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C H APTE R

Curriculum Considerations in Nursing

Education Offered by Distance 16
CHAPTER PREVIEW
In this chapter, nursing education offered partially or fully by distance delivery
and the institutional requirements for education using distance delivery are
described. Ethical considerations and values and beliefs about distance edu-
cation are proposed. The sources of decisions to offer nursing education by
distance and the consequent curriculum implications are outlined. Curriculum
design is briefly overviewed. The section on course design focuses specifically
on nursing education provided using technology-enabled, or online, distance
education. The criticality of pedagogy in technology-enabled teaching and learn-
ing is emphasized. Addressed are technology, course concepts and content,
strategies to ignite learning, features of individual online “classes,” opportunities
for students to demonstrate learning, and evaluation of student achievement.
Implementation and evaluation of courses that are offered by distance educa-
tion are addressed. The relationship of nursing education offered by distance, in
whole or in part, to a context-relevant, evidence-informed, unified curriculum is
explained. The core processes of faculty development, ongoing appraisal, and
scholarship activities related to distance education are presented. The chapter
concludes with a summary and synthesis activities.

QUESTIONS ADDRESSED IN THIS CHAPTER

• What are the various terms used to convey the idea that education is
offered at a distance?
• What are the institutional infrastructure requirements to offer distance
education?

447
448 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

• How do values, beliefs, and ethical principles influence choices to

teach by distance?
• How does distance education influence course design, implementa-
tion, and evaluation?
• What considerations about cognitive, social, and teaching presence
should be taken into account when accepting the responsibility of
teaching by distance?
• How can students’ sense of control and confidence in their ability
to be successful be fostered in distance education courses?
• What is the relationship of nursing education by distance to an
evidence-informed, context-relevant, unified curriculum?
• How are the core processes of faculty development, ongoing
­appraisal, and scholarship integrated into the process of designing
courses for distance?

Distance Education
Distance education is teaching and learning where technology serves as a conduit
(Frith, 2013) to provide formal, rigorous, educational offerings when students
are physically separated from the instructor and/or educational institution. The
term distance education is often used synonymously with technology-enabled
methods such as Internet-enabled online learning and webcasts, m-learning,
and e-learning, as well as technologies such as broadcast systems, audio- and
video-conferencing, pod- or video-casts, or telecommunications systems, among
others. The teaching and learning process can be synchronous or asynchronous,
print-based or technology-enabled, fully or partially online, or a combination
of these. The choice of delivery systems and approaches is dependent on many
factors such as the learners, their learning styles, the learning context, curricu-
lum goals and intended outcomes, as well as available human resources, faculty
members’ knowledge and readiness, available wired or wireless technologies,
cost, and institutional infrastructure (Friesth, 2016; Frith, 2013).
In contrast to traditional or conventional place- and time-dependent
in-class/in-seat delivery, distance education implies single or combined use
of delivery methods that are adaptable to a wide variety of students and ex-
pected learning outcomes. In essence, distance education is shaped in whole
or in part by the concept of flexibility, which suggests suppleness, elasticity,
and nimbleness. These adjectives capture the idea of nonlinearity, which is
consistent with the teaching-learning processes of distance delivery. In other
words, there is flexibility in the delivery methods employed, in addition to
when and how they are used.
 Distance Education 449

The technologies used in distance education are generally web-based, mul-

tifaceted learning management systems (LMSs) with provision for private and
two-way communication between and among teachers and students. The LMSs
used by educational institutions allow for learning resources to be embedded
with technology tools such as blogs, wikis, social networking sites, discussion
groups, instant messaging, cloud computing sites, learning objects, closed cir-
cuit TV, satellite, podcasts, and vodcasts, among others. The combinations and
permutations continue to evolve as technologies become more sophisticated
(Frith, 2013).
Distance delivery, with or without the inclusion of web technologies, can
be employed for complete curricula, individual courses, or for parts of courses
in nursing using hybrid/blended delivery. Typically, back-channel digital com-
munication (e.g., email, instant messaging, Facebook®, Twitter®, LinkedIn®) is
used to support connections between students and faculty members (Schmitt,
Sims-Giddens, & Booth, 2012). Collectively, these systems must be agile and
allow students and faculty members to communicate, collaborate, create content,
generate knowledge, and share evidence-informed approaches (Adams Becker
et al., 2017; Chu & Kennedy, 2011), consistent with a constructivist theory of
learning (Greener, 2012; Paily, 2013).
Distance education suggests a physical or geographic separation between
and among the participants, but it is possible for students and course professors
to be in the same city, close to the educational institution, yet engaged in online
courses for reasons of convenience, personal preference, or course availability.
Depending on the method chosen, the social distance is often imperceptible, and
interactions and shared learning experiences between and among participants can
be rich and deep. The quality and rigor of technology-enabled distance learning
with regard to knowledge, skill, or satisfaction outcomes are at least equal to and
not significantly different from conventional teaching methods (Allen & Seaman,
2015; Frith, 2013; Lahti, Hätönen, & Valimaki, 2014; McCutcheon, Lohan,
Traynor, & Martin, 2014; Vogt & Schaffner, 2016; Voulitinen, Saaranen, &
Sormunen, 2017).
Geography, by itself, is no longer an obstacle to education except for indi-
viduals for whom: computer or mobile device ownership is not possible; Internet
access is absent, uneven, or slow; or efficacy with technology is lacking (Adams
Becker et al., 2017). Consequently, technology-enabled distance education is
not yet an absolute solution for many learners, including nursing students in
under-resourced areas of the world. However, the integration of computers and
mobile devices and a worldwide telecommunications network to connect them
has led to greater feasibility of computer-based distance education in much of
the world (Amirault, 2012). Therefore, computer-based distance education has
been embraced by degree, certificate, and continuing nursing education programs.
450 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

Institutional Requirements for Distance Education

Robust strategies that integrate online, mobile, and blended learning approaches
are important for continued survival of educational institutions (Adams Becker
et al., 2017). “While mobile and digital learning strategies have increased over
time, disparities in high-speed broadband connectivity and in engagement
between different student groups (socioeconomic status, gender, etc.) prompt
higher education leaders to continuously evaluate the affordability, access, and
quality of their offerings” (Adams Becker et al., 2017, p. 6).
Distance education for an entire curriculum or individual courses, whether
web-enhanced, fully online, blended, or hybrid, can be considered only if suit-
able supports are in place. Without them, the desire of faculty members to
extend the curriculum beyond the physical classroom will be unfulfilled or, at
best, fragmented, depending on what individual faculty members can cobble
together to meet teaching and learning goals. Therefore, the nature, quality,
and extent of the institutional supports available are parameters for curriculum
and course design for distance education.

