Web-enhanced pharmacology for nursing students.

Abstract

This paper reports on the design, implementation, and evaluation results of a web-enhanced pharmacology course in an undergraduate nursing curriculum. Students supported the use of on-line learning in this course and found that the environment enhanced their learning. Formative and summative evaluation methods were utilized in this initial course offering. Issues in implementing a web-enhanced course are also identified.

Introduction

The availability and introduction of new information technologies, along with changes in higher education, have contributed to an increased interest in web-based learning. Careful consideration must be given when transforming a course from a traditional teaching strategy to an independent learning strategy such as with web-enhanced courses (Thiele, Allen, & Stucky, 1999). One of the reasons for the interest in web-based learning from a student perspective is the unlimited access to courses. Up to 75% of today's students may have family and jobs in addition to obtaining a higher education (Stith, 2000). Nursing education is rapidly embracing the World Wide Web and exploring various techniques in offering on-line courses. In the basic nursing curriculum, not all courses are amenable to on-line learning due to the nature of the practice of nursing. One course that could be web-based or web-enhanced is undergraduate pharmacology since this is primarily a lecture course without a clinical component. This article will describe how using a web-enhanced technique was useful in the design of an undergraduate nursing pharmacology course at a mid-western university.

Development of Materials

The software program used for developing this on-line course was Web-CT. This program assists in setting up an effective web-based educational environment. Course materials can be presented as well as grades, on-line discussions, quizzes and assignments. The use of Web-CT was fairly new to this university; therefore, the initial use of this software program was fairly basic. Weekly worksheets and answers to class activities were posted on Web-CT. Additionally, the grade book tool for students to track their progress within the course was used.

The instructor prepared worksheets intended for class preparation weekly. Microsoft Front Page was used to ensure the materials were in html format and could be uploaded into Web-CT easily. Students were told when these worksheets on Web-CT could be accessed. The instructor developed the questions on the worksheets after reviewing the chapter(s). Thus, students would be able to obtain the answers by reading their textbook. Questions were designed as short answer or fill in the blank. Some sample questions for the topic of Cardiovascular Drugs included: "Thrombolytic treatment is now standard practice for treating an early myocardial infarction. Which agent is most effective when given within 4-6 hours of pain onset?"; and, "What is the major complication of thrombolytic therapy? Which drug has a higher incidence of intracranial hemorrhage?". Having the worksheets available on the Web was beneficial for both students and instructor. Students could access and print the worksheets at any time of day or night and were not dependent on locating the instructor. The unlimited access is important for today's nursing students who are frequently concerned with other time commitments such as childcare and work. Additionally, the school of nursing saves unnecessary copying costs by printing either too many copies or multiple copies for students who lose the assignments.

Course Implementation

Due to a curriculum change, pharmacology had been expanded from a one-semester course to two semesters. The first time the second semester course was taught three sections were offered, and each of the faculty followed a different teaching approach. This author chose to use a web-enhanced method. This method has also been described by Angulo & Bruce (1999) as Supplemental Web-based Instruction and defined as: "an innovative approach to delivering the instruction using the Web as the medium .... and does not rely on the electronic medium as the sole source of instructional communication and interaction" (p. 106). The intent of this manuscript is to report on the efficacy of web-enhanced instruction for this critical nursing content area, therefore, no direct comparisons were made between this approach and the lecture method used in the other sections; or on student performance between sections.

This course was scheduled to meet twice weekly on Thursdays and Fridays. During the first week of the semester, class met on both days with Thursday as an orientation day and an introduction to the use of the web-based teaching approach. The assignment for Friday was to access Web-CT for on-line course instruction. Thus, the Friday class session focused on any problems accessing the site and to introduce the first assignment. After this initial week, the students were to view the web-based pharmacology worksheets on Fridays and prepare the answers for discussion on the following Thursday in the classroom. The classroom format involved an introduction to the topic by the instructor and an opportunity for the students to ask questions regarding any specific questions that were difficult on the web-based worksheet. The instructor did not give answers to all the questions on the worksheets since the textbook was the basis for the questions. After the brief overview by the instructor, the students were separated into groups of 4-5. Each group was then given another set of questions, a case study, or a quiz related to the topic of the week. In order to answer these questions, the students would have to come prepared with their completed worksheets they had printed from Web-CT. Toward the end of the classroom time, each group responded with their answers to the case study or quiz posed to them. The instructor acted as a facilitator and would confirm or clarify the answers as the groups presented. Later that same day the answers to the "in-class" exercises were posted on Web-CT. Having this information available online in a concise format served as a review as well as a study guide for students as they prepared for unit examinations.

