Strengthening Communities of Inquiry Online and Offline : Exploring the Benefits and Challenges of Including Service-Learning in a Fully Online Women’s Global Health Course

Abstract

Online learning is no longer novel in higher education. Decades of research have proven it to be an effective modality for learning when designed and facilitated well to students who are ready and supported to participate in this type of instruction. With demand increasing for online and blended course and program offerings, faculty and practitioners who work in health education and promotion are pressed to adopt new paradigms of teaching and course development that engage the learner and cover professional competencies (many skills-based). While service-learning has become an integral facet of higher education, embraced by many disciplines for its positive influence on student learning and community, service-learning and community-based projects are not commonly part of online learning. Working in and with communities provides students opportunities to experience transformative moments that help them not only develop academically and professionally but also lead to increased social consciousness about the world around them. There is a need for empirical studies that explore the integration of service-learning in fully online health promotion courses. This article presents findings and lessons learned from a pilot project that explored the impact of service-learning on community of inquiry measures (e.g., cognitive presence, teacher presence, and social presence). The authors introduce a new online course model in health promotion that includes service-learning or other forms of community engagement.

Keywords

community of inquiry online service-learning health promotion

In Fall of 2014, more than 5.8 million students enrolled in academic institutions of higher education in the United States were taking all or some of their courses online (Allen & Seaman, 2015). According to Online Report Card: Tracking Online Education in the United States, one out of every four students at U.S. institutions of higher education was enrolled in an online course (Allen & Seaman, 2015). These findings demonstrate that online learning is no longer an experiment: it is a part of a spectrum of learning models and one that has proven to be an effective modality when designed and facilitated well (U.S. Department of Education, 2010). Recent findings from the Allen and Seaman (2015) report on eLearning also demonstrate a shift in student demographics for those enrolled in higher education. The once “nontraditional” (e.g., older, returning) student of the past is quickly becoming the “traditional learner” of today. Consequently, universities and colleges are facing the challenge of providing access to quality academic programs that meet the needs of working and caregiving adults. The rising cost of education, worsened by declining state resources for public higher education, has also led institutions to adopt online learning as a means to address these issues. Of course, learning in a virtual environment is not without its drawbacks, some of which are the following: learners feeling that they are learning in isolation, mundane assignments lacking in the experiential, and students feeling a lack of instructor presence and community online. Research shows that these experiences negatively affect student engagement and retention (Fryer & Bovee, 2016; Jaggars, 2014; Murphy & Stewart, 2017). With demand increasing for online and blended course and program offerings, faculty are pressed to find a balance between creating quality, engaging courses that address professional competencies, provide community-based experiences, and provide some versatility to work within the busy lives of today’s learner.

While service-learning (SL) has become an integral facet of higher education, embraced by many disciplines for its potential for positive influence on student learning and community (Caspersz & Olaru, 2017), SL and community-based projects are not commonly part of online learning. Empirical studies that explore the integration of SL in fully online health promotion courses are lacking. This pilot course was a first step toward filling this gap. The aims of this article are twofold: first, to highlight results and lessons learned from an undergraduate course design project that explored the impact of SL on community of inquiry measures (cognitive presence, teacher presence, and social presence); and second, to introduce a new model for online and blended learning in health promotion that includes SL or other forms of community engagement. The lessons shared by the authors may benefit others who are seeking ways in which to engage online students more with their local communities as well as with their peers in the virtual classroom.

Guiding Questions

Will adding a SL component into a fully online undergraduate women’s global health class result in positive measures of cognitive presence, teaching presence, and social presence?

Do “nontraditional” students taking a fully online course find SL of value to their educational experience or an added stressor?

What are the benefits and challenges of including SL in fully online health curricula?

Research on Service-Learning

The research on SL in higher education spans decades. SL is a teaching and learning strategy that combines community service with intentionality around learning objectives that allow students to apply knowledge and skills gained in order to address community needs (Cashman & Seifer, 2008; Seifer & Vaughn, 2002). Traditional SL is centered on a primary objective to provide services while meeting academic goals, engaging in reciprocal learning, reflecting on experiences, and engaging in collaborative experiences with community partners. Gillis and MacLellan (2010) expanded on this characterization of SL using a critical pedagogy lens, adding that “critical service learning” focuses on these areas also but requires a deeper analysis into root causes of inequity, structural oppression, reciprocity in partnerships, reflection, and ethical considerations (Gillis & MacLellan, 2010). Working in and with communities provides students with opportunities to experience transformative moments that help them not only develop academically and professionally but also lead to increased social consciousness about the world around them.