Infrastructure
The structural features, processes, and procedures of an institution’s LMS and
seamlessly integrated content management system (CMS) should be robust enough
to accommodate a wide variety of course management and web functions, stu-
dent learning needs, and curriculum outcomes. The design and functionality of
the system have to be considered to accommodate various teaching approaches
(Davis, Little, & Stewart, 2008). The necessary data security, backup, quality
assessment features, and quality improvement measures are also essential so that
appropriate system evaluation data are collected and protected. An institutional
technology plan with attention to financial, technical, and cultural readiness, and
centralized maintenance of the technology system are necessary (Basak, Wotto, &
Belanger, 2016; Cheawjindakarn, Suwannatthachote, & Theearoungchaisri,
2012). However, “once developed, any infrastructure must be able to evolve
in order to accommodate changing student needs, technologies, and curricula”
(Davis et al., 2008, p. 121).
From the perspectives of students and faculty, the LMS and CMS need to:
• Accommodate the desired teaching, learning, assessment, and testing
activities and leave room for adjustments for growth and increased
demands
• Have intuitive navigation and built-in help features
• Allow for interaction between and among faculty members and stu-
dents, collectively and privately, synchronously and asynchronously
 Institutional Requirements for Distance Education 451

• Be comprehensive enough to preclude the need for use of systems

­external to the LMS
• Accept podcasts, vodcasts, wikis, blogs, and embedded links to
­external websites
• Interface with student information systems for course enrolment
(­Davis et al., 2008) and include a recordkeeping system for marks
­associated with course activities and assessments
• Provide reliable access to library holdings, electronic databases,
­journal articles, and e-books as well as support the use of copyrighted
material within course sites

Resources to Support Distance Education Design,

Teaching, and Learning
Allen and Seaman (2015) report that the percentage of academic leaders for
whom online learning is a critical aspect of their long-term strategy has grown
from 48.8% in 2002 to 70.8% in 2015. However, they also note that the added
effort inherent in teaching online poses a significant barrier for 78% of aca-
demic leaders and “only 28% of chief academic officers say that their faculty
members accept the ‘value and legitimacy of online education,’” revealing no
change from their 2003 findings (Allen & Seaman, 2015, p. 6). Nevertheless,
more that 4.9 million post-secondary students participated in distance educa-
tion in Fall 2015 in the United States, and of those, 2.1 million students were
exclusively enrolled in distance education courses despite existing reservations
in the academic world about distance education (McFarland et al., 2017).
There are a number of reasons why concerns about the value and legitimacy
of distance education continue to exist. In a meta-analysis of research about
barriers to distance education, increased time commitment, difficulty keeping
up with technological changes, and lack of support staff to help with course
development were identified by faculty members (Berge & Muilenburg, as cited
in Simonson, Schlosser, & Orellana, 2011). The potential threat to tenure and
promotion, the lack of expertise in instructional design for online learning, the
fear of losing intellectual property, as well as skepticism about the quality of
interactions or even the possibility of building an online community (Crawford,
2015; Oaks, as cited in Crawford, 2015; Yuksekdag, 2015) are also barriers, which
point to a need for improved and sustained faculty development and support.

Faculty Development
Faculty development related to every aspect of distance education is essential
once a decision has been made to offer a course, in whole or in part, or an
452 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

entire curriculum, by distance delivery. According to Hicks (2014), “We are

moving into an era where all faculty need to have a level of competence with
online learning and technologies. This is no longer optional but is core to the
university learning environment” (p. 267). It is imperative for educational in-
stitutions to support faculty development in order to optimize the teaching and
learning experience, particularly for those with little to no experience teaching
online as they will have greater trepidation about distance delivery than those
with experience (Lloyd, Byrne, & McCoy, 2012). Specific ideas about faculty
development are presented in a later section of this chapter.

Instructional Design Support

Instructional designers should be available to support faculty members’ transi-
tion to alternate delivery methods, providing guidance not only in how to use
the technology, but also in facilitating integration of high quality learning ex-
periences, and scholarship when using various media (Yuksekdag, 2015). Ideal
would be instructional designers with both pedagogical and content expertise,
and a sound understanding of disciplinary culture when facilitating curriculum
or course design (Kanuka, 2006). Lenert and Janes (2017) assert that “the role
of faculty development (and professional instructional design) is increasingly
more important now in guiding faculty on how to create learning spaces, spe-
cifically with the use of technology online and how to help instructors adapt
to the new roles expected of them” (p. 3). The creation of smooth, productive,
and comprehensive teaching and learning experiences may require the expertise
of instructional designers and media specialists until faculty members acquire
confidence, experience, and skill in distance education.

Technological and Academic Support for Faculty Members and Students

Concomitant with assistance for faculty members from instructional designers is
assistance with and orientation to the technology being used for course profes-
sors and students. Learning to use the technology, having access to expert help
such as a role model or mentor for teaching and learning, along with immediate
assistance when problems arise during course implementation, are essential.
Prompt assistance from technical and library help desks, and from others with
expertise, will reduce stress and build confidence in all users. A telephone technical
help line, ideally available 24 hours a day, and above all, staffed during peak and
online examination periods to resolve problems quickly, is essential. Although
just-in-time (JIT) support may be a great help to deal with an immediate issue,
it should not preclude the need for faculty members and students to learn to
use the technology and processes that will form their learning environment in
 Institutional Requirements for Distance Education 453

