Adoption of reusable learning objects by postgraduate nursing students in Oman

Background: E-learning offers innovative methods of education and is increasingly recognized as an advanced teaching strategy in healthcare education and lifelong learning, facilitating nurses’ continuous professional development. E-learning offers various solutions in higher education and nursing, but raises challenges in terms of the provision of high-quality materials, in terms of both content and media. Therefore, there is a need to explore the extent to which reuse of materials can be a successful strategy. This study explores how innovative technologies like reusable learning objects (RLOs) can support postgraduate nursing education in theory and clinical in Oman. Specifically, it explores the adoption of RLOs developed at the University of Nottingham (UK) for use in Oman Higher Institute of Health Specialities (HIHS). Aim: To explore the drivers of and barriers to the adoption of RLOs by postgraduate nursing students in Oman, to improve their knowledge, skills, and confidence. Methods: Q-methodology was used, building Q-statements guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), and the Hofstede’s (1991) Culture Model. Data were collected from 24 postgraduate nurses in HIHS by Q-sort, followed by interviews. A follow-up qualitative study was conducted using semi-structured interviews with seven graduates one year after completion of their programs in their clinical areas, to explore the impact of RLOs in their clinical practice. Results: Q analysis revealed three groupings of reusable learning object use perceptions and experience factors with consensus statements. Factor 1 (traditionalist) participants valued face-to-face education and had limited experience of online learning. However, they did agree that RLOs could be used with suitable advice and support from faculty members. They also acknowledged that the attractive design of RLOs, along with belief in the flexibility of the tool and ease of use. Factor 2 (pragmatism) participants believe that RLOs are crucial tools for learning and should be used in higher education. These students believe that RLOs support the learning process in the theory class and practice sessions. Thus, RLOs support the application of knowledge in practice more quickly. Factor 3 (self-regulated) participants were similar to those of Factors 1 and 2 in acknowledging the design of RLOs, but the students in this factor had a stronger belief in their pedagogical value. Students believed in their responsibility and initiative in using RLOs. RLO authentication was seen as very important, in terms of the type of knowledge and related resources being recognized and reliable. Consensus statements included the reusable nature of RLOs, which was considered in all factors, while weak Wi-Fi was a persistently bemoaned problem that acts as a barrier to the use of RLOs in the institute. Finally, age and gender were not viewed as instrumental in the ability to use RLOs for any factors. The qualitative research study findings indicated that RLOs positively affected graduates’ clinical practice, as reflected in the reuse of some RLOs (particularly for pharmacology), as well as the use of additional RLOs not originally included in the implementation phase. The current study used UTAUT2 and the Culture Model; from the integration of findings of Q methodology and qualitative study, it was found that some factors were common across both models, while others differed according to culture, which could influence RLO reusability in Oman and in other national and cultural contexts involving RLO adoption and adaptation. Consequently, the current study proposed a variant UTAUT2 representing factors specifically influencing reuse acceptance of technology across cultures, the Technology Reuse Acceptance Model (TRAM). Conclusion: This thesis contributes original knowledge on the adoption of e-learning from a Western to non-Western cultural context, specifically from the UK to Oman. It has also created the new TRAM to guide such adoption. This research contributes to existing knowledge on e-learning in Oman and other countries. Implementing RLOs is known to be valid and reliable in the UK, but application in other contexts such as Oman necessitated identifying drivers and barriers in successful adoption, as explored in this study, which pioneers analysis of RLO reuse among postgraduate nursing students, and reuse in their clinical practice. This contributes to understanding factors relating to the use and reuse of valuable learning resources, particularly across cultures with different languages. E-learning might save money, time, and effort in nursing education, with its use and reuse features. The study recommends future research directions in nursing education and practice towards the development of open education resources (OERs)