RUSSELL, CYNTHIA K. PhD, RN; BURCHUM, JACQUELINE R. RN, DNSc; LIKES, WENDY M. RN, DNSc; JACOB, SUSAN RN, PhD; GRAFF, J. CAROLYN RN, PhD; DRISCOLL, CAROLYN RN, PhD; BRITT, TERESA RN, MSN; ADYMY, CINDY RN, MSN; COWAN, PATRICIA RN, PhD
Today's health professions educational programs have a unique mix of students from the Baby Boom Generation (born 1943-1960), Generation X (born 1961-1981), and Millennial, or Net, Generation (born 1982-2000) who demonstrate unique generational differences in their use of the Internet. Such differences have serious and immediate implications for the way content is presented, interacted with, and learned.
An increasing number of individuals are turning to the Internet for their communication and information needs. Among the worldwide population of 6.5 billion individuals, slightly more than 1 billion, or 15.7%, use the Internet on a regular basis.1 In the United States, approximately 204 million, or 68.1% of the population, regularly use the Internet.2 The Pew Internet and American Life Project3 report generational differences in the use of the Internet. The Baby Boom Generation cohort gets e-mail and news, conducts product research, and makes online purchases about as frequently as younger generations. Generation X users dominate online activities such as obtaining health information and conducting online business, including travel reservations and banking. The Millennials are the highest users of online activities that enable communication and socialization, including instant and text messages, blogs, and video. On an average day, 94 million Americans use the Internet, with 77% using e-mail and 63% using search engines, such as Google, Yahoo, and MSN.4 Surfing the Internet for a variety of resources, materials, and information is a well-accepted and entrenched way of life for many Americans.
Many students entering today's health professions educational programs are members of the Net Generation, those "digital natives" born between 1980 and 2000 who have grown up with technology, including computers, video games, CDs, mobile phones, and the Internet.5-7 As some of the most active users of the Internet, these students enjoy multitasking, multiprocessing, and multiconnectivity. In large measure because of their technology experiences to date, these students expect to instantaneously find answers to their questions on the general Internet using a search engine.8 This expectation follows them into health professions educational programs, where their use of library resources and databases may be a last resort, instead of an integral first step in researching topics and issues.9 Results of a newly developed information literacy and computer acumen test, the Information and Communication Technology (ICT) Literacy Assessment Core Level, administered to 3000 college and 800 high school students, revealed that only 13% of those taking the test were information literate.10 Overall, students were poor at distinguishing mass marketing from authoritative sources, identifying biased Web content, and discerning irrelevant results.
Students of all ages face challenges in accessing and evaluating the proliferation of information found in online, scholarly databases as well as on the Internet. Foundationally, they require specific information technology competencies, which are the contemporary skills, foundational concepts, and intellectual capabilities required for becoming fluent with computers and other information technologies.11 To ensure that material they find is relevant, applicable, credible, and accurate, students must also possess specific information literacy competencies. Information literacy competencies are the set of abilities required for understanding, locating, evaluating, and using information.12 Acquiring and staying current with clinical advances and new knowledge is necessary for the provision of safe and competent healthcare. Yet the task of keeping up has never been more challenging. Even with advancing technology capabilities, the increase in healthcare information is exponential, and the task of reliably and quickly finding necessary information is daunting.
Faculty in health professions educational programs are responsible for ensuring that students possess and are able to apply information technology and information literacy competencies. Students enter their educational programs with diverse backgrounds in using information technology and in their information literacy abilities. Thus, it is important that programs designed to increase information technology and information literacy competencies are student-centered and attentive to the level of competence and uniqueness of each individual student. A one-size-fits-all program for enhancing these competencies is doomed to failure because it will be too basic for some students, too advanced for many others, and just right for only a few.
