The perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng

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(1)COPYRIGHT AND CITATION CONSIDERATIONS FOR THIS THESIS/ DISSERTATION. o Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. o NonCommercial — You may not use the material for commercial purposes.. o ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.. How to cite this thesis Surname, Initial(s). (2012) Title of the thesis or dissertation. PhD. (Chemistry)/ M.Sc. (Physics)/ M.A. (Philosophy)/M.Com. (Finance) etc. [Unpublished]: University of Johannesburg. Retrieved from: https://ujcontent.uj.ac.za/vital/access/manager/Index?site_name=Research%20Output (Accessed: Date)..

(2) THE PERCEPTIONS OF PROFESSIONAL NURSES REGARDING THE IMPLEMENTATION OF STAFF DEVELOPMENT PROGRAMMES IN A PUBLIC HOSPITAL IN GAUTENG. By. JOYCE JOHANNA MOGOROSI-PHETO. A DISSERTATION. Submitted in fulfillment of the degree. MAGISTER CURATIONIS. In. PROFESSIONAL NURSING SCIENCE: NURSING MANAGEMENT. in the. FACULTY OF HEALTH SCIENCES. DEPARTMENT OF NURSING. at the. UNIVERSITY OF JOHANNESBURG. Supervisor: Mrs H. ALLY. Co-supervisor: Mrs W. JACOBS. 2016.

(3) DEDICATION. This dissertation is dedicated to my late parents Rakale Thomas Mogorosi, and Motiki Lizzy Mogorosi, who inspired, encouraged and motivated me and always said, ”let education be your pillar of strength”, that made me believe that where there is a will, there is a way. As well as my late sisters Basetsana and Isabella.. And. To my son Ofentse Omphémetse Pheto for being understanding, motivating, and supportive throughout my studies.. i.

(4) ACKNOWLEDGEMENTS. To God all is possible. I would like to thank God Almighty for granting me strength, courage to continue through tiring hours of the study. My deepest and sincere gratitude goes to the following people who have helped and inspired me throughout the writing of this dissertation.. Mrs Hafisa Ally: My supervisor who has guided me along my journey, with constructive criticism, mentoring, support, encouragement, motivation and tolerance and who always insisted on receiving a high quality of work. She kept me on track when I felt discouraged.. Dr Wanda Jacobs: My co-supervisor for her guidance, inspiration, support and contribution to this study.. The Hospital management and the Research Committee: that granted the opportunity and permission to conduct this study.. My colleagues who became my participants, for the intense sharing of their thoughts, views and opinions with me, without whom this study would not have been possible.. Ms Thembisile Hlatshwayo: and the rest of my colleagues for being available when I stressed out and needed support.. My sisters: Dolly, Sebaetseng, Peggy, Setlhabi, and their children for their support and encouragement.. Rearabetswe:. my niece for always being available to assist me with the. arrangements of interviews when need arose.. My family for their constant love and support throughout the long period of my study.. ii.

(5) Omphémetse: “Wonderful son” for the encouragement helping with typing, for having endless patience, and understanding. Thank you for being there for me.. Thipe: My husband for his caring, understanding, patience, support and for believing in me. Teaching me to fight fear and for continuously carrying out the household chores.. iii.

(6) ABSTRACT. This study is important because in South Africa the National Department of Health (NDoH) views staff development programmes as a national priority and it features in the National Core Standards for quality. Staff development programmes in healthcare environments are essential for enabling nurses to gain both knowledge and skills, while empowering them to render quality care to patients. The implementation of staff development programmes must be encouraged to ensure the development of a competent and confident professional nurse.. The purpose of this study is to explore and describe the perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng in order to develop recommendations that will facilitate the implementation of staff development programmes in the hospital.. The research design for this study is qualitative, exploratory, descriptive and contextual in nature. The study was conducted in two phases. Phase one focused on exploration and description of professional nurse’s perceptions regarding the implementation of staff development programmes (SDPs) in the public hospital in Gauteng where this study was conducted. Phase 2 focused on the development of recommendations to facilitate the implementation of staff development programmes based on concluding statements from the integration of relevant literature into the findings and outcomes in phase One.. Data was collected by means of focus group interviews from the purposive sample of professional nurses who were selected from staff development attendance registers and who were willing to participate in the study. Data was analysed using Tesch’s method of qualitative analysis. Principles of trustworthiness and principle of ethics namely credibility, transferability, dependability and confirmability were adhered to throughout the study to ensure the protection of participants and the scientific, academic quality of the study.. The findings of the study identified a central theme that participants have negative perceptions regarding the implementation of Staff Development Programmes in the hospital in Gauteng where this study was conducted.. iv.

(7) Two main themes emerged namely that of ineffective management practices and negative staff attitude towards the implementation of staff development programmes (SDPs).. The following recommendations were made: Implement effective management practices. Ensure active participation of all staff to facilitate implementation of SDPs. Plan SDPs adequately. Improve on the implementation of staff development programmes. Formulate and promote a managerial support system to facilitate the implementation of SDPs. Improve nurse’s attitude towards the implementation of staff development programmes. The limitations of the study, recommendations for nursing practice, nursing education, nursing research and a conclusion of the study are presented.. v.

(8) TABLE OF CONTENTS. DEDICATION ................................................................................................................ i ACKNOWLEDGEMENTS ............................................................................................ ii ABSTRACT ................................................................................................................ iv CHAPTER 1 ..........................................................................................................................................1 1.1 INTRODUCTION BACKGROUND AND RATIONALE .............................................................1 1.2 PROBLEM STATEMENT ...............................................................................................................3 1.3 RESEARCH PURPOSE AND OBJECTIVES .............................................................................4 1.4 DEFINITION OF KEY CONCEPTS ..............................................................................................5 1.4.1 Perceptions ..............................................................................................................................5 1.4.2 Professional Nurses ..............................................................................................................5 1.4.3 Implementation .......................................................................................................................5 1.4.4 Staff Development Programmes ........................................................................................6 1.4.5 Public Hospital ........................................................................................................................6 1.4.6 Gauteng.....................................................................................................................................6 1.5 RESEARCH DESIGN AND METHODOLOGY ...........................................................................7 1.5.1. Research Design ..............................................................................................................7. 1.5.2. The Research Methodology ...........................................................................................7. 1.6 LAYOUT OF DISSERTATION ......................................................................................................7 1.7 CONCLUSION .................................................................................................................................8 CHAPTER 2 ............................................................................................................................................9 2.1 INTRODUCTION .............................................................................................................................9 2.2 RESEARCH DESIGN .....................................................................................................................9 2.2.1 Qualitative Research Methodology .................................................................................10 2.2.2 Exploratory Research..........................................................................................................11 2.2.3 Descriptive Research ..........................................................................................................11 2.2.4 Contextual Research ...........................................................................................................12 2.3 THE RESEARCH METHOD ........................................................................................................13 2.3.1 Population ..............................................................................................................................14 2.3.2 Sample and sampling method ..........................................................................................14 2.3.3 Data collection Methods .....................................................................................................15 2.3.4 Data analysis .........................................................................................................................20 2.4 TRUSTWORTHINESS ..................................................................................................................22 2.4.1. Credibility .........................................................................................................................22 vi.

