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Use of the seven principles of effective teaching to design and deliver an interactive hybrid nursing research course.

Abstract

AIM This study examined how applying the seven principles of effective teaching to designing and delivering an undergraduate nursing research course in a hybrid format affected course quality.

BACKGROUND Existing research does not adequately describe how the design and delivery processes of hybrid courses affect course outcomes or how these processes address informatics learning resources and students' varying levels of computer skills.

MSTHOD A hybrid nursing research course was designed and delivered to 105 nursing students using Blackboard and Tegrity systems. Using a mixed-methods approach, students' satisfaction with the course was measured and achievement was compared with those of a comparable previous cohort that had taken the same course in the traditional format.

RESULTS Students reported high satisfaction with the course and obtained significantly higher scores than students in the previous semester. Concerns included working in groups and the additional workload associated with the online component.

CONCLUSION Applying the seven principles of effective teaching in design and delivery can improve the quality of hybrid courses.

KEY WORDS

Research in Nursing--Effective Teaching Principles--Hybrid Courses--Nursing Education

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The use of technology in nursing education varies widely and includes delivering courses completely online in a distance-learning format and combining online instruction and practice with face-to-face interaction in hybrid (or web-based) courses. A growing number of nursing institutions are integrating the hybrid approach into their teaching when they have the necessary technological infrastructure, such as learning management systems (LMSs), computer labs, and Internet access for students. This pedagogical mode combines the efficiency and flexibility of online education with the advantages of the traditional course format to promote learning and accommodate today's students, many of whom are either older and have full-or part-time jobs or are from the technology-oriented generations. Both groups demand more flexible learning strategies.

However, because instructors and students are accustomed to the traditional didactic approach to learning, technology should be cautiously utilized (Koch, Andrew, Salamonson, Everett, & Davidson, 2010). The real benefits of utilizing the LMSs in hybrid courses should be based on employing tools that enhance collaboration and learning rather than being used as data repository systems. In different studies, the use of LMSs in hybrid courses ranges from content presentation (Salamonson & Lantz, 2005; Woods, Baker, & Hopper, 2004) to the integration of discussion board questions and other interactive online features (Hsu, 2011; Kavanaugh et al. 2009). One study of 862 faculty members using the Blackboard LMS in hybrid courses at 38 U.S. academic institutions found that it was used only to present content and manage course grades (Woods et al., 2004). Less than 5 percent of the faculty reported employing any interactive features.

The design and delivery of hybrid courses should also take into account the reliability of students' Internet access and the sufficiency of their computer literacy, low levels of which have repeatedly been found to be barriers to online education for both undergraduate and postgraduate nursing students (Farrell, Cubit, Bobrowski, & Salmon, 2007; Jacobsen, 2006). Although participating in hybrid courses improves students' computer literacy, this method assumes that students would have some computer literacy to access and manage the course content. Unfortunately, the majority of studies on technology-based education have examined only these variables' effects on student satisfaction with and the overall success of hybrid course delivery (Farrell et al.) when it would be more instructive to examine how to design courses that meet students' needs by accommodating limited access to and knowledge of technology.

Although there is a large body of research on technology-mediated education in health and nursing, the quality of the design and management of such courses is of concern to educators. Few studies described the course design and delivery processes, which greatly affect the course outcomes (Bangert & Easterby, 2008), and none assessed student characteristics prior to course development. Our study attempts to fill these gaps in knowledge and describes our use of sound pedagogical principles to design, deliver, and evaluate an interactive hybrid nursing course that would be responsive to students' needs. Evaluation of the course's success was based on student satisfaction with and achievement in the course.

Interactive hybrid learning experiences should be based on pedagogical principles suggested by current theories of learning. Constructivist principles of learning are the most often cited underpinnings in web-based education (Bangert & Easterby, 2008)). Constructivism holds that learners construct their own knowledge by engaging in the learning process, interacting and collaborating with teachers and other students, reflecting on the content, and meaningfully integrating the new information with prior knowledge. The theory embraces dialogue rather than the passive receipt of information. The teacher's role is that of a facilitator who helps students construct knowledge by designing and offering the appropriate learning tools.

