Unravelling the Complexities of Pre-Licensure Nursing Education in an Open and Online University
Kristin Petrovic
Abstract
Nursing education faces a complex challenge: balancing the demands of higher education systems, professional regulatory bodies, and an ever-changing healthcare landscape. Educators must prepare nurses for safe, competent practice while adhering to external mandates. This complexity intensifies as institutions adopt innovative teaching methods, such as open and online education, which may not be fully understood by interacting systems. This research examines how nursing education is situated within the context of the broader healthcare system, profession, higher education system, and specific program elements. In this case study, I discuss my approach to open education research. Specifically, I examine my research concerning how open pedagogical practices function, are challenged, and are supported in a single Canadian undergraduate nursing education program within an open and online institution. Open pedagogy is defined by five major characteristics: being relational, student-centred, critical, utilizing open knowledge practices such as open educational resources (OERs), and harnessing the scholarship of teaching and learning. Using a critical realist lens and a social complexity theory methodology, I conducted qualitative research through institutional document analysis and interviews with nurse educators. The data were analyzed using an applied thematic analysis approach. As an educator, advocate, and fellow of open pedagogy, I experienced unique daily practices and processes that facilitated meaningful and relevant education through open pedagogy. Sharing this research, which highlights both successes and challenges, is a personal and professional endeavour aimed at enhancing nursing education and furthering the development of open education practices.
Unravelling the Complexities of Pre-Licensure Nursing Education in an Open and Online University
Nursing education exists in a complex, ever-changing landscape with the integration of systems and agents of higher education, regulatory bodies, and the shifting needs of healthcare systems and learners. Educators are tasked with navigating the interaction between these systems and the agency of individuals within them to ensure nursing graduates are ready for safe and competent practice. As institutions adopt innovative teaching models like open and online education, nursing programs must adapt to diverse systems that support effective learning. This ensures future nurses are well-prepared to deliver high-quality care to their communities.
In this chapter, my aim is to provide an in-depth discussion in the form of a case study, focusing on how I undertook my research examining the operation of open pedagogical practices in a Canadian undergraduate nursing program at an open and online institution (Petrovic, 2023). Open pedagogy emphasizes relational, student-centred, and critical approaches, utilizing open knowledge practices like open educational resources (OERs) and the scholarship of teaching and learning (Bali et al., 2020; Cronin & MacLaren, 2018; Koseoglu & Bozkurt, 2018; Werth & Williams, 2022). I discuss my approach to the research with a critical realist lens and social complexity theory to complete qualitative research of institutional documents, and interviews with nurse educators. I then discuss the data analysis process using applied thematic analysis. Finally, I share personal reflections of the process, including the successes and challenges faced during this research study.
The following uses a case study approach to share how I undertook this study, my approach to open education research, and my results regarding how open pedagogical practices function, are challenged, and are supported in a single Canadian undergraduate nursing education program within an open and online institution. It also covers the challenges I faced, the satisfaction I gained, and personal revelations.
Background
Across most Canadian provinces and territories, a Bachelor of Nursing or a Bachelor of Science in Nursing is the required preparation to practice as Registered Nurses (RNs) (Carter, Beattie, et al., 2016; Carter, Hanna, et al., 2016). Nursing degrees are designed to provide RNs with a comprehensive education that includes the necessary knowledge, skills, and attributes for practice in today’s healthcare system (Canadian Nurses Association, 2020). Once they graduate, they qualify to take an externally provided licensing exam and subsequently receive licensure from provincial nursing regulators such as the College of Registered Nurses of Alberta (CRNA), n.d.).
Nursing curricula must be responsive to various factors in order to ensure the delivery of safe and competent care within a constantly evolving system and an increasingly complex and aging clientele (Bonini & Matias, 2021; World Health Organization, 2018). External regulators provide key policies and regulations to support nursing curricula in meeting these standards (CRNA, 2024). Nursing schools must also consider how to align with the larger post-secondary institutions, which also have their own aims, missions, practices, and policies. Finally, nursing programs must discover ways to offer education that effectively supports learners’ needs for meaningful learning.
