Dental Hygiene E-Learning (Online) Degree Completion Program
The Dental Hygiene E-Learning (Online) Degree Completion Program allows dental hygienists with Associate’s Degrees to complete their Bachelor’s Degrees. Coursework includes topics in leadership, professional writing, evidence-based practice, advanced topics in health promotion, service-learning projects, community health, and dental hygiene education (i.e., learning to teach dental hygienists at the university level).
This degree completion program comprises eleven courses and an electronic reflective portfolio. Except for a two-day orientation and several courses that incorporate service learning and practicum experiences at locations geographically convenient to the student, the entire program is online.
We use an instance of Sakai (CTools) and a customized instance of the Sakai Open Source Portfolio (OSP) to manage all content delivery, student interaction, student assessment, and reflection.
- Anne Gwozdek – program director
- Emily Springfield – instructional designer
- Seven additional course instructors
- Each person above was involved in the development of every course. Wendy Kerschbaum, Director of Dental Hygiene, also consulted regularly on course development and implementation.
We believe our course development model is one of the strongest aspects of our online program due to our extensive curriculum planning and our collaborative approach to course design.
Before any courses were developed, we spent 18 months researching best practices in online education. Rather than converting our existing face-to-face curriculum to an online format, we developed a new, integrated curriculum where skills from each course serve as the foundation for skills acquired in the next course. We added service learning components and planned for extensive reflection throughout the program. Program competencies were also written; these competencies serve as the framework for much of the electronic portfolio.
Each course was developed by a 3-4 person team: the instructor, the online program director, and an instructional designer, with frequent input from the director of the hygiene program. Instructors were selected for their content expertise, reasonable technology skills, and willingness to participate in all facets of the program development and implementation. Instructors began by creating a rough outline of the course: readings, assignments, and activities. Then, as a group, we clarified the learning activities for the course. We emphasized student-student interaction through discussion forums, group projects, and peer review of draft and finished papers and projects.
Over time, several basic course templates emerged: read-and-discuss courses (Leadership, Health Promotion, and Special Populations courses); writing-intensive courses (Oral Diseases, Evidence-Based Practice, Community I); and project-based courses (community project, teaching practicum, mentored experience). The basic frameworks of these courses lend themselves to reuse within our program and are readily transferable to other disciplines.
Two portfolio questions accompany every course. Each course ends with a reflective portfolio question that asks students to put what they’ve learned in the course into a real-world context. For the beginning of the next course, 1-4 illustrative quotes from these reflections are used to develop a discussion question that creates a cognitive bridge between the two courses. For example, at the end of their Evidence-Based Practice course, students are asked, “Now you know the importance of basing your treatments on scientific evidence. How can you use evidence to change your patients’ behavior?” This is a direct lead-in to the next course, Health Promotion, which is all about getting individuals to change their behavior. The portfolio questions offer us a great opportunity to refocus students’ attention – changing the scope of inquiry from the individual practitioner to the literature, from the literature to an individual patient, and from the patient to populations of patients, etc.
None of our faculty had used CTools (Sakai) to teach in an online environment before teaching in this program. We built in extensive faculty development time and assistance. Very little of it was in traditional “workshop” format; instead, we provided one-on-one help. We developed not only grading rubrics, but “grading worksheets” which help faculty manage workflow. For example, keeping track of forum discussions and grading portfolio reflections can be a bit overwhelming, so we have printable sheets that give faculty a place to keep grading notes as they read through multiple postings. After tallying up the form, the instructor can then put the grade and feedback into the proper place within CTools (usually the Assignments tool).
Our instructors also learned that after the exceptionally detailed planning phases, they needed to step back a little and let students direct the discussions. Instructors would read all postings, but only comment a few times per forum, often asking leading questions instead of giving outright corrections.
We made extensive use of the Assignments tool in preference to using the Gradebook or the grading feature on Forums, because Assignments allowed us to attach feedback along with grades. It also put all grades and feedback in one location, and students are very pleased at the level of input they are getting from their instructors.
The Sakai Forums tool is the main venue for students to process course content together. Every course has between 3-7 forums – usually one per module, except in especially writing-intensive courses. Students average 6.3 postings per forum, and the vast majority of postings are rich and thoughtful – very few of the “I agree!” variety. We attribute the quality of postings to the exercise we do during orientation, where we show students a number of sample postings and have them use our standard discussion rubric to come to a group consensus on a grade for each posting.
In addition to regular discussion forums, students give PowerPoint-based presentations/posters and received peer and faculty feedback on those presentations; they collaborate on papers and projects; and they give feedback to the instructor on their peers’ contributions to group work. Most collaboration uses the Sakai Forums tool, but some happens via instant messaging, telephone, and e-mail outside of the Sakai environment. Students periodically use the Sakai forums and chat tools for casual conversation among students, and for online office hours with faculty.
Every course uses the same CTools template – the same tools are used in the same fashion in every course. There are some variations among courses – for example, some courses are more writing-oriented and some have modules that span more than one week – but the basic graphic design and tool use is the same throughout.
This is further enhanced by the extensive use of the Modules tool, which has been enhanced with clip art to help students “cue in” visually on important points. For example, all readings for a module are gathered onto one page within a module. It is always labeled “Readings” and has the same clip art and page layout. Students quickly learn that everything they have to read for that module is on that page – no need to hunt for web links, resources, or embedded textual links in different places in the site.
