Online program recommendations

n_g · Dec 8, 2008

I'll say it again. There are no accredited online US MD or DO medical schools. In fact, if online coursework was the mainstay of your medical training even during the pre-clinical years if you're from a foreign medical school, I don't know of one state that will license you.

core0 · Dec 8, 2008

ANPFNPGNP,
I don't have access to medscape either.. but I found this as a googled summary.. I make the assumption that it is not accredited in USA. I view online continuing ed among established professionals as very accepted.. but this seems a bit outlandish IMHO.
Medical Schools Team Up to Form Online Medical School

http://www.medscape.com/viewarticle/443292
Students who leave their home countries to receive their medical school degree often do not return to practice medicine in that country. In order to slow down this type of "brain drain", over 50 medical schools in 16 countries have teamed up to form the first online medical school. Free registration is required to access this October 30, 2002
Medscape
article.
v/r

Unless you count Oceania as a medical school there isn't one. The article describes a concept paper published 5 years ago. It hasn't gone anywhere. Some of the medical schools have collaborated on PBL modules but thats about it.

You can read more about it here:

http://www.ivimeds.org/overview.html

There are probably one or two DO school that have some online content. Most of the rest is either lecture based or group PBL for both DO or Allopathic schools.

David Carpenter, PA-C

MSADN, ADN · Dec 8, 2008

Jackson, MS. Sure wish I could eat at Hamils today!

Zenman, you do know that Hamils moved to a brand new building. They're not in the rickety, old house anymore. The food is still good though. (I live less than a mile from Hamil's.)

ANPFNPGNP · Dec 8, 2008

Golytely, thank you for the post... I feel this concern as well. However, instead of gaining confidence in the programs the aggressiveness of some to defend their program and eliminate any doubters is a turn-off for young students such as myself. I think the GA state BONs recent decision with a particular online school is interesting and look forward to understanding what data supported this move - as it is rather bold move to go against the standard certifying agency. .

I'm curious, what decision did the BON in GA make regarding that online program?

just_cause, BSN, RN · Dec 9, 2008

Here is an extract from SEP GA BON newsletter to give a summary...

www.georgianurses.org/GNA_GBON_091908.pdf

GNA and Excelsior College officials urge Board of Nursing to reconsider interpretation of HB 1041

"ATLANTA - In an official presentation, the Georgia Nurses Association (GNA) and Excelsior College officials urged the Georgia Board of Nursing (BON) to reconsider its interpretation of House Bill 1041, which became law in July 2008. The Board's interpretation of this new statute (O.C.G.A. 43-26-7) will no longer allow students of

Excelsior College's nationally accredited nursing program to apply for and receive registered nurse (RN) licensure in Georgia. At the meeting, the BON took no action and shifted the matter to its Education Committee. Because of this inaction, more than 1100

students of Excelsior College in Georgia remain in limbo as to whether they will be able to practice as RNs in the state."

...

"Part of the language in this legislation also allows the Board of Nursing to deny license to "fly-by-night" nursing

schools that often pop up, enroll students and then close their doors."

I am not sure about the current status - I imagine there are a bunch of those with vested interest or those that do not want to ever question a BON partaking in finding reasons to shut down an institution they view as having a low quality factor - despite online or brick. I am interested in seeing why the decision was made - from what data. I've heard some angry as they feel it's the state BON job to ensure the RNs are quality once they get licensure... i disagree..if there is a systemic problem from a particular school - it's everyone's interest to place it on probation until the problem is resolved and then allow everyone to improve based on the outcome.

v/r

DavidNP · Dec 9, 2008

I am one semester from completing the Duke SON Online FNP program. I take exception with several comments in this thread generalizing online NP programs as substandard and mischaracterizing the Duke program in particular.

First, Duke has several online NP programs for BSN prepared nurses. A previous Masters degree is not required for any of the NP programs. The part of the sentence ANPFNPGNP bolded referred to the post master's certificate option. Second, there are no 100% "online" NP programs of which I am aware. All have a local clinical requirement. Thus "off-campus" or "distance" may be a better term for these programs.

I too have had surprised reactions from patients and providers when I tell them I am in an online program, however once I explain how an online program works it makes sense to them. As for MD perceptions of an online program, many of my recently graduating classmates have been offered positions by their MD preceptors.

Duke's distance program has the majority of the didactic content online. Clinical is arranged locally to the student (usually

The online courses also have extensive group assignments such as case studies requiring virtual collaboration throughout the semester. You must be active, contribute, and willing to take initiative or faculty will quickly notice. Discussion boards in most courses required weekly input, graded for content. Tests are timed and depending on the instructor, open or closed book. The tests draw from a random bank of 100's of questions, multiple choice, short answer, and essay. If you need to look up something like a practice guideline you had better know exactly where to find it. There is no time for research. The faculty keeps close watch on grades and curves for the online and on-campus tests are consistently similar.

