The Effectiveness of Web-enhanced Self- directed Learning in Promoting Information Literacy of Nursing Students in Taiwan

Transcription

1 The Effectiveness of Web-enhanced Self- directed Learning in Promoting Information Literacy of Nursing Students in Taiwan by Tsai Ling-Chun RN, BSN, MN A thesis submitted in fulfilment of the requirements of the degree of Doctor of Philosophy to the School of Nursing and Midwifery, Faculty of Health, Griffith University June 2014

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3 Abstract Background and Purpose: It has become imperative for health professionals to have information literacy, including database searching skills, to enable them to practise contemporary quality patient care, and developing information literacy requires computer literacy and self-directed learning (SDL). More than the half of the current nursing workforce in Taiwan graduate from an Associate Degree in Nursing (ADN) program, but the effectiveness of integrating e-learning to promote the information literacy and SDL of students in the ADN program is unclear. This study investigated whether a researcher-developed web-enhanced education intervention guided by Knowles Adult Learning Theory (KALT) would improve Taiwanese ADN students online searching knowledge, skills, self-efficacy, and self-directed learning. The 10- week intervention comprised a self-paced online learning package, an online forum, a face-to-face tutorial, and an optional weekly drop-in session. Method: A mixed methods intervention design was used with focus groups, following pre and post-test questionnaires. A total of 142 ADN students were recruited and allocated to the experimental group (n = 69), or the control group which simply received face-to-face instruction (n = 73) using cluster randomisation. The learning outcomes were measured using an online searching knowledge test (OSKT) and online searching skills test (OSST) developed by the researcher, the Online Searching Skills Self-efficacy Inventory (OSSI), and the Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE). The level of significance was set with an α of.05. Four semi-structured questions were used to guide the focus group discussions in Chinese. Comments made in the focus groups were recorded and fully transcribed, then analysed using free-form coding with translation into English. Participants responses were thematically analysed guided by the five research questions. Triangulation was achieved with the convergence of findings from the two separate data sources. Results and Implications: At baseline there was no statistically significant difference between the experimental and control groups regarding their demographic, i

4 background, or the outcome variables (their OSKT, OSST, OSSI, and SDLRSNE scores). After the intervention, the OSSI scores of the experimental group were statistically significantly higher than those in the control group (t = 2.19, p =.027). Focus group data supported the quantitative results and clearly indicated that the experimental group participants benefited from the self-paced additional online learning materials in combination with timely feedback via the online forum. The web-enhanced approach offered learning support that closely matched participants learning needs, although there was no statistically significant difference between the OSKT, OSST, and SDL scores of the control group and the experimental group. Control group participants reported feeling information overload. They remarked on the lack of hands-on exercise during their short face-to-face instruction session, and commented negatively on group discussion when teachers were not present, and on previous e-learning experiences involving limited teacher-student interaction. In contrast, the experimental group participants reported that the intervention supported development of their online searching skills and promoted learning engagement and time management skills. This study provides empirical evidence of the usefulness of KALT for guiding the use of online teaching strategies to develop the information literacy of Taiwanese nursing students. The findings support Knowles assumptions that adults prefer problemsolving and life-related learning based on their previous experience. The researcher recommends that information literacy education be started at the earliest stage of the ADN program in order to better prepare students for evidence-based practice. Ongoing facilitation by teaching staff should assist ADN students engaging in experiential learning in the area of information literacy to enhance students positive learning experiences and outcomes, particularly when project-based group assignments are used. Conclusion: This study indicates that a web-enhanced learner-focused approach, informed by KALT, can support students online searching self-efficacy. An online forum with timely feedback from lecturers is more likely to encourage students SDL and learning satisfaction, and to closely match their learning needs. As a result, group assignments can be adopted by more courses for developing ADN students required knowledge, skills, and attitudes. It is recommended that teaching strategies informed ii

