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The Bits and Bytes to Advanced Graduate Degree ProgramsUniversity of Medicine and Dentistry of New Jersey, Newark, New Jersey Correspondence: Correspondence: Diane Rigassio Radler, PhD, RD, University of Medicine and Dentistry of New Jersey, 65 Bergen Street, Room 157, Newark, NJ 07101-1709. Electronic mail may be sent to diane.radler{at}umdnj.edu. Lifelong learning may afford the dietetics professional more opportunities for career advancement, a richer self-satisfaction, and a revived confidence regarding career choices. The avenue to lifelong learning is a process unique to every health professional because of individual differences in interest and work arenas. Learning activities may take the form of continuing education conferences or certificate programs, advanced or specialty training, or academic degree programs. These programs may be in one's local community or may be accessed via distance learning. This paper will focus on advanced-degree academic programs using the distance education route. Characteristics of technologically savvy programs and learners will be addressed. Lifelong learning is "a way to kindle inspiration and spark active learning"1 according to American Dietetic Association past president Dr Judith Gilbride. Active, lifelong learning can help healthcare professionals advance career development, foster a richer self-satisfaction, and promote a revived sense of confidence regarding career choices.1,2 These concepts of lifelong learning apply across the health professions to individuals seeking advanced education either as degrees or certificate programs. As one of the health professions for which entry into practice is postbaccalaureate, advanced-level dietetics education is often at the master's degree level. Although the concepts addressed in this paper are presented in relation to distance education advanced degrees in dietetics, many of the themes discussed can be applied to other health professions. Characteristics of technologically-savvy programs and learners will be addressed.
Several caveats merit delineation before a discussion of advanced-degree or distance education programs. Preprofessional education prepares health professions students for entry-level practice. Health profession organizations' academic credentialing bodies define standards, knowledge and competency statements that guide the requisite components of entry-level education, and training requirements for program accreditation.3 In dietetics, the majority of entry-level programs are at the baccalaureate level, although some may be at the graduate level. For example, a coordinated program in dietetics or a dietetic internship tied to a master's degree program in dietetics would be considered an entry-level program because the students in such a program engage in supervised practice and are not yet credentialed, hence, preparing for entry into the profession. Similarly, physicians, pharmacists, and dentists receive a doctoral degree upon graduation as a "preregistration qualification" to become credentialed for practice.4,5 After entry into their chosen profession, health professionals may advance their knowledge and skills in an area of specialization and receive an academic degree or specialty certification after demonstrating that they meet required competencies, often including a credentialing examination.6,7 Graduate degrees designed exclusively for credentialed health professionals can be specialty or advanced degrees. Although some health professions such as nursing have accreditation standards for beyond-entry-level degrees, dietetics does not. According to the U.S. Department of Education, master's degrees can be "awarded as advanced research degrees in academic or professional fields of study"8 or "as basic professional qualifications."8 Often, an advanced degree is referred to as a "postprofessional" degree (ie, a degree obtained after credentialing as a professional in a field of study). It should expand upon knowledge and skill learned during baccalaureate-level programs.9 In dietetics, this may be at a specialty level such as a master's degree in counseling or a master's in business administration (MBA), or at an advanced level within dietetics. In nursing, this level may be the advanced practice nurse or a certification in nutrition support nursing. The differentiation between advanced and specialty is somewhat "gray." For the purposes of this paper, however, advanced degrees in dietetics/nutrition will be those that are for registered dietitians (RDs) only (credentialed professionals) and focus on advanced clinical nutrition practice. Advanced degrees that include didactic course-work combined with a focused clinical specialty experience offer credentialed healthcare professionals the opportunity to develop new knowledge, leadership, and clinical acumen. Programs with a thesis requirement provide students with knowledge and basic skills in the design, conduct, and analysis of research. Advanced education resulting in a master's or doctoral degree is usually associated with gains in compensation.10 It also provides a rung in the career ladder for health professionals, propelling the practitioner to greater autonomy, achievement, and satisfaction.11 Because the field of dietetics is embracing evidence-based practice, advanced nutrition interventions, and clinical outcomes monitoring, advanced practice skills help position the RD on par with other healthcare professionals. Obtaining these skills while working with "real-life" examples reinforces applications to practice. Hence, if the advanced-degree curriculum is offered on a part-time basis, the working professional has the opportunity to participate in designing outcomes research within his or her own work setting, thus contributing to the professional image and respect of the RD. Doctoral-level programs may be focused on research such as the doctor of philosophy (PhD), education such as the doctor of education (EdD), public health such as the doctor of public health (DrPH), or practice such as the advanced practice doctorate. In