The Journal of Continuing Education in Nursing

Original Article 

Self-Directed Learning Among Nurse Learners in Sri Lanka

Ranjanie C. Samarasooriya, MSN, RN; Jiyoung Park, PhD, RN; Sook Hee Yoon, PhD, RN; Jina Oh, PhD, RN; Suyon Baek, PhD, RN

Abstract

Background:

Although self-directed learning (SDL) has become an essential instrument for educating nursing professionals, little is known about SDL among nurses in a developing country.

Method:

Data were collected using a structured self-reporting survey, which included Fisher's Self-Directed Learning Readiness (SDLR) scale, and a multiple linear regression analysis was conducted.

Results:

The mean score per item on the SDLR was 4.31 of 5. The learning-related factors that influenced SDLR were motivation for learning and self-efficacy in English proficiency, and the working-related factor was job satisfaction. These variables accounted for 17.6% of the variance in SDLR scores.

Conclusion:

The SDLR of nurse learners in Sri Lanka was influenced not only by learning-related factors but also by working-related factors. Therefore, it is necessary to develop multidimensional strategies to strengthen nurses' SDLR. [J Contin Educ Nurs. 2019;50(1):41–48.]

Abstract

Background:

Although self-directed learning (SDL) has become an essential instrument for educating nursing professionals, little is known about SDL among nurses in a developing country.

Method:

Data were collected using a structured self-reporting survey, which included Fisher's Self-Directed Learning Readiness (SDLR) scale, and a multiple linear regression analysis was conducted.

Results:

The mean score per item on the SDLR was 4.31 of 5. The learning-related factors that influenced SDLR were motivation for learning and self-efficacy in English proficiency, and the working-related factor was job satisfaction. These variables accounted for 17.6% of the variance in SDLR scores.

Conclusion:

The SDLR of nurse learners in Sri Lanka was influenced not only by learning-related factors but also by working-related factors. Therefore, it is necessary to develop multidimensional strategies to strengthen nurses' SDLR. [J Contin Educ Nurs. 2019;50(1):41–48.]

The rapid development of the health care system increases the need for health care practitioners to obtain new knowledge to grow professionally and to provide quality patient care (Findley & Bulik, 2011). In health care, self-directed learning (SDL) is considered to be a key strategy for lifelong learning that ensures the continuous revision of knowledge as new understandings are generated (Cadorin, Ghezzi, Camillo, & Palese, 2017). In addition, SDL has been emerging as the foremost educational method for the advancement of competency-based continuing medical education (Moja & Kwag, 2015). In Sri Lanka, RNs have limited opportunities to obtain continuing education from the Post Basic College of Nursing (PBCN), which is the only nationally recognized center for advanced nursing education (Ministry of Health, 2014). Recently, PBCN is making an effort to convert its educational approach from teacher centered to learner centered in collaboration with other national health care professionals and foreign universities. To improve student-centered learning, SDL readiness (SDLR) and a positive perception of student-centered learning must be encouraged among potential learners.

Background

The educational systems of many developed countries are fostering the development of self-directed professionals because SDL has become necessary as an increasingly important instrument of individual development in the 21st century (Guiter, 2014). As a supplement to the traditional learning approach, SDL provides learners with greater opportunities to reach their individual capacities and to unlock their latent skills (Edmondson, Boyer, & Artis, 2012). In particular, in an environment such as Sri Lanka's in which educational resources and opportunities are lacking, nurses' capacity for SDL is essential. SDL has developed noticeably in recent years mainly because it is a relatively cost-effective learning method (Herrick, Jenkins, & Carlson, 1998). In a recent study on nursing education in Sri Lanka, the researcher emphasized the use of student-centered teaching and learning, including SDL, considering the educational context of the country (Jayasekara, 2013). Therefore, SDL can be a strategy for strengthening the learning capabilities of nurses and health professionals in developing countries and for solving inequalities in nursing education.

SDLR is one of the individual-level concepts associated with SDL (Dačiulytė & Pinchuk, 2010). Previous studies of SDLR have focused mainly on identifying the level of SDLR in precertification nursing programs and investigating the individual demographic and learning factors that influence learners' SDLR. The relationship between demographic factors (gender, race, age, and level of education) and SDLR remains a controversial issue in the literature (Botha & Coetzee, 2016; El-Gilany & Abusaad, 2013; Slater & Cusick, 2017).

