The affordances of mobile learning for an undergraduate nursing program: A design-based study Juliana Joan Willemse

Introduction Mobile learning (M-learning) is fundamentally defined as learning with mobile devices and has the ability to offer something innovative and distinctive to extend the philosophies of learning. Bridging the gap in the continuation of learning while on-campus (formal learning) or off-campus or private time (informal learning) can be made possible with the application of mobile devices in teaching and learning.

Importance of the topic Mobile learning could also be applicable in the examination of the head and neck within the health assessment module offered in a nursing programme at a university in the Western Cape Province. With 5.3 million individuals living with HIV and Aids, South Africa has the highest incidence of HIV and AIDS infections globally. The complexity in the prevalence of HIV in South Africa has influenced the clinical manifestation of conditions of the head and neck that includes: (i) oral manifestations; (ii) sinonasal infections; (iii) neuro-otological presentations; (iv) neck and salivary gland pathology; and (v) HIV- associated neoplasms. The use of mobile devices may enhance the learning of students by using a medium that they are able to access and use, that is of interest to them as individuals or during a collaborative process.

Purpose of the study The aim of this research project is to describe and explore the affordances of mobile learning to integrate theory and practice of the examination of the head and neck within the health assessment module in an undergraduate nursing program at a higher education institution in the Western Cape.

Research objectives – Phase 1 1. What knowledge do students, lecturers and clinical facilitators have about mobile devices? 2. What are the viewpoints of students, lecturers and clinical facilitators on the affordances of mobile learning with the integration of theory and practice of the examination of the head and neck within the primary health care module in an undergraduate nursing program at a higher education institution in the Western Cape? 3. How can a plan be developed to integrate theory and practice of the examination of the head and neck within the primary health care module through mobile learning in an undergraduate nursing program at a higher education institution in the Western Cape?

Research objectives – Phase 2 4. Implement the plan (intervention) to integrate theory and practice of the examination of the head and neck within the primary health care module through mobile learning in an undergraduate nursing program at a higher education institution in the Western Cape.

Research objectives – Phase 3 5. Reflect on the implementation of the plan (intervention) of the integration of theory and practice of the examination of the head and neck within the primary health care module through mobile learning in an undergraduate nursing program at a higher education institution in the Western Cape. 6. Describe guidelines for lecturers on how to integrate theory and practice of the examination of the head and neck within the primary health care module through mobile learning in an undergraduate nursing program at a higher education institution in the Western Cape.

Design The methodological design for this research project is design-based research. It integrates the three phases of the Integrative Learning Design Framework of Dabbagh and Bannan Ritland (2005) with the design-based research approach of Reeves (2006) to systematically develop an online learning support for students while doing the examination of the head and neck within the primary health care module within the third year of an undergraduate nursing program.

Assumptions of this approach - The elements of quantitative and qualitative research approaches will assist the researcher to ascertain the extent and complexity of the understanding and validation of the integration of mobile devices in undergraduate nursing to enhance teaching and learning (Creswell & Plano Clark, 2010:297). - Students, lecturers and clinical facilitators will participate in or contribute to the design and development of guidelines on how to integrate the theory and practice of the health assessment of the Head and Neck within the Primary Health Care Module through M- learning in an undergraduate nursing program at a HEI in the Western Cape, even though they are not specialists in instructional design (Dabbagh & Bannan-Ritland, 2005:115). - The knowledge gained by the researcher in the exploration of perspectives on learning, enacting specific instructional strategies, and learning from the results, can promote the development of effective instruction in undergraduate nursing programs (Dabbagh & Bannan-Ritland, 2005:115).

Phase 1 The exploration phase (Situational analysis) The situational analysis is the exploratory phase and will consist of quantitative and qualitative sub- phases. A quantitative, exploratory, descriptive research design method (electronic survey) will be followed to investigate the knowledge of and use of mobile devices by participants (Objective 1). An accessible sample will consist of all third year undergraduate nursing students (n=100) registered for The Health Assessment semester module. The survey will take 30 minutes to complete. Descriptive statistics will be conducted and the results will inform objective 2.

Phase 1 The exploration phase (Situational analysis) The qualitative design will explore and describe the perceptions of students, lecturers and clinical facilitators on the integration of theory and practice in teaching and learning of the examination of the head and neck within the primary health care module of the third year of an undergraduate nursing programme (Objective 2). The non-probability purposive and accessible sample will consist of all third year undergraduate nursing students (n=100) registered for The Health Assessment semester module, the lecturer (n=1) and clinical facilitators (n=4) involved in facilitating this module. Qualitative data will be collected through focus groups and in-depth interviews.

Phase 1 The exploration phase (Situational analysis) From the results of objective 2 a plan (intervention) will be developed (Objective 3)

Phase 2 The enactment phase Phase 2 will explore an intervention solution to integrate theory with practice from the data collected in Phase 1. The enactment phase (objective 4) will guide the researcher in an attempt to generate strategies that will be congruent with theories of learning. During the intervention solutions to integrate theory with practice will be explored. The activity theory of Engeström will be used to implement the intervention.

The activity theory of Engeström

Phase 3 Reflection Participants will be requested to reflect (objective 5) electronically on their experiences with the implementation of the plan (intervention) to integrate the theory and practice of the examination of the head and neck within the primary health care module through mobile learning in an undergraduate nursing program at a higher education institution in the Western Cape. The following question will be asked to start the conversation: How was the intervention for you? Guidelines for lecturers will be described (objective 6) on how to integrate theory and practice of the examination of the head and neck within the primary health care module through mobile learning in an undergraduate nursing program at a higher education institution in the Western Cape.

CONCLUSION Fundamental changes in curriculum design and delivery at Higher Education Institutions with the use of appropriate emerging technology could provide students with an opportunity to enhance the learning of the 21st Century student (Bates & Sangra, 2011:3). Fundamental changes in curriculum design and delivery at Higher Education Institutions with the use of appropriate emerging technology could provide students with an opportunity to enhance the learning of the 21st Century student (Bates & Sangra, 2011:3).