Elsevier

Nurse Education Today

Volume 31, Issue 8, November 2011, Pages 768-773
Nurse Education Today

Nurses' Internet self-efficacy and attitudes toward web-based continuing learning

https://doi.org/10.1016/j.nedt.2010.11.021Get rights and content

Summary

Objective

There are increasing opportunities for nurses to engage in continuing learning via the Internet; hence, it is important to explore nurses' attitudes toward web-based continuing learning.

Method

This paper explores 267 Taiwanese clinical nurses' attitudes toward web-based continuing learning. In addition, the role of the nurses' Internet self-efficacy in their attitudes is investigated. This study utilizes two questionnaires to respectively survey the nurses' Internet self-efficacy and their attitudes toward web-based continuing learning. In particular, the Internet Self-efficacy Survey includes two scales: ‘Basic self-efficacy’ (the perceived confidence of using basic Internet functions, such as the confidence in using a web browser or searching for online information) and ‘Advanced self-efficacy’ (the perceived confidence of using advanced Internet functions, such as the confidence in online discussion or making online payments).

Results and findings

Exploratory factor analyses indicated adequate reliability and validity of the two questionnaires. The regression analyses revealed that both nurses' basic and advanced Internet self-efficacy can positively explain the perceived usefulness, ease of use and friendly feeling when using web-based continuing learning environments, whereas nurses' advanced Internet self-efficacy was the only predictor to explain how they intend to use web-based continuing learning environments more.

Introduction

Over the past decade, Internet technology has had a considerable impact on many aspects of education by offering a totally new instructional mode. In nursing education, many researchers have also begun to rethink and investigate the unique features of the incorporation of Internet-based learning for clinical nurses. For example, nurses and midwifery educators have continued to integrate new technology with distance-learning and web-enhanced curricula to increase the access to nursing and midwifery education (Carr, 2003, Chang et al., 2008). Twomey (2004) reviewed the relevant literature and discussed the implications of web-based teaching and the role of the online teacher for nurses' professional development. Twomey further concluded that more and more web-based learning institutions are helping nurses' teachers to create new teaching and learning environments to mediate between the nursing-related knowledge and the nursing students (Twomey, 2004). McVeigh (2009) discovered the factors influencing the nursing students' utilization of web-based learning, and found that their perceptions of e-learning were positively related to factors including the flexibility of the time arrangement, the pace of learning, self direction, and widening access to multiple sources of information. Moreover, C.Y. Chen et al. (2009) developed a questionnaire to measure the quality of nurses' web-based continuing learning systems, and found that the most important factor for nurses to be engaged in web-based continuing learning environments is service quality.

Internet learning environments are considered as individual and learner-centered learning environments as they contain multiple and rich resources and have an autonomous character which offers a flexible learning environment (Chu and Tsai, 2009). These environments are now available to nurses working in hospitals to develop their professional knowledge with web-based learning. In contrast to traditional in-class education, the underlying characteristics of Internet learning environments, such as autonomy, time flexibility, interactivity, clear learning goals, more opportunities for practice, and immediate online feedback, may promote nurses to engage in learning more, especially in their continuing education (C.Y. Chen et al., 2009; Yu et al., 2007). Web-based learning provides nurses with a new environment that allows them to develop professional skills and knowledge in self-initiated learning (Liang and Wu, 2010). This new version of learning may make a change that prompts nurses from the role of passive learners into active constructors of advanced clinical knowledge.

As a result of nurses' adoption of web-based continuing learning, the most important advantages are the convenience and ease of the capture of the online knowledge and information they need (C.Y. Chen et al., 2009). A previous study has suggested that web-based continuing education should empower nurses to balance their own learning and workloads at the same time (Cook et al., 2004). Some other reasons for nurses to adopt web-based continuing learning are the flexibility of both time and space, self-regulated learning, cost-effectiveness, and less impact on their family and personal life (Yu et al., 2007). Such a learning environment also assumes that nurses have the ability to make good judgments and choices regarding their own learning needs (C.Y. Chen et al., 2009). Although web-based learning environments have provided effective and alternative learning approaches for nurses' continuing learning as mentioned earlier, there are a number of limitations such as supply of equipment, the cost and the training required both for the teacher and the learners to use the technology (Baid and Lambert, 2010). Previous studies have also indicated the problems faced by users when using the Internet to participate in Internet activities, especially the social-interaction problems (Kim and Davis, 2009, Caplan, 2010). Baid and Lambert, 2010 mentioned that e-learning does not suit all learning styles, and that the main problem of the nurse learners in web-based learning may come from their resistance to or unfamiliarity with using computer technology (S.W. Chen et al., 2009). These studies have shown different aspects of nurses' attitudes or perceptions which influence their decision to participate in web-based continuing learning. Therefore nurses' attitudes toward web-based continuing learning have become a critical issue in nurses' education.

