Using VoiceThread to Promote Collaborative Learning in On-Line ...

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The movement to advance the clinical nurse leader (CNL) as an innovative new role for ... The challenge for nurse educators is to provide collaborative learning.
USING VOICETHREAD TO PROMOTE COLLABORATIVE LEARNING IN ON-LINE CLINICAL NURSE LEADER COURSES OLA H. FOX, DNS, CNL⁎ The movement to advance the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards continues with CNL programs offered on-line at colleges and universities nationwide. Collaborative learning activities offer the opportunity for CNL students to gain experience in working together in small groups to negotiate and solve care process problems. The challenge for nurse educators is to provide collaborative learning activities in an asynchronous learning environment that can be considered isolating by default. This article reports on the experiences of 17 CNL students who used VoiceThread, a cloudbased tool that allowed them to communicate asynchronously with one another through voice comments for collaboration and sharing knowledge. Participants identified benefits and drawbacks to using VoiceThread for collaboration as compared to text-based discussion boards. Students reported that the ability to hear the voice of their peers and the instructor helped them feel like they were in a classroom communicating with “real” instructor and peers. Students indicated a preference for on-line classes that used VoiceThread discussions to on-line classes that used only text-based discussion boards. (Index words: Clinical nurse leader; CNL; VoiceThread; Collaborative learning; Asynchronous on-line communication) J Prof Nurs 33:20–26, 2017. © 2017 Elsevier Inc. All rights reserved.

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HE MOVEMENT TO advance the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards continues with CNL programs offered on-line at colleges and universities nationwide. Quality on-line learning environments include opportunities for students to engage in collaborative activities with their peers (Brindley, Walti, & Blaschke, 2009). Collaborative learning activities offer the opportunity for CNL students to gain experience in working together in small groups to negotiate and solve care process problems. Knowledge is cocreated and shared among learners as they work toward a common learning goal or solution for a problem (Brindley et al., 2009). The challenge for nurse educators is to provide collaborative learning activities for learners in an asynchronous learning environment that can be isolating by default. On-line learners separated by time and distance sometimes feel disconnected from peers (van Tyron & Associate Professor & Director MSN Program, Spring Hill College, Mobile, AL. Address correspondence to Ola Fox: DNS, CNL, Spring Hill College Division of Nursing, 4000 Dauphin St., Mobile, AL, 36608. E-mail: [email protected] 8755-7223

Bishop, 2009). This disconnection can hinder students from fully engaging with the instructor and their peers in the learning process. Then there is the reality of low participation based on the perception of collaborative learning as a reduction in the flexibility and convenience to choose study hours that fit around the demands of work and family. No matter the reason, lack of full participation with peers in the on-line classroom can be counterproductive to emulation of expected CNL competency in facilitating collaborative, intra-, and interprofessional approaches to solving care process problems.

VoiceThread and Collaborative Learning Many practitioners of on-line communication advocate the use of VoiceThread to extend and foster collaborative learning activities in the on-line environment (Ching & Hsu, 2013; Pacansky-Brock, 2013; Pacansky-Brock, 2014). VoiceThread is a cloud-based communication application that allows instructor and students to upload a presentation in the form of PowerPoint slides, images, video, or all three, add voice comments, and securely share the presentation with others enrolled in a class. Most importantly, others can stop the presentation at any

Journal of Professional Nursing, Vol 33, No. 1 (January/February), 2017: pp 20–26 © 2017 Elsevier Inc. All rights reserved.