On the other hand, the relationship between learning motivation and SDLR is relatively consistent. According to Bodkyn and Stevens (2015), learning motivation was the most influential factor on learners' SDLR. Grandinetti (2013) investigated the effects of motivation on baccalaureate nursing students' SDLR and explored the motivation to learn as a predictor of SDLR. Recent studies by Triastuti (2016) and Saeid and Eslaminejad (2017) emphasized the correlation between SDLR and learning motivation. Currently, the most significant worldwide educational trend is teaching in English (Ebad, 2014). Therefore, proficiency in English can affect learners' learning style and achievement in this context. In Sri Lanka, the primary language used in nursing education is English, both spoken and written. Language self-efficacy is self-belief in one's capability related to a certain language that can affect learning strategies and performance (Raoofi, Tan, & Chan, 2012; Wong, 2005). Considering these facts, in this study, the authors assumed that self-efficacy in English proficiency could affect the level of SDLR among Sri Lankan nurse learners. Internet usage also has been found to be positively correlated with SDL (Rahardjo, Lubis, & Harijati, 2016) as the Internet has become an essential source of information.

Employers and workers have recognized the importance of ongoing learning in the workplace in response to the changes of the 21st century (Association of American Medical Colleges & American Association of Colleges of Nursing, 2010). Education is a determining factor in employee satisfaction (Millán, Hessels, Thurik, & Aguado, 2013). Nurses already have opportunities to engage in SDL in clinical settings as part of their everyday work activities (Nokdee, 2007). Advanced practice nurses' satisfaction with their clinical practices and their SDL were significantly positively correlated (Kim & Park, 2011). Consequently, highly motivated, self-directed learners can approach the workplace as a classroom (Min-Huei & Lien-Hsiang, 2015). Therefore, it is important for organizations to support workers by promoting SDL. However, it appears that SDL in the workplace has not received recent research interest (Dieffenderfer, 2014).

At a time when the importance of SDL for adult learning is emphasized, this study investigated the level of SDLR and the factors influencing SDLR among nurse learners in Sri Lanka. This study aimed to provide fundamental information for developing strategies to strengthen the SDL skills of nurse learners in Sri Lanka. To the best of the authors' knowledge, this is the first study to consider SDL issues in Sri Lanka.

Method

Design and Sample

This study was descriptive, predictive, and nonexperimental. The target population of the study was nurse learners in Sri Lanka. Participants in this study were selected through convenience sampling of RNs who participated in the nursing specialty program at PBCN supported by the Sri Lanka Ministry of Health. Participants were selected for the program based on their performance on a national examination. The program consisted of three semesters of full-time courses and provided both management and teaching training. Attending this program was a prerequisite to be promoted to nurse manager in state hospitals or nurse educator in nursing schools.

Calculations conducted using G*Power 3.1.9.2 for Windows yielded a minimum sample size of 118 participants to ensure that multiple linear regression analysis could be performed with a medium effect size of .15, a significance level of .05, a power level of 80%, and a maximum of 10 predictors. There were 200 potential participants, and data ultimately were collected from 196 individuals, yielding a 98% response rate. Of those 196 individuals, 16 did not complete the survey questionnaires and so were excluded. Therefore, data from a total of 180 nurse learners were included in the analysis.

Measurements

SDLR. The SDLR of nurse learners was measured using Fisher's SDLR scale (Fisher, King, & Tague, 2001). This instrument consisted of 40 items across three subdomains: self-management (13 items), self-control (15 items), and desire for learning (12 items). Each item was answered according to a 5-point Likert-type scale (1 = very low, 5 = very high), with higher scores indicating better SDLR. Total scores of more than 150 indicated good readiness for SDL. The Cronbach's alpha of each subscale was .80 to .85 in a previous study (Malekian, Ghiyasvandian, Cheraghi, & Hassanzadeh, 2016) and .74 to .81 in this study.

Sociodemographic Factors. The sociodemographic factors were age, gender, and level of education.

Learning-Related Factors. The learning-related factors included motivation for learning, self-efficacy in English proficiency, and Internet usage frequency.

Motivation for learning. The Motivated Strategies for Learning Questionnaire (Pintrich, Smith, Garcia, & McKeachie, 1991) was divided into two parts: motivation and learning strategies. In this study, responses to the motivation part were used to measure the nurse learners' motivation for learning. This part consisted of 31 items scored on a 7-point Likert-type scale (1 = almost never true, 7 = almost always true) with higher scores indicating stronger motivations for learning. The Cronbach's alpha was .88 in a previous study (Taylor, 2012) and .84 in the current study.