Every course begins with a Course Orientation module, which explains the basic structure of the course (e.g., “seven one-week modules, with readings and activities each week” or “four ten-day modules, with a paper draft due in the middle of the module, peer feedback, and the final paper due at the end of the module.”) We open the course three days before the start date to let students participate in the orientation, obtain the syllabus, and ask any questions they have in the “Course Questions” forum for each course.
Content is not explicitly delivered to cater to a variety of learning styles. However, assignments are quite varied within and among courses. Examples include papers (professional-level writing is a key competency of the program), PowerPoint presentations, analysis/explanation worksheets, video analysis, role-plays, advocacy letter-writing, service learning projects in community agencies, clinical and teaching observations, personal reflections, etc. This variety of assignments gives students practice in application and synthesis in the cognitive, psychomotor, and affective domains and appeal to a range of learning preferences.
As discussed above, assignments are varied and exceptionally active. Assignments are vetted to address higher-level critical thinking skills. For example, there are no knowledge-level quizzes or assignments; all assignments ask students to either apply what they’ve learned to a specific case or to synthesize what they’ve learned across modules (and, in some cases, courses).
Students are trained in reflective writing throughout the program. The first course of the series is heavily reflective – several assignments ask students to reflect – and, of course, we give students resources teaching what reflection *is* and how to do it well. They received feedback on their reflections the same as any other assignment (within 3 days to 1 week after submission).
Students also reflect on the course and their development in program competencies at least once during every seven-week course through the OSP-based portfolio. The portfolio assignment at the end of each seven weeks asks them to apply course material to the “real world” and to connect what they’ve learned in this course and others to program competencies, professional practice, and their own experience.
At the beginning of the next course, excerpts from these reflections serve as the basis of a discussion among the entire cohort of students and the faculty of both the course that just finished and the course that’s about to begin. These regular reflections have been invaluable for keeping students in touch with program goals and making sure they take away key messages from each course. They also help students keep past material in mind and prepare for upcoming material – in fact, the discussion questions are designed to do just that: emphasize an overview of the previous course and illustrate how that relates to the upcoming course.
Another benefit of the frequent portfolio reflections is that we can check to be sure students finish courses with the correct “take-away” message. If students seem to be off-track, we have an opportunity to correct that information or refine students’ focus before the next course gets too far underway.
Students regularly give each other feedback. No final project is due the last day of class; they are generally due at the end of the sixth week. This allows time for students to review and discuss each others’ projects and papers and complete the portfolio reflections. Students also receive feedback from mentors at practicum sites and interact with occasional guest speakers.
Our first cohort has finished 6 of the 11 courses as of February 26, 2009. First analyses of data from qualitative student and faculty surveys and quantitative analyses of student grades suggest student learning and satisfaction are extremely high.
See also “Learning materials evidence”
We take exceptional care to make sure our courses are consistent in their design. All courses use the same tools, and all tools are used in the same way across courses. In addition, all students have the same model of laptop, so we can be sure the multimedia we post will function for all students.
Each course is reviewed by program faculty (beyond just the course instructor) and the instructional designer before the course is opened to students. This helps us ensure that all links are working, all important information appears in the correct place, and nothing was left out. It also gives the instructors of other courses a glimpse into the content and teaching methods of their colleagues.
Note: We have not tested our materials rigorously for accessibility to the visually impaired and those with severe upper body motor problems, as it is not possible for dental hygienists with those disabilities to be licensed.
Learners are supported in many different ways:
- General questions are handled through a “Course Questions” forum that appears in every course
- Technical support is provided through the program director, instructional designer, departmental IT staff, and campus-wide online/phone IT support
- Writing support is provided through a special arrangement with the campus writing center. (Faculty members also receive support in learning how to give good feedback on writing through the same center.)
- Library support is provided through personal contact with our librarian during orientation, and an ever-present link to live online library help in each course
- The program web page (also a permanent web link in every course) has links to other frequently-needed support information, such as the registrar, financial aid office, and departmental contact information
There are questions about the adequacy of learner support in our course evaluations, and the students give very high ratings for every course.
The UM School of Dentistry has never used so many Sakai tools in any one course, let alone eleven linked courses, as it does in the Dental Hygiene E-Learning (Online) Degree Completion Program. Using Sakai has helped us revise our course delivery to include much more active learning and raise our expectations of students. We decided early on not to deliver “voice-over-Powerpoint” or recorded lectures; instead, we would ask students to read articles and textbooks and apply what they’ve learned.
After teaching online, surveys of faculty show that 100% feel students are learning more in their online courses than in the face-to-face versions of the class. Many also say they will start using teaching techniques they first implemented online and use them in face-to-face courses. These techniques can be summed up as “active learning” techniques; faculty say they want students to be more responsible for ingesting the basic knowledge, so class time can be spent discussing in small groups, giving student presentations, and working on cases. One instructor is even eliminating some face-to-face class time and replacing it with online discussions.
Student surveys show students are very happy with their courses and the amount they are learning. It is telling that after 6 courses, the Sakai technology itself elicits very little comment from students. The tools we use work so well, they have become transparent, and the focus is all on student learning.
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