Instructional-Design Theories to Support an Online Nursing Leadership Learning Community
by
Brenda J. Stutsky
A research paper submitted in partial fulfillment of the requirements for the course DCTE 870 Project in Courseware Design and Development
Graduate School of Computer and Information Sciences Nova Southeastern University
2006
Table of Contents
List of Tables iii Introduction 1 Statement of the Problem 1 Goal Statement 3 Relevance and Significance 3 Research Questions 4 Review of the Literature 5 Historical Overview 5 Learning Needs 7 Behaviors in an Online Learning Environment 8 Leadership Competencies 10 Instructional-Design Theory 12 Summary 15 Contribution of the Research 17 Conclusions, Implications, Recommendations, and Summary 19 Conclusions 19 Implications 22 Recommendations 24 Summary 25 Reference List 27
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1
Introduction
Statement of the Problem
Background
In 2004, the average age of a registered nurse in Canada was 44.6 years, and nurses
over the age of 44 represented nearly 53% of the workforce (Canadian Nurses
Association [CNA], 2005). The percentage of registered nurses working in nursing
leadership positions including managers, directors, and chief nursing officers was only
5.5% in 2004 (CNA, 2005). As a result of work restructuring and budget limitations in
the 1990s, many nursing leadership positions were deleted leaving front-line nurses with
less support and guidance (Canadian Health Services Research Foundation [CHSRF],
2006). CNA (2003) noted, “Professional nursing organizations have never had a harder
time filling key leadership positions…” (p. 1).
As the majority of nurses progress towards their retirement years, succession
planning is needed to recruit qualified nurses into leadership positions (CNA, 2003).
Formal leadership training and professional development have been identified as key
components in the succession planning process (CHSRF, 2006; CNA, 2003). Little
support for continuing education in the workplace, decreased financial resources, and the
inability of nurses to attend educational sessions in the workplace have been identified as
barriers to professional development (CHSRF, 2006). Electronic programming is seen as
an innovation that facilitates access to education for nurses (CNA & Canadian
Association of Schools of Nursing, 2006).
The Winnipeg Regional Health Authority (WRHA) Nursing Leadership Council
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(NLC) , in Manitoba, Canada, adopted a framework used by the Dorothy M. Wylie
Nursing Leadership Institute in Toronto, Ontario, and have further developed the
framework by identifying leadership competencies within each of the various
components of the framework. The development of the WRHA NLC (2006) framework
and future educational plans related to the framework in part fulfills the recommendations
of the CNA (2003) and the CHSRF (2006) to enhance the leadership skills of nurses
through professional development.
The concept of using the Internet as the delivery method for nursing leadership
education is in keeping with the thought that electronic programming facilitates access to
education (CNA & CASN, 2006; Jeffries, 2005); however, the use of Internet technology
brings opportunities as well as challenges. Researchers have found that the computer
literacy level in nurses is low (Wilbright et al., 2006); however, nurses are satisfied with
online learning environments (Billings et al., 2006; Maag, 2004), and have positive
attitudes towards technology (Maag, 2006). Online nursing learning communities have
been found to promote connectedness, improve reflective ability, engage students in
critical thinking, improve writing skills, and enhance the sharing of ideas (Maag, 2005;
Maag & Fonteyn, 2005).
How does one begin to develop an online learning community? Morrison, Ross, &
Kemp (2004) indicate that learning theories describe how learning takes place,
instructional theory, known as instructional-design theory, prescribes specific teaching
strategies, while an instructional-design model or plan applies instructional-design theory
to create an effective lesson. As a starting point in the process, the author identified
researching instructional-design theories.
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Problem Statement
The problem was that there is a shortage of nurses who possess the leadership
competencies required to fill a projected increase in nursing leadership vacancies.
Effective nurse leaders are an important member of the health care team for they
increase group cohesion, empower nurses, reduce turnover, and ultimately improve
patient care (CHSRF, 2006). Nurses no longer have numerous career-laddering
opportunities in leadership because of decreased nurse leader positions resulting from
years of restructuring and budget cutbacks (CHSRF, 2006). With just over 5% of nurses
in leadership positions and an aging nurse population (CNA, 2005), one can assume that
with impending retirements, the vacancy rate for nurse leaders will continue to increase.
Goal Statement
The goal was to explore instructional-design theories that would support the
establishment of an online learning community to enhance leadership competencies in
nurses employed within the WRHA.
