An Evaluation of Nurse Practitioner Student Experiences with Online Education

Roberta Heale, Robyn Gorham and Jennifer Fournier

VOL. 24, No. 3

Abstract

Many nurse practitioner (NP) education programs have embraced distance education opportunities. A comparison the experiences of NP students in one course delivered across nine sites was undertaken. Some sites offer traditional face-to-face sessions and others provide tutorials online. A survey of all the students evaluated barriers with respect to the technology, infrastructure and support systems, social aspects and the time commitment to the program as well as a comparison of grades for online vs. onsite students. Results indicated that there were no differences in the learning experience or grades between the online and onsite students. However barriers common to all students provide insight into potential improvements in course delivery.

Résumé

Plusieurs programmes éducatifs pour les infirmières praticiennes (IP) se sont prévalus des opportunités offertes par l’éducation à distance. Une comparaison des expériences d’IP étudiantes a été réalisée dans le cadre d’un cours donné sur neuf sites. Certains sites offrent des séances traditionnelles en face-à-face et d’autres offrent des tutoriels en ligne. Un sondage effectué auprès des étudiants a évalué les obstacles liés à la technologie, à l’infrastructure et les systèmes de soutien, aux volets sociaux et à l’investissement en temps au programme, et a permis de réaliser une comparaison entre les notes obtenues par ceux qui étudient en ligne vs. ceux qui étudient sur place. Les résultats démontrent qu’il n’y a pas de différences dans l’expérience d’apprentissage, ni dans les notes obtenues, entre ces deux catégories d’étudiants. Toutefois, les obstacles rencontrés chez tous les étudiants fournissent des indications sur des améliorations possibles à la dispensation du cours.

Introduction

An estimated 6.4 million adult Canadians went online in 2005 for education with numbers rising each year. This is not surprising given the flexibility and accessibility that Internet based education offers. It is known that those who use the Internet for education are more likely to be younger than other users, spend five or more hours online per day, have high speed access at home and have five or more years of Internet experience (McKeown & Underhill, 2008). Education programs also realize numerous benefits from online education including the ability to enrol students from a wide geographic area. However, the Internet experience and skills of the students may not be taken into account during the design and delivery of online education programs, resulting in barriers to learning.

The past twenty years have seen tremendous growth in the nurse practitioner (NP) profession. NP education programs have been developed at an equivalent pace and many NP programs now use the Internet for course delivery. One of the most common reasons online learning modalities are used is that the Internet allows for, “increased learning location flexibility” (Wu & Chao, 2008, p. 1). Yet nurses who enrol in nurse practitioner programs with an online component tend to be older, may not be current Internet users, and are required to adjust very quickly to the technological aspects of the program. There is little research pertaining to NP students’ experiences with online learning, or with related academic outcomes.

Description of the Nurse Practitioner Program

A well established, Canadian, primary, health-care, nurse practitioner program consists of centralized courses that have a professor and a base university. However, the courses are delivered by tutors at nine university sites that are geographically separate from the base. The role of the tutor at each site is to evaluate students’ written work and to facilitate seminars which usually occur weekly. Courses are offered through a program-specific Internet site where all students can access the course syllabi and post messages to tutors, professors and other students. Each student is given an NP program email. However, the method of seminar delivery varies by location. Some sites offer traditional in class seminars while others deliver seminars online, facilitated by computer software designed for this type of activity. The learning software allows for voice, chat and the posting of work such as presentations. It does not offer video connections. The purpose of the seminar sessions is to enhance student understanding of the course material. While all students complete some course components in an online format, a percentage of the students participate in online learning for the majority of course activities including tutor-led seminars.

The purpose of this study was the exploration of all student experiences with the online components of one of the NP courses offered. Analysis of differences between the experiences of online and onsite learners was reviewed and the effectiveness of the online and onsite seminars was also evaluated by comparing grade achievement among the two groups.

Literature Review

Learning by a Distance

A literature search through Cinahl ™, ProQuest™, Medline™ and Google Scholar™ and Academic Search Premier for the years 1999 to 2009 revealed considerably more studies assessing undergraduate nursing students’ experiences and outcomes in online educational courses than for nurse practitioner students.

