DISTANCE EDUCATION IN NURSING

Introduction

The scientific and technological advancement have influenced and will continue to
influence nursing, as they do in all spheres of human activities. According to the
report of the high power committee of nursing and nursing profession, there is a need
or re organising of nursing education to keep it linked with the existing education
pattern and in order to keep pace with the changing pattern of health care delivery
system and the role of nursing personal. Since nursing functions are carried at
different level of knowledge, skills and most importantly decisions making, the
system of nursing education must have provision for preparing personnel accordingly.
The distance education help aid in that way of continuous nursing profession
development.

Meaning

Distance education is a form of education in which the students of universities and

institutes of higher learning do not attend regular classes or lecturer, but instead study
teaching material especially prepared for this purpose by professor and their staff
together with experts in distance education and interact individually with member of
teaching staff by mean of technical media for the guidance and control of their
learning. The students are not pinned, own to fixed times, place and person, but are
free to decide themselves when, where, what and how they wish to study.

Definitions

Distance education is defined as any learning experience that takes place distant away
from the parent institutions, home campus, or central headquarters.

(Keating SB,2006)

Distance education is defined as students receiving instruction in a location other than

that of faculty. (Clark CE, 1998)

Aims

It aims at not only providing certificate and degrees but also help in personal growth
and training for better job prospect, job enhancement and in service education.
 • To bring changes in attitude in addition to knowledge.

• Make education socially more relevant.

• Provide flexibility to time to enable students to pace there studies.

• Caters to educationally disadvantage groups like unemployed people living in

remote and rural areas, working people who can attend.

• Regular institution house wife etc…..

• Provide opportunities for self enrichment and professional upgrading.

Elements

To contribute to supporting the distance education trend, we need to review some of

the basic requirements and skills that the learner must master. And this is determined
according to the following elements:

Requirement:

REQUIRMENTS

SKILLS LEARNING
EVENTS

ELEMENTS

RESPONSIBILITY

We need many tools and equipment in the distance educational process, such as:

The computer, the Internet, and the printer, in addition to the basic drivers, such as
office programs, file play applications of all kinds, and multimedia players, such as
video, audio and images, educational sites, and approved educational platforms.
Skills

These are skills that the learner needs to acquire, such as:

1.Technical skills: Such as dealing with the Windows system, such as creating new
documents, using word and image processing software, producing visual
presentations, e-mail, safe navigation through the Internet, and the ability to download
the required programs and applications.

2.Personal skills: These are the skills that a person must acquire and develop in order
to equip him with strengths, such as taking responsibility, patience, perseverance, time
management, self learning, research, flexibility and passion, and critical and creative
thinking.

Learning events

The learning event is divided into two types:

1.Synchoronous learning: Synchronous learning is a type of group learning in which a

group of students are engaging in learning at the same time and in the same place.

In synchronous education, the teacher and students interact at the same time. Targeted
learners are required to log in to their computers during specified times.

Synchronous learning happens in real-time, often with a set class schedule and
required login times.

2.Asynchronous learning: Asynchronous learning is a form of education, instruction,

and learning that does not occur in the same place or at the same time.

Asynchronous learning is more self-directed, and the student decides the times that he
will learn and uses resources that facilitate information sharing outside the constraints
of time and place among a network of people.

For the success of the education process, students need to know the basics of dealing
with educational platforms, through preparation, communication, and interaction with
explanations and assignments, interaction with activities, their design, browsing and
navigation between sites, and ease of sharing information

Responsibility
To achieve the desired success in distance education, we need seriousness, solidarity,
cooperation, and a great deal of awareness and responsibility from family and school.

In order to achieve success, the distance education stage is a critical stage, and it
requires a high degree of honesty and responsibility. Because it is a patriotic, training
and educational duty.

A- The role of the family:

Family is the key to success because it plays the role of the direct supervisory
authority on the student in the distance learning stage. Its responsibility is to follow
up, monitor and observe, organize student time, and allocate time for study.

It is the family's duty to follow up on educational developments, communicate with

the school, request technical support, and consult when needed, without hesitation.

B- The role of the school:

The school’s role requires skills in responding quickly and adapting to events. This is
to meet the students' needs, by preparing electronic educational content, broadcasting
and presenting it in a timely manner.

The teacher should prepare students mentally and psychologically as in the usual
class, through electronic content, and thorough preparation.

The school's role also requires the formation of teamwork, to achieve the goals that
ensure the success of the distance education process, such as follow-up, electronic
support, digital content design, creative output, preparation of schedules for the
study material plan, following up of students ’attendance, measuring their progress,
designing discussion sessions and dialogue with students in the scientific material,
and addressing their deficiencies and the needs of educational losses.