advance of using it. Adequate staffing to manage JIT help may be challenging
for institutions (Wingo, Peters, Ivankova, & Gurley, 2016), but contributes
significantly to the quality of the teaching-learning experiences.
Orientation to technology for faculty members and students, especially those
for whom learning technologies are new, will be important so that actual course
time is not needlessly diverted to technical issues as the course begins. Essential is
information about account activation, computer and software requirements, Inter-
net speed, course registration, and access to the library system and library services
(Ellis, 2016; Lenert & Janes, 2017; Zhu, McKnight, & Edwards, 2006). Reliable
access to learning materials is vital to support course-related work for professors
and students unable to visit or be physically present in the on-campus library.
Orientations to technology can be accomplished through onsite sessions,
provision of written material or instructional websites before courses begin,
­faculty mentoring, and peer-tutoring systems, among others. Elements that
­influence online success for professors and students can also be addressed
in orientation sessions (Blackmon & Major, 2012; Cho, 2012; Schmitt et al.,
2012). These may include:
• Strategies for teaching and learning in an online environment
• Knowledge construction and shared learning
• Commitment to online co-presence and engagement
• Quality of interactions and participation
• Best practices for use of social media
• Time commitment, time management, and academic–personal life
balance
• Assessment of readiness for distance education
• Self-direction and motivation in an online environment
Of particular importance is providing sufficient guidance and attention to
faculty members, including those who are part-time and unfamiliar with distance
delivery options but who will be expected to transition seamlessly to use of the
technology in their courses. Student frustration and discouragement, negative
instructor ratings, and ultimately, attrition, can result when faculty members are
not adept with distance education and when there is a lack of timely assistance
for students experiencing academic and technological problems (Lee & Choi,
2011; Tallent-Runnels et al., 2006).
All faculty members also need to know how to:
• Access support for students’ academic success, such as online tutoring
• Provide timely responses to student questions about courses, academic
requirements, and assignments (Outlaw & Garrett, 2016)
454 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

• Provide early outreach to at-risk students (Shaw, Ferguson, & Burrus,

2016)
• Redirect students when a need arises for financial aid, and academic or
personal counseling

Institutional Policies, Guidelines, and Practices

Suitable institutional polices such as access to and security of servers, privacy,
and transparency are needed to support distance education. Academic integrity
policies and ethical practices are vital in technology-enabled curricula. The poli-
cies, guidelines, and practices require frequent review as the distance education
landscape is constantly evolving, presenting new opportunities and challenges
for institutions. On the horizon, policies about data mining and learning analyt-
ics (Ferguson, Brasher, Clow, Griffiths, & Drachsler, 2016; Ferguson & Clow,
2017; Woodie, 2016), as well as adaptive learning systems (Pugliese, 2016) with
relation to technology-enabled learning will also be considerations.
Guidelines for faculty development, different financing structures, workload
adjustments, reductions or release time to recognize the learning curve and time
required to build and teach online courses, could be reasonable provisions of
faculty contracts (Adams Becker et al. 2017; Lloyd et al., 2012; Wingo et al.,
2016). Intellectual property rights and ownership of courses authored for
distance education could also be addressed in faculty contracts (Hentschke,
2017). Additionally, guidelines related to class size and examination processes
to ensure safety, security, and rigor should be in place (Vaughn, 2007).
Policies addressing ethical behavior in distance education and “students’ digital
citizenship” (Adams Becker et al., 2017, p. 26), that is, rights and responsibilities
related to technology-enabled learning, warrant attention (Simonson, 2012).
Institutional policies related to plagiarism, cheating (including e-cheating), and
deceptive actions related to “collection, security, ownership, access, dissemina-
tion, and application of learning data” (Adams Becker et al., 2017, p. 14) may
require close review and modification for technology-enabled courses. Ques-
tions might arise regarding whether physical presence is required for testing for
online courses or whether biometric verification and visual identification to log
on to the testing site software, is sufficient (Bedford, Greg, & Clinton, 2011).
Within schools of nursing, professional requirements related to privacy and
confidentiality become critical when clients, their families, or practice agencies
become part of class discussions. Course participants need to be fully informed
about the importance of using secure sites for course discussion and assuring
privacy of any client or agency information.
As course sites and dialogue within discussions can be archived by the in-
stitution, it is important for course participants to be aware of why, how long,
 Sources of Decisions to Offer Distance Education and Consequent Nursing Curriculum Implications 455

and in what circumstances course data are retained, as well as to whom the
data belong. Students should also be aware that their course participation can
be tracked in the LMS system.

Values and Beliefs Inherent in a Commitment to Nursing

Education by Distance Delivery
A commitment to nursing education using distance technology reflects nursing
faculty members’ values and beliefs about themselves, students, nursing educa-
tion, and the nursing curriculum. These include acceptance and openness to
advances in educational methods and technology, readiness to learn and apply
new pedagogical and technological skills, willingness to engage students in
technological learning environments, and belief in the importance of accessible
education for nurses. Additional values and beliefs inherent in the provision of
distance education in nursing are:
• A conviction that rigorous and high quality nursing education is pos-
sible through the use of technology
• The view that active participation and shared knowledge construction
are essential to learning (i.e., support of constructivism and brain-
based learning)
• Recognition of and respect for the importance of ongoing cognitive,
social, student, and instructor presence
• Dedication to the development of scholarly learning communities as
well as safe and supportive class cultures
• Trust in students’ autonomy and their capacity and desire to learn
• Respect for diverse student characteristics and learning styles

Sources of Decisions to Offer Distance Education

and Consequent Nursing Curriculum Implications
A decision to offer distance courses in a nursing curriculum can arise from
three different circumstances. Each has implications for subsequent nursing
curriculum and course development.
First, during curriculum development, the analysis of contextual data can
lead to the logical decision that educational approaches should include distance
delivery for all or part of a nursing curriculum. In this situation, the total fac-
ulty group endorses the idea, and this decision will be a significant parameter
in subsequent curriculum and course development.
456 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

Secondly, apart from a formal curriculum development process, nursing

faculty members may decide to initiate or expand the use of distance technolo-
gies within existing programs in response to student characteristics, a desire to
increase enrollment or access, a conviction that quality learning outcomes can
be achieved, and so forth. This choice will result in modifications in course de-
sign and implementation, within the existing curriculum design. The number of
courses involved will determine the extent of necessary development activities.
Thirdly, there can be a strategic decision by the educational institution to
increase access to educational programs through distance education. As a con-
sequence, the school of nursing is obligated to support the institution’s strategic
plans. This situation can result in the development of a completely reconcep-
tualized nursing curriculum, or modifications within the existing curriculum.

Designing Nursing Curriculum and Courses

for Distance Delivery
Curriculum design, explicated as the configuration of a program of studies,
includes the courses selected, their sequencing and delivery, relationships be-
tween and among them, and associated curriculum policies. The curriculum
design process entails all activities and decisions that result in the creation of
the actual program of studies, that is, the completed curriculum. The design
process for curricula employing distance delivery parallels that for curricula
with campus-based, face-to-face delivery.
The starting point for nursing curriculum development is the context in which
the curriculum will be offered and in which graduates will practice nursing. The
aim is to develop a curriculum that: is evidence-informed, context-relevant, and
unified; provides opportunities for students to achieve goals or intended out-
comes; is congruent with curriculum foundations; and has internal consistency,
logical flow, and unity. There should be planning to maximize implementation
fidelity and to prepare for formative and summative evaluation of students’
achievement and the curriculum. These fundamental considerations are neces-
sary in all curriculum development, regardless of the delivery method.