(9) 2.4.2. Transferability .................................................................................................................23. 2.4.3. Dependability...................................................................................................................24. 2.4.4. Confirmability ..................................................................................................................24. 2.4.5. Reflexivity .........................................................................................................................25. 2.6 ETHICAL CONSIDERATIONS....................................................................................................28 2.7 CONCLUSION ...............................................................................................................................30 CHAPTER 3 ..........................................................................................................................................31 3.1 INTRODUCTION ...........................................................................................................................31 3.2 PHASE ONE: DESCRIPTION OF FINDINGS AND LITERATURE CONTROL .................32 3.2.1 Central Theme: Negative Perceptions Regarding the Implementation of Staff Development Programmes ..........................................................................................................33 3.2.2 Theme 1: Ineffective Management Practices ................................................................34 3.2.2 Theme 1: Negative Staff Attitude towards the Implementation of Staff Development Programmes ..........................................................................................................58 CHAPTER 4 ..........................................................................................................................................66 4.1 INTRODUCTION ...........................................................................................................................66 4.2 PHASE TWO: RECOMMENDATIONS REGARDING IMPLEMENTATION OF STAFF DEVELOPMENT PROGRAMMES IN A PUBLIC HOSPITAL ......................................................66 4.3 EVALUATION OF THE RESEARCH .........................................................................................74 4.3.1 Introduction............................................................................................................................74 4.3.2 Purpose ...................................................................................................................................74 4.3.3 Objectives...............................................................................................................................74 4.3.4 Research design ...................................................................................................................74 4.3.5 Trustworthiness and ethics ...............................................................................................75 4.4 LIMITATIONS OF THE STUDY ..................................................................................................76 4.5 RECOMMENDATIONS FOR NURSING PRACTICE, NURSING EDUCATION AND FUTURE RESEARCH .........................................................................................................................76 4.5.1 Recommendations for Nursing Practice ........................................................................76 4.5.2 Recommendations for Nursing Education ....................................................................77 4.5.3 Recommendations for Nursing Research......................................................................77 4.6 CONCLUSION ...............................................................................................................................78. LIST OF REFERENCES.................................................................................................78. vii.

(10) LIST OF TABLES TABLE 2.5 Consent to record the interview using a tape recorder........................126 TABLE 3.1: The perceptions of professional nurses regarding the implementation of staff development programmes …….....................................................33 TABLE 3.2: Summary of themes with recommendations ........................................63 TABLE 4.1: Recommendations for the implementation of staff development programmes in a public hospital in Gauteng............................................66. ANNEXURES ANNEXURE A:. Academic Ethics Committee Letter of Permission to Conduct Research. ANNEXURE B:. Higher Degrees Committee Letter of Permission to Conduct Research. ANNEXURE C:. Letter of Consent to conduct research in the Hospital under study. ANNEXURE D:. Invitation to participate in research study. ANNEXURE E:. Consent to participate in the research. ANNEXURE F:. Consent to the use of an audio recorder. ANNEXURE G:. Consent letter for permission to conduct research: Gauteng Department of Health. ANNEXURE H:. Transcription of an interview. viii.

(11) CHAPTER 1. ORIENTATION TO THE STUDY. 1.1 INTRODUCTION BACKGROUND AND RATIONALE. Staff development (SD) is the systematic process of teaching, training and growth through which an individual acquires skills and knowledge, and develops attitudes and perceptions. Staff development is the induction, orientation, clinical teaching, in-service training, and continuous education of all members of staff (Jooste, 2010:249). Hughes (2005:42) suggests that the implementation of staff development programmes (SDPs) is at the heart of professional development. The importance of implementation of staff development programmes is to enhance the existing clinical skills and competencies of nurses and to bring about change and quality nursing care (Roberts and Kelly, 2007:6). Staff development contributes to higher job satisfaction, organisational commitment, and lower stress levels among staff (Pool, Poell & Ten Cate, 2013:35).. According to The South African National Department of Health Strategic Plan for Nursing Education ,Training and Practice (2012/2013-2016/2017:40), a Continuing Professional Development (CPD) system for all nurses must be introduced urgently. Consequently, the National Department of Health is encouraging the promotion of continuing professional development. This is communicating the importance of staff development programmes to render quality patient care, hence it is important for professional nurses to attend and implement staff development programmes.. Pool et al. (2013:36) is of the opinion that some older nurses perceive staff development programmes as a poor investment since they will retire shortly while Chang, Sheen, Chang and Lee (2008:827) report that professional nurses perceive staff development programmes as participation in live presentations and taking time away from the continuity of patient care.. The availability of staff development programmes does not guarantee that the implementation of programmes will be used efficiently or satisfactorily. However, effective support systems will facilitate and enhance the professional nurse’s satisfaction and ability to implement staff development programmes (Chang et al., 2008:827). In order to 1.

(12) clarify the issue of staff development, it is necessary to examine the Skills Development Act.. The Skills Development Act The Skills Development Act, (SDA) 1998 (Act no. 97 of 1998), is primary legislation that seeks to restructure the country’s National Education and Training system. It is supported in law by the Skills Development Levies Act, 1999 (Act no. 9 of 1999). These Acts where promulgated to develop and improve the skills of the South African workforce to improve the quality of life of workers, to increase productivity in the workplace for the promotion and enhancement of skills in the workplace. The purpose of the SDA is to encourage employers to use the workplace as an active learning environment to provide employees with the opportunities to acquire new skills, to encourage staff to participate in education and other training programmes, and to ensure the quality of education and training in the workplace. In addition, these Acts aim to ensure the development and improvement of the skills of the South African workforce according to Muller, Bezuidenhout and Jooste (2011:347), thus putting pressure on employers to continuously enhance employees’ skills through implementing staff development programmes.. The South African Nursing Council (SANC) in South Africa regulates the training, development of nurses and the quality that it provides. Consideration must be given to staff development programmes and the implementation of these programmes. Additionally, the National Department of Health (NDoH) has published a Policy on quality healthcare for South Africa focusing on the following principles (Department of Health, 2007:3).. Creating an environment in which quality healthcare will flourish, building. capacity to improve quality and ensuring delivery of quality care through staff development. Consequently, the National Department of Health, South Africa (Human Resources [HR] strategy, 2012/13-2016/17:10) states that the strategic framework must ensure a health care environment where the heath force is valued supported and has the opportunity to develop while providing quality care in order to achieve the overall goals of a flexible, efficient and high-quality workforce, staff needs to be developed. It is essential to ensure that quality professional care is an ongoing process which requires the development of the workforce according to The National Department of Health (Human Resource Strategy, 2012/13-2016/17:60-61).. 2.

