Web-Based Informatics Education: Lessons Learned From Five Years in the Trenches L.K. Goodwin RN, C, PhD Duke University, Durham, NC linda. goodwin(d,duke. edu Abstract Duke University has a five-year history with high-quality and clinically oriented informatics web-based nursing informatics education. This paper highlights an overview of instructional methods used and pedagogical considerations for both students and faculty. To do the job well, faculty workload for web-based instruction has been more than double the time and effort required for teaching an on-campus course. Results suggest that virtual teamwork is difficult but possible for highly motivated students. Committed to excellence, Duke's program finds that most students do well in achieving their goals and achieving Duke's high standards of academic rigor, however some students are not successful with on-line courses. BACKGROUND A new paradigm of technology-based pedagogy and its application to learning have been slow to evolve in our informatics domain; this seems paradoxical, given the nature of informatics immersion in technology. Traditional teaching derives from the time of the great philosophers like Aristotle, Plato and Confucius and the practice of an oral tradition. The interaction of teacher and pupil, master and novice allowed for the transfer of specific facts and information and the seeds of knowledge to be sown. This "sage on the stage" model of teaching and learning has been with us for more than two millennia. Through the ages, as populations and technology have developed, the process of teaching and learning has also evolved. Within old paradigms, an instructor demonstrates their expertise (sage/wisdom) in a given topic by imparting what they know to a targeted group of learners. The learners are expected to take in the information, determine its relative value or relevance, and regurgitate on demand. This "tell'em and test'em" format has never been effective in promoting real long-term learning. However, it remains the method that most of the world's learning institutions utilize and the one with which most individuals are comfortable. A more appropriate faculty role involves a "guideon-the-side" role where learning opportunities and experiences are structured by the faculty, and the real effort of learning is left up to a motivated student. Transitioning from old models of "sage on the stage" to a role that involves active learning on the part of the student can be surprisingly difficult for both faculty and students who have grown comfortable in the old "sage" paradigm. Many students find distance learning courses are ideally suited to their busy lifestyles, and they do well at adapting to web-based and technology-intensive learning modalities. Other students often begin with good intentions but find that their learning styles or personal discipline are not good candidates for success with on-line courses. Sorting out the pros and cons of web-based informatics courses will be an important area for continued research and development in the next decade. And objective criteria to help evaluate the quality and pedagogy of proliferating web-based AMIA 2002 Annual Symposium Proceedings 300
informatics programs will be an important contribution for future students in our informatics discipline. * Faculty workload LESSONS LEARNED Based on five years of experience, we are now convinced that it is considerably easier to teach campus-based courses from a faculty workload perspective. Advanced planning and preparation require enormous investments of faculty time to develop quality online course materials that consume at least 2-3 times more effort than traditional classroom teaching. If this preparation time were paid back with less time in teaching during the semester, there might be an even trade-off, but this has not been our experience in the Duke program. In our rapid-moving informatics domain, the need for annual content updates has rendered most online content obsolete and in need of revision each year. And faculty support for distance-based students has required more time each semester than a comparable campus course. While it would be possible to manage online courses without a high level of faculty involvement, our experience finds that maintaining quality and high academic standards requires a high level of faculty interaction. The difficulty with high levels of faculty interaction and involvement is that it competes with academic research priorities and can lead to both frustration and faculty burnout. Varying strategies have emerged for faculty to deal with competing demands for high levels of interaction and involvement with online students while developing and maintaining an academic research career. Year 97-98 99--00 00-01 01-02 Faculty Heavily Partially Minimally Partially Involve- involved involved involved involved ment 24 X 7 12 X 7 but with using with with weekly multiple Online weekly audio strategies Students office office I I_ Ihours hours I Two years of year-round heavily involved interaction with online students resulted in