Types

Satellite campuses are defined as those programs that offer the curriculum in whole or
in part in off campus sites from the parent institution. The majority of the teaching
and learning takes place in classrooms and involves in person interaction between the
faculty and students. Faculty members who teach in the parent institution serve as
onsite faculty or act as consultants to off-site faculty who teach the same curriculum.
In the instances of off-site satellite campuses, the course content and materials for
both theory and clinical are identical to that of the home campus. Activities are
planned to link the off site and home campuses to foster the socialization process for
the student faculty, so that there is a feeling of belongingness to the same institution.
They use webbased instruction and videoconferencing.

This technology requires an UPLINK from the origination site to communicating with
the orbiting satellite and a DOWNLINK at each of the sites selected to receive the
transmission from a distance source. The visual component is only from the
origination site. A Satellite origination classroom is usually simulated in the
production studio located in the uplink site. Technical staff is necessary to support the
studio classroom.

Use of satellite requires the students cluster at each downlink location for classes.

Video conferencing and broadcasting through teleconferencing

Videoconferencing and teleconferencing require an infrastructure for cable TV or

closed circuit TV, dedicated classrooms that both broadcast and to receive
communications, and technological support staff who manage the broadcasting and
hardware and software for instructional support purposes.

It combines a television picture with audio or computer transmission. The video

image can be real–time or freeze frame, with the cost of the transmission directly
proportionate to the sophistication of equipment. The visual image is often carried on
telephone, microwave, or fiber optic lines and enhances the audio conference or
computer correspondence. Video conferencing configurations are either one- way
video and two way audio or two-way audio. Equipment is required at both the
origination and the receiver sites to enable the videoconferencing facility.

Audio conferencing

Instruction transmitted over phone line is referred to as audio conferencing. A teacher

located in the origination site, not necessarily a classroom, interacts with students in
one or more receiving sites. Courses to be offered through this medium must be
selected carefully to ensure that they can pedagogically be delivered without live
video. Students should be oriented to the use of microphone or speaker phone.
Because the teacher is unable to identify the nonverbal cues, teaching strategies
should include more questioning to class understanding of content being addressed.
The minimum number of students per site is 8-10 and the maximum should not
exceed 35-45 students.

Computer conferencing
It uses a computer to establish network on a mainframe or a file saver in which an
unlimited number of individuals can communicate with each other using personal
computers linked by a local or wide area network or modems. It may be used as an
adjunct to on-campus courses or as the communication for the courses offered totally
on the world wide web. It is a medium to support many-to-many students without
requiring participants to be gathered in a central place at a specified time. Personally
directed email messages also can be sent only to selected individuals.

Web based course development

Web based teaching and learning require a learning management system, computer
access to the web by faculty and students, technological support through the use of
instructional support staff, and training sessions for faculty and students who are not
familiar with the system. Multiple learning activities are available through the
internet, such as real time chat rooms when students and faculty meet at a prearranged
time and discuss topic or review questions about course assignments. Asynchronous
entries (occurring at various times) about selected topics provide the students and
faculty with opportunities to discuss topics and present their ideas and views on them.

Pre Requisities for successful implementation

• Provision of periodic classes for the teachers and learners to interact.

• Combined use of media print materials to disseminate the course content.

• Facilities for two-way communication between the teachers and learners.

• Size of the groups receiving instruction can be small or individual and

avoidance of large groups.

• Structured regular meetings of study groups.

• Feedback on course work, projects, and assignments given at regular intervals.

• Easy way to get and access learning content and resources.

• Adequate guidance, supervision, and counselling whenever needed.

• Manpower and equipments for production and circulation of materials in

sufficient number for all the instructors and enrolled learners.

• Maintenance of appropriate records of students learning and having LMS.

• Appropriate methods of assessment, evaluation and grading systems.

Common expenditures required

• Learning material development and production. Technical and personnel
support required to develop teaching materials.
• Cost associated with recognition of the courses, approvals and
examination bodies.The courses need to be recognized by universities, councils by
paying the stipulated fees including the fees to be paid to conduct examination and
qualification rendering bodies.

• Equipments for knowledge and skill transfer through media. The recurring
expenses associated with transmission in media (eg. Radio station, satellite, television,
internet, mobile phones etc. ) including maintenance, repairing, and updating of
necessary equipments for transmissions.

• Infrastructure. The baseline network and building space required at the

originating, receiving, and circulating sites for transmission of learning content.