Studies of undergraduate nursing students demonstrate that computer skills are an important factor in student comfort within online nursing programs (Kenny, 2002). Online learners must be confident and self motivated (Ali et al, 2004). Nursing students experience a greater sense of competition and increased motivation when learning online (Ali et al, 2004). A qualitative assessment of student experiences in distance education suggested that students find the flexibility of the online learning environment to be empowering (Ledwell et al, 2002).

Student impressions of the social atmosphere in online learning were mixed. Some students noted increased social interaction while others felt that interaction was lacking (Ali et al, 2004). Online learning promoted communication among students from diverse geographical areas and less timid students indicated that they were able to participate more in the online environment (Ali et al, 2004; Ryan et al, 2005; Leners & Sizman, 2006).

Studies assessing student perceptions of their relationships with faculty produced varied responses across studies. Some students expressed appreciation for anonymity in their relationship with instructors (Ali et al, 2004). Meanwhile, other students indicated that they felt that less connection with faculty was a drawback to learning online (Ali et al, 2004; Leners & Sitzman, 2006).

Teaching by a Distance

Teaching is different by distance online than in a classroom. Online courses “may diminish or eliminate teachers’ customary ways of knowing and connecting with students in traditional face-to-face environments” (Diekelmann & Mendias, 2005, p. 393). Online instructors must relinquish control over the teaching/learning process (Rounds & Rappaport, 2008). In doing so, they move from the authority figure role towards more of a facilitator role (Johnson, 2008). Online distance learning, “moves the teacher into a mediating role, coaching and encouraging learners and helping them construct knowledge in an active and personal way” (Shovein et. al., 2005, p. 342).

Faculty members face challenges when adapting to new course delivery technologies such as online learning software (Ryan et al, 2005). Additionally, new online educators often lack familiarity with “pedagogy of online teaching and learning” (Johnson, 2008). The effective online educator asks questions more and delivers material less (Johnson, 2008). Faculty respondents in Johnson (2008) indicated that they found the lack of visual cues (facial expressions) from students to be a new challenge associated with the online teaching environment. Even experienced educators transitioning from onsite to online teaching can move from expert to novice and faculty challenges of this nature can impact student experiences and outcomes (Johnson, 2008).

Professors’ participation in the online classroom is highly valued by students (Ledwell et. al., 2002). Faculty support and direction are essential to a positive student experience (Ledwell et. al, 2002). The content of professor responses is important (Leners & Sitzman, 2006). Respondents in Leners & Sitzman (2006) indicated that professor affirmation and encouragement were essential and that the choice of words and punctuation in online feedback could make a difference in the student learning experience.

Students in two studies indicated the need for enhanced access to faculty and technical support and emphasized the importance of timely responses to inquiries (Ali et al, 2004; Leners & Sitzman, 2006). Faculty respondents in Ryan et al. (2005) also identified that delayed responses were a detractor to student learning in the online teaching environment (73%). Online learners expressed frustration with the length of time required to get technical assistance. As a result, some students dropped out of courses (Elfrink & Harding, 2008)

A study of American graduate nursing students taking online educational modules revealed that students found online delivery to be innovative, time saving, convenient and economical. Learners did not miss the face-to-face interaction and felt that they learned more. They indicated that they enjoyed the online format and would prefer to have subsequent courses designed and delivered online (Huckstadt & Hayes, 2005). Nurse practitioners who complete their training using online distance learning develop transferable skill sets applicable to future learning and the clinical practice setting (Andrusyszyn et al, 1999).

A 1999 evaluation of the Ontario Primary Care Nurse Practitioner program pointed out that the use of technology was a challenge and the availability of technical support was a barrier to student success (Andrusyszyn et al, 1999). Some learners found adaptation to online course delivery to be burdensome and tended to prefer traditional learning methods. Nonetheless, comfort with all course delivery strategies (including computer conferencing) increased for all survey participants as the program progressed.

Limited work has been published in evaluation of online and traditional instruction. Mills (2007) evaluated online and onsite Masters and Post-Masters nursing programs through a summative evaluation process in order to determine future program directions and faculty decision making. While the institution offers a nurse practitioner program, NP outcomes were mixed within the sample. Seventeen courses were analyzed and 12 of those demonstrated no difference in final course grades between online and onsite courses. The online programs had higher retention rates but took considerably longer for students to complete. The on-site courses had higher evaluation scores than corresponding online courses (Mills, 2007).