Evaluation

When designing teaching materials for use on the Web, one needs to consider incorporating both formative and summative evaluation (Karuppan & Karuppan, 1999). A formative evaluation technique used in this undergraduate pharmacology course involved asking another nursing faculty colleague, who was not teaching any of the pharmacology sections, to come to the classroom and meet with the students alone for evaluation purposes. The evaluation was focused on the students' learning and use of the web-enhanced method after six weeks of the course. Several positive themes emerged from the groups' feedback with the faculty-colleague. Findings included the convenience of using Web-CT, a great appreciation of being able to access materials on their own schedule as well as having the "study guide" information available for examination preparation, the ease of finding the answers to worksheet questions in their textbooks, and how the web-enhanced class format promoted independent learning. One very positive, as well as interesting, comment was related to the fact that the worksheet preparation prior to class caused the students to read the textbook! Suggestions to improve the learning environment included having the instructor discuss all of the answers to the worksheets in class or post answers on Web-CT, allowing more space on the worksheets for answers, and altering some of the in-class group assignments by having a question from each classification of drugs rather than having each group specialize in one drug classification.

In response to the formative evaluation, this instructor thanked the students for their open and honest feedback and discussed their concerns. Changes were made to the in-class assignments to ensure that all students were exposed to each drug classification. The format of the Web-CT worksheets was redesigned to include more spacing for answering each question. Concerns regarding the answers to the Web-CT worksheets were addressed by explaining that the instructor had designed the worksheets directly from reading the textbook. Therefore, reading the answers in-class should not be necessary. This concern was further addressed by allowing the first 10 minutes of in-class time for students to discuss the Web-CT assignment within their group. Prior to beginning the in-class exercise, the instructor would clarify any questions that remained unanswered or confusing.

A summative evaluation form was used at the end of the course to obtain additional student feedback on the teaching strategies. Several comments indicated appreciation for asking for feedback mid-semester, rather than at the end of the course when it would be too late for their suggestions to make a difference. When asked what they liked about the course some descriptors were: freedom to do assignments on own time; convenient class schedule (only one day per week of on-site class meetings); and, in-class exercises reinforced content studied from Web-CT worksheets. Comments specifically regarding the use of Web-CT included: easy to use; can work at your own pace; worksheets were helpful in studying for exams; and, worksheets encouraged reading the chapters in the textbook. A couple of negative comments regarding the use of Web-CT included: costly to print pages; and, inconvenient for those who do not own a computer.

Lessons learned

The use of a web-enhanced technique for this undergraduate nursing pharmacology course seems to be an appropriate and sound educational method. Obtaining feedback from the students at mid-semester was invaluable. Students were able to contribute to their own learning environment and the instructor was able to provide explanations and make necessary changes. As with any first-time use of instructional technology, there was a great deal of preparation time in learning the Web-CT software and then applying course materials to that software. Use of programs such as Microsoft FrontPage was valuable in placing the web content in html format.

When deciding to place class materials on the Web, some faculty may fear that students may not attend class. However, studies have shown this not to be the case and have even found attendance at lecture presentations to increase substantially (Karuppan & Karuppan, 1999; Schaad, Walker, Wolf, Brock, Thielke, and Oberg, 1999). Results from the undergraduate pharmacology course described in this article validated these studies. Attendance at the weekly classroom session was regularly well attended.

Future undergraduate nursing pharmacology courses could incorporate further utilization of Web-CT and more of its functions. This author would improve the course by including more application exercises either during classroom time or on Web-CT. Discussion groups could be formed on the Web-CT bulletin board to discuss case study content pertinent to each week's content. Quizzes could also be placed on Web-CT either as practice or for credit.

The use of information technology via the World Wide Web is gaining rapid speed in higher education. Many courses can be web-based or web-enhanced. As courses are placed on-line, they must be constantly evaluated to assess the effectiveness of the learning environment. Additionally, through publication of initial efforts such as the one described in this article, educators will learn from each other.

References

Angulo, A.J., & Bruce, M. (1999). Student perceptions of supplemental web-based instruction. Innovative higher education, 24(2), 105-125.

Karuppan, C.M., & Karuppan, M. (1999). Empirically based guidelines for developing teaching materials on the web. Business Communication Quarterly, 62(3), 37-45.

Schaad, D.C., Walker, E.A., Wolf, F.M., Brock, D.M., Thielke, S.M., & Oberg, L. (1999) Evaluation of technology-enhanced education. Academic Medicine, 74(10), S84-S86.

Stith, B. (2000). Web-enhanced lecture course scores big with students and faculty. The Journal, 27(8), 20-26.

Thiele, J.E., Allen, C., & Stucky, M. (1999). Nursing and Health Care Perspectives 20(4), 199-203.

Christina Quinn, Georgia State University, GA

Dr. Quinn is an assistant professor in the School of Nursing. She was awarded the Doctor of Nursing Science by Louisiana State University Medical Center New Orleans where she studied adult health nursing and graduate nursing education.