Theory into practice: The design of an online technology skills course for nontraditional nursing students
Suzanne P. Stokes,
Krista P. Terry,
Nontraditional students in an upward mobility nursing track delivered largely through distance learning technologies enroll in a one-hour credit elective course to learn skills required for success in the online learning environment. The course, "Introduction to Technology in Nursing Education," began as a traditional classroom course. Its transformation to an online course reflects strengths inherent through using a systematic instructional design process in course development. An overview of the Dick, Carey, and Carey (2002) model of instructional design, examples of design components reflected in the course, and illustrations of instructional objectives and strategies from the lessons are presented.
Designing and developing online learning environments for purposes of allowing students access to course materials, methods in which they can interact with content, and mechanisms for communication with faculty and peers is the focus of many practitioners, researchers, and administrators within the educational environment. While many publications serve to bridge the "theory to practice" gap when developing online education (e.g., Clark & Mayer, 2003; Mantyla, 1999; Stephenson, 2001) this paper attempts to bring into focus practical issues surrounding theory-based design and development of an online course for nurses. Consequently, it will provide a discussion of the development of an online basic technology skills course in the nursing program at a mid-sized comprehensive institution in the southeastern United States.
Providing online, web-based learning is the primary method of instructional delivery for students enrolled in a Registered Nurse (RN) to BSN-MSN degree track within the School of Nursing. The purpose of this degree track is to allow Registered Nurses who have earned the Associate of Science in Nursing degree to complete the nursing sequence required for the Bachelor of Science in Nursing degree in one academic year and, if desired, move seamlessly into the Master of Science in Nursing degree program. Registered Nurse students in this track are typically full-time nurses living in the predominantly rural southeastern quadrant of Alabama. Time and location constraints imposed by work, family, and community involvement make the choice of a distance learning program appealing. Because of the unique nature of nursing education, the program is delivered via a blended methodology. Theory courses are delivered in an online, web-based mode while clinical experiences are personalized to meet individual needs and are conducted in facilities in students' locales. Additionally, students have their choice of three branch campus sites at which they can receive student services, attend course orientation sessions, and take selected written and skills examinations.
of the heavy online component of the degree track, nursing program administrators
committed themselves to preparing these nontraditional students for
success in the program and satisfaction with their educational experiences.
Results of studies by McCoy (2001) and Stokes (2001) indicate that students
who have prior experience with using the World Wide Web are more likely
to be satisfied with their online educational experiences. Recommendations
from McCoy's investigation of technological self-efficacy of nontraditional
nursing students include developing strategies to enhance students'
technology skills and techniques for self-directed learning. Earlier
work by Stokes (1999) found that public school teachers entering a graduate
program with online components including an introductory technology
skills course were able to identify their technological weaknesses,
and through guided coursework, develop skills important to success in
the degree program. The results of these studies therefore provided
the basis for the development of an introductory technology course in
which nursing faculty could equip students with the technology skills
necessary for them to succeed in a primarily online learning environment.
The "NSG 1160 - Introduction to Technology in Nursing Education"
course (shortened to "Introduction to Technology" in this
paper) was then designed, developed, and delivered to entry level students
enrolled in the RN to BSN-MSN track.
Evolution of the Course
The online adaptation of the "Introduction to Technology" course evolved over four years. When faculty in the RN to BSN-MSN track observed that the program's first group of nontraditional students was experiencing technology obstacles to learning, even though students had completed a prerequisite basic computer applications course as part of the University's general studies requirements, a request for an online technology orientation session was submitted. This request was further substantiated by some students expressing frustration with adjusting to a return to college and adapting to a learning format that differed substantially from their previous learning experiences. To address these matters, the second year's group of Registered Nurses entering the degree track was encouraged to participate in a basic technology orientation session delivered online during the week prior to the beginning of classes. The content was suggested by nursing faculty and was based on required nursing course activities that included synchronous and asynchronous communication, submitting work as email attachments, and using electronic databases for scholarly research. The orientation leader quickly noted considerable technology deficits in most students as well as a lack of basic software important for course activities, although students were informed of software requirements upon acceptance into the program. Course faculty saw only a moderate decrease in technology obstacles when the new term began. As the situation was assessed, suggestions were made that the orientation's length and timing be changed to take into account individual differences in learning needs and learning paces, as well as to encourage students to complete arrangements for access to necessary software such as Microsoft Word and PowerPoint prior to the beginning of the term.
