Are online NP programs good for the profession??

PMHNP10 · May 6, 2010

My problem with it is - writing and reading. Aside from introductions, I've virtually zero interaction in my program. I realize I'm still early into it, but to read books and powerpoints and have no lecture, no video, no visuals, no discussion - I really feel that it's lacking. And, of course, those schools within driving distance either have already switched to doctorate, aren't accepting students, or are taking apps for 2 years in the future, when I'll be just about done. So - I'm stuck, and guess I just have to make the best of it! Still - for all the info that's out there regarding the learning needs of adult students - I'm disappointed.

Let me first say that I loathe being lectured at; my ADD starts firing on all cylinders within minutes (and even seconds) of the start of a lecture, and for this reason, as a rule of thumb I absolutely love online classes; some things are better for an online format (e.g., classes where lectures are the primary mode of learning) or where the class consists of a project or paper of some sort; with online lectures you can start and stop, rewind when you have a "look at the pretty butterfly" moment, and learn when/where you're most comfortable; however, the problem with an online program is that you lose the collegiality, the open communication, the 1 on 1 sharing of thoughts and experiences, and the spontaneity; with an online class, everything is robotic--forced communication on the interwebs, and no "real" interaction with another human

Having said that, however, as I experienced, and similar to what you mention, an online class that offers virtually no instructor prepared notes or lectures, but then expects you to take an exam on the information you happen to retain from chapters within medical textbooks and published articles/websites baffles me; I have 2 bach. degrees, the ADN, and now an MSN (on Friday); and never in my life have I heard of a class that has exams but no lectures/notes, until my current program

IMHO it is extreme laziness for these program "teachers" to do nothing more than assign readings and written assignments; why do schools even need to hire them if that's all they're going to do to prepare us for our future roles as primary care providers; anyone can assign chapters in a book and write nitpicky statistical questions about one of the 10000s of words read for an exam; at least with classroom education, it forces the teacher to teach, to maybe come up with an original thought, to offer their experience, and to offer their knowledge--what a concept

sure one could argue that any given teacher is ineffective at their job or they are confusing, or difficult to understand, or don't know what they're talking about, but listening to a lecture is introducing learners to another modality of learning; theoretically, these instructors are practicing in our chosen area and have sat for the same exam we are hoping to sit for, be it through the AANP or ANCC, so they should be our best source for picking out key information that we really need to know for our careers and for our certification exams; lectures take an ocean of information and reduce it to maybe a sea or even great lake, which is obviously much more managable than an ocean

and bear in mind--even if we only retain 1% from any given lecture, when you combine what you hear with what you read, it's still better than reading alone

btw...this thread's asking if online programs are good for the profession (and I'll stick with the logic that when we talk about online programs we are obviously referring to a program with a non-online clinical portion); and I clearly stated that I do not think they are based on my experience, and what you indicated in your post; but it's interesting that a few of the reader comments in the recent slam article against NPs by Keith Ablow support my assertion that online is not good for our profession; God forbid, more programs like the ones we mentioned, pop up in this country

PMHNP10 · May 6, 2010

As with nursing school I did not become a nurse until after I started working.

You bring up an intersting point--Do you think the doctor you're working with to treat patients in an outpatient setting would be comfortable with you saying..."well I'm here to learn how to become a primary care provider", because that is the expectation of nurses when we come out with the LVN or RN license; often we get several weeks (even months) working side-by-side with a more experienced nurse to learn how to become a nurse; do you think an MD who's doing a reimbursement split with you will be ok with sitting in the office with you, not seeing their own patients, while you see some of their patients? I truly don't know, but my guess is that a new NP graduate is expected to come out of a program as not quite an independant practitioner, but certainly one that could see patients on their own with minimal need to consult with their collaborating physician

PMHNP10 · May 6, 2010

Mercedes, with all due respect, most of us get what you are saying and are not putting down online programs; however, think about it - most of us on here are nurses or APNs, and we sometimes question how online programs are run and how they are monitored. Can you imagine what the general public/other health care disciplines think with regards to online programs?.

Having just completed an online program, I would absolutely not be the right person to promote them based on my experience.