Additionally, a number of research studies show a positive relationship between SL and student retention (Astin & Sax, 1998; Bringle, Hatcher, & Muthiah, 2010; Celio, Durlak, & Dymnicki, 2011; Chaney, Hurley, Kugler, & Liang-Luo, 2015; French, Moores, Sheppard, & Smith, 2015; Glass, Cochran, & Davidson 2015; Marchese, 1997). For example, in a seminal longitudinal study, Astin and Sax (1998) collected data from 3,450 incoming college freshman at 42 different U.S. colleges and universities about their SL experiences. They examined the impact of SL on three domains of student development: academics, civic engagement, and life skills. When controlling for individual student characteristics such as inclination for service engagement, leadership ability, religious affiliation, gender, and so on, completing courses that involved SL increased the students’ academic success, life skills development, and overall sense of civic duty (Astin & Sax, 1998). Furthermore, there is evidence that learning environments that foster collaboration, active learning, content that is personally relevant, and frequent feedback have a positive impact on student performance, satisfaction, and persistence (Bringle et al., 2010; Celio et al., 2011; Marchese, 1997).

Additionally, researchers have reported that SL can help students overcome biases against certain populations such as those experiencing homelessness or displacement, HIV/AIDS, and addiction (Chaney et al., 2015; French et al., 2015; Glass et al., 2015; Hunt, 2007; Loewenson & Hunt, 2011; Schaffer, Mather, & Gustafson, 2000). Studies have also shown that SL can deepen individuals’ cultural understanding and encourage cultural humility (Short & St. Peters, 2017; Ward et al., 2007), gain skills in leadership and partnership building (Childs, Sepples, & Moody, 2003; Hayward & Weber, 2003), and increase understanding of evidence-based practice (Balakas & Sparks, 2010). In one phenomenological study (Knecht & Fischer, 2015), nursing students described their experiences participating in SL courses during their sophomore, junior, and senior years in a series of interviews. Students reported the SL experiences in these courses helped them develop critical thinking, reflective practice, and a better understanding of barriers faced by the community. Striving to help community members address their needs with limited resources also allowed the nursing students to enhance their role as patient advocates (Knecht & Fischer, 2015). Additionally, SL opportunities provide opportunities for students to reflect on their privilege and power and their own experiences with injustice; increasing their social consciousness can lead to increased civic engagement, advocacy, and social action (Cashman & Seifer, 2008; Murray, 2013; Seifer & Vaughn, 2002).

Creating Communities of Inquiry Online

Garrison, Anderson, and Archer (1999) first introduced the communities of inquiry (COI) model, modelled after John Dewey’s (1938) notion of practical inquiry, which demonstrated that social, cognitive, and teaching presence were demonstrably imperative to successful learning experiences (Figure 1).

Figure 1.

Original community of inquiry model by Garrison, Anderson, and Archer (1999).

Over the past decade, a number of studies have confirmed the validity of the model and its three dimensions as they apply to fully online, blended, and face-to-face learning formats (e.g., Akyol, Garrison, & Ozden, 2009; Arbaugh, 2007, 2008; Kanuka, Rourke, & Laflamme, 2007; McKlin, Harmon, Evans, & Jones, 2001; Shea & Bidjerano, 2009; Shea, Li, & Pickett, 2006; Swan & Shih, 2005). A description of each of the three dimensions is below:

Cognitive presence requires that students be able to construct meaning from experiences. It is generally divided into four phases: triggering, exploration, integration, and resolution (Garrison, Anderson, & Archer, 2001). Triggering is the act of identifying an issue or dilemma that leads to exploration of the issue and brainstorming. When more information is found, ideas are integrated to construct meaning of concepts that lead to a resolution of the issue through testing or implementation of the solution (Garrison et al., 2001).

Social presence allows the student to present themselves to their community of inquiry as “real people” with real characteristics. Swan and Shih (2005) demonstrated that course design and organization affect students’ perceptions of social presence. In their study that focused on the development of four online courses, they found that course (design) and seven variables (e.g., instructor, class, age, gender, online experience, and time spent in discussion) significantly affected perceived social presence.

Teaching presence requires both the selection and presentation of appropriate content to support the learning experience, as well as facilitation and communication that guides students through discovery (Garrison et al., 1999). Anderson, Rourke, Garrison, and Archer (2001) conceptualized teaching presence as having three components: (a) instructional design and organization, (b) direct instruction, and (c) facilitating discourse (originally called “building understanding”).