An evaluation of online versus traditional classroom delivery of two womens’ health nurse practitioner courses included assessment of both the courses themselves and of learning and achievement among students in the courses. The mean score for the web based course was higher than the lecture format course and student grades for the two modalities were similar. The students did not express a distinct preference for either learning method, but students did identify that the web based delivery mode led to better preparation and material review on a weekly basis (Stiffler, 2008).

Adult Learners

Nurse practitioner students have work experience and tend to be older than their undergraduate counterparts. These students may be familiar with the Internet, but the nature of their Internet use and their familiarity with online formal education is a question mark. A British survey noted that “… adults’ use of computers and the Internet, education and learning are minority activities, most commonly taking the form of informal learning at home” (Selwyn, Gorard & Furlong, 2004, p. 269) A well-designed NP distance education course would strive for congruency between the characteristics of the adult learner, including autonomous, self-directed, goal-oriented, relevancy-oriented and practical, and the characteristics of the successful distance learner, including independent, self-disciplined, adaptable to new learning environments, highly motivated active learners with excellent organizational skills (Rounds & Rappaport, 2008). Key factors include the previous Internet experience of the nurse practitioner students, comfort with the teaching style and availability of the tutor as well as the technological and time demands of the online program.

Summary

Questions arise as to the effectiveness of online versus onsite instruction in NP education programs. In addition, NP student satisfaction with online learning also remains relatively unknown. The literature review indicates that factors related to student perceived barriers to online learning include comfort and confidence with online learning technologies, availability of technology support, skill in online instruction of the tutor and motivation, time and support for studies (Muilenburg & Zane, 2005). An assessment of these factors in the context of NP education in one Canadian program will be done using a survey designed for this purpose. Grade achievement among the online and onsite seminar groups will also be compared. The resulting data will create a snapshot of the NP student experience and outcomes with online education that will provide a framework for further inquiry.

Method

Survey, Subjects and Data Collection Procedures

The Survey of Student Barriers to eLearning was utilized in this study(Muilenburg & Zane, 2005). The survey consists of three parts. The first section includes eleven questions about demographic data, the mode of delivery of seminars of the respondent for the NP course as well as general opinions of the respondent to online/Internet learning. The second section is comprised of 47 Likert-scale questions. There are five possible responses ranging from “no barrier” to “very strong barrier’. These questions are separated into four categories which are relevant to online learning including Technical, Social, Infrastructure/Support Services and Time/Interruptions. The final question is open-ended and allows respondents to make comments. The survey was preceded by three questions which positioned the respondent in online vs. onsite seminars.

All students who were registered in the targeted NP course were sent an invitation via the NP education program email address after the final exam. The email message asked students to complete the survey focusing on barriers to online learning. The email message contained a direct link to an Internet survey site called Surveymonkey (2009) which was used to administer the questionnaire and collect responses. The course ran from September to December 2008. This same group was sent a separate email invitation asking them to consent to release of their grade for the course so that academic achievement of those receiving seminars online and on site could be compared.

Data Analysis

SPSS (2009) was used to analyze responses. Demographic data and questions about general opinions toward Internet learning were analysed using descriptive and frequency techniques. The Likert-scale questions were analysed using a comparison of the means and barriers were listed from most to least severe. The Likert-scale responses were re-coded whereby the two responses of no barrier and weak barrier were grouped and moderate, strong and very strong barrier created a second group. Chi square analysis was then used to compare onsite and online student responses within the two newly coded groups. A separate analysis of the grades was completed to identify any significant difference in outcomes based on delivery method of the course (traditional classroom versus web based delivery).

Results

The survey was sent to 138 students. A total of 82 students participated in the online survey representing a response of 59%. Survey participation produced a medium effect size with α = 0.05 and a power of 0.88.

The minimum age was 26, the maximum age was 56 and mean age was 37.7 years. Six out of 82 respondents were male. Only 8.8% of respondents had never taken an online course prior to the NP course evaluated in the study. Of the respondents (n = 82), 23 (28.4%) received seminars online while 58 (71.6%) of the students received seminars in a traditional classroom setting (onsite).