Using constructivist theory and 80 years of research on best instructional practices for enhancing learning, Chickering and Gamson (1987) proposed seven principles of effective teaching: 1) high expectations, 2) effective student-faculty contact, 3) prompt feedback, 4) cooperation among students, 5) active learning, 6) time on task, and 7) respect for diverse talents and ways of learning.

THE CURRENT STUDY

This study examined the value of using the seven principles of effective teaching in designing and delivering an interactive hybrid nursing research course for undergraduates at a school of nursing in Jordan. Since this was the first such course at the school, students' access to technology, confidence in using computers in an interactive learning environment, and previous experience with LMSs were assessed and the course's structure was tailored accordingly. After completing the course, students responded to a satisfaction questionnaire that assessed their perception of the application of the principles in this course. In addition, student achievement in the course was compared to that of a comparable cohort of students who had taken the course in a traditional format in the previous semester.

The school of nursing, established in 1995, is one of the largest public nursing schools in Jordan, enrolling approximately 250 undergraduates per year. It offers a four-year bachelor's degree in nursing as well as postgraduate programs. Although incorporating technology in education is an integral part of the school mission and philosophy, a report issued in 2010 showed that only five out of 21 theoretical nursing courses were taught using the hybrid pedagogical method and none were taught using distance education. In all of these courses the LMS was used only as a data repository, not to enhance collaborative and/ or interactive learning. Large class sizes, lack of incentives, and work overload were among the major factors faculty cited as deterrents to using interactive technology-based learning environments. The report also indicated a somewhat negative attitude toward e-learning and a need for student and faculty training on using the modality. Like most nursing students, the majority of students are accustomed to learning in a face-to-face, passive environment.

METHOD

Participants included all undergraduate nursing students (N = 105) enrolled in the two sections of the Scientific Research in Nursing course during the spring semester of the academic year 2008-2009. The first author taught students in two sections using the same course content. Approval to conduct the study was granted by the university's human research ethics committee. Students were informed about the study at the end of the course, just before collecting the satisfaction data, in order to avoid affecting their performance and their usage of the LMS. The voluntary nature of participation was emphasized. A faculty member not involved in teaching the course was asked to distribute and collect the questionnaires.

Course Design and Delivery

Scientific Research in Nursing is a three-credit required course in the undergraduate nursing curriculum. The course prepares students to be good consumers of research and to employ evidence-based practice, and emphasis is placed on how scientific inquiry builds a knowledge base for the nursing profession. The focus is on understanding and critiquing the research process, ethical considerations of nursing research, and how to apply research findings in practice.

The web-based part of the course was created to supplement the three-hour-long weekly interactive face-to-face lectures and designed using Blackboard (Release 7) e-Education Suite [TM] LMS and the Tegrity [R] (Tegrity Campus 2.0) distance-education system. Blackboard is widely used in online and hybrid nursing education because it can enhance classroom management with tools such as gradebook and exam systems and enrich the learning experience with both synchronous (i.e., live chat) and asynchronous (i.e., discussion forum) communication. Tegrity is used to record interactive presentations given by instructors. The system displays all applications on a computer screen and allows using a document camera for more interactive presentations as well as handwriting using a stylus pen.

The course was designed and delivered using Chickering and Gamson's (1987) seven principles of effective teaching, as described below.

PRINCIPLE 1: HIGH EXPECTATIONS Precourse discussion of the workload and course requirements is critical for students to have a successful online experience (Masiello, Ramberg, & Lonka, 2005; Rovai, 2007). Many students have the misconception that technology-based courses require less studying time than traditional courses, but in fact their workloads are usually heavier (Hillstock, 2005).

In addition to reviewing the course requirements, students' prior experience with online/hybrid education must be assessed at the beginning of any technology-based course. The technical aspects of hybrid courses are cited as a main cause of student anxiety and negativity toward this form of education (Farrell et al., 2007).