The need for effective and meaningful learning in higher education has led to the advocacy for adopting innovative teaching methods. One of the recent changes in the landscape of learning is the shift to more internet and computer technology-enabled learning, such as online learning environments. During the COVID-19 pandemic, higher education worldwide was forced to transition to the online modality (Dewart et al., 2020; Sessions et al., 2022; Ust, 2021). This quick shift in practice required rethinking teaching practices, course design, learner engagement, and learner needs (Kraglund-Gauthier & Moseley, 2019; Porter et al., 2020; Sessions et al., 2022). Although an imposed change, it ultimately opened the door for a whole new group of learners and educators to engage with online learning.
The online modality has become a way to expand access to education by removing the barriers of geography and increasing flexibility to meet personal and professional demands (Athabasca University (AU), 2023). The online modality is often used in open universities that are founded to increase access to education by removing barriers experienced in traditional education (AU, 2023). Barriers may include competitive admission practices, geographical barriers and rigid academic pathways (AU, 2023). Open pedagogy is a way of teaching and learning that promotes the five major characteristics: being relational, student-centred, critical, utilizing open knowledge practices such as open educational resources (OERs), and harnessing the scholarship of teaching and learning (Bali et al., 2020; Cronin & MacLaren, 2018; Koseoglu & Bozkurt, 2018; Werth & Williams, 2022). When nursing programs are housed within open and often online institutions that embrace innovative open education practices, they face a unique challenge. They must align their curricula, policies, and practices with a pedagogically supported open system, while also fulfilling their core responsibility of preparing safe and competent future RNs.
The Process of Researching the Case
Using a case study approach, the following explores the real-life contemporary context and setting of a nursing program situated in an open and online institution, exemplifying open pedagogical approaches and describing the challenging and facilitating structural and agentic factors (Creswell & Poth, 2018). Specifically, I studied how open pedagogical practices function, are nurtured, and are challenged in a single Canadian undergraduate nursing education program within an open and online institution (Petrovic, 2023). Using a critical realist paradigm and social complexity theory methodology, I conducted a qualitative doctoral research study through institutional document analysis and interviews with nurse educators. The data were analyzed using an applied thematic analysis approach. The following subsections briefly discuss choosing the topic, paradigm, and research design.
Choosing the Research Focus
I initially aimed to explore open and critical pedagogy as intersecting pedagogies. My first doctoral publication was a literature review exploring both pedagogies and their alignment with nursing ethics, based on the idea that nurse educators can apply their practitioner experiences in teaching (Petrovic et al., 2023). Critical pedagogy has gained traction in nursing education literature, enabling more concrete findings to be established in this area. Conversely, the characteristics of open pedagogy are acknowledged in the literature, although they are not explicitly identified as open pedagogy (Petrovic et al., 2023). While critical pedagogy was more established, I was drawn to the emphasis of the scholarship of teaching and learning within a critical lens that open pedagogy offered. Finally, open pedagogy encompassed key principles of critical pedagogy, but as a scholar, I felt more capable of upholding socially just principles as an ally. Thus, narrowing my focus to open pedagogy alone was a deliberate choice based on my desire to occupy a space that reflected my allyship (Petrovic, 2023).
My work as a nurse educator at an open and online university directly inspired this research. It is interesting to reflect on how hard I tried in the beginning to avoid conducting research within my own institution. Initially, I looked for other ways to explore open pedagogy in nursing education because I was worried about the bias I might introduce as an insider to the phenomenon under study (Dwyer & Buckle, 2009). I was also contemplating how the nature of research, its approaches, goals, and whose interests it serves, could be well served from an insider perspective. Using Dwyer and Buckle’s insider-outsider theory of researchers, I recognized that while there is a greater chance of bias and assumptions, there is also the advantage of having a deep understanding of the system and phenomena, along with an increased likelihood of acceptance by those being studied (2009). From here, I began to deeply think about the research paradigm for this study, which was critical realism.