Self-efficacy in English proficiency. Participants answered questions on how confident they were speaking, writing, listening, and reading in English. An example of an item was, “How do you perceive your English language speaking ability?” This instrument consisted of four items scored on a 5-point Likert-type scale (1 = poor, 5 = excellent), with higher scores indicating higher confidence in the respondent's English language ability. The Cronbach's alpha was .86 in this study.

Working-Related Factors. Working-related factors included career characteristics, such as clinical experience and clinical care settings, job satisfaction, and perception of learning opportunities in the workplace.

Job satisfaction. Job satisfaction was measured using the Warr-Cook-Wall Scale (1979), which assessed overall job satisfaction based on salary, working hours, and personal relationships in the workplace. This instrument consisted of 10 items scored on a 5-point Likert-type scale (1 = very dissatisfied, 5 = very satisfied), with higher scores indicating better job satisfaction. The Cronbach's alpha was .86 in a previous study (Hills, Joyce, & Humphreys, 2012) and .88 in this study.

Perception of learning opportunities in the work-place. Participants answered the question, “How do you rate your workplace learning opportunities, e.g., workshops or in-service programs?” Their responses were scored on a 5-point Likert-type scale (1 = very dissatisfied, 5 = very satisfied), with higher scores indicating better perception of learning opportunities in the workplace.

Data Collection

Data were collected from RNs in the nursing specialty program at PBCN from January to February 2017. Before collecting data, a pilot test was conducted with three nurse learners to check their understanding of the questionnaire, and some questions were modified to reflect their opinions. The purpose and methods of the study were introduced to the nurse learners before a class. The survey was conducted with nurse learners who voluntarily agreed to participate in the study and submitted their participation consent forms. With the assistance of the program coordinators at PBCN, one-to-one interviews were conducted with structured questionnaires after the class. Each interview took between 20 and 30 minutes to complete. A small gift was presented to participants as a display of gratitude.

Data Analysis

All data were screened for data accuracy, then SPSS® 23.0 was used to analyze the data. Descriptive statistics were used to identify SDLR levels. Independent t tests, one-way analysis of variance, and Pearson correlation coefficients were used to identify significant associations between SDLR and related factors. A multiple linear regression analysis using a stepwise method was conducted to determine which factors influenced SDLR. In this study, a p value of less than .05 was considered to be statistically significant. Variables that showed an association at a significance level of .05 were included in the multiple linear regression analysis.

Ethical Considerations

This study was approved by the institutional review board of the researcher's university. In addition, approval for data collection in Sri Lanka was received from the dean of PBCN, the Director of Nursing Education, and Deputy Director General of the Sri Lanka Ministry of Health. The instruments used in the study were approved for use by the authors.

Results

Nurse Learners' SDLR and Related Factors

The mean SDLR score was 172.47 (SD = 12.93) of 200. The mean score per item was 4.31 of 5. The desire for learning was the highest at 4.42, followed by self-control at 4.33 and self-management at 4.18 (Figure 1). Participants with a score greater than 150 were 94% of participants had a score over 150. Table 1 shows descriptions of the sociodemographic, learning-related, and working-related factors among nurse learners.

Level of self-directed learning readiness (SDLR) among nurse learners in Sri Lanka.

Figure 1.

Level of self-directed learning readiness (SDLR) among nurse learners in Sri Lanka.

Sociodemographic, Learning-Related, and Working-Related Factors Related to SDLR (N = 180)

Table 1:

Sociodemographic, Learning-Related, and Working-Related Factors Related to SDLR (N = 180)

Association of Sociodemographic, Learning-Related, and Working-Related Factors With SDLR

No statistically significance difference was found between gender (t = 1.141, p = .266), level of education (t = 0.906, p = .366), Internet usage frequency (F = 0.042, p = .959), and clinical care setting (t = −0.489, p = .625) and their impacts on SDLR (Table 2). SDLR was positively correlated with motivation for learning (r = .330, p = .000), self-efficacy in English proficiency (r = .305, p = .000), and job satisfaction (r = .165, p = .027) (Table 3).

Differences in SDLR According to Sociodemographic, Learning-Related, and Working-Related Factors (N = 180)

Table 2:

Differences in SDLR According to Sociodemographic, Learning-Related, and Working-Related Factors (N = 180)

Correlation among Self-Directed Learning Readiness (SDLR) and Study Variables (N = 180)

Table 3:

Correlation among Self-Directed Learning Readiness (SDLR) and Study Variables (N = 180)

Factors Influencing SDLR Among Nurse Learners

Table 4 shows the results of the stepwise multiple linear regression analysis. The results show a significant association for motivation for learning (β = 0.270), self-efficacy in English proficiency (β = 0.256), and job satisfaction (β= 0.137). Variables included in the model accounted for 17.6% of the variance in SDLR (F = 13.713, p < .001).

