1.       Introduction

Online education is steadily growing since many academic institutions are adding online courses to their programs. Alen, et al. [2] found 29.7% of all students are taking at least one online course, 14.3% are taking courses delivered totally online, and 15.4% are enrolled in a course using combination of face-to-face instruction and online teaching. Undergraduate courses account for 83.0% of all online courses [3]. Nursing has been a leader in online education over the last two decades [4]. Online education provided an opportunity to students who wanted a nursing degree, but unable to enroll in on campus nursing program for working full time, having a family responsibility, or living away from a nursing school [4]. Also, the pedagogical change from teaching to learning has positioned online education in nursing to be the appropriate avenue to promote active participation of students in their learning process [5].

The availability of online education in nursing has contributed to expansion in enrollments in RN-BSN programs leading to an increased need for recruiting faculty to teach online [6]. The RN-BSN programs offer a Bachelor of Science for Registered Nurses (RN) with associate degrees. Similarly, the growth of accelerated baccalaureate nursing programs that transition individuals with baccalaureate and/or graduate degrees from other disciplines into nursing have benefited from the availability of online education in nursing [6]. The Institute of Medicine (IOM) recommended that 80% of the nursing workforce to have a BSN degree by 2020 [7]. Online education gives nurses the opportunity to pursue lifelong learning and provides an avenue to educate future nurses and future educators to address the shortage of nurse educators [7]. Moreover, traditional baccalaureate, Master’s, PhD, and Doctor of Nursing Practice (DNP) programs are enhanced or totally delivered by online education [6].

As a result of the expansion of online education in different nursing programs, many academic nurse educators are teaching online, totally, blended, or both. In order to evaluate the efficiency of online education, determine policy and guidelines for teaching online, help recruit and retain new faculty to teach online, there is a need to identify lessons learned and current challenges in online teaching and learning by academic nurse educators.

2.       Background

Most research studies have examined educators’ attitudes toward online education and technology. Yet, few studies have addressed nurse educators’ lessons learned from teaching online and their perceived challenges in online teaching and learning.  Bollinger et al. [8] found satisfaction and motivation among faculty who teach online despite lack of face-to-face interaction and not having enough time to participate in the development of online courses. The 2015 Inside Higher Ed survey [9] of over 2000 faculty showed that less than third of participants taught online. Participants expressed greater needs for technical support, support to develop online courses, concerns regarding time demands of online teaching, and inadequate compensation for the development of online courses [9].  The 2014 Inside Higher Ed survey of faculty attitudes on technology [10] showed that 77% of participating faculty agreed that online education cannot reach students who are at-risk to learn, and face-to-face intervention must be done early before students fail.

A recent synthesis study of empirical research that used the Technology Acceptance Model examined faculty’s   concerns in online teaching [11]. Concerns emerged were related to student success in online classes, effective communication, technical proficiency, and students achieving course outcomes without cheating. Other faculty’s concerns included technical support needs, institutional support, workload consideration in promotion and tenure deliberations, and online class size [11]. Likewise, a literature review study of e-learning and information technology identified three themes: (1) issues related to students, (2) issues related to information technology, and (3) faculty’s concerns in the areas of pedagogy and workload [12].

A phenomenological study of the experience of teaching online of 14 academic nursing faculty in baccalaureate, master’s, or doctoral program was examined [13]. Participants in the study had completed at least 50% of their teaching load in teaching online courses. Gazza reported four themes from data analysis: (1) looking at a lot of moving parts, (2) always learning new things, (3) going back and forth, and (4) time is a blessing and a curse [13]. Wingo et al. [14] explored benefits and challenges of teaching online among nine academic nursing faculty, six administrators, and six instructional designers. Among the nine-nursing faculty, four themes emerged. These are: (1) teaching strategies, (2) instructor availability, (3) training and support, and (4) institutional issues.