When asked about their comfort levels with online learning and use of Internet, 80.4% (66, n = 80) of the respondents indicated that they have learned or are learning online and feel comfortable and confident when doing so. In contrast, 63.3% (50, n = 79) of the respondents indicated that they could not learn as well online as in a classroom setting with other learners and an instructor and 24% (19) didn’t see much difference in their online vs. onsite learning. In addition, 56.3% (45, n = 80) of respondents indicated that they “enjoyed the online learning experience significantly less” and of the five who had not taken online courses, two predicted they would enjoy it significantly less than learning in a classroom setting.

The scale for the Likert questions in the survey included the following: 1 = no barrier, 2 = weak barrier, 3 = moderate barrier, 4 = strong barrier, 5 = very strong barrier. The mean scores of each question were calculated and compared. The mean scores ranged from 1.22 to 2.83. None of the means were above 3.0 indicating that the majority of responses were no barrier or weak barrier.

Table 1. Range of Means for All Students in Survey Sections

Table 2.  Individual Questions with Highest Mean Score or Widest Range of Responses 

Survey responses of onsite and online seminar students were compared to assess for differences. In order to specifically determine whether there was a significant difference between the online and onsite students who were experiencing difficulties the Likert-scale responses were re-coded in SPSS whereby the two responses of no barrier and weak barrier created one group and moderate, strong and very strong barrier created a second group. The recoding ensured that the students who indicated the strongest barriers would be directly compared. Chi square analysis was used to compare the proportion of onsite and online student responses within the two newly coded groups. These groupings allowed for a comparison of online and onsite students who experienced the highest level of barriers to online learning. The results (p values reported as Fisher’s Exact Test, one-sided) demonstrate a significant difference in the onsite and online groups for only three survey questions “I lack a reliable Internet connection, high speed connectivity, or an Internet service” p = 0.05, “I am unfamiliar with the technical tools needed in e-learning” p = 0.045 and “I am concerned about or have found a lack of technical assistance” p = 0.021.

Course grades for the onsite and online seminar groups were also compared. Sixty-nine of a possible 138 students gave consent for use of their marks in this study. The ranges among the groups were statistically similar.

Table 3. Comparison of Marks for Students with Onsite vs, Online Seminars

Discussion

The survey results reveal very few significant differences between the experiences of the NP students with online and onsite seminars. Interestingly, both groups identified similar barriers and concerns with respect to the process of online learning in general and these findings are congruent with those of previous studies.

The survey results revealed relatively few student identified barriers related to the technical aspects of online learning (skills, support, etc.). However, a larger proportion of students receiving seminars online identified a reliable Internet connection, familiarity with technical tools and technical support as moderate to very strong barriers to their learning. This result is not surprising given that earlier findings emphasized the importance of technologic competence and enhanced accessibility to technical support for student achievement (Kenny, 2002; Ali et al, 2004; Ryan et al, 2005; Lerners & Sitzman, 2006; and Elfrink & Harding, 2008). The overall comfort with the technology could be a reflection of rapid changes in the availability and use of Internet technology in our society. In fact, the majority of students in this survey reported they had taken at least one online course and indicated that they use the Internet regularly.

A small number of students, particularly those receiving online seminars, indicated that it posed significant barriers to their learning. Kenny (2002) reported that undergraduate nursing students with limited computer experience had feelings of anxiety, fear, apprehension and dread at the beginning of a computer course and this lack of computer experience had a negative impact on their learning. NP students with limited computer and technology experience would be expected to experience similar feelings and setbacks. In an earlier study, graduates of the Canadian NP program being evaluated here indicated that orientation to the relevant technologies prior to commencement of coursework could have alleviated frustrations (Andrusyszyn et al., 1999). Early intervention and support for online learning are essential in order to encourage lifelong education. As stated by Sweeney, Saarmann, Flagg and Seidman (2008),“continuing education programs must be sure there are no technological problems because nurses who encounter difficulties are unlikely to give the system a second chance” (p. 40).

While the less technologically skilled students are the minority, their success should continue to be encouraged through early identification of computer skills deficits and the provision of adequate training. Strong, accessible and ongoing technologic support is also necessary. These strategies are particularly important for those receiving online seminars that may be further disadvantaged by distance and availability of adequate Internet resources.

The survey responses from both the online and onsite groups were similar. These results suggest that the mode of seminar delivery may not be as important to student learning as is the overall quality of the Internet/online course components common to all the NP students. The majority of all the NP students indicated that they could not learn as well online as they could in a traditional classroom setting, yet the grades for the online and on site seminar groups were similar, indicating that neither method of seminar delivery was superior in terms of student academic achievement. Nonetheless, grades are only one measure of learning and the students may feel that they cannot learn as well online as in a traditional classroom setting for a variety of reasons.

