By Louise Racine RN PhD
Associate Professor, College of Nursing
University of Saskatchewan

Lorraine Holtslander RN PhD
Associate Professor, College of Nursing
University of Saskatchewan

Barbara Schindelka
Instructional Design Specialist
University of Saskatchewan

Ryan Banow, MEd
Instructional Design Specialist
University of Saskatchewan

Abstract

The use of wikis as pedagogic tools to engage students is not a new phenomenon in computer sciences, collaborative writing and learning, or online education, yet its adoption appears to be slower in nursing and health education. In nursing education, wikis have been used to facilitate collaborative learning in graduate community health course and to improve writing skills. The use of wikis remains to be further documented for graduate nursing education, and specifically when teaching online graduate nursing theories. This article provides a definition of wikis and illustrates how to use them as pedagogical tools within a constructivist online learning environment. We then provide a process for the effective integration of a wiki into an online nursing course. The authors’ experience with wikis may be useful to guide nurse educators in decision-making related to the inclusion of wikis in nursing education.

Introduction

Over the past decade, the exponential growth of technologies has provided greater access to a diversified clientele of nursing learners, ranging from digital savvy younger students to busy adult students living in urban or remote geographic areas. A majority of North American nursing schools use technology to deliver courses, even entire programs, through a mix of classroom-based, online, and distributed learning models (Hillman & Corkery, 2010; Salyers, Carter, Barrett, & Williams, 2010; Smith, Passmore, & Faught, 2010). The use of wikis as pedagogic tools is not a new phenomenon in computer sciences (Frydenberg, 2008; Ionannou, 2011), collaborative writing and communication (Deters, Cuthrell, & Stapleton, 2010; Huang, 2010; Su & Beaumont, 2010; Trentin, 2009 ), and online education (Huang, 2010; Lamb, 2004; Schwartz et al., 2004), yet its adoption appears to be slower in health and nursing education (Sandars, 2007).

Wikis have been used to facilitate collaborative learning in graduate nursing education, although their use as a pedagogical tool in teaching graduate nursing theories remains to be better documented. In an evaluation of a graduate community health course, Ciesielka (2008) reported that students found the wikis to be an important tool to facilitate group work and communication, stating that wikis represent “a reasonable way to engage students in a collaborative community project within an online environment” (p. 474). In assessing the usefulness of wikis to improve writing skills, Thompson-Martin (2012) found “all students agreed or strongly agreed that the wiki was beneficial to learning course materials” (p. 658). Despite the recognized usefulness of wikis, the literature in nursing education indicates that nurse educators seldom use wikis besides a few exceptions (Ciesielka, 2008; Kardong-Edgren et al., 2009; Thompson Martin, 2012; Seckman, 2014). Ciesielka (2008) believes that a lack of familiarity with wikis may explain the slow adoption of this technology among nursing faculty.

This article describes how wikis can be used to facilitate the teaching and learning processes of nursing theories. We do not intend to provide an in-depth discussion on the teaching of nursing theories, as we believe these issues have been lucidly discussed by other scholarly works (Karnick, 2013a; 2013b; Thorne & Sawatzky, 2014; Turkel, Ray, & Kornblatt, 2012). Rather, our goal is to highlight the usefulness of wikis as a pedagogic tool to support graduate nursing students’ theoretical learning experiences through an asynchronous fully online delivery. To this end, we provide a definition of wikis and illustrate how to use one as a pedagogical tool within a constructivist online learning environment. We also provide a process for the effective integration of a wiki into an online nursing course. In closing, we discuss comments provided by students that specifically describe their appraisal of the wikis.

Constructivist Pedagogy

Teaching nursing theories represents an interesting pedagogical challenge due to the abstract nature of the content matter. Teaching nursing theories through an asynchronous fully online delivery constitutes another pedagogical challenge. In our case, the challenge was threefold. First, we transitioned from a traditional classroom to an asynchronous model of delivery. Second, we shifted the content delivery from an instructor-centered to a student-centered philosophy. Finally, we adapted the content delivery to capture students’ interests and make the learning more active by stimulating participation. Literature in nursing education suggests that wikis facilitate collaborative learning and align well with the assumptions of constructivist pedagogy (Kardong-Edgren et al., 2009; Parker & Chao, 2007). Constructivist pedagogy acknowledges the students’ active engagement in the learning process and that each learner brings personal experiences to learning (Parker & Chao, 2007; Legg et al., 2009).