Yes, most of us on here do get that online programs are accredited, just as rigorous as brick and mortar programs and that in-person clinical components are absolutely required; however, it is not that easily accepted or understood when you try to explain that to the rest of the world.
We're just trying to explain/reason why other disciplines view it has a bad thing.

Another interesting point...I do not know the accrediting system, but I just finished a program that was suspended by the school in 2006, only to be brought back in this online format in 2008. This program is the only online program amongst all graduate nursing programs at the school. So how does a program get accredited? Do individual programs get accredited, or do schools that offer the program get accredited? If it's an individual accreditation, does someone come and review the curriculum, the faculty, etc. similar to the process an hospital goes through with joint commision? Or do you fill out an application, send in money and call it a day?

caitiecait · May 7, 2010

PsychRN, I knew somebody who take that statement too literally. What I mean is that I am most certainly not the ICU nurse I am now versus what I was 2 years ago as an RN, and I most certainly will not be the same nurse I am today in another 2 years. Nursing school gave me the basics. my career however sculpted me into the nurse I am today. I can critically think, advocate for my pts, educate, and even run codes and delegate tasks, I do these things with confidence because I know each day I am still learning and I will never stop learning. To think that I will graduate with my MSN and become an expert FNP is just untrue and plain scary! We must realize our strengths and weaknesses and focus upon them to improve ourselves; by doing so only makes us stronger and better providers. Oh and PS: this is my edgy ADD side speaking, I could care a less what Joe SchmoMD thinks of me, if I did I would never survive this profession!

Advanced Practice Columnist / Guide · May 7, 2010

Another interesting point...I do not know the accrediting system, but I just finished a program that was suspended by the school in 2006, only to be brought back in this online format in 2008. This program is the only online program amongst all graduate nursing programs at the school. So how does a program get accredited? Do individual programs get accredited, or do schools that offer the program get accredited? If it's an individual accreditation, does someone come and review the curriculum, the faculty, etc. similar to the process an hospital goes through with joint commision? Or do you fill out an application, send in money and call it a day?

The accreditation process needs a lot of improvement. Currently, NP programs are accredited by either NLNAC and CCNE as part of the institutional accreditation process of colleges and universities offering graduate degree programs in Nursing (except PhD). This seems more like a general accreditation process although I'm sure either NLNAC or CCNE performs audits of the quality of clinical instruction and clinical placements during their accreditation visits in schools that offer NP tracks. However, I think it would benefit the NP field if we could come up with a separate accreditation process just for NP programs alone.

The CCNE recently started accrediting dnp programs and if this degree does become the requirement for entry into NP practice, this could potentially be the "gold standard" for accreditation of NP programs. However, realize that some DNP programs out there aren't even geared for NP training alone. I've known schools accepting prospective DNP students who have non-clinical nursing positions as administrators and educators.

I also think that what complicates matters is that we have many different NP tracks and some NP tracks have more than one national certification board involved in administering corresponding certification exams. As a result, one nursing specialty board have actually come up with their own way of letting the public know which programs meet certain standards. The Pediatric Nursing Certification Board which administers the AC-PNP and PC-PNP exams have a list of "recognized" programs in their website. It seems like it could be stringent process for a program to be added to their list but being on the list does not, in any way, indicate that this is a formal stamp of accreditation.

PMHNP10 · May 7, 2010

PsychRN, I knew somebody who take that statement too literally. What I mean is that I am most certainly not the ICU nurse I am now versus what I was 2 years ago as an RN, and I most certainly will not be the same nurse I am today in another 2 years. Nursing school gave me the basics. my career however sculpted me into the nurse I am today. I can critically think, advocate for my pts, educate, and even run codes and delegate tasks, I do these things with confidence because I know each day I am still learning and I will never stop learning. To think that I will graduate with my MSN and become an expert FNP is just untrue and plain scary! We must realize our strengths and weaknesses and focus upon them to improve ourselves; by doing so only makes us stronger and better providers. Oh and PS: this is my edgy ADD side speaking, I could care a less what Joe SchmoMD thinks of me, if I did I would never survive this profession!

I'm sorry, but I do not know which statement someone might take too literally. Could you please point out the specific statement I made that you're referring to (after all I made a million of them, give or take)?

