A systematic review protocol on the use of online learning and blended learning for teaching clinical skills to undergraduate health professional students

Aim: This paper is a review protocol that will be used to identify, critically appraise and synthesize the best current evidence relating to the use of online learning and blended learning approaches in teaching clinical skills in undergraduate nursing.

Background: Although previous systematic reviews on online learning versus face to face learning have been undertaken (Cavanaugh et al. 2010, Cook et al. 2010), a systematic review on the impact of online learning and blended learning for teaching clinical skills has yet to be considered in undergraduate nursing. By reviewing nursing students’ online learning experiences, systems can potentially be designed to ensure all students’ are supported appropriately to meet their learning needs.

Methods/Design: The key objectives of the review are to evaluate how online-learning teaching strategies assist nursing students learn; to evaluate the students satisfaction with this form of teaching; to explore the variety of online-learning strategies used; to determine what online-learning strategies are more effective and to determine if supplementary face to face instruction enhances learning. A search of the following databases will be made MEDLINE, CINAHL, BREI, ERIC and AUEI. This review will follow the Joanna Briggs Institute guidance for systematic reviews of quantitative and qualitative research.

Conclusion: This review intends to report on a combination of student experience and learning outcomes therefore increasing its utility for educators and curriculum developers involved in healthcare education.

Perceptions of some teachers about the similarities and/or differences in teaching online versus in a classroom environment /

The introduction of computer and communications technology, and particularly the internet, into education has opened up some new possibilities for teaching and learning. Courses designed and delivered in an online environment offer the possibility of highly interactive and individually focussed teaching and learning experiences. However, online courses also present new challenges for both teachers and students. A qualitative study was conducted to explore teachers' perceptions about the similarities and differences in teaching in the online and face-to-face (F2F) environments. Focus group discussions were held with 5 teachers; 2 teachers were interviewed in depth. The participants, 3 female and 2 male, were full-time teachers from a large College of Applied Arts & Technology in southern Ontario. Each of them had over 10 years of F2F teaching experience and each had been involved in the development and teaching of at least one online course. i - -; The study focussed on how teaching in the online environment compares with teaching in the F2F environment, what roles teachers and students adopt in each setting, what learning communities mean online and F2F and how they are developed, and how institutional policies, procedures, and infrastructure affect teaching and learning F2F and online. This study was emic in nature, that is the teachers' words determine the themes identified throughout the study. The factors identified as affecting teaching in an online environment included teacher issues such as course design, motivation to teach online, teaching style, role, characteristics or skills, and strategies. Student issues as perceived by the teachers included learning styles, role, and characteristics or skills. As well, technology issues such as a reliable infrastructure, clear role and responsibilities for maintaining the infrastructure, support, and multimedia capability affected teaching online. Finally, administrative policies and procedures, including teacher selection and training, registration and scheduling procedures, intellectual property and workload policies, and the development and communication of a comprehensive strategic plan were found to impact on teaching online. The teachers shared some of the benefits they perceived about teaching online as well as some of the challenges they had faced and challenges they perceived students had faced online. Overall, the teachers feh that there were more similarities than differences in teaching between the two environments, with the main differences being the change from F2F verbal interactions involving body language to online written interactions without body language cues, and the fundamental reliance on technology in the online environment. These findings support previous research in online teaching and learning, and add teachers' perspectives on the factors that stay the same and the factors that change when moving from a F2F environment to an online environment.

Elementary computer-mediated online distance education : identification of criteria for successful implementation and practice