In the FNP program there may be one "on-campus" day most semesters. However, in the semester prior to beginning courses with a clinical component, an advanced physical assessment course is required that does have three 3-day sessions on-campus for teaching and practice of the physical exam. These weekends are in addition to the semester's weekly lecture, exams, and readings. Students are expected to come to these weekends well prepared. There are individual skill demonstrations and checkoffs, thorough hands on instruction with male and female professional medical models, and an excellent 1/2 day orthopedic seminar. On the last weekend students must perform a timed complete physical and several randomly assigned acute and chronic exams. Obviously I had still had and still have a great deal to learn but I felt well prepared for basic physical exams after this course. I have been told by 2 experienced preceptors that their Duke online students have been the best prepared NP students they have taught.

Because I had added a 2-semester cardiology component to my program I was required to drive to campus this fall to take 2 courses or wait an extra semester to complete my degree. The transition to the classroom was seamless other than the tedium of sitting through 6+ hours of morning and afternoon lecture. I had been used to watching a lecture, pausing to take notes or read about a specific point, web search, etc. and then continuing lecture (or mowing the yard).

Just like my on-line courses, the on-campus classes had an extensive online Blackboard component, additional online lecture assignments, journaling, and discussion boards. Lectures are recorded and available on Blackboard in a narrated Powerpoint format and MP3 download by the next day for review. The main difference was there were less group assignments required than for the same online courses. The discussion board was not as active, but there usually were still one or two interesting threads a week along with case studies. The technology may sound advanced, but it is becoming the norm. My local community college has the same capabilities. If I were ever to teach in a similar environment I would require online lecture content to be reviewed prior to class. Face to face time is better used for interactive discussion, case studies, etc.

The problems that ANPFNPGNP mentions with her local online NP program sounds as if it may be a poorly designed program. I have been told by my preceptors of a "brick & mortar" NP program in my area that similarly expects their students to get their assessment instruction in clinical. It puts a lot on the preceptor, but the online aspect is not the reason for a poorly designed program. I would recommend contacting the dean and letting him or her know your concerns.

I think the criticism leveled at online programs is somewhat based on generational and technological perceptions as well as individual learning style. The Duke SON faculty have been encouraging, supportive, and sometimes forgiving. However the program requires a high level of motivation, determination, time management and organization. We were told that 15-20 hours/week of non-lecture study is expected for each 3-4 credit graduate class. Some weeks I did less, but usually I studied at least that much.

Thankfully there are options for more than one type of learner and lifestyle. Some folks learn better in a person to person lecture, others require a weekly class to keep on course, and some watch lectures in their Blue Devil slippers at 11pm.

The quality and standards of any program must stand on their own. I will always be very proud to have graduated from Duke's Online program.

n_g · Dec 9, 2008

FNP2009,

It sounds like you got a great experience from your well-structured program. However, the arguments that people are making here is that there is no mechanism in place to guarantee that all online NP programs are of high standard. Too many of them are substandard and the grads of these programs are giving NP's everywhere a bad name. There needs to be tighter quality control of NP programs nationwide so that a consistent, high quality product is produced at each and every program.

ANPFNPGNP · Dec 9, 2008

Here is an extract from SEP GA BON newsletter to give a summary...
www.georgianurses.org/GNA_GBON_091908.pdf
GNA and Excelsior College officials urge Board of Nursing to reconsider interpretation of HB 1041
"ATLANTA - In an official presentation, the Georgia Nurses Association (GNA) and Excelsior College officials urged the Georgia Board of Nursing (BON) to reconsider its interpretation of House Bill 1041, which became law in July 2008. The Board's interpretation of this new statute (O.C.G.A. 43-26-7) will no longer allow students of
Excelsior College's nationally accredited nursing program to apply for and receive registered nurse (RN) licensure in Georgia. At the meeting, the BON took no action and shifted the matter to its Education Committee. Because of this inaction, more than 1100
students of Excelsior College in Georgia remain in limbo as to whether they will be able to practice as RNs in the state."
...
"Part of the language in this legislation also allows the Board of Nursing to deny license to "fly-by-night" nursing
schools that often pop up, enroll students and then close their doors."
I am not sure about the current status - I imagine there are a bunch of those with vested interest or those that do not want to ever question a BON partaking in finding reasons to shut down an institution they view as having a low quality factor - despite online or brick. I am interested in seeing why the decision was made - from what data. I've heard some angry as they feel it's the state BON job to ensure the RNs are quality once they get licensure... i disagree..if there is a systemic problem from a particular school - it's everyone's interest to place it on probation until the problem is resolved and then allow everyone to improve based on the outcome.
v/r

Very interesting. Do you know anything about the content of House Bill 1041?

zenman · Dec 9, 2008

Always excellent to hear the voice of reason. You sound like you'd be a great preceptor.

just_cause, BSN, RN · Dec 9, 2008

ANPFNPGNP,

http://www.legis.state.ga.us/legis/2007_08/sum/hb1041.htm

The BON said that it decided to stop certifying Excelsior graduates because of a new law, Act 527 (House Bill 1041), which took effect on July 1, 2008. The act required criminal background checks for nurse license applicants, but also required applicants to have graduated “from a nursing education program approved by the board or which meets criteria similar to, and not less stringent than, those established by the board.

