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I really appreciate the support from my friends and family for my decision in August 2010 to begin the doctoral journey. Having completed 70% of the coursework, it was time to attend the third (and final) residency in Atlanta this past week.
I have been an Internet advocate for almost twenty years. My basic tenet has been that the Internet provides “power to the people” and one of the many areas in which this is true is education. Whether you call it computer assisted instruction, e-learning, or distance learning, the concept is the same—to enable people anywhere in the world to learn what they want to learn, when they want to learn it, and use whatever device they want to learn it on. While evangelizing the power of the on-line environment, I also embrace the validity and need for meeting in person. There is no substitute for what occurred in DOC/731R – Collaborative Case Study and DOC/732R – Doctoral Seminar this past week in Atlanta. Webcams and various forms of virtual reality can enhance an on-line experience, but no virtual capability can replicate the emotion behind the stories shared by learners in the class. I learned a lot about diversity, teams, dissertations, the Scholar-Practitioner-Leader model, doctoral degrees, and information technology.
Appreciation for diversity
I worked at IBM Corporation for 38 years and am proud that the company took diversity very seriously in thought, word, and deed. I have also been active in various non-profit organizations such as the Opportunities Industrialization Corporation and Habitat for Humanity, both of which feature diversity as a model. The University of Phoenix has brought my awareness and appreciation of diversity to a new level. Diversity is not simply black and white or male and female. Diversity includes cultural background, work experience, education, family, upbringing, experiences, and philosophy, to name a few areas that I observed in the classroom. I was particularly impressed with the drive to achieve exhibited by learners who at the same time have childcare, eldercare, and job responsibilities. It was also impressive to hear of the goals the learners expressed. Nearly all of them contained an altruistic element that motivates them. The diverse backgrounds provide diverse perspectives and these in turn provide a broader and deeper insight into the subject matters being learned. I feel fortunate to have learned a lot in my life, but relative to the breadth and depth of my fellow learners, I humbly realize that I have a lot to learn.
Value of Team
I must confess that I was skeptical about the team assignments in the first couple of classes. The on-line tools are not as advanced as they could be and some learners are not adept at using them. On the surface, the team assignments looked like they would take more time, but not produce better results. For team assignments this past week, that was definitely not the case. In part because it was in person and in part due to the strength of my team members, I feel this was one of the best team experiences I have had in many years. Even in areas where I have considerably more experience than my team members, they found oversights in some of my thinking and added some thinking of their own that enhanced what I was thinking. The bottom line is that although there may have been a small premium in the time spent, the collaborative efforts of the team produced higher quality and more scholarly presentations than I could have produced on my own. The problems that teams were assigned to research, develop a solution, and make a presentation were challenging to say the least.  The portfolio of problems we worked on included global warming, organizational development and innovation, global water shortage, and genocide — just to name a few.  
Dissertation Planning
The final three days of the 8-day residency focused on the dissertation — the largest challenge standing between the doctoral learners and graduation.  The goal that every learner shares is to successfully complete a doctoral dissertation. The checklist and blueprint are helpful, but what was really helpful was to hear the first hand experiences of Dr. Bronsard and Dr. Amankwaa, our faculty for the classes. Dr. Amankwaa met with each of the 15 learners individually multiple times to coach us and assist us with our dissertation proposals. Each of us made short presentations about our research questions, the problem we are hoping to solve, and the research design we intend to use.  The other 14 learners made helpful suggestions. Some say that at least half of doctoral learners never complete their dissertation because of the incredible detail required to get a topic developed and approved for research. A typical dissertation is 200-300 pages in length. Some consider the process more than challenging – a friend of mine told me he had an ABD degree – all but dissertation. A visit to Amazon and you can find a lot of books on how to “survive” a dissertation. I still remember the meeting with the academic review committee when I had to defend my masters thesis forty years ago. It seemed challenging at the time, but I can now see that it was nothing compared to what lies ahead for the doctoral dissertation.

