Online teaching and learning pedagogy is increasingly an expectation of faculty in schools of nursing. 1 The ability to learn in the online environment helps students continue their education and stay current in their profession. Hybrid classes are courses in which significant portions of the learning activities have been moved online. This combination of traditional classroom and Internet instruction can be a mechanism to empower students to engage in lifelong online learning and communication.

In hybrid classes, time traditionally spent in the classroom is reduced but not eliminated. In this example, senior undergraduate nurses enrolled in the required leadership/management class were given the opportunity to meet face to face once weekly instead of the usual two-class schedule. The other content, assignments, and discussions were completed via the Internet.

Orientation

The initial class session was held in the computer lab so all students could log into the course simultaneously. After the initial welcoming statements the instructor led the students through a discussion of why computer and online technology is important for professional nurses. The discussion included the responsibility to stay current in this dynamic profession. The need for lifelong learning and being able to search the Internet for reliable and current research relating to their practice was also discussed. Students were also told of the possibility of completing many of their graduate degree classes in an online format that would offer convenience and flexibility in their schedules.

Using the Blackboard software system, students were then asked to move through the course pages for this particular class. Course information, syllabus, schedule, faculty contact information, Microsoft PowerPoint slides, and a description of course assignments were available. Students voiced pleasure with seeing the entire semester organized so they knew the course expectations.

Next, students were asked to complete interactive activities that included using the discussion area to introduce themselves to their peers, first by name and then by describing their dream automobile. This activity enabled the students to relax and have fun while learning the mechanics of the Blackboard system.

Students were then asked to move electronically into their assigned group and complete the activity that included a discussion of how to solve the parking situation on campus. One student was asked to be the facilitator and another the recorder. The group was asked to reach a consensus and then post their solution for the rest of the class to read. Again, this was low stress but students were successful and gained confidence in their ability to use the system.

Lastly, students were asked to log into the online quiz; they felt immediate anxiety and fear of losing points toward their final grade. Students were encouraged to try; repeated words of support were given. Students soon saw that the quiz consisted of easy multiple-choice questions. The purpose was not to test on course content but to teach the skills. All students were allowed to earn 2 points for this exercise. The earning of points seemed to be a major focus throughout the semester.

Students were then asked to vote if they were willing to try the online course format. The traditional class was scheduled for early Monday morning; the flexibility of not being in the classroom at 8:00 a.m. was a motivator. Every student in the class reported having computer and Internet access from home.

Concerns

Questions and comments were encouraged. Options to contact the professor electronically, individually, in confidence, via the general discussion board or in an anonymous hand written note, were given. The most common concern voiced during the initial class session was that their final grade for this class might be lower than grades received in a traditional classroom. Students were shown literature that clearly reports little change in student grades in the online environment. 2,3

Additional student concerns included questions such as, "What if I miss an assignment?" "What if the technology crashes?" and "What if I can't understand the material presented in the online format?" Students were assured that reminders for assignments would be given for the first 2 weeks of the course. Telephone numbers for office, home, and cell phones for both the faculty and the teaching assistant were given to students with instructions to call if problems arose. The class was also reminded that their input and evaluation was important in this new mode of instruction.

Students were told they would be asked to vote after 4 weeks of class to decide whether to continue the online coursework or return to the traditional face-to-face meetings. This process seemed to provide sufficient reassurance and all agreed to at least try the hybrid methodology.

Testing

The first quiz on course content caused increased stress for students. Most of the anxiety seemed to evolve from fear that the technology would not work or their score would not be recorded. To support the students through this anxiety they were allowed to take the first quiz twice and were told that their higher grade would be recorded. Course content was being covered, but the goal of this exercise was to allow students time to master the mechanics needed for online test taking. These quiz points did count toward their final grade and students learned that they had to read and understand the material to pass the timed quiz.

For the second quiz, students were allowed to take the quiz twice and their scores were averaged. Students quickly learned that taking a quiz without preparing adversely affect their average score. The students were engaged in understanding the course content as evidenced by their discussion questions directed toward the instructor for clarification.

Evaluation

Feedback and evaluation continued throughout the semester. Likert scale surveys were done at 4, 8, and 15 weeks. The lingering concern was the technology's unpredictability. Students were given clear instruction of how to report problems. Ninety-three percent of the students reported reading as much or more as in traditional classrooms and 90% reported they had learned as much or more as a traditional class. Several also noted that being comfortable with technology might help on the NCLEX exams. Ninety-two percent reported they would consider taking another online class.

The final exam was given online in a proctored classroom. Final exam scores and course grades were similar to previous semesters. The overall class composite for the critical thinking Health Education Systems, Inc. (HESI) 4 standardized exam for leadership and community was 92%. Of special note is that technology problems occurred while completing the HESI exam. Students had to be moved to an alternative laboratory for testing. This cohort, while frustrated, remained calm and joked about the technology while waiting to write their exams. Perhaps the technology frustrations of the semester had even greater benefits than were first apparent.

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