Towards Modules in Open Distance Learning for Nurses

Ulrich Bernath und Wolfgang Fichten

in: EADTU-News, Newsletter of the European Association of Distance Teaching Universities, Issue 14, August 1993, S. 38 - 39

In 1985 the Department of Distance Studies and the Department of Psychology in the Health Service at the Carl von Ossietzky University of Oldenburg started developing and implementing a further education programme for nurses.

Meanwhile, there are first results of the evaluation of a distance teaching programme. Our aim is to introduce the modules on Psychological Health Promotion for Nurses into the the reorientation of the nursing curricula and to give an example of further education by open distance learning at universities.

In the 1980s the situation of nurses in Germany came under discussion because of the dramatic change in the professional image. As a consequence, the traditional system of basic and continuing nursing education was being criticised. A reorientation of the professional image is connected with a turn towards social and health-promoting relations in the hospital and with the changing role of nursing personnel in the hospital system 1).

With its Six-year Nursing Programme (1990-1995), "The Nursing in Action Project", the WHO made it clear that the change in the professional image is a European matter and that it must be met with new concepts of basic and continuing education 2). In Germany pressure groups, political parties and ministries are busy with the development of new concepts. The memorandum "Pflege braucht Eliten" ("Nursing needs elites")3) of the Robert-Bosch-Foundation resumes the efforts made to implement higher and further education at universities and polytechnics in Germany. The Deutsche Wissenschaftsrat urges universities to participate in job-oriented further education by open distance learning in co-operative models of universities 4).

Along these trends the working group "Psychological Health Promotion for Nurses" at the University of Oldenburg has been committed to further nursing education since 1985. A self-study certificate course comprising about 120 hours has been developed, consisting of six modules on the topics "Reflecting the role as a helper", "Illness in its social context", "Relation between body and soul", "Health Promotion by Counsellings", "Supervision within the group of colleagues", "Influencing patient behaviour". By steadily developing the course and by taking into account the results of evaluation accompanying it 5), the modell of an open distance learning programme has been implemented and evaluated for the first time.

In a distance learning course designed as further education, improvement of professional competence means an integration of theory and practice. Health workers, whom we can regard as nursing specialists, assess the knowledge transmitted in the course in the light of their professional experience; they relate it to their own professional practice and partly use and adapt it. A special characteristic of the course is that such a transfer is not only encouraged but also counselled. Participants are given advice during the transfer partly by comments on their solutions to given assignments. Thus in this course concept the mentor fulfils not only the function of a counsellor in the learning process but also that of a "facilitator of competence".

Evaluation results show that the participants of the course want a more far-reaching professionalization - an understandable claim related to rapid changes in a largely specialised and diversified profession. In this context, nursing personnel attach great importance to further education at universities.

The course contributes to professionalization by aiming at the development of a psychologically oriented health-promoting knowledge that can be applied to many different professional situations. All in all the course furthers professional competence, manifest in the ability to critically analyse professional situations and to look at them from different angles.

In order to fulfil these aims and claims (a) the course texts and (b) the assignments must be designed accordingly.

- The theoretically founded approaches and concepts discussed and taught in the course are to be grounded in the professional practice of nurses. This is achieved by presenting examples of application and giving advice for putting them into practice.

- Assignments do not pre-eminently aim at reproducing transmitted knowledge but focus on transferring the subject matter to the specific circumstances of the professional context in question. Thus e.g. participants were asked to observe a patient over a certain period of time and to make a case study of the data by applying certain given criteria. Among others they were asked to analyse the structure of relations between the staff of their ward and to give an account of their own ways of coping with professional stress. The authors' comments on the solutions were passed on to the participants. These comments present the chance to influence the professional competence of the participants and to counsel the transfer processes.

As the solutions of the assignments cannot be standardized in a course concept like ours the people asessing them must thoroughly consider each single case. Thus, however, the learning process reaches an especially high quality standard, because the extremely individual and diversified learning processes of the participants are taken into account.

One of the instruments ensuring the quality of the course is the learning diary. The participants are asked to enter their learning activities into a diary, thus intensifying the acquisition and discussion of the contents of the texts. The assessments and comments on the text contents that the participants have to give are part of the reflection process by which they actively and independently integrate theory and practice.

These reflective and dialogical moments are included into the further development of the modules. The learning diary, which gives the authors a feedback about their texts, forms an important component of the course-inherent revision process. Thus the course material is being continually modified in an addressee-oriented dialogue with the participants in the sense of a learner proof curriculum.

The data of the evaluation show the following general effects of the course:

(a) Nurses develop a better understanding of their patients which results in a more positive social interaction style. The conveyed perspective of partner-oriented interaction has a positive influence on the patients' coming to terms with their illness and the stimulation of a self-healing process.

(b) The nurses' conception of their professional role is modified. This leads to the possibilities of self-control and self-regulation.

The testing of open distance learning concepts by the University of Oldenburg will open up a new far-reaching prospect for further curriculum development and further education for nurses. The results of the trial-run document the level of development that has already been reached.

Since the study year 1992/93 the course material has already been adopted by six universities in Germany 6). This is an expression of the great demand for university founded further education. It also shows that German universities are willing to participate in further education programmes for nurses. Finally the adoption of study units tried out at the University of Oldenburg will also contribute to a teacher proof curriculum.


  1. U. Bernath, W. Lauth, Psychologische Gesundheitsförderung als Aufgabe der Weiterbildung von Krankenhauspflegepersonal; in: Gesundheitsförderung. Eine Investition für die Zukunft. Internationale Konferenz, Bonn, 17.-19. Dezember 1990. Erziehung, Ausbildung und Forschung. Ergänzungsband Nr. 2 zum Konferenzbericht, p. 74ff. (zurück zum Text)
  2. The Nursing in Action Project, World Health Organization, Regional office for Europe, Copenhagen 1991, Health for All Series, No. 3. Reviewing and reorienting the basic nursing curriculum, ibid. No. 4., Preparing nurses teachers and managers, ibid. No. 6. (zurück zum Text)
  3. Robert-Bosch-Stiftung, Pflege braucht Eliten. Denkschrift zur Hochschulausbildung für Lehr- und Leitungskräfte in der Pflege, Gerlingen 1992. (Sonderdruck aus: Beiträge zur Gesundheitsökonomie 28) (zurück zum Text)
  4. Wissenschaftsrat, Empfehlungen zum Fernstudium, Drs. 929/92, Hannover, den 13.11.1992, p. 81, 84, 91, 92, 96. (zurück zum Text)
  5. Ulrich Bernath, Wolfgang Fichten, Ulrich Rohlfing, Psychologische Gesundheitsförderung als Weiterbildungsmodell für das Krankenhauspflegepersonal, Oldenburg, 1989, 111 p. (zurück zum Text)
  6. Kontaktstudium im Medienverbund "Psychologische Gesundheitsförderung" für Krankenpflegepersonal in einem Netzwerk der Universitäten Frankfurt, Hamburg, Hildesheim, Kaiserslautern, Karlsruhe, Koblenz-Landau und Oldenburg. (zurück zum Text)

Zurück zum Literaturverzeichnis des Fernstudienzentrums