Designing Nursing Courses for Distance Delivery

A defining characteristic of course design for distance delivery is the conflu-
ence of pedagogy and technology. Ample time should be provided to prepare
a course for the online environment because course design is not a matter of
simply transposing a conventionally delivered course to another format.
Designing nursing courses for distance delivery includes planning all com-
ponents of conventional courses: title, purpose, description, goals or competen-
cies, strategies to ignite learning, content, classes, opportunities for students
 Designing Nursing Curriculum and Courses for Distance Delivery 457

to demonstrate learning, faculty evaluation of student achievement, and the

relationships between and among these components. The skillful integration
of these components gives vitality to courses. Achievement of a satisfactory
convergence with technology might require assistance from instructional design
and media experts. Only the details of course design that require particular
consideration for distance delivery are presented in this chapter.

Course Design Parameters

Course designers are mindful of parameters that influence all course design,
such as characteristics of students, educational and philosophical approaches,
curriculum goals or intended outcomes, major curriculum concepts, key profes-
sional abilities, and placement of courses in the curriculum. For courses offered
by distance, the institution’s LMS, the availability of web 2.0 technologies to
promote interaction and collaboration, and policies about distance education
are major parameters of course design.
Course designers also consider factors within distance courses that influ-
ence student success such as student interaction with faculty, technology, and
the educational institution (Paul & Cochran, 2013), other students and self
(Andrusyszyn & Davie, 1997), student–content interaction, student autonomy
and control, and student social presence or sense of community connectedness
(Shearer, 2013). Although these are considerations in conventional courses, they
are highlighted in distance courses because of the physical distance between
and among participants and instructor, and the potential for some students to
feel invisible, isolated, or disenfranchised. Another possible parameter is tem-
porality. An a priori decision may be made about whether course delivery will
be synchronous or asynchronous, or include elements of both. Alternately, this
decision may emerge during the design process.

Technology Selection
The technological aspects of course design are most prominent when consider-
ing strategies to ignite learning and opportunities for students to demonstrate
learning. The LMS and web technologies that are used should serve and support
learning and teaching in as seamless a fashion as possible and never overwhelm
students or distract them from the course purpose.
An institution’s LMS provides a consistent organizational template for
course materials and teaching-learning processes, while allowing choice in the
features that are used, and in the teaching, learning, and assessment processes.
The template provides a standardized look across courses and this facilitates
students’ familiarity with, and timely access to, commonly used course elements
such as syllabi, discussion groups, timetables, and web links (Halstead, 2005).
The standardized look also contributes to the curriculum’s visual unity.
458 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

Course Design Process

Designing distance courses is not a matter of recreating a face-to-face class
online (Dennen, 2013). Rather, it requires beginning with the course goals or
intended competencies and creating a course that takes into account the fac-
tors that influence student success, the curriculum foundations, the available
technologies, the best blend of technologies, and the nature of student participa-
tion. Nursing education courses offered by distance delivery are not designed in
isolation from other courses in the curriculum. Each course is part of a larger
whole whose aim is to facilitate students’ development as professional nurses.
Thus, it is essential that course designers consider the placement of each course
within the curriculum and ensure that there is logical and conceptual unity
within and among courses.
Course design is facilitated by faculty consultation and collaboration with
instructional designers, media specialists, and by access to technologies that
capture best practices in distance education, whether the course is fully online
or hybrid. Decisions about course design are similar for conventional courses
and those offered through distance delivery, with the added feature that an
instructional designer and media specialist may be part of the process. Itera-
tive thinking, discussion, and ongoing appraisal are necessary about the course
components and their relationship to the technology, and the overall fit of the
technology with the course design. Consideration should be given to:
• How the course looks and feels. Consistency among courses within a
curriculum contributes to visual unity and ease of navigation for par-
ticipants. Faculty members’ comfort and ease with the LMS is critical
to ensure smooth operations and inspire a positive learning experience
for all participants.
• Guidelines, rubrics, and self-assessment tools to help students develop
confidence in their learning progress (Dunlap, 2005).
• Methods for students to demonstrate learning within the context of
selected technologies, course expectations, and timelines.
• Moderation of discussion forums. Will students assume leadership
roles, acting as moderators or discussion summarizers while faculty
members coach them from the side?
• Expectations about frequency of participation, active presence for fac-
ulty members and students, course etiquette, and ethical issues regard-
ing professional practice discussions.
• Provision of lectures, and preparatory and/or supplementary materi-
als and timely learning opportunities that will blend course goals
or competencies, content, and technology, seamlessly, transparently,
and intuitively.
 Designing Nursing Curriculum and Courses for Distance Delivery 459

A finalized course design will result when nursing faculty members, instruc-
tional designers, and media specialists are satisfied that they have achieved a
reasonable convergence of pedagogy and technology, where the pedagogy drives
the technology. The result should be a course that is:
• Philosophically, educationally, and conceptually consistent with the
curriculum foundations and incorporates evidence-informed design
and teaching scholarship
• Constructed with technology whose navigation is intuitive and trans-
parent, or a combination of technology and conventional learning that
engages students and moves them toward achievement of curriculum
expectations
• Rigorous and contributes to the unity of the curriculum

Course Concepts and Content

As in conventional courses, the course concepts and content are determined
by the curriculum mapping that is part of curriculum development. Concepts
are addressed at the desired depth and scope in online discussion with skillful
facilitation to ensure a suitable balance between concepts and content. It is
important to ensure that any interactive web technology is intuitive and does
not overshadow attention to course topics.