Choosing a Critical Realist Lens
As the researcher, I acknowledged two key assumptions. First, I believed that I had a profound influence on what was studied and how it was studied. Second, I believed that there was a concrete truth out there. I felt challenged by what I would describe as being “situated within the divide between positivist and social constructivist assumptions” (Petrovic, 2023, p. 51). I located myself within a critical realist paradigm, where there is an objective reality; however, finding and understanding it remain influenced by the beholder’s perspective (Maxwell, 2012). Thus, critical realism allows me to be who I am, balancing positivism, wherein events in the world are independent, with the notion that the way they are understood is mind-dependent (Clark, 2015; Clark et al., 2008). Critical realism holds to six foundational principles: “1) the existence of an independent reality, fallibly known; 2) a stratified emergent generative ontology; 3) an explanatory focus; 4) recognition of agency and structure; 5) reality as a complex, open system; and 6) methodological eclecticism and post-disciplinarity” (Clark, 2015, p. 22:31).
Choosing Social Complexity Theory
Once I established the research paradigm, I knew I had to think carefully about how my methodological approach would enable me to develop an in-depth understanding to answer my research question while aligning with the paradigm of critical realism. I understood that I wanted to reflect on the bounded system, the system elements, and the relationships between structure and agency within the system. In my search and strategizing, I examined various complexity and system methodologies. I consulted my methodology advisor several times during my early planning for my study. It certainly helped to have an expert in critical realism and complexity theory as part of my support system. Through several of his recommendations, I found myself reading about Castellani and Hafferty’s research methodology and the method of Social Complexity Theory (2009). As both a methodology and method, social complexity theory informed how I conceptualized and operationalized the study (Petrovic, 2023).
Social complexity theory provides a systematic approach, with specific terminology and procedures for describing and analyzing complex social systems (Castellani & Hafferty, 2009). The aim is to create a model of the system that describes subsystems, social practices, social structures, and social agency (Castellani & Hafferty, 2009). Social complexity theory uses a two-phase approach, in which the model is discussed using the system’s specific terminology. According to Castellani and Hafferty, the first phase serves as a pilot to test whether the system is a social complex system, and if the intended research design appears to work (2009). Furthermore, researchers are encouraged to revise as needed after phase one to ensure alignment between the research question, design, and analysis process.
For my study, after phase one, I changed the sampling strategy from the plan of convenience to purposive sampling. This change was made as a responsive adaptation to ensure I got the needed data. Phase one resulted in findings on operationalizing open pedagogy, but needed additional data on nurturing and challenging open pedagogy (Petrovic, 2023). For this reason, I invited educators to interview who were demonstrating open pedagogy characteristics in their practice.
I developed a deep appreciation for social complexity theory, which greatly influenced my choice to adopt it as a detailed and nuanced methodology that remains relatively obscure in the fields of education and health research. While I do not regret my choice, I had to invest considerable additional effort, seek assistance from a methodologist, and forge my own path, requiring that I become the expert in my chosen methodology. This discussion provided a brief and simplified overview of social complexity theory. For a fulsome understanding, Castellani and Hafferty provide an eloquent and thorough guide to its use in their book (2009).
Choosing Applied Thematic Analysis
In social complexity theory methodology, researchers are encouraged to use analysis strategies that support answering the research question. I chose to use applied thematic analysis, which employs an iterative process for coding, and theme identification and refinement (Guest et al., 2012). Furthermore, applied thematic analysis has a well-defined stepwise process to ensure rigour and built-in reflexive steps to minimize bias (Blanchard et al., 2018; Mackieson et al., 2019). Maximizing rigour and minimizing bias was important as a novice researcher with an insider perspective.
Results
As previously shared, this study had a two-phase process. Both phases used an applied thematic analysis approach (Petrovic, 2023). The first phase involved analyzing institutional documents. The thematic results from this phase were utilized to develop the initial model of how open pedagogy functions, is challenged, and is nurtured. The thematic findings from phase one were subsequently used to build upon and evolve into what became known as the working model of the system for phase two. This model employs an organizational system of folders represented through detailed narrative descriptions and visual aids such as Venn diagrams, tree diagrams, and charts (Petrovic, 2023).