(13) In order to ensure that the workforce has the requisite skills for the delivery of quality care, it is necessary to achieve a high-quality, efficient workforce.. The National Department of Health [NDoH], (2011:38) emphasises staff development programmes as a national priority which is highlighted in the National Core standards for quality, as domain 6. This domain states that a comprehensive programme for staff training and continuing professional development must be in place. The criteria for the standard stipulate that staff must receive on-going in-service education according to their roles and responsibilities [NDoH], (2011:38). SD is an organisation’s intentional effort to improve current and future performance by increasing capabilities of staff. In providing assistance to employees to become effective in the workplace the organization gains quality care (Muller, Bezuidenhout & Jooste, 2011:350).. The importance of the implementation of staff development programmes (SPDs) will improve the quality of care, reduce clinical incidents, and improve patient and staff satisfaction, according to Sullivan & Garland (2010:148). Booyens and Bezuidenhout (2014:258) emphasise the fact that staff requires on-going training to maintain effective performance and to be brought abreast with new developments in the workplace. To ensure that an institution’s training and development investment has the most significant outcome SDPs must be encouraged and implemented (Booyens & Bezuidenhout, 2014:258). SDPs are taken advantage of by staff since they attend as many training sessions and activities as possible, but do not bring any value to the organization in terms of an improved standard of work performance. Nurses do not implement what they have acquired from attending SDPs and consequently do not improve the quality of nursing care (Booyens & Bezuidenhout, 2014:265). Having introduced the study, the problem statement will be discussed below.. 1.2 PROBLEM STATEMENT. Staff development programmes are offered in a public hospital in Gauteng that nurses are required to attend. However, the nurses are reluctant to attend, and if they do attend, they do not implement what they have learned. As a result, identified learning needs are not remedied by staff development programmes, and poor nursing care continues.. 3.

(14) Some professional nurses make excuses to justify not attending and implementing the staff development programmes, the most common excuse being that they do not have the time to attend and to implement new procedures.. According to Hughes (2005:47), nurses may be experiencing a lack of direction and support which contributes to the negative perceptions surrounding the implementation of staff development programmes. He adds that a lack of implementation after attending staff development programmes causes professional nurses to be disempowered, thus leading to poor quality patient care. In addition, professional nurses have a responsibility to keep abreast with current knowledge and skills by attending staff development programmes and implementing what they have learned. Despite the fact that there are policies, procedures, and a year-plan on staff development, the implementation of staff development programmes still remain a problem in this hospital where this study was conducted. The research questions that guided this study are presented next.. Research Questions The following research questions emanated from the above problem statement: • What are the perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng? • What recommendations could be developed to facilitate the implementation of the staff development programmes in a public hospital in Gauteng? As a result of the above research questions, it is necessary to explain the purpose of the research and the research objective, which are discussed next.. 1.3 RESEARCH PURPOSE AND OBJECTIVES. The purpose of this study was to develop recommendations to facilitate the implementation of the staff development programmes in a public hospital in Gauteng.. The objectives of the study are:  To explore and describe the perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng. 4.

(15)  To develop recommendations to facilitate the implementation of staff development programmes in a public hospital in Gauteng.. Definitions of key concepts are presented below to contribute to the comprehension of these when used in the dissertation.. 1.4 DEFINITION OF KEY CONCEPTS. 1.4.1 Perceptions According to The Oxford Thesaurus and English Dictionary (2006:445), ‘perception’ is the ability to sense, feel, hear, observe, have a thought, believe, an idea of something, a realisation, an awareness and recognition. In this study perception refers to the professional nurses’ views, their insights or intuitions, beliefs and opinions regarding the implementation of staff development programmes in a public hospital in Gauteng.. 1.4.2 Professional Nurses “A professional nurse is a person qualified and competent to independently practice comprehensive nursing in the manner and to the level prescribed and who is capable of assuming responsibility and accountability for such practice according to the Nursing Act” (South Africa, 2005:6).. In this study professional nurses refer to those nurses registered with South African Nursing Council (SANC) in the capacity of a professional nurse and work in all the wards of a hospital. According to the Occupational Specific Dispensation [OSD] 001(2007:3) the professional nurses provide comprehensive nursing treatment and care to patients in a cost effective, efficient and equitable manner in the various levels of healthcare and also provide effective education and training to student nurses at a nursing college as well as in the general wards. A professional nurse’s scope of work is determined by the OSD therefore applies to the professional nurses in this study.. 1.4.3 Implementation Implementation is the act of accomplishing some aim, or executing an order. “The act of implementing is providing a practical means for accomplishing a task” (Word Net, 20035.

(16) 2012), while the Oxford Thesaurus and English Dictionary (2006:224) defines implementation as “an application, carrying out, carrying through, performance and administration.”. In this study implementation refers to the direct action of professional nurses regarding the implementation of staff development programmes.. 1.4.4 Staff Development Programmes According to Jooste (2010:249) staff development programmes refer to “a well-planned, comprehensive system of continuing professional growth activities carried out over a period of time to achieve specific institutional goals and objectives.”. In this study, staff development programmes refer to the scheduled development programmes designed for professional nurses, additional preparation to fulfill their job requirements in leadership and patient care, to improve the quality of service delivery in hospitals.. 1.4.5 Public Hospital The National Health Act, (Act no. 61 of 2003:7) describes a public hospital as a healthcare establishment for all South Africans. The public hospital also refers to a healthcare establishment that provides affordable healthcare to the community.. In this study the public hospital is a mother and child facility situated in Gauteng Western Region.. 1.4.6 Gauteng Gauteng is a small province embracing dense metropolitan complexes in South Africa, hosting a population of nine million multi-cultural and multi-racial people (Harrison, 2004:20).. In this study, Gauteng refers to a province in which the public hospital is situated and where this research study on the perceptions of professional nurses regarding the implementation of staff development programmes for professional nurses was conducted.. 6.

(17) 1.5 RESEARCH DESIGN AND METHODOLOGY. 1.5.1 Research Design A research design is a blueprint for conducting a study. It maximizes control over factors that could interfere with the validity of the study findings (Grove, Burns & Gray, 2013:195).. The research design for this study is qualitative, exploratory, descriptive and contextual in nature. The design is used for exploring and describing the perceptions of professional nurses regarding the implementation of staff development programmes (SDPs) in a public hospital in Gauteng. The researcher aimed to establish what the participants have in common regarding their perceptions on the implementation of staff development programmes (SDPs) in this hospital (Creswell, 2013:76).. 1.5.2 The Research Methodology Qualitative research is a useful, as it draws from varied research and theory traditions experience about working ways to approach and analyse different aspects of human reality. Additionally, it introduces theoretically informed practice and craft of doing social research. Qualitative research is used by researchers who want to involve the human factor in their research and delve beneath the surface of numeric. In order to communicate with the participants in social research, and by examining the participants’ words, it affords a researcher the ability to comprehend in-depth their emotions and experiences. The research design and methodology are dealt with in-depth in the following chapter.. 1.6 LAYOUT OF DISSERTATION. The layout of the dissertation is set out below:. Chapter One: The Background and Overview of the Study.. Chapter Two: The Research Design and Methodology.. Chapter Three: The Description of research findings.. 7.

