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Congratulations, CIN, on your 25th anniversary! The journal has played an important role in the evolution of distance education (DE) in nursing by creating a forum for dialogue about DE issues, publishing hardware and software reviews, and disseminating the work of the nurse educators who were pioneers in the field. This anniversary gives us an opportunity to reflect on DE in nursing by considering the evidence we have gathered indicating that DE "works," how we have refined our practices for teaching and learning using DE, the publication of various position papers that illuminate the DE issues for nursing, and the many successes we have had along the way.



Distance education involves the separation of the educator and learner in time and space. Educators use DE for delivering entire courses and/or educational programs worldwide, or for providing specific learning experiences for academic courses, staff development, or continuing education.


Distance education also involves the use of technology to support the connections that establish the learning community. Early in our history, we used television (did you ever use microwave, satellite, or one-way video, two-way audio); computer aided instruction (CAI) and Interactive Videodiscs (do you remember the patient having a heart attack? or the woman delivering her baby?);correspondence courses and audioconferencing (not so much for nursing); 64 K "desktop" computers with dial-upmodems, and mainframes with rudimentary "learning management systems" (did you use Groupwise mail or VaxNotes to create that first "online learning community"?).


Fast forward to 2007. During the last few years we have migrated to using well-developed online courses, Internet video Web casts, pod casts, PDAs, and cell phones with text messages. We use blogs, wikis, and social networking; content is cocreated. Learning takes place anytime, anywhere, just in time, or just in case, and we have access to learning management systems that actually support learning.1



As we first began to use DE, educators and administrators wanted "evidence" before adopting any innovation. Our initial questions (for each technology!) focused on the effectiveness of DE methods and technologies, particularly as they were used in comparison with teaching in the classroom or using other DE methods, such as video, CAI, or CD-ROM. In most instances, the "no significant difference" phenomenon prevailed,2 and we were assured that DE could work for nursing.


We continue to be mindful of the ongoing need to assess DE practices and outcomes. Now our questions focus on identifying the best practices for teaching and learning using DE: How do students learn? What learning styles are best suited or adapted for DE? How can the use of DE technology promote learning for diverse groups of students? What is the most effective blend of DE? On-campus? Online? Synchronous? Asynchronous? How can we teach clinical courses at a distance? How can we develop the nurse of the future in a DE environment? Testable theoretical models3-5 guide our work.



As we embraced the shift from teaching to learning,6 revising courses for DE delivery prompted educators to reconsider their teaching methods. The roles of faculty changed, particularly in the asynchronous online classroom, from the dispenser of information to the learning facilitator and coach. Lecture was replaced by learning activities that required active learning on the part of the student.


Using DE technology and teaching strategies made novices of otherwise expert educators, and we became aware of the faculty development needed to teach in DE environments. Faculty development included learning not only the technical requirements of the DE delivery system (videoconferencing setups, online learning management systems), but also new pedagogies and course design principles. Teaching is a team effort as educators work with instructional designers, Web technicians, and graphic artists. From an administrative perspective, DE requires an infrastructure shift to provide the necessary technological and pedagogical supports, and many schools and education departments have reconfigured support staff accordingly.


Students, despite the growing population of a generation of "M learners"-those mobile, multitasking whizzes-also require orientation to the use of the technology, and development for self-directed learning.



In the mid-1990s, nursing education's professional organizations took notice of the proliferation of DE offerings and, following the lead from higher education organizations such as the Western Interstate Commission on Higher Education's Principles of Good Practice in Electronically Offered Academic Degree and Certificate Programs, developed position papers for nurse educators.7 For example, the American Association of Colleges of Nursing published a white paper, "Distance Technology in Nursing Education," urging leaders to support increased funding for infrastructure development, faculty development, student support, and evaluation of outcomes, as well as to be aware of legal and ethical issues surrounding confidentiality, intellectual property, and copyright.8 The dialogue continues as educators consider workload credit, appropriate class size, whether to offer just a few courses or full programs, and how to blend on-campus and DE experiences.


Concerned about accrediting programs offered at a distance, the Council of Regional Accrediting Commissions proposed principles for best practices in electronically offered degree and certificate programs.9 Following suit, The Alliance for Nursing's Accreditation Statement on Distance Education Policies advised that schools of nursing seeking accreditation for DE programs should meet the same standards as their on-campus programs.10 Presumably, these recommendations were based on the then-mounting evidence published in peer-reviewed nursing journals!



So what has been accomplished by using DE delivery systems for connecting nurses and nursing students and their faculty? Initially, schools of nursing used DE to assure access and convenience for students seeking additional academic or continuing education. Having access to educational programs allowed many nurses to remain in their hometowns and balance the multiple responsibilities of work and family. DE is a recruitment and retention strategy, and the increasing numbers of distance-accessible master's and doctoral programs will continue to allow nursing programs to prepare nurses for advanced practice roles.


DE has also encouraged global access, thus creating opportunities for nurses worldwide to participate in nursing education programs. The worldwide classroom has enriched learning for all participants.


Distance education is easing the educator shortage. Faculty are no longer bound by place and can teach in their area of expertise for students who may be enrolled at another school of nursing. Clinical preceptors can participate in online post-clinical conferences, thus enriching the online community of professional practice.


Using DE has contributed to a renewed interest in teaching and the scholarship of teaching. Faculty who have changed their pedagogical approaches for the DE "classroom" also translate those approaches to the traditional classroom.


Using DE technology has made continuing education, staff development, and orientation of nurses to clinical practice more efficient and effective. Well-designed courses provide consistent information to all learners and on all shifts.


Nurse educators have also formed consortia, partnered in many instances with clinical agencies to offer courses where they otherwise would not exist. Courses and faculty resources are pooled for wider distribution and more effective use of resources.


We have gone the distance with DE. In short, DE, either as fully technology-mediated courses or programs, or artfully blended with on-campus and/or clinical practicum experiences, has become the norm, rather than the exception.



Thank you, CIN, for providing a venue in which to share our experiences and publish our findings. Here is a toast to the next 25 years of the journal and our continued use of DE in nursing!




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7. Western Interstate Commission on Higher Education. Principles of good practice in electronically offered academic degree and certificate programs, 1995. Available at: Accessed February 15, 2007. [Context Link]


8. American Association of Colleges of Nursing. Distance education in nursing, 1999. Available at: Accessed February 15, 2007. [Context Link]


9. Alliance for Nursing Accreditation Statement on Distance Education Policies. Available at: Accessed February 15, 2007. [Context Link]


10. Council of Regional Accrediting Commissions. Best practices for electronically offered degree and certificate programs, 2001. Available at: Accessed February 15, 2007. [Context Link]