Current and Future Trends In Nursing Education and Online Courses and Programs, Evaluation of Learning Outcomes
Online Courses and Programs in Nursing Education
The use of the online courses and programs has increased the array of educational offerings available to students. Online courses can offer quality instruction to remote students, reach underserved populations, respond to the diverse learning styles of and paces at which students learn, break down barriers of time and space, and give access to students with different languages and cultures.
Yet despite all these advantages, there are cultural issues at play that can affect teaching and learning. Recognizing that instructional design cannot be culturally neutral is a first step in the process of becoming more culturally competent.
Joos (1967) identified a number of potential issues: content, multimedia, writing style, writing structure, and web design. Hanna and De Nooy (2004) studied the validity of four assumptions some people may have about how culture is present in cyberspace:
(1)The Internet removes cultural differences
(2)The Internet is a direct access to cultural differences
(3)Communication over the Internet is similar to communication in other forms
(4)Computer mediated communication influences cultural and genre related communication
Overall, the authors found that the first three assumptions were difficult to validate as culture is discernible in online content and communication. The same applies in website and e-mail communications. Clear norms and netiquette (network etiquette) must be established at the outset of the course to indicate key principles, such as respect for diversity.
An initial challenge is that in online courses visual cues as to gender and race of both students and faculty are absent. Faculty can seek to overcome this by requesting that students post their photos (and that faculty do likewise) or by using voice thread technology for students to post introductions and short comments.
If instructors are able to recognize the capability of students to construct their own knowledge and apply prior experience and their own culturally preferred ways of knowing to the task, then it is likely that a more culturally sensitive online classroom will be created.
In addition, the roles of the student and the instructor in an online course may raise cultural issues. For instance, in some cultures it is considered inappropriate for students to question the instructor or the knowledge being conveyed in the course. The co-creation of knowledge and meaning in an online course, coupled with the instructor’s role as an equal player in the process, may be uncomfortable for a student from this type of culture.
Conversely, a student whose culture is more communal, and where group process is valued, may feel uncomfortable in a course where independent learning is the primary mode of instruction. Faculty can devise strategies to facilitate cultural engagement in online classrooms.
For example, faculty can employ approaches to help students understand cultural differences such as discussing the cultural differences in online classroom dynamics in the United States in comparison with other cultures prior to the first days of class.
To enhance open communication in the online classroom using developmental approaches such as structured group exercises, permitting students to present written assignments verbally in small groups and progressing to the point at which the fear of participating in discussions is overcome have been reported as highly successful in achieving this aim.
Games are another widely used medium for engaging students and encouraging participation. Online courses and experiences have the additional potential for linking classrooms for the purpose of establishing cultural exchanges through the use of virtual experiences.
Additionally, faculty teaching online courses can facilitate students’ awareness of their own beliefs and those of others by posing questions that require students to reflect on their values, beliefs, or culture and contrast them with those of other members in the class (Flowers, 2002). Online surveys and journals are two strategies for prompting these discussions.
Evaluation of Learning Outcomes In Nursing Education
Evaluation of all students must be fair and equitable. When evaluating underrepresented minority students, faculty must follow best practices in evaluation such as having clear learning outcomes, providing opportunity for learning and practice, and providing clear guidelines for evaluation.
Tests, written work, and clinical performance as evaluation strategies must be developed with the diversity and language abilities of the students in mind. Teacher-made tests are often a source of unintentional multicultural bias.
Faculty should review these tests to eliminate references to the nurse as she, to remove any cultural stereotyping, to avoid the use of American slang, and to use language that would be understood by all students to test fairly (Ukoha, 2004).
If tests are biased because of poorly written questions, faculty evaluation of student competency will be distorted (Hicks, 2011). One way to avoid these test errors is to have colleagues take the teacher-made test; often colleagues can provide new insights because they have a fresh set of eyes and are more likely to find test construction errors.
Experts also recommend writing test questions to reduce linguistic bias that can occur with multiple-choice questions (Bosher & Bowles, 2008; Lujan, 2008), unnecessary language complexity, and construct-irrelevant variance. Linguistic modification is a process by which the language load of test items is reduced semantically and syntactically while the content and integrity of the items are maintained.
For highly vulnerable students, every test becomes a test of language proficiency. To a greater degree than their native English–speaking peers, nonnative English speakers must process the language of tests and negotiate the cultural expectations embedded in them.
When faculty write tests, they must consider word frequency; word length; sentence length; and linguistic structures such as passive voice constructions, long noun phrases, long question phrases, prepositional phrases, conditional clauses, and constructions that are negative, abstract, or impersonal.
Sentence completion, items asking for priority actions without bolding or highlighting, or using clauses and unclear wording are frequently cited as issues for many students (Bosher, 2009). Lampe and Tsaouse (2010) reviewed questions in a selected textbook publisher’s test bank and found significant linguistic bias.
All of the questions were in sentence completion format, priority questions did not use bolding or highlighting to emphasize important words, and 20% of the questions had embedded clauses. All of these occurrences can have an adverse effect on a student’s test scores, their self-worth, and ultimately their successful matriculation in a program.
When evaluating written work, faculty must consider the needs of students for whom English is not the first language and provide opportunity for students to receive feedback and review of their work prior to grading. Grading rubrics should be used to clarify the elements of the written work that will be evaluated.
Clinical performance evaluation also depends on having clearly stated learning outcomes and opportunity to practice. When evaluating students from diverse cultures, faculty must take into consideration the challenges involved when any student is giving care to a patient that is from a different culture than theirs.
Current and Future Trends In Nursing Education for Educators and Students
The increasing enrollments of diverse student populations in nursing programs provide opportunities for educators to be engaged in changes and to use current knowledge of multicultural education, equity pedagogy, and life experiences of diverse students to create a rich learning environment so that all students have an equal chance to achieve academically and professionally.
Faculty must develop curriculum and course requirements that explicitly state goals for cultural competency. Given that all encounters are cultural encounters and therefore teaching opportunities, faculty must develop inclusive learning environments in which all students are welcome, learn from each other, become empowered, manage differences, avoid bias, and learn to provide competent cultural care to their patients.
The use of teaching–learning strategies that incorporate concepts of equity, inclusiveness, and active engagement can also affect positive learning. Cultural competence may be used as an exemplar for applying some of the principles of multicultural education while at the same time facilitating an understanding of its value in quality care.
By exemplifying cultural competence as a process or a journey, both academic leaders and students will realize that lifelong learning is inherent and a requirement for teaching, learning, and preparing graduates to work in a society that includes multiple diverse groups.
Principles of inclusive excellence suggest faculty give consideration to the four major course components: managing the environment, content, instructional strategies, assessment of student knowledge, and classroom dynamics. This is particularly important as long as there are power inequities as in the workplace, the world place, and academia.
Lorrie Davis Dick, who is African American, in her insightful poem “Dance Professor Dance” sums up the request and desires of all students, which is to remember that success and achievement are either race, ethnicity, generational, or sexual identity specific goals.