contrast, the advanced practice doctorate should focus on building the requisite depth and breadth of knowledge, research that drives practice, and skills to integrate knowledge and research into practice.12 Although practice doctorates are increasingly common among healthcare professions at the entry level,13 the only one to date in dietetics is at the advanced level.14 Identification of the appropriate level of graduate degree can be determined through program recruitment materials and websites, by interviewing program faculty members and administrators, and by talking with enrolled students and alumni. The first question would be whether or not applicants are limited to those who are already credentialed in the profession. Then one might compare the goals, objectives, and competencies of the program to those required for entry-level practice. After that, the competencies and curriculum of the program can be compared with published guidelines or standards for advanced practice.15–17
A Flexible Learning Option? Advances in technology have opened educational options for nontraditional students.18 Distance education venues provide flexibility and part-time scheduling and may be designed to offer a certificate or an academic degree. Technological developments have transformed distance education opportunities from independent correspondence programs to rigorous curricula that foster discussion and collaboration among fellow students and faculty members. Students may actually work harder and find the online courses more satisfying when compared with traditional classes.19,20 Although distance students may not have the travel time to and from classes, time spent online involves reading course lecture materials, researching, participating in discussions, posting and responding to such questions, and communicating with fellow students and faculty. This typically takes 12–15 hours per week per 3-credit graduate class. Time commitments for discussions further vary, depending on whether the discussions are asynchronous (independent of real time using a bulletin board), synchronous, or real time such as chat or instant messenger, which would require the learner to be online at a given time. Successful students should understand how to identify a quality online program and self-reflect to evaluate if online learning is suited to their learning style. Graduate studies may be best suited for distance education because students are generally adult learners with some work experience that may add to the practice application of new knowledge. Web-based courses provide students with the opportunity to learn at their own pace, moving through online class sessions as slowly, rapidly, or often as they need within a specific timeframe. In the online classroom, faculty members may include a presentation that combines assigned readings and website reviews with required responses to asynchronous learning questions. Student responses to the questions provide evidence that the student has completed the weekly readings, posted "lectures," or presentation. Students can be assigned to respond to questions either individually or to work in small groups and post a collective response.
Characteristics of a Good Online Program One primary attribute of a quality online program is that the institution should be a veteran in the online environment, with a positive reputation. Look for programs that are housed within accredited academic institutions and that have a history of online course offerings. When choosing a master's degree program, start by exploring the program website and read the school and program's mission, vision, and goals, as well as the anticipated student competencies of program. Explore course descriptions to make sure they meet your interests and professional needs. Evaluate the research interests and activities of faculty members and past students. Check to see that the website is current and integrates technology appropriately. After exploring the available information regarding the program, individuals may have particular questions according to their needs. These may be addressed via a telephone or in-person meeting with the program director or a faculty member to ask specific questions. Determine the program level (entry or advanced) and focus (eg, clinical, basic science, research, public health). Given the knowledge and practice base of practicing RDs, there are substantial differences between programs geared toward individuals entering the profession (entry-level degree programs) and those designed for individuals who have the RD credential. Ask whether a research thesis is part of the degree requirements and whether the thesis is student or faculty driven (ie, can the students choose their own area of research or are they limited to faculty-initiated research). Those planning to continue their education beyond the master's degree should consider a master's degree program that includes a thesis; otherwise, it may ultimately mean that additional credits are required once the student is in a doctoral program. Other important questions include the timeframe required to complete the degree (5–10 years is typical for master's and doctoral degrees), whether students can be part time or if they need to carry a full credit load, and the options for credit for experience. Determine whether there are practice experience requirements and if there is flexibility for enrolling in courses in other disciplines or schools. Determine the program's venues for student recruitment (advertising or word of mouth by reputation) and the program's rate of student retention. Ask whether there is an online student resource center or gallery for important program information and for opportunities to interact with other students and post messages to groups of students. Find out if the program is 100% online or if courses or the program involve visits to campus. If there are campus visits, it is important to know up front how often and how long each visit must be. It is not uncommon for distance programs to include periodic on-campus sessions for various courses or for student