The need for training and support that include instructional methods and tools for teaching online, how to interact with students, mentoring and orientation were also identified in earlier studies [15-18]. An exploratory factor analysis study of barriers perceived by faculty teaching online identified four factors: (1) interpersonal barriers, (2) institutional barriers, (3) training and technology barriers, and (4) cost/benefits analysis barriers [19]. Faculty training in the use of technology and examination of student expectations versus faculty expectations in online teaching of graduate management education were also prevalent constructs in another study [20].

Online nursing education has expanded but nursing research that examines successes and challenges in online teaching and learning has not followed the same path. One consistent finding of most research studies reviewed focused on the use of technology in teaching and faculty’s need to get further training. However, online teaching and learning include technology skills, course re-design, issues related to the online students, new pedagogical approaches, and innovative teaching strategies. Although few research studies identified barriers and/or challenges perceived by faculty teaching online, lessons learned and successes in online nursing education were not identified. Identification of lessons learned/successes and challenges in online nursing education will set policies and guidelines for online teaching, promote nursing programs that use virtual methods of teaching, and help recruit and retain faculty. The purpose of this study was to identify lessons learned and challenges in online teaching and learning among academic nurse educators who teach online.

3.       Research Questions

(1) What are the lessons learned from teaching online?

(2) What are the current challenges facing online teaching and learning?

4.       Methods

This study was part of a mixed research with quantitative and descriptive qualitative approaches. The quantitative part examined emotional intelligence and online teaching self-efficacy among academic nurse educators [21]. This paper presents the descriptive qualitative findings of that study. The open-ended questions were: (1) what are the lessons learned from teaching online? and (2) what are the current challenges facing online teaching and learning?

5.       Design

The study’s design is exploratory, descriptive.

6.       Participants

Participants of the study were 115 academic nurse educators; however, only 107 electronically responded to the two open-ended questions of the descriptive qualitative part. This would make a 93% response rate of the total 115 participants. The sample was randomly selected from schools of nursing accredited by the Commission on Collegiate Nursing Education (CCNE) that have baccalaureate, masters, and/or doctoral programs (Commission on Collegiate Nursing Education) [1].  Participants were recruited by school of nursing administrators via e-mail. Then the online study was forwarded by the administrator to interested faculty who teach online totally, blended, or both. The Institutional Review Board of the investigators approved the study before data collection.

7.       Results

Characteristics of the study sample are shown in Table 1. The majority of the sample was females (93%), with 41% in the age group of 41 - 60 years. Forty-six percent reported their degrees as PhD/EdD while 23% as DNP. Duration of being an academic nurse educator was almost 14 years and duration of teaching online was seven years (Table 1).

Participants responses related to lessons learned (Table 2) addressed the online course design, the online students, and innovative teaching strategies. Constructs identified were course preparation with anticipation of issues that may occur during teaching and learning, style of communication in online teaching, innovation in creating different methods of teaching and facilitating learning. Other lessons learned included methods to avoid problems in grading, plagiarism, cheating, and incivility. Table 2 shows the constructs deduced from participants’ responses and participants’ summarized statements or their quotes.

Participants’ challenges in online teaching and learning (Table 3) were in the areas of online learners (students), technology, and institutional issues. Constructs gleaned from participants’ responses included students’ engagement, how to guide critical thinking in online teaching, grading issues, how to balance time management in online teaching along with maintaining scholarly productivity, how to reduce incivility, how to keep integrity in students’ posting and testing, and issues related to compensation for online teaching. Table 3 shows the constructs along with participants’ summarized statements or their quotes.

8.       Discussion

This study explored the lessons learned and current challenges in online teaching and learning as experienced by academic nurse educators. Lessons learned identified in this study mainly centered on students. Students being in the center of online education is in line with a previous study finding that emphasized online education is more about meeting students’ needs, utilizing new pedagogical methods, creating new innovative instruction approaches, and being flexible with students [15]. Lessons learned begin with outlining a clear design of the online course, with thorough syllabus that addresses course work, grading, cheating policies, plagiarism, and incivility. Clear communicational instructions and frequent interactions with students are very important concepts to maintain in online education. Interaction in online environment will create a sense of community among students and give each student an opportunity to be active and engaged rather than being just a listener in a face-to-face classroom [4]. One of the lessons learned in online teaching as expressed by participants of this study was to continually be innovative in facilitating learning using a variety of teaching methods and considering every learning style. This finding is congruent with a very recent study that reported different pedagogical designs such as self-directed learning, case studies, group discussion, and brainstorming have facilitated online education for nursing students [22]. Lessons learned from teaching online can be used in continuing education programs for academic nurse educators who currently teach online or newly hired faculty who are going to teach online.  

