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This paper appears in the publication, International Journal of Information and Communication Technology Education, Volume 4, Issue 1
edited by Lawrence A. Tomei © 2008, IGI Global

Fostering Meaningful
Interaction in Health Education
Online Courses:
Matching Pedagogy to Course Types
Richard G. Fuller, Robert Morris University, USA
Gary Kuhne, Penn State University, USA

ABSTRACT
This research study examined the best interactive practices of effective health care education faculty from
six major universities that offer online health care programs. Program directors from six major universi-
ties identified effective faculty, from which twelve faculty members were interviewed to uncover effective
practices and an additional thirty faculty participated in a Delphi study to identify and prioritize effective
practices. The findings for this study indicate that different types of facilitation approaches are needed to
generate adequate interaction in four distinct types of health care courses, i.e., foundational classes, skills
classes, analysis/synthesis classes, and hybrid type courses.

Keywords: analysis/synthesis class; foundational classes; distance education; hybrid type courses;
interaction; online pedagogies; skills classes; types of courses

INTRODUCTION face-to-face teaching, there are methods and


Wlodkowski (1999, 1985) suggests that effec- techniques that work in some venues and not in
tive instructors must have expertise, empathy, others. Strategies that foster effective interaction
enthusiasm, and clarity, a conclusion that is in an engineering classroom may not offer the
relevant whether the teaching takes place in same efficacy in a healthcare program. Effec-
traditional face-to-face settings or in online tive teachers are willing to explore why certain
formats. Interaction with the student is a central interaction techniques work and don’t work in
factor in demonstrating each of these elements. order to discover the most effective techniques
Effective instructors have discovered interac- for their particular educational programs.
tive practices that work well in face-to-face Knowles (1999, 1980) and Rogers (1969)
classrooms. The challenge for online instructors argue that adult education teachers serve as
is to discover how to replicate effective interac- facilitators, providing the resources to enhance
tion practices within the online, asynchronous and facilitate the self-directed learning oppor-
learning environment. As with traditional tunities of their students. Such an understand-

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Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008 45

ing of the role of instructors is particularly Howland and Moore (2002) found that
pertinent to the online asynchronous arena of when students initiated interaction with instruc-
higher education systems, where educators tors and other students, knowledge was often
must design a variety of courses for a variety built spontaneously, such as through students
of learners. Effective instruction requires that guiding the direction of discussion-board
teachers understand the changing needs of their threads. Such student leadership then led to
learners based upon the nature of the educational positive results for others. One student said,
program. In other words, an effective instructor “Several times, I have seen questions asked by
does not approach each learning situation with others that had not even occurred to me to ask
the same pedagogy and style. Different styles of and the answers benefited me” (p. 188). Swan
course require different techniques to facilitate (2001) found that students with higher levels of
success learning. Knowles (1980) suggests interaction with their classmates through online
the specific learning needs of the particular discussion also reported higher levels of learn-
participants of a given learning activity must ing and satisfaction from courses. Rovai and
be diagnosed. Understanding the unique needs Barnum (2003) also found evidence that student
of different university and college programs at perception of learning from online courses was
graduate and undergraduate levels in different positively related to course interaction, lending
disciplines will go far toward enhancing inter- further support to the need to provide oppor-
active teaching practices online. Regardless of tunities for online students to learn by active
the mediated nature of the communication, “It interaction with each other and with instructors.
is the teacher’s responsibility to precipitate and Effective online instructors develop highly
facilitate learning that has purpose and is focused interactive material and facilitate participation
on essential concepts and worthwhile goals” in online discussions. Rovai and Barnum also
(Garrison & Archer, 2000, p 48.). Adults and suggested that passive interaction, analogous to
distance-education students relate in an interac- listening to,but not participating in, discussions,
tive collaborative construction of knowledge, was not a significant predictor of perceived
a system that typifies many of the concepts of learning in the present study. Consequently,
adult education theory (Anderson, et al., 2002). using strategies that promote active interaction
The dilemma facing online instructors is how leads to a greater perception of learning and
best to accomplish the designing, facilitating, higher levels of learner satisfaction.
and guiding of a predominantly text-based learn- Beaubien’s research (2002) described
ing arena to best foster the different levels of instructor characteristics that contribute to ef-
interaction required for learning success. fective online courses. Students need to feel that
the instructor is online regularly. The instructor
BACKGROUND does not need to be intrusive to the online dia-
In conducting online teaching, interaction needs logue but his/her presence needs to be known.
to be planned to facilitate learning. Vrasidas and Short postings are good for the most part but the
McIsaac (1999) found that structure can affect teachable moment should be capitalized upon to
interaction, and concluded that educators need to provide sufficient information and clarification
design courses to foster learner-to-learner inter- as is necessary. Sometimes the instructor can
action and dialogue. Kozma (1991) agrees with pose questions that will stimulate or lead the
the need for less structure and more dialogue discussion in a direction. Instructor modeling
and suggests that learners should actively col- of a high level of presence sets a positive norm
laborate in order to construct knowledge rather for the class and encourages students to do the
than relying solely on knowledge gained from same. Moore (2001) suggests that instructor
direct instruction. For such collaboration to oc- interaction should have the goal of establishing
cur, learners must feel a sense of connectedness a culture of independent learning and peer par-
with the group (Gibb, 1995). ticipation. Positive instructor feedback tends to