20 http://dx.doi.org/10.1016/j.profnurs.2016.08.009

USING VOICETHREAD TO PROMOTE COLLABORATIVE LEARNING

point and use a microphone on his or her computer, a Webcam, or even a telephone to add their own voice or video comments. This creates a thread of audio or video asynchronous communication much like the back-and-forth conversation that occurs in a face-to-face classroom. Pacansky-Brock (2013), an innovator in the use of VoiceThread in education, validated many of the ideas about social presence and its humanizing effect in the a s y nc h ro no us o n- l i ne en v i ro nm en t. Be ne f i ts Pacansky-Brock identified include the following: • Improved sense of social presence. The ability to see and hear their peers and instructor reminds students that they are interacting with a real person, rather than a computer. • Improved sense of community. The humanizing aspects of VoiceThread foster a sense of community. Students are more motivated to participate when they feel they are part of a group and community of learners. • Improved understanding of complex ideas in different ways. Students reported increased understanding with VoiceThread. In addition, Pacansky-Brock (2014) analyzed the student responses to open-ended questions about how voice comments affected his or her on-line experience. The five themes that emerged were a perceived sense of community, improved learning, more like a “real” class, improved communication, and improved nuance/ emotion. Ching and Hsu (2013) explored the experiences of 20 graduate students using VoiceThread for a collaborative activity in an on-line graduate course. The results of the study revealed that the students had very positive experiences toward using VoiceThread for collaborative learning. Fifty percent of students reported that they felt more connected to peers; however, feeling more connected did not result in a level of participation beyond the course requirement. Fifty percent of students did not feel more connected to peers. The most frequently mentioned benefit of using VoiceThread as compared to text-based discussion was the ability to communicate emotion and other nonverbal cues conducive to understanding and interpretation of meaning. Forty-five percent of students preferred VoiceThread to text-based discussions for collaborative learning activities. Twenty-five percent of students preferred text-based discussions to VoiceThread, and 30% preferred a mix of VoiceThread and text-based discussions depending on the nature of the task. In Ching and Hsu's (2013) study, only three students identified areas they disliked about using VoiceThread for the collaborative activity. One stated that “he was shy and did not like to speak in public.” Another said that “the control for making the VoiceThread public needed to be more obvious,” and another commented that “the voice response made receiving feedback and making revisions more cumbersome than did the text response.”

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Theoretical Framework for VoiceThread Enhanced Collaborative Learning Ching and Hsu (2011) developed a framework to guide the design of VoiceThread enabled collaborative learning activities. The major components of the framework are shared goals, knowledge construction through social interaction, distributed cognition to process and produce artifacts, and situated cognition for learning in an authentic and meaningful context. A shared goal establishes a purpose for participation, communication, and collaboration among the members of a learning group. Distributed cognition suggests that knowledge is distributed across collaborators. When individuals construct knowledge through social interaction, they create learning experiences for each other as they discuss and negotiate how to achieve the shared goal. Both the process and products of collaborative knowledge construction align with the shared goal. Learning is situated and occurs in an authentic context that requires participation, communication, and collaboration. Based on Ching and Hsu's (2011) framework, VoiceThread (a) supports social and interpersonal interactions through its commenting function, (b) can record the artifacts created from the distributed cognition of collaborative individuals separated by time and distance, and (c) provides an environment to build authentic learning contexts in which learners collaborate in knowledge construction through situated participation. Collaboration is a necessary competency for all practicing nurses and can be strengthened through engagement of on-line students in meaningful collaborative learning activities. This article reports on the experiences of 17 CNL students who used VoiceThread, a cloud-based tool that allowed them to communicate asynchronously with one another through voice comments for collaboration and sharing knowledge. Based on the research associated with the use of VoiceThread in the on-line environment, the following question was the focus of this inquiry: What are students' perceptions of using VoiceThread for collaborative communication and knowledge sharing in an asynchronous on-line environment?

Methods Setting The setting was a small private college located in the southeastern United States. The master of science in nursing (MSN) program for CNL is delivered in an asynchronous on-line format. All enrolled students are required to complete an on-line tutorial and pass a quiz on using the on-line learning management system. Each semester is divided into two 8-week terms, Term I and Term II. The two 8-week terms make it possible for students to take one course each term, complete two courses each semester, and graduate in five to six semesters. The didactic course content is divided into eight units with learning activities and discussions to be completed

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in the period of time a unit is scheduled. A new unit opens each Monday and closes the following Sunday. Four CNL education models are implemented for the master's degree in nursing: • Model A: Master's degree program designated for bachelor of science in nursing graduates • Model C: Master's degree program for registered nurses (RNs) with a baccalaureate degree in another discipline • Model D: Master's degree program for RNs with an associate degree or diploma in nursing (RN to MSN) • Model E: Postmaster's certificate program designated for RNs with a master's degree in nursing in another area of study