Students were surveyed at the beginning of this course about their past experience with technology-based learning environments, with a response rate of 100 percent. Nearly three fourths (72 percent) had never used Blackboard or another LMS. None of the students had used Blackboard's interactive communication tools, such as discussion board forums. Sixty-five percent had no email address and 90 percent had not used email for educational purposes. Fifty-one percent had no computer at home and 70 percent had no Internet access. The mean score of self-reported computer skills on a 5-point scale was below average (2.3 [+ or -] 0.9).

Students were therefore given detailed, hands-on instructions on logging in to the course, creating and posting assignments, using synchronous and asynchronous communication tools, and using group pages. In addition, they were instructed on using email for educational purposes and on using other applications, such as Microsoft Word and PowerPoint, to complete course assignments. They were directed to free online tutorials on how to improve their computer skills. The instructor used Tegrity to record a comprehensive demonstration on using all of Blackboard's functions, and this was available throughout the course in an introductory module. For students lacking technology access at home, arrangements were made for them to use on campus computer labs anytime during the day.

At the beginning of the semester, students were informed of the course objectives regarding their professional role expectations, required readings, and the methods to be used for evaluation, including the grading criteria for the assignment. A detailed description of the course assignment and examples of well-completed assignments from previous semesters were provided.

Weekly participation on the discussion board was encouraged to promote students' taking an active role in the web-based learning. Standards for answering questions were set out, such as ensuring that answers reflected a careful reading and synthesis of course materials, used professional language, were timely, and incorporated and commented on other students' posts while avoiding agree or disagree comments. Students were advised to access the course online every week, to follow up on announcements, and to contact the instructor in case of access difficulties. Ethical issues about the use of professional language on the Internet as well as ethical and legal aspects of research (e.g., avoiding plagiarism) were emphasized. The instructor's role in the course was also explained.

The course requirements (detailed in the next sections) were designed to help students fulfill their professional roles to utilize research and evidence-based practice. These requirements included developing skills in critiquing and synthesizing research and using informatics to retrieve research studies.

PRINCIPLES 2 AND 3: STUDENT-FACULTY CONTACT AND PROMPT FEEDBACK Receiving prompt feedback from the instructor is important in online learning environments. The timeliness of faculty feedback was one of the four main factors found to affect the retention of 10,466 students in web-based community college courses (Doherty, 2006). Conversely, a lack of instructor-student contact was the most frequently reported disadvantage (Doherty; Miri Baraka & Rafaelib, 2004).

In this study, contact with students was invited using different modalities. Weekly face-to-face lectures were the primary method used to maintain contact between students and the instructor. The Blackboard announcement area was used to convey important dates for exams and assignments. The introductory module, which also included a video presentation on how to submit assignments, helped students use the hybrid course effectively. Group pages were used to follow up on students' progress on assignments. Email was used to clarify course concepts and to arrange meetings with the instructor. Discussion board forums were used to clarify the application of course concepts, and students could also post questions about course materials and the Blackboard LMS in a special discussion board category that the instructor checked and responded to twice a week. Questions about the Blackboard system were also addressed in face-to-face lectures and via email.

The instructor established and adhered to standards for providing feedback. For example, the instructor responded to emails within 48 hours, read all student responses to each discussion board question, referred students to excellent responses, and corrected any misconceptions observed. Questions about course exams were answered in detail in class. Two ungraded online quizzes that students could repeat multiple times were available to help them assess their knowledge with immediate feedback.

PRINCIPLE 4: COOPERATION AMONG STUDENTS Feelings of isolation in online courses are a major problem affecting student retention and participation (Jiang, 2008). Knowledge authoring and community building are therefore vital (Liu & Tsai, 2008).

Because both nursing research and practice are team-based efforts, the importance of fostering cooperation among students, especially in a research course, cannot be overemphasized. Completing the main assignment for this course required groups of students to carry out evidence-based practice projects whose main objectives were to help students acquire basic skills in analysis, synthesis, and evaluation of health-related research studies and to develop a recommendation for practice. Each group was required to select or suggest a researchable topic of interest, retrieve pertinent studies, analyze and critique all the components of each study, analyze the similarities and differences among the studies, and develop a final recommendation for whether to use the intervention in clinical practice. Critical thinking was emphasized in critiquing. Examples of topics chosen for this assignment included the effectiveness of hand washing for infection control, whether massage reduces unpleasant symptoms in cancer patients, and whether bar-coding technology decreases medication administration errors. Information on the grading criteria, clear instructions with examples, and a video about conducting every step in the project were provided online. At the project's end, every student submitted a peer-reviewed evaluation of each member in the group, including himself or herself.

