A course delivered on the World Wide Web, Culture and HealthCare Linkages through Technology, would increase cultural diversity in education and practice in not only schools of nursing but related health and human services areas. The amount requested from IHETS for the development of this first-time technology delivery course is $12,000 (65%) and an institutional matching portion of $6,443 (35%).
Indiana Partnership for Statewide Education
Need for course Learners to be served:
Leininger (1997a) predicts that by 2010 all healthcare practitioners will need to be knowledgeable and culturally competent to work in multicultural settings. This requires the ability to analyze similarities and differences in culture care knowledge and practices. Healthcare professionals will be required to shift from ethnocentric and unicultural positions to a multicultural knowledge base in order to be relevant and effective in working with individuals worldwide (Leininger, 1997a). In order to prevent cultural bias, professionals will need to understand their own cultural values, beliefs and practices.
As we approach the 21st century, world wide population movements will be more evident than ever (Leininger (1997b). Until recent times nursing education and practice were focused on the dominant unicultural medical model which focused on the physical and emotional needs of individuals, or cure without culture care. Educational programs need to be changed to incorporate culture care knowledge. There can be no cure without care. Leininger (1995) challenged nurse educators worldwide to educate five million nurses worldwide to provide culturally competent care. How better to meet this challenge but through putting technology to work!
The rapidly expanding World Wide Web (WWW) and emerging virtual communities now provide previously unimagined access to a rich state, national and international community of multicultural connections, resources and information databases. The Internet is not only a viable vehicle for delivery of educational programs but also has astounding potential for linking geographically dispersed and diverse cultural groups (Hodson Carlton, 1996; Hodson Carlton, 1997; Holmberg, 1990). Many examples of effective course delivery have been cited in recent literature. There are also increasing examples of the use of a continuum of technologies for multicultural and multidisciplinary healthcare collaboration and investigation of multicultural issues via the use of technology.
A course designed on the Internet, Culture & HealthCare Linkages through Technology, would increase cultural diversity in education and practice in not only schools of nursing but related health and human services disciplines in the entire State of Indiana. The purpose of this proposal is to develop and implement this course using various asynchronous and synchronous modes of technology for culture linkages and healthcare information from cultural diverse perspectives. Learners to be served include students in nursing programs and other health and human service disciplines throughout the state of Indiana. After the beta testing of the course is completed in the state, the course will be available on a national scale.
Significance of the Course:
Recent statistics indicate that Hispanic and Asian Americans are the two most rapidly growing minorities in the United States. By contrast, the Caucasian population is expected to decline to 62.1% by the year 2025 (U.S. Bureau of the Census, 1993). The United States has high immigration rates and population mobility. These are factors that mandate increased awareness for healthcare professionals. At the same time worldwide communication, global corporations and international travel are expanding. Further, Indiana is a state where cultural diversity is somewhat limited. This proposal will meet a population need for both citizens and healthcare professionals by breaking the barriers of "nondiversity" and expanding opportunities for diversity.
Marketing of the Course:
A network of schools of nursing currently exists with an organization of deans and directors. The Director of our School, Phyllis Irvine, chairs this committee. Cooperation and participation will be sought through this group. Other organizations, Sigma Theta Tau, Beta Rho Chapter, and the American Organization of Nurse Executives also afford an opportunity to market this course. With a documented record of national publications and presentations, each of the course developers has numerous occasions to market the course for national distribution. As Associate Editor of the Computers in Nursing journal, Hodson-Carlton, has a ready venue to publish outcomes from the beta testing of the course at the state level; she writes quarterly articles for this journal.
Collaboration on international nursing experiences has already been established with Anderson University; Marion College; Indiana University, Kokomo; Indiana University; Indianapolis; Indiana University-Purdue University; Fort Wayne; Purdue University, West Lafayette; and Indiana State University from Regional Networking Project in 1996 (Ryan, Twibell, Miller & Brigham, 1996). This project will support the continuation of these regional networks.
Quality of Development Plan:
The quality of the course will be assured because qualified faculty will design and implement the course from two perspectives, transcultural nursing and technology applications. Both faculty have graduate status and teach graduate courses. Input will be sought from the statewide network for course content. The course will be peer reviewed at the school level. An instructional designer is assisting faculty with web course design.
The development of an electronically delivered cultural care course addresses a statewide need to increase transcultural nursing and use of technology as a tool for collaboration and information access. The course would be transferable to other schools. In addition to the course, a need has been identified in relation to culturally focused field experiences. Several schools have established such programs (Anderson University, Marion College, and Indiana Wesleyan) Since establishing transcultural experiences takes extensive faculty commitment, time and money, sharing these experiences would allow for multiple opportunities for all schools. The intrastate network has been established through recent projects among the above named schools. Establishing field sites will allow for an established network, which will broaden electronic participation in the course and diversity.
Evaluation Plan
A recent qualitative research study has been completed between Ball State University faculty and Anderson University faculty. The purpose of the study was to determine the impact of a transcultural nursing course and field experience on graduate nurses and on their professional practice. The outcomes of the study revealed substantial impact on individuals and practice. The experience changed their worldview as well as practice (Brigham, Ryan, Twibell, Bennett, Koepke, 1997).