presentations. It is essential to find out if program faculty members apply technology appropriately for learning. Graduate education is directed to adult learners, each of which may favor a different approach to attaining and applying knowledge. Learn whether faculty members use various media to reach the adult learner, which may range from electronic tutorials, electronic books, or CD-ROMs and DVDs to more traditional textbooks and lecture notes. As a learner, it is important to know the time and technology requirements in advance; ask about course integration of media, timeframes, and due dates for assignments. Institutions that offer online courses and programs need to have committed resources for technical support. Be aware that successful migration of a course or program to the online environment is more than posting lesson plans on a website. Faculty members must be supported for the development of new courses or conversion of traditional curricula to online learning. Likewise, technical assistance should be available for the students on a continuous basis because students may work on courses at all hours of the day and across national and international time zones. Distance education programs use either the WebCT or Blackboard21 platform for distance learning. Individual courses are "housed" within the platform. Typically, the course "shell" includes various icons containing the course components (Figure 1). These components usually include the course syllabus and any other web-based resources such as websites; a link to the institution's virtual library; a "grade book" in which students can see their grades in the course; links to quizzes and examinations; and links for chat rooms, asynchronous discussion boards, course e-mail, and course units or sessions. Programs may include an honor code on the homepage of the course, requiring students to read and sign it, indicating that they will adhere to the policies of the course and the program at the beginning of each semester.
The syllabus typically includes required readings, books, and regularly scheduled "sessions" and assignments. Sessions may be asynchronous or synchronous in nature and tend to require discussion. Presentation notes may be posted in the course site with or without audio; audiocasts (podcasts) for MP3 players may be used to provide mobile access to course materials. Synchronous or real-time class sessions may be done via chat rooms, conference calls, or web meetings. Class presentations may be scheduled through one of several venues, including online postings in which the student posts the presentation and discussion questions that may or may not include a chat room in which students and faculty "meet" at a scheduled time for an online chat, or a posting with a conference call. Online examinations can be posted either as take-home examinations, in which students download the examination, complete it according to the guidelines, and submit it online as an attachment by a prescribed date, or posted and completed online for a scheduled period of time. Individual faculty-student or student-student communications can occur through course e-mail, regular e-mail, telephone interaction, or, when geographically feasible, face-to-face meetings.
Another benefit of distance education programs is the opportunity to interact with students and faculty members from across broad geographic areas. Because distance education erases the travel barrier, students may live in different regions of the world. This provides an excellent opportunity to learn about practice patterns, research, and opportunities beyond the student's own state or region. Guest lecturers in courses may include professional experts located around the globe who are not constrained in their ability to share knowledge and skills by virtue of geographic boundaries. For example, a course may be based in a New Jersey university, taught by a faculty member from Oregon, and include guest faculty members and students from the United States, Europe, and Asia.
Characteristics of a Successful Online Student Online learning requires a significant amount of independent learning time, flexibility, and commitment, as well as self-discipline. In addition to the aforementioned characteristics, students should ascertain and comply with what is expected of them within individual courses and the program. Students should know if they will be required to collaborate with other students for assignments and therefore be able to delegate and accept direction for completing the task. Understanding what is expected helps in scheduling time for one's studies. Finally, among all of the important attributes of a successful online learner, one that may be overlooked is an understanding of the time commitment. Online courses may be more rigorous than traditional classroom courses because the student is an active learner in reading and takes responsibility for understanding the lecture materials. Students may think they should research and reference replies to questions more thoroughly than in an in-person seminar-type class or that they will be held more accountable because there is nowhere to "hide" if the reading was not done. Hence, the time commitment may be greater than that of a traditional class, and the student must dedicate hours on a weekly basis; for example, every Tuesday between 7 and 9:30 PM and every Thursday between 4:30 and 7 PM. Maintaining the commitment to a timeframe is essential to prevent slipping behind and losing the momentum of the course. Evaluate whether courses have synchronous discussions/chats and when they are typically scheduled. Living in different time zones than faculty members or fellow students requires a determination of not only the date the assignment is due but also what time, and the faculty's willingness to accommodate a mutually agreeable time period for all students. For example, an assignment may be due on June 20, 10 AM Eastern Time; this would be 7 AM Pacific Time, 3 PM in England, and 5 PM for individuals in Israel and Egypt. The time zone element comes into play as well when students collaborate in groups.