In addition to face-to-face group meetings, Blackboard group pages were used to foster a collaborative learning experience and allow students to share research and completed portions of the evidence-based practice project. Group pages were also used by the instructor to monitor students' progress.

An online community was promoted to enhance collaboration. Students were required to introduce themselves in the "Let Us Know You: area of the discussion board. There, they posted such information as their academic year, their expectations for the course, their level of anxiety, their interests and future plans, and positive and negative things they'd heard about the course from previous students. The instructor also introduced herself on the same page. Students were encouraged to refer to other students' posts using their names.

PRINCIPLE 5: ACTIVE LEARNING

Asynchronous discussion board exchanges are valuable complements to the traditional learning classroom, especially for students who do not speak up in class. Discussion boards also expose users to how other students think. Studies have found that online learning engages more students than traditional courses do (Mahoney, Marfurt, daCunha, & Engebretson, 2005).

On the other hand, Kim and colleagues (2006) found that even when instructors use discussion boards to promote active learning, they rarely adhere to feedback standards like those used in the current study and described above. In addition, Mahoney and colleagues (2005) reported that students enrolled in hybrid and online courses suggest that standards should be set for answering discussion board questions and for how frequently students should review others' posts.

In this study, the use of weekly threaded discussions promoted an active learning experience. The course included authentic discussions relating real expectations about the status of nursing research in Jordan. Guidelines were given for framing an appropriate response, including reading 5 to 10 posts by other students to get a picture of the discussion.

An evidence-based teaching method employed required students to interview nurses about the perceived importance of research, the research infrastructure available in their hospitals, and about perceived barriers to implementing evidence-based practice (EBP). Nurses' responses were to be posted for discussion (with no names used), and for the latter topic, students were to propose solutions.

The group assignment required students to undertake active and collaborative learning. As part of the assignment, students conducted online database searches and described their search strategies. Students were also to create two course-spanning tables, the first reporting differences observed between qualitative and quantitative research in every step of the research process, and the second containing a glossary of terms learned. A research study about barriers to EBP was posted for students to identify barriers relevant to Jordan, and methods for overcoming them were then discussed in class. Threaded discussions also referred students to the websites of professional organizations that mandate the use of EBP as a core competency for all health care team members.

PRINCIPLE 6: TIME ON TASK Doherty (2006) stressed the importance in technology-mediated education of communicating special reminders about course deadlines to monitor students' progress and deter procrastination. Doherty examined four factors affecting student (N = 10,466) retention in web-based community college courses and found that poor time management is one of the primary reasons students drop or fail courses. Both faculty and students reported that web-based courses required more effort (Nelson & Thompson, 2005), particularly at the beginning, until students got oriented to the course. However, having a well-designed infrastructure for online and hybrid courses can decrease faculty and student workloads.

In this study, the content in the hybrid part of the course was divided into different modules. All the modules were designed with a consistent format in order to help students navigate through the course efficiently. Each module consisted of objectives, expectations, information on learning activities for achieving the objectives, an introductory video, PowerPoint slides, and a list of required readings. The Tegrity system was used to record an introductory streaming video for each module as well as sessions on how to complete the EBP assignment. All instructions regarding the course assignment, examples of previous classes' completed projects, and information on how to search online databases were included in the demonstrations and posted in one place to efficiently guide students through assignment completion. Videos were limited to 20 minutes to decrease the download time and speed online access. The announcement area and bulletin boards were also used to communicate important dates and information. Expected problems in using the system, such as system downtime, and ways to manage the course during such periods were communicated. In addition, for easier and timelier instructor approval of research studies for assignments, students were encouraged to post their studies on the group pages.

Since the hybrid course was supplementing the weekly three-hour-long face-to-face lectures, the actual time spent in the face-to-face lectures was around two to two-and-a-half hours for a fair learning load for students.

