...technology has created many opportunities to develop new teaching strategies in nursing. The past decade has seen a significant increase in the use of electronic media in educational settings. This use of technology has created many opportunities to develop new teaching strategies in nursing. Of concern, however, are challenges facing faculty who did not “grow up” in the computer age. Today’s expectation that faculty will use electronic technologies in their teaching can be particularly stressful for nursing faculty with little or no computer knowledge. This can be compounded when the faculty person is teaching many students who have grown up in the computer age. These students are often referred to as the “Net Generation” based on their digital literacy and need to be electronically connected. As Sherman noted in 2006, meeting the needs and expectations of diverse generational cohorts can be challenging.

Most schools of nursing are already suffering from a shortage of faculty (American Association of Colleges in Nursing [AACN], 2005). The additional burden, on already stressed faculty, of mastering new advances in technology and developing electronic courses could potentially hasten the departure of many highly qualified faculty members from schools of nursing, thus exacerbating the already existing nursing shortage. Actions must be taken to retain highly qualified nursing educators through support and training programs focused on developing technological skills.

The additional burden...of mastering new advances in technology and developing electronic courses could...hasten the departure of many highly qualified faculty members from schools of nursing... With the rapid expansion of electronic learning environments, the need to bridge the gap among the generations of educators and learners is critical. Programs to prepare faculty to gain the requisite knowledge and experience needed for implementing technology as a teaching strategy must be developed. This article will describe a Technology Fellowship Program (TFP) designed to assist faculty as they develop technological competencies to enhance their teaching skills. The article will describe one University’s initiation of a TFP, the School of Nursing’s faculty involvement in the Program, the implementation of a technology-learning project, and an evaluation that identified desirable qualities of a technology mentor, described the learning experience, and noted resources needed to increase the use of technology by faculty. This TFP prepared me to serve as a mentor and guide for less experienced nursing colleagues, helping to make their transition to using electronic media in their teaching less daunting.

Background

The work setting for practicing nurses has undergone rapid technological changes in the past ten years. In 1997 Saba and Riley began noting the need for nursing students to develop the technological skills they would need as practicing nurses. Today the use of technology in healthcare is no longer optional, as noted by a federal mandate in April of 2004 in which the United States government called for the nationwide adoption of electronic medical records. This created an immediate need to prepare a technologically competent workforce. In 2005 Johnson listed employers, including those who hire nurses, who require computer literacy as one of the important trends impacting nursing education. Nursing education now has, and will have, no choice but to prepare nursing students in as many ways as possible to work in a highly technological environment.

...the use of technology in healthcare is no longer optional,As early as the 1990s nursing education did begin to incorporate technology into the teaching process as power-point presentations started replacing the overhead projector, and electronic communication via email became an expectation. In 1997 the National Council (of State Boards of Nursing) Licensure Examination (NCLEX) for registered nurses was first offered via computer. Concurrently the National Informatics Agenda for Nursing Education and Practice (1997) recommended that more core computing and nursing informatics concepts be included in the nursing curricula, clearly defining the future for nursing education.

Soon the compelling need for technological fluency and competency among nursing educators emerged. In 1999, an ANCC white paper addressed the significance of technology in nursing education and acknowledged the occurrence of inevitable revolutions with this new technology-mediated teaching. As noted by Neuman in 2006, the impact of technology on nursing education has indeed changed traditional nursing education. The innovations allow for more choices, enhanced faculty-student interaction, and variations in learning.

Integrating technology into nursing education requires an educator who is prepared to facilitate an effective learning experience. Nursing educators are now recognizing that they must step up and join in this revolution or risk becoming obsolete. Nursing education administrators continue to endorse ongoing faculty development and involvement in the area of distance education and the use of technology in the teaching-learning processes.

[By the late 1990s] the compelling need for technological fluency and competency among nursing educators emerged. Of concern, however, is how this revolution affects nursing faculty who are dealing with the myriad of other issues in nursing education, including an educator shortage. The efforts needed to address shortage-related concerns, together with the burdens and stresses of learning a new technology can increase the dissatisfaction with the nurse educator role, and in turn may contribute to an even greater faculty shortage. The arguments for supporting the integration of technology into teaching and learning are true. However, they do beg the question “Who is prepared to teach the teachers how to integrate technology into the curriculum?” 