Strategies to Ignite Learning

The intent of strategies to ignite learning is to move students toward achieve-
ment of course goals or intended competencies, in a manner unhampered by the
available technology. Active learning and collaborative knowledge construction
are critical values of distance education; thus, the strategies to ignite learning
typically require students to engage in divergent thinking, discussion, and col-
laborative work.
The strategies to ignite learning ought to encompass four types of interac-
tion previously described: student–faculty, student–student, student–content,
student–self (Andrusyszyn & Davie, 1997; Moore, as cited in Bernard et al.,
2009). While the first three are readily understood, student–self interaction focuses
on the two-way interaction between the inner/personal self and the academic/
professional self and occurs through reflection and reflexivity. Revisiting and
analyzing insights through individual and shared reflection can lead to deeper,
more meaningful learning (Andrusyszyn & Davie, 1997). Therefore, strategies
to ignite, promote, and sustain reflection and reflectivity should be integral to
nursing courses offered by distance delivery.
460 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

Embedded opportunities within the LMS for social interaction, synchro-

nous and asynchronous discussion, and collaboration on practice issues or case
studies perceived as authentic by students will promote disciplinary discourse
and allow student engagement with the content and the process of knowledge
construction (Dunlap, Sobel, & Sands, 2007; Larreamendy-Joerns & Leinhardt,
2006; Martens, Bastiaens, & Kirschner, 2007). With courses delivered through
a LMS, didactic material and links to other learning resources can be posted
electronically. The learning resources could be designed with technological
enhancements to overcome limitations of written text and static presentations
and consist of resources such as videos, journal articles, material posted on
other websites, and supplementary notes.
Other strategies might involve online live discussion or real-time virtual
classrooms with lectures and demonstrations, provided these features are part
of the LMS. Such strategies are convenient for guest lecturers and practice
experts, and add immediacy and authenticity to the learning. Student presen-
tations are also possible in this way, or through didactic postings. Full use of
LMS components allows for a wide range of strategies to ignite learning and
attends to a variety of teaching and learning styles. Countless combinations and
permutations of strategies and technologies are possible, limited only by faculty
members’ imagination, creativity, time, and expertise, and the institution’s tech-
nology infrastructure and support. Web 2.0 technologies such as blogs, wikis,
and cloud computing are readily employed in nursing education, depending on
course context. Web 3.0 technologies, also referred to as the semantic web or
artificial intelligence, take Web 2.0 a step further by empowering teachers and
learners through the use of open and cross-platform applications, data mining
through built in algorithms, 3-D virtualization, and cloud computing (Chauhan,
2015). In an expanding technological world, it is most critical to select strate-
gies to maximize achievement of curriculum goals or intended outcomes, and
to respect student diversity and multiple ways of knowing.

Individual “Classes”
Guidelines for student learning can be prepared for distance education courses,
just as they are for conventional courses. These guidelines for activities provide
direction to learning, assisting students to focus on the ideas and processes that
lead to success in the course. Because these ought to be prepared in a consistent
format throughout the curriculum, the guidelines provide visual unity to the
course and curriculum as a whole.
When planning for individual classes, it is necessary to decide exactly what
constitutes the temporal span of a “class” in a course that employs ongoing dis-
cussion. For example, will the class start on Monday at 9:00 a.m. and continue
 Designing Nursing Curriculum and Courses for Distance Delivery 461

to Friday at 4:00 p.m., or continue for 7 days a week? When, how, and by whom
will the summary and transition to the next topic occur? Will discussions be
closed to further contributions after a unit of time, or remain open for review
and further contributions for the duration of the course?
Another aspect of temporality is how best to facilitate students’ substantive
and continuous engagement in asynchronous online discussion, rather than
sporadic superficial participation that does not advance the dialogue. Setting
clear expectations about the frequency and timing of contributions will enhance
course rhythm and avoid chaos within an asynchronous learning environment.
Of note is that use of blogs or sites such as Google Drive™ online storage ser-
vice allows for tracking of contributions, possibly enhancing participation in
collaborative work and reducing the “missing in action” phenomenon (Bento
and Schuster, as cited in Booth, Andrusyszyn, & Iwasiw, 2011) in online courses.
Class design decisions also include matters about small group versus ple-
nary work. If a large class is divided into smaller groups, timing and design
considerations need to include whether all small groups will report back to
the whole at a plenary session or if summaries of discussions should be posted
for all to read. Whether small group discussions are visible (or not) for other
groups is a philosophical debate with which the course professor must wrestle,
weighing the benefits and drawbacks of either design choice.
Consideration may be given to whether or not students will share leadership
responsibility for facilitating discussion in small groups and in the total group.
This may be desirable if the activity aligns with course expectations and if the
logistics can be organized so that all students have an opportunity to do so.
The need for faculty presence in online discussions is important for student
guidance and learning. Faculty presence through role-modeling, coaching,
and reinforcing active engagement with positive feedback builds students’
self-confidence. In conventional classes, students typically manage their own
discussion in small groups, albeit with physical presence, but limited involve-
ment, of a faculty member. Therefore, a suitable balance between faculty pres-
ence and student autonomy is considered when online courses are designed.

Opportunities for Students to Demonstrate Learning

and for Faculty Members to Evaluate Student Achievement
In all courses, students will be expected to demonstrate, and faculty members
to evaluate, achievement of course goals or course competencies. The choice
of methods for students to demonstrate learning is related to consistency with
philosophical and educational approaches, and course goals or course com-
petencies. As always, a variety of methods are preferred. The appropriateness
of giving grades for participation remains debatable. A decision for rewarding
462 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

participation (or not) with grades is rooted in faculty members’ beliefs and
values about teaching and learning and should be carefully considered.
When deliberating about methods for students to demonstrate achievement,
faculty members examine factors such as:
• Compatibility of ideas with curriculum foundations and the available
technology
• Student access to the necessary resources and supports to demonstrate
learning
• Balance among individual work, group work, and individual contribu-
tions to group work
• Plans for timely feedback
• Examination schedules (synchronous or asynchronous)
• Security and ease of testing and the assignment-submission system
The opportunities available for students to demonstrate their learning can
occur within or beyond the bounds of the LMS. In all cases, the effort required
by students to create the work, and by faculty members to evaluate it, should be
commensurate with the extent to which the completed work will demonstrate
an integrated achievement of course expectations.