(18) Chapter Four : Recommendations to facilitate the implementation of staff development programmes, limitations, recommendations for nursing practice, nursing education, nursing research and conclusion of the study.. 1.7 CONCLUSION. This chapter provided an overview of the study, its background and rationale for conducting the study. In addition, this chapter presented the problem statement, the proposed research design and methodology, the next chapter presents a comprehensive discussion of the research design and methodology used for this study.. 8.

(19) CHAPTER 2. RESEARCH METHODOLOGY. 2.1 INTRODUCTION. Chapter one introduced the reader to the background and rationale of the study. The problem statement, research questions, objectives of the study, definitions of the key concepts, research design including methodology and a layout of the dissertation. The purpose of this chapter is to describe and justify the research design and methodology used to conduct this study. The research methodology chosen for this study was the qualitative research method, which includes the population and sampling methods, inclusion criteria, method of data collection, data analysis and trustworthiness. The purpose and objective of this study was to explore and describe the perceptions of professional nurses regarding the implementation of staff development programmes (SDPs) in a public hospital in Gauteng in order to develop recommendations for the implementation of SDPs in the public hospital. A discussion of the research design follows next.. 2.2 RESEARCH DESIGN. A research design involves all decisions a researcher makes in planning for conducting the study (De Vos, Strydom, Fouché & Delport, 2011:307; Creswell, 2013:49). The research design selected for conducting this study was a qualitative, exploratory descriptive and contextual design in order to gain insight into and understanding of the perceptions of professional nurses regarding the implementation of staff development programmes in the public hospital in Gauteng. The design guided the researcher in understanding and exploring the reality of the participants (De Vos et al., 2011:308; Creswell, 2013:76).. Below is a discussion of the qualitative research method.. 9.

(20) 2.2.1 Qualitative Research Methodology The Qualitative research method is a systematic, interactive, subjective, holistic approach used. to describe life experiences and to have an understanding and make meaning of. those life experiences (Grove, Burns & Gray, 2013:23). Qualitative research is an approach to inquiry that begins with assumptions, an interpretative/theoretical lens, and the study of research problems exploring the meaning individuals or groups ascribed to a social or a human problem (Creswell, 2013:64). The qualitative research approach refers to a broad range of research designs and methods used to study phenomena of social action which we do not understand (Brink, Van der Walt & Van Rensburg, 2012:121).. According to Creswell (2013:43) qualitative research is a situated activity that locates the observer in the world. The qualitative research design allowed the researcher to explore the depth, richness and the complexity of the phenomenon under study (Brink, 2012:120). The Qualitative approach was used to answer questions about the complex nature of a phenomenon with the purpose of describing the phenomenon from participants’ point of view (De Vos et al., 2011:64).. The reason for the choice of a qualitative research design was that the qualitative design involves an interpretive, naturalistic approach to the world (Creswell, 2013:44). This means that qualitative researchers study phenomena in their natural settings to make sense of/or interpret phenomena in the meaning that people bring to them (Denzin & Lincoln, 2011:3). Leedy and Ormrod (2010:135) suggest that in qualitative research “we need to dig deeper”, while Brink et al. (2012:121) purported that the researcher, who wants to obtain an insider’s perspective, needs to stand back and let the research’s participant’s voice be heard.. Additionally, the qualitative research design was selected for this study because it enabled the researcher to explore by digging deeper into the perceptions of professional nurses regarding the implementations of staff development programmes in order to develop recommendations to facilitate the implementation of staff development programmes in a particular public hospital in Gauteng. It is necessary to discuss exploratory research and this discussion follows.. 10.

(21) 2.2.2 Exploratory Research Exploratory research begins with a phenomenon of interest instead of just recording and observing incidents of the phenomenon (Creswell, 2013:35; Blaikie, 2000:75). For the purpose of this study the researcher explored the perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng. Exploratory research is not intended for generalisation to large populations. It is designed to increase the knowledge of the field of the study through experiencing the phenomenon under study (Grove et al., 2013:370). The researcher departed from the point of not knowing and thus used the exploratory method to gain information about the perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng.. Exploratory and descriptive research explores the reason why something occurs as in the nurses’ perceptions regarding the implementation of staff development programmes (Kreuger & Neuman, 2006:23). According to Rubin and Babbie (2005:126), a study seeking to develop an initial understanding of a phenomenon (even though it might include asking respondents why, or to explain their actions) is more likely to be exploratory. The aim of this exploratory study was to gather new data in order to gain insight into the phenomenon of interest and the participants’ perceptions regarding the implementation of staff development programmes in the public hospital in Gauteng. The understanding of professional nurses’ perceptions contributed to the development of recommendations to facilitate the implementation of staff development programmes in the public hospital. This could assist nurses in gaining knowledge and skills from the SDPs which when implemented would improve quality nursing care. Descriptive research is discussed next to clarify its use in this study.. 2.2.3 Descriptive Research Descriptive research refers to a more intensive examination of phenomena and their deeper meanings leading to thicker description (Rubin & Babbie, 2005:125). For this study the researcher described the perceptions of professional nurses regarding the implementation of staff development programmes and developed recommendations to facilitate the implementation of staff development programmes in the public hospital. Descriptive research is conducted to address an issue or problem in need of a solution and/or understanding (Grove et al., 2013:27). Nurse researchers who conduct Qualitative 11.