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46 Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008

bring out the best in people and motivate them strategies faculty employ to foster and facilitate
to invest discretionary effort (Braksick, 2000; the sense of interaction. It was hypothesized that
Daniels, 2000). Positive instructor feedback effective faculty employ certain methodologies,
can energize the learning system and increase practices, and mindsets in planning and active
interaction frequency. teaching phases to promote interaction when
Vrasidas (1999) examined the conceptual utilizing online courseware. The research asked
framework of interaction in online courses and what successful online distance education facul-
found that the factors influencing interaction ties do to make their teaching more interactive,
were learner control, social presence, structure, and do they use different approaches to generate
feedback, and dialogue. In a follow-up study, interactivity in different situations.
Vrasidas and McIsaac (1999) found that each
of these factors has specific implications for The Study or Methodology
teaching practice. For example, activities can The research design for this study involved
be structured to increase interaction with the a triangulated three-tiered process. The first
instructor, other students, and the course content. phase was to identify graduate and undergradu-
Discussing a paper outline with an instructor; ate health-care faculty from major university
collaborating activities with peers, and partici- schools of nursing and health professions who
pating in required online discussions were found provide effective interactive education that
to increase interaction among participants. This fosters learning. Potential faculty were identi-
study, not unexpectedly, found that higher-than- fied by program directors from six university
expected workloads contributed to decreased health education programs (The University of
interaction. Thus, the appropriateness and Pittsburgh, George Washington University,
on-task time of course requirements must be West Virginia State University, West Chester
suitable to facilitate online interaction. University, University of Maryland, Baltimore
County (UMBC), and Drexel University), who
PURPOSE OF THE STUDY, based their identification on the criteria that the
HYPOTHESES, AND instructor, (a) promotes a high level of student-
to-student interaction through threaded e-mail
QUESTIONS and discussion-board activities as well as other
The purpose of this study was to investigate the
activities that allow learners to construct or
interactive practices of effective online health
formulate an idea in a deeper sense, and raises
care graduate and undergraduate instructors
the interest and motivation of the students, (b)
as gleaned from the experience of successful
the instructor promotes a high level of student-
faculty. This study focused on understanding
to-instructor interaction through both quantity
how the online teaching technologies in the
and quality of assignments that maximize the
courseware of an Internet portal system were
impact of interactions, and (c) the instructor
being employed to promote interaction. The
promotes a high level of student-to-content
goals of this research study were: (a) to bet-
interactions through offering a variety of activi-
ter understand the phenomenon of successful
ties and resources that offer students a variety
online computer-based education in graduate
of alternatives for learning.
and undergraduate healthcare education through
The second phase, utilizing the program
the identification and description of online
director’s listings, involved interviews with
educational constructs that exemplify effective
twelve (12) selected faculty from the list de-
interactive practice, (b) to better understand
veloped in phase one. These instructors were
how effective distance educators in health-care
requested to participate in phenomenological
education utilize the innate capabilities of online
interviews, either face-to-face or by telephone
courseware to support interactive constructs,
to establish trends and common themes in ef-
and (c) to better understand what techniques and
fective online instruction.