As for Dr. Schmo--as a rule, while working as a staff RN in an hospital I usually don't care what MDs think of me either; they cannot hire nor fire me as a staff nurse if I manage to upset them because I call in the middle of the night for an emergency PRN, or to report a significant change in status, etc.; however, in a primary care setting, where your are treating clients as an APRN, the MD hires you and to a degree you are their business partner; it is probably a good idea to impress them with what you know because 1--if they believe you are not any good, they won't keep you around and risk losing clients; 2--you might have noticed that we (APRNs) are not at the top of MDs Christmas card list; burn 1 MD and you'll have a difficult time finding another job with anyone else because MDs do communicate; and 3--by providing outstanding, competent and compassionate care, not only do we help the client and our reputation as a provider, but we also help maintain a positive reputation of APRNs everywhere to MDs as well as the general public; does this mean that my value as a human is based on an MDs opinion of my knowledge in a primary care setting? Of course not, but certainly my life will be far less stressful if I somehow manage to become a respected provider amongst MDs, PAs, and fellow APRNs

CuriousMe · May 7, 2010

Let me first say that I loathe being lectured at; my ADD starts firing on all cylinders within minutes (and even seconds) of the start of a lecture, and for this reason, as a rule of thumb I absolutely love online classes; some things are better for an online format (e.g., classes where lectures are the primary mode of learning) or where the class consists of a project or paper of some sort; with online lectures you can start and stop, rewind when you have a "look at the pretty butterfly" moment, and learn when/where you're most comfortable; however, the problem with an online program is that you lose the collegiality, the open communication, the 1 on 1 sharing of thoughts and experiences, and the spontaneity; with an online class, everything is robotic--forced communication on the interwebs, and no "real" interaction with another human

It's amusing how different we all are. My ADD starts firing on all cylinders when I have to watch recored lectures. My brain just turns off and I need to watch the dang thing over and over and over and...well you get the idea :)

However, I can pay attention in live lectures with no trouble (if I sit in the front, etc). I think it's because there's a person that I'm engaging with, it's interactive, I can ask questions. The recording, is just a recording.

So, I'm one of the rare folks who is looking for a face-to-face grad school program. I have a scholarship that carries over from my undergrad, that requires that I go to school full time, and do not work full time. So, really a face-to-face program works best in that respect as well.

It's tough though, most of the top programs I'm looking at are bragging about how much of their program is online.....

linearthinker, DNP, RN · May 7, 2010

I think the question re: adequacy of ANP education is legitimate. Distance education is still evolving, and it is not a mere matter of prejudice to question their efficacy. I agree that some standardization across the board would improve perceptions. I think time and the success of graduates coming from distance-based programs will do the rest. Nursing is really on the cutting edge here, as one of the first professional disciplines to wholly embrace the medium. Being the first carries an element of risk and uncertainty, but I am confidant it will bear out as effective pedigogy. In fact, I suspect it is going to become the norm for most post-secondary education in the next generation.

I am in a hybrid program, and save one course, I have been highly pleased with both the campus and on-line experiences. Advanced Pathophys in the on-line format was not progressing well from my perspective so I began making a 200 mile drive to attend the class in person; unfortunately I discovered that it was not the on-line format at all, rather it was the Professor and the text book. I think McCance and Huether is a ridiculous text book, and it's ubiquitous presence in nursing education mystifies me. Alas, the Professor was just a dud. Happens in the best of school (and I'm in one of the best, lol).

I was sorry to read that some distance programs are not making use of all the technology available that really rounds out the course work. We have used live chat, skype and video conferencing extensively, and have the opportunity to attend lectures via live video feed, including asking questions in real time and participating in the full extent of the classroom experience from home. Certainly power point has a place, but I'm sad to see some schools are relying solely on an asynchronous format. Our exams are either taken on campus with a scheduled appointment in a given time frame, or proctored by willing faculty at an accredited college or university near home. Quizzes have been on-line, but with a time limit so narrow, it would have been nigh impossible to google fast enough, lol. You simply had to know it. I have had both group projects and individual projects and papers, irrespective of on-line or campus format.

