To all those pushing the ideas that one must attend "brick and mortar" classes to learn anything, well I'm just ROFLMAO
http://forums.studentdoctor.net/showthread.php?t=602511
http://forums.studentdoctor.net/showthread.php?t=602511
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Distance Education
Started by zenman
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Skipping lectures and distance education are very different things in health care. Those students who are skipping all their lectures are still attending their labs. I know quite a few medical students who never go to lecture and still do quite well. They didn't up and skip their anatomy labs, etc... Distance education typically doesn't have significant on-campus requirements besides lecture.
Combine that with the fact that I believe most med schools provide audio or video tape of lectures to download and review later, +/- powerpoint slides--> it's almost like you're there! Just can't ask the prof a question...
Far, far more importantly, healthcare students are supervised in clinical rotations that are accredited by their respective professional organizations, and not signed off by some random preceptor. MD/DO and PA programs have far more clinical training than NP programs, which is a severe weakness of the latter but does allow them to get away with distance education.
Many med schools provide audio or video of lectures in addition to the powerpoint slides. For example, my school provided video and I rarely went to the lectures. If people had questions for the lecturer, it was captured on video. I watched those videos religiously. If you didn't watch the lectures, the powerpoint slides didn't make much sense or you didn't retain that much. No matter what your learning style is, you still have to pass the exam. I noticed that people who tried to skip lecture but did poorly on exams began to attend lectures again. In addition to lectures, you have histology and anatomy labs. Besides good hands-on experience, it gives you the chance to connect with your peers and instructors about the course material. They usually also had review sessions where you could come and ask questions.
As been pointed out ad nauseum, you can't replicate that learning experience with online courses where most of the time you're just looking at powerpoints on the internet. Let's not forget the minimum 17000 hours of clinical training that physicians have compared with <1000 for NP's. There is no comparison.
As been pointed out ad nauseum, you can't replicate that learning experience with online courses where most of the time you're just looking at powerpoints on the internet. Let's not forget the minimum 17000 hours of clinical training that physicians have compared with <1000 for NP's. There is no comparison.
Zenman, why do you bother? None of the physicians I am acquainted with are this hypercritical of nursing education, online or otherwise. I really think this attitude is unique to these individuals, and I don't think they are ever going to be convinced otherwise. I appreciate all that you lend to these forums.
There will definitely be a range of opinions (N=1, and all of that jazz), so it is important to figure out what is best for your individual situation. I do think it is important to understand the different viewpoints because it should help inform the + / - 's of each approach.
I agree, I just think SDN is full of outliers on this issue. 😉 I was concerned about online education myself (I live in Appalachia and it is all that is available to me). Zenman's insight has been very encouraging. I am grateful for his input.
You need to clarify what kind of distance education (DE). ASN to BSN is primarily management and theory, so DE is fine. ASN by DE is without structured clinical training and no one accredits such programs. BSN to NP is ludicrous for exactly the same reason ASN to BSN is good: i.e., it is heavy on theory with limited practical clinical training. As a result, DE "trained" NP's have poor clinical experience and rely on their RN experience. If the latter is inadequate, then the patient is in danger. Yesterday I spent hours going through a pt's prescriptions trying to determine what a poorly trained NP did in a GI office that through him into Atrial flutter. It turns out, she prescribed an anti-cholinergic with arrythmia side effects and ignored what the cardiologists were doing. This is one example of poor training, that can be minimized by better education.
There are bad providers everywhere, but why aggravate the problem with poor training programs with poor clinical oversight. It is a scandal that many NP programs have less than half of the clinical requirements as PA's, which is why my wife who is an ICU RN decided against NP programs and is a PA. This rant will be interpreted as anti-NP; it is not. It is anti faux NP education. PA and NPs should have combined programs but there are too many bureaucratic turf battles.
Because sometimes I have the time. 😀 I just thought it interesting that some demean DE yet are doing the same in their traditional programs, ie. PP, videos.
I've never had any PP only classes. All that have had PP also had videos, tests, etc. Labs are a different story. All my classes that have lab have onsite labs, as in clinical.
Very true. I've always been one that actively searches out info and don't need to sit in a class being bored. Others however, need to be in class.
And all health care students that I'm aware of have oversight agencies. Clinical hours btw PA and MDs is totally off topic for this thread.
It is not off topic. It is the core of the problem with DE for graduate level nursing education. DE programs were adopted because they promised to be cheaper, whereas they are only convenient for students. The quality of DE is limited to classroom didactics. Trying to use DE as a substitute for clinical experience is dangerous.
They're not cheaper at all. My RN-BSN courses have been hundreds of dollars more expensive than the classes I was able to take on campus. Probably cheaper for the university though. 
They're not cheaper at all. My RN-BSN courses have been hundreds of dollars more expensive than the classes I was able to take on campus. Probably cheaper for the university though.
Absolutely right. I should have clarified; thanks. University administrators saw DE initially as a way to save money and then make money.