Several nursing agencies have begun to address this question by offering structured programs to prepare nursing faculty to use technological advances in their teaching endeavors. The University of Indiana, in collaboration with the National League for Nursing (NLN), offers a series of online courses in web-based learning. The program, titled “Teaching & Learning in Web-Based Courses Certificate Program,” began in 2001 with the goal of increasing knowledge, experience, and teaching skills for nursing educators. Topics include: (a) an introduction to web-based teaching, (b) designing web pages for online courses, (c) teaching and evaluation in web-based courses, and (d) a practicum for the web- based educator that provides practical application of the web-based teaching experience. Participants may complete all four courses and earn a certificate or take a single course as needed.

The American Association of Colleges of Nursing also provides a comprehensive, web-based program for nurse educators. This program, “The Education Scholar Program,” is designed to advance teaching skills, professional scholarship, and instructional improvement for educators in the health professions. One of the online modules in the curriculum guides the educator in preparing and delivering educational content using a variety of distance education resources.

Fortunately nursing is not alone in its struggle with the technological revolution in education. The infusion of technology into higher education is not unique to nursing. Campuses nationwide have identified the need to enhance the availability of technology and promote the development of online courses and degree programs. With the impetus to expand the use of technology, faculty must be prepared to use available resources, have access to needed support, and develop competency for using resources and support throughout the curricula.

EDUCAUSE, a nonprofit association of more than 2,000 colleges, universities, and educational organizations, was created to promote the “intelligent use” of information technology. Since its inception many universities have participated in its continuing education, national program and initiatives for mentoring, and its development of information technology (IT) professionals in higher education. A major initiative is the ongoing development of virtual communities of practice (VCOP). The VCOPs function as persistent online forums allowing individuals with common interests to explore and address shared issues or problems. The EDUCAUSE web site provides updated resources and research for educators and IT professionals.

University Program

In order to promote the use of technology and provide development for faculty seeking to improve their technology-related teaching skills, our urban university developed a unique program known as the “Technology Fellows Program” (TFP) to recognize, encourage, and reward faculty members who are leaders in the innovative use of technology in teaching and learning. The primary purposes of the program are to support Fellows in gaining knowledge about and utilizing information technology regarding both different learning techniques that can be used in the classroom and various mechanisms to link individuals having common interests. The program goals are: (a) to produce a diverse community of practice whose members would become recognized as leaders in technology integration for improved instruction in their fields, (b) to promote the use of collaboration techniques in teaching and learning, and (c) to insure that students attain a reasonable degree of information technology fluency for their discipline in the classes of involved faculty.

Ten faculty were selected from a pool of 22 applicants through a competitive process based on applications which described their teaching philosophy, experience with technology, and specific goals or needs for instructional development. All applicants were endorsed by their Dean and Department Chair; and the selections were made by a committee consisting of senior faculty, administrators, and Advanced Learning Center staff.

The selected Fellows represented ten different disciplines and came from four different schools and colleges of the University. A unique feature of the program was the diversity of faculty represented in the group. Participants represented areas such as nursing, science, engineering, sociology, English, communication, and the fine arts.

As faculty from various colleges on the campus came together, it became evident that technological skills could be developed in many different ways. In the English department computers were outdated and faculty members were resistant to moving forward with technology. These colleagues shared the challenges of having adequate resources to implement large scale projects and decided to focus their project on increasing the use of technology in the freshman English courses. In other colleges, such as engineering and business, where the demand for technology is significant, faculty recognized that graduates must be prepared to use successfully cutting-edge computer software. Faculty participants from these areas planned for more interactive learning projects to prepare future graduates. Collaboration with faculty teaching the pre-nursing science courses was an added benefit of participation in the TFP. It allowed me to recognize how nursing students’ use of electronic courseware prior to taking nursing courses was already allowing them to become more comfortable with these technologies. As a group the TFP participants were supportive of new ideas and challenged one another to think in non-traditional ways. Members acknowledged similarities in their zeal and quest for innovative teaching strategies, and shared their teaching philosophies, strategies, and student evaluation methods.

