HIM Transitions

Construction Continues

2008-07-21T15:22:00Z

Last week I discussed the progress I have made with developing online courses for the community college. The Introduction to the Electronic Medical Record will be offered this fall and the Coding and Billing course will not be offered into the spring semester. At this point, all of my focus is on completing the Electronic Medical Record course.

This week I made a lot of progress with the course. I decided to create only four modules to cover the 16 weeks in the semester. The objectives for each module have been completed along with student expectations. The four modules will include computer terminology associated with the electronic medical record, HIPAA privacy and security, electronic record standards and practical applications of the electronic medical record. Within each module students will be required to complete research assignments on the electronic medical record. One of the assignments will require the students to research companies who offer electronic medical record software. Students must research four companies and provide an analysis of the company and the product. Another assignment requires the student to play the role of the office manager in charge of HIPAA education. The student will be required to create a PowerPoint presentation to staff on HIPAA privacy and security.

The discussion board is almost complete and this will encourage students to engage each other in stimulating conversation. I have created scenarios on the discussion board that will require the students to put their critical thinking caps on. The discussion board scenarios are based on the information within the modules and textbook. I have not decided how many points the discussion board will be worth. I want the students to really have a meaningful conversation and not just comments like "I agree with you." I am working on the criteria for receiving full points to the discussion board. This way the student will know exactly what is expected of them.

Overall, I have made significant progress with the course. I hope to have all the work completed in the course within the next 2 weeks.

Construction of Online Courses

2008-07-14T11:35:00Z

Over the last few weeks, I have been working on developing two online courses for the community college where I teach in the medical assisting program. The two courses under construction are Coding and Insurance and introduction to the Electronic Medical Record. Since the last article, I have made significant progress.

The coding and insurance course will provide students with the basics of CPT coding. The coding course will be an 18-week course that will provide an overview of the CPT coding system and reimbursement. I decided to approach each week in modules that will cover the major sections of the CPT manual. Each module will consist of lecture notes, practice exercises and assignments that correlate to the section of the CPT manual. Students will also be active in the discussion board with postings of real life coding scenarios. Students will be tested at the end of each module. This way I can work with them on any weak areas before they proceed to the next module.

So far I have developed the skeleton of the modules. I have to go back and enter the major content of each module. The overall course objectives have been developed and general information about the course have been placed on Blackboard. The textbook has been selected and the course schedule has been written around the school calendar.

The Electronic Medical Record course will center around a computerized version of electronic medical record training software. The students will be able to simulate the basics of an electronic medical record using this software. Students will be able to enter patient demographics, insurance, medications and schedule appointments. So far, I am working on developing modules for certain areas of the software that we will cover. The modules will also include lecture notes, assignments and the discussion board. The students will have to complete projects within each module that requires research on the issues surrounding the electronic medical record.

My goal is to have both courses completed by the first week in August. Stay tuned for another update next week.

Juggling Act

2008-07-08T11:25:00Z

I have accepted my third teaching position at another online university. I will be teaching an associate-level course on billing and coding. The university is on the quarter system and the course will be taught over a 5-week period. The curriculum will have the students engaged with critical thinking by conducting research on the issues surrounding health care. There are individual and group projects that will require students to really focus on how to work as a team and understand group dynamics. The discussion posts will also involve research and forming opinions based on credible sources to support their claims. The course is accelerated and jam-packed with a significant amount of course material that must be covered in a short period of time. Although I teach at another online university, the platform is entirely different. I will have to learn my way around the online course room all over again.

The last week has involved an extensive orientation for new faculty. I am required to complete a 2-week orientation class. This orientation class is not just fun and games but I have to complete assignments by a certain date. If that wasn't enough fun, I also have a group project due by the end of next week. The training for new faculty is designed to simulate the virtual world of the online course room. Part of the orientation involves attending six weekly live chat sessions facilitated by a trainer from the university. The live chat sessions involve audio and we can actually interact with the trainer.

When I wasn't working on my mandatory orientation assignments, I was exploring the course room. I played around in my live chat room and had fun with all the cool features. I am a little freaked out by the audio for the live chat sessions. I am required to facilitate two live chat sessions a week and record them for archives. The audio classes will help me to improve my skills as a facilitator.