It should be noted that in contrast to traditional face to face learning, online education uses adult learning theories and “view the educator as a facilitator of learning and an assessor of outcomes. The change to this technology requires a shift in the focus of a course from the educator to the subject” (Magnussen, 2008, p. 82). Using this theory, the student is largely responsible for their achievement in coursework. Furthermore, as online education is still a relatively new approach to nursing education, it must be recognized that educators will “possess varying levels of expertise and knowledge of evidence-based andragogy for online courses”(Little, 2009). It could be argued that with time, faculty expertise and skills with online education will increase, and lead to a corresponding increase in student satisfaction.

Two online learning barriers identified by survey respondents were communication and isolation. Many respondents found online learning to be impersonal. They expressed concern about lack of visual cues from students and the instructor online and noted decreased collaboration with other students. When asked about impediments to learning online, some students identified decreased instructor contact and delays in receiving instructor feedback and responses. These findings were similar to those of earlier studies focused on undergraduate nursing students engaged in online learning (Ledwell et. al., 2002; Ali et al, 2004; Learners & Sitzman, 2006 and Johnson, 2008).

Strategies to address the feelings of isolation and the concern with communication are important. Communication requirements and response timelines (faculty and student) need to be specified in order to adequately meet learners’ needs in the online environment (Ryan et al, 2005). Expectations for communication frequency should be clarified by the course professor and tutor at the outset of the course (Ali et al, 2004). Course orientation should include details about when e-mail and telephone messages will be screened and answered, as well as an estimated timeframe for the return of marked assignments. Tutors should be required to visit the online classroom daily and to respond to student queries within a specific timeframe. Videoconferencing, online networking and occasional onsite sessions could be incorporated into the course schedule to enhance the social aspects of students’ learning experiences.

Limitations and Recommendations for Future Research

Certain limitations should be considered when interpreting the findings presented. The sample included NP students in one Canadian province and only students one course of the five course NP program were evaluated. The seminar delivery method (online versus on site) was determined by each university site so that students did not have the choice to receive seminar sessions in their preferred format. While the study evaluated perceived barriers to online learning and grade achievement among online and onsite seminar students, both groups used the Internet for other course components including messaging, news and other postings. Therefore neither group learned on site or online exclusively. The study might have attracted students frustrated by barriers, while deterring more satisfied students from participating. At the same time, students who were experiencing difficulty with online learning may not have completed the survey because it was offered in an Internet based format.

Future research may address these limitations through the replication of this survey in other NP courses and education programs. If changes are made to improve the student’s experience in this NP course a follow up survey would be beneficial to determine if the changes were successful in addressing the identified barriers to online learning. The delivery of the survey in paper format may capture those students who experience the most significant barriers to online learning. Further comparison of cohorts may confirm significant differences in perceived barriers and online learning between those with very little and those with extensive online education experience. Finally, the impact of the skill level of the seminar instructor on the student experience and grades needs to be explored.

Conclusions

It is important for Canadian NP programs to offer Internet courses. E-learning technology has enhanced access to NP education in Canada, especially to those living outside of urban centres. Online courses provide opportunities for nurses to achieve NP education regardless of where they live and what employment, family and community responsibilities they have. There is potential for an increase in primary health care nurse practitioners in rural, remote and underserviced areas to make a real difference to health care in Canada. NPs who learn at home build relationships and capacity for future health service delivery in their communities. In addition, delivering education across a wide area using Internet technology decreases the impact of a qualified faculty shortage. For these reasons, efforts should be made to continually assess outcomes and improve methods of online delivery for NP education.

There are ongoing demands on the nurse practitioner profession to move entry to practice to higher graduate levels in Canada and terminal practice degrees in the USA. This further supports the need to explore and improve alternate methods of education delivery that facilitate learning opportunities for students from a wide geographical area who may not otherwise have the opportunity to complete the educational requirements for an NP degree.

Results from this study demonstrate areas for improvement and point to issues that require further research. Survey respondents wanted enhanced access to knowledgeable instructors and increased social interaction. These included specific timeframes for communication and feedback, and faculty and tutor training specific to online pedagogy. Once implemented, an evaluation of the impact of these initiatives, on both students and faculty members, should be undertaken.