Participants Following institutional review board review and approval, participants were recruited at the end of spring semester from 18 students who had used VoiceThread for participation in asynchronous on-line discussions and a collaborative learning activity. Each student received an e-mail inviting them to participate in an anonymous survey to help the course instructor understand how the use of VoiceThread affects on-line learners. In the e-mail, it was explained that participation was voluntary and that the collected data would be reported to the instructor as aggregated data to guarantee their anonymity in responding and later analysis of the data. Those students who elected to complete the survey clicked on a link that opened the survey posted in Google Docs. The conditions of voluntary participation and anonymity were repeated in the introduction to the survey. The first “Yes” or “No” question on the survey asked, “Do you agree to the participation conditions explained above?” A “Yes” answer allowed the student to continue and complete the survey. If the student selected “No,” the survey was immediately submitted without further input from the student.

Procedure Graded VoiceThread collaborative activities were delayed until the third week of the course. The use of low-stakes ungraded activities in the orientation to the course allowed for the norms of the VoiceThread application to be laid out. Each student completed his or her VoiceThread profile, viewed tutorials on how to record and share VoiceThread comments, and uploaded a photo for identity. The photo became their avatar and would be visible with every comment they posted in the VoiceThread. Users clicked on each others' avatar to hear specific comments. The course professor presented the orientation to the course, the course syllabus, class schedule, and assignments in a VoiceThread presentation. The first low-stakes and nongraded assignment for the students was to stop the orientation presentation on any slide where they had a question and use a plugged-in microphone or Webcam to post the question as an audio comment. The course

instructor answered the student's question with an audio comment. The ability to rearrange the VoiceThread timeline and link the answer to the student who asked the question created a thread of conversation similar to what students experience in an asynchronous text-based discussion. The second low-stakes and nongraded VoiceThread activity during the orientation to the course instructed the students to return to the professor's self-introduction VoiceThread and make their own self-introduction, basic information about their background, and an interesting fact about themselves. The purpose of the self-introductions was to provide a foundation for students to develop on-line relationships with peers. When this is done early in the course, students have foundational relationships to build on in collaborative learning activities (Brindley et al., 2009). The first graded collaborative activity for the first year students enrolled in the leadership course required that they participate in a communication and relationship-building case study about a nurse asked to lead an established multidisciplinary policy and procedure committee. The instructor introduced the case study and gave specific instructions for participation while the students viewed an image of a meeting room in disarray. A handout of the case study along with guidelines for participation, and a grading rubric was posted and available for downloading from the course document sharing tool. Case study questions asked the students to respond to several questions about the knowledge and skills one would demonstrate for effective leadership of a group. The case study unfolded with descriptions of what the new leader did to prepare for her first meeting with the committee and activities that took place at the first, second, third, and fourth meetings. Students were asked to respond to questions about the new leader's preparedness to lead the meeting, the stages of group process the group worked through, and whether the group progressed sequentially through the stages. Finally, students were asked to reflect on comments made by their classmates. They could highlight a comment from the VoiceThread discussion that closely matched their own thinking and discuss why the comment made sense to them or highlight a comment from the discussion that they respectfully disagreed with and discuss the evidence they would use to persuade the commenter to change his or her point of view. Second year students followed Carla a 29-year-old woman with renal failure from polycystic kidney disease on her complicated journey through the health care system (Baum, 2010). Students were able to point out the multiple factors that contributed to an adverse event that forced this young woman into a long-term care facility. Working as a team of colleagues, students completed a root cause analysis to uncover what went wrong, why it went wrong, and how the system might change to prevent a similar event in the future. The root cause analysis created a shared goal or purpose for interaction among the members of the class.