I am exciting by challenge of the course and the opportunity to improve my teaching skills. I feel extremely fortunate to have three teaching contracts at the same time. This will certainly keep me busy.

The scary part is keeping track of the courses and figuring out what planet I am on. How will I ever keep everything straight? How will I get all the assignments graded on time? I am sure there are plenty of technical gadgets that can keep me organized. I am working on completing a PowerPoint for the first week of class. The course starts on July 21 and I am sure that I will be stressed out until I facilitate my first live chat.

Construction Zone

2008-06-30T20:15:00Z

As I stated in last week's article, I am in the process of developing two online courses at the community college. I will be teaching Medical Coding & Insurance and Introduction to the Electronic Medical Record to medical assisting students. I have tons of ideas floating around in my head about how I want the classes to be structured. The problem is sifting through these ideas and narrowing it down to fit the course objectives. Where do I start? Do I start developing both courses at once? Do I tackle one course and then start the next one?
I decided to start with medical coding and insurance course. I need to start with a roadmap to get to the finish line. So, I started with developing the course outline. The course outline will include the schedule for the next sixteen weeks based on the school calendar. I need to be sure that I work around school holidays and other campus events. The second step was to decide on the textbook for the course. This was an easy task because I have been reviewing coding textbooks over the last few months. I had no idea how many coding textbooks are on the market. Everyone seems to want to get in on this. When I was in school, there were not many choices for textbooks. We used a simple three-ring orange-binder that included the basics up to advanced coding. I don't recall who the publisher or author was but the instructor did an awesome job.

In my selection of the course textbook certain criteria was used to make a selection. The author of the textbook must be credentialed as a certified coder. This is the industry standard today for hiring coding professionals. The content of the textbook must be thorough and explain the concepts in a manner that is user friendly. Coding is such a difficult task to learn and with beginners they can easily get lost by a text that is too complicated. The flip side of that are some texts that I reviewed that were a little too elementary and lacking in substance. Another important factor, are texts that use illustrations and examples to reinforce the written text. This is very important for those learners who are visual. Visual learners learn best through pictures and other illustrations to help process information. I decided to go with the coding textbook book by Carol Buck which does an excellent job with explaining how to code using CPT-4. Buck uses illustrations and practice exercises within each chapter so that students can check their progress. Another reason for choosing the text, is that the students will be working in physician offices where the focus is on CPT coding. We will spend the last few weeks with a basic overview of ICD-9-CM coding.

Now that the coding textbook has been selected, I can determine how much material from the textbook we can cover in sixteen weeks. I don't want to exclude any information but I won't have time to cover everything. I will have to make this decision based on what information they will routinely work with in the physician's office. Because CPT is arranged in distinct sections, I want the students to be informed about all of these. What do I leave out? How do I balance what they need to know with the time constraints? Tune in next week for update on the construction zone.

Developing Online Courses

2008-06-23T23:43:00Z

I have received my teaching assignment for the fall semester at the community college. I will be teaching Medical Coding & Insurance and the introduction to Electronic Medical Records. Both courses will be online and will be open to the public, as well as, the medical assisting students. The courses will be created from scratch using the Blackboard platform.

When I started using Blackboard I didn't like the structure. Partially, because I was already teaching online at another school and was more comfortable with their online platform. I will admit that I am a little spoiled because everything was already developed by instructional designers. The instructional designers along with a team of other professionals develop the curriculum, discussion board questions, grading rubric, course schedule, and select the textbook.

All instructors can make suggestions to these areas to improve instruction and the course overall. This leaves me with just the responsibility to facilitate the course, grading and communicate with my students.

Now, the responsibility for developing the course syllabus, course objectives, assignments, curriculum, discussion board, textbook selection and grading rubric will fall on my shoulders. Starting out as a new instructor, this is an exciting challenge for me. I will be able to set up the course based on my own parameters and creative talents. The scary part is the awesome responsibility that the Chair of the program has placed with me to develop these online courses.

Of course, I have anxiety about developing courses that meet the objectives of the program. Since the courses will be open to the public, I want to provide students and the community with the tools they need to succeed in a new career.

The fall semester starts on August 18th. So, I have a small window to create the courses. I have plenty of resources to help with the development of the course materials. I will be blogging over the next few weeks about my progress and maybe a few mishaps along the way.

