E-nursing

=e-Nursing WA 2008=

Background
The project involved embedding a blended online learning solution. This is a variant of the CYOC e-learning model (blend of virtual classroom, LMS and other) specifically for Nursing this includes face to face classes) into the delivery of the Diploma in Enrolled Nursing and the Certificate IV Preparation for Enrolled Nursing courses to provide: • resources and links to support learning (particularly knowledge development) across the qualifications • access to practise and assessment tasks • access to additional support materials in LLN, Study Skills and underpinning knowledge • opportunities for discussion and groupwork for geographically dispersed students • opportunities for peer to peer interaction with reduced travel thus decreasing the sense of isolation for geographically separated students • experience in e-learning through the Cert IV preparation course that will facilitate the transition into the Diploma thus leading to increased uptake of the course, and greater retention and completion rates among students studying Enrolled Nursing.

The Framework Connection
This is a 2008 Western Australian E-learning Innovations project output, developed by CY O’Connor TAFE, with seed funding from the national training system's e-learning strategy, the Australian Flexible Learning Framework (Framework). The Framework provides the vocational education and training (VET) system with the essential e-learning infrastructure and expertise needed to respond to the challenges of a modern economy and the training needs of Australian businesses and workers. E-learning Innovations aims to embed e-learning into the national training system by supporting and enabling innovation in training design and delivery, at the state and territory level. A number of Framework project products, resources and support networks were used/referred to during the project. Probably our most used Framework resource was AREDv2 – this was used for the development of a number of learning resources. We also accessed LORN (Learning Object Repository Network) – we were able to use one learning object (this was customised to limit student access to the relevant content). This learning object was large, covering all the units specific to medical secretary/receptionist. The students only needed the unit relating to basic medical terminology. We also used: • Support from the Framework team in WA • Designing e-learning • E-standards for Training • Copyright Kitchen.

e-Nursing: how we did it
As with most projects of this type what we actually did was not exactly what we had planned originally. However the broad project objectives have been accomplished. The project plan was very structured and intended to consist of a number of phases, but in reality these were merged. From previous experience this is not unusual, particularly in action learning projects which are also piloting delivery to real students during the project.

//**The team**// The team consisted of the facilitator/project manager, the lecturers delivering the Diploma in Enrolled Nursing and those due to start delivering the bridging course – Certificate IV in Preparation for Enrolled Nursing. There was also input from the Aged Care team and about halfway through the project an additional team member (with a care background and relevant IT skills) was involved. The IT skills of the nursing team were varied ranging from members who used computers as little as possible to ones with some basic knowledge of using an HTML editor.

//**What actually happened**// //The early stages// The initial concept was to make parts of some units from the Diploma in Enrolled Nursing available through online delivery. This was to be a blend of virtual classroom (VC) and learning management system (LMS). The specific platforms were Elluminate (VC) and Blackboard CE6 (LMS). However this was soon (at the business case rewrite phase) refined to focus on the Certificate VI units in the first instance. The rationale for this was that it would enable the students to develop skills in e-learning use before starting the much more demanding Diploma course. In the early stages the project consisted of a number of informal meetings and discussions between the facilitator and the nursing team. Much of this time was spent with the facilitator describing, explaining and demonstrating some of the possible strategies and talking about advantages for both lecturers and students. Time was also spent in demystifying the e-learning concept as much as possible. In addition the team discussed the requirements of Framework projects in terms of outcomes, copyright and implications of using unattributed images etc in a Framework project. The team initially seemed to be very enthusiastic about using pre-existing online resources through links and mapping these to ensure unit coverage. There are many excellent interactive resources relevant for nursing students that are available on the internet. The facilitator provided links for a wide variety of these and also spent several days working with individual lecturers to explore potential online resources. However despite the initial enthusiasm the majority of resources used were either pre-existing traditional resources converted to a more interactive form, or were newly created for the Certificate IV or Diploma. The facilitator also worked (mainly in the early stages) with the lecturers, including the new staff member who joined about half way through the project to train them in using the VC, in developing and converting resources using AREDv2 and in the basics of structuring and uploading content and links to the LMS.

//Introducing the concept to students// Open days for potential nursing or other health/community care students had been planned for the two campuses where we deliver nursing. At the facilitator’s suggestion these were used to introduce the concept of e-learning and to provide ’tasters‘ of the VC and LMS. This was done using a live demonstration with the facilitator at a remote location and an Aged Care team member (who delivers using VC) to show potential students how to use the microphone. The introduction to Elluminate took the form of a short orientation facilitated though Elluminate. This included: an overview; using the microphone; polling; and an opportunity to ’play‘ with some of the most frequently used whiteboard tools through activities of a type that might be used in a learning situation. Whiteboard activities used were: a drag and drop activity in labelling a diagram of a skeleton; a wordsearch involving highlighting health care related words; and an icebreaker activity involving typing their name and an interest on the whiteboard. The LMS taster was the nursing front page and sample interactive resources.