This study had three purposes related to the effective implem,entation and practice of computer-mediated online distance education (C-MODE) at the elementary level: (a) To identify a preliminary framework of criteria 'or guidelines for effective implementation and practice, (b) to identify areas ofC-MODE for which criteria or guidelines of effectiveness have not yet been developed, and (c) to develop an implementation and practice criteria questionnaire based on a review of the distance education literature, and to use the questionnaire in an exploratory survey of elementary C-MODE practitioners. Using the survey instrument, the beliefs and attitudes of 16 elementary C'- MODE practitioners about what constitutes effective implementation and practice principles were investigated. Respondents, who included both administrators and instructors, provided information about themselves and the program in which they worked. They rated 101 individual criteria statenlents on a 5 point Likert scale with a \. point range that included the values: 1 (Strongly Disagree), 2 (Disagree), 3 (Neutral or Undecided), 4 (Agree), 5 (Strongly Agree). Respondents also provided qualitative data by commenting on the individual statements, or suggesting other statements they considered important. Eighty-two different statements or guidelines related to the successful implementation and practice of computer-mediated online education at the elementary level were endorsed. Response to a small number of statements differed significantly by gender and years of experience. A new area for investigation, namely, the role ofparents, which has received little attention in the online distance education literature, emerged from the findings. The study also identified a number of other areas within an elementary context where additional research is necessary. These included: (a) differences in the factors that determine learning in a distance education setting and traditional settings, (b) elementary students' ability to function in an online setting, (c) the role and workload of instructors, (d) the importance of effective, timely communication with students and parents, and (e) the use of a variety of media.

The emergence of an online learning community in first year tertiary studies in psychology

The introduction of an online supported, resource based learning environment into a large, multi-modal first year psychology unit led to the spontaneous development of a small, but active, learning community. While off campus students were more active online contributors, many other students "observed" these interactions, not actively contributing but finding the discussion postings valuable to their learning. Overall, use and perceived value of the online communication facilities were related to how confident students were that they had an appropriate study strategy, with off campus and older students reporting greater confidence in their study approach. The results highlight that the nature and function of learning communities for large, multi-modal foundation units are quite different to those typically articulated in the literature and are worth further investigation.

Learning how to engage students online in hard times

In a context of financial restraint and enterprising university managers, teacher-researchers have reason to be sceptical about the trend towards online teaching and away from learning for its own sake. This article departs from both economic and technological determinism and turns instead to ideas about technology embedded in social and political institutions. Activity theory offers a useful means of analysing such embeddedness. Its Marxian assumptions about human nature specify a non-deterministic approach to technology. Its dynamic model of the subjects, tools, and objects of activity within a context of rules, a community, and a division of labour helps to specify aspects of the authors process of learning how to use electronic conferencing effectively. A full deployment of activity theory would also analyse the activity of students. Here the evidence comes mainly from the activity of researcher-teachers engaging greater activity among students. The numbers of students involved precludes reliable quantitative analysis but qualitative evidence from students does support conclusions about researcher-teachers learning how to make best use of electronic conferencing.

Exploring the foundations of practicing online collaboration

In collaborative learning, instruction is learner-centered rather than teacher-centered and knowledge is viewed as a social construct, facilitated by peer interaction, evaluation and mutual support [1]. Such computer supported collaborative learning (CSCL) enables and encourages learners to confer, reflect and help to develop meaningful learning in an environment where significant learning can be achieved through interactions supported by electronic communication and discourse [2]. This paper proposes a theory that supports educational collaboration in a peer-to-peer computing environment, thus blending the two disciplines.

Security in the online e-learning environment

This paper addresses the role of security in the collaborative e-learning environment, and in particular, the social aspects of security and the importance of identity. It represents a case study, completed in Nov 2004, which was conducted to test the sense of security that students experienced whilst using the wiki platform as a means of online collaboration in the tertiary education environment. Wikis, fully editable Web sites, are easily accessible, require no software and allow its contributors (in this case students) to feel a sense of responsibility and ownership. A comparison between two wiki studies will be made whereby one group employed user login and the other maintained anonymity throughout the course of the study. The results consider the democratic participation and evolution of the work requirements over time, which in fact ascertains the nonvalidity of administrative identification.

Moving from face-to-face to online classrooms: the reflective university teacher

This study explores the similarities, differences and possible interaction between two small groups of Canadian and Australian university teachers’ face-to-face and online teaching approaches and philosophies. The paper compares their perspectives on teaching face-to-face and online at two comparable Canadian and Australian universities, both of which offer instruction in these two modes. Teaching philosophy data were gathered with the ‘Teaching Perspectives Inventory’ developed by Pratt and Collins at the University of British Columbia, which assessed participants’ teaching approaches and philosophies in terms of their beliefs, intentions and actions in both modalities. The study upon which this paper is based builds upon a well established research partnership of the two authors who have previously explored emerging philosophies of learner centred teaching in distributed classrooms in Canada and Australia.