Cyberspace Fears

2008-06-16T17:16:00Z

I teach online and have become accustomed to facilitating the discussion group and the live seminar sessions. In the live seminar sessions, the students can see my PowerPoint presentation and class instruction is built around the PowerPoint. The students ask me questions by typing in the question and waiting for me to type a reply. Just when I was finally comfortable with the navigating my way through the virtual world of online teaching, something new is in store for me.

Starting with the next term, we will conduct seminars via an audio platform. My lap top will be equipped with a microphone in which the students will be able to hear me conduct the seminar. Instead of typing my response during the live seminar, I will be able to speak to the students directly. When the announcement was made about adding the audio to seminar, I had mixed feelings about the change. The advantages to audio include having a direct dialogue with the students and being able to take more control over the seminar. Sometimes the students can veer off course with typing in their responses.

One of my biggest fears is having the sound of my voice transmitted through cyberspace. I have never liked the sound of my voice and the idea of other people scattered across the country listening to my voice is a little frightening. Will my students cringe at the sound of my voice? Will they dream of the days of no audio? How will my voice be projected? What can they tell about me from the sound of my voice? Will I have to use the webcam in the near future? Not only can they hear me but now they can see me. I don't exactly look my best between certain hours. Ok, I have probably gone off the deep end about this but that is just how my mind works.

I have already completed training on the new audio feature. It is truly amazing how the virtual world works. I was able to complete the training online with a virtual trainer walking me through every step in the process. After the training was over, I took a test to see how much I comprehended from the session. There is even a "sandbox" which is a simulated training module for instructors to practice their techniques before we go live next term. I am sure I will spend a lot time in the sandbox honing my skills. I will keep you posted on how the audio seminars are working out. In the meantime, I will be practicing projecting my voice through cyberspace.

More Changes

2008-06-09T14:17:00Z

I attended an HIM workshop last week to hear the latest on the ever-changing world of government regulations. The workshop was an update on the Centers for Medicare and Medicaid Services (CMS) changes affecting coding and DRG assignment. For the last twenty years, hospitals were reimbursed under the old inpatient prospective payment system (IPPS). CMS has made major changes to the system, which is now called MS-DRGs (medical severity diagnostic related groups.) The new payment structure will be based on the severity of the patient's condition. The current 538 DRGs will be replaced with 745 MS-DRGs.

In addition to the changes with DRGs, hospitals must indicate on all Medicare claims if conditions were present on admission. Claims without the present on admission (POA) status will be returned to the facility. CMS developed a coding system for POA indicators:

Y-Yes-condition present on admission

N-No- condition not present on admission

U-Unknown- insuffienct documentation to determine POA

W-Clinically Undetermined-the provider cannot clinically determine if the condition was POA

As if POA indicators were not enough, certain hospital acquired conditions (HAC) will affect the reimbursement the hospital receives. On October 1, 2008, codes representing these HAC will not be included with calculating MS-DRG assignment.

Since these are the most sweeping changes to IPPS in over twenty years, many are concerned about how the changes will affect their bottom line. Although hospitals must be concerned about their reimbursement, the most important factor is to take the burden off coders. When DRGs were first implemented, coders had to worry about selecting the correct principle diagnosis, comorbidities and complications. Now, the coders must worry about assigning the correct principle diagnosis, comorbidities, complications, POA and HACs.

I have not worked in acute care in years. Now, I am convinced the decision to leave this area was a good one. In my years away from acute care, I have tried to keep up with what is happengning in this area. Now, that I am teaching I need to have more than a general knowledge of the world of IPPS. This area of HIM has always been subject to every changing government regulations. I spoke with coders who struggle to keep up with the changes. The biggest area of concern is the problem of continued lack of documentation. A major part of POA is having sufficient documentation to support the coding assignment. HIM managers must take the pressure off their coders and implement educational programs that will ensure compliance with the regulations.