In contrast to behavioral and cognitive approaches, educators who adopt a constructivist view of learning believe that knowledge is socially located and constructed (Young & Maxwell, 2007) rather than acquired. Within a constructivist approach to learning and teaching, nurse educators become facilitators of the knowledge construction process rather than transmitters of knowledge. Kumar and Ochoa (2011) pointed out that the ability to personally and socially construct knowledge is one of the most powerful benefits of asynchronous online communication tools (such as wikis) in post-secondary education. A constructivist pedagogy locates the process of learning in the hands of the learners while facilitating acquisition of knowledge and skills. The use of a wiki as a learning tool in the fully asynchronous nursing theories course represents a means to operationalize a constructivist pedagogical approach to facilitate the process of learning and foster the development of critical skills associated to knowledge (nursing theories) acquisition.

Design and Usefulness of Wikis in Education

A wiki is “a system that allows one or more people to build up a corpus of knowledge in a set of interlinked web pages, using a process of creating and editing pages” (Franklin & van Harmelen, 2007, p. 5). More simply put, a wiki is a website where all members can collaborate and make changes to the collective content. It is an online web page development tool that enables users to add, edit and delete their own and/others’ content (text, images, links to other wiki pages or websites, etc.). Pages can be added to the wiki by adding links for more webpages. Most wiki tools provide a “history” function that enables users to view the evolution of the wiki over time. Biasutti and El-Deghaidy (2012) suggest that this function could provide teachers with valuable insight as to the processes students use to construct their knowledge.

Wikis are a tool that can perform many educational functions: facilitating collaborative learning, writing assignments, sharing information and resources, and supporting group work (Franklin & van Harmelen, 2007; Ionannou, 2011; Kardong-Edgren et al., 2009). Wikis are accessible, flexible, convenient and relatively easy to use in online courses (Parker & Chao, 2007; Huang, 2010; Thompson Martin, 2012; Trentin, 2009). Conversely, the use of wikis in teaching and learning do present some risks, but those risks can be easily managed by instructors. For instance, risk of plagiarism or non-participation can be monitored by faculty members through wikis’ inbuilt features within online management programs.

Many post-secondary institutions have institutionally supported wiki applications, or have wikis embedded in their learning management systems (LMS). Wikis are integrated into the Angel™ and Moodle™ LMSs (Educause, 2010) as well as Blackboard™ and Web CT™ (Frydenberg, 2008). However, viable no-cost (or low-cost) options such as PBWorks™ (www.pbworks.com), WetPaint™ (www.wetpaint.com) and Wikispaces™ (wikispaces.com) are freely available to educators. When considering an open wiki application, the instructor must make sure that the option “class member only” is available and that it is compliant with the institution’s privacy policies. A wiki based assignment requires some general steps to ensure that the experience is not overly complex.

The first step is to ensure that the instructor has an account set up on the institution wiki system or learning management system. After that, the process of creating a wiki assignment is similar, though the specific mechanics of setting up wiki assignments will differ from system to system.

For clarity’s sake, it is important to choose the type of group activity that students will collaborate on via the wiki. Will it be the analysis of a research paper or a textbook chapter? Will learners be asked to compare and contrast materials or ideas? Will they be asked to develop a case study?  After choosing the materials, then instructors must decide how to assess the work. There are many assessment options such as creating a detailed rubric or a grading checking. There may be some space for peer-evaluation which may increase active participation of students and develop skills in assessing their peers’ work.

Instructors may also choose the number of students in each group and how many groups will be needed, especially in case of high enrolment in online courses. If using group work, then it is important to select the topic (e.g. critical analysis, research question, case study or specific analytical questions) that will be assigned to each group. Instructors may also choose to create a list of topics for group selection.

After this step, instructors need to create a wiki in their chosen wiki system. We recommend naming the wiki according to the course number and assignment. Instructors must provide clear assignment instructions in the text field, and save or submit. Educators may choose to distribute the wiki link to students or have each student sign up for a wiki group (topic). BBLearn allows students to assign themselves to wiki groups or the instructors may choose the tool to randomly assign students in wiki groups.