In my results section, I first provided a narrative discussion of how open pedagogy was operationalized. I included a detailed description of the system structures, how agency and structure interact, and what the outcomes of the interaction look like in the system. Data from phases one and two informed this section.
I then followed with a discussion on nurturing open pedagogy. The document analysis outlined the necessary information that helped me develop the interview guide for phase two. Phase two was where much of the data was derived. Key themes in nurturing open pedagogy were identified as nurse educator agency, and course design and development. Less prominent themes were specific to nurturing open pedagogy through institutional program aims and policies, the use of technology, and community impact.
Finally, I discussed the challenges faced by open pedagogy. Similar to my processes for nurturing, the document analysis provided an outline and guided the development of the interview guide for phase two. The two prominent themes identified were course design and development challenges and institutional and program barriers. Other themes that emerged as challenging to open pedagogy included educator agency and development, along with “challenges from COVID-19, technology, and external regulators, and cost” (Petrovic, 2023, p. 123).
Discussion
This research study revealed several key findings related to open pedagogy. It began by identifying a gap between intentions and practices, then explored how educator agency can be harnessed to enhance professional development and finally highlighted the impact of course development and design practices (Petrovic, 2023). I follow this discussion with a summary of my overall reflections about completing this research study.
Exploring the Gap
One of the key findings from this study was discovering the gap between the intentions or aims of open pedagogy and its implementation (Petrovic, 2023). This was one of the most impactful findings for me. It highlighted the difference between how a system is expected to function compared to how it actually functions. Comparing documents with interviews revealed how open pedagogical characteristics varied between the two data sources. For instance, the documents discussed terms aligned with critical practices such as accessibility, equity, open admission practices, flexibility, diversity and inclusion, and reconciliation. In interviews, these characteristics were much less prevalent. In contrast, the interviews primarily focused on implementing relational and student-centred practices, whereas these practices were much less evident in the document analysis.
Another interesting gap was how those practicing in the system discussed the importance of using OERs; yet, when reviewing the documents, OER policy and documented practices were underrepresented. The findings from my study align with a noted lack of support for OERs in higher education in the literature (Doyle et al., 2022; Marín et al., 2022). Although not part of this study, my colleagues and I also investigated OER development, revision, and maintenance practices relative to the educator role in higher education (Doyle et al., 2022). We noted disparities in how tenure-track academics are expected to create and share knowledge through OERs. However, the value of OER practices does not translate to the expectations of the academic role in tenure and promotion structures.
Educator Agency
Social complexity theory explores the intricate connections between structure and agency within systems. A key theme that emerged from the findings focused on educator agency (Petrovic, 2023). This theme was prominent in both the nurturing and challenging aspects of open pedagogy. Data from the interviews exemplified educators’ self-reflection on the characteristics of relational and student-centered practices, along with harnessing the scholarship of teaching and learning in their practice with students. Interview findings provided powerful examples of educators choosing to enact their agency. Many of these moments truly completed my journey, underscoring what motivated me to pursue this research.
Open pedagogy is not named often in the literature, even my participants were not familiar the term. But like the literature, the participants shared rich examples. I recall during my initial recruitment when two of these participants were not sure if they were “good enough.” By deconstructing the terminology and highlighting why I had asked them, they were then able to see what I saw in how their practice emulated open pedagogical principles. It really reinforced the need for continued support of educators to realize their excellence in teaching and learning.