During the time the RN to BSN-MSN track was initiated, a new one-credit hour elective course for traditional nursing students wishing to improve their technology skills was offered in the School of Nursing's baccalaureate program. "Introduction to Technology," the course that has been referred to previously, blended faculty presentations with computer-based learning activities. The instructor was present at all class sessions to provide immediate assistance as needed. Since the objectives of this course matched the needs identified in students in the RN to BSN-MSN track. A ssection of "Introduction to Technology" was modified for online delivery during the summer semester prior to the fall class of new RN students. The program director encouraged each student to enroll in the course. The course instructor guided students through skills activities; students practiced skills, realized the need for required software, and were technologically ready for beginning the program the following semester. Substantial improvements were noted by program faculty, and students' evaluations of the online format were much more favorable than in the previous year. Between the third and fourth years, the course was redesigned based on the Dick, Carey, and Carey (2002) model of instructional design. The details related to the course as it now exists, as well as the theory that supported the design and development of the course, are described in the following sections.
Overview -- NSG 1160 - Introduction to Technology
The catalog description for the course, "Introduction to Technology in Nursing Education," states that the course:
The general course objectives state that upon successful completion of the course, the student will be able to:
There is no text for the course since all materials are available through the Internet. However, students are required to purchase a three-ring notebook, divider tabs, and a diskette. In addition, students are required to have access to a computer with an Internet connection, a printer, Web browser (Microsoft Internet Explorer or Netscape Navigator, version 4 or higher), Microsoft Word, and Microsoft PowerPoint. Downloading Acrobat Reader and obtaining current virus protection software are covered in the course lessons. Access to course materials is through the university's course management system via University-assigned usernames and passwords.
The course is comprised of 17 basic lessons, two projects, a written examination, and a skills demonstration, all of which were derived from and correlated with the instructional objectives of the course (see Table 1 above). Table 2 provides a summary of each lesson's purpose and selected activities. The two course projects are the development of a reference page that is comprised of resources from the World Wide Web and the CINAHL database (Cumulative Index of Nursing and Allied Health Literature) formatted according to APA style, and the development of a PowerPoint slide show that incorporates basic elements of an electronic presentation. Using APA format and the CINAHL database are components of the BSN and MSN curricular requirements, and because baccalaureate nursing graduates are expected to be producers of knowledge as well as consumers of knowledge, PowerPoint software was chosen as the medium for simulating information transfer from the nurse to the client community. Each student selects a health topic to use for both projects; this strategy helps students learn to take a single topic, locate consumer and scholarly resources, evaluate resources related to the topic, and incorporate information into a classroom presentation with an accurate reference list.
Table 2. Examples of lesson components for "Introduction to Technology."
Although the skills demonstration at the end of the course provides a performance assessment opportunity from which the instructor can evaluate the cumulative skills of each student, the instructor's observations of students' work and their questions as they progress through the lesson tasks are key formative evaluations of the instructional materials design. In addition, these observations serve as a lesson to the instructor of the many means that students discover to reach the end product. Because the instructor is the course designer, these observations assist in refining instructional materials and related tutorials to guide students in the best methods of executing skills related to learning in an online environment.
Instructional Design Model
The "Introduction to Technology" course that has been described was designed and developed to meet specific needs within the nursing program. The course designer and developer utilized the Dick, Carey, and Carey (2002) model of instructional design as a basis for designing a pedagogically-sound course that could be delivered via an online environment to meet the needs of the nursing students. The following paragraphs describe how each phase of the design model was addressed as the course was redesigned from a traditional to a web-based format, therefore addressing both the theoretical and practical aspects of delivering a technology skills course in an online environment to nursing students.
Dick, Carey, and Carey (2002) model of instructional design is based
on a systems approach to designing instruction which identifies many
components of a learning system as being crucial to developing successful
learning environments. Instructional design models that are based in
a systems approach generally assume that a large amount of instruction,
such as an entire course, will be developed and that a significant amount
of resources will be devoted to the development process (Gustafson and
Branch, 1997). Other instructional design models that are based on the
systems approach are the Smith and Ragan (1999) model and the Interservices
Procedures for Instructional Systems Development (IPISD) (Branson, 1975)
model. Although all models vary in their levels of specificity and complexity,
each is based on the typical processes of the major phases of instructional
systems design; these are analysis, design, development, implementation
and evaluation (Dick, Carey, and Carey 2002). The Dick, Carey, and Carey
model consists of the following specific phases:
Each of these phases of the model was critical to the design and development of the "Introduction to Technology" course as it now exists. What follows is a discussion of how each phase was applied to the development of the course.
