Self-directed Learning Readiness among Nurses in Teaching and Non-Teaching Hospitals

Self-directed Learning Readiness among Nurses in Teaching and Non-Teaching Hospitals
CHAPTER I: INTRODUCTIONThe ability to demonstrate self-directed learning amongst nurses is perceived as an essential element of professional practice amongst them. Self-directed Learning (SDL) plays a key role in enabling nurses to continue updating and advancing their knowledge throughout their professional career. Nursing education and practice have currently been changing, and there is a need keep pace and continue supporting the nurses in the areas of critical thinking, creativity, and the problem-solving. The increase in the complexity of the obligations and the roles in the health care sector require the nursing professionals to have the capabilities of the self-directed learning and critical thinking as they do perform their duties (Edwards, Hanson & Raggatt, 2013). The problem-based learning approach is being promoted to facilitate the self-directed learning among the nurses as well as giving them the abilities to have critical thinking skills whenever faced with issues in the course of their duty. Self-directed learning is an important element to allow nurses cope with the demands of the hospital experience. Kar, Premarajan, Ramalingam, Iswarya, Sujiv and Subitha (2014) define SDL as the process by which individuals decide what they should learn. Subsequently, assessing the readiness of a learner for SDL implores the extent to which a person possesses the abilities and positive attitude to pursue the process.

Its applicability to hospital setting is vital since nursing students after their graduation will be exposed to the real life situations where they will encounter several challenges in the practice of the profession.
Reflection plays a vital role in determining a nurse’s ability to engage in self-directed learning. Reflection is influential as it determines an individual’s ability to set goals that would have an impact on their professional life. Reflection helps students to create a pathway that would enable them to develop learning goals that are in line with the need to grow their profession. However, for students to take part in reflection activities, they also have to grasp the fine details of their learning. The strategies help them to come up with models and prompts that foster critical thinking and thus, take a positive approach towards their learning (Robertson, 2011). With reflection, the student is able to create time to plan for their daily activities and even allocate the required time for going through further reading. The process has been instrumental in promoting high-order outcomes amongst students. Critical thinking abilities fostered by reflection have illuminated to have an influential role in promoting readiness for self-directed learning. Using a structured model of reflection helps students to strengthen their approaches for SDL. Reflection helps nurses to prepare themselves for SDL (Nothnagle, Goldman, Quirk, & Reis, 2010). The readiness for SDL is thus dependent on the type of activities that nurses indulge themselves when in their line of duty. Reflection offers an ideal way upon which nurses can realize self-control, self-management and develop a desire for learning.
There are several aspects to the professional development of a learner. According to Terry (2012), professional development is supposed to be learner-centered. Similarly, professional development is supposed to involve a combination of lectures, case studies, and discussions. Self-directed learning provides an avenue upon which learners can decide what they wish to learn and in what depth of breadth. Giving nurses a chance to experience self-directed learning implies that they are responsible for their own learning process (De Bruijn & Leeman, 2011). Moreover, such learners understand the importance of remaining in control of their learning process. The freedom that comes along with self-directed learning processes is also known to have a profound impact on the learning capacities of learners. Nonetheless, the implementation of the concept is only possible when the beneficiaries of self-learning processes are willing.
Being ready for the process translates to improved academic performance and is known to enhance the degree of nursing competency. The study aims at determining self-directed learning readiness (SDLR) among nurses in teaching and non-teaching hospitals in Saudi Arabia. The outcomes of the study will be instrumental in enabling medical educators to assess the learning capacities of their students as well as implement the recommended strategies to foster SDL. Moreover, experts purport that fostering an SDL approach amongst nursing learners plays an influential role in enabling them to adapt to the ever-changing clinical environments. Finally, the study will help to develop an appropriate framework upon which policy makers can identify the most appropriate strategies to promote self-directed learning. The methods would ensure that nurses are adequately prepared to manage the emerging complexities of their work environments.