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Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008 47

The third phase of the research involved or perspective, of the identified instructors. This
taking the 12 phenomenological interviews and research did not take into consideration student
synthesizing the results to create a Delphi ques- perspectives of effective practice. This research
tionnaire for use with an experienced group of 30 also relied upon the identification of effective
faculty members drawn from the list developed faculty from the perspective of program direc-
in phase one. Trends and common threads were tors who based their recommendations upon a
identified to assist in categorizing the data. To provided set of criteria.
assure that all common themes and trends were
identified, a second evaluator was utilized to as- Interview Findings
sure inter-rater reliability. The questionnaire was The 12 faculty members interviewed suggested
operationalized following the Delphi Technique that different types of courses require different
with the 30 additional faculty. This tool allowed types of facilitation to generate effective interac-
a group of defined experts to come to a consen- tion. As one instructor for this study stated:
sus of opinion when the decisive factors were
subjective, and not knowledge-based. Through There are different types of courses, such as the
a series of questionnaire exchanges, the experi- hard sciences classes versus the social science
ence group identified additional ideas through classes. There may be classes such as skills
individual brainstorming and communicating classes, such as a clinical class, or a research
ideas with the investigator to clarify and validate class where students need to leave with a skill.
the findings from the previous questionnaire. There may be social science or discussion/opin-
Questionnaires were exchanged through e-mail ion classes that take information and apply it in
to maximize efficiency and minimize time as- different situations. This is both online and in
sociated with conventional mail. A series of the traditional courses. There is a big difference.
three exchanges with progressive fleshing out of At times the conceptual pieces in putting things
ideas as well as generation of new ideas beyond together as opposed to the nitty-gritty facts and
those attained through the phenomenological research and data collection are trickier to do.
interviews was facilitated. It was determination The relating this in the everyday life can be
after the third questionnaires that no new ideas more difficult and more challenging.
had emerged.
Four types of courses were distinguished,
Limitations including foundational classes, skills classes,
The attempt of this research was to capture analysis/synthesis classes, and hybrid type
interactive fundamentals of practice among courses.
health care online educators. It is acknowl-
edged that in the context of the interview, that • Foundational or rote memorization
some may have issued their espoused theory courses: Such courses provide the foun-
and not their actual theories in use (Argyris, dation or knowledge that will be used to
1999). Argyris suggests that people consistently build upon in other courses. The prioritized
act inconsistently, unaware of a contradiction interactions in such courses focus on
existing between their espoused theory and helping the student make more “student-
their theory-in-use (what they actually do in to-content” connections. As one instructor
the practice setting). Despite this possibility, from this study stated, “In the foundational
participants offered what they envisioned as course, you either get it or you don’t.”
the most effective pedagogies to maximize Foundational courses include courses like
interactivity in online health care programs. anatomy and physiology, pathophysiology,
It is further recognized that one of the medical economics, and the business of
limitations of this study is that the definition of health care. Many of the assignments in
effective practice is based upon the single lens, such courses are e-mailed weekly based

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48 Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008

upon module content to assure interaction courses focus on content, however, and
with the content and understanding of key expand beyond “student-to-content” con-
concepts. Some “student-to-student” is nection, requiring instructor facilitation
fostered, primarily through having assign- and presence to promote dialogue specific
ments shared and discussed on discussion to the skill and the application of the skill.
boards, something that does not routinely Instructors facilitate critical thinking and
happen in a face-to-face classroom. As one understanding of the concepts through
instructor stated: the skillful use of questioning, such as “if
we did this what would happen” or “how
Health Care economics is a foundational could we do this if…?” or “Great idea.
course (not all economics courses are this way). Does anyone have any other directions?”
In this course it is more of the memorization Examples of such skill-based courses
and regurgitation that is important. I can’t ask would include Nursing Research, Medi-
them to compare and contrast John Maynard cal Informatics, and Patient Assessment.
Keyes to Karl Marx because they are not there Skills classes such as Nursing Research
yet. I facilitate this differently than an upper or Health Education Research should be
level class. I use more discussions based upon project-based, as students need to flesh out
the facts. They come into their first class and ideas and application of concepts. Interac-
think that they understand this stuff. They tion focuses on how and where to perform
think that they have all the answers. But they the skills as well as facilitating students
give what I call, “man on the street” answers. toward a finite answer and how they get
I have to remember that what I am doing here that answer (example: Identifying research
is building a “foundation.” This type of course questions). As one instructor stated:
and a rote memorization course is foundational
for other courses. Part of my goal is that I want them to under-
Such interactions are not generally open- stand the complexities of research and how you
ended and are designed primarily to reinforce work with other people, so I do include a group
the memorizing of basic concepts that will project into the course. I believe that you learn
be applied later in their professional studies from your peers. There is a skill set in how do
and practice. For example, an online nursing you develop a proposal, how do you interpret
student may not understand all the reasons for statistics, how do you design research. The
memorizing anatomy and physiology, but will goal isn’t to make them an expert when they
come to understand better the value of such are finished but to give them a set of skills that
memorization as the anatomy and physiology they can apply.
facts are applied in future courses.
The faculty interviewed believed that Another example drawn from an instructor
while foundational courses do not innately teaching a Physical Assessment course:
lend themselves to great online discussions,
providing interactive e-mailed assignments, I found teaching Physical Assessment online a
more instructor presence for Q & A, and in- difficult course to teach online because there
structor interaction in discussion boards helps is, or should be, so much hands on, and if you
to foster meaningful learning interactions with teach it in the classroom there is. So it is very
such courses. difficult to deliver the physical assessment
content Web-based because there has to be a
• Skills based courses: Such courses require video portion. The student has to be able to
students to gain a particular skill(s) set see how you percuss (thumping of the different
that is applicable to a specific environ- body areas to determine if air or fluid is pres-
ment. The prioritized interactions in such ent), what the assessment of the abdomen looks