References: MS-DRGs: CMS implements major revisions to IPPS (warning: PDF), BKD Healthgroup, by Tom Wolters

CCS Prep!, Advance for Health Information Professionals, by Cheryl D'Amato

Summer Fun

2008-06-02T11:50:00Z

With the end of the Memorial Day holiday, summer is fast approaching. The kids have special school events that will mark the end of the year and the start of the summer vacation. They are excited about the end of school and have already started making plans. Unfortunately, this means that I cannot do what I want this summer because my life will evolve around them for the summer. I don't teach at the community college in the summer but will be working online the entire summer. I love teaching and I am grateful to have work this summer. When I worked full time in HIM, summer meant finding a summer camp so that my work schedule would not be interrupted. Now, that my life does not evolve around an office I can have the summer that I dreamed about. Carefree days of teaching and spending time with my family.

The key for survival will be how to maintain my sanity for the next three months with the kids. I have already told them that my online class will require me to be unavailable for several hours on Thursday evening. This means that word "Mom" cannot be uttered between 6 p.m. to 9 p.m. If you have kids, you always have to specify exactly what this means. In kid terms this means that unless someone is bleeding or the house is on fire do not disturb me. I am sure that I will have to repeat this several times during the summer.

Summer won't be a total drag. The kids will be going on a three week vacation to Atlanta and Daytona Beach. The great part about this vacation is that I will not be going. My sister and mom will be with the kids on this vacation. So, I am counting on at least three weeks of a "kid free summer." What will I do with myself? Should I ignore the $4 gallon gas prices and take a vacation with the hubby? Should I help the economy by spending the tax rebate on a frivolous trip? Whatever I decide it will be a great summer for me and the kids. They get to go to all of their favorite places in Atlanta and a bonus trip to Daytona Beach. I get to teach online without having to leave the house and my gas tank will be full. It sounds like summer will be a great time for all.

So Little Time

2008-05-27T14:26:00Z

I subscribe to several professional journals to keep abreast of the changes and the latest technological advances in health information. I have been a member of AHIMA and have received the journal for several years. I remember getting my first journal after graduating from college. I was so excited to receive it and read every article with great excitement. The AHIMA journal was considered the premier source for issues surrounding health information.

As I think back to my early years of subscribing to the magazine, it has undergone tremendous changes. The journal was not as sleek and eye catching as it is today. There are a lot more snap shots of information in smaller articles. There are a lot more colorful advertisements and articles with graphs and charts. As health information has evolved, so has the number of professional journals and internet magazines. In addition to receiving the AHIMA magazine, I also receive several smaller publications dealing with health information issues.

With the restraints on time that all of us have, I am finding it difficult to read all my professional journals. When I receive the journals, I scan them for changes in regulations or best practices that I can use. I usually go through the journals a couple of times and still not have enough time to read every single article. I also receive electronic journals that provide a snapshot of the latest issues affecting health information. I spend a considerably amount of time online and tend to be drawn to information that is electronic. I can also save the information and read it whenever I want. My home office is stacked with journals in which I have flagged articles that I need to come back to and read in its entirety. As each month rolls around, my stack of journals continues to grow. As I purged out my oldest journals, I still find myself with a considerable stack of journals. I am afraid to discard this just in case I might need the information later.

I think there is still a market for paper journals and that some people have a love for old fashioned reading from print. I still enjoy picking up the latest novel from one of my favorite authors' James Patterson. I can devour one of his novels in one day. When it comes to receiving information, I prefer to receive it electronically. I don't have the same enthusiasm that I had as a recent college graduate. Back then I believed that it was a necessity to read every article in my journal to be a success. Keeping abreast of the changes in the profession is still a necessity. Now, I have so many choices for the source of the information. So, I have decided not to stock pile my journals but discard them after I read the most important information. The key is to be smart about what information I need to know and where to find it if I need to reference it again.

Balancing Act

2008-05-20T12:17:00Z

It is amazing how the wisdom of children can stop you in your tracks. My son is excited about school ending in a few weeks. He is looking forward to summer vacation, lazy days at the pool and staying up late. He mentioned to me that he was excited that I would have more time to spend with him this summer. I explained to him that I would not be working at the community college this summer but I would continue to work online. He replied, "don't you get the summer off at your online school?" I told him that online schools operate year round and that I will be teaching a class on Thursday night. He replied, "why would someone want to go to school at night?" I told him that I teach grownups who work during the day and they can only attend class at night. He replied, "I thought since you were working at home you would be able to spend more time with us." I didn't have a great comeback for this response.