(22) research explore an issue or problem area using a variety of qualitative techniques with the intent of describing the topic of interest and promoting understanding. Descriptive designs are used where more information is required in a particular field through the provision of a picture of the phenomenon as it occurs naturally (Brink et al., 2012:112). Through descriptive research the researcher was able to describe in-depth what the perceptions of professional nurses were regarding the implementation of staff development programmes, and to describe recommendations to facilitate the implementation of staff development programmes in the public hospital in Gauteng. Contextual research is explained next.. 2.2.4 Contextual Research Cobin and Strauss (2008:94-95) summarise a context as a set of conditions within which action or interaction strategies are taken. This study is contextual because it was conducted in a specific hospital focusing on mothers and children. The hospital is situated in Gauteng Western Region. It is approximately 9 kilometres from Johannesburg CBD. The facility serves predominately, the community of the surrounding areas that are: Industria West (0.66 km), Westbury (0.69 km), Hurst Hill (0.18 km), Crosby (1.35 km), Westdene (1.66 km), Sophiatown (1.68 km) as well as serving the province and Africa. The institution has a capacity of 332 beds and it has 18 inpatient wards and 6 outpatient wards which are run by operational managers appointed to oversee the effective management of the wards, as well as the optimal performance of the staff.. The facility provides 24 hour services, more than 10 000 births occur annually, 36 000 outpatients are also seen annually of which 15% attend sub-speciality clinics, specialist follow up clinics that include neonatal cardiology, nephrology, endocrinology, genetics, epilepsy and asthma. Paediatrics, gynaecology, emergency area, paediatric intensive care unit (PICU) and adult high care (AHC), The National Health Act, (Act No. 61 of 2003).. The hospital is affiliated to unions and has representatives that are shop stewards. According to an article from EWN (m.ewn.co.za/2015/11/18) [Accessed 8 February 16], a complaint was lodged regarding incorrect treatment by nursing staff. A woman lost her baby and claimed that nurses had mistreated her. The Gauteng Department of Health (GDoH) investigated the matter and has appointed an industrial psychologist to assist nurses on how to manage challenging patients, diversity cultural differences, language, how to focus better professionally, identify system challenges and 12.

(23) team work between departments. This will be augmented by improving employee wellness programmes, and counselling for nurses to help them debrief. The hospital has staff development programmes that nurses attend, and need to implement what they have learned. Based on this, and the incidents that occur nurses need to be knowledgeable, the researcher embarked on this research to explore and describe the perceptions of nurses in order to develop the recommendations to facilitate the implementation of staff development programmes in this hospital.. 2.3 THE RESEARCH METHOD. A research method evolved from behavioural and social sciences as a method of understanding the unique dynamic, holistic nature of human beings (Grove, Burns & Gray, 2013:24). The Research method is a humanistic study of phenomena that is conducted in a variety of ways according to the philosophy of the researcher. During the study, the researcher experiences reflections, and interpretations influenced by the data collected from the study participants (Burns & Grove, 2009:25). The research method constituted a description of the population, sample and sampling method, data collection, data analysis and trustworthiness. The researcher obtained information through direct interchange with an individuals or a group that is known or expected to possess the knowledge she seeks (De Poy & Gilson, 2008:108).. This study was conducted in two phases as follows: Phase 1 focused on the exploration and description of the perceptions of the professional nurses regarding the implementation of staff development programmes in the public hospital in Gauteng. Phase 2 focused on the development of recommendations that are anticipated to facilitate the implementation of staff development programmes in the public hospital in Gauteng.. The research method that was used focused on the following domains (Burns & Grove, 2011:55).. 13.

(24) Phase 1 . Population and sampling. . Data collection. . Data analysis. . Trustworthiness. . Ethical considerations. 2.3.1 Population Population is an entire group of people that is of interest to the researcher that meets the criteria that the researcher is interested in studying (Brink et al., 2012:131). Population is also described as setting boundaries with regard to the participants all individuals that meet certain criteria for inclusion in the study (De Vos et al., 2005:193). In this study the population is all professional nurses working in the public hospital in Gauteng while the target population was professional nurses working in this hospital who participated in this study.. 2.3.2 Sample and sampling method A sample is a subset of the population that is selected for a particular study (Grove, Burns & Gray, 2013:44). The study required rich data to be collected from the participants. The researcher’s decision was to identify the participants who would provide rich information and consequently selected a sample of a group of participants from the population who it was anticipated would. provide extensive information about the topic (Creswell,. 2013:157). The sample comprised professional nurses who were identified from staff development attendance registers and who were willing to participate in the study.. Sampling Method Sampling involves selecting a group of people, events, behaviours or other elements with which to conduct a study (Grove et al., 2013:351). The number of participants who participated was determined by data saturation, at the point at which participants were no longer giving new information. At fourth 4th focus group interviews. Creswell (2007:125) pointed out that purposive sampling is used in qualitative research and participants are selected purposefully because they have an understanding of the research problem of the study and are able to provide valuable information. The researcher’s choice of purposive sampling to identify participants was with the sole purpose of obtaining rich, thick data to answer the research questions and achieve the 14.

(25) aim of the study. In addition, the researcher used purposive sampling method to select participants with rich information regarding the implementation of staff development programmes in this hospital. The researcher identified participants from staff development attendance lists who were willing to participate in the study.. 2.3.2.1 Sampling criteria Sampling criteria also referred to as eligibility criteria include the use of characteristics essential for membership or eligibility in the target population (Grove, Burns & Gray, 2013:352).. Inclusion criteria Inclusion criteria consists of characteristics that should be present for the participant to be included in the sample (Burns & Grove, 2009:345). In this study, the inclusive criteria were: . Participants who were willing to participate in the study.. . Participants who were employed at the public hospital.. . Participants who consented to the use of an audio recorder.. . Participants who had 18 months & longer experience in the field.. Once the sample was selected the data collection may begin, the data collection methods are described next.. 2.3.3 Data collection Methods Data collection is the process by which the researcher gathers information relevant to the study, from the participants. Data collection involves gaining permission, conducting a good qualitative sampling strategy, developing means for recording information both digitally and on paper, storing the data, and anticipating ethical issues that may arise (Creswell, 2013:145).. Data collection commenced after the following structures granted permission and ethical clearance: •. The UJ Faculty of Health Sciences Research Ethics Committee (Annexure A). •. The UJ Faculty of Health Sciences Higher Degrees committee approval (Annexure B). •. The public hospital ethics committee permission to conduct the study at the public hospital (Annexure C). 15.

(26) 2.3.3.1 The role of the researcher in the Collection of Data Following the approval and ethical clearance from all the above structures, the researcher proceeded with the research process as follows: •. The researcher had a briefing session with the participants before the actual interview session in order to build a rapport with them. The researcher introduced the topic with the explanation of the background and rationale, the purpose and objectives of the study.. •. The participants were informed that the interviews would be audio-taped to capture their responses verbatim and that voluntary informed consent was necessary for these two processes (Annexure E, F). Participants were reminded that their participation was voluntary and that they were entitled to withdraw at any time without any repercussions or penalty.. •. The researcher who was the interviewer arranged the scheduling of the interviews were scheduled with those who had volunteered to participate in the study. The researcher ensured that the participants work schedule was not disrupted therefore interviews were scheduled for when participants were off duty.. •. A tentative time frame was established, allowing 30 to 45 minutes per individual interview, although the participants would be allowed more time to elaborate on their experiences should the need arise. The focus group interviews were scheduled for 45 to 60 minutes.. •. The researcher assured the participants that they would only be identified numerically to ensure their anonymity and that all their responses would not be divulged to anyone; thus upholding the principle of confidentiality.. •. A private venue was allocated at the hospital for conducting the interviews. The principles of establishing a non-threatening environment that ensured an inviting atmosphere was adhered to. The principles included a wellventilated/air-conditioned room with adequate lighting. The interview room was private and free of environmental noises, like a telephone and frequent disturbances by staff members. A “SILENCE. INTERVIEWS IN PROGRESS” sign was placed on the door.. •. The researcher ensured that water was made available for the participants and general stationary was supplied for making notes. 16.