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Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008 49

like, and one of the big issues that we have is explore and support the differing viewpoints
not bandwidth on our end at the university but with the facts. For the instructor in this type of
among the receiving students. So I can decide class, the key was not to intervene too much.
to send them this fabulous thirty-minute clip, As one instructor stated:
the best I’ve ever seen, and they are not going
to be able to download it if they don’t have the I’ve found that if I post my particular opinions
technical capabilities. I have to make a deci- about a topic, then I change the discussion in
sion about how much information I can chunk that students stop posting or they just restate
into a block. my opinions. I think you have to be very care-
ful. What I do is post more personal experience
Assignments that facilitate student-to- than personal thoughts and beliefs. You have
content interaction in a skills-based class are to control that and it can be very difficult. You
weekly assignments that are e-mailed back to have to post more with “what I’ve found is.”
the instructor to assure that they are interacting Any time you give them a clue on which direc-
with content and understanding it. Interaction tion you lean the majority of the class is going
with students and instructor focuses on the to lean that way too because they want a good
processes that they are going through in learn- grade too. So you need to be very careful how
ing the content. you do that. I think that if you come down with
a very dogmatic statement then you shut them
• Synthesis/Analysis Courses: Such dis- down as people don’t want to be wrong. They
cussion-based courses are used to teach are still learning and fleshing out their own
students to analyze a situation and engage thought processes and if you post too much
in problem solving. Instructors find that you shut down their thought processes or they
authoritative postings tend to shut down may not agree but are not willing to take this
dialogue or that students simply parrot instructor on.
instructor ideas or postings (most students
do not want to challenge instructors and risk There is a need to establish the culture of
receiving a lower grade). Dialogue among independent collaborative learning. Instructors
participants provides regular opportunities do not respond to the majority of postings in this
for reflection and inquiry and requires type of course but read them all and respond to
the least intervention in the discussion key ideas and elements and, through additional
boards of all the course types. Simulated questions, guide the learning process. If the
interaction in this manner through subject discussion is getting one sided or negative, the
matter presentation can subsume part of the instructor can, through a posted thought, direct
interaction by causing students to consider the dialogue to view all sides. “That is true but
different views, approaches, and solutions what would ‘so and so’ say regarding this and
and generally to interact with a course. why?” One technique in this type of course is
to create an online debate where students don’t
These are courses where core information get to pick but defend an assigned point of view,
is presented but there is not necessarily a right which forces them to see all sides. In a Nurse
or wrong view. An example may be an Issues Practice course, one technique reported was
in Health Care, Health Care Policy, or Nursing that students were facilitated to choose a topic,
Practice course where a module or lesson would interview someone, and then write a paper and
focus on “Compare the value of the Canadian discuss their issue and what they have found by
versus the USA health systems.” This is the leading a discussion-board thread.
type of course or topic that will prompt many
opinions and views. The key is to flesh out all • Hybrid Courses: Such courses have a
angles of the subject and have the students combination of the above three and re-