USING VOICETHREAD TO PROMOTE COLLABORATIVE LEARNING

Table 1. Demographics of Participants in the VoiceThread Survey Participants n = 17

Prior on-line classes completed

Age 25–32 years 33–40 years 41–50 years 51–60 years

old old old old

(18%) (12%) (29%) (41%)

0 (29%) 3–4 (6%) 5–7 (18%) 8+ (47%)

Students were provided a handout of the case study, written guidelines for participation, and a grading rubric. In a VoiceThread presentation, the course instructor discussed the guidelines for participation, the grading rubric, and the learning outcomes for the case study. The course instructor assigned each student to individually analyze a section of the case study, present the analysis in a VoiceThread for peer feedback, and revise one's original analysis if necessary. Students shared the Uniform Resource Locators to their VoiceThreads in a designated discussion forum in the course management system and then used the posted Uniform Resource Locators to review peers' presentations and make voice comments on their analyses. Each student was asked to provide at least two peers constructive feedback that could help improve the case analysis. After receiving peer feedback, students modified their original analysis accordingly. The students set a schedule of due dates for posting original analyses because completion of one's own analysis might depend on what was said in a preceding analysis. Individual tasks and a clear due date coming before the beginning of group efforts ensured that both individual learning and shared goal were assessed. The entire collaborative activity was completed over 3 weeks and counted for 30% of the final course grade. A separate discussion forum was created in the course for posting asynchronous text-based communications. Collaboratively, the students completed several tasks relevant to the CNL work setting: • An overall care process map of the major steps in Carla's story.

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• A list and fishbone diagram of things that went wrong in Carla's care. • One or more rules that might guide the development and evaluation of Carla's ideal health care system. • An overall care process map of Carla's ideal health care system based on the rule(s) created. • A specific aim statement for at least one process in Carla's case that, if improved, could have moved Carla's care closer to the ideal. • Process, outcome, and balancing measures that could be used to know that improvement efforts made a difference. • A plan to test improvement efforts. • A list of challenges leadership might need to overcome in order to implement the improvement efforts and what a CNL might do to help.

Data Collection Mixed-methods design (Graff, 2014) was used to collect quantitative and qualitative data to answer the aforementioned question. The quantitative data and subsequent analysis provided a general understanding of the number of students of who perceived VoiceThread as useful for collaborative communication and knowledge sharing in an asynchronous on-line environment. The qualitative data from the analysis of the responses to the open-ended questions provided a more in depth exploration of the quantitative results. The primary source of data was an on-line questionnaire completed by 17 of the 18 students invited to participate. Permission was obtained from the author (Pacansky-Brock, 2014) to use an on-line questionnaire she had developed to help her understand how use of VoiceThread to make audio comments affected her on-line students. The questionnaire gathered demographic and experiential information about the respondents. Perceptions of using VoiceThread were explored through responses to open-ended questions and ranking of level of agreement or disagreement with closed-end Likert scale statements.

Table 2. Emotion Felt When First Learning of the Requirement for Voice Comments Theme

Frequency

Nervous

(n = 8)

Intimidated

(n = 3)

Neutral Positive feelings

(n = 3) (n = 3)

Sample responses • • • • • • • • • • • • • • •

“I felt very nervous, it was my first online class.” “I felt interested but a little nervous.” “At first quite nervous since this was my first experience with using VoiceThread.” “Uncomfortable at first but after the initial thread it was easy to use.” “Nervous.” “I was nervous at first.” “I was a bit apprehensive.” “It was scary initially but later it became very interesting.” “I was intimidated at first because I lack computer savvy.” “A little bit intimidated.” “Intimidated.” “No feelings.” “It made class more interactive.” “I didn't mind at all.” “I was OK with it. I like the idea of VoiceThreads.”

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Table 3. Listening to Peers Comments Versus Reading Comments Theme

Frequency

Sample responses

Improved learning

n=4

Community

n=3

More like a real classroom

n=2

Improved communication

n=2

Improved nuance/emotion

n=2

• “I did learn from others.” • “Enhanced learning.” • “My learning was enhanced.” • “Very interactive; increased the learning process.” • “I felt that I actually knew my classmates a bit more.” • “I felt more connected to my peers.” • “Class seemed more personal.” • “Made it seem like we were in a classroom.” • “Created more of a classroom atmosphere.” • “Made it easier to understand my peers point of view.” • “More of a discussion rather than posting little essays.” • “Nice to hear expression and inflection, gave more meaning and context to the words.” • “It made it easier to understand my peers' point of view through the tone of their voice.”