Some of the challenges expressed by participants in this study were congruent with previous research studies [13,11,14]. These challenges include lack of social interaction; time consumed in online teaching, needs for technical skills and technical support, workload consideration in promotion and tenure, class size, institutional issues, and how to ensure integrity in posted information and in testing. The link between time consumed in online teaching and class size is a challenge to online educators. Online communication in a large class will affect the teaching strategies used and interfere with students’ participation in learning and in social interaction with teacher and other students [23]. Orellana [24] reported that the ideal class size that allows for interaction between students is between 12 to 16 students. A recent study proposed a discussion protocol to deal with large class in online teaching [25]. The online discussion protocol involves dividing the large class into small groups of students. Each group will post their work, followed by a response. Then reflection is encouraged to refine the response. After conclusion is made to the refined response, the work is submitted for grading [25]. 

Integrity in online education is a challenge that has been identified by participants of this study. The Higher Education Opportunity Act of 2008 that sets the standard against which integrity in online is evaluated can be adopted in online classes to address integrity issues [26]. Other approaches to maintain integrity include randomized examination questions to each student separately, discussing academic integrity, tracking students’ submission to recognize potential inconsistency, receiving institutional support in upholding integrity policies, and having a system in place for enforcing integrity [27,28]. One phenomenon that emerged from this study is about online students’ negative attitudes toward online education. Participants expressed challenges related to students who are reluctant to be engaged in the learning activities, procrastinating students, those who lack the motivation to read what is in the course or follow instructions, and those who are entitled, cheat, and making offensive remarks with instructor and/or with other students. According to Galbraith [29], most of the previously mentioned negative attitudes of students would fall under incivility acts.

Educators must be cognizant of what predispose students to be uncivil, prevent it before it occurs, and address it when it happens [29]. One way to address students’ negativity is to incorporate in course syllabus policies related to incivility acts. Also, workshops or continuing education programs on how to deter students’ incivility acts can be held to faculty teaching online. Similarly, workshop on addressing students’ incivility can be conducted to students. Other challenges expressed by academic nurse educators are related to adjunct faculty who teach online courses that were not developed by them. Traditional faculty do not perceive adjunct faculty to follow the policies and standard of the program. But also, adjunct faculty do not perceive courses designed by others to be totally clear in instructions to complete assignments, thus overloading faculty and students. Compensation for online teaching and difficulty to pursue scholarly productivity while teaching online were also reported as challenges. Issues of adjunct faculty, compensation, and scholarly productivity can be resolved through communication between the involved faculty and the school administrators.

9.       Conclusion

This study provides some evidence of lessons learned and challenges in online teaching and learning from a national sample of nurse educators. Findings could be used in improving nursing programs that deliver courses online. More research is needed to explore in depth specific issues that pertain to specific academic institutions since successes and challenges can be different by different institutions. Also, future research could explore successes and challenges of students and comparing them to those of faculty.

Table 1: Demographics and Characteristics of Academic Nurse Educators, N=115.

Table 2: Lessons Learned in Online Teaching and Learning among Academic Nurse Educators, N=107.

Table 3: Current Challenges in Online Teaching and Learning among Academic Nurse Educators, N=107.