Educators play a key role in constructing wikis as rich learning experiences. Wiki assignments play a role in socialization among groups as each wiki member is encouraged to follow wiki etiquette rules. Wiki etiquette reminds instructors and students to treat others with respect and dignity, be polite, and that one’s opinion is only one of several. Presenting the wiki as a unique way to learn collaboration is another outcome of this technology tool. Instructors should seek to enhance the quality of the learning experience. To this end, it is important to remind students that the point of the wiki is collaboration. In applying a student-centered philosophy, educators encourage students to freely express their ideas rather than being constrained by writing quality or the fear of making mistakes.

In our asynchronous nursing theories course, we provided an additional step to allow students to know each other before getting into the task of writing the wiki. They were able to discuss their potential answers. Discussion forums were created for the groups to use to discuss the questions prior to creating the wiki post, though this is not necessarily required for all wiki assignments. Using wikis within constructivist pedagogy, educators foster the use of prior learning experiences and encourage learners to add supplemental materials such as pictures, diagrams, links, and videos to their wikis. Finally, it is important to monitor the work of each group as they navigate the collaborative process and use the “comments” feature of the wiki to ask questions, prompt clarifications, and give constructive feedback to the group.

Design of Wiki Assignments in Nursing Theories Course

Wikis have been used to facilitate collaborative learning in graduate nursing education but not to the extent to which this technology can be used. The literature in nursing shows an increased use of wikis in nursing education but there remains a dearth of articles describing the use of wikis as pedagogical tool to facilitate teaching and learning of nursing theories. For instance, in an evaluation of a graduate community health course, Ciesielka (2008) found that the use of a wiki was useful to meet learning competencies in a nursing community health course. She reported that students found the wikis to be an important tool to facilitate group work and communication. In assessing the usefulness of wikis to improve writing skills among a group of graduate nursing students, Thompson-Martin (2012) found that wikis were useful to increase students’ and faculty’s comfort with new technologies.

The University of Saskatchewan offers thesis and course-based options in their Masters of Nursing degree program, and the nursing theories course is a mandatory requirement for both. A team of faculty and educational designers worked together to transition the course from its initial classroom-based offering to a fully online asynchronous delivery. This transition required a shift from an instructor-centered to a student-centered philosophy congruent with constructivist pedagogy. The content was adapted for a full online delivery with a course package accessible through the institution’s Learning Management System (LMS), Blackboard Learn™ (BBLearn). PowerPoint™ files, videos, and mandatory and recommended readings were accessible online.

Wiki-based activities were designed to replace the collaborative learning done in classroom-based group work and team presentations. Students came from different geographic locations and different time zones, so it was important that a flexible and accessible tool was used to facilitate teamwork. Our team believed that wikis would be a pedagogical tool that could help students to think critically about nursing ontology and epistemology. As part of the wiki assignments, students participated in online discussions with their assigned group and submitted a wiki summarizing the major ideas arising within their group discussion. Online group discussions and the wiki aimed at supporting interactions between students while developing critical thinking skills in assessing nursing theories. The course was delivered weekly for 13 weeks and involved four wiki assignments that were carried out in randomly assigned teams of 4 or 5 students, depending on enrollment. The wiki used was integrated into the BBLearn system, and the wiki assignments were worth 40 percent of each student’s final mark.

The purpose of using the wikis as pedagogical tools was to support learners to think critically about nursing ontology and epistemology and the implications of theory development and testing on nursing knowledge. As the nursing theories class is the first course of the program, Author 1 provided some guiding questions to start group discussions and the writing of wikis. Questions such as 1) What is the use of nursing theory? 2) Does nursing have a distinct body of knowledge? and 3) Can science answer all questions related to nursing? were used. Group discussion questions aligned directly with the course learning outcomes. The online course included an introductory module that contained a lexicon developed by Author 1, designed to develop students’ familiarity with new and abstract theoretical vocabulary. Students could also choose from a wide array of online library resources, and had access to IT support technicians as well as to You Tube™ videos to illustrate the steps of creating and writing the wikis. The course instructor also offered scheduled virtual office hours to support the students either in the use of the wikis or to answer questions pertaining to the content.

Students were given two weeks to think about and discuss the topics via the BBLearn discussion board function. Then, each group collaborated to create a summary of their discussion using the wiki, and submitted the wiki page(s) for marking. Students were invited to reflect on their personal experience as nurses when reflecting on the guiding questions. The instructors had created a marking rubric, which was shared with the students at the beginning of the course. The rubric included criteria such as adequacy of comments, scholarly presentation of ideas, substance, and clarification of an idea. The adequacy of comments was met when comments were focused on questions related to the course material. Scholarly presentation indicated that students needed to use scholarly literature and bring substantial points for discussion, rather than contributing trivial comments. Finally, clarifying an idea meant that students could describe what they had learned. Each educational innovation needs to be evaluated for quality improvement. This is why we collected feedback from student users.

