Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more


Building an online learning community to support nurse education

  • Comment

This article explores developing an online learning community that student nurses can use to support their education


Lee, P. (2009) Building an online learning community to support nurse education. Nursing Times; 105: 11.

This article explores the topic of developing an online community for student nurses to use in learning. It examines the different definitions and types of e-learning and outlines the online community’s role in healthcare education, together with some of its pitfalls. A comparison is then made to the process of bidding on eBay, to determine possible similarities.

Keywords: Online community, E-learning, Education

This article has been double-blind peer reviewed



Polly Lee, MSc, BA, DipN, ILTM, RSCN, RM, RGN, is lecturer in child health, School of Community and Health Sciences, City University, London.


Practice points

  • As students tend to post on online discussion boards towards a deadline – and this is also when bidding takes place for the most popular items on eBay – consideration should be given to deadline times
  • Although eBay bidders tend to have more time at weekends, not all healthcare students necessarily have internet access at home and therefore may not be able to contribute to the ‘last-minuteness’ of postings in the case of weekend deadlines
  • Some students may initially be more reticent to contribute to discussion boards as they do not know who is reading the postings. While they are often happy for other quiet students to sit in class knowing they are listening but not contributing verbally, in online discussions students do not know who may be reading the postings and ‘lurking’
  • As increasing numbers of healthcare students are digital natives rather than digital immigrants (Prensky, 2001), it is important for educators to be aware of how natives undertake everyday activities such as eBay bidding. This in turn may affect the way they approach learning (Honey and Mumford, 2006) and particularly learning online


As healthcare education at both pre-registration and post-registration levels incorporates more e-learning, it is necessary to ensure that relevant government strategies are incorporated in such developments (Higher Education Funding Council for England, 2005; Department for Education and Skills, 2003).

Definitions of e-learning

There are several different definitions of e-learning. Clarke (2008) suggested: ‘The term e-learning covers a wide range of techniques and methods. It includes the use of technology as part of a conventional or traditional course as well as an online course where learners and tutors will never meet face-to-face.’

This, perhaps, is one of the more straightforward ones. Glen and Cox (2006) outlined the debate regarding definitions of e-learning, and Santy and Smith (2007) outlined what e-learning includes.

Various educational organisations and government bodies have given their own definitions of e-learning and some of these are included in Box 1.


Box 1. Definitions of e-learning
The Department for Education and Skills (2003) defined e-learning as ‘the blending of traditional and ICT-based information and communication technology forms of teaching and learning’
It can be defined as ‘learning facilitated and supported through the use of information and communications technology’ (JISC, 2009). It can cover a spectrum of activities from the use of technology to support learning as part of a ‘blended’ approach (a combination of traditional and e-learning approaches), to learning that is delivered entirely online. Whatever the technology, however, learning is the vital element (JISC, 2009)
The Higher Education Funding Council for England (2005) said it had debated whether adopting a specific definition was necessary, since this might curb exploration and restrict diversity. It decided to limit the scope of its strategy, to be sufficiently focused, to the use of technologies in learning opportunities
The HEFCE (2005) added: ‘The government e-learning strategy defines e-learning as any learning that uses ICT. In embedding this strategy, we want to ensure there is confident use of the full range of pedagogic opportunities provided by ICT. For higher education, this will encompass flexible learning as well as distance learning, and the use of ICT as a communications and delivery tool between individuals and groups, to support students and improve the management of learning
The Higher Education Funding Council for Wales (2007) defined e-learning as the enhancement of learning through the use of technology


Furthermore, within healthcare some trusts and strategic health authorities are now devising their own definitions of e-learning or e-learning strategies. Some examples include:

  • Benstead’s (2003) Wirral Hospital NHS Trust now Wirral University Teaching Hospital NHS FoundationTrust e-learning strategy;
  • Manchester Mental Health and Social Care Trust’s (2003) strategy;
  • Whitehead’s (2007) e-learning strategy in NHS South West.

Readers may wish to investigate whether their trust/SHA/health board has their own definition of, or strategy for e-learning. Some healthcare organisations outside the NHS are developing their own strategies.

As can be seen, the various definitions of e-learning have different approaches and emphasis. For some people, there may be confusion in that there is no single accepted definition of e-learning. However, all the definitions include the use of technology and enhancing learning.

