ACEN accreditation perspectives: Distance education.

Many nursing programs implemented the use of distance education in response to the COVID-19 pandemic. Faculty must consider the mission of the governing organization and the fiscal, physical, technological, and learning resources available while ensuring the quality of the education being provided when using any type of distance learning method of delivery. The purpose of this article is to discuss how selected 2017 ACEN Accreditation Standards and Criteria can assist the faculty in ensuring quality nursing education in distance education methods of delivery.

Introduction

In Spring 2020, the U.S. Department of Education (USDE) provided temporary flexibility for the use of distance education in response to the declaration of a national emergency related to the COVID-19 pandemic. The Accreditation Commission for Education in Nursing (ACEN), as a USDE-recognized accrediting agency, issued its first guidance on the temporary flexibility related to distance education in March 2020 (https://www.acenursing.org/about/news/covid-19-correspondence/). As described by Ard et al. (2021) and the National Council of State Boards of Nursing (NCSBN, 2022), nursing education programs quickly implemented distance education methods of delivery for students to continue in their studies and complete their programs of study. Although President Biden continued the national emergency declaration concerning COVID-19 in February 2022 (https://www.whitehouse.gov/briefing-room/presidential-actions/2022/02/18/notice-on-the-continuation-of-the-national-emergency-concerning-the-coronavirus-disease-2019-covid-19-pandemic-2/), many nursing education programs have returned to face-to-face learning. While some nursing education programs continue to use distance education due to the sporadic resurgence of COVID-19 infections and in response to local health and safety guidelines, now is the time for nursing education programs to re-evaluate their methods of instructional delivery and determine if they will continue to use distance education regardless of the COVID-19 pandemic. The purpose of this article is to provide an overview of the ACEN definition of distance education and to provide an overview of selected best educational practices for distance education.

ACEN Accreditation and Distance Education

For students to be eligible to receive federal financial aid through Title IV-HEA funding, a nursing education program or its governing organization must be accredited by a Title IV-HEA gatekeeper and the governing organization's institutional accrediting agency (e.g., SACSCOC, HLC, ABHES, COE) must approve the governing organization's use of distance education. The ACEN is recognized by the USDE as an accrediting agency for the accreditation of nursing education programs and schools, including those offered via distance education and serves as a Title IV-HEA Gatekeeper for all types of nursing education programs offered by certain governing organizations that are eligible to participate in financial aid programs administered by the USDE or other federal agencies (e.g., HRSA).

The ACEN Glossary (2021) defines distance education for nursing courses as any educational method of delivery “in which instruction occurs when a student and instructor are not physically in the same place” (p. 9). Therefore, as defined by the ACEN, a program is using a form of distance education when it implements a hybrid delivery method. Whether a program needs to report to the ACEN its use of distance education through the Substantive Change process is beyond the scope of this article. Per ACEN Policy #14 Reporting Substantive Changes (https://www.acenursing.org/acen-accreditation-manual-policy-14/), not all use of distance education must be reported to the ACEN. However, nursing faculty are advised to review ACEN Policy #14 and then use the resources provided on the ACEN website to make a determination about the need to submit distance education information to the ACEN. Guidance about the submission of a substantive change for distance education is available on the ACEN website (https://www.acenursing.org/for-programs/resources-reporting-substantive-change/changes-in-distance-education/). Additionally, all use of distance education must be consistent with ACEN Policy #15 Distance Education, which outlines ACEN's criteria for effective implementation of distance education. (https://www.acenursing.org/acen-accreditation-manual-policy-15/).

Use of Distance Education

Members of the National Council for Online Education published an opinion editorial (Opinion, 2022) in which they sought to clarify the difference between remote learning and distance learning. They argue that many faculty implemented temporary remote learning in response to the COVID-19 pandemic, wherein they attempted to replicate the face-to-face course they had previously delivered. The authors of that opinion distinguished distance learning from remote learning in that distance learning is a planned strategy that is carefully selected and implemented to achieve identified learning outcomes. They further posited that many students appreciated having access to a variety of learning options and more individualized control of scheduling and planning to meet their educational goals; therefore, distance learning may be something that students will want continued.

