CLINICAL NURSE EDUCATORS' ADOPTION OF SOCIOCULTURALLY-BASED TEACHING ...

223 Pages·2009·1.03 MB·English

CLINICAL NURSE EDUCATORS’ ADOPTION OF SOCIOCULTURALLY-BASED
TEACHING STRATEGIES
Janet Martha Phillips
Submitted to the faculty of the University Graduate School
in partial fulfillment of the requirements
for the degree
Doctor of Philosophy
in the School of Nursing,
Indiana University
May 2009
Accepted by the Faculty of Indiana University, in partial
fulfillment of the requirements for the degree of Doctor of Philosophy
__________________________________________
Pamela M. Ironside, PhD, Co-Chair

__________________________________________
Anna M. McDaniel, DNS, Co-Chair
Doctoral Committee
__________________________________________
Judith A. Halstead, DNS
February 26, 2009

__________________________________________
Henry S. Merrill, EdD

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© 2009
Janet Martha Phillips
ALL RIGHTS RESERVED
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DEDICATION
I dedicate this dissertation to my family, especially…
to Brad for understanding why I must try to make a difference;
to Alison who showed continual interest and support;
to Mom who encouraged me not to be afraid;
to my late Dad who inspired me to become a nurse;
to Chris who was always “rooting” for me;
to Laura who checked to see how I was doing;
to Wilbur and Orville for their unconditional love;
and to Doug for his unrelenting love and support.
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ACKNOWLEGEMENTS
I am grateful for the support of many individuals who have contributed in
countless ways to the completion of my doctoral studies and this dissertation. I wish to
acknowledge my committee co-chairs, Dr. Pamela Ironside and Dr. Anna McDaniel, who
have served as outstanding role models and have supported me in reaching my goals
every step of the way. They are both valued colleagues who are thoroughly dedicated to
nursing research. I would also like to thank Dr. Judith Halstead for her continued support
and collegiality in my development as a nurse educator and Dr. Henry Merrill for his
thoughtful input and confidence in me throughout my doctoral studies.
I would like to thank Dr. Diane Billings for encouraging me to reach beyond my
potential, Cynthia Hollingsworth for her outstanding editing skills and continued
encouragement during the final stages of the dissertation journey, Donna Butcher for her
ever-present friendship and distractions for fun, Michele Carey for regularly checking in
with me, Sonia Strevy for her camaraderie in nursing education, my Ph.D. cohort for
being there throughout it all, and lastly to my professors who challenged me in the rigor
and fashion necessary for a Ph.D. from Indiana University School of Nursing.
I would like to thank the National League for Nursing for their financial support
for the pilot study, publications, leadership in nursing education, and for the opportunity
to be involved with making changes in nursing education on a national level.
My study respondents, clinical nurse educators from around the country, deserve
thanks for supporting my study with their gift of time in completing the survey and for
their commitment to clinical nursing education.
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Most importantly, I thank my family and friends for their unconditional love and
support throughout this process. My family continues to be my biggest support,
especially my husband, Doug, who has been my anchor in every storm and has always
championed the fulfillment of my dreams.
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ABSTRACT
Janet Martha Phillips
CLINICAL NURSE EDUCATORS’ ADOPTION OF SOCIOCULTURALLY-BASED
TEACHING STRATEGIES
Nursing education is faced with addressing the challenge of educational reform as
a result of the rapid changes in the complexity of health care delivery systems, increased
technology and biomedical knowledge, a shortage in nursing faculty, and increased
enrollment in schools of nursing. Although national nursing organizations have called for
reform and innovation in nursing education little is known about the factors that are
related to educators’ adoption of such changes.
The purpose of this descriptive, exploratory, correlational, survey study was to
explore the adoption of socioculturally-based teaching strategies (SCBTS) by examining
the following variables in relation to their adoption using Everett Rogers’ diffusion of
innovations model: (a) clinical nurse educators’ perceived characteristics of SCBTS, (b)
clinical nurse educators’ perceived organizational support for innovation, and (c) selected
demographic characteristics. Minimal research has been conducted regarding the factors
related to clinical nurse educators’ adoption of SCBTS, which may better prepare nurse
graduates for today’s health care system.
Findings from this study suggest that adoption is not straightforward, but the
perceived characteristics of teaching strategies play an important role in the clinical nurse
educator’s decision to adopt or not adopt SCBTS. Rogers’ model was partially supported
based on the findings that clinical nurse educators were more likely to adopt a teaching
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strategy if it was perceived to be advantageous, compatible, and not too complex. On the
other hand, clinical nurse educators were more likely not to adopt teaching strategies that
they must “try out” or that must be observable by others, which was not supportive of
Rogers’ model. Adopters of SCBTS were more experienced clinical educators who felt
supported by their academic organizations in terms of innovation; however organizational
support for innovations was not associated with adoption of the teaching strategies.
Holding a certificate in a nursing specialty, the type of program in which the educator
taught, and the age of the educator were not associated with the adoption of SCBTS.
Future research using Rogers’ model or other appropriate models is called for to further
explore the adoption of SCBTS by clinical nurse educators.
Pamela M. Ironside, PhD, Co-Chair
Anna M. McDaniel, DNS, Co-Chair

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Getting a new idea adopted, even when it has obvious advantages, is difficult.
— Everett M. Rogers, Diffusion of Innovations

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TABLE OF CONTENTS
List of Tables ................................................................................................................. xii
List of Figures ................................................................................................................ xiii
Abbreviations ................................................................................................................. xiv
Chapter One: Introduction ............................................................................................. 1
Background and Significance ............................................................................ 2
Rogers’ (2003) Diffusion of Innovations Model ............................................... 4
Perceived Organizational Support ..................................................................... 5
Organizational Climate ...................................................................................... 6
Sociocultural Learning Theory .......................................................................... 6
Purpose ............................................................................................................... 7
Definition of Terms............................................................................................ 7
Assumptions ....................................................................................................... 10
Limitations ......................................................................................................... 10
Chapter Two: Review of Literature ............................................................................... 12
State of the Science of Clinical Nursing Education Literature .......................... 12
Diffusion of Innovations .................................................................................... 16
Perceived Organizational Support ..................................................................... 23
Organizational Climate ...................................................................................... 27
Sociocultural Learning Theory .......................................................................... 31
Integrative Review of SCBTS in Clinical Nursing Education ........................... 38
Preliminary Studies ............................................................................................ 72
Conclusion of Literature Review ....................................................................... 88
Chapter Three: Methodology ......................................................................................... 89
Research Design................................................................................................. 89
Research Questions ............................................................................................ 89
Open-ended Question......................................................................................... 89
Population and Sample ...................................................................................... 89
Protection of Human Subjects ........................................................................... 90
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