Conclusiones y Recomendaciones – Fortalezas y Debilidades

A quantitative descriptive design was used to collect data regarding health sciences students‟ perceptions of the safety climate and decision latitude and social support on the Transnet-Phelophepa HCT (Grove et al., 2013:216).

4.4.1 Study Population and Sample

The accessible population consisted of all the health science students (n=666) allocated on the Transnet-Phelophepa HCT in the year that the study was conducted. The Optometry, Nursing, Dental, and Psychology students from different colleges and universities in South Africa are the main health care service providers, supervised by different clinic managers on the Transnet-Phelophepa HCT.

Non-probability, convenience sampling was applied with the goal of achieving a sample size (n=333) from all health sciences students allocated for service learning on the Transnet-Phelophepa HCT. The sample size was calculated based on a confidence level of 99% allowing for a marginal error of 5% (using the calculator at www.raosoft.com). All the health science students were considered eligible for the study and were provided with a participant information letter (Appendix 4.1) inviting them to participate in the study. The hotel and tourism students were excluded on the basis that they are not in the health science field, and because they are allocated on the train for a period of up to six months. A total of 35 health science students are allocated on the Transnet-Phelophepa HCT for a period of one to two weeks.

4.4.2 Data Collection

4.4.2.1 Data collection instruments

There was no existing data collection instrument found to measure safety climate and student learning on a mobile health care service. As such Gillen et al. (2002) self- administered questionnaire was adapted for this study. Gillen et al. (2002) modified and used Dedobbeleer and Beland‟s (1991:97) Safety Climate Measure for Construction Sites as well as the Job Content Questionnaire (JCQ) in a study exploring perceived safety climate and job demand, and co-worker support among construction workers in the USA.

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4.4.2.1.1 Safety climate measure for construction sites

The Safety Climate Measure for Construction Sites is a 9-item scale. The Safety Climate Instruments in industry organisations were initially developed by Zohar (1980). Zohar‟s (1980) model as described by Dedobbeleer and Beland (1991) included the following eight dimensions: (a) importance of safety training programs; (b) management attitudes toward safety; (c) effects of safe conduct promotion; (d) level of risk at workplace; (e) effects of required work pace on safety; (f) status of safety officer; (g) effects of safe conduct on social status, and (h) effects of safety committee. Brown and Holmes (1986) validated the model on a sample of American production workers and the model was reduced to a three-factor model. Employee perceptions of management concerns and safety activities, as well as physical risk perception, were retained.

Further validation of Brown and Holmes‟ (1986) three-factor instrument designed for production workers was conducted by Dedobbeleer and Beland (1991:101). The three-factor model consisting of a 9-item scale was tested on construction workers. The weighted least-squares model as described by Gillen et al. (2002) was used to test the three-factor model against the two- factor model. From the results, the 9-item scale was retained and no significant difference was found between the two-factor and the three-factor model (Dedobbeleer and Beland, 1991:102). However, the two-factor model comprising perception of „management commitment to safety‟ and „workers‟ involvement in safety‟ was found to be an overall better fit for describing safety climate on the Transnet-Phelophepa HCT.

The first factor „management commitment to safety‟ as stated in Dedobbeleer and Beland (1991:102) comprises workers‟ perceptions of management‟s attitude towards safety practices, and workers‟ safety, workers‟ perceptions of foreman‟s behaviour and availability of proper equipment and safety instructions. The second factor „workers involvement in safety‟ is related to workers expressing their perceptions of susceptibility to injuries, risk taking, perception of control over one‟s own safety and holding of regular meetings. Table 4.1 provides a summary of the factors included in the questionnaire.

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Table 4.1: Summary of factors, their description, total number of items and the rating scale

Factor Number of

Item Description Rating Scale

Management commitment to safety

4

Perceptions of management‟s attitude towards safety practices

1=very important to 3=not at all Perceptions on emphasis placed on safety

practices

1=regularly and frequently 4=never

Perceptions of action taken to ensure students „safety

measured by an itemised rating scale ranging from 1 – 3

Student involvement in safety

4

Students‟ perception of the availability of proper equipment

Safety instructions refer to the student‟s self-reported exposure to safety instructions on arrival