(27) •. The interviewer provided an audio recorder and spare batteries were available, as well as second audio recorder to serve as a backup.. •. The researcher displayed an attitude of respect and gave positive affirmation to ensure a good environment and created an environment that encouraged independence and freedom of expression.. The following research questions were posed to the participants: “What are your perceptions regarding the implementation of staff development programmes in this hospital?” “What can be done to facilitate the implementation of staff development programmes?”. 2.3.3.2 Interview techniques used by the researcher The researcher made use of the following interview techniques including: Clarifying: clarification strives to promote mutual understanding between those involved in the research process (Okun & Kantrowitz, 2008:77) by attempting to understand the basic nature of a participant’s statements (Kneisl & Trigoboff, 2009:155). The researcher asked for clarification to bring vague information into sharper focus in order to promote understanding. The researcher also clarified the question by making it less confusing and clearer to understand for participants to answer, for example “Could you tell me more about ...’’ . Paraphrasing: is the process of rewording the content stated (Sommers-Flanagan & Sommers-Flanagan, 2003:64). The researcher utilised this communication technique by repeating the key words that the participants had said to express the ideas clearly using the participant’s own words for better understanding. Participating stimulates the participants to elaborate what they have said. The researcher was expressing participant’s ideas by repeating what they had said in different ways.. . Probing: refers to the researcher’ ability to identify and explore experiences, behaviours and feelings that will assist the participant to engage more constructively in other steps of communication (De Vos, Strydom, Fouché & Delport, 2005:70). Probing picks up on the client’s last remarks (Murphy & Dillon, 2011:161). Typically probing questions were, asking the participants to elaborate, explain or describe and tell more about the topic. Probing gave the researcher the opportunity 17.

(28) to clarify and expand responses and explicate meaning (Brink, Van der Walt & Van Rensburg, 2012:158). . Summarising: means combining the different views and feeling at the end of the interview by compiling them into one meaningful single statement (Okun & Kantrowitz, 2008:78). During the interview, summarising was used to assist participants to elaborate further on what they were thinking. The researcher summarised the participant’s ideas, thoughts and feelings verbalised to see if they really understood what they were saying (Jarbandhan & Schutte, 2006:674). At the end of the interview, summarising was used for closure.. 2.3.3.3 Focus group interview A focus group interview is a powerful means of exposing reality and investigating the topic and is a way of closing the gap between participants (De Vos et al., 2011:362). Focus group interviews are interviews with groups of approximately 5-12 people in a group whose opinions and experiences are requested simultaneously (Brink et al., 2012:158).. In this study the researcher chose focus group interviews because it exacted a process of sharing and comparing among the participants. The group discussion generated and produced data in a short period of time. Group dynamics frequently brings out aspects that would not have emerged with individuals (DePoy & Gilson, 2008:110). The participants were able to generate information regarding the implementation of staff development programmes in a short space of time (Kroll, Barbour & Harris, 2007:691).. The focus group interviews were conducted to explore and describe the perceptions and experiences of professional nurses regarding the implementation of staff development programmes. In this study focus group interviews were conducted with professional nurses to gather information in a natural environment.. Professional nurses and operational managers were utilised to gather data because of the experience they have lived or undergone.. The interaction among participants consisted of their efforts to understand each other. The method used was friendly and respectful for both participants and researcher and participants felt empowered and supported in a group and were able to share their experiences and feeling amongst themselves in some way (Kroll et al., 2007:692). The 18.

(29) researcher conducted this study in an environment that encouraged a comfortable conversation for participants to tell and share their experiences and perceptions regarding the topic.. The interviews continued until data saturation was reached. Data saturation in this study was the point where the researcher began to hear participants repeatedly reporting the same information until they were no longer reporting anything new (Monette, Sullivan & De Jong, 2005:242). Data saturation was reached at the fourth (4th) focus group interviews.. 2.3.3.4 Field notes According to Bogdan and Biklen (2007:169) field notes are a written account of things the researcher hears, sees experiences and thinks about in the course of the interview. Field notes are frequently the record keeping device for interviews (Brink, 2012:159). Field notes are an important data collection technique. Royse (2004:237) suggests that the researcher literally walks in the shoes of the participants by, submerging herself in order to become part of the group to facilitate gathering of field notes. Field notes, have an advantage because they add to the richness of collected data. In qualitative research field notes are important because they enable the researcher to note the observations gained during the interviews and those field notes are analysed when required (Babbie, 2007:311) observations were made during the interviews. Compiling field notes was very helpful for relating participant’s behaviour that is verbal confidence, mannerism, slang, tone of voice, repetition, stammering, and colloquialism. In this study the researcher made sketchy notes followed up later with written notes in more detail as soon as observations had ended.. Bracketing Creswell (2013:80) refers to bracketing as; when the researchers set aside their experiences, as much as possible to take a fresh perspective of phenomena under examination. The researcher attempts not to be judgemental and suspends her opinions or biases by using focus group interviews, field notes, and an audio-tape recorder to minimise bias.. 19.

(30) 2.3.4 Data analysis Data analysis is conducted to reduce, organise and give meaning (Grove et al., 2013:46). Data analysis is the process of bringing order, structure and meaning to the mass of collected data. “This is the activity of making sense, interpreting and theorising data” (Schwandt, 2007:6). Data analysis could be treated both as science and as art rather than technique. This entails categorizing, ordering, summarising and describing making data meaningful. The researcher chose methods of exploring and organising the raw data as well as organize and interpreting the data, in order to give answer to the question of this study (Brink et al., 2012:177).. Data analysis assisted the researcher to better understand the process and allowed her to become immersed in the data. The researcher followed a path of analysing the data to develop a detailed knowledge of the topic under study. Data analysis involves coding the data by classifying words or phrases, categorizing the data into subcategories and identifying the ones that are of greatest priority for the study (Schwandt, 2007:7) identifying patterns, themes or aspect that are alike and unalike.. In this study, the data recorded from the audio recorder was transcribed verbatim before being analysed according to Tesch’s open coding as described by (Creswell, 2013:184). The audio recorder interviews were transcribed verbatim (see Annexure D).. a) Verbatim transcription of interviews occurred soon after the interviews were conducted. Transcripts are records of interviews. The researcher aimed at transcribing all the data in order not to leave out some of the information. The purpose of analysing the transcripts was to ascertain meaning. In some cases, the words used have little or no meaning. Sometimes the participants asked for exact interpretation of what was meant, may not be able to explain the meaning. Transcribing was important since it produced a reliable presentation of precise words used by participants including emotions like sadness, use of technical language, slang, being talkative, disinterest, uncertainty and hesitation.. In this study all transcripts collected were carefully read by the researcher and the independent coder. Consensus discussions between the researcher and the independent coder were confirmed. 20.

