A little bit of this, a little bit of that

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How to effectively combine teaching methods to obtain maximum results

Classroom lectures allow for face-to-face interaction between learner and educator. E-learning brings great schedule flexibility. And the clinical practice setting is conducive to hands-on learning. So which method is right for teaching at your facility? According to the experts, the best move is toward a combination of methods.

“Adults like to learn from a variety of ways,” says Janet Phillips, PhDc, RN, nursing professor at the Indiana University School of Nursing (IUSN) in Indiana-polis. “We’re finding that there’s improved learning when we blend.”

Phillips’ colleague, Cynthia Hollingsworth, MS, coordinator of instructional design and adjunct assistant professor at IUSN, concurs about the benefits of blended learning.

“I really think blended learning is greatly underrated,” says Hollingsworth. “I would rather see blended learning as a way to offer multiple channels to students. Frankly, I want my students to have some hands-on, rather than just distance, education.”

Why blending is the way to go

The fact that blended learning makes it easier to incorporate simulation training is a huge plus, says Phillips.

“The neat thing about simulation is that students who are learning very complex situations for a patient can practice it safely in a lab,” she says. “If you’re a student, you may not have taken care of someone who’s had a heart attack. But you can simulate everything that happens in a heart attack.” The same principle applies to both experienced nurses and students, as simulation allows nurses to practice a new technique in a safe, controlled manner conducive to experimentation.

Phillips has witnessed the growth of Web-based learning among her fellow teachers. But she feels that the face-to-face component of blended learning is what makes it so effective, allowing teachers to keep that much-needed communal aspect alive.

“People learn well when they come together,” says Phillips. “People missed the social interaction, and we’ve seen that learning in a social setting is conducive to higher learning.”

Literature also supports the benefits of blended learning; in the article “Reasons to go hybrid” in the Distance Education Report, the author found that the best education courses feature abundant and timely feedback, judicious use of technology, and learning by doing. He also concluded that the best online courses demonstrate attributes recognized in effective classroom teaching and that Internet-supported or hybrid courses are an improvement over fully online courses.

A great deal of flexibility also comes with blended learning, adds Phillips. Learners often are able to complete online assignments and simulation tasks on their own time.

As learning takes place in three ways—visual, auditory, and kinesthetic—blended methods allow for a combination of all means of learning to take place. Also, instructors may excel in different teaching methods, and blended learning gives them opportunities to work within their strengths and to be trained in new ones, says Phillips.

“When you have blended learning, you may come across different competency levels of the instructors,” she says. “Someone might be really good online, and someone might be good in the clinical setting. You have to train your trainers and make sure everyone’s up to speed.”

An article in T&D Magazine, the publication of the American Society for Training and Development, states that “as long as technology and delivery formats are optimized for the situation, blended learning is usually the right answer for a company seeking to benefit from a complete mix of training and support that will give its employees what they need when they need it.” The authors also wrote that “expanding the mix to include a rich variety of formal training; support for informal learning; and easy-to-find, just-in-time performance support will provide your staff members with a learning environment that should create ‘magic from the mix.’ ”

Hurdles to watch out for

Perhaps the most daunting aspect of blended learning, says Phillips, is the associated front-end costs. A learning management system—a software package that enables the management and delivery of online content to learners— or simulation robots may carry a high price tag. The hiring of new staff members, such as technology experts, can also be expensive. However, the facilitation of “any time, any place, any pace” access of students to the learning content and administration will likely offset the costs of a learning management system and other components, says Phillips.

Another possible downfall is that people may reject the unfamiliar.

“Some people resist blended learning, because it’s different from what they’ve done in the past,” says Phillips. “I would say this is especially true of more mature learners and those who’ve never worked with a learning management system. They want to go in a classroom and be told what to do.”

This aspect requires initiation of the learners to reduce resistance, says Phillips. “But hospitals are often forerunners with technology. They already have a lot of technology going on, so there’s not as much resistance. But it’s still an issue,” she says.

Also, when online learning is part of the equation, an instructor must also make sure that students don’t “fall off the face of the earth,” says Hollingsworth.

How to get people on board

You need to get people in an open mindset when approaching them with blended learning, says Phillips.

“They have to be open to different types of learning, and you may need to convince people of its benefits,” she says.

There should also be a mentor involved who can help instructors become comfortable with blended learning techniques. “I don’t want any of my faculty jumping in without having seen it in action by a skilled educator,” says Hollingsworth. “They should take online classes and then be hooked up with a good mentor.”

One of the best ways to do this is internal marketing, says Phillips.

“Staff educators can have a whole marketing campaign to get people on board for different teaching styles,” she says. “They can advertise, meet with managers in their departments, or have people come in from the outside who are experts to discuss how slick it is and how you learn so much. Then they can bring in academics who can talk about the research.”

The number one group to convince, says Phillips, is peers. “The champions become change agents and can make all the difference in the world,” she says.

“Because it appeals to the adult learner who likes to learn in a variety of ways, the research shows you can get improved learning from it and high-order thinking,” says Phillips.


Green, D. and Oaks, K. (2003). “E-learning: The answer is blended learning, now what was the question again?” T&D Magazine, October 2003.

Hopper, K. (2003). “Reasons to go hybrid,” Distance Education Report 7(24): 7.