significant faculty burnout. Alternate experimental models tried setting limits on the hours of response and levels of interactivity, and those work well for faculty but not well for students. The most recent experiment seems to be the most successful and uses a negotiated model of interaction that includes weekly synchronous seminar discussion, frequent email that is answered promptly most of the time, and faculty phone calls to each student at least twice a semester. When faculty has competing demands and deadlines, the students are notified and asked to be patient for faculty responses when possible and to be sure to communicate urgent needs that will not wait. This remains an imperfect process in search of ongoing solutions. * Small student cohorts and virtual teamwork Duke's web-based program was originally designed to create a caring and collaborative culture for a group of 12 advanced-practice nurses throughout a year-long post-master's certificate program. Curriculum, pedagogy, learning assessment, and course structure are deliberately designed to support virtual learning teams that develop collaborative leadership strategies. Students have attended Duke's program from Alaska, Canada, California, and states throughout the Midwest and East Coast. Traditional academic settings were 301
historically geared for the convenience of the faculty and the institution. Today's students lead busy personal and professional lives that they often maintain while pursuing their education. Key to the success of distance-based pedagogy is a collaborative culture that creates a "virtual learning community" that is student-centric and helps students genuinely feel that they are an important member of a course. Easy access to faculty is an important component of a student-centric culture; however, providing this level of support creates an enormous burden on faculty if they remain available via email, or other modes, on a daily and round-the-clock basis. To accommodate students' busy lives, Duke's program uses a combination of asynchronous content delivery and required virtual teamwork that includes both asynchronous and synchronous interaction. Scheduling of synchronous team meetings has been challenging when students live in 3 different time zones. Synchronous modalities utilized the old-fashioned telephone conference call, and newer strategies involving Internet chat and audio communications. Multiple efforts to use synchronous video technologies have met with mixed results where some of the students who live in remote areas of the country have been limited to slow modem access that yield poor bandwidth and failed video conferencing results. Year 97-98 99-00 00--01 01-02 Virtual Email Email Email Black- Team- Phone Phone Phone board [4] work ftp ICQ [1] ICQ chat; Tools ftp Lotus Groove [5] multiple Notes [2] failed ftp synchronous efforts e-circles and Firetalk [3] Successful strategies used in Duke's program find student groups scheduling times to complete their team assignments using primarily email, ftp, Internet chat, and audio conferencing technologies. Duke students have reported that their virtual teamwork experiences are amongst the best and the worst of their experiences with the program. Students are required to provide graded peer review and feedback to their team members; this process helps manage typical problems with laggards and over-achievers in balancing out a team's workload. The virtual team facilitates student interaction and connection with their classmates, thus avoiding a pervasive problem where distance students may feel isolated and drop out [6]. But the time and frustration when technology fails often adds considerable stress in a web-based learning environment, both for students and for faculty who are trying to provide distancebased support. * Content Delivery Duke's program combines a block of oncampus time each semester with web-based content mastery. Students consistently report the on-campus sessions are their favorite part of the program, and they still prefer traditional personal interaction to web-based interaction formats. Typically, students will spend 3-4 days on campus each semester, and the program is launched with orientation at a campus session; the class of 2002 missed their campus session in September 2001, which resulted in fewer campus days and more stress for students who were trying to learn software and teamwork without the benefit of in person dialogue. Campus sessions are used for computer lab instruction, team building, and 302