Given the identified need for nursing leadership training across Canada (CHSRF
2006; CNA, 2003), one would predict that there are few opportunities for online
leadership training. The establishment of an online learning community for nurses was
identified as a potential effective mechanism to increase the human resource pool of
qualified nurse leaders.
Relevance and Significance
Leadership courses are commonly included in nursing curricula, and with increasing
availability of online courses, nurses are gaining access to online nursing leadership and
management courses (Barker, 2004). The establishment of online learning communities is
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a relatively new concept for professional working nurses, as many researchers have
focused their efforts on examining online learning within the context of a university or
college environment. The establishment of an online learning community for professional
nurses could prove to be beneficial to nurses, employers, and ultimately patients.
The scope of the study was closely related to the goal, and was to explore
instructional-design theories that would support the establishment of an online learning
community. Testing of the instructional-design theory was not within the scope of the
study; however, if an appropriate instructional-design theory was developed to support
the enhancement of leadership competencies, Reigeluth (1999) would agree that a
significant contribution would be made to the field of instructional-design theory and
computing technology in education.
Research Questions
The following research questions were explored:
1. What are the learning needs of nurses participating in an online nursing leadership
learning community?
2. What behaviors and leadership competencies are expected to improve in nurses
participating in an online nursing leadership learning community?
3. What instructional-design theory will best enhance an online nursing leadership
learning community?
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Review of the Literature
Historical Overview
As the research goal was to explore instructional-design theories that support the
establishment of an online learning community, it is important to examine the evolution
of instructional-design theory. Hutchins (as cited in Reigeluth, 1999) notes that when a
societal system changes in significant ways, related subsystems must also change to
survive, as each subsystem essentially meets the needs of one or more of its
supersystems. Reigeluth notes that if the supersystems for instructional systems change
significantly, then the instructional system, and consequently instructional-design theory,
needs to change or risk the chance of becoming obsolete. Reigeluth describes how
supersystems have evolved from the agrarian age where businesses were organized
around the family, for example, the family farm, to the industrial age where the family
was replaced by bureaucracy and departments, to the information age. In the information
age, businesses are organized around holistic processes, and employees are organized
into teams with considerable autonomy to manage themselves within the boundaries of
the corporate goals and vision.
The evolution of business fits within the definition of systemic change of a
supersystem; therefore, the subsystem of instruction needs to change or become obsolete.
Reigeluth (1999) describes how the paradigm of instruction needs to change from
standardization to customization, from teacher-directed to student-directed learning, and
from passive to active learning. Reigeluth’s comments equate to the evolution of learning
approaches described by Alessi and Trollip (2001). Alessi and Trollip present the
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evolution of learning approaches starting with a behavioral approach, moving to a
cognitive approach, and finally a constructivist learning approach.
Lee (2006) agrees that paradigm shifts in educational philosophy along with
technical advances in instructional technology are the driving forces behind changes in
distance learning practices. Educators are transitioning from delivering information to
remote learners, to constructing a community of learners (Lee, 2006). Lee notes that
curriculum delivery is the focus in traditional face-to-face or online educational
environments, and the development of a community, as a foundation for learning, is often
ignored. In addition, Lee claims that the misapplication of learning approaches, such as
implementing a behavioral approach as opposed to a constructivist approach to shape the
development of a learning community remains an obstacle in online learning, as
constructivism is emerging as the preferred learning approach when creating an online
learning community.
Overall, a shifting of paradigms appears to be a common theme when reviewing the
literature. Instruction is shifting from a teacher-directed approach to a learner-centered
approach (Fay, Johnson, & Selz, 2006; Lee, 2006; Reigeluth, 1999). Learners are being
required to shift from a passive mode of learning in a traditional face-to-face classroom
environment dominated by lecturing, to an active mode of learning in an online
environment (Barker, 2004; Ryan, Hodson-Carlton, & Ali, 2005). Resultant behaviors
demonstrated by learners in an online environment exhibit the shifting paradigm. Finally,
instructional-design theory is shifting from a teacher-directed approach to a learner-
centered approach to best attain instructional goals (Reigeluth, 1999).
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Learning Needs
When examining the current state of nursing education in regards to online learning,
it was found that information technology skills might be present in curricula; however,
given the questionable skill level of nurse educators in regards to computer technology, it
is not evident that educators are teaching the content (McNeil et al., 2003). The fact that
students may not be exposed to information technology is concerning, for Maag (2006)
and McNeil et al. found a clear perceived need for information technology skills in
nursing curricula. A consequence of a lack of exposure to information technology and
computer training in either basic nursing education programs or continuing education
programs is that nurses are not prepared to manage the information systems in the clinical
areas (McNeil et al., 2003; Wilbright et al., 2006).