Data Analysis Both quantitative and qualitative data were analyzed to examine students' perceptions of using VoiceThread for collaborative learning activities. Data from the on-line questionnaire were collected, and responses and frequency counts were used to produce percentages for demographic data and preferences for using VoiceThread compared to text-based asynchronous discussions. Responses to the open-ended listening and speaking questions were analyzed for the five predominant themes Pacansky-Brock (2014) identified in her study: a perceived sense of community or connection between learners, improved learning as an outcome of the voice comments, more like a real class or similarities to face-to-face conversation, improved communication or ability to convey oneself more effectively than through text communication, and improved nuance/emotion or ability to hear the subtleties in the voice. During data analysis, the qualitative data assisted with describing and validating the quantitative results.

Results and Discussion Seven (41%) of the students were in the second year of the MSN program and 10 (59%) of the students were in their first semester of the program. Fifteen of the students (88%) were bachelor of science in nursing prepared, and two associate degree-prepared students had completed the RN-MSN bridge courses for eligibility to enroll in the MSN courses. Fifty percent of students in their first semester of course work were taking their first on-line course, and 50% had completed one or two on-line courses. The reported age of participants ranged from 25 to 60 years old (see Table 1). Seventy percent (70%) of the students in the second year of the program were in the 41–60 years old age group. Thirteen of the 17 students (76%) reported their race or ethnicity as White/ Caucasian. One student was Hispanic, and three students were African American.

Qualitative Data An analysis of the open-ended responses revealed that “nervous” was the predominant emotion learners felt when first learning of the requirement to leave voice

comments in the discussions (see Table 2). Pacansky-Brock (2014) also reported nervous as a specific word her students used to describe how they felt when required to leave their first voice or video comment. Challenges related to the speaking and listening elements of the class centered around recording the first audio comment. Typical challenges were described as setting up the microphone, volume too high or too low, and learning how to minimize background noise. Students reported that the VoiceThread tutorials were helpful in resolving technology challenges. Nontechnology challenges were classmates who did not speak English as their first language, accents, and following the cadence of different ethnic voice patterns. Once students learned the new technology, their anxiety was resolved, and voice commenting was identified as preferred to text comments. Overall, the comments on using VoiceThread were positive. Tables 3 and 4 present the analysis of the listening and speaking open-ended comments for the five predominant themes Pacansky-Brock (2014) identified in her study. The two predominant themes of improved learning and community aligned with findings from Pacansky-Brock's study. Improved learning (see Table 4) was mentioned nine times and was the predominant theme from the responses to the open-ended question, “How did speaking out loud vs. writing all of your assignments affect your learning in this online class?” Community was mentioned one time, “Speaking out loud made my online experience more interactive with the content and my peers.” In the category of improved communication, one student responded, “I felt VoiceThread prepared us for speaking in front of a group and allowed us to critique our oral presentation skills.” Four students responded that speaking out load versus writing all assignments “made no change” in his or her learning. Improved nuance was mentioned one time in the comment that “Speaking out loud was more personal.” One student did not respond to the question. Likert scale questions included in the survey reinforced the theme of improved learning. For example, 71% of the students strongly agreed or agreed that “Hearing my peers improved my ability to reach the learning objectives in this online class,” 29% responded they were neutral, and none

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Table 4. Speaking Out Loud Versus Writing All Assignments Theme

Frequency

Sample responses

Improved learning

n=9

• “I absorbed more information.” • “Helped me learn the material.” • “Reinforced learning.” • “Improved learning because I could hear myself and others.” • “I prepared more.” • I thought of new things as I spoke and shared things I might have omitted in a text-based discussion.” • “Double learning because I wrote out what I was going to say before I recorded.” • Speaking out load increased my learning, no question.” • “Helped my learning, I wrote down the information before I spoke.”