Doing literacy online : teaching, learning and playing in an electronic world

The essays in this volume provide an international perspective on persistent and emerging questions related to the use of online technologies for teaching and learning. They demonstrate that online literacy practices can be understood only when they are examined within their social, political, economic, cultural, and historical contexts.

Teaching philosophy : moving from face-to-face to online classrooms

This article explores the similarities and differences between Canadian and Australian university teachers’ face-to-face and online teaching approaches and philosophies. It presents perspectives on teaching face-to-face and online in two comparable Canadian and Australian universities, both of which offer instruction in these two modes. The key research question was to determine if moving from face-to-face instruction to on-line teaching results in new teaching approaches or in a creative blend of those developed within each teaching modality. Qualitative data were collected using an open-ended survey, which asked participants for their thoughts on their face-to-face (f2f) and online teaching experiences. Quantitative data were collected using the “Teaching Perspectives Inventory,” which assessed participants’ teaching approaches and philosophies in terms of their beliefs, intentions, and actions. The authors’ conclusions address the issue of assisting teachers to successfully make the transition from traditional teacher-centred to newly emerging learner-centred teaching approaches in distributed classrooms.

Online delivery and learning in regional Australia : benefits and barriers

The potential for online learning to enhance learning opportunities of those living in regional Australia cannot be over-emphasised. This chapter* describes a study where online delivery was mapped to determine ‘what’ is happening and ‘why’. This enabled the benefits, barriers and ‘promoters’ of online learning to be identified. However, an important conclusion of this study is that there is a lack of consistent, comparable enrolment data relating to online learning, which obviously affects funding allocation decisions. To ensure high-quality learning experiences and appropriate support for students and staff, institutions require adequate funding and resources based on models which reflect the reality of online delivery and learning.

Blended and online learning : student perceptions and performance

Purpose – The purpose of this paper is to improve educator knowledge of the antecedents and consequences of blended learning in higher education.

Design/methodology/approach – A longitudinal case study approach is adopted. Three case studies each involve tracking a student evaluations of teaching (SET) measure (willingness to recommend) and grade point average for three subjects from the same business discipline over six years. The cases involve comparison of: a business subject taught solely online; a business subject where experimentation in the blend of face-to-face teaching and learning is involved; and a business subject where face-to-face teaching is primarily used, and where in the most recent iteration online content supplements the learners' experiences.

Findings – The findings suggest that there are situations where integrated use of blended learning involving face-to-face teaching, digital media and digital communication with simple navigation between the content items leads to positive student perceptions. This is in contrast to negative student perceptions in the situation where learners must navigate in online learning, and where there is little or no face-to-face instruction. While not examined in detail, nor part of the research question, it is not surprising to find no relationship between learning mode and grade point averages is evidenced.

Research limitations/implications – The effects of prior computer literacy and language proficiency across the students used in this study, and potential demographic and experiential differences between on-campus and off-campus students are not controlled for. Additionally, only three business subjects are investigated and it is recognised that there is a need for a broader study. Finally, with response levels to the university-controlled SET that typically range between 20-43 per cent for these large subjects, there is possible non-response bias that it was not possible to counter over the six years involved.

Practical implications – The findings in this study suggest that while blended learning offers many benefits to higher education institutions and learners alike, care needs to be taken in the manner in which such approaches are implemented in light of possible negative learner perceptions where a less traditional approach is taken.

Originality/value – A major contribution of this study is the fact that experimentation has taken place in terms of the degree of face-to-face and online learning that have been blended in at least one subject (case study two), and the fact that the SET for this subject are compared, longitudinally, with two other subjects which lie on either side of this subject in terms of the extent of online and face-to-face teaching and learning employed – 100 per cent online in case study one and almost 100 per cent face-to-face in case study three.