PRINCIPLE 7: RESPECT FOR DIVERSE TALENTS AND MULTIPLE WAYS OF LEARNING Instructional strategies that respect diverse talents and accommodate multiple ways of learning are congruent with and essential to independent learning. Offering a hybrid course is itself evidence of respect for multiple ways of learning. Adhering to this precept emphasizes that knowledge construction is an individual process. Students' abilities, learning styles, perceptions, and expectations differ, and this should be taken into account when designing a web-based course.

The survey conducted at the beginning of the course to assess students' prior use of technology and the instructions provided to help students manage the course are essential to a quality learning experience. These, too, are evidence of respect for students' backgrounds. The use of text-based information; PowerPoint handouts with text, images, and graphs; and video sessions, as well as the assignment to conduct interviews with nurses at hospitals, all served diverse ways of learning by different kinds of visual and verbal learners. The individual discussion board questions and reading assignments and the group assignments were also essential in integrating different learning modalities.

Nursing students often perceive the Scientific Research in Nursing course as one of their most difficult courses. In a face-to-face learning system, some students may be unable to follow discussions at the same pace or to quickly comprehend new information and terminology; such students might prefer another way of learning. Some students need to attend a lecture during the regular classroom time and again during another section's class in order to grasp some concepts, and students who learn by writing down the instructor's every word often ask for an audio recording of the class. Clearly, it is essential to employ flexible teaching strategies that can accommodate the differing needs and abilities of students. The unlimited access to course materials that hybrid learning allows gives students as much time as they need.

Course Evaluation

The effectiveness of this course was evaluated by assessing students' satisfaction with the course and comparing their achievement with that of a comparable cohort of students (in terms of academic year in the program, gender, age, and mean cumulative grade point average [GPA]) who had completed the traditional version of the course with the same instructor in the previous semester. In this hybrid course, the response rate for the satisfaction questionnaire was 87 percent (91 students). The majority of students (65 percent) were in their third year of the program, with the remainder in their fourth year. Almost two thirds (64 percent) were male. The mean reported age was 21 [+ or -] 0.5 years, and the mean GPA out of 4.0 was 2.9 [+ or -] 0.6.

A 29-item satisfaction questionnaire with a five-point Likert-type scale of agreement was designed to elicit student attitudes about the effectiveness of the course and the instructor's application of each of the seven principles of good teaching (Chickering & Gamson, 1987). The content validity of the questionnaire was examined by technology-in-education experts for the clarity, appropriateness, and comprehensiveness of the items and revised based on their recommendations. Two open-ended questions were also included to examine the advantages and disadvantages of the course design from the students' perspective. The internal consistency reliability of the questionnaire as estimated by Cronbach's alpha was 0.87, indicating a high reliability.

Students' responses to the survey supported the course's success in applying the seven principles of effective teaching. The majority of students agreed or strongly agreed with almost all of the statements.

The only statements of concern were "Group pages were very helpful to interact with my group and complete the assignment" (55 percent agreed) and "Group assignment was a joyful experience in this course" (35 percent agreed). Because these results were unexpected, we analyzed the relationship between the frequency of students' visits to Blackboard group pages and their attitudes toward both statements and found significant positive relationships (r > 0.50, p = .001). Frequency was determined using automatically generated log files of the number of times each student accessed these pages over the entire semester. Only 50 percent of the students had accessed their group pages one time or more. In addition, it is worth noting that 20 percent of the students in this course did not submit their assignments.

Analysis of answers to the open-ended questions on the advantages and disadvantages of the hybrid course also revealed important information. Some of the advantages reported were the ability to learn from other students' posts (n = 70); improvement in computer skills (n = 60); timely feedback from the instructor (n = 57); easy access to the course from different locations (n = 54); the ability to submit work electronically (n = 45); and higher autonomy in learning with flexibility (n = 30). In addition, 75 students commented on the usefulness of the introductory module in managing the course.

