STRATEGIES TO ENHANCE THE USAGE OF

,.

STRATEGIES TO ENHANCE THE USAGE

OF AN e-LEARNING SYSTEM FOR

NURSES' PROFESSIONAL DEVELOPMENT

Abel Jacobus Pienaar

(B.Cur.; Post Graduate Diploma in Health Sciences Education & Health Service Management; MA; PhD)

A dissertation submitted in fulfilment of the requirements for the degree MAGISTER EDUCATIONIS

in

Teaching and Learning

at

NORTH-WEST UNIVERSITY

(VAAL TRIANGLE FACULTY)

Supervisor:

Dr. E. Strydom

July 2010 AkacJerni8Se i·\clrnfnistrasie PosiJus Box ·J i 7 Ll. VAf\IDI::f':BIJLPi-\RK ___________ 19_00 ________ ~

DEDICATION

I dedicate this research to my late father, Gert Pienaar, who taught me since childhood that 'if you can read you cannot get lost'. In his own way confirming that 'knowledge is power.'

"You cannot teach an old dog new

t . k

r1c s ...

"

\

I

'

'

" ••• unless

you

facilitate

learning

respectfully, involving and motivating the

learner in a climate conducive to teaching

and learning"

(Adjusted from Gravett, 2006:44)

Acknowledgements

I would like to thank the following people who contributed to my personal, professional and Spiritual growth during the process of this research:

God and my Ancestors who guided me through this process.

Dr. Esmarie Strydom, my research supervisor, for her educational expertise and eloquence in guiding me meticulously through this process.

My mother who still assists and guides me lovingly.

My beloved primary family, namely my wife Pettula, children Abigail, X'odas and Quincy for their support in being an inseparable part of my life.

The editor who powdered the nose of my language usage.

Koetlisi Koetlisi for, assistance with data-collection and analysis, meticulous proof-reading and the final outlay of this work.

My dear friends-and-brothers (the boys) for their unconditional support and

trust that never ceased or declined from beginning to end.

My nephew, Jason and my sisters-in-law, Hilda and Madge, for their most welcome support throughout this process.

My colleagues and very close friends Corrie, Daleen and Kharirunnisa for their

advice and assistance.

Mindset Network (Mindset Health) and the nurses who took part in this

research; I gained more respect for your efforts!

Summary

The potential of e-learning to deliver innovative approaches in nursing

education is accepted globally. Currently this acceptance is fuelled in South

Africa by the publication of the White Paper on e-Education by the

Department of Education in order to ratify e-Learning. Except for the pressure

from the Department of Education, nurses are coerced to use e-Learning due to the severe shortage of nurses in clinical practice, the need for further education as well as the facilitation of professional development. The National Department of Health identified e-Learning as a method to bridge the current challenge in professional development. E-learning may be viewed as an ideal

method to facilitate learning innovatively, not only in the general education,

but also nursing education and professional development. In response to the

quest for professional development for nurses in the public hospital context,

Mindset Health, that is part of Mindset Network, developed an e-Learning

system for nurses' professional development.

Contrary to expectations, nurses are not utilising this e-Learning system in the

public hospitals. A question therefore arose: Why are nurses not using the Mindset Health e-Learning system effectively for their professional development in a public hospital setting? This research aimed to enhance the

usage of the Mindset Health e-Learning system for nurses' professional

development in a public hospital setting.

In this research a single qualitative case study was deployed. This case

included a public hospital setting, where the Mindset Health e-Learning

system had been installed to facilitate professional development for nurses.

Data were collected through multiple qualitative methods. A qualitative methodology was used to establish why the Mindset e-Learning system was

not effectively utilised by the nurses. The same methodology was applied to

determine in which ways the utilisation, through an Appreciative Inquiry

strategy of the Mindset Health e-Learning system, could enhance nurses' professional development in future.

The findings of this research mainly suggested that the inadequate training and motivation of the nurses working in the in-service training department,

regarding the Mindset Health e-Learning system during implementation, had

led to the lack of use of the Mindset Health e-Learning system in this hospital.