Feedback from Student Users

Course and teaching evaluations represent an important part of quality improvement and all collected information was anonymous and confidential. All course evaluations are collected by the university through a centralized system to protect the integrity of the evaluations and protect students’ rights to freely express their assessment of the course content or the instructor’s performance. The university collects course evaluations after the completion of the term and when the final marks have been sent to the registrar, the evaluations are emailed to instructors. A university policy stipulates that students have 30 days to appeal a final mark, so course evaluations are not sent to instructors before that deadline. This process does not represent a formal research project but protects the rights of the participants through respect of confidentiality and anonymity. Students are free to provide comments while some may choose not to write any comments.

Although the wikis seemed to be accepted quite well by students, some critiques were reported in students’ evaluations of the course. One respondent said: “The group discussions with wikis were helpful. I really liked them as a way of working through the materials. I found it helpful for developing a rapport and ensuring equal participation and division of the work.” Another student mentioned: “The wiki assignments were somewhat valuable for learning the content.” These comments align with previous scholarly articles in which the use of wikis was found to help teamwork, collaboration, and learning (Deters et al., 2010). The comments also support Huang’s (2010) findings, which report that wikis enhance online learning interactions.

However, others indicated that they did not find the wiki assignments useful to their learning because of the time it took them to get used to using the technology. As Seckman (2014) points out, the lack of computer literacy may be surprising, but it does occur among graduate students. The most frequent critique shared by the respondents, though, was the investment of time to do the wiki-related work. Graduate students often work full-time and the introduction of the wikis increased their workload. One student commented: “The amount of work involved in the creation of the wiki was very onerous.” Another student pointed out “I did not enjoy the wikis because I find myself and one other person doing most of the work.” Several respondents suggested that a less formal structure, and not randomly assigning students into groups, might help to keep stability among wiki group members in the future.

Seckman (2014) emphasized the importance of preparing students for interacting and collaborating in an online learning management system. Student comments suggest that wikis represent a promising feature but there is a need for flexibility in how wiki-based assignments are structured. Student responses also highlight the importance of providing students with low-risk opportunities to practice using the wiki when it is first introduced to a course, both to increase student comfort with the technology as well as to help students develop digital literacy skills.

Summary

Teaching nursing theories represents a challenge for nurse educators due to the nature of the subject, which may seem arid and abstract for some learners. This article summarizes what a wiki is and how it can be used as a pedagogical tool in an online master’s degree nursing theories course. This educational innovation presents limitations. The efficacy of using wikis in nursing education deserves further evidence of its usefulness but its design and use as a pedagogic tool is relatively straightforward. We believe that this teaching innovation may guide other nurse educators who would like to use wikis for teaching graduate nursing theories courses.

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AUTHOR BIOGRAPHIES

Dr Louise Racine

(Corresponding author) Email: louise.racine@usask.ca

Dr. Louise Racine, RN Ph.D. is an Associate Professor in the College of Nursing at the University of Saskatchewan, Saskatoon. Dr. Racine’s research and teaching interests are in the areas of non-Western immigrants and refugees’ health, qualitative inquiry, and education. The team acknowledges funding received from the U of S Tel Grant initiative.

Dr. Lorraine Holtslander

Dr. Lorraine Holtslander, RN, Ph.D., CHPCN(c) is an Associate Professor in the College of Nursing at the University of Saskatchewan, Saskatoon. Dr. Holtslander is an Honorary Associate Professor at the University of the Witwatersrand. Dr. Holtslander’s research and teaching interests include family nursing, palliative care, bereavement, nursing education, and qualitative methodology.

Barbara Schindelka

Barbara Schindelka is an Instructional Design Specialist in the Gwenna Moss Centre for Teaching Effectiveness at the University of Saskatchewan, Saskatoon.

Ryan Banow

Ryan Banow, MEd is an Instructional Design Specialist at the Gwenna Moss Centre for Teaching Effectiveness at the University of Saskatchewan. He also works as a sessional instructor in the College of Education. He received an MEd from the University of Saskatchewan. His primary interest and expertise is blended learning.

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