Nurses' perceptions of barriers to online continuing education

Nursing

I include notes & tips at the end but just a few pointers to get you started:

Always use the insert header (different first page) option to correctly format your paper

The things struck out in blue are your original phrase- I reworked things in red so you could see the original and the rewrite and decide which you liked better.

I know it looks a little overwhelming but really your content was pretty good it was just phrasing and some unnecessary repetition I scored out.

The demands for cost-savings and improved efficient in health care ( exacerbated by the nursing shortage and graying of the workforce) have created greater reliance on computer information systems to deliver quality health care efficiently.

As such, online learning has become an increasingly popular form of instruction for method of continuing Nursing Education. Within In the plast ten years nursing education has experienced tremendous and dramatic changes with the due to the pervasive computer use in both teaching and health care. As computer technology is incorporated into all aspects of teaching, learning and health care. Today, not only are As a result of this technological advance, nurses must learn to incorporate computers into their daily duties as well as accept an influx of individuals trained virtually. nurses challenged with using the computer systems for daily tasks such as charting, ordering, communications, and medication dispensing, but nurses also use the electronic technology in learning and development of competencies. AlThough the hospitals often times provides assistance in maintenance of continuing education, nurses often cite that the use of computers technology and lack of confidence in virtually obtained competency as significant factors in their decision not to utilize such resources. reasons to avoid this type of resource. Therefore Online learning, as a result, is not being used to its complete potential effectively by the nursing staff. Koivunen, Valimaki, Koskinen, Staggers, and Katajisto (2007) examined factors inhibiting staff's optimal use of computers: There are several obstacles and barriers restricting nurses' motivation to use computers. Firstly, nurses are very little infrequently exposed to the development process of designing and the development of IT developing computer based applications for their own work (Staggers1994, Gerrard et al. 1999), which would such exposure may help support motivate nurses IT motivation to use computers (Larrabee et al. 2001). Other obstacles impeding motivation to use IT

are include: lack of educational and technical support (Sinclair & Gardner 2001,

Gholamreza & Van Dyke 2002), lack of interest (Bowies 1997) or and fear of the potential negative effects of computers use in the context of patients care [(May et al. 2001) as cited in Koivunen, Valimaki, Koskinen, Staggers, and Katajisto,2007].

To address these issues in a comprehensive manner it is important to have an understanding regarding the implementation of online competencies and the barriers that some nurses view. Strategies that provide information in a survey forum will help gain answers to the challenge of maintaining professional competency.

Design

Research Framework.

The research framework that was used to further develop and answer the problem statement was descriptive research in design. Though this type of research design is often considered the simplest form of research, it was able to provide for a description of phenomena in our world. A descriptive research design looks at a phenomenon and identifies it's the major elements or events of a phenomenon. This design also allows for gathered data that describes events to be placed in an organized, and tabulated, effectively and descriptive manner (McEwen & Wills, 2007). This type of tool helped to organize data into patterns that emerge during analysis. One advantage in of using this type of design for the current study is was that descriptive research would be used most effectively it's efficacy within the an educational setting. This was noted because Educational research experiences cannot be are not as realistically controlled as laboratory experiments. In contrast to laboratory experiences, descriptive research was valuable because it allowed for the human element of research. Using the descriptive research design was able to assist in drawing a conclusion to the question that is set forth: due to the lack of staff confidence

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in using technology, online learning is not being used to its complete potential. In this descriptive study an attempt is made to identify problems with current practice, justify current practice or identify what nurses using computer technology may be doing. In this study there is will be no manipulation of variables and no attempt to establish determine causality. (All data was kept confidential and information coded to prevent reveal of participant's identity ensure participant confidentiality). This doesn't belong here….. It belongs in procedure and then the discussion section of the paper

Instrumentation.