Presence of regular meetings

1=always to 5=never yes or no tick

yes or no tick Perception of control over their own safety

on the job

1=almost no control 3=little control Perception of risk taking 1=very much to

3=not at all Perceived likelihood of injuries 1=very likely to

4=not at all likely

4.4.2.1.2 Job content questionnaire

There are several versions of the Job Content Questionnaire (JCQ). The instrument is based on a model that measures job strain based on the work demands, control over work situations and social support. The questionnaire scales have been used to predict job-related stress and likelihood of stress-related coronary heart disease in the United States of America (1982). The scales are also relevant for studies of worker motivation, job satisfaction, absenteeism and labour turnover. The recommended 49-item JCQ instrument consists of seven scales. The scale items in the questionnaire are scored using a four-point evaluation scale: from „strongly disagree‟ or „disagree‟ to „agree‟ and „strongly agree‟.

In this study, only the Decision Latitude and the Social Support scales were applied in the study of Phelophepa train students. The questions on physical exertion, psychological demand and job security were excluded as these questions are intended for individuals employed in a full-time capacity as opposed to students placed on the train for a short period of experiential learning. The tasks performed on the health train are according to the different disciplines‟ curriculum core competencies.

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 Decision Latitude consists of two subscales: skills discretion and skill authority, with a possible low score of 24 and a possible high score of 96.

 The Psychological Job Demands scale has a possible low score of 12 with a possible high score of 48.

 The Social Support scale has a possible low of score of 8 with a high score of 32; with each subscale (Co-worker Support and Supervisor Support) having a possible low score of 4 and a possible high score of 16.

4.4.2.1.3 Reliability and validity of the instruments

The reliability validity process of the Safety Climate and Job Content instruments were conducted simultaneously. The items on the questionnaire were reviewed by the researchers in this study and the wording was slightly modified to suit the health care setting. No changes were implemented on the Job Content instrument during and after the pilot study. However, changes made to the Safety Climate instrument included:

 changing the word „foreman‟ to „clinic managers‟;  changing „employee/worker‟ to „student‟;

 changing „perceived likelihood of injury in the next 12 month period‟ to „period of placement‟.

The Safety Climate and Job Content questionnaires were not separated; hence, the pre-test was conducted on the same sample of students (n=28). Section A recorded the following demographic data: age, gender and category of the health science students. Section B explored the health science students‟ perceptions of safety climate, and Section C explored the health science students‟ perceptions of decision latitude and social support on the Transnet-Phelophepa HCT.

The researcher travelled to where the Transnet-Phelophepa HCT was stationed. Permission was obtained from the managers of the different clinics to address the students in a group or individually. Students were provided with information about the study (Appendix 4.1) on the first day of placement. Subsequent to this, those who agreed to participate were requested to fill in the questionnaire (Appendix 4). The instrument pre-test process was conducted among students allocated to the Phelophepa Health train for research for a period of two weeks. The responses were analyzed to test for suitability of the modified questions, understanding of the

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terms, and the length of the questionnaire as applied to a health setting. In addition, Cronbach‟s alpha was used to test for internal reliability of the two scales.

The Cronbach‟s alpha coefficient for the 9-item Safety Climate scale was 0.81. The result compared well with Baltz, Gassel, Kirsch and Vaccaro (2002) and Gillen et al. (2002). Cronbach‟s reliability tested 0.78, and construct validity was 0.95.

4.4.3 Data Collection Process

The health science students were categorised according to their professional orientation, and data were collected once during their period of placement for clinical service learning, as suggested by Grove et al. (2013:221). The two scales were implemented simultaneously as in Gillen et al. (2002), on the same population and sample of health science students. The results of both surveys are presented in two separate sections. The Safety Climate survey results and the decision latitude and social support are presented in sections 4.6.2 and 4.6.3 respectively.

Data were collected over a period of four months. The researcher travelled to where the Transnet-Phelophepa HCT was stationed, to meet the new students on their first day to orientate them about the study. With subsequent groups, the researcher arrived on the last day of the two-week allocation period and stayed on until the next Monday to meet the new group. Letters explaining the purpose of the study (Appendix 4.Ι), and the questionnaire (Appendix 4), coded for categorisation and numbered to ensure anonymity, were distributed every second week for the Nursing, Optometry, Dental and Psychology students, and on a weekly basis for the Pharmacy students. The managers of the four clinics and of the pharmacy were requested to remind the students to place the questionnaires in the „research box‟ in their respective clinics and in the pharmacy area. All ethical requirements were adhered to as indicated in Chapter Three.