• Continuous financial support . Continuous funding support is required for

the smooth implementation and for enduring conduct of the distance education
programme.

• Manpower costs . Salaries and compensations to people to implement all the

necessary functions.

List of programme conducted by open universities (IGNOU) through

distance education in nursing

Post basic bsc nursing programme

The need of starting higher education course in nursing was felt by

TNAI in 1987, TNAI requested the INC to conduct 10 month Diploma
in nursing education and

nursing administration through correspondence –in 1988, the executive

committee of INC resolved to take up the matter with IGNOU to start 2
year post basic BSC Nursing programme instead of 10 month course in
nursing education. The INC approved programme (post basic bsc
nursing) was launched in the year 1994 by IGNOU and later it was
recognized by INC.
Post graduate diploma in materal and child health programme

The implementation of Post graduate diploma in maternal and child

health programme in1997 was a pioneering effort by IGOU that created
an implementation model of imparting clinical training through blended
learning.

Post graduate diploma in hospital and health management

This programme is a 32 credit programme including project work. This

programme aims at improving the managerial skills of hospital for the
effective and efficient performance of the hospitals. This programme
was launched in January 2001.

Diploma in nursing administration

This programme is a one year continuing education programme of 28

credits for in-service nurses. This programme has been developed for
nurses working in hospitals or community or educational institutions.
This programme will help to upgrade the administrative knowledge and
skills of the in-service nurses to enhance their administrative
competence.

Pros and cons

Benefits

• Lots of flexibility: Students who opt for correspondence education can opt for
easy classes just with an internet and a computer, and complete their requirements
from anywhere, anytime. There is no need to include more classes to an already busy
schedule and allows the students to work when and how it is convenient.

• No commuting: Energy, resource, and time are saved by absence of

transportation and money to and from class and students also work from home in
completing their assignments.
• Numerous choices for schools : It does not matter if you wish to study as a
distance learner and there are no colleges besides where you stay. There are always
wide range of colleges to choose from that may be beneficial to your criteria. There
are many schools that you may find online that provide an amazing educational
programme.

• Lower costs: Online courses are generally cheaper in terms of fees as well as
when it comes to saving on transportation, meals, and hostel plans.

• Learn while working: Since you are still working while doing a distance
education programme, you still have a sense of self-reliance, stability and freedom
owing to the income that you earn monthly, as compared to traditional educational
programmes of study.

Negatives

• Lack of social interaction: If you are a type of person who loves to be a part
of classroom learning, then you might want to reconsider your choice of distance
learning before signing up for a distance education. Apart from live chat discussions
and emails you may not have the true experience of a normal classroom.

• Contents is not suitable for all learners: If you are a person who have
trouble with motivation and adjournment and need the attention and guidance of a
lecturer, then you might want to rethink your decision of a distance education.

• Certain companies do not accept an online degree: Certain firms do not

entertain the prospects of an online degree. Though there are majority of companies
still accept candidates with an online degree and some are still dogmatic about it.

• Needs adaptability towards newer technologies: Make sure you are well
adapted with a computer and up to date on all newer modes of technology. If not you
may find yourself well behind, amongst your fellow counterparts.

• Not all courses offering a degree may be available online: Majority in

subjects like nursing requires a fine eye for detail and a constant hand touch
relationship with a patient. Before signing up for an online course, always make sure
you find out your offline requirements that you may need to complete.

The quickening of the process of distance education occurs due to advances of

computer networking on by the development of sophisticated computer network tools,
is pushing discussion and action on a variety of challenges faced by distance
educators. Hence, solutions need to be sought out regarding conflicts arising about the
institutional and instructional directions.
• Technological mastery: For the online programme, the students will need a
good head start in the use of technology and so will the institution. In depth training is
needed for efficient use of technology involved.

• Programme valuation and recognition: According to Mugridge 1991, Good

care must be taken in order to elevate standards of distance education and bring to the
level of full time education. Mechanisms need to be developed for faculty evaluation
of programmes originating at their institutions. There need to be standards for course
evaluation and programme accreditation. Successful programmes need to be re-
evaluated before implementing them in a different cultural environment in the
increasingly global village.

• Losing in the content in the technology: According to Douglas 1993, there is

a need to avoid simply providing information, or rather than instruction; or of simply
transmitting lectures through the transmitting medium. This would be a disservice to
the learners and a reduction in content and functionality over the intended result.
Avoid focusing on the technology rather than the instructional design and support.

