This academic year marks the 20th anniversary of our online graduate program in informatics. As I mentioned in my last column (Skiba, 2017), I have been reflecting on the many changes that have happened in the realm of distance learning, including the various regulations now in place by federal and state regulatory bodies. In the old days, I did not need to check a matrix to see if I could admit a student from a particular state. I admitted students and provided them a quality education program, but those days are gone.

In case your school does not yet offer any online programs, here are some things you now need to consider. First, there have been numerous efforts at the federal level to connect Title IV funding for higher education institutions to state authorization compliance in terms of distance education programs (Parks & Dowd, 2017). Specifically, since 2010, the US Department of Education (DOE) has made several attempts to enact state authorization regulations. In December 2016, the DOE released regulations for State Authorization of Post Secondary Distance Education, Foreign Locations, with an enforcement date of July 1, 2018. As noted in the Federal Registry (DOE 34 CFR Parts 600 and 668 Federal Register/Vol. 81, No. 243/Monday, December 19, 2016/Rules and Regulations), here are the major provisions of this regulation:

* Require an institution offering distance education or correspondence courses to be authorized by each state in which the institution enrolls students.

* Define the term "state authorization reciprocity agreement" to be an agreement between two or more states that authorizes an institution located and legally authorized in a state covered by the agreement to provide postsecondary education through distance education or correspondence courses to students residing in other states covered by the agreement.

* Require that an institution provide public and individualized disclosures to enrolled and prospective students regarding its programs offered solely through distance education.

THE STATE AUTHORIZATION ON RECIPROCITY AGREEMENT RESPONSE

The State Authorization on Reciprocity Agreement (SARA) was developed in response to the impending regulation. According to Parks and Dowd (2017, p. 5), "SARA allows participating higher education institutions in SARA member states to engage in a wide range of educational activities a cross state lines without a need for the IHE [Institutions of Higher Education] to pursue traditional state authorizations."

Currently, more than 1400 higher education institutions from 47 states and the District of Columbia are part of SARA. The bottom line is that, if yours is a SARA institution, you can offer distance education in other SARA states. (Check the SARA map to see if your state and institution are part of SARA, http://nc-sara.org/sara-states-institutions.) In non-SARA states, you can contact that state's DOE to see what is required to offer distance education programs to state residents.

THE NONDIDACTIC COURSE DILEMMA

Now that you know you are authorized to offer educational programs in certain states, your next dilemma is related to nondidactic online courses, such as clinical practica, internships, and experiential learning. In some instances, if you have an internship, with an adjunct faculty member supervising the internship, this may trigger the definition of "physical presence," which in turn may mean that you need state authorization.

In the case of health care professionals, the state board of nursing (BON) may dictate additional requirements. This is of particular importance for prelicensure and advanced practice nursing programs. According to Parks and Dowd (2017, p. 3), "Additional approval may be required by a state professional board if the educational activity is part of a program that leads to professional licensure or certification."

Now let us examine the views of the National Council of State Boards of Nursing. On the council webpage (http://www.ncsbn.org/671.htm), the focus is on prelicensure programs, with the warning that schools that offer both didactic and clinical courses in another state must be in compliance with that state's BON rules. This is particularly important in terms of whether your faculty must be licensed in that state for teaching both didactic and clinical courses. The bottom line is, if you are not in a state that belongs to the Nurse License Compact, you need to contact the BON.

States have different requirements for prelicensure and postlicensure programs, and there are even differences in postlicensure programs if students are in a program that requires certification, such as a nurse practitioner program. For example, we cannot offer our NP program in certain states without getting BON approvals, but we can offer our indirect care role program, such as in informatics, which is not regulated by the BON. Our program actually dedicates a person to contact each state's BON.

REGULAR AND SUBSTRANTICE INTERACTION

The next item to examine is whether your online courses meet the "regular and substantive interaction" rule. In 2005, the DOE expanded Title IV funding to include telecommunications in courses. In 2006, according to Poulin and Davis (2016), the DOE noted that this ruling was added to distinguish between correspondence and distance courses. As noted in the audit report for the administration of Title IV programs for Saint Mary-of-the-Woods College (US DOE Office of the Inspector General [OIG], 2012, p. 11), "a telecommunications course is a course offered principally through the use of one or a combination of technologies including television, audio, or computer transmission through open broadcast, closed circuit, cable, microwave, or satellite; audio conferencing; computer conferencing; or video cassettes or discs to deliver instruction to students who are separated from the instructor and to support regular and substantive interaction between these students and the instructor, either synchronously or asynchronously." If a course does not meet these requirements, it is considered a correspondence course.

This is further clarified in the Code of Federal Regulations, Title 34, and Education [S]602.3 (34 CFR [S]602.3), which includes the following definition of distance education: "education that uses one or more of the technologies listed in paragraphs (1) through (4) of this definition to deliver instruction to students who are separated from the instructor and to support regular and substantive interaction between the students and the instructor, either synchronously or asynchronously" (http://www.gpo.gov/fdsys/pkg/CFR-2014-title34-vol3/pdf/CFR-2014-title34-vol3-sec).

Since the audit report in 2012, many questions have been raised as to the meaning of regular and substantive interaction. Poulin and Davis (2016) noted that "there now seem to be four criteria that the Office of Inspector General is expecting in a course for it to be considered as meeting their expectations for interaction:" The four criteria are the following:

* Interaction must be initiated by the instructor.

* Interaction must be "regular" and probably somewhat frequent.

* Interaction must be "substantive," of an academic nature.

* Interaction must be with an instructor who meets accrediting agency standards.

Since this posting, the notion of "regular and substantive interaction" has risen again in the DOE OIG final audit of the Western Governors University (WGU). In this audit, it was determined that WGU was not eligible to participate in Title IV programs. One reason stems from an analysis of course design materials. It was found that "at least 69 of the 102 courses were not designed to offer regular and substantive interaction with an instructor and, therefore, did not meet the regulatory definition of distance education" (DOE OIG, 2017, p. 3).

Of course, there was rebuttal from WGU and a series of postings across the blogosphere. In a post by Lieberman (2017), who interviewed prominent leaders in online education, I saw three dominate themes: 1) There is concern about how we balance innovations within education and the need for federal financial aid for students; 2) the report "did not put students first," and there is a need to balance prevention of fraud "while allowing innovations to improve student learning" (Poulin); and 3) "sadly, the Office of the Inspector General began this latest report by abdicating any consideration of quality when it stated, 'We did not assess whether the [WGU] model was improving educational quality or expanding access to higher education'" (Davis). All are issues that we in academia need to address as online education continues its presence in higher education.

What should we be doing in nursing education, particularly if we are providing online education? I offer you a sage advice from Poulin and Davis (2017): "Our main message to you is to react, but don't overreact. Done properly, this Report can be used to prompt healthy reflection on quality, faculty and student interaction and other practices in your distance education, CBE, and other courses."

As we proceed into 2018, we will start the dialogue to engage in reflecting on faculty and student interaction as well as best practices and quality in online education. As always, your thoughts are welcome at mailto:[email protected].

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