//Implementation// The team re-worked their original delivery model to some extent – originally the plan was to deliver content for each unit through face-to-face workshops. Each unit being split over two successive days in the same week or over two days a fortnight apart. The intention was then for students to be assessed both during the workshops and through additional tasks to be completed very soon afterwards. This was modified using the CY O’Connor blended learning model for online/e-delivery as a basis.

The result was a blend with VC sessions replacing some of the face-to-face and also as an alternative for those students who had time and/or travel issues with attending on campus. These sessions were each much shorter than a full day workshop but running over more weeks (and sometimes duplicated at several different times to enable as many students as possible to attend at least one of them) so that the students were getting a greater amount of contact time overall. Content and activities were also made available on the LMS and sometimes also supported by the pre-existing traditional paper-based learning guides. Individual lecturers ’tweaked‘ the blend to suit student and unit needs and to their own preferences. With online courses where students work off-campus (from home, telecentres, libraries or employer sites) and use VCs, there are a range of potential issues relating to student connections, there are also possible issues with respect to the LMS but generally these cause fewer difficulties. Main difficulties relate to the wide variation in system configurations.

Part of the facilitator’s role was to support students in getting online – this meant dealing with the varied configurations through initial provision of information on how to configure for virtual classroom (including the support link for downloading Java and setting up connection speed and audio) and LMS. This was followed by troubleshooting by phone or online for anyone with problems. Additionally the facilitator has experience in talking individuals through the whole process by phone if they are nervous about making changes to their computers. We have found this approach works well across the college and the facilitator has been doing this to enable students from a range of industry areas to get online from home. The facilitator also provided orientation and an introduction to tools for the VC and partially delivered the two basic IT units that form part of the bridging course. The large range of configurations and different applications, email clients and operating systems in use by the students, combined with prior IT skills ranging from none to high level self-taught posed a number of challenges. These had been largely anticipated by the facilitator through two strategies: VC sessions largely took the form of supporting tutorials rather than content delivery; LMS content included links to relevant tutorials for different operating systems and email clients. The other issue of range of pre-existing skills was more problematic and is addressed in lessons learnt. There were a range of problems experienced during the implementation – and resulting lessons learnt. Most of these are described in the lessons learnt section. However one large issue occurred that was completely outside our control and that of the college. This was due to problems of overloading with the WA Department of Education and Training (DET) servers. Despite the problems and issues the nursing lecturers embraced the use of the e-learning strategies and started to take ownership of the e-parts of the courses. This left the facilitator with the dilemma of how much to ’interfere‘. There was a need to balance the requirements of the E-learning Innovations funding (ie for embedding) and the necessity for the team to take ownership for this to occur, with the possible negative consequences of team inexperience in e-learning development and delivery (eg making inappropriate decisions or of interactive resources/links not working). The facilitator’s decision was to be ’hands off‘ and just be available if required for help and advice.

There were a variety of impacts from the ’hands off‘ management strategy. On the positive side the nursing team took very full ownership and have picked up and ’run with‘ the project. They have been taking part in real action learning and thus the lessons learned are likely to be well embedded in their practice. Less than positive impacts include: use of copyright materials by the team with copyright issues not yet resolved; also the student experience was not entirely good as a result of team inexperience in virtual classroom use, LMS use and e-learning development. However the benefits appear to outweigh the negative impacts in that we have an embedded approach to e-learning by the team, a very flexible model, and generally good student outcomes.
 * //Impacts of the facilitator's 'hands off' strategy//**

//Student opinions// Student feedback was collected informally both orally and through VC tools (whiteboard and polling). Student reaction was generally positive. The main issues raised by students were the technical problems they experienced when attempting to access their online classes and resources from on-campus ie in college computer rooms or the college library. A short online survey (using SurveyMonkey) with the link emailed and available on the LMS was also used towards the end of the semester. Although response level (typically for this type of survey) was quite low (approx 30%), all the responses have indicated benefits to the individuals of having an e-learning component in their course. Primary benefits have been reduced travel and the flexibility afforded by using the LMS. Despite the issues experienced with connection dropout, all respondents would be willing to undertake e-learning again in the future with only one of these preferring not to do so.

Benefits experienced by stakeholders
//**Students**// The majority of potential students were initially very excited about using e-learning as they immediately saw the benefits of reduced travel and increased opportunities to interact with their peers. Throughout the course the students developed new skills in using e-learning, these will be useful to them in future as they continue learning. This is particularly so for regional students in WA where e-learning is becoming more available. Students also experienced a reduction in the social isolation from fellow students that is common to all distance learners and particularly learners from regional locations. For a number of students the main advantages lay in the increased flexibility to study at times of their own choosing and the reduced need for travel with the subsequent saving of time and fuel costs.