disagreed with the statement. Similarly, 71% strongly agreed or agreed to the statement, “Hearing my instructor improved my ability to reach the learning objectives,” and 29% responded that he or she were neutral. When asked to indicate his or her level of agreement or disagreement with the statement, “Hearing my peers and instructor increased my ability to understand complex ideas in different ways,” 77% of students strongly agreed or agreed, and 23% were neutral. In response to the statement, “When I listen to comments, I remember more of the information compared to when I read text comments,” 82% strongly agreed or agreed, 12% were neutral, and 6% disagreed with the statement. Community or improved connection between learners was a dominant theme in the Likert scale responses. For example, when asked to indicate his or her level of agreement of disagreement to the statement, “The VoiceThread activities contributed to making me feel like I was part of a group,” 88% of students strongly agreed or agreed, and 12% were neutral. In addition, community was indicated by the level of agreement or disagreement to the statement, “The VoiceThread activities helped me feel more connected to my classmates.” For this statement 88% of students strongly agreed or agreed, 6% were neutral, and 6% disagreed. When asked to indicate his or her level of agreement or disagreement to the statement, “VoiceThread activities contributed to making me feel more connected to my instructor,” 76% strongly agreed or agreed, 18% were neutral, and 6% disagreed. In Pacansky-Brock's (2014) study, the theme of improved learning was supported by the finding that it was mentioned seven times in the responses to the open-ended statement on listening to peers' comments versus reading all of them on the screen. This finding was further validated by 88% of students responding that he or she strongly agreed or agreed to the statement that, “Being required to present my ideas verbally helped me understand the information I was learning more effectively than through writing alone.” When asked if VoiceThread contributed to making him or her feel part of a group, 94% of students in Pacansky-Brock's study strongly agreed or agreed, which supports the theme of community. The same number of students (94%) strongly agreed or agreed to the statement “VoiceThread helped me feel more connected to my instructor.”

In the current analysis of students' perceptions of using VoiceThread, the level of agreement or disagreement to specific statements revealed that being able to hear and see their peers and instructor in the asynchronous VoiceThread communications contributed more to on-line learning than improved learning. For example: • Ninety-four percent strongly agreed or agreed: They noticed an increase in their confidence with using technology in general. • Ninety-four percent strongly agreed or agreed: This class increased his or her confidence when using on-line voice/video communications. • Ninety-four percent strongly agreed or agreed: The ability to be able to communicate effectively with on-line voice/video communications is an important 21st century skill. When students were asked to indicate his or her level of agreement or disagreement to the statement, “In the future, I would prefer to take online classes that use only written discussion boards,” 59% strongly disagree, 12% strongly agreed, and 29% were neutral. As in previous studies (Ching & Hsu, 2013; Pacansky-Brock, 2013), more students prefer using VoiceThread to text-based discussions. A possible explanation for the 12% preference for written discussion boards is it takes less time to read a text-based response. In response to the open-ended question, “Is there anything else you would like to share about your experiences learning out loud?” students commented the following: • “Learning out loud is an asset to any online learning experience.” • “I really like the experience and recommend it for future classes.” • “I think it is important to utilize technology to enrich and advance the online learning atmosphere. This program helps us achieve that goal.” • “Great learning tool.” • “It is now my preferred method of learning.” An interesting finding was that students did not contribute to the VoiceThread discussions beyond the required participation. A similar finding was reported by Ching and Hsu (2013). However, it should be noted that

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the students in the current study are all working full-time with family and work responsibilities that may be a factor in time to contribute to discussions beyond the course requirement.

Conclusions Overall, graduate nursing students reported very positive experiences using VoiceThread to collaborate and share knowledge. The humanizing elements of VoiceThread enabled instructor and learners to communicate emotion, personality, and other nonverbal cues conducive to better understanding and interpretation of meaning when collaborating in an asynchronous on-line environment. Students reported feeling more connected to their peers and the instructor. Hearing audio comments from their peers and instructor were preferred to reading all comments and perceived as improving the ability to reach the learning objectives. Aspects of the sociocultural and distributive cognition perspective of Ching and Hsu's (2011) framework for collaborative learning using VoiceThread were evident in the students' responses to the survey indicating perceived sense of community or improved connection between learners. Through language, the tool people use directly for social interactions, the knowledge constrained in each collaborator's mind was represented externally for the use of involved individuals. Situated cognition was evident in perceptions of VoiceThread as useful for meaningful interaction and collaboration in an asynchronous on-line environment. When individuals construct knowledge together, they create learning experiences for each other (Ching & Hsu, 2011). In addition, VoiceThread recorded the process and product of the collaborative communication. The instructor was able to assess how well the process and product of the collaborative communication addressed the shared goal or purpose for the interaction.