Descriptive research design has several types of instruments that can be developed by the researcher. Surveys, interviews, observations and portfolios may be used singly or in various combinations depending on the research question to be addressed. Since The problem was related to specific phenomena, choosing to use a survey instrument where development of the survey tool can be described was seen to be the most beneficial for data collection. Survey data included the following: written questionnaires data was the most efficient method of acquiring the necessary data in the context of this study. The descriptive survey chosen (include name of survey here) design was used to describe assessed nursing staff's computer usage and relationships as well as various other factors including: among their age, gender, basic education, participation in computer or continuing education courses and motivation to use computer technology. Once decided on the exact nature of survey to use a survey was chosen as the method of data acquisition the demographic qualities of ideal participants were determined. Factors to be considered included: access to participants, manner of sampling, potential cost associated with data collection, length of time necessary to collect sufficient data, and preliminary hypothesis regarding expected response rates., it was important to consider sampling, type of population, costs, response rates, and length of data collection. With these factors in mind, using A questionnaire survey was considered. that was timely, appropriate, and applicable to the problem statement. Since The questionnaire survey gave us returned measurable data which would be analyzed statistically to determine what if any relationships were present between the demographic information of the sample and their competence and confidence in computers both in the work place and in continuing education., this was considered a quantitative study. Functionally, nursing staff computer use (independent variable) was compared to In this quantitative research study the aim was to determine the relationship between nursing staff computer usage (an independent

variable) and their age, gender, basic education, job position, participation in professional computer courses (a dependent or outcome variable) and motivation to use

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computer technology (you need to clarify whether this is another dependent variable, a potential confound, etc.) Ultimately the relationship of interest was the correlation between demographic information and computer usage. The aim was consider the correlation between these characteristics and computer usage.

Data.

Following data collection, the information was analyzed in terms of descriptive statistics, such analyses include: tendency, mean, median and mode. Once data had been collected, the information can then be reported as a measure of tendency, mean, median, and mode. Deviation would also be assessed once variance and range were established. Measures of deviation can also be reported using variations and range. The information that was obtained was results were coded and analyzed with an excel spread sheet. placed into an excel spreadsheet using coding to allow for easy calculation and distribution of the responses. Descriptive Statistics were used to present represent qualitative data in quantitative terms which could be studied in terms of statistically significant relationships. quantitative descriptions in a manageable form. With descriptive statistics one is simply describing what is or what the data shows.

Cross-Sectional Study & Sampling Design.

A cross-sectional study is a survey of a population at a single point in time. Cross-sectional studies have the advantages of being fairly quick and easy to perform (Jekel, Katz, Elmore, & Wild, 2007). This type of study will allow for samples of individuals of various age groups representing a cross section of the sample population's age range.

The design was a Non-probability sampling was used. This sampling method was chosen because ensuring that each age cohort within nursing would be practically impossible. As there was no way of assurance that each part of the nursing population was represented in the sample. The sampling did involve purposive sampling In purposive sampling, people or other units are chosen, as the name implies, for a particular purpose (explain this.. what purpose, who was chosen, why was it necessary to include them) (Leedy & Ormrod, 2005). Considering the problem statement, it was necessary to have The target population of the study was nurses who were required to use computer technology, no age range was specified. The participants be nurses, of various age groups using computer technology.

Strengths & Weaknesses.

The strengths of this design are related to the ease of application and usage. The design of the survey was easy to administer and self explanatory. While the weakness was related to the willingness of the participant to Chapter Three 5

participate complete the survey and provide truthful responses. An additional weakness is relative to the age group that was present for the survey and their relationship to the use of computers.

Subjects

After approval of the study from the Institutional Review Board at Indiana

Wesleyan University and Methodist Hospitals, Inc. Nursing staff were recruited to participate in for the study. Participants were eligible for the study if they were currently an employee of the employed by Methodist Hospitals, Inc., It was also necessary that they hold a current nursing license, participated in online learning, and were able to read and write English. A registered nurse who has participated in any online learning events, and are able to read and write English. Risk to participants was minimal, however, all participants were given information regarding the nature of the study and properly debriefed. They were provided with the name and contact information of counseling services should they require consultation following completion of the survey. Further, participants were made aware that their information would be kept in the strictest confidence and that there would be no individually identifying information on the survey. Should they choose to have their survey not included in the data analysis they were free to withdraw at any time. There was minimal risk in participation.

