Developing Online Courses in Nursing Education: Guidance from Expert Online Educators

Patricia Benner, R.N., Ph.D., FAAN

August 11, 2020

We are excited to bring you four inspiring and informative interviews about developing online learning. Our goal is to help faculty “get started” putting classes online in effective ways, despite the current time-demand of moving all courses online in the COVID-19 Pandemic. These interviews were conducted via Zoom.

Dr. Glenise McKenzie and Dr. Paula Gubrud-Howe are well known in Oregon for their excellent online course for R.N. to B.S.N. completion program at The Oregon Health Sciences University School of Nursing (OSHU, SON). (We featured the faculty and curriculum of the Oregon Health Consortium in our February 2017 newsletter and video series.)  Dr. McKenzie and Dr. Gubrud-Howe point out that culture and the extensive faculty development of OCNE have influenced their online R.N. to B.S.N. program, particularly their adoption of the Communities of Learning Model of Course design (Fiock, 2020). Many of the Oregon Health Sciences Consortium graduates enroll in the online Oregon Health Sciences University (OSHU) R.N. to B.S.N. Program.

This R.N. to B.S.N. Program designs its online courses using learning science and continuous evaluation and improvement. Dr. McKenzie and Dr. Gubrud-Howe give you their pearls of wisdom from five years of experience teaching online in this outstanding program. You will gain insights about developing online courses for nursing students at all levels. The Community of Inquiry approach to online learning focuses on Faculty Presence, Student Presence, and Cognitive Presence (Fiock, 2020).  Both Drs. McKenzie and Gubrud-Howe give insights about how they make that model work in designing and evaluating online courses for both classroom instruction and online screen-based clinical simulation for clinical replacement during the COVID-19 pandemic.

The Community of Inquiry Model has a lot in common with our June 11, 2020 newsletter that focuses on learning sciences about teaching online. “Curiosity, sociality, emotion, authenticity, and failure” are essential components for active learning that have been proven to enhance learning outcomes. Watching these videotaped interviews will give you front-line insights for design and evaluation strategies to create effective online learning.

To help introduce these Zoom interviews, here is a background for the Community of Inquiry components; Cognitive Presence, Teaching Presence, and Social Presence.

Cognitive Presence

Cognitive presence seeks to engage the student in inquiry as an active learner.  Design for cognitive presence requires designing for student inquiry, engagement, and problem-solving (Fiock, H.S., 2020). Cognitive presence is based on the Practical Inquiry Model (PIM) created by Garrison et al. (1999). It has four phases of inquiry:

  1. A triggering event, scenario, clinical case and so on, is presented for further inquiry;
  2. Exploration, where learners collectively or individually explore the issue;
  3. Learners articulate meanings, perceptions, and explanations based upon their exploration of ideas in phase 2;
  4. Resolution, learners use new skills and knowledge gained in actual clinical practice or simulated clinical situations;
  5. Reflection, increases cognitive presence by extending, using, and evaluating knowledge gained in the inquiry process. (Garrison et al., 1999; Redmond, 2014).

Social Presence

Social presence is critical to online learning and depends on student and faculty engagement and commitment to shared learning outcomes. Social presence calls attention to having students and faculty show up as real people, with concerns, motivations, embodied intelligence and agency. We emphasize embodied intelligence and agency because extra intentionality and planning are required for precisely these aspects of learning a clinical practice, especially in online learning since actual embodied presence has to be imagined and presented online instead of the usual face-to-face encounters with students in traditional learning settings.

Social presence includes the social climate and mood of the online learners and faculty, as well as open, interactive communication, recognition practices that allow students and faculty to understand know and learn from one another. Group cohesion and a sense of belonging are also important, where learners and faculty develop and experience a commitment to one another and their shared goals for learning (Garrison et al., 1999). Social presence increases student and faculty satisfaction and enjoyment of the course (Richardson and Swan, 2019).

Teaching Presence

Teaching presence, including the style of presence and metaphors for teaching-learning, sets the tone and design of online learning.  Teaching presence guides the learning activities, clearly connecting the activities with the learning objectives and the evaluation of meeting those objectives. Both Dr. McKenzie and Dr. Gubrud-Howe give valuable guidance on developing teaching presence through videotaped faculty insights on the goals for the assignments, and designing feedback from students on those assignments. Richardson et al. (2012) note that teachers can create teaching presence “By creating mini-lectures (audio/video), embedding personal insight in the course material, and providing scaffolding on how the course structure helps the learners.” For example, when nursing faculty include their own clinical experiences, they help form the students’ clinical imagination, ethical comportment, and stimulate questions and reflection. The teacher’s presence stimulates student inquiry, interactions, engagement, reflection, and more. As McKenzie and Gubrud-Howe point out, the goal is to be a “guide on the side” rather than a “sage on a stage.”

They recommend following the widely accepted “The Seven Principles for Good Practice in Undergraduate Education” published in 1987 by the American Association of Higher Education (Sorensen, & Baylen, 2009, p. 71):

  1. encourage student-faculty contact,
  2. encourage cooperation among students,
  3. encourage active learning,
  4. give prompt feedback,
  5. emphasize time on task,
  6. communicate high expectations, and
  7. respect diverse talents and ways of learning. (Sorenson & Baylen, 2009, p.71).

While these guidelines were developed for all undergraduate education, in general, they are also adaptable to online learning and are reflected in the model outlined above: “Designing a Community of Learning for Online Courses” by Fiock (2020) used by the OSHU, R.N. to B.S.N. Online Course.  Both Drs. McKenzie and Gubrud-Howe recommend continuous improvement through frequent evaluation of learning outcomes and ongoing student feedback.

We also draw on insights from Dr. Janet McMahon and Dr. Debbie Wallace, Curriculum and Integration Consultants with ATI, who also use the Communities of Learning Model. Drs. McMahon and Wallace provide some practical “getting started” advice and strategies for ensuring that students stay engaged. Dr. Lee Shulman, President Emeritus of the Carnegie Institute, often noted that the “invisibility of the student” is the most common learning disability. There is a real risk of student invisibility in online learning, and Dr. McMahon and Dr. Wallace emphasize steps to enhance the involvement of online students. They point out the importance of active learning in online courses, rather than providing “just hit the play button” passive lectures. They offer specific suggestions from their own experience as online instructors as well as program elements from the ATI menu that subscribing members can use to improve their online classes.

Enjoy your front-row seat to insightful guidance on developing online courses and developing online clinical replacement screen-based simulation.


Fiock, H. (2020). Designing a community of inquiry in online courses. The International Review of Research in Open and Distributed Learning21(1), 134-152.

Garrison, D., Anderson, T., & Archer, W. (1999). Critical inquiry in a text-based environment: Computer conferencing in higher education. The Internet and Higher Education2(2-3), 87-105.

Redmond, P. (2014). Reflection as an indicator of cognitive presence. E-Learning and Digital Media11(1), 46-58.

Richardson, J. C., Arbaugh, J. B., Cleveland-Innes, M., Ice, P., Swan, K. P., & Garrison, D. R. (2012). Using the community of inquiry framework to inform effective instructional design. The Next Generation of Distance Education, 97-125.

Richardson, J. C., & Swan, K. (2019). Examining social presence in online courses in relation to students’ perceived learning and satisfaction. Online Learning7(1).

Sorensen, C.K., Baylen, D.M., (2009) “Learning online. Adapting the seven principles of good practice to a Web-based Instructional Environment.” In  Orellana, A., Hudgins, T.L., & Simonson, M. (Eds.) The perfect online course. Best practices for designing and teaching. Information Age Publishing.  


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