Wilbright et al. (2006) noted that many clinically experienced nurses have limited
basic computer skills, because clinically experienced nurses would have graduated when
computer training was not considered an essential component of a nurse’s basic
education, nor were computers prominent in clinical units. Wilbright et al. analyzed the
responses of 454 nurses who responded to a 15 question self-assessment survey
pertaining to computer skills. Wilbright et al. found that nursing department staff reported
fair to poor computer literacy skills, with limited proficiency in basic skills such as using
a mouse, minimizing windows, saving files, dragging and dropping files, using email, or
using a web browser. Kozlowski (2004) noted similar findings in regards to computer
literacy skills.
Researchers have identified various computer related competencies important for
learners enrolled in online nursing programs, and the author was able to extrapolate
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computer related competencies from two models: one designed for nursing faculty who
teach online (Ryan et al., 2005), and the other used to explain persistence in continuing in
an online distance education program despite obstacles (Rovai, 2003). Overall, it was
found that learners participating in an online learning environment require basic
computer and word processing skills, the ability to send and receive email with
attachments, and the ability to use and understand Internet protocols (Barker, 2004;
Kozlowski, 2002; McNeil, Elfrink, Beyea, Pierce, & Bickford, 2006; Rovai, 2003; Ryan
et al., 2005). Learners also require hardware competencies such as troubleshooting
computers (Barker, 2004; McNeil et al., 2006; Ryan et al., 2005). McNeil et al. noted that
education related to discussion groups, asynchronous and synchronous chats, and online
learning programs was important. A significant point to note is that older students who
enter an online program may have poor computer skills initially, but will exit with highly
improved skills (Ostrow & DiMaria-Ghalili, 2005). Kozlowski (2004) also found that
that a student’s ability to use the Internet increased over time.
Behaviors in an Online Learning Environment
In order to determine the behaviors expected to improve in nurses participating in an
online nursing leadership learning community, a review of behaviors associated with an
online learning environment was required. An online learning environment appears to
enhance critical thinking (Kozlowski, 2004; Lee, 2006; Maag & Fonteyn, 2005; Pethtel,
2005) and foster reflection (Kozlowski, 2004; Maag & Fonteyn, 2005; Ryan et al., 2005).
It was noted that learners are able to construct new knowledge (Lee, 2006; Maag &
Fonteyn, 2005) and apply concepts learned in an online course to their nursing practice
(Billings et al., 2006; Jeffries, 2005; Kozlowski, 2004).
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There are opportunities in an online learning environment for sharing of creative
ideas (Maag & Fonteyn, 2005; Pethtel, 2005). The ability to communicate clearly online
was a skill that developed over time, and the potential for miscommunication was
believed to be a major barrier to student success (Kozlowski, 2004). Writing skills also
improve in an online environment (Maag & Fonteyn, 2005).
For most learners, anxiety, fears, and concerns ease over time in an online learning
environment (Kozlowski, 2004). Learners need to adapt to a different type of faculty to
student relationship, different pedagogies, and a different learning environment (Ryan et
al., 2005). Ku, Cheng, and Lohr (2006) reported that for students to work well in an
online group collaborative setting, members needed to practice the five C’s:
communicate, cooperate, compromise, complement, and commitment. Tilley, Boswell,
and Cannon (2006) found that in an online environment there is a supportiveness and
open sharing of oneself, learners build interpersonal relationships (Rovai, 2003), and
establish networks (Pethtel, 2005). Learners experience a connectedness, are better
acquainted, and challenge each other (Maag & Fonteyn, 2005). It is agreed that
socialization occurs in online learning environments (Billings et al., 2006; Kozlowski,
2002; Lee, 2006; Tilley et al., 2006).
Barker (2004) identified that educators as well as learners struggle with the paradigm
shift from traditional teaching to learning that is engaging, deep, long lasting, and
achieved in an online format. Barker noted that learners must accept the active and
engaging learning model that is different from a traditional passive model of listening to
lectures, and for learners to make the transition, learners need to be self-directed and have
good time management skills. Kozlowski (2004) and Rovai (2003) would agree that good
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time management skills are needed, and Kozlowski (2004) would agree that learners
require self-direction and self-discipline.
Leadership Competencies
In the second research question, the author examined two components, namely,
behaviors and leadership competencies. In reviewing leadership competencies, Mahoney
(2001) claimed there is a need for nurse leaders to move from a traditional to innovative
role that involves risk taking and planning for the future. Mahoney also noted that great
leaders practice and develop their skills over time, and are aware of their own beliefs and
values.