Assessing Needs to Identify Goals
Dick, Carey, and Carey (2002) identify the most critical event in the instructional design process as being that of the identification of the instructional goal. This goal, derived from processes of assessing needs, can be developed and articulated by using a subject matter expert approach in which designers develop instruction in their areas of expertise, or the performance technology approach, in which the designers develop instruction in response to a set of problems or opportunities. Regardless of the methods, course designers engage in a process to determine the needs that will be addressed by the instruction, therefore forming the instructional goal.
instructor who developed the "Introduction to Technology"
course was a subject matter expert, therefore the methodology employed
to determine the needs that shaped the instructional goal was both content
generated and generated via the performance technology approach. Nursing
faculty members who contributed to the needs assessment recognized the
importance of student success and satisfaction from a student-centered,
programmatic, and institutional perspective, and understood the need
to develop a technology-based course that would attempt to facilitate
the success of students who would be learning via a technology-based
medium. Learner satisfaction is an important factor in the effectiveness
of instruction and in program-related benefits (Biner, Dean, & Mellinger,
1994; Chute, Thompson, & Hancock, 1999). High levels of satisfaction
with distance learning, regardless of the medium, influence students'
willingness to continue in a program. This willingness is evidenced
by lower attrition rates, more referrals from enrolled students, greater
motivation, better learning, and increased commitment to the program.
The need to develop technological skill and competence in an online
learning environment was therefore responded to by creating a course
in which the instructional goal was to provide the students with a foundation
for learning in a technology-based environment.
Once the goal of promoting student success and satisfaction in an online environment was established, the process of conducting the instructional analysis was undertaken. This process, which involves identifying the specific skills and knowledge base that should be included in instruction, requires breaking the instructional goal down into discrete units in order to identify skills and the relative subordinate skills learners will need to possess to achieve the goal. According to Dick, Carey, and Carey (2002), when conducting the instructional analysis, the designer should ask, "what exactly would learners be doing if they were demonstrating that they already could perform the goal?" (p. 37). This process led to the identification of skills that students would need for tasks such as accessing course materials, communicating through email, locating Internet and library resources, completing online forms and quizzes, and developing class presentation materials. In addition, skills important for accessing University services such as the Writing Center, basic computer skills assistance, and administrative elements including grades and transcripts were determined. Each skill area was examined in a step-by-step manner in an attempt to identify all relevant subordinate skills and eliminate assumptions of prior knowledge or experience. Areas where experience was expected but not assured were linked to subject area experts for individual student assistance. Table 1 outlines the specific lessons that were developed as a result of the goal analysis phase that identified the skills needed to succeed in the online learning environment of the RN to BSN-MSN track.
Learner and Contextual Analysis
After determining the specific set of skills that need to be taught in order for the learners to be able to achieve the instructional goal, Dick, Carey, and Carey (2002) recommend conducting a learner and contextual analysis in order to determine "the characteristics of the learners, the contexts in which the instruction will be delivered, and the contexts in which the skills will eventually be used" (p. 95). They acknowledge that at times the designer may have sufficient knowledge of the target population to forego formal data collection, but they recommend areas in which designers should have knowledge of their target population. The authors (2002) recommend gathering information such as entry behaviors and prior knowledge, attitudes and motivational levels, general learning preferences, and group characteristics. This information serves to assist designers with developing instruction that will meet the needs of their students and will transfer to appropriate contexts.
Learners' needs in the "Introduction to Technology" course were identified based upon prior experiences with students in traditional and online learning environments, and through discussions with program faculty who requested the course option for RN students. This anticipatory analysis indicated that some students would have minimal prior experience with using computers while others would have high levels of expertise and confidence. The wide variation expected in learners' abilities and attitudes was the determining factor in developing formative assessment activities. Because the targeted students were adult learners, the necessity for relevant activities was emphasized. Additionally, it was believed that most prior educational experiences were traditional in which the classroom situation was teacher-centered rather than learner-centered. Transferring the responsibility for learning to the student was perceived as a key need as well as a major course purpose. The emphasis on self-directed and problem-centered learning, fundamental in Knowles's (1970) theory of androgogy, is consistent with the constructivist model that is particularly appropriate for teaching and learning using emerging technologies (Lunenberg, 1998).