The program began in the June, 2004 and ended in May, 2005. The training began with a week of half-day sessions conducted by various technology experts. During the University workshops TFP participants were introduced to new ideas and state-of-the-art technology and shared their individual experiences related to teaching and learning using technology. An overview of the information technology facilities, software, and instructional technology available across the campus  was provided during these sessions. In addition, campus experts from library resources and curriculum development, technology leaders, and university administrators were introduced to the participants. Each of the experts shared information about how they could be helpful to enhance teaching skills and expand the use of technology on the University campus. The program leaders and support staff were instrumental in challenging and supporting each participant in brainstorming and developing departmental (school) project proposals. One of the most challenging aspects of the process was the need to narrow broad aspirations and visions associated with project proposals.

Each Fellow received a laptop computer, a small stipend, software specific to their project, training, and consultation for the year. Fellows agreed to attend scheduled face-to-face sessions and develop, during this program, one significant project for their department that focused on a way to enhance technology throughout the department and the University. The end product was showcased at the end of the program year. The program consisted of a hybrid of instructional strategies, specifically, face-to-face, hands on labs, and online learning, as well a discussion, collaboration, and individual opportunities to brainstorm and investigate practical applications for the use of technology in teaching.

The School of Nursing Program Involvement

After the initial sessions offered by the University, I began working with the School of Nursing (SON) Dean and the Associate Dean to identify specific SON courses that could benefit from integrating electronic technology into the course. We identified two online courses for undergraduate students, the Nursing Research course and the Nursing Issues and Trends course, which at that time could be taken either online or in the traditional classroom setting. Interest in the online courses had grown significantly and we noted a clear need to expand the number of sections for students taking the course online. Additionally, a new graduate degree in nursing had just been approved and would include the use of both electronic and traditional classroom sessions. The concurrent, rapid growth of technology in the SON, and the steep learning curve for faculty implementing the new programs required action. Discussions with the Dean and Associate Dean of Nursing, anecdotal experiences of “emergent calls from colleagues,” and review of the strategic goals for the SON guided the discussions about the areas of focus for this University project within the SON. Building upon this information and in consultation with the leaders of the TFP program the following observations were made: (a) SON faculty were committed to using the course-management system adopted by the university (b) faculty lacked competency in using the available technology, (c) this lack of competency had resulted in challenges and frustrations for the faculty, and (d) help with online course development was critical to the success of the newly adopted hybrid graduate program. Based on the identified needs within the nursing program it was decided that the TFP mentor (TFPM) would mentor selected nursing faculty, assist with the implementation of online courses, and develop an electronic repository of key resources.

This mentoring project which I headed was named, “The Evolution of Technology into Nursing Curricula: Supporting Faculty via the Technology Fellowship Program.” As a current nursing faculty member, I knew the strengths of these courses and understood the challenges inherent in integrating technology into these courses. I presented an outline of the SON project proposal during a faculty meeting and invited colleagues to participate in this project to expand the use of technology in the SON with an emphasis on course development and individualized support for nursing faculty. Four faculty members eagerly expressed an interest in being mentored and identified immediate learning needs for the upcoming semester. These needs and goals are described below.

Faculty Member #1 chose to develop the ability to teach the Nursing Research course online and to develop competency in utilizing the electronic, course- management system. This online course had been developed and taught by the TFP mentor over the past three years. The specific technology skills needed by this faculty member included skills in developing and grading course discussions, developing and grading quizzes and exams, and preparing two, narrated slide-presentations of nursing journal article critiques. The faculty member self-reported computer skills as “weak,” and was “very committed” to participating in the project. This colleague was selected based on many previous interactions with the TFP, including face-to face instruction, telephone conferences, and discussions related to stresses and fears about technology.

Faculty Member #2 requested assistance in developing online learning modules for two graduate-level nursing courses for our new hybrid graduate program which would have 50% of the courses taught in the classroom and 50% taught online. The identified learning needs included: (a) learning to use an html composer program to develop interactive modules, (b) learning to upload files and learning modules to the course-management system, and (c) developing increased competency with other resources, such as virtual class and quiz preparation, using the course-management system. The faculty member identified computer skills as “comfortable” and was eager to expand the integration of new technology into the course. This colleague was selected based on the immediacy of learning needs, prior participation with the pilot program to integrated electronic testing in the undergraduate program, and the expressed interest to possibly become a future TFP participant.