To recruit Registered Nurses participants the surveys were administered during staff meetings held on in various nursing units throughout the hospitals.

Data collection began in January 2010 and ended in February, 2010.

Participants were Registered Nurses who have accessed and taken online continuing education courses. The participants were employees of the Methodist

Hospitals, Inc. The researcher is an employee of the Methodist Hospitals, Inc. And therefore will have access to the hospitals two campuses. The main campus is located at 600 Grant Street Gary, IN and the second campus is located at 8701 Broadway

Merrillville, IN. (unless specifically requested this information is not necessary this information may be included in an appendix where you include the letter of permission or the meeting dates for each institution) From the nursing employees A sample size of 200 was acquired. The participants included were roughly equal in number from each location. used dividing the participants evenly between the two campuses. This allows for 100 Registered Nurses from each campus to participate. Sample subjects Participants were randomly selected to generalize the population from which the sample data was drawn (discuss how you selected randomly). The Black or African-American

and Hispanic or Latino communities are well established in Lake County, Indiana thus the data collected accurately represented the population of the area.

Therefore cultural and ethnic diversity was seen within the survey results. Since Because the survey was administered during a monthly staff meeting, the sampleing consisted of those in attendance at the meetings.

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Procedure

A total of 200 Two hundred questionnaires surveys were passed out for review with a total of 172

questionnaires returned for analysis distributed. At the end of data collection One hundred seventy two completed surveys were returned. The process of distributing and collecting surveys took approximately two months, the researcher (myself) and an assistant were the only individuals involved in data collection. Data was collected by the researcher and Data

Assistant over a two-month period of time. This allowed for adequate distribution and return of the questionnaires. A cover letter outlining the purpose of the study and how anonymity and confidentiality procedures would be maintained will be was attached to each questionnaire survey. Responses were voluntary and consent was implied by questionnaire completion. Haigh and Jones (2005) note that this form of implied consent is appropriate in sample groups who are over 18 and when potential harm to respondents is low. The surveys were distributed by the researcher, the assistant researcher then remained to collect completed surveys in a lidded box. Incentive for participation was microwavable popcorn which was distributed to participants upon completion of the survey. The Researcher passed out the Questionnaires with the Data Assistant left behind to collect the completed questionnaires. Once the participant completed the questionnaire, the participant was directed by the Data Assistant to place the questionnaire in a lidded box and a complementary thank you gift of microwavable popcorn was obtained by the subject. To ensure subject participant anonymity the survey was completed at the conclusion of the meeting, with the Data Assistant remaining behind to assist subjects in placing questionnaires into a lidded box, no traceable personally identifying information was placed or recorded included on the surveys. The absence of the researcher during the completion of the surveys not only ensured anonymity, it also removed the potential confound of demand characteristics whereby the participant may be inclined to answer in a manner he or she believes the researcher desires as opposed to reporting honestly. The Researcher chose to leave the room as this would assist in elevating bias for the subjects. There was minimal risk. Due to the manner of collection of data, the subject was protected by the anonymity of the Data

Assistant and no recording marks on the collected questionnaires. Therefore, personal contact between the subject and researcher did not take place in reference to completion of the questionnaire.

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Data was maintained held in a locked cabinet in the Nursing Education Department

office at the Gary Methodist campus. The survey contained general information however no identifying personal information was recorded on the surveys. The measure used to obtain relevant data consisted of 32 self report multi-step questions. The measure assessed general knowledge regarding computer use and HIS applications as well as the individual's personal reliance on computers. The data collection tool focused on 32-item five point multiple-step self-report instrument measures nurse's knowledge regarding general computer use and HIS applications and the nurse's role and participation with computers. This instrument also allowed the nurse to rate themselves on a novice-to-expert scale (Hobbs, 2002).

The data collection tool will focus on multiple-choice questions for ease of measure utilized multiple choice questions to facilitate efficient data analysis and questions will be pertinent to the understanding regarding the implementation of online education/competencies and the barriers that some nurses view or experience regarding this type of education. The data will be analyzed using descriptive statistics, percentage of agreement, and t test.