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50 Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008

quire a mixing of techniques to facilitate not effective, does not facilitate mastery of the
interaction. An example of this may be a material, and frustrates the students.” Another
Health Care Management or Leadership articulated that: “Instructor interaction in this
course where there is specific theory to type of course takes a lot of instructor facilita-
understand and employ but also where you tion and takes on a greater role with telephone
want students applying and understanding follow-up when they are having difficulty in
their own personal leadership style in dif- understanding concepts.”
ferent situations.
Synthesis/Analysis or
THE DELPHI FINDINGS Discussion-Based Courses
The Delphi process suggested that interaction It was agreed that in these types of courses, the
strategies vary according to the type of course. free flow of ideas monitored and facilitated by
Those participating in the Delphi component the instructor is the best technique. This requires
agreed with the majority of the interview find- that the instructor monitor carefully, and he or
ings, and in many cases further elaborated on she must be diligent in fostering good online
the four types of course offerings. dialogue about the topics at hand. In this type
of course, a majority of instructors reported
Foundational or Rote using a “search and report” technique, where
Memorization Courses students go out and research a topic and then
It was agreed that while these types of courses report back as a catalyst for generating good
don’t generally lend themselves to great online discussion boards. Additionally, instructors
discussions of the material, the interaction reported using weekly discussion board topic
generated was centered on assisting students questions based upon the readings and students’
with learning the content material. It was also own research to generate discussions. The
believed that a greater instructor presence was instructor would monitor and then post as was
necessary so that some students don’t have the appropriate to guide, stimulate, and assure good
feeling of learning alone or in a vacuum. dialogue. As one instructor stated: “In my nurse
practice course they will choose a topic and go
Skills-Based Courses interview someone and then write a paper and
It was agreed that the interaction in a skills- discuss their issue and what they have found
based course is centered on the content, and by leading a discussion board thread.”
that interaction was again used to make con-
nections between content and skill application. Hybrid Courses
This type of course was again found to require It was agreed that there are these types of courses
more instructor presence for students to gain but not all agreed on which type of course was
the skill, and that the instructor’s role was to in which category. Some reported that a research
generate thinking and a better understand- course was felt to be a skills class while others
ing of the concepts. A majority of the Delphi felt that it was a hybrid class where multiple
participants utilize the weekly assignments techniques are employed. It becomes less of an
format for a skills class. The concept of forc- interest to this research to categorize courses
ing a student-to-student interaction just for as it is to understand that there are different
the sake of having one was not described to be courses that may need facilitation using dif-
effective. One instructor stated: “Certain topics ferent techniques differently to maximize the
don’t lend themselves to meaningful discus- online learning.
sion. Having a discussion assignment because
there should be student-student interaction is

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Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008 51

CONCLUSION AND Instructors need to design interaction


DISCUSSION that is more finite in assisting participants to
One of the more significant findings in this understand the material. This interaction takes
research is the identification and confirmation its form in assisting students to learn and
that different types of courses require different memorize the material, to see how it all fits
types of facilitation to generate interaction. together. The design of the interaction is seen
The four types of courses in the health-care through e-mailing assignments to the instructor
educational systems (foundational classes, for feedback and assistance in learning the key
skills classes, analysis/synthesis classes, and objective elements of the foundational course.
hybrid type courses) require the employment While this type of course does not lend itself
of specific facilitation techniques on the part of to great online discussions, but is more focused
online instructors. This finding has implications on learning the concepts, it is also paramount
for interactive design and online teaching. for the instructor to practice a greater presence
that provides the student with a sense of contact
with the instructor (Townsend, 2002; Kanuka,
Foundational or Rote
Collett, & Caswell, 2002; Beaubien, 2002).
Memorization Courses
The interaction in this type of course is more
focused on providing a greater understanding of
Skills-Based Courses
The implications of the research suggest that
material to serve as the basis for future learning.
instructors need to design their interaction in
The central focus here is on student-to-content
this type of online course to assist students
interaction. Health care programs have in-
to gain the skills necessary to function in the
nately established a framework of knowledge
particular health-care environment. Effective
and skill that serves as a foundation for future
interaction requires designing discussion board
learning. The information learned in a Medi-
activities to present applications and allow
cal Terminology course is the building block
students to see other’s work and learn from
for an Anatomy and Physiology course. The
each other toward the final goal of attaining the
knowledge gained in these courses serves as the
skill, whether it is learning the physical skills of
universal knowledge for the rest of the health
chest percussion, or lung sounds (where there
care clinical education, whether in nursing or
are significant limitations), or the mental skills
any other allied health field. These courses are
of designing and conducting medical research,
typically very structured in nature and require
or the skill of learning database construction
the instructor to clearly articulate the material
and manipulation in a medical informatics
for ease of consumption by the learner. The
class. The ability to demonstrate competence
learner of online foundational material must be
for the physical skills innate to health-care
independent in learning the material but, as with
practice is one that has significant limitations
a face-to-face class, the interaction is designed
in the current online environment within the
to assist the learner to that end. Carnwell’s
present available technological structures,
(1999) concept of developing internal dialogue
and assessment of competency often requires
is supported here. His research indicated that
a face-to-face environment with credentialed
the students in this situation desire more highly
professionals. The implications for the design
structured materials. Design of text materials
of interaction are for the instructor to use a more
is also important since the level of structure
facilitative role to assure that student-to-student
within the text may create either independence
interaction is being assisted here toward apply-
or dependence in students. Jones and Kemper
ing the information from the class to the field.
(1994) suggested that independence can be
Kennedy (2002) supported this premise as he
fostered by requiring students to use self-study
suggested that learner-to-learner interaction is
packages in an unsupervised manner.
a valuable part of the online learning experi-