Faculty Members #3 and #4 chose to work together on their project. They requested assistance in managing computerized examinations for their undergraduate nursing courses. Specific skills they desired to focus on included: (a) developing and uploading questions in Respondus^© (an electronic test bank program), (b) up-loading exams in the electronic, course-management system, and (c) managing the exam administration, analysis, and statistical programs. Both faculty members were confident in their basic computer skills and felt they needed more hands-on instruction to successfully use the electronic test bank program. These two participants were selected because of their specific learning need. The TFP participant attended a seminar and successfully mastered the use of Respondus^© as a tool for developing and managing examination questions. The two faculty members also agreed to assist other colleagues as they gained confidence with the program.

Project Implementation

Based on the varied needs of the faculty, a plan was developed both to address the immediate needs (described above) of these faculty and to provide resources to guide faculty when face-to-face interaction was not needed. The mentoring I provided included scheduled face-to-face instruction, experience and practice forums, and development of online tutorials and a resource repository. These mentoring activities will be discussed below.

Face-to-Face Sessions

Many of the nurse educators on this faculty were at the novice or advanced-beginner level in the use of technology. Skills, such as word processing, graphic and presentation software, and electronic course-management systems presented a daunting challenge for them.

Use of a standard template proved to be most effective as it allowed for ease of learning and a consistent, standard look for electronic course materials. For the most novice participant, who had been assigned to teach a course using the electronic course-management system, I offered planned, face-to-face, instructional sessions that provided the most essential guidance in using the electronic course- management system. The course she had been assigned to teach had typically been taught using learning modules, quizzes, discussion boards, group projects, and real-time chat for office hours.

I met with this faculty member each week for one to two hours. Initially I spent our time together teaching her how to create learning modules using a simple html editing program. I created a template to aid in formatting and ease of including web-based learning links. Use of a standard template proved to be most effective as it allowed for ease of learning and a consistent, standard look for electronic course materials. Once the learning modules were created, I taught her to upload graphic files and modules, several of which included presentations with narration. Time was dedicated to setting up the narration tools, converting files to the required format, and uploading to the courseware system.

In the following weeks the face-to-face sessions with this computer-novice faculty included my teaching the steps in answering email communication, posting and replying to discussion topics, and creating quizzes. The most challenging skill for a novice technology user is often related to the lack of intuitiveness in certain electronic programs. Unfortunately, the electronic course-management system had an email system that worked very differently from the traditional email program used by the campus. This created obstacles for this faculty member and often required on the spot telephone support to complete tasks such as downloading or sending attachments. In this situation, the course was being taught as the faculty member was learning and refining technology skills. Because this is often the case for faculty, the need for just-in-time learning and the availability of reliable and knowledgeable support is essential.

...the need for just-in-time learning and the availability of reliable and knowledgeable support is essential. Faculty participants who had stronger technology skills also used the learning module template to create learning exercises for their students. The support they required consisted primarily of short sessions or step-by-step guides that included screen captures with precise information needed to create exam question sets, develop examinations, and manage the electronic testing format. As part of the mentees’ participation in this project, informal support networks began to emerge among all the faculty as they began to embrace the use of electronic testing for all course examinations in the nursing program.

Experience and Practice Forums

The University had previously adopted a course-management system for the campus that could be used to provide access to class materials, such as slides, study materials, and course examinations. In this system, all electronic communication could be conducted within the system for easier organization and communication between and among students and faculty. The nursing faculty participants spent considerable time practicing their technology skills in using this system. This practice in using the system in their ‘student’ role provided them with valuable insight into what they could expect their own students to experience, thus enabling them to better anticipate students’ needs in using this system.

The nursing faculty with the stronger technology skills studied the various tools in the system and decided to learn how to use those they felt would be most valuable for their students. This process was developed as an experiential exercise. Two practice forums, “Developing and Implementing Online Testing,” and “Hot Topics and Questions” provided hands-on learning for using the interactive discussion forums. These forums allowed questions to be posed by the participants as they responded to the instructions provided. This particular course-management system did not include editing capability; and faculty quickly learned to develop their more lengthy responses in a text-based program, spell check the response they had developed, and then copy and paste the response into the system. In order to maintain these two interactive forums, faculty members were asked to participate as least one time each week to mimic the true “anytime/anywhere” learning experience. In addition, the electronic-chat room was used on one occasion to provide “real time” instruction for holding “office hours” with the nursing students. These nursing faculty also gained skill in using the course-management features that facilitated their development of a repository to organize and store instructional tools for future review.