Factors Influencing Self-Directed Learning Readiness among Nurse Learners (N = 180)a

Table 4:

Factors Influencing Self-Directed Learning Readiness among Nurse Learners (N = 180)

Discussion

SDLR Among Nurse Learners in Sri Lanka

The participants of this study represented a well-educated group of nurses in Sri Lanka. The participants will be either the leaders of the hospital or nurse educators of the school after completing the PBCN program. Thus, not surprisingly, the vast majority of them reported a high level of SDLR, indicating their confidence in their SDL abilities. The mean SDLR score was 172.4 (SD = 12.93) with desire for learning as the highest and self-management as the lowest levels with regard to the subscales. These results are consistent with previous studies conducted in Pakistan and Saudi Arabia (El-Gilany & Abusaad, 2013; Said, Ghani, Khan, & Kiramat, 2015). The fact that the participants' highest level of desire for learning among the subdomains of SDLR can be interpreted as proving the lack of continuing education and in-service training programs for nurses within the health care systems of developing countries such as Sri Lanka. Therefore, efforts to provide continuous and systematic educational support to nurses should be expanded further.

Factors Influencing SDLR Among Nurse Learners

The results of this study did not show any significant relationship between sociodemographic factors and SDLR. These results are in line with the results of previous studies (Chen, Wang, & Lin, 2006; Malekian et al., 2016). However, the association between demographic factors and SDLR remains a controversial issue in the literature (Slater & Cusick, 2017). Therefore, further research is needed to confirm the relationship between sociodemographic factors and SDLR.

The results of this study showed a significant relationship between learning- and working-related factors and SDLR. Motivation for learning, one of the learning-related factors, was found to be correlated with SDLR. In a previous study, motivation for learning was mentioned as an important factor influencing the SDL of nursing students (Oh, 2017). In educational psychology, the motivation (why learn) is a component of the learning processes with cognitive (what to learn) and metacognitive (how to learn) regulatory dimensions. However, Kusurkar, Croiset, Mann, Custers, and ten Cate (2012) noted that the motivational processes may be a substantially undervalued factor in health care educational curriculum development. In other words, problem-based, learner-centered, integrated teaching, outcome-based, and community-based approaches are focused more on cognitive processing of content or metacognitive regulation than on motivating students. In light of these results, educational strategies should involve autonomy support, adequate feedback, and emotional support (Kusurkar et al., 2012) to stimulate the nurses' intrinsic motivations to improve their SDLR.

A particularly remarkable result that emerged from the data was the correlation between participants' self-efficacy in English proficiency and their SDLR. This finding is consistent with previous studies (Basereh & Pishkar, 2016; Mohammadi & Araghi, 2013). Therefore, the researchers would like to propose that a language learning course be delivered before students enroll in PBCN's advanced nursing program. Those programs will be effective for nurse learners' SDLR improvement, given that Sri Lanka textbooks and classes are conducted in English.

This study investigated the SDLR of nurses working in the field, unlike most previous studies on SDLR, which have focused on students. As a result, the working-related factors for SDLR were explored, and it was found that job satisfaction (salary, working hours, and personal relationships in the workplace) was one of the factors that influenced SDLR. These results support the findings of previous studies. In a study of factors affecting SDL in advanced practice nursing students (Kim & Park, 2011), belongingness during clinical practice was shown to have a significant positive correlation with SDL and was shown to both directly and indirectly influence SDL. In the same study, satisfaction with clinical practice (practice contents, practice environment, practice hours, practice instruction, and practice evaluation) was shown to have a significant positive correlation with SDL. This result could be related to the fact that as nurses become more satisfied with their environments of job or clinical practice, they have increasingly stable psychological bases for pursuing SDL. In other words, improving the SDL of a nurse working in a clinical setting requires institutional efforts to improve working conditions, rather than personal factors alone. These institutional efforts are emphasized when considering the professional responsibility of nurses to develop professional knowledge and skill through continuous education in a rapidly changing health care environment. These efforts will ultimately help nurses provide high-quality health care to their patients.