Problem StatementNurses’ professional development is the continuation of their undergraduate education. This is done to expand the experience through the knowledge and skills acquired in their training in the hospital setting. The nurses are supposed to make sure that they have continuously updated the skills and knowledge that they have in their specialization. However, the needs assessment is essential in determining the level of preparedness or readiness of the nurses in the present and future encounters they will experience in their practice. There were limited studies on the applicability of the self-directed learning readiness (SDLR) for professionals. Much of the literature and related studies concentrate on the students. It is therefore the intention of this study with this phenomenon, to focus on the professional registered nurses and be able to determine its outcomes to their performance and eventually implications to their chosen profession. Self-directed learning is essential in assisting nurses to meet the challenges presented in today’s health care environment. Quality educations in Colleges of Nursing and Nursing Orientation Program among newly hired nurses in the hospitals have important roles in maintaining their nurses to acquire the skills for self-directed learning. Nursing department in the hospital specifically the training and education section should be able to prepare the nurses in understanding the need for self-directed learning. This study will determine self-directed learning readiness (SDLR) among nurses in teaching and non-teaching hospitals, in two selected tertiary government hospitals in Riyadh, Saudi Arabia.
Significance of the Study
The research will help the nurses to identify their self-directed learning readiness in their respective assigned units in the hospital. This study will have insignificant implications for the Nursing education and training program of the hospital focusing on the nurses’ self-directed learning readiness in their practice in the clinical settings in two selected teaching and non-teaching hospitals in Saudi Arabia. With the determination of the self-directed learning readiness, nurses will be able to improve their performance in providing quality care for patients.
Aim of the StudyThis study aims to determine the self-directed learning readiness (SDLR) among nurses in teaching and non-teaching hospitals in Saudi Arabia.Definitions of terms:
Within the context of the study, the following terms are defined operationally and conceptually:
1. Self-directed Learning (SDL) – pertains to the amounts of responsibility the learner accept for his or her own learning (Fisher, 2001). In this study, SDL refers to self-directed learning readiness activities of the nurses are measured in the study along the following categories such as: self-management, desire for learning, and self-control.
2. Self-management – is defined as taking of responsibility for one’s own behavior and well-being (Oxford, 2016).
3. The desire for learning – refers to the curiosity that motivates investigation and study (Farlex, 2003).
4. Self-control – is the ability to control oneself, in particular one’s emotions and desires, especially in difficult situations (Oxford, 2016).
Summary:
This chapter includes the general overview of the research topic, Problem Statement, and as well as Significance of the Study. Questions of the Research identified and definitions of terms listed. The next chapter constructed to discuss detailed literature in related to self-directed research reediness.
CHAPTER II: LITERATURE REVIEW
This chapter presents the reviewed literature and related studies on the major variables of the study namely Self-directed Learning Readiness among Nurses in Teaching and Non-Teaching Hospitals .A comprehensive literature review was performed in this study involving on-line databases: (1) PubMed Central, (2) Science Direct, (3) Medline (Ebsco), (4) CINAHL and (5) Google Scholar. The analysis entailed gathering data from the existent publications with a consideration of the relevance to the subject of self-directed learning and readiness among nurses. Essentially, the review included an assessment of apparent theories, facts, proclamations, findings, and philosophies from peer-reviewed articles and journals in addition to other equally significant publications such as books.
Conceptual Framework
28366781149704Teaching Hospital
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Self-directed Learning Readiness
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Job title in Nursing Department
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Demographic Characteristics
00Teaching Hospital
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Self-directed Learning Readiness
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The conceptual framework of this study seen in Figure SEQ Figure * ARABIC 1, Self-directed learning is essential in assisting nurses to meet the challenges presented in today’s health care environment. Assessing the skills for self-directed learning readiness in two selected teaching and non-teaching hospitals will be able to prepare the nurses in understanding the need for self-directed learning and eventually improve their practice of their profession, similarly in the current and future encounters in their practice.