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52 Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008

ence and that the distance education format is will simply repeat or “parrot” the instructor’s
particularly well suited to engaging students view on the issue. This is in direct conflict of
in this type of interaction. These discussions what the instructor may wish to accomplish by
can be deeper and more reflective, covering a allowing students to analyze and synthesize all
broader range of issues that assists students to views of the problem or issue. Dialogue among
gain the skills taught in the course. Encourag- participants provides regular opportunities for
ing greater interaction among learners not only reflection and inquiry (Wesley & Buysse, 2001)
enhances student learning and application of the and requires the least intervention in the discus-
new skill set, but also places the instructor in a sion boards of all the course types. Simulated
more supportive, facilitative role, which results interaction through subject matter presentation
in more efficient use of instructor time (Udod & in pre-produced courses can subsume part of
Care, 2002). Instructor interaction in this type the interaction by causing students to consider
of course needs to take on greater monitoring different views, approaches, and solutions and
of the learning, and the utilization of personal generally to interact with a course (Holmberg,
e-mail contact and telephone conversation 1999, 1989).
may assist with students having difficulty in
understanding concepts. Hybrid Courses
The interaction to facilitate these skills in Courses that reflect a combination of the above
online teaching needs to be planned to include three forms require a mixing or blending of tech-
learner-to-learner contact to assist students to niques to facilitate interaction. The advantage
learn from each other in how they design and for an online instructor is to be aware of the first
apply the skills discussed above. Vrasidas and three types of courses and the methodologies
McIsaac (1999) supported this finding, as a that are effective in facilitating those types of
need for educators to structure for dialogue courses, and then applying that on the micro-
including learner-to-learner interactions was application level for the hybrid course.
found important. Kozma (1991) supported this If we frame the curriculum in the context
premise seeing the need for more dialogue by of the four different types of courses, then we
visualizing learners actively collaborating with provide a better opportunity in the planning
the medium to construct knowledge and skill. phases to maximize the learnings, as we are
focused on the goals and best structure for
Synthesis/Analysis Courses interaction given the different types of course
The implications for these courses are for the limitations and opportunities available in the
instructor to understand that there may be mul- online courseware. Knowlton (2000) believed
tiple views of a situation that require exploration that learning and teaching are reconceptual-
by the participants to fully realize the depth and ized in the online course to allow maximum
breadth of the concepts. The obvious nature of independence among students by framing the
these types of courses is for students to explore curriculum and student interactions through
all aspects of the topic and then draw conclu- the providing of resources and opportunities.
sions based upon the information presented and Framing is used to facilitate students’ desire to
explored. The online instructor in this type of develop and implement shared goals in making
course must take care not to be too authoritative, connections with the curriculum. Students must
as stated above, otherwise he or she will shut be able to find space for their own inquires and
down the exploration and the insights that can needs within the assurance of a well-planned,
be gleaned from students interacting and dia- content-rich, and flexible learning environment
loguing about opposing viewpoints. Instructors with adequate navigational tools and support
will find that taking an authoritative stance and systems (Vandergrift, 2002). This type of in-
letting participants see their opinions on an issue depth planning is more demanding and time
will close dialogue, or they will find that students consuming than the traditional classroom