Emergent Research on COI

Swan and Shih’s (2005) study revealed overlaps in perceptions of instructor and peer presence, suggesting a revised iteration of the model. This 2005 study suggested that the perceived presence of instructors may be more influential in determining student satisfaction than the perceived presence of peers. More recent studies also support this. Armellini and De Stefani (2016), in the British Journal of Educational Technology, traced the role of cognitive, social, and teaching presences in the professional development of 40 English language teachers completing continuing education courses delivered in blended learning format. Their findings suggest that teaching presence and cognitive presence have become “social” and are not separate but rather interrelated.

Based on the patterns they identified in their study, Armellini and De Stefani (2016) concluded that social presence is part of teaching and cognitive constructs and embedded in all presences in contrast to what the original COI framework illustrated. Hence, it is the social aspects of teaching facilitation (e.g., using group texts or Twitter for class reminders and announcements; facilitating discourse) that explain why perceived presence of instructor was found to be more influential than perceived presence of peers (Swan & Shih, 2005) and more influential than course organization or direct instruction (Figure 2).

Figure 2.

Suggested update of the communities of inquiry by Armellini and De Stefani (2016).

So How Does This Relate to Online or Blended Courses That Include Service-Learning?

It is important to consider the recent findings by Swan and Shih (2005) and Armellini and Stefani (2016) with regard to this pilot project, which found that students felt slightly more social presence than cognitive and teaching presences (see Results section). This could be attributed to the instructor’s intentional design of the course to emphasize peer collaborations and community building (on and offline) and “socialization” of the content. Rather than didactic methods and direct instruction, the pilot course included more constructivist activities, provided multiple channels of communication and feedback (e.g., discussion boards, group working areas, announcements, and e-mail), and added a SL component that could (depending on the project) require more peer and community collaboration than other courses. This supports the updated COI model suggested by Armellini and De Stefani (2016; Figure 2), which, at least for online courses that include SL, puts social presence and community development at the heart of the learning experience.

Furthermore, if one considers the four phases of cognitive presence (triggering, exploration, integration, and resolution) in relation SL, it seems logical to hypothesize that adding a SL component into online communities of inquiry will benefit the socialization of content and self-discovery in addition to teaching and social presence. Research has already demonstrated that service has this ability, at least in relation to face-to-face courses (Table 1).

Table 1.

Twelve Benefits of Service-Learning.

• Deepens students’ understanding of topics and concepts covered in the course

• Increases learners’ confidence and positive feelings toward self

• Shapes affirmative attitudes toward school and learning

• Can improve academic performance

• Enhances collaboration, communication, and problem-solving skills

• Allows students translate theory into real-world concepts and situations

• Strengthens professional networks by connecting students to communities and organizations

• Provides a shared learning experience that ideally benefits the partnering organization, those served by the organization, and the students

• Enables learners to gain added insights into complex issues from varied perspectives

• Increases interaction and communication among students

• May increase student motivation and engagement

• Fosters empathy and increased concern for others

Note. Adapted from Billig (2009); Billig, Root, and Jesse (2005); Celio et al., 2011; Giles and Eyler (1994); Harwood and Radoff (2009); Markus, Howard, and King (1993); Melchior and Bailis (2002); Perry and Katula (2001); Sabo et al. (2015); Seifer and Vaughn (2002).

Method

The primary instructor of the course received a small Community Engagement Grant from the university’s Office of Community Based Learning and Research to design and launch the pilot. The course, Women’s Global Health & Human Rights, was/is a 10-week fully online undergraduate elective for RN-BSN students as well as for those enrolled in the BA of Health Studies and the BA in Gender, Women, and Sexuality Studies. The course description and objectives are included in Figure 3.

Figure 3.

Course description and objectives for BHLTH 420: Women’s Global Health & Human Rights.

The course design followed the standards and criteria outlined by Quality Matters (QM), a nonprofit, international consortium of faculty and staff that provides research, training, and models for quality assurance in online education. During and post design, the course was reviewed by one of the university’s eLearning specialists who was also trained as a QM course reviewer. The class was delivered through the Canvas LMS platform, and in addition to the SL project, the course assignments included online discussions, quizzes, a film critique, synchronous (live) and recorded presentations by invited speakers, and a group virtual “work space” within the Canvas course where students could communicate and work with team members on their select SL projects.