1. Commission on Collegiate Nursing Education (CCNE) - Nursing Education Degree Programs - CCNE Accredited Programs.
2. Allen IE, Seaman J, Poulin R, Straut TT (2016) Online report card: Tracking online education in the United States. Babson Park, MA: Babson Survey Research Group.
3. Allen IE, Seaman J (2017) Digital Learning Compass: Distance Education Enrollment Report. Pg No:1-36.    
4. Glasgow M, Lockhart J, Nolfi D (2017) Online nursing education. Health Progress September - October. Pg No: 46-51.
5. Russell B (2015) The who, what, and how of evaluation within online nursing education: State of the science. Journal of Nursing Education 54: 13-21.
6. American Association of Colleges of Nursing (2017) 2016 -  2017 Enrollment and graduations in baccalaureate and graduate programs in nursing.
7. Institute of Medicin (2011) The future of nursing: Leading change, advancing health. Washington, DC: National Academic Press.
8. Bollinger D, Inan F, Wasilik O (2014) Development and validation of the online instructor satisfaction measure. Educational Technology & Society 17: 183-195.    
9. Straumschim C, Jaschik S, Lederman D (2015) The 2015 Inside Higher Ed survey of faculty attitudes on technology. Washington, DC: Inside Higher Ed.    
10. Jaschik S, Lederman D (2014) The 2014 Inside Higher Ed survey of faculty attitudes on technology. Washington, DC: Inside Higher ED.
11. Wingo N, Ivankova N, Moss J (2017) Faculty perceptions about teaching online: Exploring the literature using the technology acceptance model as an organizing framework. Online Learning 21: 15-35.
12. Button D, Harrington A, Belan I (2014) E-learning & Information Communication Technology (ICT) in nursing education: A review of the literature, Nurse Education Today 34: 1311-1323.
13. Gazza E (2017) The experience of teaching online in nursing education. Journal of Nursing Administration 56: 343-349.
14. Wingo N, Peters G, Ivankova N (2016) Benefits and Challenges of teaching online: Exploring perspectives of different stakeholders. Journal of Nursing Education 55: 433-440.
15. Hunt D, Davis K, Richardson D, Hammock G, Akins M, et al. (2014) It is more about the students: Faculty motivation and concerns regarding teaching online. Online Journal of Distance Learning Administration 17.
16. Nguyen D, Zierler B, Nguyen H (2011) A survey of nursing faculty needs for training in use of technologies for education and practice. Journal of Nursing Education 50: 181-189.
17. Sorensen C (2014) Classroom without walls: A comparison of instructor performance in online courses differencing in class size. MERLOT Journal of Online Learning and Teaching 10: 569-576.
18. Sword TS (2012) The transition to online teaching as experienced by nurse educators. Nursing Education Perspectives 33: 269-271.
19. Lloyd S, Byrne M, McCoy T (2012) Faculty-perceived barriers of online education. Journal of Online Learning and Teaching 8: 1-12.
20. Hall OP (2013) Assessing faculty attitudes toward technology change in graduate management education. Journal of Online Learning and Teaching 9: 39 -51.
21. Ali N, Ali O, Jones J (2017) High level of emotional intelligence is related to high level of online teaching self-efficacy among nurse educators. International Journal of Higher Education 6: 122-130.
22. Harerimana A, Mtshali NG (2018) Facilitation strategies used in e-learning by nurse educators in Rwanda. Journal of Nursing Education and Practice 8: 24-32.
23. Rocca KA (2010) Student participation in the college classroom: An extended multidisciplinary literature review. Communication Education 59: 185-213.
24. Orellana A (2006) Class size and interaction in online courses. The Quarterly Review of Distance Education 7: 229 - 248.
25. Chen B, DeNoyelles A, Patton K, Zydney J (2017) Creating a community of inquiry in large-enrollment online courses: An expoloratory study on the effect of protocols within online discussions. Online Learning 21: 165-188.
26. The Higher Education Opportunity Act 2008.         
27. Mcallister C, Watkins P (2012) Increasing academic integrity in online classes by fostering the development of self-regulated learning skills. The Clearing House 85: 96-101.
28. Lee-Post A, Hapke H (2017) Online learning integrity approaches: Current practices and future solutions. Online Learning 21: 135-145.
29. Galbraith MW (2010) Understanding incivility in online teaching. Journal of Adult Education 39: 1-10.