Writing Instructional Objectives
The writing of instructional objectives, or behavioral objectives as they are sometimes referred to, is a process that is seen as being central to designing instruction. Authors such as Robert Mager have greatly influenced the educational community by publishing books that provide instructions for writing clear and precise statements of what learners should be able to do when they complete the instruction (Mager, 1975). The objectives written for "Introduction to Technology" followed the model set forth by Mager and described in other instructional design models. The lesson objectives (see Table 1) contained clear, concise statements of what learners would be able to do as a result of their participation in the instructional activities of the course.
course objectives were established when the original traditional section
of the course was approved by the University and therefore were not
altered for the online course section. The course sections are the same
course, differing only in the method of delivery. Because the objectives
were well developed for the traditional section of the course, no problems
existed in their use as the online section was developed. The outcomes
specified by the objectives guided the plans for measuring achievement
Course activities were planned so that areas of weakness would be evident,
and opportunities for corrections to work submitted were given throughout
the course (see Table 1 for examples of lesson objectives).
Assessment strategies and instruments
After developing sound instructional objectives, Dick, Carey, and Carey (2002) recommend the development of assessment instruments that evaluate learners' progress and instructional quality, and that are both learner-centered and criterion-referenced. Basing the assessment measures on the instructional objectives and goals of the course provides learners with a clear conception of what skills they will need to master, and provides instructors with information as to how well the students are mastering the skills and how effective instructional materials are at facilitating learning. "Introduction to Technology" relies on performance-based assessment measures to assess the learners' levels of progress toward obtaining the instructional goal. Projects were designed to allow both direct and indirect demonstrations of skills. The summative assessment is comprised of an individual timed skills demonstration and a computer-based exam.
Carey, and Carey's (2002) discussion on developing instructional strategies
- the chunking, sequencing, and presentation of materials - relies on
a primarily prescriptive approach in which the learning components are
tied directly to the content structure. Dick, Carey, and Carey, however,
recognize alternative approaches such as constructivism as being viable
alternatives for presenting and facilitating instruction. Tapscott (1998)
described learning based on digital media as interactive learning that
is learner-centered with a focus on the construction of knowledge, as
compared to the broadcast learning that is teacher-centered and focuses
on instruction. The designer of the "Introduction to Technology"
course blended both prescriptive and alternative approaches to developing
instruction in order to tie learning to the stated objectives and engage
learners in authentic problem-solving tasks. The instructional strategies
employed within the course followed a pedagogical model advocated by
Jonassen (2003) in which learners are engaged in meaningful learning
tasks and are actively learning from technology and with technology.
lessons were planned to guide each student individually through tasks.
Each lesson ended with students submitting forms indicating that the
lesson had been completed; completing a lesson carried no point value.
However, because students were aware that skills from each lesson would
be evaluated at the final exam, those who needed help in completing
the lessons requested received assistance from the instructor before
leaving the lesson. The course was divided into three sections to reflect
the overall instructional strategy of learning skills, applying knowledge
through activities and projects, and evaluation of skills and knowledge
through summative assessments. Course sections were basic lessons, projects,
and evaluation. Lesson and project component pages stated the purpose
and objectives of each component, followed by sequential tasks to acquire
or improve skills needed to accomplish each objective. Students were
then asked to work through the material in a self-directed manner. Because
students determined for themselves when lessons had been completed,
accountability for learning was transferred from the instructor to the
student, therefore engaging the students in authentic, problem-solving
tasks, which are more typical of the constructivist paradigm of learning.
Dick, Carey, and Carey (2002) describe the "developing instructional materials" phase of their systematic design process as being one in which the designer decides on the delivery system and media selection, the amount of instructor facilitation, and the components of the instructional package (e.g., instructional materials and assessments). While the authors discuss many of the options and constraints inherent in choosing a delivery system, they also acknowledge that at times those choices are assumed and such related choices will be fairly stable.
Since the goal of "Introduction to Technology" was to engage students in a technology-based learning experience in an online learning environment, the media choice and options regarding subsequent materials development procedures were assumed and thus stable. Instructional materials development therefore was based upon the medium, which in this case was the course web site. This was the appropriate format in that students were preparing for entry into an online instructional track of the nursing degree program. The department in which the course was developed and delivered already employed the Blackboard course management system as the primary mechanism for the delivery of course materials.
