When both financial and human resources are limited, how can an institution establish a distance education program? In this case study, we detail how a nursing department overcame its lack of internal resources by tapping community resources in order to create a distance education course, Advanced Neonatal & Pediatric Assessment, that met the professional development needs of its community. Based upon our experience with this course, we offer suggestions for institutions facing similar constraints. We close the study by reflecting on the strengths and limitations of the means by which we were able to launch the course.

History

The Health Sciences Centre (HSC), located in Winnipeg, is the largest health care referral and teaching/research hospital in the Province of Manitoba. Its Department of Specialty Programs (DSP) offers on-site advanced registered nursing education programs. Established in 1979, the Neonatal and Pediatric Critical Care Nursing Program (NPCCNP) is the only neonatal/pediatric nursing program offered in the province.

In 1992, the Manitoba Association of Registered Nurses (MARN) recognized the need for more easily accessible nursing education programs and began offering financial support for the development of distance education courses. In 1997, HSC faculty members submitted a proposal to develop a neonatal/pediatric distance education course using videotaped teaching sessions, but the proposal was not accepted because of the limited scope of this technology.

In 1998 Brenda Stutsky, the HSC Director of Specialty Programs, was introduced to the course management system (CMS) the University of Manitoba (UM) was implementing on its campus, WebCT. Since the HSC was affiliated with UM and students who completed the NPCCNP received transfer credit towards a degree from UM's Faculty of Nursing, the university was willing to house the HSC's course on its server. This development was a crucial first step. Through collaboration with UM, the HSC gained free access to services that had previously been unavailable because of limited resources.

With the support of UM, HSC submitted a second funding proposal for distance delivery of the NPCCNP using the university's CMS to MARN. This proposal was accepted in the fall 1998 and we received nearly $10,000 in funding. Through its financial support, MARN became another partner in the collaborative production of the course.

In 1999, HSC faculty attended WebCT training sessions at UM, their computers were networked and upgraded, and course planning began. A HSC technology staff member was contracted as course designer; however, course development was slow since the project was added to pre-existing faculty workloads. In order to avoid losing MARN’s financial support due to time limits associated with the grant, we requested a one-year extension, which was accepted.

Progress throughout the first half of 2000 was not much better. Because of changes in the technology staff, course design responsibilities were transferred to the Director of Specialty Programs, who had neither the time nor the detailed knowledge required to complete this task before the second deadline. When "crunch time" arrived in the fall of 2000, the HSC elected to employ an independent course designer, Carol Stroud, who lived in the community and was suggested by UM. Thus we found the fourth piece of the community-based collaboration, and through this group effort, we were able to complete course development. After two years in the making, we delivered the pilot course in March 2001.

Development Considerations

Although collaborative course development is not new to the world of distance education, the collaborative development of NPCCNP is unusual because it brought together four independent entities: the Health Sciences Centre, the University of Manitoba, the Manitoba Association of Registered Nurses, and an independent course designer. And even though the program had been successfully delivered face-to-face, online delivery via the CMS highlighted the need for different faculty skill sets. Our experience has generated two sets of considerations for others who are developing similar courses and who are not located within colleges or universities.

The first set of considerations consists of broader questions to use in assessing a community's resources:

• Does an institution in your community have the necessary infrastructure (e.g., a university)?
• Does your organization presently have a relationship with that institution?
• Are you able to partner with the institution and house your course on their server?
• Will the institution charge for its support services?
• Are you able to obtain funding from professional associations or through grants in order to hire a contractor for course design?
• Are you familiar with independent course development contractors, or is there a source for this information in your area? Geography need not be a defining factor as long as course content can be transferred effectively.
• Will you have the skills to maintain or revise the course, or will you continue to use a contractor?

The second set of considerations contains a more detailed list of points for those undertaking such collaborative course development:

• Establish at least two methods of communication between group members to avert communication failure. In this situation, e-mail was the primary method, and telephone contact, including voice mail, was the secondary method.
• Plan how course content will be transferred between content creators and course designers. In this collaboration, the course designer was geographically separated from the content creators, so transferring material was not as simple as walking down the hall. Moreover, the course content existed in several formats (e.g., electronic files, print texts, and videotapes), which required correspondingly different forms of delivery (e.g., by e-mail, by courier, and in person).
• Establish and coordinate deadlines for project completion. This collaboration was a series of small projects that merged into a course. As with any project management task, deadlines maintained the motivation for task completion. MARN's funding deadlines stimulated us to initiate technology updates, educate HSC staff, and employ the independent course designer. Subsequent deadlines were established to allow course content creators, the course designer, and other partners adequate time to complete their tasks within the confines of the academic calendar. Barriers that impeded meeting deadlines included workload demands, holidays, and the inevitable technology failures.
• Clarify the scope of responsibility of each group member and create a plan of action based upon this scope of responsibility. In this situation, MARN's responsibility was strictly financial. UM provided CMS education for HSC faculty, administered all aspects of the delivery of NPCCNP, and offered help desk support to the students. The course designer provided the skill and resources throughout the design, development, and revision phases. The content creators produced the content, completed a functionality review of the course before implementation, and facilitated course delivery.
• Resolve course ownership and copyright issues. The content development staff must understand the copyright issues surrounding the material they intend to use and ensure that permissions are in place. Citation procedures should also be discussed and agreed upon. Under our arrangement, for example, the copyright holder for all course materials is the Health Science Centre Department of Specialty Programs.
• Address personnel training and technology concerns at the outset to ensure an efficient course creation process. The DSP had to invest in new technology and educational training to allow its faculty to be able to create the WebCT course content. Investment at this stage means less investment will be required for future WebCT course projects.
• Establish a content stylesheet, which defines the format for how the pages of the content will look. The course designer and the content creators should decide on colors, heading sizes, table formats, font settings, and graphic placement before content creation begins. In our case, this was not done, and it resulted in some duplication of work.
• Identify who is responsible for creating the full HTML pages, including scanning and image insertion. The content creators worked strictly with Microsoft Word document files in which they inserted some clip art and some hyperlinks. The course designer then converted document files to HTML files with Microsoft FrontPage and also scanned and inserted images into the HTML files. This delineation of responsibilities helped the course development meet its deadlines since the faculty did not have to learn additional technical skills.
• Ensure that technology is compatible between the course content creators, the independent contractor, and the course-hosting site. In this situation, because the course designer accessed the University WebCT server from off campus and behind a firewall, technological harmonization took some time to achieve.
• Establish a point of contact with the hosting institution to assist with troubleshooting relating to course administration. By having a good working relationship with the WebCT administrator at UM, the NPCCNP course designer was more easily able to respond to technical difficulties that arose.
• Decide upon how and in what format the completed course files will be transferred from the independent course developer to the course owner once the term of the contract is over. Because the course designer was not a member of the HSC, she transferred the final course files to the unit within the HSC that was responsible for teaching the course, the DSP. This was accomplished by using a CD that contained the individual files as well as a backup of the final course.

Benefits and Drawbacks of Collaboration

For a health care institution, the benefits of collaboration with a professional body for funding, a university for computer education and infrastructure, and an independent contractor for design, development, and implementation, are numerous and significant. External financial support means that existing programs are not financially compromised by distance education course development. Similarly, the use of an independent course designer allows faculty to focus on course content as opposed to technology concerns. The collaboration with UM meant that the course was administered and the infrastructure maintained by experts specifically trained in this area.

At the same time, collaboration's benefits are also its drawbacks. In particular, collaboration creates a network of dependencies. For instance, by hiring an independent contractor, the HSC did not allow faculty members to develop the technical skills needed to maintain and revise the present course or to construct others. Therefore, the HSC must either continue to hire a contractor or, at some point, train its faculty. The other relationships raise similar issues: Will UM continue to educate HSC faculty and to host HSC distance education courses? Will MARN fund future distance education proposals?

Moreover, collaboration does not fully resolve the institutional problems, such as workloads and time constraints, that inspired it in the first place. Although it would be technically and financially prohibitive for the HSC faculty to develop a second course independently, the framework built into the present course by the course designer will allow faculty members to continue offering it and to make minor revisions without much difficulty.

Conclusion

Despite the provocative questions raised by this form of collaborative course development, the fact that plans are in progress for the next delivery of our program attests to its value and success. It also proves that a little ingenuity in the face of what seemed to be insurmountable obstacles allowed the HSC to achieve its overall goal of making a specialty nursing education program more accessible to registered nurses in Manitoba. A motivational saying reads, "The range of what we think and do is limited by what we fail to notice." What opportunities are you failing to notice within your community?

[Editor's Note: This paper is modified from a presentation at the 2001 WebCT Conference in Vancouver.]

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