(31) b) The independent coder is a data analyst who was consulted to analyse the interviews independently of the researcher. The independent-coder works independently on data to minimise the chances of errors. All transcripts collected were carefully read by the independent-coder and the researcher. The data was analysed using Tesch’s descriptive method (Creswell, 2009:186).. The following steps were followed by the researcher: . The researcher acquired a sense of the whole by carefully reading through all the transcripts as well as ideas jotted down as they came to mind.. . The researcher picked up one document (one interview). For example, the shortest and most interesting, and the one on top of the pile and went through it asking: “what is this about?” Was the purpose of the question to find the underlying meaning of the information? Thoughts that came to mind were then jotted in the margin.. . When the researcher had completed this task for several participants, a list of all topics was made. Similar topics were clustered together and put into major columns arranged into major topics, unique topics and the leftovers.. . The researcher then took the list of topics and returned to the data. The topics were abbreviated as codes and written next to the appropriate segments of the text. The researcher tried out a preliminary organizing scheme to establish whether new categories and codes had emerged.. . The researcher found the most descriptive wording for the topic and returned them into categories. Then looked for ways of reducing the total list of categories by grouping together topics that were strongly related to each other. Lines were drawn between categories to show interrelationships.. . Subsequently, the researcher made a final decision on the abbreviations for each category and alphabetized the codes.. . The data belonging to each category was assembled in one place and a preliminary analysis was performed.. . Where necessary the existing data was recorded by the researcher.. 21.

(32) The transcribed audio recorded interviews and field notes were given to the independent coder who was a skilled, qualified, qualitative researcher. Triangulation of data was made using focus group interviews and field notes, by the independent coder who analysed the interviews independently of the researcher.. After the interviews were analysed the researcher and the independent coder met for a consensus discussion. They both came together to discuss the data collected from participants and worked together until they arrived at a final decision on acceptable themes and subthemes from the findings.. 2.4 TRUSTWORTHINESS. Strategies of trustworthiness In this study the strategies of trustworthiness are namely credibility, transferability, dependability, conformability and authenticity. Each strategy is described below:. Each of these strategies is then explained in more details.. 2.4.1 Credibility Credibility refers to the extent to which the researcher will demonstrate truthfulness of the research findings (Lincoln & Guba, 1985:297). Credibility requires adequate submersion in the setting to enable recurrent patterns to be identified and verified (Krefting, 1991:217). The strategy of prolonged engagement with participants, doing member checking and consensus meetings between the researcher and participants Lincoln, and Guba (1985:298) was applied.. Prolonged engagement ensured that professional nurses understood the process of the research as well as to establish a relationship that is built on trust between them and the researcher. The interviews lasted approximately 45-60 minutes. The researcher collected data until saturation was reached. The researcher has done and passed the one-year research methodology course and was promoted by two supervisors who are masters’ degree holders, one pursuing her doctoral degree with the other already honoured with her doctoral degree.. 22.

(33) Preferential sufficiency was captured by means of field notes that was discussed during data analysis, audio recording of focus group and in-depth individual interviews.. Triangulation is a powerful strategy for enhancing the quality of the research particularly credibility of a study. It is based on the idea of convergence of multiple perspectives for mutual confirmation of data to ensure that all aspects of a phenomenon have been investigated (Krefting, 1991:219).. Triangulated data sources are assessed against one another to cross-check data and interpretation. Triangulation was reached by means of data collection methods that are focus group interviews, and field notes.. Peer examination is based on the same principle as member checks but involves the researcher’s discussing the research process and findings with impartial colleagues who have experience with qualitative methods.. Insights of participants are discussed and problems presented as a form of debriefing. Lincoln and Guba (1985:297) suggested that this one way of keeping the researcher honest, and the searching questions may contribute to deeper reflexive analysis by the researcher. Peer debriefing involved the researcher’s discussion of the research process and findings with colleagues who have experience in qualitative methods. In this study follow up interviews were done with the operational managers’ and professional nurses’ focus group interviews to verify accuracy of collected data. A consensus meeting was held with the independent coder to verify data analysis.. 2.4.2 Transferability Transferability refers to the degree to which the findings of the research study can be generalised to all contexts within that same population (Lincoln & Guba, 1985:296). In this study, transferability was ensured by comparing characteristics of participants in the subject being studied, the content of interviews, and the behaviours.. The researcher provided enough description of methods used for conducting the focus 23.

(34) group interviews, as well as description of the population and sampling method used. It was to ensure that future researchers have the necessary information of the research should the need arise.. Another means of ensuring transferability was to use the comparison of the characteristics of the informants to the demographic information available on that group being studied.. 2.4.3 Dependability Dependability refers to the consistency of research findings in different situations (Krefting, 1991:221). The following technique was the strategy of dependability; the independent coder conducted audits on the exact method of data gathering, analysis and interpretation and allowed the researcher to come up with conclusions about dependability and consistency of research findings (Krefting, 1991:221).. In this study, frequent consultation with study supervisors as experts in nursing research to guide the research project from the start to completion was done to ensure dependability of the research findings.. Triangulation ensures that the weakness of one method of data collection was compensated for by the use of alternative data gathering methods. In this study, focus group interviews, field notes and an audio recorder were used as data collection methods.. 2.4.4 Confirmability Confirmability refers to the evaluation of data and whether the results of the research could be confirmed by others (Lincoln & Guba, 1985:298). The findings should be a true reflection of the participant’s perceptions, rather than the reflection of the researcher biases. Confirmability also refers to the degree to which the findings are a result of the conditions of research and not of other biases, motivation and perspectives.. Krefting (1991:221) viewed neutrality not as a researcher’s objectivity but as data and interpretational confirmability and described the audit strategy as the major technique for establishing confirmability. In this study, all research records were kept for auditing and will be stored in a cupboard for two years and will be destroyed after publication of the study. The audit strategy was a major technique for establishing confirmability which 24.

(35) involved an external auditor to follow the progression of events in a project and to trying to understand how and why decisions were made. This was achieved through consensus meetings as well. A confirmability audit was monitored throughout the study by the researcher’s supervisor, co-supervisor and independent coder.. 2.4.5 Reflexivity Reflexivity is a concept in which the researcher is conscious of biases or experiences that he or she brings to a qualitative research study (Creswell, 2013:216). In this study, reflexivity was achieved by the use of focus group interviews, an audio recorder, and recorded field notes.. A summary of the above strategies is presented in Table 2.5 below. 25.