References

Andrusyszyn, M., Van Soeren, M., Laschinger, H., Goldberg, D., & DiCenso, A. (1999). Evaluation of distance education delivery methods for a primary care nurse practitioner program. The Journal of Distance Education, 14(1), 14-33.

Diekelmann, N., & Mendias, E. (2005). Being a supportive presence in online courses: Attending to students’ online presence with each other. Journal of Nursing Education, 44(9), 393-395.

Elfrink, V. & Harding, T. (2008). Delivering online nursing education across the international dateline. Computer Informatics Nursing, 26(5), 249-254.

Huckstadt, A. & Hayes, K. (2005). Evaluation of interactive online courses for advanced practice nurses. Journal of the American Academy of Nurse Practitioners, 17(3), 85-89.

Johnson, A. (2008). A nursing faculty’s transition to teaching online. Nursing Education Perspectives, 29(1), 17-21.

Kenny, A. (2002). Online learning: enhancing nurse education? Journal of Advanced Nursing, 38(2), 127-35.

Ledwell, E., Andrusyszyn, M. & Iwasiw, C. (2006). Nursing students’ empowerment in distance education: testing Kanter’s theory. Journal of Distance Education, 21(2), 78-95.

Leners, D. & Sitzman, K. (2006). Graduate student perceptions: Feeling the passion of caring online. Nursing Education Perspectives, 27(6).

Little, B. (2009). Quality Assurance for Online Nursing Courses. Journal of Nursing Education, 48(7), 381-388.

McKeown, L., & Underhill, C. (2008). Learning online. Factors associated with use of the internet for education purposes. Education matters: Insights on education, learning and training in Canada. Retrieved May 22, 2008 from: http://www.statcan.ca/english/freepub/81-004-XIE/2007004/internet-en.htm

Magnussen, L. (2008). Applying the Principles of Significant Learning in the e-Learning Environment. Journal of Nursing Education, 47(2), 82-87.

Mills, A. (2007). Evaluation of online and on-site options for masters degree and post-masters certificate programs. Nurse Educator, 32(2), 73-77.

Muilenburg, L.Y., & Berge, Z. L. (2005). Student barriers to online learning: A factor analytic study. Distance Education, 26(1), 29-48.

Rounds, L., & Rappaport, B. (2008). The successful use of problem-based learning in an online nurse practitioner course. Nursing Education Perspectives, 29(1), 12-18.

Ryan, M., Hodson-Carlton, K., & Ali, N. (2005). A model for faculty teaching online: Confirmation of a dimensional matrix. Journal of Nursing Education, 44(8), 357-365.

Selwyn, N., Gorard, S., & Furlong, J. (2004). Adults’ use of ICTs for learning: reducing or increasing educational inequalities? Journal of Vocational Education & Training, 56(2), 269-290.

Shovein, J., Huston, C., Fox, S., & Damazo, B. (2005). Challenging traditional teaching and learning paradigms: Online learning and emancipatory teaching. Nursing Education Perspectives, 26(6), 340-343.

SPSS Inc. (2009). SPSS student version 17.0. United States of America: Prentice-Hall, Inc.

Stiffler, D. (2008). A comparison of web-enhanced versus traditional classroom teaching in womens’ health nurse practitioner education. Topics in Advanced Practice Nursing, 8(3).

Sweeney, N., Saarmann, L., Flagg, J., & Seidman, R. (2008). The Keys to Successful Online Continuing Education Programs for Nurses. The Journal of Continuing Education in Nursing, 39(1), 34-42.

Surveymonkey.com (2009). Retrieved June 2, 2009 from: http://www.surveymonkey.com

Wu, T., & Chao, H. (2008). Mobile e-Learning for Next Generation Communication Environment. International Journal of Distance Education Technologies, 6(4), 1-13.

Roberta Heale is an Assistant Professor, Laurentian University School of Nursing. E-mail: rheale@laurentian.ca

Robyn Gorham is a Lecturer, Laurentian University School of Nursing Primary Health Care Nurse Practitioner. E-mail: rgorham@laurentian.ca

Jennifer Fournier is a Primary Health Care Nurse Practitioner/Nurse Legal Consultant. E-mail: jlynn.fournier@personainternet.ca