Section 7 Post#4

This will be a very brief post at the conclusion of this section's postings. One of the topics of thought for this week was ethics in distance learning. In my mind, I think of student situations that would not be considered ethical or moral, such as having someone else do the work for the student, using somebody else's work, plagerism, etc. But my final thoughts or more a parting question on this particular topic is one that I found in an article ICDE Dusseldorf 2001 Special Presidential Session on Ethics in Distance Education and Open Learning at http://www.learndev.org/ICDE2001-Ethics.html This is from panelist Fredric M. Litto (submitted April 3, 2001, who questions about liability with such concerns as what if the student complains about the distance learning course's poor quality - who is responsible.? One of the concerns we have in our nursing department is the fact that several nursing students that have failed our courses have attempted to sue, based on what they claim is inadequate content and preparation from the courses. That is the main reason our syllabi are so frequently scrutinized by us and our objectives are always aligned with the NCLEX licensing exam. Our courses are reviewed, updated and changed prior to every offering. Our syllabi and assignments never change once a course begins because we feel it is our contract with the student. The only thing that is subject to change (which is clearly written throughout the syllabus) is the calendar because of weather etc.

Section 7 post #3

I'm surrounded by distance learning today, well maybe that's an exaggeration. I've just finished 3 crueling hours (with Elliot-misery loves company) doing BLS CPR Renewal online. Actually it was fun - and most convenient to do in your own home, very conducive to learning especially with the new changes that are now in effect. Now on Monday, we will need to do hands-on practice of the skills. If anybody is interested in renewing their CPR this way the site is www.onlineaha.org there are also videos as well as text and testing. Really cool!

Section 7 - post#2

Continuing with my interest in online teaching/learning and community colleges I found an article entitled Online Education in Community Colleges: Conversations With the Field by Robert Threlkeld, Monterey Institute for Technology and Education, 2006 at http://www.league.org/publication/whitepapers/1006.pdf My community college has an enrollment of over 5000 students with approximately 200 full-time faculty and of course a tremendous amount of adjunct faculty as well. Currently we offer about 5% of our offered courses as either online or hybrid courses. My department, the nursing department, has but one, and it is a hybrid module in pharmacology. From an earlier section that peaked my interest, I'm reviewing the statistics to see which students are performing better in drug calculations and pharmacology - those that took a hybrid class or those who were in a f2f class. I will have more info on this by the end of this semester.

Anyway the article discusses trends in community college towards online courses. What is interesting are the factors that influence online education in these colleges. Of course, finances and resources are an important factor, but the article mentions other obstacles such as the institutional leadeership, policies and procedures, faculty culture and support of course creation.
At my institution, it starts with faculty having an interest and an idea. Once that instructor has created the objectives and course content, it must be presented and accepted by the curriculum committee. There is minimal instuctional design support and even more minimal technological support. However our leadership is supportive of faculty creativity. There is also contractual guidelines for renumeration for creating course, workload, and the number of students per course. I'm getting excited to put units of my fundamentals of nursing curriculum online. After we are finished with this program - I'm hoping to know how to do it.

Section 7 Innovations in Distance Learning

I found this article Web-Mediated Faculty Professional Development: Improving Learning, Building Community and Assessing Outcomes by Robert W. Fulton, Paula E. Noonan and James M. Dorris at http://www.league.org/publication/whitepapers/1004.html This was of particular interest to me both at the Community College and for the Hospital Community. Time and distance are such obstacles for anybody to attend Professional Development Offerings even though they are contractual requirements. Surveys were given to 28 faculty members who took an on-line offering. In brief the comments elicited from one of the questions on the survey were: "better learning experience", "more flexible", "more interactive", "more focused, scholastic and professional' "less traveling", less leaving normal duties". The comment that there was "access regardless of status, workload of employment level" and "leveled playing field" really impacted upon me - there have been classes that I have been to where there are the dominators and I felt restricted to get into the discussions. We at the hospital, in particular, are looking at several web-based courses (Health Streams) to reach more employees, tap into the various learning styles and of course what the hospital is primarily interested in is cutting the cost of orientation and staff development.

Section 2 - Distance Learning Communities

The distance learning community that I chose is Health Care - specifically Telemedicine/Telehealth. At Robert Wood Johnson University Hospital, I am responsible for the providorship of continuing education for the nurses. Presently our educational activities that grant CEUs are mostly face to face. This type of offering while extremely informational is very inconvenient in a major institution that is addressing a nursing shortage. The nurses do not have the time to leave the units to attend such a class in the other end of the institution. So it is one of my goals to offer them more on-line offerings.



Telemedicine/Telehealth offers many opportunities. Telemedicine is defined as clinical services where health care providers (physicians, nurses, etc) can bring access to health care to the people in rural or urban areas. Techniques, diagnoses and treatments can be shared and taught from one institution to another anywhere in the world provided the technology and funding is available. Telehealth sometimes referred tp an an umbrella term to encompass both, delivers continuing education such as CME's for physicians and CEU's for nurses and other allied health professionals. These can be generic or related to specialties. Also under this rubric is community education where patient education is given to both patients and families.



There are two basic modes of delivery - Store and Forward, with such examples as radiographic studies stored and sent on to other institutions for further analysis and diagnosis; and Two-way Interactive Television (IATV) which is live and allows participants from many sites to interact at the time of the offering or face to face for consultations. Both modes involve technology and or the use of the internet. The higher the level of technology to allow for the use of peripherals, the capability of bandwidthes, and Use of ISDN or IP the more sophisticated and enhanced the health care and programs can be. Examples of equipment used are electronic stethoscope, electronic otoscope, examination camera and dermascope to aid in long distance assessments and diagnoses.



I found many phenomenal programs in existance:

- KUCTT Kansas University Center for Telemedicine and Telehealth started in 1991 and now considered one of the most active telemedicine programs in the world. The program offers clinical services, continuing education and community education. An example of one of the services is TeleKidCare touted to "Bring the doctor to the school" a health care delivery system where a physician can "exam" and diagnose children in the nurse's office at their school. Since it's beginning approximately 10 years ago - 57% of the cases were mental health issues and 38% were ENT problems. The goal of KUCTT is for the people of Kansas to have access to the best available health care and education and technology. The education and care is to be administered in a professional, timely and convenient manner. http://www2.kumc.edu/telemedicine/2008Technology.htm

-The Idaho State University Institute of Rural Health offers Virtual Grand Rounds (VGR) offering education onf specialty care more accesible to rural and urban health care providers. From 2001-2004 3,910 person-hours continuing education was given over 42 video-conference sessions. The largest group of participants (25%) were nurses. http://tie.telemed.org/

-The University of Wisconsin Medical School - Continuing Medical Education program offers CMEs via conferences, workshop, home study, distance learning by teleconference, PC or PDA.

-MyNursinsingCE Learning Portal - Online continuing education via self-learning modules.

- The University of Wisconsin Collaborative Nursing Program for RN to BSN degree via Distance Learning.



The barriers to Telemedicine/Telehealth include:

Individual states requiring that physicians have licenses in the state that the patient is in, in order to care for those individuals.

Even thought the cost of care can be lest expensive - CMS restricts medicare reimbursement in mant instances, as well as many private insurers placing the same restrictions.