On the other hand, some of the major challenges students cited included the need to read an overwhelming number of responses to discussion board questions (n = 50) and the extra work required compared to traditional courses (n = 40). The group assignment drew several negative comments, including "I prefer individual assignments" (n = 67), "Lack of cooperation from other students on group project" (n = 55), "Students in my group were not responsible and caused a delay for me" (n = 51), and "It is unfair for some students in my group to have the same grade as mine" (n = 47). Student achievement was significantly higher in this hybrid course (78 [+ or -] 5.5 percent) than in the traditional course (70 [+ or -] 8.5 percent), p = .001.

DISCUSSION

This study evaluated using the seven constructivist principles of effective teaching in the design and implementation of an undergraduate nursing research course taught in a hybrid learning format. The results showed that the course served students' needs and effectively applied the principles.

It is well supported that student satisfaction in web-based courses is mainly determined by the quality of the instruction (Yang & Liu, 2007). In this course, interaction and collaboration among students were increased by using various tools. In addition, students received continuous support and encouragement to use the web-based part of the course, regular and prompt feedback about their performance, and clear information about expectations for the course requirements. The instructional strategies used were critical to keeping the students from being overwhelmed by the technology and better able to focus on the course content. Two examples of this were including recorded presentations in the introductory module and providing hands-on instruction on appropriate use of the technology and efficient management of the course. This facilitated an easy transition to the interactive hybrid learning activities. Although the course constituted the first experience with interactive hybrid learning for all students, just over half of them were without computers at home, and even more were without an Internet connection, the utilization of these principles of instruction motivated them to participate and succeed in the course.

It is noteworthy that all the advantages to participating in the hybrid course that were identified in the content analysis and that students recognized were related to Chickering and Gamson's (1987) principles of effective teaching. For example, "the ability to learn from other students' posts" emphasizes the active learning principle; "timely feedback from the instructor" highlights the student-faculty contact and prompt feedback principles; "easy access to the course from different locations" emphasizes the high expectations principle; and "higher autonomy in learning with flexibility" stresses the active learning and respect for diverse talents and ways of learning principles. Thus, the seven principles of effective teaching were congruent with students' expectations and appreciated by them.

On the other hand, although the majority of students enjoyed having an active part in the learning process, some reported that they experienced a greater workload than with traditional courses and dealt with an overwhelming number of responses to discussion board questions. Nicol, Minty, and Sinclair (2003) found that online discussion results in deeper knowledge processing than traditional courses do. But Mahoney and colleagues (2005) found that some students were uncomfortable with taking a more active role in learning. Even though this study presented students with standards for dealing with discussion board questions and on the average number of posts they should review, log files recorded via Blackboard showed that some of the students reviewed the majority of other students' posts, which for some questions reached 30 posts. This finding suggests that some students chose to spend too much time in this learning environment.

Another negatively rated experience, working in a group to complete a project, could be attributed to different factors, for example, the frequency with which the student accessed group pages within Blackboard. In general, it is well supported that the frequency of accessing web-based course materials is highly correlated with student achievement in a course, attitudes toward the course, and degree of motivation to engage in the learning process (Campbell, Gibson, Hall, Richards, & Callery, 2008; Farrell et al. 2007).

The limited time available for students to meet in person to work on their projects could be a factor in negative attitudes toward group work; all students spent two days a week in the clinical area. Although group pages were designed to facilitate students' communication with each other, not all students utilized them well. In addition, although the role of each group member was clearly explained on Blackboard's assignment page as well as in class, some students shirked their responsibility and demonstrated a low level of commitment to completing group assignments.

A third major issue potentially affecting a student's experience and completion of a group project is time management problems, which might also explain the relatively high percentage (20 percent) of students who did not submit their assignments. The experience of this course's instructor has been that not submitting assignments is very common among nursing students in many courses, including clinical courses. It seems that some students delay working on their assignments, most of which are due at the end of the semester. In a study of factors affecting student retention in web-based college courses, Doherty (2006) found that the majority of students who failed or dropped out of them had time management issues.