traditional lectures for difficult content that is better provided in a real-time classroom. Year 97-98 99--00 00--01 01-02 Campus days in a yearlong 12 14 12 9 program There is general agreement, however, that online content delivery provides Duke's students with learning opportunities they would not otherwise pursue. Multiple strategies have been tried for delivering content to distance-based students. Students consistently prefer lectures that simulate classroom experiences and include both audio and video components that facilitate different learning styles. Future plans include adding streaming video to lectures and student project presentations. Year 97-98 99--00 00-01 01-02 98--99 Content HTML Real- CD and CD and delivery player Real- MS Powerpoint Web- player Windows [7] with based Media text notes streaming Player audio [8] streaming audio 9 ] * Intellectual property Since developing online course content is intensely tedious and time-consuming, it was both surprising and disconcerting to be contacted by faculty from other schools who wanted permission to re-use content from Duke's program when they were not authorized to gain access to our materials. After investigating and further questioning, we believe that well-intentioned students and faculty colleagues shared course materials by providing login information to web-based materials and by making copies of course materials provided on CD. This will probably remain a persistent problem, and grows increasingly worrisome as the number of nursing informatics programs continues to expand but without qualified faculty to teach in those programs. The MIT Open Courseware Initiative [10] may offer solutions to this unresolved problem. * Time management strategies Internet access is frequently problematic and at least half of the distance-based students change Internet service providers during the program. Even students who have cablemodem access are experiencing server problems and slow access to course materials. From both faculty and student perspectives, dynamic URL links remain consistently difficult to maintain and update even within a semester; rather than posting web resources for an entire semester, these are now done on a week-by-week basis to capture the most current links. Another frequent problem encountered by students is time management and information processing strategies, and a problem they have now labeled "link creep" (finding interesting URLs that aren't related to the assignments). Content modules that were designed by faculty for student completion in 2-3 hour timeframes were frequently reported to require 6-10 hours for students to master the material. Over time, students design information processing strategies that help them remain focused on their assignments while organizing and filing other URLs into folders for later review. Helping students learn time management information processing strategies is an embedded process that might benefit from more structure. 303
Faculty Email and Online Seminar Volume -or Web-Based Informatics Courses Summer 1997 18 766 849 514 Summer 1998 Informatics 10 311 408 630 Summer 1999 Issues 18 1148 1287 894 Summer 2000 6 280 394 172 Fall 1997 18 Not Collected Not Collected Not Collected Fall 1998 Applied 10 437 544 516 Fall 1999 Informatics 18 1017 1230 942 Fall 2000 Theories 6 168 244 67 Fall 2001 9 684 721 587 Spring 1998 18 304 447 NotCollected Spring 1999 Clinical 10 511 577 471 Spring 2000 Residency 18 901 1033 Spring 2001 Not collected Spring 2002 * E-mail overload The volume of email that accompanies a group of active and engaged leamers in an online course is sometimes overwhelming. The table above shows email volume from a faculty perspective. Students exchanged even more email that was not tracked and counted. Students report a minimum of 100-200 messages in their personal e-mail during the first week of class. This becomes exponential from a faculty standpoint. As time evolves, students develop improved strategies of communicating and filtering, but managing electronic communications continues to be a tedious and timeconsuming task for both faculty and students. Student immersion in the online course seems correlated with the level of faculty interaction and involvement with the students. DISCUSSION AND CONCLUSION In early May, each student submits a comprehensive portfolio of the work completed during their year-long Duke postmaster's certificate program. Over time, and in most (but not all) of the courses, an In Progress affective learning domain and a sense of virtual teams has fostered teamwork and developed both personal and professional relationships that have been sustained amongst the alumni even after graduation. Graduates now work in a variety of informatics roles that include work for hospitals, health care enterprise information systems (both in-house and outsourced), health care information systems consulting firms, and multiple health care information systems vendors. Based on five years of experience and lessons learned, Duke will expand their Nursing Informatics program to offer a mostly online new master's program that will begin fall 2002. REFERENCES (web links accessed 3/6/02) [1] http://www.mirabi1is.com [2] http://www.lotus.com/home.nsf/welcome/domino [3] http://www.ecircles.com and http://www.firetalk.com (now out ofbusiness) [4] www.blackboard.com [5] groove.net [6] Dorn, S. Creating the Dropout: An Institutional & Social History ofschool. Praeger Pubs. 1996. [7] http://www.microsoft.com/ [8] htt://www.rea1.com [9] http://www.microsoft.coni windows/windowsmedia/download/default.asp [10] http://www.creni.net/know/techtalk/events/mit.htm1 304