The opportunity to work part-time at a community college and facilitate classes online has given me more time to spend with my family. Or so I thought, until my son let me know that I was still missing in action. When I worked forty hours a week, I didn't have the quality time to spend with my kids. I worked from 7:30 am to 4:00pm. This meant getting up at the crack of dawn and getting the day care bags ready and getting the kids ready to go. Some mornings were extremely difficult to get everyone up and going so that I would not be late to work. The worst days are the days when your kids don't want you to leave them at daycare and have a screaming fit. This ruins your day and makes you feel extremely guilty about working. Like most households, my family relied on a second income to survive the increasing cost of living. In today's world, a 2 working parent family is the norm. The majority of us have grown up with both of our parents working. Most times it is out of necessity. (http://www.dowhatyouloveandmakemoney.com/)

I look back at the day care days and remember how exhausting this whole experience was for me. I have no idea how I worked full time and took care of two small children. After a day at the office and getting my kids into their routine, I had nothing left to give my children. Like so many mothers across the country, we give every piece of ourselves to our jobs, children, spouses, and school activities. Since I started teaching, I have the flexibility to arrange my schedule to spend more time with my children. My routine involves getting the kids up for school in the morning and preparing their breakfast and lunch. They are at an age in which they are responsible for getting dressed and making their beds before the go off to school. After the leave for school, I have breakfast and catch a few minutes of Good Morning America. Next, it is upstairs to check emails from both of my jobs. I answer anything that needs immediate attention and table others until later. I check my drop box for any assignments that have been submitted for grading. I go into the discussion board to see if students are on the right track to help facilitate discussion. I review the upcoming week's course material so that I will be ready for class.

Once the kids come home, I have handled the majority of issues that need to be addressed. We talk about their day at school before we start on homework. Since television is banned during the week, the children have to find some other form of entertainment. We usually go to the park and hang out and enjoy ice cream or a cool drink. My son reminded me that he expects me to spend more time with him this summer. I have to remind myself that there is a time for work and there is a time to spend with the most important people in your life.

The Comfort Zone

2008-05-12T15:49:00Z

I was recently contacted by a friend whom I had lost contact with. He sent me an email explaining why he had not been in contact. I was amazed at all the changes he had made in his personal and professional life. I was surprised to hear that he left his job after several years and decided to try something different. For the most part, his job was probably secure until he decided to retire. This is a person who was level headed and always played it safe. But like me he desired something other than job security. The desire to get up every day and do what you love is such a strong feeling that it is worth the risk of trying something new.

I shared with him my own personal and professional transitions. He was astounded how my outlook on life had changed. He could tell by my response that I was truly happy with all aspects of my life. He replied, "You sound so different." It was as if my contentment was leaping out from the computer screen. I was no longer that person stuck in a rut without any idea how to make a change. I simply decided what I did not like about my life and decided to change it. For so long, I was bound by self-doubt and self-pity that paralyzed me. I felt like life was just happening to me and I had no choice but to surrender to it. Once I realized that it was up to me to find out who I was and what I needed to be fulfilled, the other pieces fell into place. I'm not advocating that everyone go out and make a drastic change but make changes that in some way move you to a different level personally and professionally. This can be small changes that give you self esteem and a boost in confidence. According to C. DiMarco in Moving Through Live Transitions with Power and Purpose, "Part of what can interfere with your ability to move through the world with confidence and certainty is the fact that often you may feel as though it is not permissible to make a mistake" (p.50).I would advise you to get out of your comfort zone and find out what you can do.

It has been almost two years since I embarked on my journey to fulfill my dream of advancing my education and making a career change. Looking back at this experience, it was by no means easy. The experience gave me a sense of empowerment. I felt like anything was possible if I believed in my own abilities. In such a small amount of time, I have teaching positions at a community college and an online university. Often, I read my professional journals and wished that my name would appear as one of the writers. I have spent the last twenty years in the profession and surely I have learned something that someone would find insightful. Last month, I fulfilled another dream of mine of being a writer. I feel fortunate to share my experiences with other HIM professionals in a weekly blog. Looking back at the person I was two years ago, I never imagined that I would be writing articles for a healthcare magazine. I have to ask myself, "Who is this person?" I am definitely out of my comfort zone.