5 by KALT be used in more courses within ADN programs to develop the students information literacy and SDL, and thereby help adequately prepare them for evidence- based nursing practice. Keywords: learning methods; computer-assisted instruction; self-directed learning; nursing education; information literacy. 3

6 Statement of originality This work has not previously been submitted for a degree or diploma in any university. To the best of my knowledge and belief, the thesis contains no materials previously published or written by another person except where due reference is made in the thesis itself. Tsai Ling-Chun 4

7 Table of contents Abstract... i Statement of originality... iv Glossary... x List of abbreviations... xii Dissemination of study results... xiii Acknowledgements... xiv Chapter 1: Introduction Background The integration of e-learning into higher education Self-directed learning Information literacy Associate Degree in Nursing students in Taiwan Knowles Adult Learning Theory and Problem-Based Learning The significance of this current research Research purpose and objectives Overview of project Research questions Structure of the thesis Chapter 2: Literature review Background Searching strategy Nursing students readiness for information literacy Quality of information & evidence-based nursing practice Information resources used & online searching self-efficacy Educational needs and challenges for online searching skills Matching teaching methods with learning needs Technology-enhanced learning Advantages of a web-enhanced approach Methods matching students information literacy education needs How learners become self-directed learners Matching learners needs with preparation for SDL The importance of facilitation during SDL Other factors influencing learners self-directed learning Nursing students SDL readiness level

8 2.5 Summary Chapter 3: Theoretical framework Knowles Adult Learning Theory Criticism of Knowles' Adult Learning Theory A critical review of the use of Knowles' assumptions in guiding nursing education Method/Searching strategy Implications for nursing education and research Conceptual framework of the current research Chapter 4: Methodology Design Setting Sample Description of questionnaire Section1: Demographic and background items Section2: Tests used in the study Section 3: Online Searching Self-efficacy Inventory Section 4: Self-Directed Learning Readiness Scale for Nursing Education Usual instruction The intervention Aim of and background to the intervention Theoretical foundation of the intervention Components of the intervention Intervention fidelity The implementation of the intervention Data collection procedure Data analysis Quantitative data analysis Qualitative data analysis Trustworthiness of qualitative data Ethical considerations Summary Chapter 5: Results Sample response rate Backgrounds of participants Results Research question

9 5.4.2 Research question Research question Research question Research question Summary Chapter 6: Discussion Participants readiness for information literacy Online searching knowledge and skills Online searching self-efficacy Participants information literacy weaknesses Matching participants learning needs Promoting participants online searching self-efficacy The significance of online searching self-efficacy Matching participants learning needs using a technology-enhanced approach Methods that nurture the participants self-directed learning Participants readiness for self-directed learning Factors that influence learners self-directed learning Encouraging participants self-directed learning Findings related to Knowles Adult Learning Theory Summary Chapter 7: Conclusion Contribution of results Future directions Recommendations for nursing education Recommendations for nursing research Recommendations for nursing practice Strengths and limitations Summary Appendices Appendix 1: Research ethics approval Appendix 2: Information sheet and consent form Appendix 3: Permission to use questionnaires Appendix 4: Research questionnaires Appendix 5: Questionnaire translation Appendix 6: Example from the online self-paced learning module References vii