The teaching delivered has different formats and may be an addition to (‘bolt-on’) or total replacement of traditional face-to-face or classroom teaching, or somewhere in between these two ends of the spectrum.


Delivering e-learning

It is important to be aware of the most common teaching methods to understand how students communicate with each other and form learning groups.

Traditionally, teaching takes place entirely face to face in the classroom/lecture theatre setting. In health care, face-to-face teaching has also been used in various placement settings. In recent years, face-to-face teaching has involved PowerPoint presentations.

Recently e-learning has been introduced to many courses and programmes.

In some places, traditional face-to-face teaching remains the main form of learning, with a little technology introduced to enhance students’ learning. This is often known as ‘blended learning’.

Blended learning may include no more than ensuring the PowerPoint presentations are available for students over a secure (password-controlled) website (‘bolt-on’).

Other courses have introduced more technology, which may mean that students do not have to attend campus for all the lecture hours. This is still a form of blended learning – it is simply that the proportions of face-to-face and e-learning are different from that described above.

As well as PowerPoint presentations, other activities may be arranged. Students can undertake some individually while others may involve some form of group learning. In addition, various media may be used (Sclater, 2008).

Other courses have moved entirely to e-learning. Some courses moved to distance learning many years ago and the Open University is the most obvious example of such a provider. These courses would have initially providedentirely paper-based learning materials (with some courses having media support) but, in all cases, students had the opportunity to correspond with or telephone their tutor. Some of these courses have simply been converted to e-learning, in that the learning materials are now available over a secure website.


Getting to know each other

In face-to-face courses, students still get to know each other through the traditional means of sitting next to each other in class, often undertaking ice-breakers (getting to know each other exercises), and talking in group work and in the coffee queue.

With the advent of technology, students in these groups often swap mobile phone numbers to speak to or text each other.

In blended learning, when there is only a small amount of e-learning involved, the same methods of learners getting to know each other can apply as with face-to-face learning. As the proportion of e-learning increases in blended learning, then online activities may be introduced and some of these are likely to include group work.

As member of the group/cohort already know each other from face-to-face work, it may not be difficult to transfer the group work to being online. Students could be required to participate in a secure discussion board or even blog (keep or contribute to a web log) or something similar as part of their learning experience.

Such discussion postings may even form part of the assessment process. Here, students must know each other and have some trust in their colleagues to be able to participate in such activities.

When learning has moved to being entirely online, students must get to know each other to build trust to enable the equivalent of group work to take place. However, this does not have the benefit that face-to-face learning has in that students have already met.

With former paper-based distance learning materials, students did not need to make much contact, if any, with other learners. However, in recent years, the introduction of e-mail means that many student groups may have formed ‘support networks’, even if they live on different continents.

This discussion illustrates that one challenge of e-learning is for students to get to know each other to feel part of a group; this is the same situation for a face-to-face group.


Types of online community

There are several different types of online community, and there are several commonly used technologies for these groups.

Perhaps the best known of these is the traditional e-mail system. This system is asynchronous, as people access and respond to e-mails at different times of the day. An adaptation of the e-mail system is where there is one central address and everyone sends e-mails for the group to this address, and then the e-mail is sent out to all the list subscribers. Boettcher (1999) described the advantages and disadvantages of these systems.

However, some people prefer to discuss issues in real time, that is, synchronously. Online communities can form in chat rooms; these can be generic, that is, for anyone to join, or they could be specialist. An advantage of this technology is that many people can simultaneously join in a discussion and it can be logged and saved for future reference.

Other types of online community can be formed, and some of these may be more relevant to higher education or healthcare settings. Within these two groups, it is possible to form a private community, whereby list-holders are able to grant access to a pre-determined group of people.

In education, each institution has its own virtual learning environment (VLE), which is an online area that can only be accessed by students and staff from that particular institution. This is most often used as a repository for lecture notes, in PowerPoint or a similar format. Within these VLEs, it is normally possible for students to have an asynchronous discussion using a specially constructed discussion board.


Building an online community

It is essential to ensure that all students have technical access to and are properly trained in using relevant technology, and this training will depend on the type of environment that has been chosen for communicating (Salmon, 2003; Benfield, 2002).

As previously stated, various ice-breakers can be used for new cohorts in the classroom setting. Indeed, within e-learning, similar consideration needs to be given to building an online community. It is usual therefore to have some form of non-threatening exercise for participants to undertake. This may involve merely saying which fruits participants do and do not like and why.