A total of 44 RN-BSN and Health Studies students enrolled in the course and were notified about the SL component at the time of registration. Since this course was an elective, students could opt not to enroll in it if they did not wish to participate in SL.

Students who enrolled in the course were given a menu of SL projects from which they could choose. These were projects prearranged by the instructor prior to the term start. Students could also propose their own project with an organization that already had an existing agreement of understanding with the university. Students selected a project based on their interest in a particular women’s global health issue as well as their ability to work collectively or individually with a community partner. Examples of projects included the following:

Organizing a supply drive for two local nonprofits (e.g., shelters) that supported women and children escaping violent or unhealthy domestic situations

Completing training and participating in canvasing and educational events with a local anti–human trafficking organization

Completing training and facilitating small group dialogues with and for youth about factors that affect gender equity and violence against women

Writing and submitting an article or book review for an online, national women’s health blog

Planning and managing a fundraiser for an organization serving refugee women and families

Organizing a film screening of a documentary relative to a women’s global health issue and facilitating a Q&A with the director and audience afterward

Creating and soliciting artistic works for an online, public digital exhibit honoring International Women’s Day

Most of the students opted to work in groups (n = 36) and eight worked alone. Students worked on their SL project over a span of 8 weeks and for a minimum of 20 hours (total). Students who chose to work in groups with a community partner met with their team and community partner “offline” throughout the term. Questions measuring teaching presence, cognitive presence, and social presence from the Community of Inquiry Survey (Swan et al., 2008) comprised a portion of the course evaluation at the end of the term and included both closed- and open-ended questions. A question that measured perceived value of the SL project was also included.

Results

Quantitative Survey Responses

Thirty-four students (77%) completed the end-of-term survey. Their quantitative and qualitative responses supported SL as a component to a fully online class: Results below reflect responses from 29 students who worked in a group and five who completed individual projects.

Social Presence: 94% (n = 32) strongly agreed or agreed that they felt a sense of community in the class and felt a connection to their peers and to the instructor.

Cognitive Presence: The majority of students completing the survey (84%; n = 29) strongly agreed or agreed that they felt motivated throughout the course to explore the course learning materials, readings, and media.

Teaching Presence: 91% (n = 31) rated the instructor’s contributions and facilitation as “excellent” or “very good”; 9% (n = 3) rated it as “good.”

Perceptions about Value of SL: The majority of students (70%; n = 24) reported that they felt the SL project was of value and enhanced their learning.

Qualitative Responses

An open-ended question was included in the end-of-course evaluation for students to comment on the overall learning experience and their perspectives on including SL in a fully online course. Seventeen of the survey respondents left qualitative feedback and most (n = 15) were positive while two were neutral in feedback and provided suggestions for future terms. For example, one respondent requested more contact with community members served directly by the project. Another suggested that the department track the number of courses requiring SL to reduce situations where students take multiple courses requiring SL during the same term. Four primary themes emerged from the open-ended question: (a) a greater awareness and social consciousness about a particular issue impacting their region or community, (b) increased motivation to get more involved in their community or to continue to work with the partnering organization, (c) added confidence from completing the service project, and (d) increased empathy through interaction with community members and population/s served.

Theme 1

An example of a comment relative to increased social consciousness was as follows:

Before taking this course, I knew violence against women existed, but I was ignorant to its pervasiveness in our society and globally. I used to think of human rights violations as things that happen only in war or in non-democratic societies. I now realize they are occurring right in our own town.

As a nurse, I’m better informed about these kinds of issues—more than the average person. From taking this course, I realize I was actually ignorant about these things. So the general population is even more unaware.

I believe the things I’ve learned in this course have made me a better nurse and a better person. I am more vocal, as a man, in asking men to stop making derogatory or degrading comments against women. I believe the men and young men I worked with on this project are now better informed about “traps of masculinity” and hopefully more prepared and willing to stop violence against women. (Student A)

Theme 2

Several students mentioned that the project had motivated them to continue to take action on the issues addressed by the SL project, or to stay involved with the partnering organization:

As I completed the final project, I became more determined to support girls attain education and be in charge of their own lives. I also joined an organization that is based in India which supports women’s health and rights and raises awareness for women’s empowerment. (Student B)

Even though I work in a neuro and spine clinic, this course helped me to expand my knowledge beyond this. For my project, I worked with an anti-human trafficking organization, and we put together a short training for staff working in the ER on signs that someone admitted may be in a trafficking situation. Medical staff and health professionals are often the first in contact with a victim who has experienced violence although so many do not know just how pervasive trafficking is—especially in this region of the country. I’m going to stay involved and keep volunteering. I recommend that this course be mandatory for all students since women’s health and human rights impact all of our health and well-being. (Student C)

