In the final three chapters of his text, Teaching Naked, author Jose Antonio Bowen discusses how and why the educational product is changing as well as why that change is necessary. He remarks that we have seen “change in the nature of the product, more customization and social isolation, and a global market of infinite choice” (Bowen, 2012, p. 222). In order to avoid some of the pitfalls experienced by other industries encountering rapid, technology-driven change, Bowen argues that both course and facility design must be altered. A large part of that redesign is the recommendation of a move toward increased technology integration and improved online content.
As consumers, students today have different needs and different expectations. They are less likely to perceive the socialization and overall ‘college experience’ to be worth the time and money it will cost, when an equivalent or even better product can be obtained online. They are, in general, a technologically savvy generation who expect choice, quality, customization and ease of accessibility (Bowen, 2012). The world is changing and the expectations of students are changing with it. As Bowen observes, “college has been focused on individual work and social interaction, but the world is becoming a place of collaborative work and social isolation” (2012, p. 228). As educators, we must prepare students for the world in which they will work. In terms of nursing education, there is no doubt that it has been and will continue to be impacted by the digital revolution. We must provide learner-centered education, collaborative learning, and simulation experiences in order to fully prepare students for the demanding and ever-changing profession of nursing (McIntyre, McDonald, Racine, 2013). Further integration of technology may well be one of the best ways to do that.
While there can be no argument that the digital revolution is changing the way in which we work, the demands of students, and the possibilities available for learning, we should be cautious about adopting technology in education for its own sake. As McIntyre, McDonald & Racine observed, “rather than uncritically embracing technology as a dominant pedagogical approach and assuming that technology affords improvement we need to consider carefully the competing demands of curriculum and its mode of delivery” (2013, p.46). There is much potential in the use of technology but we must question whether it may at times be used for reasons aside from, or contrary to, sound pedagogy. There may be times when decisions about online learning are legitimately made for other than pedagogical reasons but we must consider whether the means justify the ends. If not done well, technology adoption may come at the expense of student learning.
As educational institutions struggle to manage increased enrollment with decreased budgets, the move to adopt more online or hybrid courses is often a pragmatic solution. Furthermore, higher education needs to be made accessible to those residing outside of major centres. The value of access to nursing education should not be underrated in light of the shortage of practicing nurses. With a current shortage of 22,000 nurses and an anticipated shortage of 60,000 by 2022 (Canadian Nurses Association, 2013) the need to train nurses is critical. However, we must carefully assess both the potential utility as well as the challenges of technology as it aligns with a nursing curriculum. As Aoki observed “the instrumental view of implementation [of technology] minimizes or neglects the interpretive activities, the subjectivity of the teacher and students as they engage with curriculum”(as cited in McIntyre, McDonald, Racine, 2013, p. 47). We are unlikely to see an entirely online entry-to-practice nursing program capable of helping students fully meet outcomes. However, blended delivery or a flipped classroom could provide more time and opportunity for face-to-face exploration and application of the curriculum, thus improving the overall quality of nursing education. Numerous researchers have argued that learning through web-based simulation and other online strategies gives students greater control over their learning environment. They also gain the opportunity to engage in complex levels of knowledge application in a variety of contexts (Mgutshini, 2013). Academic success seems to be equivalent between students in online, hybrid, and traditional classrooms, however, self-reported satisfaction with education is higher for those engaged in online learning (Mgutshini, 2013). There is strength in the adoption of technology, yet educators must be cognisant of aligning their strategies with sound pedagogy. According to Sowan and Jenkins, a hybrid nursing course based on constructivist pedagogical principles should include: “interaction and collaboration among students, continuous support and encouragement to use the web-based part of the course, regular and prompt feedback about their performance, and clear information about expectations for the course requirements” (2013).
While many of Bowen’s recommendations for re-designing what a college education looks like seem directed toward large Universities, many of his points are relevant to any program and facility and clearly must be considered. Although there may be a change in the future, currently there seems to be low risk of my program losing students to other institutions. There is strong local demand for Practical Nursing Diploma programs at community colleges. However, we need to reconsider how we teach, based on practicalities, student demand, and sound pedagogy. We hold critical thinking and problem solving as dominant themes in all course outcomes, yet I question whether we are doing all that we can to ensure students develop these essential skills. As Bowen remarked, covering content is not a college’s strength, it is integration (Bowen, 2012). We need to teach students how to use the tools they will have available to them in the workplace, the majority of which will be online resources. Along with helping students to integrate and apply knowledge we can be optimistic about the development of online skills when we utilize technology in education. As McIntyre, McDonald & Racine remarked about the skills acquired through online learning, “scholarship, writing, facilitation, and technological skills are being increasingly valued as computer technology becomes a more integral part of professional nursing and health-care practice” (2013, p.50).
There are many possibilities for integrating technology into the Practical Nursing program. Although the curriculum is provincially mandated and individual facilities cannot change learning outcomes, we are free to develop our own teaching methods. I have many ideas that I will incorporate into our program in the Fall. I plan to create more simulation opportunities in the lab using high-fidelity simulators where students can integrate knowledge and skill in realistic scenarios. These simulation labs will be completed after students have worked through online content and discussions on our Learning Management System. I also plan to begin directing students toward more online resources when they work on projects in class, those that they will be using when they are working as nurses, such as online drug guides and disease databases.
Although most millennials, those born in the 1980s or 1990s, are adept with technology use we are seeing increasing numbers of people attending post-secondary education as mature students. The number of full-time undergraduate students over the age of 35 has tripled in the last 30 years, and graduate and trades programs continue to see an increase (AUCC, 2011). These students may be less immediately prepared to use technology as their counterparts. For any student, computer technology (including the unpredictability of computers & internet connections as well as the associated requisite skills to engage with technology) can either hinder or promote engagement with learning. In order to prepare students for technology use in the classroom and in their careers we will work closely with them throughout the program as they develop strong computer literacy.