Towards a new framework for nursing education and training in developing countries

Abstract

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The advancement in ICT in recent decades has transformed every aspect of life, including medical care. The most sophisticated example of this is electronic health (e-health), which in developed counties has been a major contributor to enhancing the overall quality of healthcare services. However, e-health remains primitive in developing countries, whether they are relatively poor like Jordan or wealthy like Qatar. Barriers to successful e-health adoption in developing countries are attributable either to superimposing the technology itself while ignoring staff preparedness to integrated e-health or financial inhibitions to making such fundamental changes to healthcare delivery. Staff preparedness is related to educating or training healthcare staff, particularly nurses, who have fewer opportunities to attend training, or are sometimes ignored. Hence, the focus of this research is to evaluate the preparedness of nursing community for e-health adaption in the developing countries, taking Qatar and Jordan as case studies, in order to identify existing challenges and the key requirements to establish an educational framework that can be integrated in nursing curricula or professional development to promote e-health adaptation by nurses. This research critically reviews previous literature related to the research project, identifying the challenges to e-health preparedness, and analyses nursing and midwifery curricula from different countries with regard to e-health and ICT. The findings show that e-health modules are not generally included in any higher education nursing programme, with only a few transcripts showing basic computing or ICT modules. E-health national strategies for both Jordan and Qatar were analysed to identify whether the inclusion of professional training on e-health has been considered as part of e-heath strategy. In addition, analysis of e-health national strategies for other leading countries in the field of e-heath was conducted, finding that there is a decided gap between developed and developing countries with regard to e-health. The level of readiness in nursing was investigated and to identify the main barriers for using e-health/e-nursing in Jordan and Qatar. The results showed the top challenges facing e-health are educational-related aspects, hence a plan for promoting and providing education on the benefits and use of ehealth processes and applications is advised, with prerequisite ICT training, as the results showed that nurses lack sufficient knowledge about e-health processes and applications. The findings from earlier tasks were used to identify the requirements and then propose the framework to achieve main goal of this research in providing a roadmap. The framework was constructed in accordance to with the Technology Acceptance Model (TAM), followed by evaluation by different expert groups. All the groups voted for the suggested structure of the framework to be taken to the next phase of deployment. The final task was to evaluate the attitude of the nursing community working towards the possibility of implementing an e-learning system, which has been presented as the main platform in the proposed framework. The findings have demonstrated a very positive attitude from the nursing staff towards the idea of using e-learning. There also does not appear to be any apparent obstacles to deploying the concept of e-health as the audience in question have the necessary computer skills. In summary, this research project has contributed in presenting framework and some useful findings related to e-health in general and in Qatar and Jordan in particular. The proposed framework can be as a roadmap for future e-heath/e-nursing projects, in addition, it can be utilised with some modifications to foster similar electronic applications