Internet attitude is regarded as an important component of Internet literacy (Tsai et al., 2001); that is, the disposition toward or the perception of using the Internet plays an important role in its actual use. Learners' Internet attitudes may affect their willingness to learn and their interest in learning through web-based learning environments (Peng et al., 2006). For example, learners expressing more positive Internet attitudes tend to have more willingness to participate in web-based learning. As previous studies have suggested that learners' Internet attitudes influence their performance in web-based learning environments (e.g., Tsai et al., 2001), nurses' Internet attitudes may have interactions with their learning performance in the web-based environment. Previous studies have designed scales to investigate nurses' attitudes when they work (Katsuki et al., 2005, Katsuki et al., 2008). There are, however, only a few studies particularly exploring nurses' attitudes toward web-based continuing learning (Wilkinson et al., 2008). Web-based continuing learning is efficient in delivering clinical knowledge about new medical information (Wink, 2009); therefore nurses' Internet attitudes toward web-based continuing learning may be an essential factor for them to gain new skills and information from the web-based continuing learning environment.

Self-efficacy refers to an individual's judgment of his/her capabilities to perform specified tasks successfully at the intended level (Bandura, 1997). It also refers to an individual's beliefs, confidence and expectations as a result of his/her own ability to complete a special task (Liang and Wu, 2010). Lev et al. (2010) explored undergraduate and graduate nurses' self-efficacy, particularly focusing on their ability to pursue research. Nowadays, people have more and more chances to use the Internet for their work, information searching and sharing (Liang and Tsai, 2009). Internet self-efficacy refers to an individual's expectations and confidence in using the Internet (Peng et al., 2006). Further, Liang and Wu's (2010) study revealed that nurses' Internet self-efficacy plays an essential role in their motivation toward e-learning. However, there has been little research identifying the relationships between nurses' Internet self-efficacy and attitudes toward web-based continuing learning. One of the possible reasons might be due to the fact that web-based learning has not been popular in nursing education till now, or that nurses' web-based learning is not adequately supported (McVeigh, 2009). Determining and exploring nurses' Internet self-efficacy and attitudes toward web-based continuing learning can contribute to the development of better quality web-based learning environments and thus learning outcomes.

In an effective web-based learning environment, the nurses' Internet self-efficacy and their attitudes toward web-based learning may act as a catalyst to support their web-based learning initiative. Therefore, how to improve nurses' Internet self-efficacy and attitudes toward web-based learning is a very important issue for nurses' web-based learning. The purpose of this study was to utilize two questionnaires to respectively survey a group of nurses' Internet self-efficacy and attitudes toward web-based continuing learning. The relationships between them were also investigated. This study further used nurses' Internet self-efficacy to predict their Internet attitudes toward web-based continuing learning by stepwise regression models.

Section snippets

Method

This study analyzed questionnaire responses from a group of nurses in Taiwan. The sample, questionnaires, and data collection procedure are described subsequently.

Factor analysis

This research has utilized exploratory factor analysis for validating the factors of the ISS questionnaires. The factor analysis of the ISS shown in Table 1 reveals that the students' responses on the questionnaire were grouped into two factors, that is ‘Basic self-efficacy’ (9 items) and ‘Advanced self-efficacy’ (6 items). These factors accounted for 75.33% of the variance. The eigen-values of the two factors from the principal component analysis were both larger than one, and the reliability

Discussion

This study reveals the relationships between nurses' Internet self-efficacy and their attitudes toward web-based continuing learning. In this study, the ISS was utilized for evaluating nurses' Internet self-efficacy. By exploratory factor analysis, the results show that the ISS is sufficiently reliable for investigating nurses' Internet self-efficacy. Another survey, the AWCL, was also applied in this study to explore nurses' attitudes toward web-based continuing learning. The exploratory

Acknowledgement

Funding of this research work was supported by the National Science Council, Taiwan, under grant number NSC 96-2511-S-011-002-MY3 and NSC 98-2628-S-243-001-MY3.

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