Chapter 4: This chapter presents the research findings starting with sample realization, demographic data, teaching strategies used at postgraduate nursing programme, methods that
3.11 Reliability and Validity of the Instrument
Validity and reliability are traditionally used in a quantitative research paradigm (Golafshani, 2003). In this study it was used for the quantitative aspect. Academic rigour or trustworthiness was applied to the qualitative aspect of the study.
Validity and reliability serve as a means of ensuring the rigour of the research process and research findings (Burns and Grove, 2009).
Validity. According to Joppe (2000), validity determines whether the research truly measures that which it was intended to measure or how truthful the research results are. Burns and Grove (2009) stated that the content validity of a new instrument can be achieved by referring to literature pertaining to the topic or by calling the experts in the content area to examine the items to check whether they adequately present the hypothetical content in the correct proportions. These authors indicate that if the research can demonstrate that an instrument measures all the various components of the variables in question, the researcher may be confident that the instrument has a high content validity. In this study content validity was determined by subjecting the questionnaire to the experts in nursing education and research methodology for their critique and recommendations. The experts evaluated each item on the instrument checking the degree to which the variable to be tested was represented, as well as the instruments‟ overall suitability for use (Polit and Beck, 2009; Brink, 2006). The suggestions
79 recommended by experts on analysis of the instrument were addressed; corrections and adjustments were made accordingly.
Reliability. Burns and Grove (2005) defined reliability as a measure of the consistency obtained by using a particular instrument. Kirk and Miller cited in Golafshani (2003) identified three types of reliability in quantitative research which relate to (a) the degree to which a measurement, given repeatedly, remains the same (b) the stability of a measurement over time;
and (c) the similarity of measurements within a given time period. According to Struwig and Stead (2001), reliability is the extent to which test scores are accurate, consistent or stable. As a means of testing reliability, the internal consistency of the questionnaire was ascertained by conducting test/re-test reliability. The instrument was administered twice to similar participants within the space of two weekends. Six Bachelor of Nursing, Advanced Practice students who are also mature students agreed to be part of the test/ re-test. Cronbach‟s Alpha test was then used to compute the scores to establish the level of reliability. Cronbach‟s Alpha test was appropriate to this particular structured instrument being more recommended when applying instruments that use Likert-scales (Burns and Grove, 2009). The instrument, excluding demographic data and open-ended questions comprised 64 structured questions. The instrument was found reliable with a Cronbach‟s Alpha of .876. There were ten items on teaching methods and the reliability of that section was .850. The section on items related to learning comprised 54 items; the Cronbach‟s Alpha score was .833.
80 3.12 Academic Rigour (Trustworthiness)
Lincoln and Guba (1985) suggested four criteria for establishing credibility and accuracy of qualitative research. This is also known in qualitative research as trustworthiness. These authors introduced four concepts: credibility, dependability, „confirmability‟ and transferability.
Analysing these four concepts in relation to quantitative research, Rolfe (2006) indicated that credibility corresponds roughly with the positivist concept of internal validity; dependability relates more to reliability; transferability is a form of external validity; and „confirmability‟ is largely an issue of presentation.
Credibility is the extent to which the data, data analysis, and conclusions are believable and trustworthy. It implies confidence in the truth of findings, including understanding of the context. There must be consistency in terms of explanation, and enough narrative data which is sufficiently rich to support the findings (Burns and Grove, 2009). In this study credibility was ensured through triangulation of data sources, and member checks where the collected information during focus groups was confirmed with the participants through reflection and through taking notes and recording at the same time to confirm and ensure correct capturing of data.,
Transferability in Lincoln and Guba‟s framework (1985) is defined as referring essentially to the generalization of the data, which is the extent to which the findings from the data were derived. This may be achieved through a purposive sample (Lincoln and Guba, 1985), as in this study. It may also be achieved through a dense description of the research methodology and the research processes followed. The researcher attempted to do this in this study. This assists in determining whether the findings are applicable to another context.
81 Dependability according to Polit and Beck (2009) refers to the stability of data over time and conditions. As recommended in Lincoln and Guba (1985), focus group interviews were conducted by one person; the note taker also took notes from all the groups. The data-collection team was not changed, ensuring uniformity in asking questions and in scribing. The researcher used four questions as a starting point across the three groups; probing questions were based on the participants‟ responses. At the end of each focus group the researcher compared the notes with the note taker, ensuring that the critical points captured by the researcher were the same as captured by the scribe. Methods of collecting data were also triangulated to ensure dependability.
The research supervisor as an expert monitored the whole research process, the collection, analysis and interpretation of findings as one way of maintaining dependability in qualitative data.
‘Confirmability’ according to Lincon and Guba (1985) is a measure of how well the inquiry‟s findings are supported by the data collected. It refers to the objectivity of the research process and outcome, the degree to which data confirms the findings, freedom from the researcher‟s biases by ensuring that the conclusion depends on the subject and conditions of enquiry rather than on the investigator. „Confirmability‟ was promoted in this study by taking detailed field notes (reflexivity), by tape recording interviews, transcribing interviews verbatim to identify variations in responses and by making field notes available for audit checks and verification, as suggested by Lincoln and Guba (1985). .
82 3.13 Ethical consideration
The researcher presented the research proposal to the School of Nursing Research Committee to ensure that ethical issues were adequately addressed. The proposal was sent to the University of KwaZulu Natal Research Ethics Committee for ethical clearance. Ethical clearance was secured from the University Research Ethics Committee before obtaining permission from the Head of the Nursing Department to conduct this study. The approval from the Research Ethics Committee was submitted to the Head of the Nursing Department as part of the securing of permission to use the campus as a research setting and to have access to students studying at this university. Permission to conduct the study was obtained from the Head of Nursing School.
Researchers have a duty to treat all respondents with dignity and to reduce anxiety or discomfort.
Participants were provided with a written explanation of the purpose of the study, the nature and the procedure of the study and their expected roles as participants of this study.
Informed consent involves voluntary status; fairness was upheld in that those who wished to withdraw could do so during any stage of the collection. Participants were assured that they would not be coerced to continue and that they would not be disadvantaged in any way by the researcher or by the outcome of the study. The respondents were also assured that they would be used only for research purposes. Anonymity and confidentiality were maintained during the analysis and the final reporting of this study. Confidentiality was observed in that the respondents who were asked to participate in this research were given assurance of confidentiality which was coupled with the anonymity principle. The questionnaire did not require the name of the university or that of the respondent. The signed consent forms were separated from the completed data collection instruments to ensure that there was no link
83 between these two. The names of the participants were not used on the questionnaires; numbers were assigned to each questionnaire.