Research instrument

A self-administered questionnaire as well as structured observations was employed to collect data from nurse educators and student nurses at four learning sites of the HEI. The questionnaire, which was an adapted version of the questionnaire used by Van Wyngaarden (2008:112), consisted of closed- and open-ended questions to clarify issues relevant to the phenomenon (De Vos, 1998:89). The researcher chose this type of data collection method due to time, financial and distance constraints related to multiple learning sites and because the data could be collected simultaneously at all the learning centres within a two-and-a-half month period.

Participant anonymity was additionally assured by the use of questionnaires. It also prevented the participants being influenced by the researcher. Lastly, it allowed for the immediate availability of the managers of the learning centres, who acted as administrators on behalf of the researcher, to clarify issues that were not clear to the student nurse participants (Maree, 2007:157; Polit & Beck, 2012:305). The disadvantages of using a questionnaire for data collection are firstly that the researcher is unable to control the conditions in which it is administered and, secondly, when different administrators oversee the completion of the group questionnaire, it can lead to different responses (Maree, 2007:157). Therefore, the researcher had a training session with the managers

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of the learning centres who acted as administrators before the study was conducted to explain the study, research instrument and content to them.

The questionnaire and consent form was emailed to each manager of each learning centre to make copies for the participants. The respondents (nurse educators and student nurses) completed the questionnaires within two-and-a-half months where after it was returned to the researcher. The student nurse participants received a questionnaire similar to that of the nurse educators which they had to complete to validate the data generated from the nurse educators. Some of the questions in the student nurse respondents’ questionnaire were slightly adapted to make it applicable to them and to assist them with answering it. For example, a question to the student nurses was: ‘If you answered “Yes” in question 12, please indicate with an ‘X’. The students then had to indicate the multimedia used with an ‘X’. The same question to the nurse educators read: ‘If you answered “Yes” in question 19 and 20, please indicate when and how’. Thus, to validate the data generated from the nurse educators, the capturing and analysis of all the data collected by the two questionnaires were done by the researcher.

Additional questions, which were not related to this study, were added to both questionnaires as the current study was done in combination with an in-depth study conducted at the HEI. This was done to prevent respondent fatigue and for time constraints as the same population categories were used in both studies.

For the purpose of this study the questionnaires used by Van Wyngaarden (2008:112) during her study were adapted after a literature review on the theory-practice gap and ways to bridge this gap had been undertaken by the researcher. A senior employee at the HEI and a statistician from Stellenbosch University assisted with the development of the questionnaires.

With the compilation of the questionnaires the researcher kept to the following guidelines as advised by Brink (2006:149) and Maree (2007:160) regarding the questions in mind:

i they had to be short, simple and clear

ii sequenced in such a way that it prevented confusion

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iv had to include closed-ended questions to allow the respondents to select a response and open-ended questions to offer them the opportunity to give detailed answers.

The non-research observer, a person not connected with the research, also provided data through structured observations, which is seen as an important data collection method. During the structured observation the observer, who sat in the classroom, used a self-designed checklist to record the observed phenomenon, namely teaching methods used by the nurse educators while facilitating theoretical learning at the learning centres. The checklist was a record-keeping instrument which specified the events to be observed and was designed to produce numeric information. (Polit & Beck, 2012:316). The disadvantage of using structured observation for data collection are firstly bias from those being observed, as participants may have changed the teaching methods utilised to “look good” and, secondly, bias from the observer (Polit & Beck, 2012:318). To avoid this researcher carefully constructed the checklist and had a training and preparation session with the observer to explain the research instrument and content to her. This was done to ensure accuracy of the data recorded. Only one observer was used to do the structured observation at all four learning centres. This was to ensure the validity and reliability of the data. The observation was done over a three-and-a-half-month period where after the completed checklists were returned to the researcher.

With the compilation of the checklist the researcher kept to the following principles as advised by Polit and Beck (2012:315) regarding a checklist:

i. list of teaching methods to be observed ii. list of teaching aids to be observed

iii. open space to the right of the methods and –aids listed for recording the frequency of the occurrence.

As mentioned before, the current study was done in combination with an in-depth study conducted at the HEI. The same questionnaires were used in both studies to collect similar data. For the purpose of this study the sections and questions on the questionnaires as outlined next were used.