Graduation

2008-05-06T13:08:00Z

The month of May is filled with graduations, weddings, and proms. This is also the time of year in which mothers everywhere dare to dream of a Mother's Day gift they will actually love. Of course as a mother of two, I will mark the occasion with the annual Mother's Day dinner and swoon over handmade cards and gifts from my kids. I will pray that they talk my husband into just getting me a gift card at one of my favorite stores.

This year May takes on a different meaning for me. I started teaching in the medical assisting program last year at a local community college. The students must pass administrative and clinical courses and complete an externship to graduate from the program. Students, who graduate from the medical assisting program, perform administrative and clinical procedures in doctors' offices and clinics.

This May will mark the graduation of the first group of students that I taught from the medical assisting program. I know this has been a stressful and difficult time for students in the program. The students in the program range from young single mothers to mature women who want to improve themselves by obtaining a degree that will make them marketable in the work place. Some students must overcome personal obstacles that can derail their dream of graduating from the program. Despite all of the distractions, all the students passed their courses and will go onto externships. Depending on how well they perform on the externship, they may be offered a position.

One of the reasons I went into adult education, was to share my knowledge and professional experiences with students. I wanted to take the skills I acquired in health information and convey how important these skills can be in their career as a medical assistant. The health information and medical assisting fields share some commonalities. Both fields require knowledge of medical terminology, anatomy, physicology, coding, insurance, record systems, computer applications, medical ethics, multi-tasking and the ability to work with others.

As I mark the celebration of my eleventh Mother's Day, I am struck by how fast my kids are growing up. Soon, their handmade gifts and cards will be replaced with that annual phone call to mom wishing her a happy Mother's Day. As I must one day let my kids go out into the real world, the students that I started out with last year will also go out into the world. They will have to stand on their own and gain the trust and respect of others. I can only hope that in some small way, I have helped to prepare them for their career.

Physician/Patient E-Mail Communication

2008-04-30T18:38:00Z

I was thumbing through the Charlotte Observer and came across an article that caught my eye. The article is called, "Physicians slow to join e-mail universe." I remember how I hated e-mail and avoided it as much as possible. I preferred to talk face to face with a person. Communicating by e-mail seemed impersonal and sterile. Like everything else, if you don't embrace technology you will be left behind. The advances in computer technology have revolutionized the way in which we conduct personal and professional tasks. The most mundane tasks are performed in an instant. Nowhere has this change been more evident than with e-mail communication. When I started out in the work force years ago, trying to schedule meetings or catch a colleague in their office resulted in numerous phone calls. Today, we can use e-mail to set up meetings and communicate information with an instant response.

In this age of instant communication, patients expect their health care providers to embrace the changes in technology. Doctors and health care practioners can communicate patient medical information instantly without having to leave telephone messages. However, some doctors are slow to embrace email communication. The Charlotte Observer article points to doctor's hesitation to discuss patient information via e-mail. The article states that "fewer than a third of U.S. doctors use e-mail to communicate with their patients." I am sure that there are many reasons why physicians are a little leery about e-mail communication. One issue surrounding the reluctance among doctors to communicate patient information via e-mail, may be confidentiality of the information. Communicating patient health information may increase the risk of the information being breeched. If there are not sufficient security measures put in place by the physician, the physician bears responsibility for the breech of information. Another area of concern, is that patients may interpret the e-mail communication incorrectly. This could result in possible legal/liability issues.

The health care industry has been slow to embrace the change in e-mail communication. We could not have imagined all of the things that can be handled online. The banking industry has been in the forefront of providing services online. You can pay bills, balance your checking account and apply for loans online. The retail industry starting using bar codes to track merchandise. The health care industry eventually caught on by using bar codes to track medical records, supplies and drugs.

The AMA supports physician e-mail communication by stating that "e-mail can aid in the delivery of the health care process by allowing written follow up instructions, test results and dissemination of educational materials for patients, as well as, a means for patients to easily reach their physician on routine health matters." Despite the AMA stance on e-mail communication, the health care industry has been slow to embrace this form of communication. There are routine medical tasks such as prescriptions, appointments, referrals and lab results that can be communicated via this medium.

My generation has been slow to embrace computer technology. My children have grown up with the Internet, iPods, cell phones, e-mails, text messaging and online chat rooms. This generation believes in instant gratification. They want everything now! They want the convenience of getting their information online. These tech savvy health care consumers will be the driving force behind the change in physician/patient e-mail communication.