Within a newly established undergraduate nursing program that admitted traditional and second degree students as well as registered nurses who were returning for a baccalaureate degree (RN-BSN), faculty confronted the challenge of enhancing students' information technology and information literacy skills by developing WebQuests.13,14 In this article, we describe the history of WebQuests and offer specific guidelines for developing WebQuests that faculty in other health professions' programs can use to create relevant, student-centered WebQuest activities in their courses.
DEVELOPING A WEBQUEST
Based on constructivist learning principles, WebQuests were developed in 1995 to promote high-level thinking and problem-solving skills using Internet resources.15 In WebQuests, students construct knowledge through knowledge acquisition and integration in a guided manner. As inquiry-oriented activities, WebQuests require that students seek answers to questions that are both relevant and important. WebQuests are heavily reliant on Internet resources, with students guided to appropriate resources.
WebQuests may be short term or long term.15 A short-term WebQuest can typically be completed in less than a week, whereas a longer term WebQuest takes 1 to 4 weeks. Students engaged in longer term WebQuests typically produce some type of material that demonstrates their reformulation of the resources in relation to the tasks of the WebQuest. Dodge15 lists comparing, classifying, inducing, deducing, analyzing errors, constructing support, abstraction, and analyzing perspectives as thinking skills that may be required in longer term WebQuests. The WebQuests prepared by our faculty were longer term WebQuests that took place over a 5-week period of time in a completely online and asynchronous course, Informatics for Healthcare.
WebQuests have critical and noncritical attributes. Critical attributes, those items that must be included for the activity to be rightfully called a WebQuest, include introduction, task, process, resources, evaluation, and conclusion.15 We discuss each item in some depth and offer examples from a WebQuest that focused on prevention of sudden infant death syndrome (SIDS).16
The WebQuest "introduction" orients students to a general topic of focus by providing background information and context for the activity. To be maximally effective, the introduction should be engaging and stimulate interest in the topic. Images, audio files, and videos may be used to arouse students' curiosity. Most engaging introductions have an element of tension or conflict that must be resolved. The introduction for the SIDS WebQuest reads as follows.
You're a team of three community health nurses who are assigned a caseload of high-risk pregnant teenagers. Prior to their deliveries, your team visits each of their homes to assess their home environments and talk with them about what to expect in the hospital and once they return home.
As your team visits with each of the teens, a recurrent topic of conversation relates to the position a baby should be placed in when sleeping. The girls tell you about the advice they're receiving from family members, especially their grandmothers. They say that unless you're able to demonstrate that one sleeping position is safer than another that they'll just have to go with their family's recommendations.
What will your team do… What evidence will you find… to convince these teens of the safest sleeping position for newborns?
Little ones are depending on your team, your scientific knowledge, and your powers of persuasion!
The "task," described as the most important part of the WebQuest,17 focuses students on the goal of the activity. Tasks should be doable, engaging, and promote knowledge integration. The task may be designed for individual or small group completion. Dodge17 jokingly states that "there must be fifty ways to task your learner," and developers must determine the task that best fits with the goal of the WebQuest. Table 1 provides an overview of the most common WebQuest tasks, the purpose for each task, a description of what the task is not, an example task statement, and the most common skills required for the task. When deciding on the question and task for a WebQuest, March18 challenges authors to consider "What's educationally most interesting" about the topic. He suggests answering the following specific questions.
What are the "parts" of the topic? What is it made of? Example tasks derived from asking this question include defining characteristics and evaluating examples.
What "opinions" do people have about the topic? Examples of tasks that arise from this question include identifying perspectives and arguing best viewpoints.
How does the topic "function," happen, or relate to things around it? Example tasks derived from this question include discovering if/then rules, causes, and effects, as well as applying rules to a new problem.
These three questions are scaffolded, from simplest to most complex. Faculty may find free downloads of concept map software19 or mind mapping software20 of use as they generate ideas about the topic of the WebQuest. The task for the SIDS WebQuest was one of persuasion.