10 List of Tables Table 1. Knowles assumptions about adult learners Table 2. Articles included in this review Table 3. Examples of the background Items Table 4. I-CVI of the Online Searching Knowledge Test Table 5. Percentage of Correct Answers for Individual Knowledge Items Table 6. Final Online Searching Knowledge Test (16 items) Table 7. CVI of the Online Searching Skills Assessment Tool Table 8. Four components of the Intervention ( 改 成 Table 8.) Table 9. Learning Objectives and Contents of the Self-paced Learning Modules Table 10. Problem-Based Discussion Facilitation Guidelines Table 11. Phases of Free-Form Analysis Table 12. Comparison of Mean Age between the Two Groups Table 13. Number and Percentage Distribution of Gender of the Participants Table 14. Participants Previous Databases Learning Experiences Table 15. Databases Instruction Given in Hours Table 16. E-Learning and Searching Competencies of Participants Table 17. Mean scores of Online Searching Knowledge of Participants Pre-test and Post-test Table 18. Example Questions for Each Area of the Online Searching Knowledge Test Table 19. Knowledge Change of Participants Table 20. Mean of Online Searching Skills of Participants at Pre-test and Post-test Table 21. Proportion of Individual Skill Performed by Participants at Pre-test and Post-test Table 22. Mean Scores of Self-Efficacy of Participants at Pre-test and Post-test Table 23. Means of SDLRSNE between the Control and Experimental Groups at Pre-test and Post-test Table 24. Means of the Post-test Outcome Variables between the Control and Experimental Groups Table 25. Correlation Coefficients amongst the Four Post-test Outcome Measures Table 26. MANCOVA of the Post-test Outcome Variables between the Two Groups Table 27. Comparisons the Post-test Outcome Variables between the Two Groups controlling the Covariates

11 List of Figures Figure 1. Nursing education in Taiwan with the Australian equivalence Figure 2. Initial database search flowchart Figure 3. Theoretical framework Figure 4. Study Design and Data Collection Procedure Figure 5. Flow Chart of the Intervention Figure 6. The Process of Integrating Problem-Based Learning into the Intervention Figure 7. Flow Diagram of Participants Progress Figure 8. Knowledge Score before and after the Intervention with Estimated Marginal Means for Post-test Figure 9. Skills Total Means before and after the Intervention with Estimated Marginal Means for Post-test Figure 10. Self-efficacy Means before and after the Intervention with Estimated Marginal Means for Post-test Figure 11. Plot of SDLRSNE total Means before and after the Intervention with Estimated Marginal Means for Post-test

12 Glossary 1. E-learning: The term electronic learning (e-learning) refers to a range of learning experiences that usually use computers and technology to support learning and teaching (Donnelly, Benson, & Kirk., 2012). 2. Web-enhanced approach: This approach is a hybrid learning approach that combines campus-based face-to-face instruction with some online learning activities using a web-based platform (Billings, 2000; Salyers, 2005; Schmidt, 2002). 3. Information literacy: Information literacy is defined by the American Library Association (2000) as a set of abilities requiring individuals to recognize when information is needed and [to] have the ability to locate, evaluate, and use effectively the needed information. 4. Information searching literacy: The knowledge and skills that individuals demonstrate while locating information. 5. Online searching knowledge: The knowledge of individuals in locating information using electronic resources. In this thesis, this term specifically refers to the use of library databases. 6. Online searching skills: The skills individuals employ while locating information using library databases. 7. Online searching self-efficacy: This concept is measured using the Online Searching Self-efficacy Inventory developed by Monoi, O'Hanlon, and Diaz (2005). 8. Self-directed learning: This concept is measured using the Self-Directed 10

13 Learning Readiness Scale for Nursing Education developed by Fisher, King, and Tague (2001). 9. Associate Degree in Nursing students: Students who graduate from this fiveyear program in Taiwan will earn an Associate Degree in Nursing. The majority of the Associate Degree in Nursing students in Taiwan are female and their ages range between 16 and 20 years. 10. Experimental group: The group of students who received a web-enhanced education intervention with the aim of improving their online searching knowledge, skills, self-efficacy, and self-directed learning readiness. 11. Control group: One group of Associate Degree in Nursing students who did not receive a web-enhanced education intervention. In this current study, the control group serves as a comparison with the group of students who received the education intervention. 12. Intervention: A web-enhanced instruction that aims to improve the participants online searching knowledge, skills, self-efficacy, and self-directed learning readiness. This intervention comprises a self-paced online tutorial, an online forum, a face-to-face tutorial with the researcher, and a drop-in session per week as requested. 11