The Registered Nurses’ Association of Ontario (RNAO) (2006) recently completed a
leadership best practice guideline. Five transformational leadership practices identified as
fundamental to transforming nurses’ work settings into healthy work environments for
nurses include: building relationships and trust, creating an empowering work
environment, creating an environment that supports knowledge development and
integration, leading and sustaining change, and balancing competing values and priorities
(RNAO, 2006). The five practices of exemplary leadership described by Kouzes and
Posner (2002) including model the way, inspire a shared vision, challenge the process,
enable others to act, and encourage the heart, are incorporated into the RNAO best
practice guideline.
Nursing leaders have been described as knowledgeable (Henrikson, 2005; Wieck,
Prydun, & Walsh, 2002), trustworthy (Henrikson, 2005; Mahoney, 2001; Murdoch,
2001), respected, competent and confident individuals (Mahoney, 2001) who possess an
inspirational motivation (McGuire & Kennerly, 2006; Shultz, 2003; Wieck et al., 2002),
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and are motivated by the excitement for the work (Stanley, 2006). Leaders have passion
(Henrikson, 2005; Stanley, 2006), are proactive, transformational, and are driven by the
heart and spirit (Stanley, 2006). Leaders are visionaries (Henrikson, 2005; Mahoney,
2001; Murdoch, 2001; Shultz, 2003; Stanley, 2006), mentors, and delegators (Heller et
al., 2004) who empower patients and staff (Mahoney, 2001; Upenieks, 2003; Wieck et
al., 2002).
Good communication and listening skills have been identified as essential qualities
of a nurse leader (Heller et al., 2004; Murdoch, 2001; Shultz, 2003; Upenieks 2003;
Wieck et al., 2002). It is important for nurse leaders to be self-directed (Shultz, 2003),
and have good time management skills (Heller et al., 2004). Leaders believe in the power
of a team (Henrikson, 2005; Wieck et al., 2002), collaboration (Heller et al., 2004;
Upenieks, 2003), networking, and developing partnerships (Heller et al., 2004). Leaders
are people oriented (Upenieks, 2003; Wieck et al., 2002), visible, accessible (Upenieks,
2003), and approachable (Wieck et al., 2002). Leaders have an essential relationship with
the organization, will associate with anyone and everyone, and approach the future by
creating opportunities (Stanley, 2006). Leaders are honest, supportive, and have a
positive influence in an organization (Upenieks, 2003; Wieck et al., 2002). Being able to
celebrate success is important for a leader, whether it is celebrating accomplishments and
goals, or lessons learned from mistakes (Mahoney, 2001).
Leaders need to be able to display creativity (Mahoney, 2001) as well as facilitate
change (Murdoch, 2001; Shultz, 2003; Stanley, 2006). Conflict resolution skills and the
ability to use conflict constructively is important for a nurse leader (Heller et al., 2004;
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Stanley, 2006), and Hocking (2006) describes that reflection is an important method to
remedy conflict.
Ready (2002) identified two essential criteria for developing potential leaders,
namely, leadership is most appropriately learned within the context it will be practiced,
and leadership lessons are best learned from trusted and well respected individuals. The
two criteria combine into one powerful method of building leadership effectiveness:
storytelling. Ready noted that effective stories are context-specific, have drama, are told
by respected role models, have high learning value, and are framed at an appropriate level
so participants can visualize themselves in the story and reflect on appropriate actions.
Instructional-Design Theory
Lee (2006) noted that constructivism is emerging as the preferred learning approach
for creating an online learning community. Bolliger (2006) stated that constructivism, as
a learning approach used in the field of instructional-design and technology, has gained
acceptance and is highly valued by educators. Shachak, Ophir, and Rubin (2005) would
agree that an instructional-design theory supporting exploration and interactivity might be
a better option, for Shachak et al. found that a behavioral instructional-design theory,
namely the Conditions of Learning, based on the work of Robert M. Gagné, was not
optimal when used in the development of graduate level bioinformatics workshops.
Deubel (2003) would argue though, that a mixed learning approach might be the
preferred direction.
