Integrating digital fluency skills to engage and empower graduate-level nursing students in a hybrid course

Health care professionals participate in online graduate programs to advance their practice. They opt for online programs, primarily for flexibility with course work and to be able to juggle work and family responsibilities. However, online learning can also be an isolating experience because students have less opportunities to connect with peers and faculty, as compared to conventional (residential) graduate programs. Yet, evidence suggests that students learn better when they form important communities of practice with peers. These connections positively contribute to the learning experience. How might instructors balance these compelling constraints to craft an active learning experience in a hybrid, graduate-level course? It is vital to offer structured flexibility in academic programs, while integrating technology that facilitates communication and co-creation of knowledge. This offers meaningful learning and sustainable, scalable programs.

We will share our rich experience from one course where we strategically chose technology readily available to students, but that also allowed them to gain skills that were transferable to their work environment. We also provided scaffolded (i.e., gradually increasing level of difficulty in the applications to be used, one application at a time) and structured (i.e., a conscious selection of tools to meet specific learning and engagement objectives) support for faculty, that noticeably complemented their technical skill development for online teaching. This support included frequent one-on-one sessions with the instructional designer and ongoing support with best practice use of technology tools. In this conference session, we will use participant polling and a think-pair-share activity using a virtual whiteboard to discuss our course design and learner feedback. 

Attendees will be able to identify at least two evidence-based strategies to engage learners, determine how to strategically select multimedia tools to enhance digital fluency among learners, and discuss the advantages and constraints of specific digital fluency tools. We believe that participants will be able to take away some ideas for how to integrate elements of this workflow in their own teaching environment, based on their individual course needs and institutional resources.

Improving Quality, Safety and Outcomes in Healthcare Systems is a graduate-level nursing course.

 Students take this course as part of their master’s and doctoral training in the Healthcare Systems track. The course was designed to meet synchronously, on site, five times over the course of the fall semester (16 weeks), the remainder of the content was presented through self-paced, asynchronous modules. Course content focused on collaborative group work and synthesis of concepts.

As a team of one instructional designer and two faculty members, we identified a need to focus on building social presence and facilitating meaningful peer-to-peer interaction throughout the course with the goal of positive learning outcomes. Prior studies link these concepts to student retention and learning satisfaction. We also believe that both faculty and graduate students needed to become digitally fluent, or comfortable with the idea of using multiple multimedia tools in their course work. In a digital learning context, fluency involves using technologies “readily and strategically to learn, to work, and to play, and the infusion of technology in teaching and learning to improve outcomes for all students.” Digital fluency is a relevant and imperative skill in any work environment.

We consciously organized students into small discussion groups from different practice settings to ensure professional diversity. Each person was assigned a reading role: Discussion Leader, Connector, Devil’s Advocate, and Reporter. Each role has specific responsibilities. For example, the Connector role linked current discussion to past readings, course topics, or life or work experiences. Thus, each person in the group had a specific role for the reading assignments and they each contributed to their discussion with a specific task in mind. Students remained in the same group throughout the semester. For group discussions, we felt that the use of video conferencing technology (Zoom) would facilitate more robust peer discussions, rather than asynchronous text-based discussions in the learning management system, which tend to be dry and resemble a string of comments. Students received structured, scaffolded support by way of a demonstration and instructions on how to use the video conferencing tool. Our work occurred prior to the current COVID-19 Zoom environment.

To foster instructor presence in the course, especially for the weeks when the course was not meeting synchronously, course faculty prepared short videos that were embedded in the weekly lesson content within the learning management system. Faculty also received a demonstration and support on how to use the video creation tool, WarpWire. Both faculty and students had ready access to IT support as needed.

At the end of the semester, we tabulated our purposeful engagement of technology and students. The course instructor created 15 short videos in addition to ten text announcements and ten email messages to the class. The students participated in four video-based discussions with their group, in addition to two text-based discussions.

At mid-semester, we examined student perceptions of video-based group discussions compared to face-to-face discussions, and asynchronous written discussion forums using a three-item survey administered through Qualtrics. To make this seamless for students, a link to the survey was embedded in the learning management system. Of 34 students in the class, 22 responded. Of those, 68% preferred the video-based discussion. Students felt more engaged. They also felt that this method was more natural, human, and enjoyable. “The zoom session allows to talk through the reading material which helps me better understand the material”. It also helped students develop strong professional contacts in their practice areas, especially since these are graduate students. However, students also reported difficulty scheduling due to work responsibilities. We therefore adapted the course design and modified the number of required video discussions. We consciously selected quality over quantity of discussions and followed up by adjusting the scoring of the assignments accordingly.  When asked what was going well, one student said, “Professor being "present" every week. Weekly reminders are really nice.” Another student said, “I like how you post a short video of the overview of each week, so it's easy to understand the plan for the week.”

At the end of the course, 65% of the class participated in the anonymous course evaluation sent out by the department. Of those who responded, approximately 95% the students felt the course was designed to keep them engaged in learning. Approximately 86% felt the instructional techniques engaged them with the subject matter. One student said, “I got to develop better relationships with my classmates, and it felt meaningful.” Another student said, “Zoom discussions were [a] more efficient use of time and compared to asynchronous discussion boards and a creative way to engage in the subject matter.”

During one of the five face-to-face class days one group noted a member was absent. This group was able to include them using video conferencing to participate in the discussion. This made the absent student feel included and they were all able to contribute effectively in their reading roles as scheduled. On that day, students were also easily able to substitute one technology for another (Zoom for Facetime), thus demonstrating digital fluency in their use of technology, once they had understood the approach.

Future implications: Based on the feedback students praised the interactive element of virtual discussions but they did not like the scheduling primarily due to difficulties negotiating work schedules. Much has changed since Fall 2019! We have all advanced in our digital fluency, use Zoom with great frequency, and we have explored Zoom breakout rooms. For similar learning needs, we propose having the instructor schedule time and assign breakout rooms ahead of time. This will allow students to focus on the discussion rather than the scheduling. This approach would mean students would have relatively less flexibility but that may be off-set by polling students at the start of the course to identify times that work for most people.

While we always work with the tools that we have now, we need to cultivate a mindset of agility and creativity with technology. Therein lies the need to achieve sufficient digital fluency that will allow our nursing graduates to effectively fulfill their roles as nurse managers and quality improvement resources within their institutions. We expect our graduates to support their teams and patients by using the right technology for the right purpose, based on their actual experience with the technology.

In a post-COVID environment, where time and attention are scarce, we are all now a little savvier with technology and increasingly aware of multiple tools at our disposal. It is even more important to be strategic in planning how students will engage with one another, and how the instructor will engage with the students, professionally. It is beneficial to map out which tools will be used and for which specific interactions they will be used. The importance of integrating instructions and having reliable IT support cannot be overstated. Such a scaffolded, structured approach can lead to meaningful learning and sustainable, scalable program development.

(Abstract: 1474 words)

References:

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