DavidNP · Dec 9, 2008

Zenman, I look forward to being a preceptor... in a few years.

N_G, I agree that national standards and control are very important. However the arguments I am reading here criticizing online programs seem to be based on anecdotal experience with students from single programs and a lack of understanding of how online NP programs are structured (thus the oft repeated "100% online" comments). There are at least 2 online FNP programs in my state (Duke & ECU) and I have never heard any practitioner speak negatively of them and I vetted both programs pretty thoroughly prior to committing my career to one of them.

Though phrased as an "online" problem, the concerns expressed in this thread should not be generalized as such. The idea that clinical judgment can only be taught in a classroom with a blackboard and nice straight rows of desks is really archaic. From my experience, I wonder about the quality of NP programs that only have reading and weekly classes with 3 hour in person lectures with no online discussion, supplementary video, audio, or written material. Faculty can only be accessed in class or during limited "office hours" on 1 or 2 weekdays. Sounds pretty limited to me.

Nursing is a second career for me after a long career in technical training and service. Throughout my nursing journey I am amazed that the adage "nurses eat their own" really is true in some settings. Unfortunately, this does not stop with conferment of an APRN degree.

I started participating in this thread because I saw a statement from Duke's website being misinterpreted and I wanted to correct it, and because I am a predominantly online student there I felt I should try to engage and educate those detractors of online education. Comments expressing fear for the future of NPs and "the public should know" strike me as very uniformed and unreasoned. The Duke SON has a very strong commitment to online education. Last time I checked, Duke is a fairly well known school, the SON 13th in NIH funding, our faculty is top-notch, and our alumnus dean of nursing came back to Duke after being dean at some backwater school called Yale. An institution of this caliper does not institute an online program to make a few extra dollars or to boost enrollment.

The argument is being made that MD, PA, or legal schools do not have online avenues and thus NP online education must be bad. Having worked at a large academic hospital in the past 4 years I can tell you that online and recorded lectures are definitely part of MD instruction. Pick a few well known schools and peruse their student web sites, you'll find lots of online content (some not accessible without login) and even (gasp!) online tests. The University of Virginia is a good example of this, also check out their iTunes videos. (There are a number of good medical resources on iTunes.)

However most all Medical education is hospital based because it requires instruction in a more acute environment. Duke's ACNP, NNP, and Acute PNP programs are not offered online for this same reason. MD students training in primary care often have rotations similar to NP clinicals at out patient clinics.

The legal analogy is just invalid. Though I'd surprised if most law schools do not have online content (never looked). The law school analogy just does not work because verbal argument is the basis of legal skills. From the first semester this skill is taught, honed, and challenged.

The Excelsior RN program that lost accreditation in GA that is being touted as an example of the evils of online education. Again this is a specific program, and its loss of accreditation cannot be generalized to all online education. I really don't care to read about it more than has been posted here, but it sounds as if the GABON made a decision based on its certifying requirements for all SON. That is a good thing, however if one bad school were to set the standard there would be no ADN or BSN programs remaining in NC based on the past performance of a very few intuitions.

This brings me back to my point in my last post. Concern for the quality of NP preparation is crucial and very important to our profession. As a soon to be FNP I appreciate the concern and oversight. If you are concerned about a particular program, call the faculty; then if not satisfied call the dean. Preceptors are valuable and their opinions count. If you know a program is turning out unprepared graduates get in touch with your state BON. But please do not judge based on preconceptions or prejudice.

I've said enough. I'll shut up now...

Happy Holidays to everyone!

n_g · Dec 9, 2008

For every good NP who comes out of one of these online NP programs, how many make the profession look bad? Maybe even you know of an NP who you said probably shouldn't be in this profession. That's the problem with these programs. Too many questionable graduates. If you talk to physicians, many can relate bad experiences with poorly trained NP's.

Look at it this way. If online NP programs were so successful and strong, why do we have so many NP's who can't find work? You can find several threads on this forum from NP's who have been looking for work for many months. I have no doubt it is because of the perception and experience of physicians with prior bad NP's. The true test of the quality of the NP's coming out of programs is the demand for them.

If we as a profession want to improve our image with the physicians and public, we have to tighten the quality of the product we produce. That means rigorously testing students to make sure they know their stuff, ensuring students receive quality clinical training at reputable sites, etc. There are too many holes in online training that someone of questionable moral and intellectual abilities can slip through.