The present project will be evaluated by a formal research study, which includes formative and summative evaluation. Hypotheses will be developed based on the pilot study to determine context, strategies and outcomes of the electronic culture course. The evaluation process will occur using technology applications. Both faculty and students (and their multicultural & multidisciplinary counterparts) will be queried about the course content and outcomes, and effectiveness of technology as a tool for collaboration and information gathering. Outcomes will be shared on a national and international level; both faculty have a proven record of presentations and publications.
Institution’s Capacity and Commitment of the Course-Development Project
There is strong institutional partnership support for the development of Culture & HealthCare Linkages through Technology. Partnership support originates from the School of Nursing, Ball State University, the established network of schools of nursing around the state, and the Ball State University technology support units. The course will be supported as a recurring electronic course offering for statewide, national and international delivery. Examples of shared contributions from each unit to the development of courses are:
- The School of Nursing, Ball State University, will provide faculty office computers for course development work and access to Course Wizard Web development tools.
- University Computing Services, Ball State University, will provide a toolkit of products for the faculty member’s Web course development work.
- Teleplex will assist with the coordination/training of a student worker to assist with the completion of the course development. This will allow access to the guidance of graphic and web course development consultation services.
- Ball State University School of Continuing Education will facilitate the processing of course admission and registration materials for the course offering throughout the state of Indiana.
The proposal is also "in line" with initiatives underway at many of the state educational institutions; for example, the initiative at Ball State University that includes the development and implementation of a diversity institute.
Instructional Design Plan
We will apply instructional design principles to the development of World Wide Web based modules for this course. After grant notification, we will identify course objectives/outcomes, instructional strategies including technology integration and evaluation plans for the course and the project. Since both course faculty have previously developed and implemented course modules for Web delivery (see http://www.bsu.edu/nursing/programs/ masters/courses.html), some design and user support materials are in place and will be adapted for use in this course (Hodson-Carlton, Ryan, & Siktberg, 1997). For example, a combination of industry products and university-developed tools will allow the faculty to use a variety of technological supported tools for Web module development. The University supported toolkit of products for the Web course development work includes the Course Wizard, a suite of software products, which include Web Designer, Web File Manager, and InQsit. The Web Designer provides a customized template to design and develop instructional materials. The Web File Manager allows the faculty to manager their own Web pages and InQsit is a tool available for testing and surveying. This combination of university-developed tools, which each faculty has already used, and industry products, such as Netscape Communicator allows both faculty to use a variety of technological supported tools for Web module development.
From the first notification of funding, an instructional design focus for this course will be the development of multicultural and multidisciplinary virtual communities for asynchronous and synchronous electronic networking activities. Gingerich and Green (1996) depict a future in which technology as a communication tool allows practitioners to work with clients in new ways as well as have immediate access to a range of information sources and professionals. And so, a primary goal of this course is to create "digital groups" of nursing and other health and human services students and faculty able to "meet" with culturally diverse students, individuals and groups to problem solve cultural and healthcare issues. The course will be designed to use a wide range of telecommunication tools which will allow the students to complete requirements at times convenient to them; they will use e-mail, list-servs, netnews groups, electronic bulletin boards and conference rooms. Students will learn and use technology as an evolving tool within the context of culture and healthcare. For example, a nursing student and a social work student may electronically "partner" with students, professionals, faculty, and/or healthcare clients from diverse multicultural groups to problem solve the cultural perspective of such healthcare issues as diabetes, cancer, or heart disease. An example of a culminating course project might be a collaboratively developed web home page where other students, faculty, and/or healthcare clients from a variety of cultural groups could visit for information and networking possibilities.
A module development approach will be used with the course. The requested peer/consultative review will occur in a formal written manner at four strategic points in the process: initial review of course plans and at the end of each one-third development of the course (May, August, December & May). Informal contact with the peer reviews (culture and technology focused experts) will occur on an on-going informal basis throughout the course development via the electronic networking established at the project initiation (March, 1998). The Web based development process will span three semesters for the course. During phase one (one semester) the faculty (one of whom is an instructional designer: Hodson-Carlton) will work closely with a Teleplex instructional designer and the computer/graphics graduate student to complete one third of the course. In phase two (one semester) the course faculty will continue to work with the Teleplex instructional designer and the project graduate student to establish a timeline for joint meetings with appropriate Teleplex graphic, video and multimedia representatives and complete the 2nd third of the course. During phase three (one semester) course development and the first delivery of the course will occur.
Project Schedule
The course, Culture and HealthCare Links through Technology, is scheduled to be offered for the first time during Spring semester of 1998-99. Electronic modules from the courses would also be available for continuing education delivery.
| February 16, 1998 |
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| March – May, 1998 |
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| June, 1998 |
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| June – Aug, 1998 |
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| August – Dec, 1998 |
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| Jan – May, 1999 |
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| June, 1999 |
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| May - Aug, 1999 |
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Key Course Development Personnel
Kay Hodson Carlton, EdD, RN, FAAN, Director, Learning Resource Center, School of Nursing & Associate Editor, Computers in Nursing, a Lippincott monthly journal publication: will design and develop the technology portion of the course. This development will include the use of synchronous and exploration asynchronous electronic tools, multiple database. Will supervise and coordinate the work of the graduate assistant with other University support services.