//**Lecturers**// The lecturers have gained new skills in e-learning development and delivery and to date these seem to have become embedded into their practice. They have also developed and/or adapted a range of resources that will form the springboard for further development and refinement as their skill levels continue to increase.

//**CY O'Connor College**// The college has increased its range of available learning options for learners – this has expanded enrolment and retention in higher level courses which are a priority for TAFE colleges. Making the Diploma in Enrolled Nursing and Certificate IV in Preparation for Enrolled Nursing at least partially available online has raised the profile and credibility of the college in online/e-learning. This project has also helped the college towards its strategic objectives.

//**Families and the wider community**// The benefits for the families of students result from increased flexibility and decreased time spent attending on campus. The wider community will benefit in that students are able to remain in their own communities more of the time while undertaking their qualifications. Ultimately the whole WA Wheatbelt community is likely to benefit from the increased availability of qualified health care professionals who already live in the region and are thus much less likely to move to or back to the city once the have completed a stint in the region.

Lessons Learnt
We need more time, with funding available earlier or extending into the next calendar year. It was not possible to start early enough to ensure that the e-strategies were fully organised at the beginning of the students’ courses. As a result there were aspects of delivery that needed better preparation and planning. There was some initial confusion on the part of students because the team chose to introduce both the VC and the LMS at the same early session. This led to students being unsure about which online platform to access for different aspects of their course. The rationale for this strategy was that the team were very anxious to get the students progressing very quickly as they felt that there was a huge amount of content to become familiar with. The facilitator had some doubts (having always started with VC and not introduced the LMS until students were at ease with the VC). However it was important in ownership terms for the team to take such decisions themselves. On reflection the team decided that in retrospect it would probably have been easier for the students if the two had not been introduced at the same time, so this will be addressed in the next delivery. There is a strong need for some diagnostic process to determine students’ prior skills in literacy, numeracy and IT at the preparation course level. As this is a bridging course there are no formal pre-requisites. Usual practice in the college with access and equity programs (the normal delivery area for the project facilitator) is for potential students to carry out some diagnostic tasks to enable evaluation of their specific needs. This was not done, if such evaluation had been carried out it would have enabled better management through the LMS and also provided opportunities to group students with similar levels of IT skills and thus avoid the issue of some being bored while still going too fast for others. It would also reduce the risk of non-completion as students far below the required literacy and/or numeracy levels could be recommended to complete a general education course first. Lecturers need to gain a better understanding of copyright issues with respect to online resources and the requirements of the Framework. Despite an initial explanation, a number of emails and being recommended to use the Copyright Kitchen resource, there were still copyright problems. Team members used un-attributable images drawn from previous resources, blogs in which there was no attribution, and also where images and resources from other sources were not referenced properly. There seems to be no real solution to this except to ’police‘ it and that isn’t really appropriate with lecturers.

The results
1) An LMS course accessible for both Certificate IV in Preparation for Enrolled Nursing and Diploma in Enrolled Nursing students, this contains: • unit specific resources developed by lecturers; • one unit specific resource from LORN • unit descriptors (for all Certificate IV units) • assessment tasks for Certificate IV units • course specific documents eg task sheets for evidence collection • links to pre-existing external subject specific resources • resources and links to support students in their learning (ie which underpin the development of the skills and knowledge required by the units in the qualifications). 2) A team of lecturers in nursing who have developed the skills to deliver VC sessions relating to unit content and learner need as required. 3) A model for delivering similar courses across other community services areas. 4) A case study detailing the development of the e-learning delivery, the issues encountered and possible solutions. We are already seeing some benefits from the project in the higher than anticipated uptake of the Certificate IV in Preparation for Enrolled Nursing qualification this semester and also in increasing enquiries and enrolments on a flexible basis. However it is too soon to evaluate the full benefits of the project. The six months funding period is a very short timeframe in which to both develop and satisfactorily trial any e-learning project or strategy, let alone have any time for real reflection. In this project this has been exacerbated by the issues experienced by the college in respect of internet access and DET server overload. The resources/delivery model has been used (with individual variations between lecturers) across all units of the Certificate IV in Preparation for Enrolled Nursing course and some units of the Diploma in Enrolled Nursing. For the nursing area there was no e-learning component prior to this. Now there is an e-learning component (both VC and LMS) in all eight units of the Certificate IV course. There is a VC and LMS component in two Diploma units and the VC has been used to support delivery of several additional Diploma units.

For more information
Jo Hart Lecturer E-Nursing / CY O’Connor College of TAFE Phone: (08) 9622 6798 Email: jo.hart@cyoctafe.wa.edu.au Twitter id: @JoHart

Phone: (07) 3307 4700 Email: enquiries@flexiblelearning.net.au Website: [|flexiblelearning.net.au]
 * For more information on the Australian Flexible Learning Framework:**