E-learning in tertiary-level nursing education in Germany and the role of the nurse educator
Lee F. Koch, MSc, RN; Uwe Fasshauer; Karin Reiber
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Purpose: Experts in Germany’s healthcare sector predict a rising need for at least 10% of the nursing workforce to be academically trained. In light of increasing occupational demands, some even anticipate a much higher quota of 50%. New legislation set to reform nurse education in Germany includes provisions for a partial transition of basic nurse education from vocational training to the tertiary level (equivalent to a BSN). In order to provide opportunities for nurses to gain academic degrees, the number of academic nursing programs must increase. This presupposes an increased need of qualified faculty with the professional and scientific training necessary for tertiary level nursing education. At the same time, e-learning is becoming more commonplace in tertiary level nursing education. Research has shown that e-learning can be just as effective at helping students achieve learning objectives as traditional face-to-face courses, provided that certain quality criteria are met. The decentralized, asynchronous nature of e-learning enables individualized and varied learning as well as the possibility of reaching many more learners than with conventional methods. However, it also precludes spontaneous, personal interaction between the instructor and the learner, which affects teaching and learning processes. In addition to this, learning objectives in nursing are not only within the cognitive, affective and psycho-motor domains, but also include clinical skills, a domain in which e-learning has its limitations. These circumstances lead to the assumption that e-learning has changed the nurse educator’s role.
Research Questions & Objectives: How will e-learning affect and change tertiary-level nursing education in Germany? How will these changes affect the developing role of tertiary-level nursing educators? The results of this study will show experts’ expectations of future developments in tertiary-level nurse education and the nurse educator’s role in light of the increasing prevalence and importance of e-learning in the form of virtual teaching and learning arrangements.
Methods: One of the premises of symbolic interactionism is that patterns of interpersonal interaction contribute to the sense of identity of the subjects. The interaction between instructor and student is a central element of the teaching and learning process. The subjective views of the participants in these interactions must therefore be considered, in order for us to gain insights into how e-learning affects nurse education and the nurse educator’s role, thus placing both student and instructor in the role of an expert. According to role theory, however, social roles (such as that of the nurse educator) are collectively defined, making it necessary to consider both normative input as well as the views of other stakeholders. Thus the decision was made to include members of scientific and professional nursing organizations as well as media designers involved in the production of e-learning modules on the expert panel. A total of 20 panel members was agreed upon, drawing five members from each subgroup of experts. Assuming an average panel mortality of 40%, this leaves us with input from at least three experts from each subgroup.
A three wave Delphi survey combining both qualitative and quantitative methods is being conducted, as this allows us to determine not only the experts’ subjective views on the effects of e-learning on nurse education and the nurse educator’s role, but also to compare their expectations of future developments in nursing education and the nursing educator’s role in light of the increasing prevalence and importance of virtual teaching and learning arrangements. The first wave questionnaire was comprised of open-ended questions and was administered to a select group of experts (n = 8) from each of the four subgroups. Seven questionnaires were returned and the data was evaluated utilizing Mayring’s method of qualitative content analysis. The second and third wave questionnaires were comprised of statements extrapolated from the results of the first wave and an earlier literature review. These were administered to the expert panel (n≥ 12) who were asked to indicate the degree to which they agreed with each statement. The second wave data is currently being analyzed using quantitative methods to determine percentages of agreement. In the third wave, those items having reached a consensus in the first wave will be excluded. The experts, having been provided feedback on the 2nd-wave results, will then be asked to idicate the degree to which they agree to each statement. The variance between answer tendencies in the 2nd and 3rd waves will then be analyzed.
Results: The first wave resulted in statements which could be grouped under four main codes pertaining to e-learning in tertiary level education in general, to e-learning in tertiary level nurse education, to the influence of e-learning on role of tertiary level educators in general, and to the influence of e-learning on role of tertiary level nurse educators. The statements pertaining to the effects and influence of e-learning on tertiary level education in general and the tertiary level educator’s role in general were informative and could be useful for further research on this general topic. Of primary interest, however, were the results pertaining to nurse education and the nurse educator’s role. The experts state that, while e-learning is conducive to many learning outcomes in nurse education, there are certain outcomes, such as clinical skills, clinical decision making, or caring, for which e-learning is not suited. Furthermore, electronically mediated communication and interpersonal interaction, which are considered vital elements of nurse education, lead to a depersonalization of the relationship between instructor and student. The experts also conclude that a vital aspect of the nurse educator’s role is their function as a professional and academic role model, which e-learning hampers. The data from the second wave is being collected and analyzed at the time of abstract submission. Results from the second wave will be available by the time of presentation in July 2017, while results from the third wave may be available by that time. This knowledge could prove useful in re-designing curricula for the training of tertiary level nursing educators.
Conclusion: This study contributes to field of tertiary level nurse education by providing insight into how e-learning is changing nurse education and, at the same time, affecting the role of the nurse educator. The results are important for re-designing curricula for the training of tertiary level nursing educators in order to adequately prepare them for the challenges posed by e-learning. The results can also inform the practice of current nurse educators involved in e-learning by helping them to critically reflect their own teaching practice and to gain a deeper understanding of their role in the virtual setting.
Limitations: Due to limited resources, this study is being conducted on a small scale, with panel members drawn from stakeholders involved in e-learning in nurse education in Germany. The results may not necessarily apply to other disciplines or to tertiary level nurse education in other countries.
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship
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