Bringing Life to online teaching

In today’s health care environment, advanced practice nurses are increasingly relied upon to provide comprehensive, high quality health care. As a result, nurse practitioners who need new skills to meet expanding patient needs are searching for online courses and degree programs to fit their busy schedules.

In particular, nurses are scrambling to add behavioral health to their skills portfolios, in the face of a shortage of mental health care providers. A new postgraduate certificate program for psychiatric nurse practitioners at the Graduate School of Nursing is being taught almost entirely online, aiming to fill the gap with a convenient option for busy adult learners.

“A lot of our discussion is about what they do in their clinical setting, bringing it to life online,” said Mechelle Plasse, PhD, assistant professor of nursing, who developed and teaches the pilot program. “Having postgraduate certificate programs online caters to the needs and experiences of working clinicians.”

"Online teaching doesn’t cast doubt on classroom teaching effectiveness, it just approaches it in a different way, ... I focus on a metacognitive strategy to help students think about how they think," Mechelle Plasse, PhD, assistant professor of nursing.

When Dr. Plasse was asked to teach mental health from a computer screen instead of a classroom, she thought it couldn’t be done. Now, she says, “Not only can it be done, it can be better in some ways.”

Online education has come a long way since its inception decades ago. Plasse and fellow GSN faculty say it is particularly suited for the learning needs of advanced practice nurses. Online courses employ innovative multimedia and interactive components along with traditional lectures and readings. Digestible “chunks” of text, enhanced visuals and participatory elements like discussion threads offer students a variety of instructional methods to accommodate different learning styles. They also allow flexibility and convenience for working professionals wanting to gain new skills and advance their careers.

Plasse, who is a psychiatric nurse practitioner, and GSN instructional technologist/designer Ricardo Poza, MEd, designed the program using best practices for online teaching and learning. The program is designed for nurse practitioners who want to add mental health treatment to a current practice, or to switch their focus entirely to mental health. Soft skills like communication, reflection and self-awareness, essential to providing effective mental health care, are addressed.

“Online teaching doesn’t cast doubt on classroom teaching effectiveness, it just approaches it in a different way,” said Plasse. “I focus on a metacognitive strategy to help students think about how they think.”

Metacognitive strategies are techniques increasingly used in online education that help people become more successful learners by looking inward to examine how they learn and to judge which methods are effective. For example, in one assignment, Plasse asks students to reflect on a clinical experience involving substance use disorder, put their thoughts in writing and present to another student, who then offers feedback. “Working online gives the student more time to reflect and respond than in a classroom,” said Plasse. “If I’ve asked a probing question, you have fewer distractions when you’re comfortable at home.

“Woven throughout is the notion of self-awareness and reflection, so everything I’m having a student do is about having them reflect upon what they thought they knew before, how they performed with what they thought they knew, what they learned so far and has that changed their thinking? There’s an ongoing theme of developing soft skills, including reflection, metacognition and self-awareness, built into every assignment.”

Jessica Ventura, DNP, enrolled in the psychiatric nurse practitioner program to obtain the skills and knowledge necessary to integrate mental health care into her full-time practice as a pain management specialist.

“There’s no question that chronic pain affects mental health. But no matter what specialty you’re in, mental health issues will come up with many patients for whom you are caring,” Dr. Ventura said. “Having the flexibility to get online when we have time at the end of the day or on the weekends is really helpful to a working person. This program made the most sense in terms of reputation and quality as well as being able to study online.”

Ventura is satisfied that while she participates remotely, online platforms provide multiple ways to interact with Plasse and fellow students—via email on Blackboard, text messages and discussion threads.

“The online technique of threaded discussions creates interactive classes,” said Plasse. “You have to be thoughtful about how you do that to keep individuals’ comments from all being the same. For example, asking personal questions where everyone’s answer is going to be different.” She posts images of artwork as prompts for online discussion, asking students to discuss the emotions the images evoke, then talks about that in the context of what they are learning about relationship building.

In another pilot for online course delivery, the GSN is offering a hybrid postgraduate program taught in class and online for the adult gerontology acute care nurse practitioner certification. Taught by Dawn Carpenter, DNP, the program enables nurse practitioners to participate remotely in classroom courses being taken by GSN students in other academic programs.

“Online postgraduate students can participate synchronously via Zoom, or participate asynchronously by watching class recordings, and doing work on their own,” said Dr. Carpenter, assistant professor of nursing. “Asynchronous class members have the same curriculum, due dates and exams; they’re just doing it on their own time.”

Conversely, the traditional students also have a hybrid learning experience in which some work is completed online. For example, since class members have different levels of experience in nursing, some already know how to interpret blood gases and electrocardiograms while others don’t. Carpenter posts modules with the foundational information online for review and use on students’ own time as needed for their individual learning needs.

Having Ricardo Poza, MEd, a dedicated instructional technologist/designer, on staff has been key to incorporating online modalities into classes. Here, Poza meets with Mechelle Plasse, PhD, who developed and teaches the psychiatric nurse practioner pilot program.

“I have the students do reading and write questions with answers and rationales to practice certification exam questions before class, then we share all on Google Documents so I can give them feedback on each question,” Carpenter said. Students then download the material to use to study for their exam as well as their certification. “Classroom learning and online resources are symbiotic. Using both makes learning richer because we’re taking advantage of multiple modes of teaching.”

Longtime nurse Catherine Curtis, MSN, RN, is the first graduate of the hybrid adult gerontology acute care nurse practitioner postgraduate certificate program. After researching options, she determined that the Graduate School of Nursing offered the only practical way for her to gain the additional knowledge required for her full-time position as an advanced practice nurse hospitalist in an emergency department.

“After speaking with Dawn, I knew this program would fit my life,” said Curtis. “She made it so easy to communicate and realizes that life happens for adult learners already working in full-time jobs.”

Having a dedicated instructional technologist/designer on staff has proven key to incorporating online modalities into classes. Poza employs software, online platforms and learning management systems including Zoom, Blackboard, Kaltura, Adobe Spark and Articulate to create online modules. “Built-in multimedia capabilities enable us to enliven visual and written course material for a richer online learning experience,” he said. “Beyond watching a recorded lecture or reading a chapter, these tools allow us to integrate video, graphics, slides and audio with built-in questions for assessments that students can navigate at their own pace.”

In one example, while the postgraduate psychiatric nurse practitioner curriculum does require students to come to campus several times to participate in simulations with patient actors, Poza is currently working with Plasse to make simulations more accessible to offsite students. They will be able to use video platform Kaltura to set up a scripted role play at home with a friend or family member and record the interaction for review when posted into the Blackboard learning management system.

Graduate School of Nursing Dean Joan Vitello, PhD, who earned her doctorate through a hybrid classroom/online program, is enthusiastic that the school is offering online options to enable nurse practitioners, many of whom work full-time, to enhance their skills, enhance their career options, and help meet the shortage of health care providers with doctoral training.

“We are always striving for innovative ways to provide educational programs,” said Dr. Vitello. “Embracing online teaching and learning allows us to offer a myriad of learning opportunities to current and future students. We’re very proud of our ability to provide creative ways of sharing knowledge and helping our learners.”

Faculty are continuing to explore the potential of online teaching techniques, and the Graduate School of Nursing has more online offerings in the works. “Having successes with new techniques fuels our passion to improve online teaching,” Plasse said.

By Sandra Gray

@UMASSMED MAGAZINE