In a constructivist learning environment, situated learning experiences (Bolliger,
2006; Cooperstein & Kocevar-Weidinger, 2004) are used to engage learners in a sense-
making process where learners investigate, (Bolliger, 2006), discover, and explore (Ali,
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Hodson-Carlton, & Ryan, 2004; Bolliger, 2006). Learners create structures (Bolliger,
2006), build new learning on prior knowledge (Cooperstein & Kocevar-Weidinger, 2004;
Deubel, 2003), and construct their own meaning to concepts (Bolliger, 2006; Cooperstein
& Kocevar-Weidinger, 2004). Concepts central to the idea of constructivism include
critical thinking (Ali et al., 2004; Lee, 2006) active learning (Bolliger, 2006; Fay et al.,
2006), and reflection (Ali et al., 2004; Bolliger, 2006; Deubel, 2003). The conditions for
learning are a social context (Ali et al., 2004; Bolliger, 2006; Cooperstein & Kocevar-
Weidinger, 2004) where students are viewed as autonomous, independent, self-
motivating, engaging (Ali et al., 2004; Bolliger, 2006; Deubel, 2003), and interactive
individuals (Fay et al., 2006).
Bolliger (2006) noted that introducing a constructivist approach is difficult if the
learners are not accustomed to taking responsibility for their own learning. Educators
need to act as a coach (Deubel, 2003) and a facilitator that creates a supportive and social
learning environment (Ali et al., 2004). Educators must be dedicated to the approach, and
be flexible to accommodate progress or non-progress of course content (Bolliger, 2006),
as time is a challenge when trying to incorporate constructivist principles into lessons
(Cooperstein & Kocevar-Weidinger, 2004).
When determining an appropriate instructional-design theory, it is also important to
consider adult learning theory. Trotter (2006) reviewed a variety of adult learning
theories and identified three key themes: experience cannot be ignored as adults use
experience as a resource, adults have their own educational interests and need to plan
their own learning path, and the promotion of individual development should be the aim
of adult education focusing on reflection and inquiry.
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Goals, values, and methods are the component parts of an instructional-design theory
(Reigeluth, 1999). Instructional-design theories were analyzed in an attempt to determine
the theory or theories in which the goals, values, and methods would be applicable to an
online nursing leadership learning community. Starting with goals, Bielaczyc and Collins
(1999) identified advancing the collective knowledge and skills of individuals, while
supporting the progression of individual knowledge and skills, as the goal of their
instructional-design theory. Hannafin, Land, and Oliver (1999) and Jonassen (1999)
developed theories with the goal of examining ill-defined or ill-structured problems. The
development of skills in problem-solving, critical thinking, and content knowledge in
complex domains was the primary goal identified by Nelson (1999). Synder (2002) drew
from learner-centered and collaborative learning environment research to develop an
instructional-design theory with the goal of fostering the online sharing of information,
knowledge, skills, and experiences among older adults with common interests and goals.
Three to seven values were identified in each of the instructional-design theories
reviewed. Bielaczyc and Collins (1999) value a culture of learning as a collective effort
and sharing of knowledge, and also respect and appreciate all members of a learning
community as well as their differences. Nelson (1999) values collaborative processes,
problem-solving, and rich social contexts for learning. Cultivating supportive, respectful
relationships among learners, as well as between learners and the instructors, is an
important value identified by Nelson. Both Nelson and Hannafin et al. (1999) value
divergent thinking and multiple perspectives. Hannafin et al. value self-directed learning,
while at the same time value providing tools and resources to aid learning efforts.
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In reference to methods, Nelson (1999) and Jonassen (1999) both speak of the need
for a resource for the learner who will coach and guide the learner as required. In
addition, Nelson and Jonassen both incorporate problem-based learning as a major
method in their respective instructional-design theory. Mayer (1999) refers to selecting
relevant information, organizing the information for participants, and integrating
information as constructivist learning methods. Stone-McCown and McCormick (1999)
use an eight-step process tool called, the Trumpet Process, as the major method for
making discoveries about and acting on issues associated with emotional intelligence. It
is important to note that emotional intelligence is a key element with the WRHA nursing
leadership development framework (WRHA NLC, 2006).
Summary
In determining what is known and unknown about the main subject areas discussed
in this paper, it is important to note that the sample population in the proposed research
study, namely professional working nurses, was not the focus of study for the majority of
researchers whose work was reviewed. Therefore, aside from the few studies in which the
researcher focused on a similar sample population, such as Wilbright et al. (2006) who
studied the computer literacy level of working nurses, and those researchers who
identified nursing leadership competencies, much knowledge still needs to be gained
about the learning needs of nurses participating in an online learning community, the
behaviors and leadership competencies expected to improve in nurses participating in an
online learning community, and the instructional-design theory that will best enhance the
establishment and ongoing development of an online nursing leadership learning
community.