Educator Development
The necessity of both revealing effective practices and providing ongoing support for them, as educators underscore, is yet another significant finding (Petrovic, 2023). As previously mentioned, I first positioned this study on the premise that the way nurses practice in the field contains significant and transferable principles applicable to their roles as educators (Petrovic et al., 2023). Most nurses are hired into educator roles from the position of expert nurses (Kraglund-Gauthier & Moseley, 2019). Therefore, they need support as they transition and should receive onboarding and ongoing educator development opportunities (Petrovic, 2023). Findings also demonstrated the need for support in teaching and learning modalities. This included how to provide educational experiences in open and online environments with flexible and accessible practices. The need for understanding different ways of teaching and learning makes sense when one considers that most undergraduate nursing education is delivered through traditional in-person nursing educational models (Petrovic, 2023). Thus, many students and educators have minimal exposure, which aligns with similar findings in the literature regarding their feelings of being underprepared to transition to online (Porter et al., 2020; Sessions et al., 2022; Shindjabuluka et al., 2022). Finally, unique to professional education, such as nursing, was the discussion of maintaining up-to-date practice in clinical nursing. This was particularly relevant when providing clinically oriented educational experiences. Key supportive practices outlined in the findings and recommendations included formal and organized onboarding practices, professional development, mentorship, and communities of practice/communities of inquiry (Cleveland-Innes et al., 2019) and sharing practices (Veletsianos, 2015).
Course Design and Development
Finally, I discuss the important theme of course design. Course design is a critical aspect of teaching and learning that gains prominence in online classrooms, where student-to-content engagement is expected to be high, particularly in self-paced and asynchronous environments. High student-to-content engagement aligns with classical theory in distance education (Moore, 1989), which emphasizes high flexibility and student autonomy (Kraglund-Gauthier & Moseley, 2019; Petrovic et al., 2020). Therefore, course design practices need to mitigate transactional distance through effective course design practices (Garrison, 2000; Petrovic et al., 2025). Three key recommendations include 1) course design that incorporates open pedagogy principles, 2) rigorous structures and processes for course development, and 3) strategic teams for course design (Petrovic et al., 2025).
Overall Reflections
This was an important study for me to complete, acknowledging that as an exploratory study, it serves as but a starting point. There is a significant opportunity to deepen and expand this work through replication at various sites and comparisons, including other voices such as students, leaders, and administrators, as well as to explore additional questions about the research concepts (Petrovic, 2023). I began with a strong belief in the value of open pedagogy and concluded with further affirmation that it offers a promising approach to enhance accessibility to meaningful and engaging learning while meeting the mandates of the nursing profession to act on socially just principles. Upon reflection, I had assumed there would be greater tension between meeting external regulatory requirements and practicing open pedagogy; however, this theme was not as prevalent as I expected. Challenges were primarily identified at the program and institutional levels rather than attributed to external factors, suggesting they may be less significant. Or alternatively, much of what we understand in nursing education is inherently integrated into how we structure our educational approach. I proposed in this study that perhaps how knowing informs structure is so deeply intertwined that we might overlook it. I believe this deserves further investigation.
Finally, as an educator inspired to pursue a doctorate in education due to my belief in the importance of the educator’s role, I am hopeful to see that the scholarship of teaching and learning in higher education has gradually been gaining traction (Bailey et al., 2022; Mathany, 2017). However, work still needs to be done to raise the value of the scholarship of teaching and learning (Booth & Woollacott, 2017; Nevgi & Löfström, 2015; Tierney, 2020; Webb & Tierney, 2020). The scholarship of teaching and learning continues to hold less power for career advancement, external funding, and overall prestige than the scholarship of discovery in higher education settings, particularly with research-intensive mandates (Booth & Woollacott, 2017; Nevgi & Löfström, 2015; Tierney, 2020; Webb & Tierney, 2020). As an early-career researcher newly on the tenure track, this leads me to consider how best to balance these competing priorities in the academic environment.
Conclusion
Nursing education operates in a complex environment shaped by various internal and external systems and demands. Nurse educators must balance the complexities and demands of these systems to prepare safe and competent nursing graduates for practice. Nursing learners require meaningful and engaging learning experiences to facilitate safe and competent care practices. Institutions may choose to adopt innovative teaching methods, such as open and online education, to meet the needs of future nurses. This chapter examines the study of open pedagogical practices as a means of promoting relational, student-centred, critically framed learning while utilizing open knowledge practices and harnessing the scholarship of teaching and learning. In this chapter, I reflected on my research journey, including the challenges I faced and the personal and professional satisfaction I gained from contributing to an important field of research.
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