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The nurse educators’ questionnaire (see Annexure A) consisted of three sections and the mentioned questions were included for this study.

i Section 1: Demographic data: questions 1, 3-9 and 11 were included ii Section 2: Theoretical environment: questions 1-32 were included iii Section 3: Clinical environment: questions 5 and 6 were included.

The student nurses’ questionnaire (see Annexure B) also consisted of three sections and the following questions:

i Section 1: Demographic data: questions 1, 3, 5-7 were included

ii Section 2: Theoretical teaching methods: questions 1-19 and 26 were included iii Section 3: Clinical environment: questions 11-13 were included.

3.3.1.1 Validity and reliability

Validity and reliability are two concepts which can be used by the researcher to assess and ensure the quality of a quantitative research study (Brink, 2006:158).

(a) Validity

Brink (2006:159) states that “instrument validity seeks to ascertain whether an instrument accurately measures what it is supposed to measure”. Two questionnaires and an observation checklist were used to collect the data in this research study. Thus, face and content validity were applied. According to Maree (2007:217), content validation is the “extent to which the instrument covers the complete content of the particular construct that it is set out to measure”. In the current study content validation referred to the representation of the items on the questionnaires and observation checklist used to collect appropriate and sufficient data on the phenomenon that was investigated (Brink, 2006:160). Face validation is the extent to which the items on the instrument look as if it is measuring what it claims to measure (Maree, 2007:217; Polit & Beck, 2012:728). In this study the questions on the questionnaires and the information on the observation checklist

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seemed as if it would render the required data pertaining to the teaching methods utilised to determine whether the appropriate teaching methods to enhance theory-practice integration were used (Brink, 2006:160). The researcher ensured that the questions on the questionnaires and the teaching methods and aids listed on the checklist were related to teaching methods and theory- practice integration.

As recommended by Brink (2006:160), a group consisting of a senior nurse educator and a senior training and development specialist (who each hold a master’s degree in the higher education and nursing field respectively) at the HEI, a research specialist, and a statistician at Stellenbosch University assisted with and reviewed the questionnaires and checklist for face and content validity before it was finalised. This was done before a pilot study was conducted: one among nurse educators facilitating theoretical learning for a DGNS programme, and the second among student nurses registered for the DGNS programme.

To validate the data generated from the nurse educator respondents, the researcher made use of person triangulation and method triangulation. Person triangulation consisted of a structured questionnaire administered to the nurse educators who facilitated theoretical learning for the DGNS students, and a similar structured questionnaire administered to the first- and second-year DGNS students. Method triangulation comprised of obtaining data through structured observations by one trained non-research observer (who was not the researcher or a manager at one of the learning centres) for clarity and consistency at the four HEI delivery sites (Polit & Beck, 2012:590). Thus, various data sources and data collection methods were used to collect the data. This was done to validate the nurse educators data through multiple perspectives of the phenomenon, in this case the perspective having been on the teaching methods and aids utilised by the nurse educators (Polit & Beck, 2012:590).

As mentioned before, the student nurses completed an adapted version of the nurse educators’ questionnaire. An information leaflet, with the same information as stated in the information leaflet of the nurse educators, was provided to the student nurses. Furthermore, structured observations were conducted for a week per learning centre during a period when most of the nurse educators who facilitated contact sessions for the DGNS students were scheduled to facilitate theoretical learning. Since the researcher was not involved in the collection of the data, a trained non-research observer observed and recorded the type and frequency of teaching methods and teaching aids utilised by the nurse educators while they facilitated theoretical learning for the DGNS students. The data were recorded on a self-designed observation checklist. The observation checklist (see

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Annexure C) included all the expected teaching methods related to the variable being measured (Brink, 2006:144).

(b) Reliability

An instrument’s reliability is “the consistency with which it measures the target attribute” and “also concerns accuracy” (Polit & Beck, 2012:331). Quinn and Hughes (2007:270) refer to reliability as the accuracy and consistency of data gathered by an instrument. In this research study internal consistency and stability were adhered to.

Two senior HEI employees who each hold a master’s degree in the higher education and nursing field respectively, were asked to assess the internal consistency of the questionnaires and observation checklist. The questions included in the questionnaires and the information on the observation checklist pertained to the variable measured, namely the teaching methods used (Polit & Beck, 2012:333). As stated by Van Wyngaarden (2008:32), ‘the reliability of the original questionnaires was further determined through a pilot study’. The reliability of the original instrument (questionnaire) that had been used by Van Wyngaarden (2008:32) in her study was tested by her for stability by means of a test re-test method.