(36) 2.5 Table Strategies to ensure trustworthiness according to Guba’s model (in Krefting, 1991:217).. STRATEGY. CRITERIA. APPLICABILITY. Credibility. Prolonged engagement.  . . . Reflexivity. . Prolonged engagement with professional nurses to establish trust. Established rapport with the participants by engaging in interaction prior to interviews. Ensured data saturation was obtained.. Field notes were taken by researcher in-depth individual, focus group interviews. A consensus meeting was convened.. Member checking. . To validate that the information obtained was correct.. Triangulation. . Employed different methods of data collection in-depth, individual, focus group interviews, and field notes.. Authority of the researcher. . The researcher underwent a training programme in research methodology during her MCur degree.. 26.

(37) Transferability. Peer examination. . There were two (2) supervisors in this study; the supervisors hold a master’s degree and pursued their doctoral degree in nursing. Both supervisors possess a vast knowledge and experience in research. They nurtured, supervised and observed the researcher’s capabilities and ethical standards.. Structural coherence. . Focus was on the perceptions regarding the implementation of staff development programmes.. Nominated sample. Dense  description. Purposive sampling was utilised in this study. The demographic profile of the participants was described. The findings of the study were discussed in-depth with permission from participants. The findings were compared and substantiated by literature.. . . . 27.

(38) Dependability. Confirmability. Dependability audit. . Field notes and reflexivity notes were checked.. Dense description. . Research methodology was described.. Code recording technique. . A consensus discussion was held.. Triangulation. . It employed efficient methods of data collection: in-depth individuals, focus group interviews and field notes.. Audit trial. . By checking field notes and reflecting.. Reflexivity. . By checking field notes and reflecting.. 2.6 ETHICAL CONSIDERATIONS. To protect the rights of the participants the researcher adhered to the four ethical principles referred to by Dhai and McQuoid-Mason (2011:14-15). The proposal was submitted for approval to the University of Johannesburg’s Faculty of Health Sciences, Ethics Committee and Higher Degrees Committee.. Principle of respect and autonomy According to Dhai and McQuoid-Mason (2011:14) respect for autonomy of an individual is an autonomous choice and decision making by participants. It is the basis of informed consent and respecting confidentiality during the study process. In this study the researcher adhered to this principle by obtaining informed consent from participants and also consent to use an audio recorder (Annexure E, F).. 28.

(39) Consent is the prospective subject’s agreement to participate in a study as a subject, which the subject reaches after assimilating essential information (Grove, Burns & Gray, 2013:176).. Principle of non-maleficence The principle of non-maleficence is defined as the principle of avoiding harm or doing as little harm as possible (Dhai & McQuoid-Mason, 2011:14). For this study the researcher respected and secured the wellbeing of participants by refraining from any means of physical, emotional, spiritual or social discomfort and harm to participants, ensured that they had the right not to answer questions if they felt uncomfortable in answering. They were also allowed to withdraw from participating in the study without any repercussions.. Principle of beneficence Beneficence means doing good for others and promoting others’ interest and well-being (Dhai & McQuoid-Mason, 2011:14). This principle required the researcher to act in the best interest of the participants and to aim at promoting their wellbeing. In this study the principle was achieved by making the researcher’s telephone number available to participants so that they could contact the researcher if they needed more information relating to the research project. Participants had the right to withdraw from the study without any repercussions if they wished to do so. Dhai and McQuoid-Mason (2011:15) states that the researcher must inform the participants about all risks and benefits that may occur as a result of the study (Annexure A). There were no risks associated with the study for professional nurses, and operational managers who participated in this study, participants stand to benefit from the recommendations developed to facilitate the implementation of staff development programmes in a public hospital in Gauteng.. Right to privacy Grove et al. (2013:169) refers to the right to privacy as an individual’s right to determine the time, extent, and general circumstances under which personal information will be shared with or withheld from others. In this study, participant’s information or records will be kept in a secure, locked cupboard for two years and be accessible to the researcher’s supervisors and co-supervisors only. Records will be destroyed two years after publication of the study. 29.

(40) Right to anonymity and confidentiality. The research participant has the right to anonymity and the right to assume that the data collected will be kept confidential (Grove et al., 2013:171). In this study, anonymity was ensured by using code names, that does not link the participant’s identities to their names. The researcher respected the participant’s privacy and confidentiality was maintained during data collection.. Principle of justice. According to Dhai and McQuoid-Mason (2011:15) the principle of justice in health care refers mainly to distributive justice and the fair treatment of participants. In this study participants were all fairly treated. They had the right to share their perceptions without unforeseen risks or discomfort and a right to withdraw from participating at any stage during the research if they wished to do so without penalty or repercussion.. 2.7 CONCLUSION. This chapter addressed the research design and methodology followed for conducting this study. Strategies to ensure trustworthiness, credibility, transferability, dependability, confirmability were described. Ethical considerations were also discussed in relation to autonomy, anonymity, privacy, informed consent, beneficence and justice, as well as quality of the research. Following the above research design and the methodology, the perceptions of professional nurses regarding the implementation of staff development programmes, were explored and described. In Chapter Three, the research findings of the perceptions of professional nurses regarding the implementation of staff development programmes in a public hospital in Gauteng will be described with the integration of relevant literature which will form the foundation for development of recommendations to facilitate the implementation of staff development programmes in the public hospital in Gauteng where the research was conducted.. 30.

(41) CHAPTER 3. DESCRIPTION OF FINDINGS. 3.1 INTRODUCTION. The methodology that was used for this study was described in Chapter Two. The research design, population and sampling method including the criteria of inclusions, method of data collection, data analysis and trustworthiness were presented. This Chapter focuses on the description of the findings concerning the perceptions of professional nurses regarding the implementation of staff development programmes (SDP) in a public hospital in Gauteng. The sample consisted of (4) four focus groups consisting of (8 – 10) participants in each group. The focus group interviews continued until data saturation was reached where no new information or no repetitive themes emerged with the. fourth focus group. The following research questions guided the. discussion . What are your perceptions regarding the implementation of staff development programmes in this hospital?. . What can be done to facilitate the implementation of staff development programmes in this hospital?. The data was analysed using Tesch’s descriptive method of data analysis as described in Creswell (2009:186). The researcher and the independent coder had a meeting where consensus was reached regarding the themes and the subthemes that emerged. Key terms related to staff development were discussed to provide clarity for the reader.. According to Jooste (2013:249) and Muller et al. (2011:254), staff development (SD) refers to a well-planned purposeful comprehensive system of continuing professional growth activities carried out over a period of time to achieve specific institutional goals and objectives. It includes induction training general orientation programmes, in-service training programmes (SDPs) self-directed learning and organisational development which are relevant to health care personnel so that staff can function effectively and optimally. 31.

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