As team members, each enacting a different role, you will explore and critically analyze journal articles, Web resources, and other relevant materials about infant sleeping position and SIDS to prepare material to present to pregnant teens and their family members, as well as to your fellow community health nurses.
Each learner will:
• collaborate with two other members of the team
• research relevant information which relates to your assumed role as a member of the team
• collect and interpret data from journal articles and Web resources to answer specific questions posed to you in your assumed role
• contribute to the completion of the two team outcomes
• prepare material to meet the three individual outcomes that include:
a) 2-3 relevant and high quality journal articles in APA format
b) 2-3 relevant and high quality web resources in APA format
c) 4-8 sentence answers to the 3 expert role questions
Specifically, the team outcomes of this Webquest will be:
1. A creative, persuasive, evidence-based, culturally and linguistically appropriate one-page patient education brochure or handout about infant sleeping position that your team would present to pregnant teens and their family members
2. A creative, evidence-based, and brief 5 minute Microsoft PowerPoint presentation that your team will present to fellow students and that relates your findings about infant sleeping position
The "process" describes how students are to accomplish the task. If students are expected to take on specific roles in the WebQuest, the process section should make these explicit. The roles should emerge as a natural division of labor from the design of the WebQuest. Students appreciate assuming realistic roles because the realism makes the WebQuest a more authentic experience. It is important to have a manageable number of roles on the team. Ideal teams consist of two to four students, which results in a tangible role for each member, who can then be held accountable and evaluated for their individual contribution. Detailing when and how collaboration can occur within the team and among other teams, if there are several on a similar WebQuest, is important to clarify for students so that they will appreciate and fully engage in the collaborative nature of the WebQuest. The following instructions for the SIDS WebQuest, which had three roles, provide specific guidelines pertaining to collaboration.
First, you will be assigned as one of a team of three students who are portraying community health nurses. You will pick one of three expert roles within the team.
* Clinical practice expert-the team member who serves as the clinical practice, evidence-based guidelines expert.
* Diversity expert-the team member who serves as the cultural, ethnic, and diversity expert.
* Patient education expert-the team member who serves as the patient education expert.
Once you've selected an expert role to play, you may pursue your role individually until you have collected the information needed to prepare the materials as a team for completion of this task. You are encouraged to share the resources you accumulate during your search with your team members, as this will facilitate completion of the group patient education materials and PowerPoint presentation. Here are the individual components of each expert role:
Clinical Practice Expert-Using journal articles and Web resources, research the clinical aspects of infant sleeping positions. Answer the following questions. Your answers should be of sufficient detail-somewhere between 4 to 8 sentences in length-and should be documented on the Web page that will be made available for your team.
1. Which organizations have been at the forefront of setting forth clinical practice standards for infant sleeping position and SIDS?
2. What does the research say about the relationship between infant sleeping position and SIDS?
3. Describe how evidence-based practice guidelines are developed.
Diversity Expert-Using journal articles and web resources, research the cultural/ethnic aspects of infant sleeping positions.
1. Which organizations and individuals have been at the forefront of exploring cultural/ethnic diversity in SIDS and infant sleeping position?
2. Describe the state-of-the-knowledge of which cultural/ethnic groups have higher rates of infant mortality from SIDS.
3. Describe the findings of research articles in relation to cultural/ethnic groups' positioning of infants.
Patient Education Expert-Using journal articles and Web resources, research the patient education aspects of infant sleeping positions.
1. Which organizations have developed patient education materials for infant sleeping position and SIDS?
2. Describe the manner in which patient education materials describe infant sleeping position distinct from SIDS. In other words, is infant sleeping position always related to SIDS in patient education materials or are there other important areas of consideration when positioning infants for sleeping?
3. Describe important issues to consider when developing patient education materials.
Organizing Information As You Go
Type your individual role questions into a Microsoft Word document so that you can add information to them as you explore journal articles and Websites.
