U.S.-Mexico Border Health Issues: An on-Line Doctoral Course

Background: Approaching 80 million residents, the population of the 10 U.S.-Mexico border states surpasses the population of France or the United Kingdom. The well-being and health status of individuals and families in this geopolitical region are unique in that they live in a bicultural/binational community. However, the multiple factors that contribute to the uniqueness of the region create obstacles to cross-border collaboration among health professionals. Preparing nursing doctoral students (in an on-line course) to contribute to creative and sustainable solutions to the complex health care issues in this geopolitical region is challenging. Additionally, as online learning has entered the mainstream of higher education, the change has raised questions such as the quality of online education, online teaching methods, and design and delivery issues. The Ecological Psychological Approach to Instructional Design (EPAID) provided the theoretical underpinnings for a graduate-level course, U.S.-Mexico Border Health Issues. Because not all of the students lived in the U.S.-Mexico border region it was critical to develop a context rich learning environment. The goal of the course was for the learner to develop a cognitive map of U.S.-Mexico border health issues with an emphasis on border health systems, binational collaboration, policy and research for shaping culturally competent research programs that respond to the complex issues influencing U.S.-Mexico border health and border health care systems.

Methods: The application of EPAID and the four major tenents, education intention, education attention, emergent learning, and situated assessment, for the development and delivery of this course will be presented. A brief overview of the course with exemplars that represent developmental challenges as well as the dynamic learner-environment interactions situated in the U.S.-Mexico border region will be provided for contextualizing the application of EPAID.

Results: Eleven nursing doctoral students completed the on-line course. Student outcomes (binational community assessments, concept exploration, binational health systems assessments, and a position paper), course evaluation, and recommendations for strengthening the course will be presented.

Conclusions: EPAID embeds learning in the complexities of real-life situations which makes it both appealing and challenging for online learning, especially when educating and preparing nurses about the complexities of U.S.-Mexico border health issues.