Demonstration of Cognitive, Affective, and Psychomotor Learning

in Distance Education
Demonstration of cognitive or affective learning in a distance course parallels
that of conventional courses with strategies such as tests, term papers, portfo-
lios, presentations, videos, and case analyses, among others. Affective learning
can be made evident through discussion, creation of video role plays, responses
to ethical dilemmas, online debating, and other approaches (Oermann &
­Gaberson, 2014).
Less straightforward is the demonstration of psychomotor learning, because
faculty members are unable to observe the psychomotor performance in per-
son. However, students can engage in virtual simulations and submit videos of
psychomotor skill performance. It is also possible to engage experts to evaluate
performance in person, depending on the course context and experts’ familiar-
ity with the expectations.
When students are asked to create health-related or issue-related videos,
blogs, or wiki entries, they are usually eager for these to become public. Thought
should be given to how the course professor can assess these learning products
quickly and give feedback so students can make necessary revisions within the
timeframe of the course. An additional consideration in the work that students
submit is the limit on the file size allowed by the LMS. A completed video may
 Designing Nursing Curriculum and Courses for Distance Delivery 463

have to be located on an external Internet site, such as YouTube. If external

sites are used, care must be taken to ensure that no infringements of privacy,
confidentiality, or copyright have occurred. It is also important to explore who
will own copyright of the work once posted.

Academic Integrity
With computer-based testing, security can be strengthened with the use of tightly
timed examinations, online proctoring systems, randomized distribution of sev-
eral forms of the exam, and randomization of test items and response options
(Bedford et al., 2011; Caudle, Bigness, Daniels, Gillmor-Kahn, & Knestrick,
2011). Alternately, consideration can be given to the use of examination centers
that all students must physically attend.
Whether or not online testing is used, the creation and support of an environ-
ment of academic integrity is an important element of all courses. Consistent with
institutional policies, clear explanations of what constitutes academic honesty
and dishonesty, why it is important to cite sources (including those from the
Internet), what plagiarism is, and when collaboration is (and is not) appropriate,
are part of developing a culture of honesty (Conway, Klaassen, & Kiel, as cited in
Oermann & Gaberson, 2014; Hart & Morgan, as cited in Oermann & Gaberson,
2014). Significantly, these ideas form part of the course syllabus. Helping students
understand that cheating is unacceptable and antithetical to professional nurs-
ing values requires serious discussion. Explanations and discussion about how
academic honesty relates to professional values and ethics can add importance to
ideas of academic integrity for students. Further, the matter of academic integrity
can be raised as dates for submission of student work approach.

Summary of Curriculum and Course Design Process

for Nursing Distance Education by Distance Delivery
The curriculum and course design process for nursing education by distance
or hybrid delivery is the same as designing for conventional delivery. The
difference lies in the influence of the delivery technology on course design.
Involvement of an instructional design expert, and, if possible, a media spe-
cialist, is often necessary until faculty members develop expertise in creating
distance education courses. Nonetheless, all decisions and deliberations are
based on the curriculum foundations, that is, the philosophical and educa-
tional approaches, the major curriculum concepts, and the key professional
abilities, along with curriculum goals or outcomes. Important to remember is
that the process of design is iterative, with the intent of achieving an internally
consistent course with a well-balanced blending of pedagogy and technology.
464 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

Implementing and Evaluating Nursing Education

by Distance Delivery
Exemplary Teaching in Distance Courses
Faculty–student interaction is essential to student achievement in all courses
regardless of delivery method. As students engage in the learning activities,
faculty members are responsible for attending to the teaching actions that
validate students’ participation and learning efforts, offer guidance in learn-
ing, support motivation, and provide feedback about achievement (Paul &
Cochran, 2013). For students to feel they are part of a community of learners,
particularly in a fully online or web-based (e.g., audio-, video-, or SKYPE
conferencing) learning environment, their social, cognitive, and affective pres-
ence require validation. In a study by Wingo et al. (2016), instructor partici-
pants expressed that they had to work harder at communicating effectively
to facilitate engagement with students and avoid feeling disconnected from
them. Therefore, the course professor should plan for intentional validation of
student participation through course design and teaching presence (Stavredes
& Herder, 2013).
A critical element of the interaction is the faculty member’s clarity of com-
munication. Unambiguous written communication is paramount, particularly
when the course is fully online because verbal clarification may not be possible.
Misunderstandings can lead to student frustration and be challenging to ­correct
(Wingo et al., 2016).
Exemplary teaching via distance delivery can be viewed as consisting of
three interrelated and mutually supportive categories of teaching actions. These
categories encompass actions that promote learning; strengthen interaction, com-
munity, and inclusion; and enhance students’ sense of control and confidence in
their ability to be successful. All require a faculty member’s continuing presence,
that is, “being visible to, engaged with, and caring for the students through every
step of the way through the learning journey on which they embark together”
(Ekmekci, 2013, p. 34). Table 16-1 includes examples of teaching actions and
their fit with the three categories of instructional purposes.

Evaluation of Nursing Education Offered by Distance Delivery

Faculty members continually engage in appraisal of curriculum and course
design. The design of the course evaluation should be completed before the
course is implemented and be consistent with the evaluation plan, model,
and procedures used in the full curriculum. There may be a need to clarify
the purpose of course evaluation specific to distance delivery, if the entire cur-
riculum is not offered in this way. Criteria or standards for courses offered
Implementing and Evaluating Nursing Education by Distance Delivery 465
466 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance
Relationship of Nursing Education by Distance Delivery to an Evidence-Informed, Context-Relevant, Unified Nursing Curriculum 467

by distance delivery could be necessary, if not already part of the overall cur-
riculum standards. Once the evaluation is completed, reporting of evaluation
results may extend to instructional designers, who are now stakeholders in
the nursing curriculum.
All aspects of conventional course evaluations ought to be included in the
evaluation of courses delivered via technology. Useful information specific to the
pedagogy-technology interface include students’ feedback about matters such as:
• Sense of connectedness with peers and course professors, feeling of
control over technology, perceptions of how the course design influ-
enced their learning, volume of work, and time on task
• Ease of navigation in the LMS and use of system features, such as
email and submission of completed work
• Fit between specific learning activities and technologies
• Reasons why students did or did not engage in specified activities
(TLT Group, 2011)
• Suitability of technologies for learning about a person-centered, prac-
tice discipline
• Authenticity of learning activities and opportunities to demonstrate
learning
• General satisfaction with course delivery
The results of organized and regular course evaluations contribute to
ideas about subsequent course refinement or revision. When offering courses
by distance delivery, or incorporating technology into on-campus courses, it is
incumbent on nurse educators to expand ideas of course evaluation to explicitly
include features of the technologies used and their intersection with learning
about nursing. If an entire curriculum is being offered by distance delivery,
the considerations noted earlier continue to apply. Additionally, all features of
planning curriculum evaluation are essential.