Implications for Nursing Education Among the essential CNL competencies is collaboration among nurse colleagues and other disciplines in the design, coordination, and evaluation of patient-centered care (American Association Colleges of Nursing, 2013). Nurse educators are in a position to facilitate and encourage the development and appreciation of collaborative skills in the asynchronous on-line learning environment. This article shared perceptions reported by 17 CNL who used VoiceThread for collaborative communication and knowledge sharing in an asynchronous on-line environment. A shared goal was necessary to establish a purpose for interaction among the learners. VoiceThread, a cloud based collaborative tool, recorded the interactions among collaborators and tracked revision history and the products of collaboration. As suggested by Ching and Hsu (2011), these tangible records of distributed cognition provide data for assessing participation, communication, and collaboration in knowledge construction and achieving the shared goal. It is important to design the collaborative learning activity in a manner that allows learners to represent their

knowledge individually, discuss and negotiate their understanding within a small group, and finally construct knowledge collaboratively to demonstrate a group understanding of the desired learning outcome (Ching & Hsu, 2011). A grading policy that allows assessment at the individual and group level helps in avoiding potential conflicts that may arise when students are graded solely on the basis of group work. In all cases, the assignment must be clearly described with specific and meaningful guidelines and a grading rubric.

Limitations and Future Research The findings reported in this article should be interpreted with caution because of the limited number of participants. Future research is needed with a larger sample and a valid and reliable data collection tool. Further data collection and analysis are required to provide more conclusive evidence of the impact of using VoiceThread for asynchronous on-line collaboration. Future research is needed to focus on determining the circumstances under which using VoiceThread for asynchronous on-line collaboration is most effective. The extent to which collaboration is appropriate may depend on a host of variables including the shared goal, desired learning outcome, communication skills, and knowledge level of participants.

References American Association of Colleges of Nursing (2013). Competencies and curricular expectations for clinical nurse leader education and practice. Retrieved from http://www.aacn. nche.edu/publications/white-papers/cnl. Baum, K. (2010). Advanced case study: A 30-year-old in the nursing home. Cambridge, MA: Institute for Healthcare Improvement. Retrieved from http://www.ihi.org/education/ihiopenschool/ resources/Pages/Activities/AdvancedCaseStudy2010.a. Brindley, J. E., Walti, C. & Blaschke, L. M. (2009). Creating effective collaborative learning groups in an online environment. International Review of Research in Open and Distance Learning, 10, 1–18. Ching, Y. -H. & Hsu, Y. C. (2011). Design-grounded assessment: A framework and a case study of web 2.0 practices in higher education. Australasian Journal of Educational Technology, 27, 781–787. Ching, Y. -H. & Hsu, Y. C. (2013). Collaborative learning using VoiceThread in an online graduate course. =5, 5, 298–314. Graff, J. C. (2014). Mixed methods research. In H. R. Hall & L. A Roussel (Eds.). Evidence-based practice: an integrative approach to research, administration, and practice. (pp. 45–64). Burlington, MA: Jones & Bartlett Learning. Pacansky-Brock, M. (2013). How to humanize your online class with VoiceThread, 22–47. Retrieved from http://www. smashwords.com/extreader/read/333499/1/how-to-humanizeyour-online-class-with-voicethread. Pacansky-Brock, M. (2014). Learning out loud: Increasing voluntary voice comments in online classes. In P. R. Lowenthal, C. York, & J. C. Richardson (Eds.). Online learning common misconceptions, benefits and challenges. (pp. 99–114). New York: Nova Publishers. van Tyron, P. J. & Bishop, M. J. (2009). Theoretical foundations for enhancing social connectedness in online learning environments. Distant Education, 30, 291–315, http:// dx.doi.org/10.1080/01587910903236312.

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