I have not had anyone disparage my education after hearing these details, and I suspect I will not. Once people become informed, they realize while it may not be for everyone, perhaps not themselves, it is a viable alternative to the traditional approach. As ANPs, I think we should lobby hard in support of our colleagues, whatever route they take, as well as advocate for excellence in nursing education across the board. This requires that we ask questions such as poised in this thread.

In the end, I do think distance education will be good for APNs. Suspicion of the format will be a thing of the past soon enough and rising tides raise all boats!

harmonizer · May 8, 2010

I was sorry to read that some distance programs are not making use of all the technology available that really rounds out the course work. We have used live chat, skype and video conferencing extensively, and have the opportunity to attend lectures via live video feed

I am a believer of the online and independent learning;however, I am frustrated with the my current online program which is not utilizing the the technology at the full extent. The online lecture recorded is a lecture from a different instructor who taught a semester before and the content did not match on with the test questions. The test questions are hard and is comparable to questions on USMLE. They must have gotten it from the test banks. While people argue about the validity of the online education, I will give kudos for those who perform well in this "adverse" learning condition.

I ended up self-studying for all materials and use my previous knowledge. Unlike being on ground, I have no clue what the exam questions will be like and what I need to concentrate on. It is 5X difficult than being in class. I am seriously thinking about changing to on-ground school. I need the live video feed or at least a "live" lecture recorded!

If all technology is properly used to the full extent, online school is a possibility.

On top of this, A for graduate level is 94-95%. uugh.. sorry for complaining. I am just overwhelmed and frustated.

EDRN-2010 · May 8, 2010

For me there is one big difference between NP and PA programs - aside from direct entry MSN programs most NP students would have previous experience as an RN. I have never heard of a direct entry MSN program (I hope they aren't out there). NP's are advanced practice nurses but there really isn't a step down from PA (is there?). So if a nurse has prior knowledge (which included direct patient care), and gets their MSN in an online format I don't think that should make a difference - assuming all online colleges require a certain number of clinical hours.

Of course PA's are sometimes RN's/EMT's or whatever and have prior knowledge but its not the same. Does that make sense? It does in my head even though I am having a tough time writing in words what is in my head!

Spacklehead, MSN, NP · May 8, 2010

I'll be completely honest - I started in a half-online/half in-class program from a "reputable" school and took one course before I transferred to a fully in-class program elsewhere. The online way of learning was just not for me - not that I didn't do well, but I didn't like how it was run. It was absolutely very easy to use your text for the timed tests (which suprisingly was allowed) and you took the tests from home. There were no lectures, only assigned readings. Granted, I do realize this is not at all how all on-line programs are - but this one completely turned me off to online education. At that point, it was only a research course that easily transferred to my next program, but I couldn't imagine doing the pharm/patho/NP-focused courses in the same manner (which is how they were offered at this particular program).

If one does choose to go the online route, I would highly suggest talking to current/former students of the program to make sure you are getting a quality education. I wish I had done the same before taking that one course (luckily, I didn't have to repeat it after transfer).

PansyKat · May 8, 2010

I have been a nurse for over 25 years in various settings...from the USAF as a flight nurse to working in a Level 1 Trauma Center to educating RN students. The great thing about nursing is options and variety. Same goes for education. I am a product of an "online" NP program...and I am a new NP. Do I feel I received an sub-standard education? Absolutely not! I had to study and be an independent learner. I did not have to have someone "hold my hand" throughout the program. I networked to get excellent preceptors and I looked for learning opportunities. I had a good experience with my online program..I think being highly motivated and with a STRONG nursing background lends itself to this type of learning. I have sat in the Brick and Mortar schools(my MSN) and felt constricted. I was limited by my career/hours as to when I could attend! Getting my Post-Master's as a FNP online was the best choice for me! Do I feel it is good for relatively new nurses? No..I think you need that nuturing, networking and support that a classroom/professor can offer. Besides, Vanderbilt offers a bridge program where basically anyone with a BS degree can become a APRN in little as 2 years of full-time study. Most of these students have little to NO background in nursing and in 2 years have a MSN/ARNP! Somehow, my online degree/background looks a little better to me...lol The fact of the matter is that universities need to make money! online programs can help provide the needed funding!

The debate will continue...the point is to know yourself and what is best for you! BTW..I breezed through my ANCC FNP boards...Not bad for a online student, huh?

:yeah: