Improving Indonesian nursing students' self-directed learning readiness

Introduction The purpose of this study was to improve Indonesian nursing students' self-directed learning readiness. An educational intervention program (EIP) was developed, implemented and evaluated. Background to the study Many studies have documented the need for nursing students to be prepared for the rapidly changing and complex health care environment. Lifelong, self-directed learning (SDL) has been identified as an important ability for nursing graduates. However, no study has documented the needs of, or preparation required for, nursing students to function effectively in the rapidly changing health care system in Indonesia. The Indonesian diploma nursing schools still use a teacher-centred approach with little emphasis on a student-centred approach. Method The study used a mixed method involving both quantitative and qualitative design. Simple random sampling was used to select an intervention school and control school. The sample was 2nd year nursing students with 47 in the intervention group and 54 in the control group. A pre-post test questionnaire, using the Self-Directed Learning Readiness Scale (Guglielmino, 1978), was used to collect quantitative data and focus group discussions (FGD) were used to collect qualitative data regarding students' perceptions of SDL prior to and at the completion of study. The intervention group received an EIP. The Staged Self-Directed Learning Model (Grow, 1991) and the Teacher Student Control Continuum (D'A Slevin & Lavery, 1991) were used as the organising framework. A self-learning module and learning plans were used as learning strategies to operationalise SDL concepts alongside teacher-centred methods. The control group received the existing teacher-centred methods. At the completion of the intervention, clinical instructors from both the intervention and control groups participated in FGD to explore their perceptions of students' activities during the EIP. Results For the majority of students, readiness for SDL was 'below average'. The mean for the Indonesian nursing students was significantly lower than established norms (Guglielmino, 1978). The introduction of SDL concepts through an EIP improved the level of readiness for SDL in the intervention group from 'below average' to 'average' compared to the control group who remained in the 'below average' range. Higher SDL readiness was reported by female students and students who completed the educational intervention. The FGD before the intervention revealed that students perceived SDL as a 'self-activity'. Perceptions of students in the intervention group changed during the EIP compared to students in the control group. Students in the intervention group viewed SDL as a 'process of learning'. Increased self-confidence, incremental learning, and having direction in learning were identified as benefits of SDL. Knowledge and skills in SDL, learning materials and communication were identified as important issues that needed to be improved. Clinical Instructors' perceptions of students' clinical activities confirmed that students in the intervention group were 'more active' compared to the control group who were 'still inactive'. Conclusion The study confirmed the expected effect of the EIP on students' SDL readiness. The EIP improved nursing students' readiness for SDL and had a positive impact on students' perceptions of SDL. Introducing the concept of SDL through the EIP was found acceptable by the sample and was deemed feasible to implement within the Indonesian nursing education system. The study has potential to make a significant contribution to nursing education in Indonesia by promoting lifelong learning and SDL in nursing students and in curricula through the development of innovative curricula and teaching and learning practices. The study also has potential wider benefit to nursing practice and global health practice