E-learning in nursing education in Rwanda: A middle-range theory

Abstract

Background: The rapid development of technology has compelled tertiary institutions to devise innovative teaching strategies to meet the students’ needs and market’s demands. Recently, the Covid-19 pandemic is forcing educational instructions to shift from in-person to online learning. E-learning is one of the areas advancing rapidly and which provide promises in nursing education. The aim of this study was to develop a middle-range theory to guide the utilisation of an e-learning platform in nursing education in the context of Rwanda.Methods: A grounded theory approach, following Strauss and Corbin, was used. The study population included nurse educators, nursing students, Information and Communication Technologies (ICT) managers, and experts in e-learning and nursing education. The sample size consisted of 40 participants. Data were collected using in-depth interviews, focus group discussion and document analysis. Data analysis was guided by Strauss and Corbin’s grounded theory framework, which facilitated the middle-range theory development.Results: Implementation of e-learning in nursing education emerged as the central concept in this model. E-learning was viewed as a mechanism to advance the country’s political agenda to integrate technology in higher education, a tool to widen access to nursing education, a student-centred approach, and blended learning. The implementation of e-learning was facilitated by catalyst agents such as institutional support, e-readiness, partnerships and collaboration, policies and regulations, effective working learning management system, and bridging the digital divide. Integration of e-learning in nursing education was expected to improve nursing education quality and increase competent nurses and midwives graduates.Conclusions: This study highlights the importance of e-learning in nursing education. The adoption of the innovative, technology-enabled nursing education models would augment capacity to scale up nursing and midwifery education, enhance the quality and relevance of training, and adopt equity-focused policies. This model is a tool to facilitate the establishment of a supported network learning space in nursing education in a fluid and dynamically changing nursing practice context.

How Attitudes Towards E-Learning Affected the Academic Achievement During the Covid-19 Pandemic: An Example of a Nursing Skills Teaching

“…Although e-learning paves the way for students to access the educational environment and materials with their peers during the pandemic, the fact that the use of this technology, in providing online communication, requires features such as internet access and technological infrastructure has brought many challenges especially for students (Divya & Binil, 2021;Kutah, 2021;Suliman et al, 2021). In nursing education, e-learning success has been reported to be associated with the adequacy of available resources and the ability of both students and educators to use information and communication tools (Harerimana & Mtshali, 2021;Divya & Binil, 2021). However, the results of both international (Gharehbagh, Seifi & Moeini, 2021;Kutah, 2021;Subedi, Nayaju, Subedi, Shah, & Mathias, 2020;Suliman et al, 2021;Thapa et al, 2021;Yekefallah, Namdar, Panahi & Dehghankar, 2021) and national (Eren, Korkmaz, Yildirim & Avci, 2021;Terke & Yamac, 2021) studies indicated that infrastructure and technology-related issues constitute a significant part of the negative experiences encountered in the e-learning process.…”

“…Yekefallah et al, (2021) pointed out that issues related to the use of e-learning technology may be associated with hardware deficiencies, limitations in computer and internet access, and students' negative satisfaction with e-learning. Harerimana and Mtshali (2021) indicated the importance of adequate educational preparation and hardware competence for information and communication technologies for both educational institutions and learners among the facilitating conditions of e-learning in nursing education. Olum et al, (2021) reported that the increase in internet connection quality and having a computer of their own were associated with more positive attitudes of nursing and medical students toward e-learning.…”

“…Thapa et al, (2021) have reported that situations that negatively affect the practicality of e-learning, ease of use for learners and increase stress in learning are also associated with attitudes that are more negative toward e-learning. When the results of different studies are examined, the importance of regulations focusing on students' motivation and satisfaction has been emphasized to improve the quality and suitability of e-learning in nursing education (Harerimana & Mtshali 2021;Suliman et al, 2021). Furthermore, it has been emphasized that the academic performance of the students is positively related to their academic motivation, participation in learning and readiness, and individuals with higher academic motivation will also have more positive attitudes toward learning (Park et al, 2010;Khalaila, 2015).…”

“…Distance education is an institutional training activity in which learners, teachers, and teaching materials in different places are brought together through information and communication technologies in cases where it is not possible to implement physical classroom teaching (Cevik & Bakiogli, 2021). The concept of e-learning is a learning method that can is an interaction with the visual and auditory responses provided by computer technology, which is realized by the individual learning by himself and at his own pace over the internet/intranet or a computer network, there is no time and place limitation in accessing information, and which connects the learners and the teacher with synchronous or asynchronous methods (Harerimana & Mtshali, 2021;Logan, Johnson & Worsham, 2021). E-learning can also be defined as the use of information and communication technologies to improve web-based, computerassisted, digital or online learning (Kim and Park, 2021).…”

Standards for Evaluating the Quality of Undergraduate Nursing Elearning Programme in Low- and Middle-Income Countries: A Modified Delphi Study

“…Delva (2019) describes that standards provide a roadmap to assess the quality of e-learning [34]. The quality of an e-learning programme includes learners who are ready to learn and supported to learn, environments with adequate resources, content re ected in relevant curricula for the acquisition of relevant skills, educators able to carry out roles in skill acquisition, assessment and outcomes that demonstrate knowledge, effective use of ICT by learners and educators, and skills and attitudes linked to desired results [35,36,21]. Standards for evaluating the quality of undergraduate e-learning programmes can be adapted for nursing education and broadened to include clinical components.…”