Relationship of Nursing Education by Distance

Delivery to an Evidence-Informed, Context-Relevant,
Unified Nursing Curriculum
Nursing education courses may be offered by distance delivery in combina-
tion with, in addition to, or instead of conventional classroom-based nursing
courses. In all cases, they ought to be visually and conceptually consistent with
other courses in the curriculum. In other words, nursing courses offered by dis-
tance technology are not separate from the school’s curriculum but an integral
part of it. Therefore, if the curriculum as a whole has been developed to be
468 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

evidence-informed, context-relevant, and unified, individual distance education

courses will fit into the curriculum framework and form part of a unified whole.
If an entire nursing curriculum is intended to be offered by distance delivery,
its development, implementation, and evaluation should follow the processes
of the Model of Evidence-Informed, Context-Relevant, Unified Curriculum
Development. If this is done, the evidence-informed, context-relevant, and
unified nature of the curriculum will be assured.

Core Processes of Curriculum Work

Faculty Development
Faculty development and support are necessary when designing and implementing
courses offered by distance delivery. Development sessions can be led by tech-
nology specialists, instructional designers, and media experts, as well as faculty
members experienced in distance education. These can focus on (1) technology
as it relates to curriculum and course design, and (2) teaching and interpersonal
interactions with distance technologies.

Technologies and Course Design

The overall goal of faculty development as it relates to curriculum and course design
is to advance members’ appreciation, understanding, and knowledge of distance
methods, the accompanying technologies, and their intersection with pedagogy.
Essential is the development of proficiency in use of the institution’s LMS and
other systems such as content and student management systems, as appropriate.
Importantly, it is incumbent upon faculty members to learn about current web
technologies, social media, and their potential applications in nursing education.
Faculty development can include individual, microlevel assistance with course
development, based on faculty members’ comfort, knowledge, and expertise
with distance delivery. Broader discussions could be undertaken with faculty
experts from nursing and other disciplines about possible opportunities for
students to demonstrate learning in distance courses, the right balance of vari-
ous technologies, academic integrity in courses, or the ethical considerations of
distance education. A strategy used by Indiana University for faculty develop-
ment when transitioning to a new online LMS was to designate “super-users,”
individual faculty members who served as ongoing resources to colleagues to
ease the process (Judge & Murray, 2017).
Faculty development opportunities with a wider scope might include cen-
trally offered workshops to address strengths and limitations of selected delivery
methods, or informal dialogue among faculty members about successes and
frustrations with specific delivery or communication methods. Sharing circles
 Core Processes of Curriculum Work 469

with novice and experienced members could encourage discussion among those
who are tentative about the effectiveness of distance education and those who
are convinced of its value. Such perspectives and experiences might provide a
balance between positive and negative views.
Guided workshops for professors developing or converting courses to dis-
tance delivery could include brainstorming about course (re)configuration to
incorporate different technologies. This may also be relevant for those wanting
to introduce a hybrid approach to their conventional classes. In addition, with
student agreement, novices might be observers in distance courses being offered
and modeled by experienced peers (Lenert & Janes, 2017) as they develop their
own courses for distance delivery.

Teaching Using Distance Technologies

A critical aspect of preparing for teaching via distance technologies is an under-
standing of the faculty role in course implementation. For some faculty members,
a shift is needed from being the playwright, active director, and featured actor of
in-class learning activities, to being a combination of playwright, minor player,
and prompter. The playwright in traditional and distance courses creates the
course structure, and develops and makes available necessary resources and
processes. As a minor player, the nursing faculty member in distance courses
contributes to the unfolding dialogue and learning but rarely becomes the central
focus and only for brief periods. The prompter’s presence is persistent and known
to students, who receive support and assistance as needed. This may represent
a significant change in teaching style for some faculty members, who although
skilled in classroom teaching, may need support in shifting their teaching style
(Johnson & Meehan, 2013). Not all faculty members are confident or suited to
teach in other than conventional settings, and a curricular change to distance
delivery may be stressful or even resented. Gradual immersion with tangible
successes may be desirable for some to ease fear or anxiety.
Facilitation of online courses or web-conferencing courses is a skill that
involves knowing when to coach or intervene, where to coach or intervene (in
the public discussion forum or privately via email or even face-to-face), how to
express ideas so the intent is conveyed clearly and without judgment, and when
to observe without comment. The aim is to promote student engagement that
will provide all class participants with opportunities to find their voice online.
Development or refinement of these skills can be supported through review and
analysis of examples of online discussion (used with participants’ permission). The
nature and tone of the faculty development and online facilitation ought to be
consistent with the philosophical and educational approaches of the curriculum.
Another faculty development activity might be to consider the evidence-informed
teaching practices that faculty members are using in the classroom and consider
470 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

how they could be transformed into teaching actions in distance education. An

introduction to best practices and research about teaching in distance education
courses would strengthen this discussion. Sessions focusing on the transition
to distance teaching could include colleagues from other disciplines and/or
members of the institution’s teaching support center.
Shared teaching with experienced distance education professors can be
a way to ease the transition from classroom to distance teaching. Ongoing
mentoring can be useful to novices as they encounter teaching challenges
in distance education. Regular discussions among faculty about topics such
as online teaching, web conferencing, the use of web technologies, and
social media can be of help to experienced and novice faculty members in
distance, hybrid, and conventional courses. Furthermore, faculty members’
self-assessment, course evaluations, and student feedback all contribute to
the development of those leading nursing education courses delivered by
distance technology.

Ongoing Appraisal
The ongoing appraisal processes of curriculum development, implementation,
and evaluation for nursing education by distance delivery includes all the
appraisal questions posed during curriculum development of conventional
courses, as described in previous chapters. Additional areas of appraisal relate
to the intersection among pedagogy, learning, and technology. Faculty might
consider the following:
• Sufficiency of plans for active student engagement to sustain comfort,
voice, presence, motivation, and learning
• Fit of learning activities with curriculum foundations, the selected
technology(ies), and course timeframe
• Availability, responsiveness, and sufficiency of academic and technical
support for students and faculty members
• Attention to matters of privacy, confidentiality, and online etiquette

Scholarship
Nursing education by distance delivery is an area of scholarship requiring de-
velopment beyond expository literature and reports of the learning outcomes
of individual courses. If comparisons are made between face-to-face and dis-
tance courses, the variables that influence learning outcomes (e.g., student time
on task, class size, course processes, course materials, nature and amount of
feedback, interactions, student and faculty member characteristics) should be
accounted for so that supportable conclusions can be drawn from the results
(Liu, 2012; Simonson et al., 2011).
 Chapter Summary 471