Online Tutorials and Resource Repository

Online tutorials provided by proprietors of the course-management system and the test-bank program were helpful in assisting faculty to enhance their ability to use online technology. As part of the mentoring process, other resources were also reviewed and key elements identified to assist these faculty in acquiring, improving, and maintaining their newly learned, online-technology skills. Information from these online resources was shared with these faculty and in many cases found to be helpful both in reinforcing what had been learned and, in some cases, learning new skills. Participants were then asked to choose resources they felt were most needed to facilitate online course development. The following resources were selected and developed: (a) Instructions for Exam Preparation, (b) How to Use Respondus^©, (c) Template for Webpage Development, and (d) Weblinks to Additional Resources. Instructional guides were created using precise, concrete information and screen captures. Emphasis was given to details easily missed by a novice user. The weblinks section included: (a) “Hot Potatoes,” a free resource for interactive games, (b) Merlot’s Multimedia Education Resource for Learning and Online Teaching, which provides a collection of peer- reviewed, teaching materials for higher education, and (c) Respondus^©, a proprietary company that develops assessments, testing, and electronic games.

Project Evaluation

This mentoring project was evaluated through observations, made by the SON TFPM, of the faculty person’s ability to offer an online course, through an item on the course evaluation, through individual interviews with each participating SON faculty member, and through my own self-evaluation of this project. These evaluation processes identified factors that contributed to the success of this project.

Evaluation by Observation and Evaluation Question

The ability of these four SON faculty to develop and implement online learning modules, organize and upload course materials, and initiate and monitor the electronic discussion forms was evaluated by a question on the students’ end-of-course University evaluation form and by TFPM observation. The end-of-course evaluation form assessed faculty skill in developing and implementing an online course. The students reported that the courses developed by these four faculty demonstrated effective use of technology. The TFPM observed that faculty had indeed mastered the skills needed to develop and implement an online course.

Evaluation by Interview and Self-Evaluation

An additional aspect of the project evaluation involved individual interviews between the TFPM and each SON faculty member involved in the project, along with my own self-evaluation. In the faculty member interview, faculty were asked to respond to the following three questions:

1. How did participation in the technology mentorship change your technology competence?
2. What aspects of the project did you find most helpful?
3. Did the mentorship assist you in meeting your goals?

The responses to these questions were content analyzed to identify mentor involvement that facilitated faculty development in preparing and offering online courses. The following themes were identified: (a) qualities of the mentor, (b) the learning experience, and (c) access to resources. Each will be discussed in turn.

Qualities of the mentor. Mentoring is a process or relationship established to provide support, feedback, and problem-solving guidance among colleagues who share resources, insights, practices, and materials. (Robbins, 1999). As noted by Barker (2006), mentoring is most often a planned relationship between an experienced person and one who has less experience in-order-to achieve specific outcomes. The mentor must avoid appearing as an expert to the protégé; and rather be seen as a source of support, encouragement, and guidance. Cangelosi (2004) described characteristics important for the mentor as including generosity, competence, self-confidence, and a commitment to the relationship. In addition, the focus must be kept on the needs of the learner with the understanding that situations may place the protégé in vulnerable situations that create a sense of insecurity. The mentor must engage the colleague in such a way as to promote success, enhance learning, and provide critical feedback and guidance. Smith and Zsohar (2007) described the elements of inspiration, nurturing, and taking time to focus on the individual as keys to successful mentoring. These qualities in the mentor were noted by various mentee responses during the interview. One participant stated:

I asked for help as needed and did not feel like my lack of ability or knowledge about computers was a barrier. I had attended classes for some of the things I wanted to learn, but often felt too embarrassed to ask for help [in class] especially if other people were catching on quicker than I could.

Another participant noted:

The willingness to problem solve with me helped me learn how to use the technology on my own. Her example has encouraged me to take on the responsibility of developing and teaching an online course and to apply for the Technology Fellowship Program myself.

