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Publication: Nursing Education Perspectives
Date published:
Language: English
PMID: 43404
ISSN: 15365026
Journal code: NHCP

FOR REGISTERED NURSES WHO ASPIRE TO HOLD BACCALAUREATE DEGREES, ONLINE EDUCATION CAN BE AN EFFECTIVE MEANS TO MEET THEIR EDUCATIONAL NEEDS. Today's working RNs require the flexibility provided by online learning environments. However, retention rates for online programs are low when compared to the traditional classroom setting (Simpson, 2004).

With attrition a major obstacle in many online programs, a wellorganized, face-to-face orientation program may help improve student retention rates and success in online nursing programs. Research has shown that the combination of an effective orientation program and sufficient technological support increases student retention in online programs (Yorke, 2004). In addition to effective orientation, quality online education programs require well-designed curricula and student support services. However, there are few empirical studies linking comprehensive face-to-face orientation programs and retention in online nursing programs.

This article describes the implementation and evaluation of an eighthour, comprehensive, face-to-face orientation program designed for a newly developed RN to BSN program in the southeastern United States. After the university converted a 30-year-old, traditional, face-to-face weekend program to an online format in fall 2007, the attrition rate was 20 percent for the first class admitted to the program. The rate fell to 2 percent for the second class admitted to the program and decreased to less than 1 percent for the third class admitted in fall 2009. The article summarizes how the program was implemented and pre-sents the results of the orientation evaluation for the first three groups. For the purposes of this article, student attrition and retention refers to students remaining enrolled in the program during the first semester.

Background Since retention is an important outcome of any academic program of study, identifying and targeting at-risk learners early in their program of study, and offering additional support, may contribute to improved retention. Distance learners require additional support that may not be required of students in face-to-face classrooms.

The literature is replete with advice on how to improve retention rates in online courses. For example, Miller (2008) offers a list of critical guidelines for instruction in online courses. The list includes having students practice using technologies before critical assignments are due; allowing time for social communication within the technological environment; and offering a required activity, with a low point value, early in the course to ensure participation.

The value of offering orientation courses for mature students entering into new programs is addressed by Collett, Kanuka, Blanchette, and Goodale (1999) and Kanuka (2001). A number of researchers have examined the effects of orientation in distance learning on student retention. Remote orientations, face-to-face orientations, and combined face-to-face with remote orientations (Kanuka & Jugdev, 2006; Lotkowski, Robbins, & Noeth, 2004; Scagnoli, 2001; Tallman & Fitzgerald, 2005) and defining technology needs of students (Tallman & Fitzgerald) may improve retention of novice distance education students. Researchers have emphasized a sense of belonging to the academic community as a retention factor (Billings, Connors, & Skiba, 2001; Greene & Puetzer, 2002; Greer, Hudson, & Paugh, 1998; Prendergrast, 2003; Read, Archer, & Leatherwood, 2003; Yorke, 2004).

Billings et al. (2001) reported that student isolation is negatively correlated with satisfaction. Greer et al. (1998) surveyed 48 adult online learners and found that student mentoring and encouragement were the most appreciated and effective aspects of instructional support.

Consideration of the learning needs, technology skills, work schedules, and students' distance from the main campus were critical factors in developing the orientation program for newly admitted RN-BSN students. The program provided an online library orientation, with the assistance of campus librarians, and an orientation to WebCT, to allow students to navigate the courses in which they were enrolled for the semester. In addition, students had the opportunity to meet and socialize with their instructors and the learning community and to complete, with faculty support, an online practice course.

Method Institutional Review Board approval for the study was obtained for the data collection. During the fall 2007, a total of 102 RNs attended a four-hour face-to-face orientation session in a university computer classroom. The mean age of the students was 30 years; their mean prerequisite GPA was 3.4; nearly all were female (95 percent); and all worked in a clinical setting. The orientation session consisted of an overview of the program and WebCT, a review of student support services and the registration process, university and program policies, technology learning services, and faculty introductions. The students were provided sessions with the university librarian and the learning enhancement representatives to review the online library and functions of the web learning environment. Evaluation results of the first orientation indicated that only 77.6 percent of the students were thoroughly satisfied with the orientation program.

The second face-to-face orientation, implemented in the spring semester of 2008, was extended to eight hours. The 47 students had a mean age of 32 years and an average prerequisite GPA of 3.2; 92 percent were female and all were employed in a clinical setting. Prior to this orientation session, all students completed the Computer Technology Proficiency Assessment (CTPA), which assessed the student's computer skills in four areas: basic computer, communication (Internet/email), word processing, and presentation.

The revised orientation session included the following components:

* Program overview, welcome, and introduction

* Review of each online course

* Review of student support services

* University and program policies

* Registration and advisement processes

* Computer technology services and technological applications used in the program

* Orientation to the online library and search engines (one hour)

* Orientation to the WebCT/Blackboard course and course navigation (two hours)

* Review of practice course

* Orientation to practice course (two hours)

* Social interaction in the virtual environment

* One-on-one assistance with course tools, navigation and downloads

* Question and answer session (one hour)

Students showed varying levels of technical competence as demonstrated during the initial orientation. The eight-hour orientation session with the additions of the CTPA, the practice course, the extended library online tour, and faculty support with navigating through the online nursing courses revealed increased satisfaction (94.6 percent). For this semester, student attrition was 2 percent.