I arrived at the residency with a 140 page dissertation proposal with more than 140 references I included from my literature review (that is what I did for the summer).  The study I am planning relates to the cost of care and quality of life due to hospital readmissions because of congestive heart failure (CHF). My mother passed away from CHF a few years ago and I learned a lot about the disease and the attendant continuum of care during her final months. As a member of the board at Western Connecticut Health Network, I can also see the impact from a hospital point of view. CHF is the leading cause of hospitalizations and readmissions for the elderly, and accounts for a large share of developed countries’ healthcare expenditures. Although CHF is a condition for which hospitalization is often avoidable, nearly 20% of Medicare patients discharged from hospitals are readmitted within 30 days at a cost to Medicare of $15 billion annually. The problem is that the frequent readmission of CHF patients to the hospital has a negative impact on the patient and the hospital. For the patient, it results in a reduced quality of life and a negative impact to their psychosocial and financial condition. For the hospital, it means using extra capacity for care while facing the risk of not receiving reimbursement for the associated cost. The purpose of my proposed quantitative research study will be to answer the question of whether home-based telemonitoring can provide an early warning of an impeding episode and allow for an intervention that can reduce hospital readmissions. As a result of the residency, I am now reframing and repositioning the research study to make sure there is no confusion between what the clinical team at the hospital will be doing and what I will be doing. My dissertation will describe the observational research design that I am planning. The hospital will perform the study and collect the data. I will be using anonymized archival data with no personally identifiable healthcare information to perform an analysis of the impact of the telemonitoring. 

I will have a further report on the proposal before the end of the year. In the meantime, I will be continuing with more course work. I have completed 18 courses and there are four more 8-week courses to go — plus the dissertation. Since the program began two years ago, I have written 68 papers. A couple of dozen or so to come and then the big one! If everything goes according to plan, the doctoral journey should be completed by the end of September — just 11 months from now.
Deeper insight to the SPL model
At first I did not see a deep or special relationship between scholar, practitioner, and leader. After each class, I see the relationship more clearly, and I am confident that my insight on the subject will continue to improve. The SPL model provides a clear example of how scholarship and practicing work together. The problem interventions the teams developed were supported by scholarly work. That provided two legs to the stool. No stool can stand on two legs, and it is leadership that makes the stool stable and useful. It is leadership that allows the practitioner to take the intervention to the next situation and apply the model they have developed to solve a problem or to inspire others to solve a problem.
The Role of the Degree
Both instructors gave the class excellent insight about the role of the degree. They shared their personal experiences and provided useful guidelines for how to leverage the knowledge gained while avoiding the appearance or reality of arrogance. I was also impressed with the advice to think of the doctorate as a way to help others, whether it is solving a problem or helping someone to learn. In the long term it is the network of doctoral learners–and later doctors—that will provide leverage to all the members of the network.
Information Technology Tips
Information technology plays a key role in e-learning; without IT there would be no learning. All the learners are busy people and, although IT can be a productivity booster, it can also be a productivity detractor if systems and procedures do not work efficiently and effectively. I have many tools that I find helpful and I make it a point to share what I have learned with others. In this residency, I helped my team use Google Drive as a technique to collaborate in the cloud instead of by forwarding attachments (anybody know who has the latest version of the presentation?).  I continue to find Evernote a useful tool as a companion to the online environment.  I save notes, ideas, web pages, etc. in the Evernote notebooks. They sync to both the iPhone and the iPad for easy access. 
Supplementing the e-learning program with periodic residencies provides an excellent way to enhance the learning process, leverage the learning, and extend the network of fellow learners and faculty. I gained increased respect for the value of diversity and the power of teams. I increased my knowledge of the scholar, practitioner, and leader model and how it works, and learned about the pathway to my dissertation and the role of the doctorate. I shared a few IT techniques that I hope increases productivity for others. The instructors were wise, selfless, and caring. They shared personal perspectives that I will remember. The third year residency was an important milestone and I feel that it has added clarity and momentum to help me achieve my goals.