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Notes:

Overall the tone of this section was pretty good. I know writing a method section can be particularly difficult. Where you ran into trouble was largely with phrasing. When writing a thesis of any description, you need to assume that your reader is at least tangentially familiar with your topic as well as the general data collection and analysis techniques. Don't explain a concept that would be common knowledge to your professor for example. Also, strive to find the most succinct and direct way of stating things. 13 pages seems quite long for a methods section if your study only included a single assessment tool. Where you need to expand is in the actual break down of your sample information. You also need to spend more time talking about the measure you used. Necessary information in a methods section is the reliability and validity of the tool if it is one which is standardized, if it is one you made up, include sample questions and explain your reasoning for creating your own etc. You also make reference to randomizing your sample, its things like that that need to be clearly and succinctly elucidated. I was always told that a methods section should read like a how to, any other scientist should be able to turn to your methods section and recreate your experiment exactly. Resist the desire to try and make it sound nice" that's what your discussion and lit review are for. This section is just straight information. Your ref. section came out formatted very strangely and I was unable to separate which documents went with what pieces. I'm also unsure what the yellow highlighted section was for. In formal writing though stating "what a paper will find or what a paper is for" is improper. Present questions or research objectives in prose using numbering and list making only when absolutely necessary. In terms of strengths and weaknesses, from what I know of your paper things you should include are:

Negatives of a convenience sample

Inherent limitations of a self report multiple choice survey

Highlight the extremely high number of participants who actually completed and returned the survey

That your survey was anonymous and legitimately assessed the specific questions you were studying

GOOD LUCK!! I really hope I was able to help.. please though email me with any questions or if you need anything

The following information was presented in the original paper Data Collection

Plan: Highlighted in yellow

Data Collection Plan

Online learning has become an increasingly popular form of instruction for Nursing

Education. Within the past ten years nursing education has experience tremendous and dramatic changes as computer technology is incorporated into all aspects of teaching, learning and health care. As a result of these changes it is important to identify ways in which nursing can overcome barriers to computer technology and online continuing education.

Design Overview

After the initial literature review a descriptive research design approach with a cross-sectional survey design will be used to conduct the study. The type of data to be obtained will be quantitative, specific and numerical data that can be utilized to make quantitative predictions.

Quantitative research, based on its assumptions of causation and reality, attempts to arrive at an in-depth understanding of the phenomenon by measuring data in an objective manner with results that can be established as valid by a set of formal scientific/methodological principles of inquiry and set criteria for reliability and validity (Leedy & Ormrod, 2005). Quantitative research looks at some objective index of the phenomenon attempting to produce information that is stable and valid for large populations and samples. Inductive reasoning will be used to derive general conclusions. In inductive reasoning, specific observations and measures begin to detect patterns and regularities, formulate some tentative hypotheses that can be explored, and finally end up developing some general conclusions or theories. The focus will be general based on random samples. The purpose of the study will be to describe:

1) Knowledge of general computer application (Hobbs, 2002)

2) Internet applications

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3) Nurses experience using online continuing education course (course design, resources, technology and environment)

4) Demographic variables that relate to course access site, and nurses' experiences

(attitudes, perceptions, and preferences)

Study Sample

Participants will be Registered Nurses who have accessed and taken online continuing education courses. The participants will be employees of the Methodist Hospitals, Inc. The

researcher is an employee of the Methodist Hospitals, Inc. And therefore will have access to the hospitals two campuses. The main campus is located at 600 Grant Street Gary, IN and the second campus is located at 8701 Broadway Merrillville, IN. The researcher will obtain permission to conduct the study from the Methodist Hospitals, Inc. Bioethics Committee. From the nursing employees a sample size of 200 will be used dividing the participants evenly between the two campuses. This allows for 100 Registered Nurses from each campus to participate. Sample subjects will be randomly selected to generalize the population from which the sample data is drawn. The Black or African-American and Hispanic or Latino communities are well established in Lake County, Indiana. Therefore cultural and ethnic diversity will be seen within the survey results. Since the survey will be administered during a monthly staff meeting, sampling will consist of those in attendance at the meeting. Instruction to return the survey within ten days from date received will be given.