• Allienating instructors: According to DeLoughry 1995, Faculty should be

involved in the whole process, and should understand that while one goal may be to
reduce costs; this will not be at the expense of faculty jobs. Distance education
technologies are not alternatives to teaching.
Failing to address these issues can lead to significant faculty rejection of proposals,
and may include union confrontation.

• Foreign language instruction: A lot of online material has a negative aspect

in that they do not accommodate foreign languages. For example a 2-byte character
system like Chinese is very problematic. This however, is reducing since standards of
internet are raising its bar.

• Institutional support for distance learners: According to Jacobsen,

Academic institutions must remember that course content is just one element of the
education they provide. If distance learners are being sought, they will need to be
provided with similar support to that received by on campus users. This includes
everything from full library support to academic counselling in addition to more
mundane administrative assistance.

• Increasing regional focus : It is not expect students from various time zones
of the world to participate in live programmes when they need that time to sleep.
There may be two outcomes of the ever-growing boom of online degrees. One,
institutions are able to market their educational products to various countries
according to the needs of the students. Secondly, there will be a development of
educational stations. This benefits the students in a way that is challenging and
stimulating in newer ways to think, learn, and interact with people apart from their
classmates.
 • Patient issues: Some researchers may openly speak about issues of questions
of copying in an electronic environment being unanswered. Hence, it is extremely
important that necessary steps are taken to evaluate the goals and inentions of the
programme and the needed clearances are made.

Challenges posed

Challenges faced by students

• Distance learning may produce disruption of family life, and poor perception of the
importance, and lack of support from family and the employers. This may cause a
sense of insecurity for the adult learner.
• As there is no personal contact of the faculty with the learners, students may not know
how they are performing.

• Feelings of isolation are common as they do not have the support of the school.
Opportunities for collaboration with their colleagues are also lacking.

• Lack of support of the teachers and management is an added problem that makes it
difficult.

• Students may feel that the special learning needs of the students are not taken into
account. The students motivation gets affected due to the poor preparation of the
content. This may lead to students unwillingness to continue in the course.

• Mobile is used by them is for communicating and engaging in leisure activities,

teaching them to make use of online portals, and use of mobiles for educational
purposes. The barriers felt by the adult learners when they are computer illiterate can
be eliminated with proper orientation and demo.

Challenges faced by teachers

Distance education may be perceived as a threat to the employment tenure and need of
faculty.

• Designing distance learning materials involves additional workload on teachers

because of the time involved in selecting, designing, and preparing material.

• Faculties who are usually teaching in a collegiate programme dealing with the
younger adults must be prepared to interact with adult learners, who may be even
 senior to them. They may need to alter the teaching styles to meet the needs of
distance students without personal contact.

• Teachers may not have much regards for the learners and academic process in the
distance education programme. This admission process should be on par with the
regular courses.
• Many teachers may be resistant to the idea of distance learning and not give their full
co-operation. Teachers also need to be motivated and give the support.

• Because college faculties may feel overburdened, their full support should be enlisted
for expanding distance education opportunities.

Challenges for educational institutions and universities

• Technology demands finances and investment to setup, computers with internet

connectivity, and ongoing costs of telecommunication and internet connectivity costs.
It may be costly for students to purchase a personal computer and net facilities for
reference and communication. Students may not join the course because of this
problem.

• There is a large amount of content with all sources not being fully reliable. Internet
connectivity or network is needed for downloading the large learning content. Just
browsing may not offer the correct information

• Unsolicited remarks and promotional tagging are problems that could occur and
require monitoring and regulation.

• Generally, it is perceived that distance courses do not give the credibility for
employment compared to the traditional courses. This serves as a dampener for the
enthusiasm of the teachers and learners. In the face of this criticism, institutions and
universities need to ensure the quality in content and delivery of the courses on par
with the regular or traditional courses.

Conclusion

To achieve the goal of EDUCATION FOR ALL AND EQUALLITY

OF EDUCATIONAL OPPORTUNITIES from quantitative and
qualitative point of view, distance education along with conventional
mode of education is the answer. This is important in the field of
nursing education because opportunities of higher education are limited.
Distance education in nursing strengthens the EARN AND LEARN
approach.

Bibliography
• R Sudha, Nursing Education principles and concepts, jaypee brothers and
medical publishers, 2nd edition.

• Latha Venkatesan and poonam joshi, Textbook of nursing education, Elsevier.

• Shebeer p. Basheer, Textbook of nursing education, EMMESS medical

publishers.

• Jaspreet Kaur Sodhi, Comprehensive textbook of nursing education, The

health science publisher.