Formative Evaluation, Revision of Instruction, and Summative Evaluation
final stages of the Dick, Carey, and Carey (2002) systematic model of
instructional design involve designing and conducting formative evaluations,
revising instruction, and designing and conducting summative evaluations.
The goal of the formative evaluation process is to develop materials
and methods through which learners can provide information to the instructor
or designer relative to the effectiveness of the course materials. Dick,
Carey, and Carey recommend that evaluation instruments be designed to
gather information related to the clarity of instruction, the impact
of the instruction on the learner, and the general feasibility of the
instruction. The data gathered from this evaluation process is intended
to inform the process of revising materials to better meet students'
needs. Consequently the final stage of summative evaluation becomes
a stage in which data is gathered to make decisions about the continued
use of the instruction.
Using sound instructional design theory is important in any educational setting to insure that learning objectives are met. Although all steps in systematic instructional design are important, evaluation of the course's design has yielded important results in building and maintaining the quality of this introductory technology skills course for students in this track of the baccalaureate nursing degree program. Reliance on a formal system for design during the redesign of this course yielded not only a fine product, but provided the instructor/designer with a sound theoretical base for further development.
Suzanne P. Stokes, Ph.D., is Associate Professr of Health & Human Services at Troy University in Troy, Alabama. With backdgrounds in nutrition and instructional technology, she teaches traditional and online classes for students in health sciences and nursing informatics. Her research interests include investigating factors that affect satisfaction and success of students engaged in learning that incorporates emerging technologies.
P. Terry, Ph.D. is Director of the Multimedia Center and Assistant Professor
in the College of Information Science and Technology at Radford univeristy,
P. M., Bink, M. L., Huffman, M. L., & Dean, R. S. (1995). Personality
characteristics differentiating and predicting the achievement of televised-course
students and traditional-course students. The American Journal of
Distance Learning, 9(2), 46-60.
R.K. (1975). Interservice procedures for instructional systems development:
Executive summary and model. Tallahassee, FL: Center for Educational
Technology, Florida State University.
A. G., Thompson, M. M., & Hancock, B. W. (1999). The McGraw-Hill
handbook of distance learning. New York: McGraw-Hill.
R., & Mayer, R. (2003). e-Learning and the science of instruction.
San Francisco: Pfeiffer.
W., Carey, L., & Carey, J. O. (2002). The systematic design of
instruction (5th ed.). New York: HarperCollins College Publishers.
K., & Branch, R. (1997). Survey of instructional development
models (3rd ed). Syracuse: ERIC Clearinghouse on Information &
D.H. (2003). Learning to solve problems with technology: A constructivist
perspective (2nd ed). Upper Saddle River, NJ: Merrill Prentice Hall.
M. S. (1970). The modern practice of adult education: Andragogy versus
pedagogy. New York: Association Press.
F. C. (1998). Constructivism and technology: Instructional designs for
successful education reform. Journal of Instructional Psychology,
25(2), 75-81. Retrieved January 24, 2000 from EBSCOhost database
(Academic Search Elite).
K. (1999). Interactive distance learning exercises that really work.
Alexandria VA: American Society for Training and Development.
R. F. (1975). Preparing instructional objectives. Palo Alto,
CA: Fearon Publishers.
C. W. (2001). The relationship of self-directed learning, technological
self-efficacy, and satisfaction of adult learners in a digital learning
environment. (Doctoral dissertation, The University of Alabama,
2001). Dissertation Abstracts International, 63(01A), 111.
J. (2001). Teaching and learning online: Pedagogies for new technologies.
London: Kogan Page Limited.
P., & Ragan, T. (1999). Instructional design. (2nd Ed). Upper
Saddle River, NJ: Merrill Prentice Hall.
Stokes, S. (1999). Preparing students to take online interactive courses. The Internet and Higher Education, 2(2-3), 161-169.
Stokes, S. P. (2001). Temperament, learning styles, and demographic predictors of college student satisfaction in a digital learning environment. (Doctoral dissertation, The University of Alabama, 2001). Dissertation Abstracts International, 62(03A), 983.
Tapscott, D. (1998). Growing up digital: The rise of the net generation. New York: McGraw-Hill.
[ Copyright © 2004 College of Education, Idaho State University | ISBN 0-9718446-0-7 ]
Please report any problems you may have with the site to our webmaster via email.