Keep your desired products in sight and organize your work around these things:
1. Individual answers to the three questions based on your role
2. Individual 2-3 relevant and high quality journal articles in APA format
3. Individual 2-3 relevant and high quality web resources in APA format
4. Group patient education handout/brochure
5. Group Microsoft PowerPoint presentation for colleagues
The "resource" section of WebQuests provides information sources, such as documents, databases, and people, that students need to complete the task. It is important to direct students to appropriate Web sites so they do not get lost in a morass of inappropriate resources. It is similarly important to ensure that students understand some of the terminology that they should use as they are conducting their searches. Particularly in the case of students who are new to the new health professions, not all will be familiar with key words for a particular content area and how to maximize their database searching. If the students are new to the institution, directing them to library resources and tutorials that can assist them with searching is imperative. To produce a successful outcome, students may also need to be directed to more general resources, such as how to tell a research article from an opinion piece; how to recognize relevant, high-quality journals and Web resources; and how to format their product. If students are expected to produce a specific type of outcome, such as a patient education handout, or if they will be required to use software that they maybe unfamiliar with, such as Microsoft PowerPoint, it is imperative to provide links to resources that will assist them in acquiring these skills. The SIDS WebQuest provided students with Web site, library, and collaboration resources, as well as guide documents that covered specific skills needed for successful task completion.
Here are some quality Web sites that you will find useful (don't worry, there are plenty of others that you'll be able to use for your required 2-3 annotated references):
* American Academy of Pediatrics-http://www.aap.org/
* Centers for Disease Control-http://www.cdc.gov/reproductivehealth/SIDS/
* National Institutes of Health, National Institute of Child Health and Development-http://www.nichd.nih.gov/sids/
* CJ Foundation for SIDS-http://www.cjsids.com/
* Agency for Healthcare Quality and Research Guidelines-http://www.guideline.gov
* National Center for Cultural Competence-http://gucchd.georgetown.edu/nccc/
* Developing Patient Education Materials-http://www.cdha.nshealth.ca/patientinformation/developingPFEdMaterial.pdf
* Developing Clear and Simple Patient Education Materials-http://www.cancer.gov/cancerinformation/clearandsimple
As you're looking at these and other sites, you may easily find information about SIDS and infant sleeping position. In some of the sites, however, you'll need to find the SEARCH box and type in what you wish to search for. Try typing in SIDS and then do another search typing in something like "infant sleeping position"(with the quote marks around the phrase) and see what results you get. You may also want to type in search terms that match your role in the team (like culture or ethnic or "patient education" or "clinical guidelines"). See below for instructions for completing the library's online tutorials that help you learn to conduct effective searches.
Once you venture beyond those initial websites, you'll want to ensure that you are viewing high quality, relevant, and reputable web sites. See below for some guidelines for helping you to determine you're at a website that you can trust!
Make sure to complete the online library tutorials to enable you to search more productively and efficiently, not only for THIS exercise, but for others in other classes. You can locate the tutorials at: http://library.utmem.edu/HSLBC/Instruction/nInstruction_frames_t.html
Look in the left-hand column of the screen when you are at that location. The three tutorials that you should complete are:
* Library Tutorial
* Ovid Tutorial
* PubMed Tutorial
Each of the tutorials works much better if you are conducting an actual search and you can do that search while moving through the tutorials. Consider what search terms you need to do to complete your individual and team tasks for this webquest. Use those search terms as you are progressing through the tutorials to maximize your time!
As you are gathering information based on your expert role, continue to dialogue and confer with your other team members in a special space that has been set up for you on the Web. Share what you've learned. It is very helpful to share and collaborate as you're going through the process of data collection, synthesis, and reflection. That way everyone benefits!
Guide Documents Covering Specific Skills Needed for Your Tasks (note: the items below were hyperlinked to new pages)
* What is an annotated reference?
* How do I use proper APA format for journal articles and web resources?
* How can I recognize relevant, high quality journals and web resources?