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To summarize the learning needs of nurses participating in an online nursing
leadership learning community, an effort was made to identify the basic skill level of
nurses in relationship to technology, and the technological skills that nurses need to
participate in an online learning community. Overall, the author found that the computer
literacy level of nurses is questionable, and although computer literacy was identified as a
necessity for clinical practice, computer technology is not consistently included in
nursing education programs. The author found that at minimum, learners require basic
computer skills including word processing, and the ability to use email and the Internet to
participate and be fully engaged in an online learning community. Being able to
troubleshoot hardware and software was seen as an advantage. If a learner has weak
computer skills when starting an online program, it was found that a learner’s computer
skills would improve by the end of the program.
A variety of behaviors associated with online learning communities were identified
in the review of the literature. Leadership competencies identified were not specifically
related to an online learning community; however, it appears that there may be
similarities between online behaviors and leadership competencies. Behaviors and
leadership competencies common in both the literature pertaining to online learning as
well as the literature pertaining to nursing leadership include the following: reflection,
constructing and supporting knowledge development, relationship building, establishing
networks, self-directedness, creativity, and good communication and time management
skills.
In determining what instructional-design theory would best enhance an online
nursing leadership learning community, the author first needed to determine whether a
17
behavioral, cognitive, or constructivist learning approach should underpin the
instructional-design theory. A shift in the paradigm of instruction from teacher-directed
to student-centered appears to be common theme in the literature, thus supporting a
constructivist learning approach. A number of instructional-design theories were
reviewed, and there are values and methods in each of the instructional-design theories
that could be combined to establish an instructional-design theory specifically for an
online nursing leadership learning community.
Contribution of the Research
Reigeluth (1999) stated, “…in order for instructional-design theory to make this
transformation to a new paradigm, we desperately need more people working to develop
theories…” (p. 27). Given Reigeluth’s statement, it would appear that much research is
needed in the field of instructional-design theories, especially related to theories that are
based on a constructivist learning approach. The development of a new instructional-
design theory, grounded in constructivist learning, for an online nursing leadership
learning community would be a significant contribution to the field of instructional-
design theory, as the author has not identified an instructional-design theory specifically
designed for an online nursing leadership learning community.
An instructional-design theory for an online nursing leadership learning community
will aid in the development of online learning communities for nurses within and beyond
the WRHA. Instructional designers and nurse educators will be able to use the methods
outlined in the instructional-design theory to ensure that online learning communities are
designed to meet the specific needs of nurses who aspire to enhance their leadership
competencies. The development of an online nursing leadership learning community will
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give nurses an opportunity for professional development that has not been available in the
past. Via the Internet, nurses will be able to dialogue with colleagues at all stages of
leadership development, share their stories and experiences, and be able to be coached by
one another to assess, plan, intervene, evaluate, and ultimately enhance their own
leadership competencies. As the number of nurses who participate in the online learning
community grows, it is expected that the number of nurses prepared to assume formal
nursing leadership roles would also increase. An increase in nurses who possess the
leadership competencies required to fill a projected increase in nursing leadership
vacancies addresses the problem identified in this research study.
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Conclusions, Implications, Recommendations, and Summary
Conclusions
As the proposed research study was not actually conducted, the conclusions for the
study need to be viewed with caution. The findings from the review of the literature were
used to generate tentative preliminary conclusions; however, it is difficult to generalize
the findings in the study.
Research Question One
What are the learning needs of nurses participating in an online nursing leadership
learning community? The answer to the first research question was that nurses require
basic computer skills such as word processing, the ability to use email and the Internet,
and the ability to troubleshoot minor hardware and software problems.
Research Question Two
What behaviors and leadership competencies are expected to improve in nurses
participating in an online nursing leadership learning community? In analyzing the
second question, as well the related literature, it was found that due to the fact that there
are essentially two parts to the question, it might have been better to ask two separate
preliminary questions, namely, one pertaining to behaviors and one pertaining to
leadership competencies, before combining behaviors and leadership competencies into
one question. Nevertheless, the answer to the second question was that nurses
participating in an online nursing leadership learning community would improve their
communication, time management, and self-directed learning skills. Creativity would be
enhanced along with improved reflective abilities. The ability to construct and support
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knowledge development, along with relationship building and networking skills were
seen as important behaviors and leadership competencies that improved while
participating in an online nursing leadership learning community.
