The research design consisted of the following:
Figure 5: Research design.
Sound research design logically links the initial questions guiding the study to the data collected and ultimately the conclusions drawn (Parahoo, 1997; Ridder, 2012; Robson,
Findings and analysis informs qualitative study component
Literature Review prior to case study
Phase 1: Educator and student questionnaires
Establish context, obtain local definitions of e-learning and confirm if key findings such as known benefits and barriers from the literature review exist within case departments.Phase 2: Review of selected modulewebsites and
documentation
To explore e-learning pedagogical practice and levels of engagement
Phase 3a: Semi-
structured interviews
with educators
Phase 3b: Focus
groups with students
Establishes and justifies research focus and questionsFindings and analysis informs review of module spaces and qualitative study component
Qualitative data analysis
2011; Silverman, 2006). The research design achieved this aim through application of case study methods advocated by both Stake (1995) and Yin (1984, 2003, 2009), in that a defined group of undergraduate healthcare programme related educators and students from one HEI have been studied in the context of a particular phenomenon (namely the use of e-learning) using multiple sources of evidence.
Case studies can be placed in three distinct categories, namely the intrinsic, where a researcher examines the case for its own sake; the instrumental case study which purposefully selects a small group of participants to explore a sequence of events or pattern of behaviour; and a collective case study which collates data from multiple sources (Stake 1995; Yin, 1984, 2009; Zainal 2007, Thomas 2010). The reported study was what Stake (1995) and Thomas (2010) consider an intrinsic case study, as it focused on providing a better understanding of the specific case in its own context, as opposed to using the case study as an instrument to facilitate greater understanding of an external situation more generalisable to a wider population as favoured by Yin (2009, 2013). Although being an intrinsic and exploratory case study, the research also aimed to provide explanations of findings through interpretation, and allowed the relating of one finding to another and so offered ‘explanations based on the interrelationships between findings (Thomas, 2010, p.101). Any explanations however, remain limited to the case context and not generalisable.
By using quantitative and qualitative components in the case study design, both process and outcomes have been explored (Tellis, 1997) regarding e-learning within health care education in its own context and complexity. This would not have been possible had a single methodological approach such as experimental or survey research, or indeed a single qualitative method such as a purely phenomenological study been adopted (Zainal 2007).
Following the literature review and initial observations by the researcher, two areas of interest on which to focus the case study were identified as suggested by Stake (1995), these were:
1. Healthcare educator views of the appropriateness and application of e- learning to professional, undergraduate healthcare education.
2. Healthcare learner and educator motivations and experiences when engaging in e-learning.
The context of the study was undergraduate professional healthcare preparation. An HEI was used as a single ‘case’ of an organisation employing e-learning within undergraduate healthcare programmes leading to professional registration. In order to achieve the triangulation of findings advocated by case study researchers (Reese, 2011; Ridder, 2012; Thomas, 2011; Yin, 1999, 2003, 2013), the research design included studying four separate university departments, with a focus on students and educators within each department. The four departments were chosen as each corresponded with the inclusion criteria of employing e-learning within undergraduate healthcare programmes, whilst each also delivering healthcare preparation for differing professional groups. Data collection was carried out over two academic years, with a questionnaire piloted and delivered in 2010/11, informing the later phase 2 and phase 3 data collection periods during 2011/12.
3.3.1: Case boundaries
Any case requires clearly defined boundaries to aid structure, data collection and analysis. To maximise research opportunities, yet take account of research achievability, the following boundaries were observed:
A focus on the consenting department staff and students willing to participate. Purposeful selection of the largest undergraduate healthcare programme in
each department as identified by the Head of Department. A focus on student and educator experiences.
Data collection would be time bounded over two academic years to maximise data collection opportunities.