High Anxiety

2008-04-22T11:54:00Z

It's springtime and the flowers are blooming and the weather is sunny and warm. This is also the end of the spring semester and final exams and projects are due. The students are anxious about preparing for their externships. Their performance will determine whether they can graduate from the program or have to repeat the externship. I find myself repeating answers to the same questions over and over again. When is our final exam? What will be on the final exam? How much will the final exam count for my final grade? When did you assign a project? What should I do my project on? My usual response is to say "read your syllabus." The response I usually get is, "What syllabus?" "When did you give out the syllabus?" My response, "we went over the syllabus the first day of class and everyone received a copy." As I look out into the classroom, they look at me as if I'm experiencing a senior moment. At this point, I wonder if I should start taking my Aricept now.

I think back to my undergraduate years in college and wonder did I suffer from these same symptoms. These symptoms consist of severe anxiety, forgetfulness, insomnia, giddiness and sheer exhaustion. Yes, I admit that I had many sleepilness nights cramming for finals and completing final projects. Oh, let's not forget all the pounds you put on munching on comfort foods to give you that extra energy boost. The convenience stores, pizza parlors and bars made tons of money from our sleep deprived and anxiety ridden state of mind during final exams. Once the final exams and projects were over, it was time to demonstrate your competency by going on an internship. My emotions ranged from excitement to anxiety. I remember having bad dreams about failing on my internship competencies. I wondered if I would be able to apply what I learned in the classroom to the real world. Somehow I made it through the exams, projects and internship successfully. Although these students don't think that they can cross the finish line, I know they will see the entire process through.

Instead of referring the students to the syllabus for the one hundredth time, I answer every question as if I have never heard it before. I found that this seems to calm their nerves and mine. Awe, springtime in the Carolinas. Nothing could be finer. What are your experiences as an educator or student?

Traditional Learning vs. Online Learning

2008-04-21T12:55:00Z

As I look through my AHIMA journal, there is a tremendous increase in online learning institutions offering degrees. If you go on the AHIMA website, pop-up ads appear for online degrees. There is much debate regarding the value of obtaining an online degree verses going the traditional route. When I started out in my educational adventure years ago, I obtained both my associate and bachelor's degree by attending the traditional institutions. The experience required me to carry a full class load and work part-time to pay for my classes. Because of the affiliation of my university with the health care community, I landed a part-time job with the HIM department at a local hospital. I couldn't quit my job or drop any classes. I had to make everything else work around my classes.

When I decided to obtain a master's degree, I knew that the online learning environment was the only option for me. For most adults returning to school, the responsibilities of family obligations and holding down a job are all factors in choosing online learning. In my case, I was working full time and responsible for two elementary age children. The online learning option allowed me the flexibility to pursue my degree without disrupting my personal and professional life.

Although I did my homework on choosing an online institution, I was filled with anxiety. I was accustomed to learning in the traditional learning environment. After settling in to the virtual world of learning, I settled down and embraced the change. The expectations were clearly spelled out and the instructors were available to provide support via online or by conference call. The amount of research was mind boggling. Instead of having to go to the library to conduct research, I did not have to leave my home. Thank God for the Internet. Some of the criticism of online learning is the sense of isolation that some students feel. I found this to be exactly the opposite. I received tremendous support from my instructors and classmates. There encouraging words got me through the difficult times.

I had the same concerns that most people associate with online degrees. I was concerned that employers would not see the value in an online degree. Some online degrees are just correspondence courses, which can leave you with a degree that is worthless. I consulted an HR director and she informed me that employers place the same value on online degrees from accredited facilities. I would recommend to anyone choosing an online institution to do their homework. The institution must be accredited and be in good standing with accreditation bodies. The Higher Learning Commission warns of the number of on line institutions that are unaccredited or accredited by agencies that are not recognized by the the U.S. Deparment of Education. To check on the legitimacy of any accrediting agency you may call the U.S.D.E. at (202) 219-7011 or go to the website.

It is clear that online learning is here to stay. It has become so popular that mainstream traditional institutions are all embracing it. I would love to hear your experiences with online learning.

Carol Dantzler, MEd, RHIA

Allied Health Instructor