Instructional design for affective learning in online nursing education

Efforts to revamp nursing education to meet enormous projected needs for RNs in the near future depends upon the development of an education research base that demonstrates the effectiveness and efficiency of various instruction methodologies in all three domains of learning---cognitive, affective and psychomotor. This study explored the effectiveness of instruction specifically design to facilitate learning in the affective domain, the domain where critical thinking in nursing begins. The online course that was studied specifically adapted the Pebble in a Pond (PiP) model of instructional design developed by Merrill to affective learning. Attitudes about elderly people, expressed as ageism, was used as the focus for change through instruction. The setting was an associate degree nursing program in upstate South Carolina where this quasi-experimental research compared before and after ageism scores in control and experimental groups of students using three validated test instruments. The experimental treatment was an online gerontological nursing course. The study found that affective learning, as indicated by decreased ageism, did occur in the experimental group and did not occur in the control group. The three instruments, the Fraboni Scale of Ageism, Palmore's Facts of Aging I, and Kogan's Attitudes Toward Old People were in agreement with statistically significant differences between the study groups. Implications for further research are replication of this study using (a) nursing students in other geographic areas and levels of study, (b) other models of instructional design in the online setting, (c) and other settings with this adapted PiP instruction design model. This research has taken place at the confluence of important issues in nursing and nursing education where nurse educators and practitioners are working to find innovative, evidence-based methods to mitigate the coming shortfall of nurses. This study provides evidence that instruction specifically designed to facilitate affective learning is part of the solution.