* How do I make sure that the patient education handout/brochure will be appropriate?
* How do I use Microsoft Office 2003's PowerPoint?
The "evaluation" provides students with detailed rubrics that will be used to assess their final products. Criteria for successful completion that will be used in the evaluation of the WebQuest should be abundantly clear to students from the beginning. Each product should be evaluated, whether produced individually or by the team. Collaborative activities should also be assessed using a rubric. The SIDS WebQuest required the completion of four evaluation rubrics.
Evaluating one's own work, as well as the work of others, is every bit as important as conducting the work. Your systematic and honest attention to the evaluation process will validate the efforts expended in producing the required outcomes.
There are 4 different evaluations that you will complete. The results of these evaluations will determine your grade for this activity.
Individual Activities Assessment
1. Individual Expert Role Evaluation Rubric
* This evaluation covers answering your assigned questions, journal article, and web resource annotations
* This evaluation is completed by the individual learner and the facultyGroup Activities Assessment
2. Patient Education Material Evaluation Rubric
3. Presentation Evaluation Rubric
* These two evaluations cover the patient education material and presentation that your team completes
* These evaluations are completed by the team, 3 other teams, and facultyCollaboration Activities Assessment
4. Collaboration Evaluation Rubric
* This evaluation covers each team member's contributions, taking responsibility, and valuing others' viewpoints
* This evaluation is completed by the individual and his/her team membersEach individual will, therefore, complete the following evaluations:
* One individual Expert Role Evaluation Rubric on him/herself
* One collaboration Evaluation Rubric on him/herself and one on each team memberEach group will complete the following evaluations:
* Patient Education Material Evaluation Rubric on your own group and 3 other groups
* Presentation Evaluation Rubric on your own group and 3 other groups
The following evaluation rubrics offer you specific details on how your performance will be evaluated as individuals and as team members. They are reproduced below for your information and to guide you as you complete your work on this activity. The official evaluation rubrics will be located in the Blackboard site, so that you can complete them and turn them in electronically. Your final grade will be comprised of an individual component and a group component. See http://www.technology-escapades.net/webquests/informatics/sids/eval.htm for the specific rubrics.
In the "conclusion," students are reoriented to the original purpose of the WebQuest. They are asked to reflect on their learning in the activity and to consider how they can apply their learning in future situations. Students may also find it helpful to reflect on their group collaborative experiences. While much is made of the need for collaborative assignments, less often students are asked to reflect on the process and to discuss whether the group process and group work were effective. The SIDS WebQuest conclusion summarized the skills students had gained and the outcomes they produced and raised questions for their consideration.
By completing this activity, you will have:
* enhanced your critical thinking skills,
* gained practice in searching for journal references and Web resources that are of high quality and are relevant to a specific topic,
* compared resources and perspectives,
* analyzed disparities in the literature and constructed support for material to present to lay and professional audiences,
* prepared an appropriate patient education brochure/handout about an issue for teaching purposes, and
* prepared a presentation about an issue for a professional audience of colleagues.
* How might you use what you've learned in this activity in other classes?
* What new questions do you have as a result of engaging in this activity?
* What else would have been useful for you to have as you completed this activity?
In addition to the critical attributes of a WebQuest that have been presented, noncritical attributes may or may not be included. However, the inclusion of noncritical attributes strengthens the WebQuest. Common noncritical attributes include incorporation of group activities; motivational elements, such as roles and scenarios; and collaborative research and decision-making. The interprofessional and collaborative nature of today's healthcare environment makes it imperative to have students working collaboratively with others from their initial days in their degree programs. WebQuest activities are well-suited to asynchronous distance education programs, where students may not see or talk with each other except through e-mail or a collaborative group space. Motivational elements are brought into WebQuests when students are given realistic and important roles that are relevant to their learning needs and plausible in terms of representing actual situations or issues they might face in practice. Having several different WebQuest topics and allowing students to sign up for the topic of their choice will increase the likelihood that the topic is of interest. Including a component that requires collaborative research and decision-making will facilitate getting teams to work together instead of as individuals. It is important to specify to students that it is both appropriate and desirable for them to share with each other resources that they locate.