Figure 6 is adapted from the work of Yin (2003, 2009, 2013) and gives a diagrammatical representation of a single case study design. The current study is considered a single case study due to having the one context of undergraduate healthcare practitioner preparation, and focusing on one higher education institution’s engagement with TEL (the Case). There are then four main embedded elements of
of data set collation and triangulation through cross-comparison. Each of the departmental units of analysis also had key sub-embedded units of staff and students in order to maintain focus on the research questions of how and why educators and students engaged in e-learning:
Adapted from Yin’s model (2014, p.50)
Figure 6: Case context and units of analysis
Figure 6 outlines the structure of context, case and embedded elements
3.3.2: Data corpus
For each department, the following data sets were collected to allow for a rich data pool and triangulation of findings from several different sources. Since department B was larger than the three other departments and situated over more than one campus,
three student focus groups were used to account for the department’s larger size in comparison to department A. C, and D. A full breakdown of department and respondent demographic data can be seen in Chapter 4, Table 5.
Table 2: Case study data corpus by department
3.3.3: Selection of units of analysis
Given the constructivist epistemological stance and interpretivist theoretical perspective underpinning this study, departments selected as embedded elements for study were not chosen with the intention of defending their ‘representativeness’ or ‘typicality’ (Tellis, 1997). Rather it was on the basis of maximising what can be learnt from the case (Stake, 2005; Thomas, 2011). To that end, the author’s previous knowledge of the case HEI, along with information on known high or conspicuously
Data Set Dept. A Dept. B Dept. C Dept. D
Educator Questionnaire n=5 (63%) n=10 (43%) n=7 (62%) n=12 (41%) Student Questionnaire n=11 (58%) n=54 (18%) n=21 (55%) n=41 (37%) Qualitative Semi- Structured 1nterviews Head of Department n=1 n=1 n=1 n=1 Programme Leader n=1 n=1 n=1 n=1 E-learning Champion n=2 E-learning Detractor n=1 n=1 n=1 n=1
Student Focus Group n=1 n=3 n=1 n=1
Module Reviews n=3 n=3 n=3 n=3
Context
University E-learning support roles
One information technology support officer and one additional E-learning Coordinator interviewed Guidance documentation Module space authoring guides
Corporate T +L strategy document Staff education packages
Undergraduate programme documentation:
Programme Specification Module Descriptors Programme Management
Team meeting minutes
n=1 n=3 n=2 n=1 n=3 n=2 n=1 n=3 unavailable n=1 n=3 n=1 Teaching & Learning
Strategy
identification of four departments delivering appropriate healthcare related programmes. Three of the departments delivered programmes directly leading to professional registration with a national body, whilst the remaining department delivered a healthcare related programme which led to a first degree qualification which acted as a pre-requisite for a course leading to professional registration. Therefore the principle criterion for selection of departments to study was less which departments were most representative of the HEI and possible wider HE sector and more which departments would best help understand the experiences of e-learning in undergraduate healthcare education in the context of this case university. Additionally, one department was identified as an atypical example of an issue of relevance to the research questions, as suggested by Thomas (2011), namely the predominantly non- clinical backgrounds of the teaching staff in comparison to the other departments. Accessibility to participants and data were also essential selection criteria (Stake, 1995), as was the author being connected with one case area (Thomas, 2011; Yin, 2013).
3.4: Ethical considerations
Due to the holistic nature of case study design which often includes concurrent collection of multiple sources of data, full ethical clearance for the study was obtained from the university ethics committee. When providing approval, ethical committees focus on the general principles of respect for autonomy, beneficence/non-maleficence, and justice (O'Leary, 2004; Parahoo, 1997; Pope & Vasquez, 2010) and it is under these topics that the ethical considerations for the study will be outlined.
Autonomy can be defined as the right to privacy, self-determination, personal liberty and natural justice (British Psychological Society (BPS), 2010; Long and Johnson, 2007). Permission from all heads of department, to include the department, its educators, students, and related online and hard copy documentary data in the study, was confirmed (Appendix A). A full explanation of the study aims, objectives, design and ultimate publication goals were given. Permission for access to data and participants by a major gatekeeper (Gray, 2009; Thomas, 2011) was granted at senior departmental level. The author attended a departmental meeting, providing a presentation and full written explanatory materials and consent forms to ensure each
staff member had the right to informed consent to participate, as opposed to an assumed inclusion and the right to opt out (Appendices B to E). The information sheet and presentation clarified the nature of the study and each participant’s involvement, along with an explanation of the multiple forms of data the author would be collecting, such as copies of programme and module descriptors, reviews of relevant module web pages, and the views of students.