The Bits and Bytes and Opportunities in Dietetics Consider the following if you have decided to pursue an advanced degree in dietetics but are not sure where to begin. First, contemplate current knowledge level and highest degree. If you earned a bachelor's degree, completed a dietetic internship, and have just a few years of dietetics practice experience, you may decide that a master's degree is the next logical step. Second, determine whether you want a degree in clinical nutrition, public health, or some other area related to your practice or in the direction that you wish to focus your future career. If, on the other hand, you have several years of experience and completed a master's degree, then a doctoral degree may be the next appropriate venue for your educational needs. Doctoral degrees may be in several areas of interest but are largely considered either a research doctorate like the PhD or the advanced practice doctorate, which focuses on advancing knowledge, skills, and research.13,14,23,24 The doctorate in clinical nutrition (DCN) is an example of an advanced practice doctorate that integrates practice, research, and knowledge.14 Once you have completed your self-assessment and determine that an advanced degree may be appropriate for your learning needs, consider some issues before making your commitment. Determine whether your academic, practice, and research interests parallel the faculty members' knowledge and research areas. Talk with current students and alumni. These individuals are your colleagues, and will most likely give you an honest assessment of the program from their perspectives; ask their reasons for attending the program. This is helpful in evaluating their comments, both pro and con, in relation to your goals for enrolling in the program. Third, consider costs of the program, including application and technology fees and travel costs to the university (if required) for in-person interviews, classes, or presentations. How often are you required to travel to campus and how long is a typical stay? Consider associated fees that you may have from not being present on campus: Will you incur printing costs of online lectures, texts, or journal articles? Are there postage fees on a regular basis? Contemplate the technology costs and required learning of new technology associated with an online degree program: Do you need to upgrade or buy a new computer? Do you need to install high-speed Internet service or buy special software? The continual advances in technology are exciting and help to advance programs; however, the learning curve required for the student's integrating the technology may present challenges at first. Hardware and software requirements may change. Use of web-meeting technology will require a high-speed Internet, web-cam, microphone, and headset. Podcasts may require purchase of an MP3 player. Use of the technology overall is simple but, like any other new task, can require more time at first until one becomes familiar with its use. Flexibility and willingness to change and learn are key in distance learning.
Learning is lifelong, and advanced academic degree programs are one avenue to further career development. The value of advanced-degree programs in professional development and career advancement is underscored by components of individual programs. Prospective students should speak with program faculty members and current students or alumni when investigating programs to determine the best choice to meet their personal and professional goals. Advanced degree programs exist on the master's and doctoral levels as specialty, practice-focused, or research-focused degrees. Completion of an advanced degree provides expanded career opportunities and may contribute to increased compensation and job satisfaction. Distance learning programs provide opportunities for working professionals to seek advanced degrees in a flexible model. Barriers such as strict schedules, personal or professional responsibilities, the inability to be away from home during the evening or on weekends, or the lack of a program within a reasonable driving distance are removed with online programs. Students in rural areas or remote parts of the world are not restricted from going to school by their geographic locale. A career move does not necessitate leaving a program. Prospective students should evaluate both themselves and the online education programs. They should assess whether they possess the skills and resources to successfully complete the courses and evaluate the caliber, curriculum, and flexibility of the program, as well as speak with current students. Lifelong learning is integral to personal and professional achievement, contributing to practice, education, management, and research to advance the healthcare professionals as a whole. 1 Gilbride JA. The challenges and rewards of life-long learning. J Am Diet Assoc.2006; 106:1933 .[CrossRef][Web of Science] 2 Leach DC. Competence is a habit. JAMA.2002; 287:243 –244.
Nutrition in Clinical Practice, Vol. 22, No. 6,
647-652 (2007)
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