The premise is crap. Everyone has to pass the same boards. Everyone has to have the same amount of clinical. Do you really think a person cannon learn on their own from books and online classes?

The online classes are not hugely different. On your computer there is a window with the instructor teaching. There is even blackboard sections she can write in.

You can even ask questions during the lecture. WOW that is so different from driving to a class room.

But the bottom line is the NPs took the same exam you did. The NPs did the same required clinical hours you did.