Failure to submit an assignment is an alarming occurrence because the purpose of an assignment is to serve specific course objectives and more actively engage students in the learning process. All of this suggests that an eighth principle of effective teaching should be introduced, "Foster the development of self-regulation skills in learning." Self-regulation is an academic strategy that helps students monitor and control their own learning and academic outcomes (Newman, 1998). Some examples of self-regulatory behaviors are setting goals, identifying sources of academic help, structuring the learning environment (e.g., studying in a quiet place), and setting time limits for completing assignments. Studies have found that students who can regulate their learning achieve better learning outcomes than do those who cannot self-regulate, and that the ability to self-regulate affects student retention in and satisfaction with online courses (Barnard, Paton, & Lan, 2008; Tsai, 2011). Barnard and colleagues found that the higher the level of self-reported self-regulation in online courses, the more positive students' perceptions were of online course communication and collaboration.

Instructors should assess and enhance students' self-regulatory skills at the beginning of each course. In their study of online course instruction, Fisher and Baird (2005) concluded that peer evaluation and collaborative group activities are essential strategies for improving student self-regulation skills. Although many students are unsuccessful in setting time limits for completing their assignments, an instructor can enhance the development of the skill by dividing large projects into small deliverables having specific due dates. Since nursing students commonly complain about most courses' workloads, and especially about clinical courses, it could prove very beneficial for nursing schools to offer time management courses.

The current study's findings on time management should be utilized when developing future nursing research courses. First, the instructor should carefully monitor students' reviewing of responses to discussion board questions and frequently remind them not to review all the posts, especially in large classes. Reviewing 5 to 10 posts by other students for each discussion board question should be sufficient to orient a student to how other students think and how to construct his or her own answers. Second, because the majority of students had a negative experience with their group project, they should be given more information regarding the importance of group assignments and working within a group as one of their future professional roles as nurses. Since using group pages in Blackboard was found to be important for having a positive experience, future courses should encourage their use. Role-playing could be undertaken at the beginning of a course to demonstrate the results of effective versus ineffective group communication as a means of encouraging students to work better in groups.

There are some limitations in this study. First, using a convenience sampling approach and one group of students without a control group could limit the generalizability of the findings. However, both the sample size and the response rate were high. In addition, it would not have been practical or ethical to randomize students to two teaching methodologies (traditional versus hybrid) given that diffusion of the hybrid course's tools would occur since the students are in many of the same courses together. Furthermore, methods were undertaken to decrease the Hawthorne effect and thereby enhance the validity of the findings, such as informing students about the purpose of the study at the end of the course, but before collecting the satisfaction data.

Second, the effectiveness of applying teaching principles to meet students' needs in this course should be interpreted in the context of the teaching activities used. In this course, these activities varied in nature and were comprehensive and detailed in order to promote active learning. Therefore, the success of a hybrid course may not depend entirely upon applying the principles of effective teaching as a framework for course design and delivery, but also on the operationalization of such principles based on the needs of the students, course objectives, and perceived level of difficulty of the course.

Third, although the study revealed a higher level of achievement in this course than in a comparable previous cohort of students, we might have overlooked confounding variables that affected the results, such as student motivation. However, informing students about the study at the end of the course might have decreased that possibility.

CONCLUSION

The use of the seven principles of effective teaching resulted in the designing of a successful interactive hybrid course on research in nursing for undergraduate nursing students. Hybrid courses should be based on these principles to provide accessible and effective educational opportunities. In addition, self-regulation should be added as an eighth principle to ensure instructors' comprehensive management of the course design and delivery processes and satisfying learning experiences for the students. Instruction should focus specifically on "clear expectation" principles and involve pre-course assessments of students' ability to access the technology needed and of their prior experience with e-learning environments.

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Azizeh K. Sowan, PhD, RN, is an assistant professor, University of Texas Health Science Center at San Antonio School of Nursing, San Antonio. Louise S. Jenkins, PhD, RN, is a professor, University of Maryland School of Nursing, Baltimore, Maryland. This study was conducted when Dr. Sowan was a faculty member in the Jordanian university that is the setting of the study. For more information, contact Dr. Sowan at sowan@uthscsa.edu.
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Author:Sowan, Azizeh K.; Jenkins, Louise S.
Publication:Nursing Education Perspectives
Date:Sep 1, 2013
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