Research Question Three
What instructional-design theory will best enhance an online nursing leadership
learning community? It was concluded that the behaviors and leadership competencies
expected to improve in an online learning community were more closely related to
constructivism than behaviorism or cognitivism; hence, a constructivist approach was
found to be the most suitable underpinning for the instructional-design theory. An
instructional-design theory specifically supporting online nursing leadership development
was not found, nor was an instructional-design theory located that included all of the
values and methods necessary for an online nursing leadership learning community;
therefore, the Instructional-Design Theory for Online Nursing Leadership Learning
Communities was developed (see Table 1).
Table 1. Instructional-Design Theory Instructional-Design Theory for Online Nursing Leadership Learning Communities Goal To foster leadership development through facilitated online communication,
relationship building, collective construction and support of knowledge development, and reflection. An instructional-design theory primarily intended for nurses.
Values Some of the values upon which this theory is based include the following: • a culture of learning as a collective effort with sharing of knowledge
(Bielaczyc & Collins, 1999); • rich social context as conditions for learning (Ali et al., 2004; Bolliger,
2006; Cooperstein & Kocevar-Weidinger, 2004; Nelson, 1999); • cultivating supportive, respectful relationships among participants
(Nelson, 1999); • creating an environment that supports knowledge development and
integration (RNAO, 2006); • self-directed learning (Hannafin et al., 1999);
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Table 1 (continued). Instructional-Design Theory Values • divergent critical thinking, multiple perspectives, and reflection (Hannafin
et al., 1999; Kozlowski, 2004; Lee, 2006; Maag & Fonteyn, 2005; Nelson, 1999; Pethtel, 2005; Ryan et al., 2005);
• personal experience (Trotter, 2006); • providing tools and resources to aid learning efforts (Hannafin et al.,
1999); • knowledge translation and application of learning to nursing practice
(Billings et al., 2006; Jeffries, 2005; Kozlowski, 2004). Methods Process Activities 1. Create Readiness (Nelson, 1999). • Provide an overview of the process and roles (Nelson, 1999). • Confirm member expectations (Snyder, 2002). • Set ground rules for how communication takes place (Stone-
McCown & McCormick, 1999). • Provide instruction and practice in group process skills (Nelson,
1999). 2. Form Groups (Nelson, 1999). • Form small homogeneous groups in terms of level of professional
nursing responsibilities (Ready, 2002). • Establish relationships and trust (Diekelmann & Mendias, 2005;
Lock, 2006; RNAO, 2006; Snyder, 2002). • Encourage groups to establish operational guidelines (Nelson, 1999). 3. Select an Appropriate Problem (Jonassen, 1999). • The problem should be interesting, relevant, and engaging to foster
participant ownership (Jonassen, 1999). • The problem should be authentic and professionally relevant
(Jonassen, 1999). 4. Provide Related Cases or Stories (Jonassen, 1999; Ready, 2002) • Effective cases or stories are context-specific, level-appropriate,
presented by respected role models, have drama and high learning value (Ready, 2002).
5. Engage in the Trumpet Process (Stone-McCown & McCormick, 1999) to Dialogue About Cases or Stories
The Trumpet Process includes the following steps for participants to take:
a. Share experiences to provide a common reference point for discussion.
b. Inventory responses: What was unique? What was common? c. Recognize patterns of unique behavior. d. Own your patterns and understand how each serves you. e. Consider the consequences of each pattern including benefits and
costs. f. Allow alternative patterns, and explore options. g. Evaluate the alternatives. h. Choose the best one for each situation.
22
Table 1 (continued). Instructional-Design Theory Methods 6. Synthesize and Reflect (Nelson, 1999). • Identify learning gains (Nelson, 1999). 7. Provide Closure (Nelson, 1999) • Formalize group adjournment through a closure activity (Nelson,
1999). Supportive Activities 1. Provide a Coach (Ready, 2002). • An advisor, specializing in leadership, who assists the facilitator
(Ready, 2002). • Acts as resource and tutor (Nelson, 2002) to the facilitator. 2. Provide an Online Facilitator (Diekelmann & Mendias, 2005). • Creates a supportive presence, and attends to and facilitates
participants’ knowing and connecting with one another (Ali et al., 2004; Diekelmann & Mendias, 2005).
• Acts as resource and tutor (Nelson, 2002) to the participants. • Formulates questions to focus participants on important aspects of
content and learning processes (Nelson, 1999). 3. Provide Just-In-Time Learner-Selectable Information (Jonassen, 1999). • Utilize the Internet as an extension of the learning community
boundaries (Snyder, 2002). • Select relevant information, organize the information for
participants, and integrate information (Mayer, 1999) into a nursing leadership website.
• In the nursing leadership website, provide both static and dynamic relevant and easily accessible resources (Hannafin et al., 1999; Jonassen, 1999).