As nursing faculty begin to reflect on and evaluate the lessons learned since Spring 2020, it is important to thoughtfully consider whether the program should incorporate distance education as one of its ongoing methods of nursing course delivery. According to the (NCSBN, 2022), nursing students in the U.S. identified concerns about the use of alternative learning strategies during the COVID-19 pandemic and the potential impact on their preparation for practice as well as their success on the NCLEX. As a practice discipline, practice learning experiences (e.g., clinical/practicum, simulation, skills lab) that include face-to-face hands-on clinical learning (whether actual or simulated) to engage nursing students in the cognitive, affective, and psychomotor work of nursing is essential and cannot be eliminated; however, the use of some distance education methods of delivery may be appropriate and effective for didactic learning. One of the lessons learned during the COVID-19 pandemic may well be that synchronous and asynchronous didactic distance education is viable and appropriate for some nursing education programs.

Distance learning must, however, be implemented only after thoughtful consideration and analysis of the learning characteristics and desires of the nursing student population served, as well as the organizational and structural supports for distance education provided by the governing organization. If an intentional decision is made to implement some method or methods of nursing course delivery using distance education, faculty will need to engage in appropriate planning, preparation, and professional development to facilitate and support student success.

Distance Education and ACEN Accreditation

The 2017 Accreditation Commission for Education in Nursing (2020a,b Accreditation Standards and Criteria (https://www.acenursing.org/acen-accreditation-manual-standards-and-criteria) provide a roadmap for ensuring that a foundation for success is laid when a program implements any form of distance education. First, the use of distance education must be congruent with the mission of the governing organization and consistent with the mission and/or philosophy of the nursing education unit (Criterion 1.11). In addition, no matter the method of instructional delivery, the program must ensure that there are sufficient fiscal, physical, technological, and learning resources to ensure achievement of the end-of-program student learning outcomes and program outcomes (Criterion 5.4). If it is determined that distance education aligns with the mission and/or goals of the governing organization/program and that there are sufficient resources for success, then it is reasonable for faculty to move forward with planning for the implementation of distance education.

Once the decision to implement distance education is made, it is important to ensure that the faculty and the students have access to the technology needed for delivery of distance education and that the faculty receive ongoing development and support for use of the technologies selected (Criterion 2.10) and maintain their expertise in distance education and related instructional processes (Criterion 2.6). The U.S. Department of Education (2022) (https://www.ecfr.gov/current/title-34/subtitle-B/chapter-VI/part-600) has identified the need for regular and substantive interaction between faculty and students as a core requirement for distance education. Substantive interaction is the process of engaging students in teaching, learning, and assessment. Therefore, any technology or processes used to deliver distance education must ensure substantive interaction through the implementation of two or more of the following activities: providing direct instruction, assessing or providing feedback on student coursework, providing information or responding to questions about content of a course or competency, facilitating a group discussion regarding the content of a course or competency, or other activities that demonstrate and ensure faculty and student engagement in the teaching/learning process. Further, distance education practices must provide for regular interaction between faculty and students through predicted and scheduled interactions, monitoring of student engagement and success, as well as prompt and proactive interaction with students when student performance and engagement warrant intervention or when students request the interaction. Nursing faculty must ensure that the technologies used for course delivery supports regular and substantive interaction with students.

To support student success in courses or programs delivered using distance education, students must be informed about any technology requirements (Criterion 3.9). Faculty should ensure that prior to enrolling in the program of study, students are aware of the technology they will need to be successful, including reliable Internet access and hardware or software requirements for full participation in the program of study. Students must also be provided an orientation to the technology that will be used (e.g., learning management system) and must have access to support for the technology (Criterion 3.8) to further support and facilitate their success in the program of study. Additionally, if special equipment is needed or there are additional costs related to student identification in the online learning environment or for testing, then this information must also be disclosed to students prior to enrollment (Criterion 3.9).