Some ice-breakers are more demanding and ask participants what they hope to gain from the course/module or even the discussion group, but some people may feel overwhelmed by this. It is usual for teachers to start off such a discussion to encourage students to participate, although in such situations the teacher’s role often changes to that of facilitator.

Santy and Smith (2007) described this as the induction stage, before participants can really move onto the incubation stage, which is when group members really begin to interact with each other and the group’s work starts.

Depending on the type of e-learning being considered, some groups may achieve the induction and incubation stage more quickly, especially if they already have an identity as a face-to-face group and are already familiar with the technology to be used.


Uses of online communities

Salmon (2003), Benfield (2002) and Boettcher (1999) have outlined the importance of online communities in education generally. However, more specifically in healthcare education, Simpson et al (2008), Santy and Smith (2007) and Moule (2006) have discussed how online communities might be used.

Santy and Smith (2007) discussed how groups of healthcare professionals can be formed. This may be for specialist groups who are dispersed throughout the UK or even beyond, or for groups of practitioners who are more local, for example, those in the same health district with an interest in a similar client group such as discharging older people from hospital. This last group may comprise physiotherapists, occupational therapists, ward nursing staff, district nurses and social workers, who are all working to the same goal. Such groups may be fluid in their membership.

For details on the advantages and disadvantages of using online communities, see Box 2.


Box 2. Issues in using online communities
Some students feel that the online environment is ‘cold’ as they cannot see what is happening, so personalising replies helps (Benfield, 2002)
Some students are comfortable posting onto discussion boards whereas others (for a variety of reasons) may be more reluctant. Some may read the discussion postings and are known as lurkers, but these students are still learning
In nursing in particular, many practitioners are reluctant to commit to a digital format (even writing for publication), for fear that someone may then challenge their thinking, although in reality this rarely happens
However, it is recognised that, despite various attempts, some online communities either take a long time to become established or just do not seem to work (Moule, 2006)
Although some students may engage with the ice-breakers, they are more reluctant to offer ‘postings’ for various online discussions, and some seem to post furiously towards the end of a module or other deadline


Possible comparisons to bidding online

Reflecting on how different students posted to a discussion board on ‘building online communities’ gave rise to some interesting comparisons – and some comparisons that can be made with eBay and other online auction sites.

Within discussion boards, there tend to be more postings and therefore more replies as the deadline approaches. Indeed, in some instances it is still technically possible to post to the discussion board after a deadline, although some are locked to postings but not viewings at the end of a course/module.

This is where the first similarity can be made to eBay bidding. Items that are highly desirable are normally auctioned so that the auction ends at the weekend (when most bidders have most time) and these items have the highest number of last-minute bids. However, this does not apply to items that are not so desirable.

Consideration should be given to the globalisation of education (Mason, 1998) and therefore to the times that discussions on boards actually end. This will of course depend on the country/countries in which the majority of students live and may of course be in a different country from the one which the course is being delivered. Similarly, as eBay sellers can choose the end time of their auction item, they consider the country where it is most likely to be sold, and therefore choose an appropriate end time. This is particularly important for both the UK and US, when bidding time might end at a time that is convenient for both countries.

Depending on the actual VLE being used, students can normally only see the postings that have been posted to the discussion board. Instructors (when working in instructor mode), on the other hand, can check people who have visited the VLE, and how often each student has viewed various postings, thus determining which students are ‘lurking’.

Instructors can still contribute to discussions (Salmon, 2003) but normally switch to student mode for that purpose. However, on eBay both seller and potential bidders can view (if included by the seller) the number of viewings a particular item has received.

Some people bidding on eBay occasionally put in a low bid part way through a posting – as a deliberate move – almost to deter other people. The bidder may be interested in the item, but knows they stand no chance of winning the bid. Equally, some students may just post a message to the discussion board so they are ‘seen’, are therefore registered as having contributed to a discussion, but it may not have received full consideration. So it would be interesting to determine if there are characteristics of people who put in earlier postings in online communities and whether those behaviours are similar to those who bid on eBay.


While the possible links between building online communities and bidding on eBay may be rather tenuous, it is nevertheless worth bearing in mind that similarities may emerge more strongly over time, particularly with the development of social software sites.

Therefore, those involved in education and online communities should be aware of the developments in using social software sites so that comparisons to education can be made, and relevant modifications made where necessary.


  • Comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.