Limitations

This study had several limitations. First, this study was cross-sectional and explored the relationships between the variables under examination and SDLR, but it was difficult to determine which variable, if any, was causal. Second, this study used convenience sampling. Therefore, the ability to generalize these findings is limited, especially because participants in this study were high achievers from a specific academic program chosen based on their performance on a national selection examination. Therefore, it is necessary to investigate the degree of SDLR and its influence on nurses in general in Sri Lanka. Third, this study's results did not demonstrate any correlation between Internet usage frequency and perception of learning opportunities in the workplace and SDLR. These results were likely due to instrument limitations. No standardized instruments were found to measure these concepts, thus each concept was measured with one question.

Conclusion

The SDLR of nurse learners is influenced not only by learning-related factors but also by working-related factors. Therefore, it is necessary to develop strategies to increase their motivation for learning and self-efficacy in English proficiency. In addition, employee-friendly work-place environments to strengthen SDL skills need to be created. Further research is required to investigate diverse organizational factors that influence SDLR among nurse learners.

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Sociodemographic, Learning-Related, and Working-Related Factors Related to SDLR (N = 180)

Characteristicn (%)Mean (SD)Min-Max
Sociodemographic factors
  Age (years)40.30 (3.66)35–53
    Gender
    Male16 (8.9)
    Female164 (91.1)
  Level of education
    Non-BSN118 (65.6)
    BSN62 (34.4)
Learning-related factors
  Motivation for learning167.76 (19.05)31–217
  Self-efficacy in English proficiency11.94 (2.33)4–20
  Internet usage frequency
    Daily122 (67.8)
    Weekly40 (22.2)
    > 2 weeks18 (10)
Working-related factors
  Clinical experience (years)14.86 (3.24)10–27
  Clinical care setting
    Generala86 (47.8)
    Specialb94 (52.2)
  Job satisfaction33.79 (7.83)10–50
  Perception on learning opportunities at workplace3.28 (1.25)1–5

Differences in SDLR According to Sociodemographic, Learning-Related, and Working-Related Factors (N = 180)

CharacteristicMean (SD)t or F (p)
Sociodemographic factors
  Gender1.141 (.266)
    Male175.06 (9.07)
    Female172.22 (13.24)
  Level of education0.906 (.366)
    Non-BSN173.19 (12.62)
    BSN171.39 (13.40)
Learning-related factors
  Internet usage frequency0.042 (.959)
    Daily172.63 (12.37)
    Weekly171.95 (15.27)
    > 2 weeks172.56 (11.69)
Working-related factors
  Clinical care setting−0.489 (.625)
    Generala171.98 (13.32)
    Specialb172.93 (12.61)

Correlation among Self-Directed Learning Readiness (SDLR) and Study Variables (N = 180)

Variable123456
1 Age
2 Clinical experience.859 (.000)
3 Motivation for learning−.033 (.664)−.005 (.942)
4 Self-efficacy in English proficiency−.281 (.000)−.182 (.014).180 (.016)
5 Job satisfaction.171 (.022).081 (.281).102 (.174).001 (.990)
6 Perception on learning opportunities at workplace.007 (.922)−.010 (.897).060 (.424).166 (.026).200 (.007)
7 SDLR.023 (.762)−.004 (.960).330 (.000).305 (.000).165 (.027).111 (.139)

Factors Influencing Self-Directed Learning Readiness among Nurse Learners (N = 180)a

VariableBSEβtp
Intercept117.1468.94013.104< .001
Motivation for learning0.1830.0470.2703.888< .001
Self-efficacy in English proficiency1.4190.3830.2563.710< .001
Job satisfaction0.2270.1130.1372.012.046
Authors

Ms. Samarasooriya is Senior Tutor, Post Basic College of Nursing, Education Training & Research Unit, Ministry of Health, Colombo, Sri Lanka; Dr. Park is Assistant Professor, Dr. Yoon is Professor, and Dr. Oh is Professor, Department of Nursing, Institute of Health Science, College of Medicine, Inje University, Busan; and Dr. Baek is Assistant Professor, Department of Nursing, College of Nursing, Eulji University, Daejeon, South Korea.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

The authors thank all of the professors in the Department of Nursing, College of Medicine, Inje University, who helped with this article. They also thank the Post Basic College of Nursing, and Education, Training and Research Unit in Ministry of Health, Colombo, Sri Lanka, for support of data collection.

Address correspondence to Jiyoung Park, PhD, RN, Assistant Professor, Department of Nursing, Institute of Health Science, College of Medicine, Inje University, 75, Bokji-ro, Busanjin-gu, Busan, South Korea 614-735; e-mail: PJY1113@inje.ac.kr.

Received: January 29, 2018
Accepted: September 06, 2018

10.3928/00220124-20190102-09

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