In conclusion the researcher exhibited the recommendations of this research

in the form of strategies conceptualised in a framework.

Opsomming

Die potensiaal vir e-Leer om nuwe benaderings in verpleegonderwys te lewer word reeds wereldwyd aanvaar. Huidiglik word die aanvaarding van e-Leer verder versterk deur die Departement van Onderwys in Suid-Afrika se misie om e-Leer deur middel van die Witskrif te bevorder. Behalwe die druk vanaf die Departement van Onderwys, is verpleegkundiges self gedruk om e-Leer te gebruik as gevolg van 'n tekort aan verpleegpersoneel in die kliniese praktyk, die behoefte om verder te studeer asook die fasilitering van professionele ontwikkeling. Selfs die departement van Gesondheid stel e-Leer voor om die huidige uitdagings te oorbrug. e-Leer kan as 'n ideale metode beskou word om leer te fasiliteer in algemene-, sowel as verpleegonderrig en professionele ontwikkeling. Mindset Health (deel van Mindset Network) het vervolgens 'n e-Leersisteem ontwikkel om die uitdagings in die professionele ontwikkeling van verleegpersoneel in die publieke hospitale te oorbrug.

Ten spyte van positiewe verwagtinge in die gebruik van die e-Leersisteem het

die teendeel gebeur, naamlik dat die e-Leersisteem nie deur

verpleegpersoneel in die publieke hospitale gebruik word nie. Die vraag het dus onstaan: Hoekom gebruik die verpleegpersoneel nie die Mindset Health e-Leersisteem effektief in 'n publieke hospitaal nie nie? Hierdie navorsing het dus ten doel om die gebruik van die Mindset Health e-Leersisteem te bevorder vir die professionele ontwikkeling van verpleegpersoneel in 'n publieke hospitaal.

In hierdie navorsing is 'n enkel, kwalitatiewe gevallestudie gebruik. Die gevallestudie het 'n publieke hospitaal, waar die Mindset Health

e-Leersisteem ge·installeer is om professionele ontwikkeling vir

verpleegpersoneel te bevorder ingesluit. Multi-kwalitatiewe metodes is gebruik om data in te samel. 'n Kwalitatiwe metode is gebruik om vas te stel hoekom

verpleegkundiges nie die Mindset Health e-Leersisteem gebruik nie.

Dieselfde metode is vir 'n 'Waarderingsondersoek-strategie' aangewend om die gebruik van die Mindset Health e-Leersisteem te bevorder.

Die bevindinge dui hoofsaaklik daarop dat die verpleegkundiges werksaam in die indiensopleidingsdepartment van die hospitaal onvoldoende opleiding en motivering ontvang het gedurende die implementeringsfase van die Mindset Health e-Leersisteem. Die onvoldoende opleiding het daartoe gelei dat die sisteem nie in die betrokke publieke hospitaal gebruik word nie. Ter afsluiting vervat die navorser die aanbevole strategiee van hierdie navorsing in 'n konsepsuele raamwerk saam.

List of Figures and Appendices

List of figures

Figure 2.1: Map of the theories relating to e-Learning 12

Figure 2.2: Map for the integration of e-Learning 22

Figure 2.3: Salmon's five stage model fore-Learning 24

Figure 2.4: Demand-driven model 26

Figure 2.5: Garrison and Anderson's community of inquiry model 28

Figure 2.6: Creative evaluation of the three models 29

Figure 3.1: Map for professional development 39

Figure 3.2: Video delivery model 51

Figure 3.3: DataCast configuration 52

Figure 3.4: Video stream model 53

Figure 5.1: Conceptual framework of strategies to enhance the use of the

Mindset Health e-Learning system in nurses' professional development

Appendix One: Appendix Two:

List of Appendices Written consent letter

Brief exhibit of transcript

99

115 117

Table of Content

Dedication ii

Acknowledgements iv

Summary v

Opsomming vii

List of figures and Appendices ix

Chapter One: Introduction, Problem Statement and Clarification of the Conce~t of e-Learning

1.1 Introduction

1.2 Problem statement

1.3 Aim and objectives of this research 1.4 Central theoretical argument

1.5 Clarification of the concept of e-Learning 1.6 Significance of this research

1.7 Proposed research methodology 1.8 Division of chapters

1.9 Summary

Cha~ter Two: Theories and Application of e-Learning

2.1 Introduction 2.2 Theories of e-Learning 2.2.1 2.2.2 2.2.3 2.2.4 2.3 2.3.1 2.3.2 Behaviourism Cognitivism Humanism Social constructivism Integration of e-Learning

Information and communication technology systems Models of e-Learning 1 1 3 5 5 6 8 9 9 10 11 12 12 15 17 19 22 22 23 X

2.4

Strategies of e-Learning

₃₀

2.4.1

Planning for an e-Learning strategy

₃₂

2.4.2

Prerequisites to embark on an e-Learning strategy

₃₄

2.4.3

Interdisciplinary team involved in the development of an

e-Learning strategy

₃₅

2.4.4

Communication approaches for an e-Learning strategy

35

2.4.5

Impeding factors in e-Learning

₃₆

2.4

.

6

Facilitative factors in e-Learning

₃₇

2.5

Summary

₃₈

Chapter Three: Professional Development in Nursing

3.1

Introduction

₃₉

3.2

The concept of professional development

₄₀

3.3

Significance and purpose of professional development for

nurses

₄₁

3.4

Strategies for professional development

₄₃

3.4.1

Conferences, simposia and seminars

₄₃

3.4.2

Workshops

₄₄

3.4.3

Home study or self-directed learning projects

₄₄

3.4.4

Teleconferences

₄₄

3.4.5

Clinical practica

₄₄

3.5

Models of professional development

₄₄

3.5.

1

Health Professional Council of South Africa

45

3.5.2

Pharmacy Council

₄₆

3.5.3

International model for nurses' professional development

₄₇

3.6

e-Learning and the professional development of nurses

₄₈

3.6.1

Legislation

₄₉

3.6.2

Shortage of nurses

₄₉

3.7

The Mindset Health e-Learning system for nurses'

professional development

₅₀

3.7.1 Technology description

₅₀

3.7.2

Planned usage of the Mindset Health e-Learning system

for professional development

₅₃

3.7.3

Theoretical underpinnings of the Mindset Health

e-Learning system

₅₄

3.

7.4

Comparative discussion of the e-Learning models

₅₆

3

.

8

reviewed in this research Summary

Chapter Four: Empirical Research, Analysis and Interpretation of Data

4.1

Introduction

4.2

Research methodology

4.2.1

Research design

4.2.2

The research site

4.2.3

Study population

4.2.4

Sampling

4.4

Data collection

4.4.1

Phase one

4.4.2

Phase two

4.4.3

Realisation of data collection

4.5

Data analysis of phases one and two

4.6

Literature control

4.7

Rig our of the research

4.8

Ethical aspects

4.8.1

Ethical considerations

4

.

9

Discussion of data analysis and findings of this research

4.9.1

Findings from the participants responsible for in-service training

4.9.1.1

Phase one

4.9.1.2

Phase two

4.9.2

Findings from the participants working in the clinical departments

4.9.2.1

Phase one

4

.

9.2

.

2

Phase two

4.9.3

Triangulation of the in-depth interviews with the focus group discussions

4.10

Summary

57

58

59

59

60

61

61

62

63

64

68

69

71

71

73

73

74

74

74

80

83

83

89

93

95

xii

Chapter Five: Summary, Recommendations and Conclusion

5.1 Summary of chapters 96

5.2 5.2.1

5.3

Recommendations of this research

Strategies to enhance the use of an e-Learning system for nurses' professional development

Conclusion Bi bl iog raphy 97

1

00

104

106

Xlll