Facilities cost and related overhead is far less online. Universities are pushing it for "student flexibility", but in reality it is really just another vehicle to fatten up the bottom-line.
Agreed. It costs substantially more in faculty and facilities to educate 150 students on campus than via online. More of the money falls to the bottom line for online education. However, people know and respect classroom training much more than online training. Online training is used to supplement, not replace classroom training. That's even more important for clinical fields like medicine where you have to interact with patients to gather history, do physical exams, and order labs and tests. That's why the University of Phoenix's degrees are usually the butt of jokes. No one will mistake University of Phoenix's MBA or JD degrees as being equivalent from ones from Harvard.
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Why do people keep bringing up clinical? Clinical is not done via DE. It's in person. Why is this so difficult to understand? So yes clinical hours is off topic.
Phoenix is a diploma mill. I'm never talking about them when discussing DE, just for the record.
For graduate nursing education -- i.e., NP or DNP -- DE has limited clinical hours requirements, lack of oversight of clinical rotations, and an over emphasis on theory and writing papers. This is a critical short-coming, and thus the core of the problem.
With those huge shortcomings in both pre-clinical and clinical training, then the nurses have the audacity to claim that they have "the medical knowledge of a physician, with the added skills of a nursing professional". Some NP propagand even claim that "NPs out-perform physicians". And now Zenman you see why NP's are looked at with great suspect and the butt of jokes.
It's interesting that some hospitals have tried to do away with physicians and replace them with NP's. When Methodist Hospital in Dallas severed its affiliation with Baylor School of Medicine, the hospital lost all of its residents. The hospital responded by hiring like 90 NP's to replace them. After a short while, the hospital was starting to realize that the NP's couldn't handle the work. They quickly formed a new affiliation with Cornell in New York and they had to fly residents down from New York to Dallas to bail out the NP's!
In all honesty, I'm in favor of more of such experiments. This is the evidence we need to present to lawmakers, lawyers, and insurance companies to show that yes there is in fact a very big difference in the training and abilities of physicians and midlevels. As patients die and suffer needlessly at the hands of independent NP's who are way over their heads, the laws will change, the lawyers will be licking their chops, and the malpractice premiums will go up. That's what I want.
I read once where the death rate dropped in a New York hospital when physicians went on strike. While that might be humorous, I look at it as a system gone crazy. So, I'm not looking for revenge on any group as there needs to be some collaboration for the common good.
I ran into this the other day when an admin. assistant came to me and showed me the results of her physician visit. She is 31 years old, almost 5 feet tall and complaining of nausea, HA, and dizziness. BP 90/65. Exam was normal except for above. The internal medicine doctor prescribed: Alprazolam 0.25mg, Fexofenadine 120mg, Omeprazole 40gm, Cinarizane 15mg, and multivitamins. Oh, yes, he told her that her K+ was low so I asked for the lab work so I could look at it. She said he hadn't drawn any yet so I guess he was psychic. I gave her a Sudafed and she is much better. I won't tell you how I came up with the diagnosis.😀
I don't think nursing education is all together, from undergrad on up. But, I don't have any trouble with a little theory as every profession is theory driven and it won't kill you to learn a little. And God knows, people need to know how to write a paper. I even had to develop a nursing theory. I survived.
I've did my nursing masters the traditional way and since I've been an assistant professor in nursing, I know that it might be cheaper for a university (cheaper for me also) to offer DE but it also is more difficult for the instructors and it makes it harder for a horrible instructor to fly under the radar.
I'm basically custom designing my curriculum from two different programs. For example, most NP programs I've seen require an advanced pharm course. One of the schools I'm in also requires an additional 3 hours of pharm for your speciality. So, I'm tacking on 3 more hours for primary care meds and 3 for psychopharm. One of the schools is less than a third cheaper than the other, so I'll probably take the additional courses that are offered by the more expensive school and finish at the cheaper, but just as well recognized school. It's all what you make of it.
Speaking of distance education, how have things been going with your NP program, shaman man? I haven't been around much lately so I haven't been up on the latest. Are you still in the States or are you back in Asia?
I admire your world travel.
I agree with much of what you say and are doing in nursing higher education.
One criticism from several NP colleagues is that they wish they had more pharm, more clinical experience, and a lot less (not zero) theory. MD/DOs overcome much of this with residency; although the weak, infirm and lazy sometimes still get through.
I have an issue with univ administrators looking for an easy buck that glosses over education problems.
Enjoy your travels.
Thanks.
I'm really betting that if at the end of my residency, I feel I need more time, the university will let me continue to sign up for more hours. I doubt if any university will just say, "you finished the required number of clinical hours, now leave." So if anyone wants more just keep signing up for the course and slap your money on the table.
I'm really betting that if at the end of my residency, I feel I need more time, the university will let me continue to sign up for more hours. I doubt if any university will just say, "you finished the required number of clinical hours, now leave." So if anyone wants more just keep signing up for the course and slap your money on the table.