Theme 3

Some comments reflected students’ increased self-efficacy or skills:

This course project really challenged me to develop skills I have not had the chance to develop throughout my nursing program. Who would have ever thought that I would be helping to coordinate a film screening and moderating a discussion with a director on International Women’s Day? Although it was stressful, I gained more confidence in myself through this. (Student D)

Theme 4

Several individuals wrote that the project enabled them to have more empathy for the populations they were serving. For example,

I am a labor and delivery nurse. Hearing Lynn [Shelton] discuss her personal journey with miscarriage as well as the women in her film made me so much more empathetic to my patients who have also experienced this loss. (Student E)

Lessons Learned

There were several lessons learned during the course of this pilot that may help others when implementing SL projects in an online class:

Provide students with some choice of projects, and offer options that students can complete individually as well as in groups to help students whose work, health, and/or life situation might otherwise prevent them from participating in service-learning.

Regular communication with community partners is vital to assure there is reciprocity and to work through unexpected situations.

Track the number of courses within your curriculum that require service-learning to assure there is a balance and a range of experiences beyond service-learning. Students taking more than one course with a SL component at the same time may feel overwhelmed.

During the first week of the SL course, and before students begin to work with and in the community, spend time facilitating discussion and reflecting on readings relative to topics such as power, privilege, social capital, bias, cultural relativism, and ethical issues associated with SL.

It is very difficult for the instructor to manage a course including SL with 44 students. The authors recommend capping an online course that includes SL and multiple community partners to 30 if possible or including a graduate teaching assistant or another instructor.

Plan for the unexpected. Always have a Plan B. For example, one of the student groups in this pilot project experienced a setback as the director of the organization they were working with had a death in the family and was out of touch for a few weeks. The students and instructor had to come up with an alternative project since the director, who had been highly involved with the first planned activity, was unable to be there. However, this situation actually created an opportunity for the group of five students to grow their planning skills even further. They opted to organize a fundraiser for the community organization. The students were excited to present the director with a check at the end of the quarter that went to purchasing books and supplies for the refugee children the organization served.

Give yourself at least 4 to 5 months lead time to plan the course and SL project if you have had online course design and/or are working with a course designer. If not, you may need even more time.

Connect with others who also include service-learning in their courses. Exchange experiences, ideas, and resources. Learn from one another.

Consider the reasons why students enroll in fully online courses. You may need to allow for more E-service learning opportunities for place-bound students.

Conclusions

When planned well, SL in an online course can enhance COI, even among nontraditional students who may be constrained by work demands, geography, and caregiver responsibilities. Providing students some choice, offering projects that can be completed from a distance as well as face to face, and maintaining good communication with partners are essentials for success. Also, providing platforms for collaboration (e.g., online work groups, social media) will strengthen social presences and build community online that aids community building offline. It is important to design curriculum mindfully to ensure that it provides for the social, cognitive, and teaching presence that demonstrates best practices in online learning and education. This pilot project adds to the knowledge base on online learning and SL, but this is only a start. Future studies could include a control group and compare measures of COI in online courses that include SL to the same course/s when taught without SL. In addition, there is also a need to explore whether students who engage in eService Learning (service completed online with a community partner and not physically in a community setting) experience COI measures differently than students who are face-to-face with community partners.

Since online learning is an inevitability for many students, exploring new models of learning and digital pedagogy that utilize community-based approaches is warranted. Students need exposure to authentic, “real-world” situations to be ready to tackle the public health and health care challenges that await them as new professionals when they leave the university. SL provides this as well as the opportunity to for students to work in teams, or even interdisciplinary teams (if co-taught). Likewise, integrating SL into online classes can also help faculty keep pace with the pressing health issues in their community, strengthen community–academic partnerships, and stay in touch with their own professional practice. In the words of Larry Green (2016), “Just as usable evidence-based practices need to include practice-based evidence, so too must usable pedagogy for practitioners be built on periodic exposure and experience of instructors in contemporary practice” (p. 1). As this pilot project demonstrated, integrating SL into the health promotion online classroom is feasible and may foster transformative moments that build communities both online and offline.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors would like to acknowledge and thank the Office of Community Based Learning and Research at University of Washington Bothell for providing funding for this pilot course development as part of the lead author’s Community Based Learning and Research Fellowship.

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