Access to potential interviewees was primarily achieved through initial identification of potential educator participants by the department Heads, and from suggestions from other interviewees using a snowballing data collection method. Potential educator participants and students were not approached directly, but given the opportunity to volunteer for interview or focus group following completion of the initial questionnaire, and via all-staff and all cohort information emails and information posters. Copies of questionnaires were also available as an on-line document and paper copies were left with the department administrators. This method ensured students and staff did not feel pressured into participating by a direct request from the researcher. Interviews with the resulting volunteers targeted educators previously identified as potentially giving the greatest insight such as those who were identified by colleagues as either e-learning champions or dissenters. The aim was to gain a consistently broad range of views from all four departments. Contact details for the author were included on the information to ensure any questions could be answered prior to starting data collection. A consent form was signed each time participants were surveyed or interviewed, which reminded participants of the range of collected data.
The principle of beneficence in research is to provide benefit to the participants, and non-maleficence is to do no harm (Hewitt, 2007), and a researcher is ethically obliged to achieve these goals. Participant benefits can be derived at both a personal and an organisational level. By completing the quantitative questionnaire and/or participating in either a semi-structured interview or focus group, participants were encouraged to consider their own learning styles, strengths, and preferences (Abdelaziz et al., 2011; Bassey, 1999). This activity was likely to promote greater student self-awareness of their learning needs and encourage educators to consider the effectiveness of their online teaching activity; whilst student participants experiencing and observing
(Chen, 2011; Ishiyama, 2002). At an organisational level, knowledge derived from participants may well strengthen future programme delivery and e-pedagogy, thus possibly benefiting not only themselves, but also future learners and educators.
An important aspect of both autonomy and non-maleficence is the right of anonymity by having individual identities hidden within any final report or publication, (Johnson, 2014, Gerring 2007). To ensure anonymity, each of the four participating departments were given a label of A, B, C, or D which participants were coded to. Care was also taken to ensure no individual, whether educator or student, was named or referred to by an identifying title. All information identifying a specific undergraduate programme or module contained within reviewed documents, websites or reports, which might lead to identification of the original department, author, or participant, was removed from transcripts and all quotations used within the final thesis.
Although the interviews were not expected to stray into emotive or sensitive areas, the opportunity to debrief each respondent was provided to support participants should such an issue arise. Additionally, the author ensured that each interview ended with the opportunity for participants to consider positive aspects of their engagement in e- learning, which often related to an issue they were proud of such as an educator explaining a webpage contribution, or a student relating positive feedback received for an exercise completed.
3.4.1: Study conduct and rigour
The quality of a case study depends less on factors such as sampling, control of variables, or statistical significance of results as applied in quantitative studies intent on producing generalisable findings applicable to a wider population, and more on the robustness of the conception, construction and conduct of the study (Thomas, 2011). Study conduct and rigour is therefore less reliant on sampling cases appropriately, and more focused on choosing cases wisely. Conduct and rigour are ensured through the thoroughness with which a researcher describes the context and phenomena within the case and how well the method of analysis and subsequent discussion and argument sits within an explicit philosophical perspective (Exworthy, 2012; Gibbert et al., 2008; Thomas, 2011). According to some case study researchers however, all case study
design must ensure quality by attention to four key issues, namely construct validity, internal and external validity and reliability (Gibbert et al., 2008; Gray, 2009; Yin, 1999, 2009). Each of these aspects will be considered separately in relation to case study methods and the current study; however it is noted by this author that case study researchers such as Yin (2013) who advocate the use of originally positivist terms such as validity and reliability, do so from a qualitative and interpretivist perspective. Thomas (2011) and Stake (1995) reject these terms, stating they have no place in a single case study which is not attempting to show generalisable results, and prefer to discuss study conduct and rigour in terms of conception, construction and conduct of the study, identified through quality indicators such as:
The clarity of questions asked
Clarity and consistency of terms and definitions used Clarity of rationale provided
Sufficiency of information
Use of triangulation in data collection
Explicitness in the formulation of the main claims. (Thomas, 2011)
To reconcile these two views, the author considered the current study applicability to the criteria advocated by writers such as Yin (2013), and further reflected on the issues of study conduct and rigour against the views of writers such as Thomas (2011).