14 List of abbreviations Abbreviation Full text 1. ADN Associate Degree in Nursing 2. CAI Computer-assisted instruction 3. KALT Knowles Adult Learning Theory 4. OSKT Online Searching Knowledge Test 5. OSST Online Searching Skills Test 6. OSSI Online Searching Self-efficacy Inventory 7. PBL Problem-based learning 8. SDL Self-directed learning 9. SDLRSNE Self-directed Learning Readiness Scale for Nursing education xii

15 Dissemination of study results Conference presentations Tsai, L.-C., Mitchell, M., Kellett, U., & Wollin, J. (2013, November). The effectiveness of web-enhanced self-directed learning in information literacy of nursing students in Taiwan. Oral presentation at the 2 nd NUS-NUH International Nursing Conference & 18 th Singapore Malaysia Nursing Conference. Singapore. Tsai, L.-C., Ho, M.-Y. (2012, September). Validation on Taiwan nursing students of a self-directed learning readiness scale. Poster session presented at the 28 th Annual Nursing Research Conference - Closing the gap: from evidence to action. Kaohsiung, Taiwan. 13

16 Acknowledgements On reaching the completion of this thesis, I would like to express my gratitude to all those who gave me the opportunity to complete it. To my supervisors: I acknowledge and thank Associate Professor Marion Mitchell, Dr. Ursula Kellett, and Professor Judy Wollin from Griffith University for their supervision throughout the completion of this thesis. To Professor Jenny Gamble, Dr. Amy Johnston (both Griffith University), and Dr. Jennie Barr (formerly Griffith University), I would like to express my thanks for their guidance in the early stage of my PhD journey. I warmly appreciate Associate Professor Ho Mei-Yao 何 美 瑤 from Meiho University in Taiwan for acting as my local supervisor while I completed this study in Taiwan. To the faculty and participating students at Meiho University in Taiwan: I want to thank Meiho University in Taiwan for granting the approval to commence this study and for providing funds in support of my PhD program. I also want to acknowledge my debt to the faculty at Meiho University s Nursing Department, Library, and Information Network centre. I am especially grateful to Mr. Lin Chien- Chih 林 建 志, Mrs. Han Tung-Chen 韓 彤 珍, A/Prof Lin Pi-Li 林 碧 莉, A/Prof Wu Jui- Wen 吳 瑞 文, A/Prof Hwang Chiou-Shu J. 黃 湫 淑, Mr. Tian Bo-Ren 田 博 仁, and A/Prof Lee Chao Hsien 李 昭 憲. The participation of the 142 Associate Degree in Nursing students from Meiho University was an invaluable contribution to the completion of this thesis. I am extremely grateful to these students for donating their precious time to involve themselves in this current research and for sharing their experiences. To other supporters in Australia and in Taiwan: To the Taiwan Ministry of Education, I would like to express my profound gratitude for providing funds to support my PhD study. In addition, I would like to express my sincere appreciation to Mrs. Shinichi Monoi, Mrs. Nancy O'Hanlon, Mrs. Karen Diaz, and Mr. Murray Fisher who gave me permission to use the OSSI and the SDLRSNE in this current study. I also would like to acknowledge my debt to nursing scholars 14

17 from Taiwan: To Professor Lee-Hsieh, J. 李 皎 正, Professor Hsu Li-Ling 許 麗 齡, and Associate Professor Lin Ming-Chen 林 明 珍, who contributed their opinions to the validity established in the questionnaires used in the current research. As an Englishas-a-second-language learner, I warmly appreciate the assistance of Mr. Larry Pouncey, Mrs. Sue Jellow, and Mrs. Margaret Lavery, and teachers from EnglishHELP at Griffith University, who provided guidance in my English expression. To my family both in flesh and in Christ: To all my family both in flesh and in Christ, whose love and petitions were like dew quenching my thirst during this dry journey and empowered me to complete this study, I cannot express sufficient gratitude. Thank God and thank all of you. May all glory belong to the Almighty God. 15