The importance of the mentor in helping the faculty person achieve desired outcomes was described as follows:

You were available and continue to be available when I have questions about managing and analyzing the data from the exams. Those questions become fewer or the questions are different because as I master certain aspects of these programs, new things pop up for me to think about or ask.

A key factor in being a mentor is providing an environment that allows for a fluid exchange of information, ideas, and concerns. Overall, effective mentoring relationships improved the quality of learning experiences and fostered satisfaction for participants.

A key factor in being a mentor is providing an environment that allows for a fluid exchange of information, ideas, and concerns. In self-evaluating the project I realized it was helpful for the participants to have a mentor who was herself a nursing educator. This allowed the mentor to focus solely on the technology needed for the SON. The faculty members and I already had a mutual understanding of the curricular requirements, school policies and procedures, and program goals thereby reducing the need for discussion or explanation of how or why processes were implemented. In many cases a technology expert is extremely helpful in the technical aspects of developing or posting content; however, the curricular aspects are not easily conveyed or understood by the technology expert. In this project the opportunity to maximize time and specifically focus on the technical aspects were critical for accomplishing the outcomes.

The learning experience. The challenges of keeping up with new resources will remain for the foreseeable future. Hence developing commitment and the confidence to explore and experiment with new electronic strategies was essential to the success for each participant. Each of the participants commented on the need to have a strong commitment to accomplishing the established learning objectives. Their satisfaction with this learning experience is noted in the following three quotes:

Each time I learned a bit more and now have just about mastered this set of new knowledge.

I have found that my comfort level and competency in doing the things you describe has increased significantly.

I appreciated your handbook/guide to uploading exams to the course site. I have referred to this on numerous occasions, which has meant that I have not had to call you directly.

...[participants] realized that the use of technology is here to stay and must be embraced and mastered rather than avoided. These participants noted their perseverance, ease of learning, and continued growth in personal confidence with technology. They also noted a decrease in frustration with using computers, less fear of attempting a new, electronic process or teaching strategy, and confidence they will continue to learn new skills to enhance their teaching. Most importantly, they realized that the use of technology is here to stay and must be embraced and mastered rather than avoided. As noted by Saba (2001) the technology revolution is here to stay. It most definitely will become more expansive and the need to develop and maintain technology competence will become greater for all nursing faculty.

Access to resources. Having the appropriate technology infrastructure and up-to-date resources is also critical to successful learning. Our University provided excellent support for the faculty, in that each faculty had their own office with a desktop computer, software, and resources for support. It was an expectation that nursing faculty use electronic communication, such as email and interactive discussion postings, with students.

Conclusion

Use of technology in nursing education has significantly changed teaching strategies and will continue to challenge nurse educators in the years ahead. The digital age is here to stay and the rapid growth of the digital age will continue. Developing the needed fluency with technology should not be fraught with frustration. Faculty development is crucial and needs be a continuing focus for nursing education administrators and faculty alike both to enhance student learning and retain faculty.

This article has described a faculty mentoring program which provided faculty with the skills they needed to offer online nursing courses. It has also discussed the qualities of both the mentor who is able to help faculty learn these skills, and the needed commitment of faculty who desire to be mentored. The required resources for such a program are also presented. Faculty with technology expertise are encouraged to consider how they can provide support for their colleagues who have weaker computer skills or need to learn how to use new programs. In addition to formal mentoring by a fellow colleague, formal certification programs are increasingly available for nursing faculty through universities and other professional organizations and agencies, although cost and time constraints may prohibit participation by some educators. Educators and nurses seeking programs to expand their skills with technology may investigate the electronic resources listed in the Figure below.

Author

Lawrette Axley, PhD, RN, CNE
E-mail: naxley@memphis.edu

Lawrette Axley has fourteen years of experience as a nursing educator. She is an Assistant Professor of Nursing in the baccalaureate and graduate programs in the Loewenberg School of Nursing at the University of Memphis (TN). She was selected by the University to be in the first group of faculty members participating in the Technology Fellowship Program (TFP) at the University of Memphis. The purpose of this program is to recognize, encourage, and reward faculty members who are leaders in the innovative use of technology in teaching and learning. This competitive award is given to ten University faculty members each year.