While some WebQuests, such as March's21 archetypal long-term WebQuest "Searching for China," take days and weeks to develop and refine, WebQuests need not involve that much time in construction. Development of the SIDS WebQuest took place over a day, once the author was comfortable with the components of a WebQuest. The author then developed a template for faculty to use in developing subsequent WebQuests; these were developed in a similar style for the same course and required faculty subject matter experts only 1 to 2 hours of development time. The template provided faculty with the Introduction, Process, and Web Resources sections of the SIDS WebQuest that they used to parallel development of their WebQuests. A listing of Web resources that will be helpful to faculty who are new to WebQuests can be found at http://technology-escapades.net/?q=node/2. In addition, reviewing existing WebQuests will also offer ideas. Table 2 offers links to some of the WebQuests that are most appropriate for health professions students.
WebQuests facilitate the assessment and development of information technology and information literacy competencies. To be successful, students must be able to use the Internet, conduct effective searches for material on the Internet as well as in scholarly databases, synthesize diverse perspectives, judge the credibility and reliability of resources, and use software programs to create documents, brochures, and presentations. All of these activities are done in the context of a relevant and meaningful assignment, which engages students in deeper learning. Faculty members assume a "guide from the side" role and facilitate students' explorations and creativity.
In WebQuests, students start from where they are at in relation to information technology competencies, information literacy competencies, and knowledge of the topic area. For instance, in an undergraduate nursing program where a second degree student enters with a first degree in library science, the student would be able immediately to put to work his/her skills in database searching and information seeking on the WebQuest, while assisting teammates in their acquisition and use of those skills. While many step-by-step activities would require demonstration that the searching and seeking activities were completed to a satisfactory and predetermined level prior to allowing students to progress, in WebQuests students can demonstrate their knowledge via their products and outcomes. This enables students to immediately invest time in areas that are more challenging and less familiar, while feeling confident in the use of existing skill sets. Feelings of success and proficiency foster a sense of self-efficacy and reinforce engagement in the learning process.
Active learning is supported in WebQuests, which require that students participate in the discovery and creation of knowledge. In the social constructivist perspective,22 individuals construct knowledge by learning with and from other people, as well as the environment. WebQuests, created with attention to the important elements of individual and collaborative meaning-making, facilitate development of the skills and attitudes students require for immediate and long-term co-creation of knowledge in their educational programs, work environments, and society.
WebQuests also support diverse students, from the more concrete thinkers to those who are more abstract or more creative. Concrete thinkers will find roles for learning the facts and reviewing evidence-based practice guidelines a fit with their preferences. Abstract thinkers will thrive with opportunities to use information to craft a persuasive message, while creative thinkers will relish the opportunity to design effective materials for presentations or handouts.
Creating truly engaging learning for all students requires that faculty members undergo a shift in their instructional styles to avoid merely e-Teaching and meaningfully engage students in e-Learning.23Jukes24 offers suggestions for making such a shift, including to make learning fun, deliver learning opportunities faster, and increase opportunities for multitasking, networking, and interactivity. In today's Information Age,25 no longer is it sufficient to merely provide students with traditional healthcare content in traditional ways. It is imperative that students receive 21st century content in 21st century ways, including critical thinking, problem solving, process skills, creating thinking, personal skills, interactive and collaborative learning, and asynchronous learning.24 WebQuests are not only creative, but also provide an enjoyable way for students to develop information technology and information literacy competencies. These competencies not only benefit them in their student role throughout their educational programs, but also give them the expertise they will need to be successful citizens and healthcare providers in the 21st century.
© 2008 Lippincott Williams & Wilkins, Inc.