By Vern Lamplot

The United States is in the midst of an unprecedented shortage of registered nurses, according to the American Association of Colleges of Nursing. At the heart of the problem is a shortage of nursing faculty, limiting the number of students who can be trained and thus making the problem worse. In order to head off a health care crisis in Arizona, the governor appointed a task force to examine the problem. Its report was due at the end of 2003.

But thanks to Proposition 301, and the resulting Technology and Research Initiative Fund (TRIF), the University of Arizona isn’t waiting. Beginning in August, 20 graduate nursing students began an online program through the UA and the College of Nursing that will earn them a doctorate degree. It will be one of the first online doctoral degree programs in nursing in the country.

The hope is that after nurses complete their program, they will train additional nurses at all levels to help overcome Arizona’s and the nation’s acute shortage of vital health care professionals. “One of the contributing factors to the current nursing shortage is the shortage of doctorally prepared faculty who can teach in baccalaureate or graduate nursing programs,” said Judy Effken, UA associate professor of nursing, who is coordinating the online curriculum. “We hope that by making our program more accessible to qualified individuals we will help alleviate that part of the shortage.”

The College of Nursing is home currently to the only doctoral nursing program in the state. “A doctorally prepared nurse has opportunities, not only in teaching, but also in research and practice that aren’t available to nurses with less education,” Effken said. “Finally, we depend heavily on doctorally prepared nurses to conduct the research to develop nursing science and by so doing improve patient care – in Arizona and beyond.”

“We’re very, very proud of this one,” said Sally Jackson, vice provost for learning and information technologies and UA’s chief information officer. Jackson said this program fits the special requirements of Proposition 301 to extend higher education access. “So we are essentially creating access within the other two metropolitan areas of the state where there are research facilities and researchers within the student’s community,” Jackson said.

The online program, being developed through funding from the Proposition 301 initiative that voters passed in 2000, offers several advantages for students over a traditional campus-resident program. In the past, may nurses have had to travel to class, take leave or even quit their jobs in order to participate, thus adding to the already pressing nursing shortage. Remaining in their communities, the students continue their connections to the local health care system. They will be mentored by UA faculty in their area and who can leverage their deep understanding of local health care needs.

Nine courses debuted last fall semester. Going from zero to a functioning curriculum is the academic equivalent of building the foundation and walls of a house at the same time, according to Jim Austin, director of the UA’s Learning Technologies Center. With approval to move ahead in 2002, Austin quickly had the task of hiring a team of technology specialists with complementary expertise and then integrating them with a team from the nursing college.

 “One thing we’ve had to do is to bring all that expertise to the table,” Austin said. “We have two teams working together trying to figure out the dance.” There is a big difference between teaching in a classroom and teaching online, he said. The challenge, Austin said, is transforming what typically goes on face to face in class to the less-personal, Web-based teaching environment. For faculty, who have internalized many of their instructional techniques, it means rethinking the way they teach.  “Now those things have to be made explicit so that they can be incorporated into the course work,” he said. “It’s energizing,” Effken said. “Our faculty have really warmed to the task.”

For Austin’s nine-member instruction team, it means breaking down teaching and learning into discrete steps. “They are getting the nurses to think about, when you do something in class what are you trying to get them (students) to do? We have to get them to do this through technology; they haven’t used this stuff before.” In order to be ready for fall, Austin says nursing faculty had to get familiar with the technology quickly. So the teachers became students. And there were technology choices to be made. “Some tools just feel better to you,” Austin said.

Because of the process of building these software tools, assessment is built in. Each learning object is tested against a series of questions. Does it do what it is supposed to do? Does it interact? Does it meet the goal of the instructor? What is the perceived student assessment? “Online teaching requires a much more collaborative approach,” Effken said. “Students have to take more responsibility for their own learning and participate much more actively.”

The program is getting some technical assistance from “Desire2Learn,” a company that designs software for education and instruction. The company is bringing together the various elements of e-mail, calendar and courseware. “They will create the (software) shell that hooks everything together,” Austin said.

The nursing team and the technology team continue to face a series of deadlines. Nine courses were ready for the fall; eight more are required for the spring semester. And then there is the second year curriculum that must be completed.  Austin’s development team meets weekly with the faculty. Nursing has cleared a small space within the college so the developers can work in place. “We’re on track to do that. We’re going to make it.”  Effken said the program will admit about 20 students per year.

While the pressure to finish the nursing degree program is intense, Austin said the software and hardware developed for this project will be applied to other programs. The doctoral nursing program is part of a larger initiative at the UA to increase the number of online courses available for Arizonans. The University will spend $5 million, in part TRIF money, over five years for online content and infrastructure. Part of the money was used to create Austin’s development team. Another piece was the recently completed high-speed data link to UA South, the University’s campus in Sierra Vista. And a third part is the creation of library services online to support all distance education efforts. “We’re trying to provide the enrichment that education from a distance needs to have to be any way comparable to a resident education,” said Jackson.

The Learning Technologies Center is already at work on developing software materials for an online program for a group of optical sciences faculty as part of a National Science Foundation grant. Other online programs are currently under consideration for future development using the Learning Technology Center team.

“We’re trying to respond to specific areas of professional and particular need,” Jackson said, “and we’re very interested in the recruitment of larger numbers of people from areas of the state that have poor yield rates for higher education.”

Effken says online education has benefits for students and teachers. She said being able to access the programs whenever and wherever you wish is a benefit for students juggling jobs and other priorities. She says there are economies of scale for providers because individual agencies don’t have to develop their own programs. “Certainly our students will be ‘experts’ at using such programs and perhaps to contribute to them once they graduate.”

“It shows what you can do when you commit resources, have the will and reason to do it,” Jackson said.

The UA also has developed a high speed data link to UA South in Sierra Vista to serve the distance-learning students in Cochise County. The University is leasing fiber optic lines and bought equipment to service the link.  The link is capable of high bandwidth traffic, including two-way interactive video.

 Infrastructure is one part of access but providing needed content is another. The University is developing an online reference service to provide library access to distance learning students and faculty.

“We are trying to provide the kind of enrichment that education from a distance needs to be any way comparable to a resident education,” Jackson said.

Even off campus, students can analyze primary scientific data, operate instruments in remote locations and interact with first-rank scholars.

The University is using $1 million per year of TRIF over five years in people and operating funds to provide distance learning services.