The number of online programs in higher education has exploded across disciplines over the last decade, leading to increasing access to learning opportunities. Interaction between online students and their faculty, affecting student engagement, is challenging.1-3 Some research has explored interventions to increase student engagement in online education. Stanley et al4 increased student engagement through video simulation scenarios and VoiceThread technology. Claman5 implemented a synchronous Multi-User Virtual World Environment to enhance student engagement in a family nurse practitioner online program. In response to faculty assessment of student engagement needs, a new online learning laboratory was developed and implemented in 2 undergraduate courses, Fundamentals of Nursing Care and Health Assessment, over the last several years.
Significance
The undergraduate BSN curriculum is delivered via traditional brick-and-mortar and online options. In the online track, electronic Learning in Nurse Education (eLine, 2003), students study didactic portions of the course entirely online and attend clinical experiences in a face-to-face clinical environment. The online delivery of the Fundamentals of Nursing Care and Health Assessment courses involves static and interactive lessons. Lessons and readings serve as the lecture course content. Internet conferencing is used in the didactic sections to clarify content and communicate expectations.
On completion of didactic work, students are required to demonstrate skills competency via check-off prior to clinical practice. Initially, students were expected to view commercially prepared videos and asynchronously communicate questions to the course faculty prior to the skills check-off. However, skills are dexterous activities, and mastery requires practice, a challenge with online learning.6 Students came for the check-off lacking adequate preparation and confidence. Students also expressed dissatisfaction with the commercially prepared videos.
Innovation Implementation
In 2013, eLine underwent a comprehensive revision designed to improve student engagement. Video conferencing technology was used to create an online synchronous learning laboratory, through which faculty were able to interact with the students synchronously and demonstrate skills. Recording of these video conferencing sessions was intentional as eLine promoted anytime, anywhere learning. In addition, according to Astin's7 Theory of Involvement, students require different levels of engagement at different points in their academic career. The recordings provided an asynchronous option, and the level of engagement was in the students' control.
However, challenges remained, and student expectations rose. During the synchronous session, students were able to see the skill demonstration full screen, but asynchronously, students reported the recorded frame was too small. Students were unable to visualize or had difficulty visualizing the demonstrated skills and reported issues with download speed and sound playback.
eIslander
Two major changes were implemented in summer 2014. The first was the integration of Apple iPad devices into the online learning laboratory sessions. Multiple iPad devices serving as IP cameras for multiple angles were used to stream onto the desktop (screen share) to use the video conferencing recording feature. The camera angles from the tablets were thus in full screen mode in the recordings. The tablets were intentionally secured on microphone stands at an appropriate height to mimic an actual nursing student in uniform, creating a paradigm shift. The effect brought the online student physically into the classroom, even when watching asynchronously. This gave the student the feeling of being in the classroom and provided a stronger student "presence" for the faculty.
The second major change was providing students with skills kits and otoscope/ophthalmoscope check-out opportunities for practice at home. With these supplies, students were able to demonstrate skills during video conferencing sessions. Faculty could correct skill inconsistencies, and students could practice performing skills correctly with faculty guidance in real time. Students watching the recording asynchronously also benefitted from the correction of skills inconsistencies and practice. This new ability to correct inconsistencies in real time was significant for students and faculty. It was as if the students were physically present with the faculty in the laboratory setting.
eIslander also integrated face-to-face readmitted students and more senior-level students. Readmitted students not only attended the laboratory as students, but also assisted with technical support and served as health assessment models. Students gained a sense of accomplishment and added a peer interaction component to the laboratory sessions. Students further along in the program volunteered to attend laboratory sessions for technical and peer support. Using the training center feature, included in the video conferencing software, laboratory quizzes were added. Student responses could be displayed in aggregate, and live discussions between students and faculty ensued. The review of quiz questions allowed for clarification of concepts and provided an opportunity to discuss testing issues such as anxiety, misreading questions, and test-taking strategies.
Outcomes
The students provided valuable feedback on the technical pieces of the laboratory experience including lighting, sound, and playback speed, but other themes also emerged. The most significant theme was a feeling of connectedness with faculty and each other that lasts across time. Tinto8 suggested that student success is highly dependent on student engagement. Tinto's8 4 conditions of success have come to fruition in the eIslander online learning laboratory. The learning laboratory has clear and high expectations and provides academic and social support. Faculty and peer interactions occur in every learning laboratory. The laboratory offers frequent assessment and feedback about student performance. Students perform skills and assessments receiving immediate faculty guidance and feedback via the same means as students learning in the brick-and-mortar setting. The online skills laboratory innovation actively involves students and faculty, which according to Tinto8 is necessary. We intentionally planned to increase active involvement in the online classroom to address the student's lack of adequate preparation and confidence during check-off. Check-offs were less stressful for the students, and they were better prepared. The need for delayed clinical practice was as good as eliminated.
Lessons Learned
We learned some lessons as we implemented the online learning laboratory. It became apparent there was a need for improved Wi-Fi connectivity and increased recording storage capacity. The shared bandwidth for Wi-Fi connectivity was sometimes slow. The online learning laboratory setup is currently hardwired to the internet, which limits scheduling space. Wi-Fi connectivity is being addressed, and the university expanded recording storage space.
Faculty, in front of the camera, learned some lessons. Facing the camera and not turning away from the microphone avoided muffling the sound. An external USB microphone was added to improve sound quality. Similar to acting, faculty taped x's on the floor as reminders of where to stand to be seen/heard on the video. Faculty also needed to remember to talk to the camera, not only to the people physically present. Having the students "in" the iPad devices helped because faculty could see them as if they were actually physically present. Wardrobe selection was important; striped or printed tops tended to make the skill demonstration difficult to see.
Conclusion
The online virtual laboratory (eIslander) has improved student-faculty interaction in the first semester. Based on current literature, using this innovation for the delivery of online nursing courses could lead to improved student outcomes as well as student satisfaction with learning. Previous use of technology has been focused on content delivery rather than engagement. This innovation involves the use of video conferencing technology to create an engaged virtual classroom and laboratory environment. This pedagogical innovation is important to faculty across disciplines, providing a mechanism with which to engage online students not only synchronously, but also personally.
Acknowledgments
The authors thank DeAnna Hensen for extensive assistance with the online learning laboratory.
References