A Comparison of Web-Enhanced vs Traditional Classroom Teaching in Women's Health Nurse Practitioner Education

Deborah J. Stiffler, PhD, RN, CNM


Topics in Advanced Practice Nursing eJournal. 2008;8(3) 

In This Article

Course Comparison Project: Traditional Classroom vs Web-Enhanced Format

In the summer of 2006, I received a grant to work with Indiana University's Center for Teaching and Learning to restructure a traditional classroom course into an online course. This grant provided full immersion in the process of developing the online course, including a support team and resources to assist with design and production of the course.

As the coordinator for the WHNP major, I was the primary faculty for the 2 health management courses, one with an antepartum (pregnancy) focus, and the other focused on gynecologic issues. I selected the antepartum course for restructuring to an online course.

The new online antepartum course followed a modular format. Each module had an introduction with objectives and readings from both texts and Web sites, and a case study. Students were required to answer questions about the case study and develop a management plan. A voice-over PowerPoint (Impatica for PowerPoint, Impatica Inc., Ottawa, Ontario, Canada) presentation was given, followed by a flash exercise or quiz for each module. I wanted to evaluate the new Web-enhanced course and compare it with a traditional classroom course, prior to making similar changes to the gynecology course.

The evaluation had several components. First, at the conclusion of each online module, the students were asked to answer 5 anonymous questions ( Table 1 ). At the end of the semester, the usual faculty and course evaluations were administered by the School of Nursing. In addition, I sent the students a short Zoomerang Internet survey (Zoomerang, San Francisco, California) that evaluated their perception of their own learning ( Table 2 ).

The gynecology course retained the traditional lecture style, conducted in a classroom. This involved a weekly lecture with PowerPoint slides and a case study that I would read to the students and then we would discuss in class. Other than suggested readings, there were no weekly assignments. The same 5 anonymous questions were asked after each class ( Table 1 ), and an Internet survey was sent to the students at the end of the semester ( Table 3 ).

At the end of the graduate program, another online survey was sent asking the students to compare the 2 learning formats ( Table 4 ). Institutional Review Board approval was obtained prior to conducting the surveys. Participation in all surveys was strictly voluntary and anonymous.

The students enrolled in the graduate nursing program, WHNP major, during the 2006-2007 and 2007-2008 school years were asked to participate by completing the surveys. There were 5 students in the program in the first year, and 9 students participated in the program in the second year.

Course Comparison Findings

Of the 14 students who graduated during the 2 years of the study, 8 students completed all evaluation surveys. Ten students also completed the end-of-semester surveys of their own learning.

The course evaluations for both the Web-enhanced and the lecture format were strong. The average score for the Web-enhanced courses for the 2 years was 4.7 out of 5; for the lecture format, the average score was 4.6 out of 5. Student grades for both courses were very similar.

The 5 questions that the students answered at the end of each module or class ( Table 1 ) were not as informative as I had hoped, even when positive ("good module," or "it was helpful"). There were a few comments about the suggested Web sites being especially helpful. One student wrote that she liked being able to review the lecture/PowerPoint presentations as many times as she needed. The negative comments included some about confusing content, but there were no comments specific to the modular or Web-enhanced format.

Other student comments were:

  • "I wish we would have had modules similar to what we had in [the online course] rather than doing verbal case studies in class";

  • "I feel we needed to do the weekly assignments [in the traditional course] as we did last semester [in the online course]"; and

  • "I don't feel as though I learned a lot this semester because we only read through PowerPoints and did not do the weekly case study assignments."

Evaluation of the Web-Enhanced Course

The students were asked to respond by short answer to what they liked best about the Web-enhanced format. Students responded that they liked the flexibility of doing the modules when they had time; they preferred the more structured approach to the learning, and believed that the online assignments prepared them better. One student stated, "It forced me to sit down at the computer, read through the material and Web sites in a more timely manner, and the case studies provided me an opportunity to apply what I had just learned to a specific scenario." Another wrote, "The modules gave me the opportunity to critically think through the material."

The next question asked what students liked least about the Web-enhanced format. The majority of student comments focused on the modules being a lot of work, the length of time that it took to complete the modules, and too much homework. One student wrote, "I had a difficult time motivating myself to watch the modules."

Evaluation of the Traditional (Lecture Format) Course

When asked what they liked best about the course with the lecture format, students replied that they liked being in class and being able to discuss the material. One student stated, "I am better as a visual learner, and going through the PowerPoint slides in class really helped me." Another student liked the more casual approach to the classroom discussion. She found it to be less stressful than the independent study format of online learning. A third student commented, "I liked talking through the lectures and going through some case studies along the way in an interactive fashion."

The students were then asked what they liked least about the lecture format course. The majority of the comments revealed that with the traditional course, students tended to be less well prepared for class. One student wrote, "Honestly, I was not always as prepared for class as I should have been. With the Web-enhanced format, I was much more prepared because I had to read the material prior to doing the assigned case study." Another wrote, "Because there were no 'assigned readings' I did not prepare myself as well for class...even though there were plenty of suggested readings...it was my own fault."

Students' Evaluations of Their Own Learning

Results of the surveys intended to evaluate students' perceptions of their own learning in the Web-enhanced format and the lecture format courses were similar. The students were asked about their ability to analyze complex clinical situations, develop interventions, consult or collaborate, use evidence-based research, improve the health status of women, implement self-care educational strategies, demonstrate beginning competence and advanced physical assessment skills, and feel comfortable and confident in coordinating the care of women ( Table 2 and Table 3 ). A Likert scale, from strongly disagree to strongly agree, was used.

The Web-enhanced survey questions were all answered with either "agree" or "strongly agree" (Figure 1). In the lecture format survey, 1 student disagreed with her comfort and ability to care for gynecologic patients (Figure 2). It is unclear whether this was because of the style of class or the type of patient.

Figure 1.

Results of evaluation of learning survey (Web-enhanced course). Total number of respondents, 10.

Figure 2.

Results of evaluation of learning survey (traditional classroom course). Total number of respondents, 10.


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