Attention should be given to the wealth of scholarship about distance educa-

tion generally, and the following question should be asked: What is particular
about distance education in nursing that requires explication or investigation?
Qualitative studies that examine how, and how well, students learn about a
person-oriented profession, develop professional values, and are acculturated to
nursing in courses with no face-to-face contact, would deepen an understanding
of effective learning strategies and activities in nursing education.
A topic worthy of development is ethics and values in distance courses. For
example, an exploration could be undertaken of the perspectives of nursing fac-
ulty members and students about the ethical issues inherent in the use of external
websites and web tools for course work in which client information forms the
basis of discussion. Results could be compared to the perspectives of students and
academics in other health disciplines to determine if there are shared values and
beliefs. This could have implications for interprofessional education by distance.
Another example of a scholarship project that could be of value is a survey
of student beliefs about academic integrity in a course that relies on student
access to and use of Internet resources. It would also be relevant to determine
if and how Internet-based learning shapes student perspectives on nursing
professional values and academic values and whether the views are the same
or different from those in conventional courses.
To expand the evidentiary foundation for nursing education by distance
delivery, a school of nursing might adopt a single theory or group of theories
upon which to base studies. In this way, a theory-based body of knowledge
would be developed and could be further examined.

CHAPTER SUMMARY
Distance education and nursing education by distance delivery are defined, and
the institutional requirements for offering distance education are explained.
Ethical considerations, values, and beliefs pertinent to distance education are
described. The sources of decisions to offer nursing education by distance and
implications for nursing curriculum are summarized. Curriculum design is briefly
overviewed and highlighted is the fact that the design process for distance and
conventional courses in nursing is the same. However, considerations particular
to nursing education by distance delivery are described. Discussed are course
components of concepts and content, strategies to ignite learning, features of
individual classes, and opportunities for students to demonstrate learning and
for faculty members to evaluate student achievement. Deciding on course design
is addressed, as are implementing and evaluating nursing education by distance.
The relationship of nursing education by distance delivery to a context-relevant,
evidence-informed, unified curriculum is explained. The core processes of cur-
riculum work in relation to distance education in nursing are described.
472 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

SYNTHESIS ACTIVITIES

The case presented for analysis is the Whitebrook University Faculty of

Nursing that is considering further integration of distance delivery into
the Bachelor of Science in Nursing (BScN) curriculum. Questions are
provided to guide analysis. Then, questions and activities are suggested
for readers’ deliberation when planning, implementing, and evaluating
distance education in nursing relative to their own programs.

„„Whitebrook University Faculty of Nursing

Whitebrook University Faculty of Nursing has a 15-year history of offer-
ing undergraduate nursing programs and the faculty members are always
seeking new opportunities for their program to be on the cutting edge of
change. They have had three classes of 150 graduates from the current
BScN program who have been well received by the healthcare community.
In the last 5 years, four new PhD-prepared faculty members have been hired
into full-time appointments, bringing the complement of faculty to 14.
The faculty members enjoy being together and sharing ideas. Every Friday,
the majority gets together with the dean for an informal potluck lunch and
inevitably someone puts forward a question, concern, or new idea. This week,
Dr. Rachel Booth wondered why none of the courses in the undergraduate
program were offered using distance delivery methods. She explained how
rich and deep her learning experiences had been in her PhD program, which
used a hybrid design, and she wondered about others’ experiences.
Two faculty members, Dr. Ursula Minton and Dr. Keisha Jefferson
both had similar experiences in doctoral studies and were eager to explore
further possibilities for the undergraduate program. Dr. Virginia Angel
shared that she could not imagine how interpersonal communication,
caring, and empathy could possibly be integrated in a technical space and
her passion about the importance of personal contact to fully socialize
students into nursing was palpable. However, she was open to exploring
the idea and learning more.
There was a heightened buzz in the room about how distance delivery
and web technologies could be incorporated into nursing courses. Dean
Sunaya Tornquist was fully engaged in discussing possibilities as well
and praised the group for their energy and creativity. She suggested that
the topic of distance delivery be added to their Faculty Council agenda
and that a small working group take the lead in exploring this possibil-
ity further. She further noted that distance education and enhancing web
 Chapter Summary 473

learning technologies are identified on the university’s strategic plan and

that the university as a whole has been working on how to maximize and
expand the infrastructure to include all programs. Four faculty members
volunteered to take on the challenge and said they would meet and pro-
pose a plan for a more formal discussion at the next council meeting.

„„Questions and Activities for Critical Analysis of the Whitebrook

University Faculty of Nursing Case
1. Develop a plan for the Faculty Council meeting. How should
the discussion about integration of distance education be
planned to encourage open dialogue and expression of appre-
hensions and convictions?
2. What concerns or questions might the working group anticipate
in proposing the introduction of technology-enabled courses?
3. Consider how the working group should or could intersect with
the school’s curriculum committee to maximize inclusion and
avoid any sense of interference in the committee’s mandate.
4. Describe the supports that might be necessary to expand the
use of distance delivery and web-based technology in the under-
graduate curriculum.
5. Compare the benefits and drawbacks of both full and gradual
immersion into distance delivery.
6. Deliberate about the fit of online teaching and learning with
professional practice courses.
7. Consider the faculty development and scholarship activities that
might be undertaken if there is a formal decision to proceed.

„„Questions and Activities for Consideration When Planning,

Implementing, and Evaluating Nursing Education by Distance Delivery
in Readers’ Settings
1. Analyze the factors propelling the school of nursing toward of-
fering nursing courses by distance delivery.
2. What strategic directions, institutional policies, infrastructure,
and resources are available within the educational institution
and the school of nursing for offering nursing education by
distance?
474 Chapter 16 Curriculum Considerations in Nursing Education Offered by Distance

3. Analyze the faculty climate regarding distance delivery and

integration of web technology into conventional and distance
courses.
4. What is one web tool not currently used that could readily form
part of a course? How could it enhance student learning beyond
what is currently done?
5. Propose ideas for learning activities that reflect a creative and
learning-focused integration of technology and pedagogy.
6. How can conceptual and visual consistency be maintained
in the curriculum when distance courses are developed and
implemented?
7. What faculty development activities might effectively support a
shift toward distance education?
8. In addition to the ideas suggested in the chapter, what ongoing
appraisal questions should be asked?
9. Suggest scholarship activities that could be undertaken about
the development, implementation, and evaluation of nursing
education courses and curricula offered by distance delivery.

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