As with all curriculum development, faculty must have a clear vision of the desired student learning outcomes. Student learning outcomes must be made explicit and must be based on professional nursing standards and contemporary practice. As stated in Criterion 4.2 of the 2017 ACEN Standards and Criteria, the end-of-program student learning outcomes must be used to organize the curriculum, guide the delivery of instruction, and direct learning activities. Therefore, faculty must ensure that the instructional processes and methods of delivery for the program of study support student achievement of the identified course and/or end-of-program student learning outcomes and program outcomes (Ard et al., 2018). In addition, the evaluation methods used for distance learning technologies should reflect the program's course and/or end-of-program student learning outcomes.

Overview of Best Practices in Distance Education

The experiences of nurse educators since March 2020 have reinforced for all of us that teaching using distance education is not merely the act of recording a lecture and posting a video to the learning management system. Although some instructional activities may be equally effective in either a face-to-face or distance education environment, effective teaching and learning regardless of method of delivery must be a planned and intentional process. Thus, the 2017 ACEN Standards and Criteria provide faculty some final guidance that regardless of the method of delivery, instructional materials, learning activities, and evaluation methods must be appropriate for the method of delivery employed (Criterion 4.11).

There is an expanding body of literature about best practices in the delivery of distance education. Nursing faculty are encouraged to review the literature and seek out the expertise of their nursing and non-nursing colleagues who are proficient and effective educators using distance education. For example, Authement and Dormire (2020) used the nationally recognized Quality Matters Program to develop a distance education quality assurance guide for nursing faculty called the ONE Guide. The ONE Guide identifies three domains of course development: course presentation, instructor presence, and assessment and measurement. These authors also developed an instructor checklist that can be used to ensure consistency and standardization across distance education courses. This instructor checklist incorporates elements such as the organization of the course (e.g., calendar is easy to access, netiquette expectations are explained), course delivery (e.g., assignments are clearly explained), availability and approachability of faculty (e.g., friendly and encouraging responses), discussion board interactions (e.g., engages in conversations), posting announcements on a regular basis and including expectations of the students, providing feedback and grading practices that are clear and descriptive, and guidelines for email interactions. Tools such as ONE Guide or a Quality Matters Rubric can help faculty ensure a consistent approach to the development, organization, and implementation of distance education courses.

Another essential component of effective distance education is building a sense of community and providing for interaction in the digital environment. As described by Gunder et al. (2021), effective design of distance learning courses includes an inclusive and equitable digital learning environment; alignment of the technology with the learning outcomes, learning experiences, and assessment practices; and consistency and clarity in expectations and assignments, combined with regular and reliable access to faculty. Recommendations for building a sense of community include the use of active learning strategies and being accessible, welcoming, and encouraging to students.

Nursing faculty should keep general evidence-based instructional strategies in mind when developing and teaching a distance education course. Evidence-based instructional strategies include active learning, scaffolded collaborative learning, increasing relevance through triggering student curiosity, use of a formative practice that provides students timely and targeted feedback leading toward mastery, limiting cognitive overload, and practices to support learners as they take control of the learning process (Gunder et al., 2021). Active learning is when learners are involved in doing things and then thinking about what they are doing. As part of a practice-based discipline, it is essential that nursing courses are designed to engage students in their learning. Whether the distance education course is a synchronous or an asynchronous course, students can be engaged using inquiry-oriented approaches that incorporate relevant experiences and are not based solely on knowledge of the content (Benner, 2020). Suggestions for active learning strategies are available online through teaching and learning centers at numerous colleges and universities.

Conclusion

Building community, ensuring engagement and interaction between and among faculty and students, and providing a welcoming and encouraging space for learning are hallmarks of a quality distance education course. The use of educational practices that ensure that courses are well-developed, organized, and structured further contributes to the success of a distance education course. Using the 2017 ACEN Accreditation Standards and Criteria in the development of distance education courses will provide a program with a sound foundation for maintaining the quality of their program of study, regardless of the method of delivery employed.