Implications
As the instructional-design theory needs to be tested, the implications of the study
are tentative, and need to be viewed with caution. First examined were the learning needs
of nurses participating in an online learning community. Nurse educators and
administrators need to be cognizant of the computer literacy level of nurses, and provide
nurse participants with a list of expected computer competencies that must be attained
prior to enrollment in an online learning community. If nurses do not meet the
prerequisite computer competencies, then nurses need to have access to either onsite or
external computer training. There are human and resource implications for administrators
23
that include providing orientation to nurses participating in an online learning
community, as well as providing ongoing technical support. A dedicated facilitator to
support learners and facilitate online discussions is also required.
Next, the enhancement of specific behaviors and leadership competencies through
the participation in an online learning community has direct implications for professional
practice environments as nurse leaders transfer learning from the online environment to
their work environment. As noted in the Problem Statement section of this paper,
effective nurse leaders are an important member of the health care team for they increase
group cohesion, empower nurses, reduce turnover, and ultimately improve patient care
(CHSRF, 2006). The behaviors and leadership competencies discovered by answering the
second research question are behaviors and competencies needed by nurse leaders to
establish and develop a health care team that will improve patient outcomes. There are
also implications for the online facilitator in the area of behaviors and leadership
competencies, for the facilitator must ensure that discussion and questioning is directed
towards the enhancement of particular behaviors and leadership competencies.
Finally, an instructional-design theory for an online nursing leadership learning
community has significant implications for nursing leadership development worldwide.
Instructional designers and nurse educators have access to a theory that meets the specific
needs of nurses who aspire to enhance their leadership competencies. As nurses develop
their nursing leadership competencies through an online learning community, the number
of nurses who possess the leadership competencies required to fill a projected increase in
nursing leadership vacancies will increase and help solve the research problem in this
study.
24
Recommendations
The Instructional-Design Theory for Online Nursing Leadership Learning
Communities will need to be applied in a variety of settings to determine preferability.
According to Reigeluth and Frick (1999), preferability is examined over validity, with
effectiveness, efficiency, and appeal being the three criteria that need to be manifested in
the research design for design knowledge to be generated. Further analysis of the
literature in regards to problem-based learning and storytelling is needed before the
instructional-design theory can be tested.
There is a gap in the literature in regards to online learning and online learning
communities for nurses and nurse leaders. The following research hypotheses were
developed to further investigate online learning and online learning communities:
1. Nurses who participate in a self-directed leadership development program that
includes facilitated online discussion will self-report higher communication ability,
reflective ability, and critical thinking compared to nurses who participate in the same
self-directed leadership development program without participating in a facilitated
online learning community.
2. A dedicated trained facilitator will increase socialization, interpersonal relationships,
and connectedness among participants in an online learning community compared to
an online learning community without a dedicated trained facilitator.
3. Manager’s leadership competency scores will be higher after participating in an
online learning community compared to pre-participation scores.
4. Nurses whose manager participates in an online nursing leadership learning
community will report higher empowerment in their work environment than nurses
25
whose manager does not participate in an online nursing leadership learning
community.
5. Computer literacy scores will be higher in nurses who participate in an online
learning community compared to nurses who do not participate in an online learning
community.
6. Nurses’ satisfaction scores with e-learning will be higher in those nurses who
participate in an online learning community compared to nurses who do not
participate in an online learning community.
Summary
The research problem was that there is a shortage of nurses who possess the
leadership competencies required to fill a projected increase in nursing leadership
vacancies. The goal of the study was to explore instructional-design theories that would
support the establishment of an online learning community to enhance leadership
competencies in nurses employed within the WRHA. Three research questions were
explored with the focus on instructional-design theory as well as learning needs,
behaviors, and leadership competencies of nurses participating in an online nursing
leadership learning community. A review of the literature was conducted to answer the
three research questions.
It was found that nurses need basic computer skills to participate in an online
learning community. A relationship was found between behaviors and leadership
competencies expected to improve in an online learning community. The Instructional-
Design Theory for Online Nursing Leadership Learning Communities was developed out
of the need for a constructivist instructional-design theory to guide nurse educators and
26
administrators in the establishment of online nursing leadership learning communities.
Included in the recommendations was the need to determine the preferability of the newly
developed instructional-design theory.
Overall, the goal of the research study was met. It will be a number of years;
however, until it is determined whether there are a significant number of nurses who
develop nursing leadership competencies as a result of participating in online nursing
leadership learning communities.
27
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