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is prohibited.
Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008 53

planning. A classroom teacher can draw upon say that the courseware becomes limiting but, as
his/her innate knowledge and platform skills with the traditional classroom, there are confines
to provide an impromptu lesson structure that of what can and cannot be done successfully.
cannot be duplicated in the online text-based The innate properties of the course shell portal
arena. Vandergrift demonstrated the need for allow options for organizing the pedagogy of
a deeper understanding of the dynamics that an interactive course and provide a level of
online teachers apply to the deliberate acts of flexibility to allow instructors and designers
design and interaction that facilitate success- freedom to explore a number of pedagogies.
ful courses. Instructors need to be open to exploring new
Visor (2000) supported this as faculty serve pedagogies that require different thinking.
to design and conduct a course, which is posi-
tive for student learning outcomes and serves to FUTURE DIRECTIONS
maximize the learning opportunities the same Insight into establishing some of the best
way that faculty foster learning in the traditional methodologies utilized in each of these types
setting. They prepare and organize content ac- of courses would assist online instructors to
cording to well-established and communicated establish the interaction that is employed and
objectives, consider methodologies, which will how best to maximize the competencies attained
assist the student to achieve the objectives in by students. Applying the practices used in the
an online format, and be cognizant of time that four types of courses would further establish a
the student will need to spend on the course. number of pedagogies that would work in dif-
Wright and Thompson (2002) support this, as ferent online health-care educational settings
faculty establish a pedagogical strategy and and may open the door for more nontraditional
begin to understand how online activities will online courses to be offered. Brooks (1999)
occur in their discipline for maximum learning, suggested that curriculum should be examined
and that faculty create templates in which they to determine how technology fits. Using technol-
can insert their specific academic content. The ogy, we should identify content that is technol-
four types of courses identified in this study ogy neutral, technology driven, and technology
have different goals and objectives for learning enhanced. Salmon (2000) identified the teacher
outcomes. Instructors need to facilitate interac- in the role of e-moderator as the key ingredient
tion specific to the needs of the students in the for effective teaching and learning online. It is
confines of these course types. the instructor who is the driver of the technology,
The innate properties of the course shell given the differing nature of the four types of
portal allow options for organizing the pedagogy courses found in this research. Providing online
of an interactive course. This also becomes educators with greater insights as to the applica-
part of the consistency described to establish a tion of pedagogies in different courses will assist
“think-forward” type of lesson. The shell portals them to create more effective online learning
have innate properties built in that provide a environments and help their students learn the
“think forward” consistency of structure that true benefits of online learning communities as
becomes a comfort for students if interaction established from interactive practice priorities.
is designed consistently by the instructor. If Until now, there are those who would only see
the online course facilitates interactions in the certain types of courses being taught online.
nature described in this study, the constructivist With the identification of these four types, and
and andragogical models of learning predict the methodologies that can be employed, ad-
that successful learning is likely to result. These ditional insights will assist the less traditional
models require students to create their own online course (clinical-based skills courses) to
meaning to knowledge in a self-directed man- be opened to this technology.
ner and take more responsibility for their own Applying Holmberg’s (2003) conver-
learning (Knowles, 1999, 1980). This is not to sational theory to the four types of online

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is prohibited.
54 Int’l J. of Information and Communication Technology Education, 4(1), 44-55, January-March 2008

health-care courses taught will assist in further Carnwell, R. (1999). Distance education and the need
understanding the dynamics of the interaction for dialogue. Open Learning, 16(2), 58-60.
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gain the maximum from their learning experi- and experiences of women using print-based and
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Holmberg, B. (1999). The conversational approach to
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Richard Fuller is an assistant professor of education at Robert Morris University in the Department of
Secondary Education and Graduate Studies. He has served as the dean of education for a career college
and as program director and assistant professor for graduate leadership studies at Drexel University. Dr.
Fuller serves as an educational consultant having worked on projects for the Department of Transportation,
the Department of Health, higher education institutions, corporate and government entities for education
and leadership.

Gary W. Kuhne is an associate professor of education at The Pennsylvania State University, serving on the
graduate faculty in the adult education program. He is currently the lead faculty for the World Campus
MEd in adult education. In addition to his work with the university, Dr. Kuhne is a consultant to business
and industry, government agencies, various higher education institutions, and various religious organiza-
tions and churches.

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is prohibited.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.