3.4.2: Construct validity
According to Colliver, Conlee and Verhulst (2012), the consideration of construct validity is a means of addressing the validity of psychological concepts that have no concrete referent in reality, such as self-esteem or bad attitude, and involves interpretation and argument. According to Yin (2009, 2013) construct validity can be defined in relation to case studies as explicitly identifying correct and appropriate operational measures for the concepts being studied. For Robson (2011) and Whittlemore, Chase and Mandle (2001), ensuring a study measures what it intended to measure is also essential in achieving construct validity and was facilitated within the current study in a number of ways. Firstly, each data collection tool was designed to remain clearly focused on collecting data directly relevant to the educator and student participants and to the overall research questions. This approach included
with question areas relating to key issues noted from the literature review such as benefits, challenges and attitudes. Secondly, construct validity was maintained in developing a critical review tool for module web spaces that standardised the assessment of issues previously confirmed as valid in the literature and applied to relevant undergraduate modules identified by the participants themselves. The semi- structured interview and focus groups were guided by protocols which allowed the participants freedom to take the discussion where they wished, but also ensured the key research questions were covered. A pilot study was then undertaken for each element of the data collection and analysis process.
3.4.3: Pilot study
To many positivist researchers in healthcare, a pilot study is often associated with testing the feasibility and safety of a clinical trial or randomised controlled study (Robson, 2011; Thabane, Ma, & Goldsmith et al., 2010). For qualitative and case study researchers, the purpose of a pilot study are similar, and focus on the pre-testing of the research design processes and data collection tools (Ridder, 2012). The pilot work for this study aimed to clarify any ambiguities within questions, or participant instructions during the questionnaire phase, whilst also checking for omissions to the data. Piloting the semi-structured interviews and focus group protocols also allowed the author to rehearse and refine interview processes and technique and confirm timings. In keeping with the advice of many researchers, undertaking preliminary analysis of the pilot data also allowed the author to explore differing analysis formats and data presentations (Simons, 2009; Travers, 2001; Woodside & Wilson, 2003; Yin, 2013).
The questionnaire tool, interview protocols and data collection and analysis processes were piloted using the process advocated by Gillham (2000), whereby each topic area and question is critiqued for relevance and necessity. Each questionnaire was reviewed for clarity and face validity by three educator peers and three undergraduate nursing students outside the case study participant population, and several minor improvements made to various sections.
The draft questionnaire was then piloted by eleven student volunteers who were engaged in an undergraduate healthcare related programme not included in the study. This allowed for testing of the tool on a pilot group with as similar characteristics as possible to the main target group. Following feedback from both the participating educators and students in the pilot phase, further questionnaire tool amendments were made included the clarification of wording to the positive and negative statements within the attitudinal question. Additionally, a simplifying change from the use of a Likert scale to a yes or no response was made to educator questionnaire Question 8A regarding educator perceptions of potential student benefits from e-learning. The amendments were as a result of feedback from educators on the pilot question regarding feeling unable to estimate the degree of benefits to students, but feeling able to comment on the presence or not of such benefits. The final questionnaire tool was then reviewed by PhD supervisors.
A similar process was carried out with the qualitative data collection methods to pre- assess the educator semi-structured interviews and student focus group protocols for validity and practicality. The aim was to explore if a semi-structured and flexible questioning approach or the adoption of a more interactive discursive style of probing proved more beneficial to data collection (Kvale & Brinkman, 2009). Three interviews and two pilot focus groups were carried out, again using similar educators and students not included in the main study. The interview protocol appeared effective in generating valid responses and it became apparent that educators needed little prompting in directing their own narrative, whilst the student focus groups required more frequent prompting. The author decided to continue with the aim of allowing the participants to direct as much of the narrative as they saw fit, and use the interview protocol topics as a guide to ensure all key areas relevant to the main research questions were covered. This decision inevitably meant that the timing of the interviews and focus groups proved difficult to predict, but these were estimated to last approximately one hour.
The recordings were then transcribed and analysed using the same process intended for the main study to ensure the data received covered the topic areas aimed for. Additionally, pilot participants were asked to comment on the overall data collection