Marilyn Ryan, EdD, RN, Associate Director, Graduate Program, School of Nursing: will design and evaluate component, cultural network establishment, student advisement, course marketing and develop course content based on regional networking.
APPENDIX
References
Brigham, C., Ryan, M., Twibell, R., Bennett, P., & Koepke, A. (1997). Undergraduate transcultural nursing experiences: Implications for teaching. Conference Proceedings American Nurses Association Perpetual learning for Competent Nursing Practice. Indianapolis, Indiana. (October).
Gingerich, W.J., & Green, R.K. (1996). Information technology: How social work is going digital. In: Raffoul, P. Aareon McNeece C, eds. Future Issues for Social Work Practice. Boston, MA: Allyn & Bacon. 19-28.
Hodson Carlton, K., Ryan, M., & Siktberg, L.. (1998). Designing courses for the internet: A conceptual approach. Nurse Educator, 23,(3). (In press).
Hodson Carlton, K. (1997). Connecting points: Telecommunications. Redefining continuing education delivery. Computers in Nursing, 15:17-18, 22.
Hodson Carlton, K. (1996). Connecting points: Reengineering of the learning environment. Linking the nursing student with the health care community. Computers in Nursing, 14:19-20.
Holmberg, B. (1990). A paradigm shift in distance education? Mythology in the making. ICDE Bulletin, 22:51-55.
Leininger, M. (1997a). Overview of the theory of culture care with ethnonursing research method. Journal of Transcultural Nursing, 8,(2), 32-52.
Leininger, M. (1997b). Future directions in transcultural nursing in the 21st century. International Nursing Review, 44, 119-123.
Leininger, M. (1995). Teaching transcultural nursing in undergraduate and graduate programs. Journal of Transcultural Nursing, 6,(2), 10-26.
Miller, P.A., & Hodson Carlton, K. (1997). Technology as a tool for health care collaboration. Computers in Nursing, 16,(1), 6-8.
Ryan, M., Twibell, R., Miller, A., & Brigham, C. (1996). Cross-cultural nursing: A report of faculty collaboration through regional networking. Nurse Educator, 21,(6), 28-32.
U.S. Bureau of the Census (1993). Population profiles of the United States; 1993. Washington, DC Government Printing Office; CPR, series p-23, No. 185.
Biographical Sketch
KAY HODSON CARLTON, Ed.D., RN, FAAN
Present Position: Professor & Director, HealthCare Learning Resource Center & Associate Editor, COMPUTERS IN NURSING
Title: School of Nursing, Ball State University (1976-Present)
Educational Background: Ed.D., Instructional Systems Technology, Indiana University, 1982; MSN, Medical/Surgical Nursing, Indiana University, 1976; BSN, Ball State University, Nursing, 1973; MLS, Ball State University, Library Science, 1969; BS, Ball State University, Social Science, 1967.
Professional History: The major focus of my professional career for the past twenty years has been the design, development and implementation of technology and telecommunications in nursing and healthcare education and practice.
Creative Technology Works:
"Design, Development, & Implementation of World Wide Web Template for Course/Program Delivery," School of Nursing, Ball State University, 1996-present.
"CD ROM Development: Clinical Encounters," Ball State University, 1994-97.
"CD ROM Development: Range of Motion: Clinical Problem Solving with Electronic Connections," Ball State University, 1994-97.
"Nursing Skill Videotapes: Fundamental Skills," Health Science Consortium, Chapel Hill, North Carolina, 1990.
"Computerized Surgical Care Advisor Expert System," Ball State University, 1989-92.
"Simulated Hospital Information System (Mainframe & Microcomputer Versions)," Ball State University, 1988-90.
"DoseCalc: 12 disk computer program providing diagnostic & tutorial instruction on drug dosage calculation," Saunders, 1984.
Publications: Articles:
"Technology as a tool for healthcare collaboration," Computers in Nursing, May, 1998.
"Partnerships for healthcare practice information," Computers in Nursing, 1997.
"Portfolio applications in a school of nursing," Nurse Educator, January, 1997.
"On-line and advanced telecommunications: redefining continuing education delivery," Computers in Nursing, 1997.
"Implications for nursing education: a virtual Mrs. Chase and cyberspace learning," Computers in Nursing, 1996.
"Computerized test development software: a comparative review," Computers in Nursing, 1996.
"Integrating electronic conferencing to enhance problem solving in nursing," Nurse Educator, 1996.
"Reengineering of the learning environment: linking the nursing student with the healthcare community," Computers in Nursing, 1996.
"Computerized NCLEX-RN preparation programs," Computers in Nursing, 1996.
"The distant learner: establishing technological healthcare resource links with the distant learner," Computers in Nursing, 1995.
"Electronic library: a collaborative venture for education, Sigma Theta Tau and healthcare agencies," Sigma Theta Tau International Reflections, 1995.