The third face-to-face orientation session used the same format as the second orientation. The 30 participants had a mean age of 29 years and a prerequisite GPA of 3.4; 98 percent were female and all were employed in a clinical setting. The orientation format was a replica of the second orientation session. The results from the evaluation showed that 98.2 percent of the participants were thoroughly satisfied with the program orientation and felt confident in their ability in the online learning environment. The attrition rate for this semester was less than 1 percent; all newly enrolled students remained in the program at the first semester benchmark.

Results A total of 179 newly enrolled RN to BSN students completed the evaluation survey over a three-year period. The first orientation session had 102 participants, the second, 47 participants, and the third, 30 participants. Findings from the first orientation session revealed a lack of student satisfaction with the face-to-face orientation. After the orientation was revised to include course navigation and support services, student satisfaction increased from 77.6 percent to 98.2 percent. The student satisfaction rate increased significantly during the revised orientation sessions.

Limitations The data collected are relatively limited in scope. Extraneous variables that may have affected the attrition rates and student satisfaction were not included in this study. However, the results indicate the importance of an extensive, face-to-face orientation, with active student participation and institutional support services, during the transition into a fully online program.It is important to note that students were able to socialize and form a learning community during the face-to-face orientation, prior to engaging in online group work.

Discussion In nursing education, student retention and success in online programs is vital for program and institutional viability. Methods to improve retention and assist the student transition into the virtual learning environment are essential for student success and program growth and improvement. This face-to-face orientation program, designed by faculty, was quite effective in reducing the first six-weeks' attrition rate from 20 percent to less than 1 percent.

The face-to-face orientation session allowed the students to become highly interactive and obtain support from one another and from faculty. As a result of evaluation data from year one, faculty aggressively developed an extensive program that included key components such as technological assessment, a practice course, online library tours, and hands-on student engagement within online courses prior to leaving the orientation session. The online program has been an overall success, with enrollment increasing from 55 students to 102 during the first year of the implementation. The attrition rate currently remains less than 1 percent. It is clear that a well-organized and interactive orientation program for online students can help improve retention and enhance transition into the virtual learning environment.


Billings, D. M., Connors, H. R., & Skiba, D. J. (2001). Benchmarking best practices in web-based nursing courses. Advances in Nursing Science, 23(3), 41-52.

Collett, D., Kanuka, H., Blanchette, J., & Goodale, C. (1999). Learning technologies in distance education. Edmonton, Alberta, Canada: University of Alberta Press.

Greene, M. T., & Puetzer, M. (2002). The value of mentoring: A strategic approach to retention and recruitment. Journal of Nursing Care Quarterly, 17(1), 67-74.

Greer, I., Hudson, L., & Paugh, L. (1998, October). Student support services and success factors for adult online learners. A conference paper presented at the International Society for the Exploration of Teaching Alternatives, in Orlando, FL.

Kanuka, H. (2001). University student perceptions of the use of the web in distance-delivered programmes. Canadian Journal of Higher Education, 31(3), 49-72.

Kanuka, H., & Jugdev, K. (2006). Distance education MBA students: An investigation into the use of an orientation course to address academic and social integration issues. Open Learning, 21(2), 153-166.

Lotkowski, V. A., Robbins, S. B., & Noeth, R. J. (2004). The role of academic and non-academic factors on improving college retention. ACT Policy Report. Retrieved February 4, 2009, from

Miller, S. K. (2008) Online, distance learning instructor guidelines to improve student retention. Maricopa Learning Exchange, Phoenix, AZ. Retrieved February 6, 2009, from slip.php?item=1372

Prendergrast, G. A. (2003). Keeping online student dropout numbers low. Retrieved February 6, 2009, from GerardPrendergrast2003.pdf

Read, B., Archer, C., & Leatherwood, C. (2003). Challenging cultures? Student conceptions of "belonging" and "isolation" at a post-1992 university. Studies in Higher Education, 28(3), 261-277.

Scagnoli, N. I. (2001). Student orientations for online programs. Journal of Research on Technology in Education, 34(1), 19-27.

Simpson, O. (2004). The impact on retention of interventions to support distance learning students. Open Learning, 19(1), 80-95.

Tallman, J., & Fitzgerald, M. A. (2005). Blending online and classroom learning environments. Knowledge Quest, 34(1), 25-28.

Yorke, M. (2004). Retention, persistence and success in on-campus higher education, and their enhancement in open and distance learning. Open Learning, 19(1), 20-28.

Author affiliation:

About the Authors Melanie Gilmore, PhD, RN, is an assistant professor at the University of Southern Mississippi, Hattiesburg. Evadna M. Lyons, PhD, RN, was at the University of Southern Mississippi when this article was written and is currently an instructor at East Central Community College, Decatur, Mississippi. For additional information, contact Dr. Gilmore at

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