Background of Self-Directed Learning
Self-directed learning is “a method of instruction used increasingly in adult education. A scale was developed in response to a need for a valid and reliable instrument to measure self-directed learning readiness” (Fisher, et al. 2001). Self-directed learning (SDL) can be defined in terms of the amount of responsibility students accept for their own learning (Reio, 2004). The self-directed learner takes control and accepts the freedom to learn what they consider important for themselves. Additionally, as highlighted by Alkorashy and Assi (2016), self-directed learners acknowledge the flexibility and obligation of realizing what is actually imperative to them and decide exactly how much control they take of their learning procedures. The measure of control they maintain relies upon their capacities, individual abilities, states of mind, and practices. Confidently, SDL is the way toward choosing what knowledge to acquire, to what profundity and broadness (Alkorashy & Assi, 2016). Still, it happens in a social setting and incorporates basic leadership and meta-intellectual reasoning capacities.
On the other hand, Naglaa et al. (2017) highlight that there are several important elements to comprehend about self-directed learning. Apparently, singular learners can end up enabled to assume progressively greater liability for different choices related with the learning process. Furthermore, self-learning is best seen as a continuum or trademark that exists to some degree in each individual and learning circumstance. In any case, self-direction does not really mean all erudition will occur in seclusion from others. In fact, self-coordinated students seem ready and capable of exchanging knowledge, as far as both information and study capabilities, and in vary circumstances.
In the explication of self-direct learning, Cadorin et al. (2017), elaborate that self-coordinated learning can include different exercises and assets. Typical examples include, independently directed perusing, support in study gatherings, temporary jobs, electronic discourses, and intelligent composition exercises. More so, compelling roles for educators in self-coordinated learning are conceivable, for example, exchange with students, securing assets, assessing results, and encouraging critical thinking for improved decision-making (Cadorin et al., 2017). Thus, in the contemporary world, some instructive organizations are discovering approaches to help self-coordinated examination through open-learning programs, individualized investigation choices, non-conventional course offerings, and other imaginative projects (Cadorin et al., 2017). Lastly, Naglaa et al. (2017) add that for self -development through edification, it is recommendable for the learners to administer and oversee their learning process through high degrees of involvement. Notably, self-directed learning’s definitions and elucidations mostly allude to the level of responsibility realized by individual learners in their knowledge acquisition processes. Essentially, this forms the foundation for readiness in self-directed learning. Several hypothesis and instruments have been produced to assess Self-directed learning (SDL) capacities that have been viewed as an essential for both understudies and human services experts.
Self-Directed Learning Readiness
Naglaa et al. (2017), note that the contemporary world of health care delivery systems and educational frameworks is marked with changes that prompt the need for consistent investigation. Subsequently, an analysis of self-directed readiness among nurses, especially as a factor that stimulates self-directed learning among nursing students must be assessed. Typically, the existing patterns in education and training underline that: nursing scholars need to acquire abilities that will empower them into becoming autonomous and self-coordinated students. Notably, expert medical attendants should be independent learners as an important aspect of their competence as healthcare providers (Naglaa et al. 2017). Therefore, the comprehension of SDLR can prompt the formation of instructive atmospheres that will encourage student-focused methodologies that for sure advance medical scholars’ independence and shared obligation concerning concrete and lifetime edification.
Fisher and King (2010) and Fisher et al. (2001) state that self-directed learning readiness (SDLR) is the extent the individual has the dispositions, capacities and identity qualities essential for self-coordinated learning. Subsequently, since the readiness for self-directed learning bases on individualization, nursing instructive foundations have been prompted to focus on the same and conduct research on aspects that alluding to the aspects of being responsible for self-directed learning, mainly among the nursing professionals. On the other hand, Naglaa et al (2017), state that the advantages of readiness in self-coordinated learning is that it incorporates augmented self-confidence, independence, and inspiration. SDLR fosters growth to survey relevant insight deficiencies and search out pertinent assets to enable students to address any shortcomings as well as create skills that are fundamental for long lasting future profession. Moreover, readiness in self-directed learning engages students to react and adjust to change, accommodate contrasts in singular students, models law-based cooperation in learning, cultivates interest, self-started request, and empowers self-assurance. Additionally, some scholars have found that better SDL readiness (SDLR) is related to better academic performance, which makes it a significant factor (Reio, 2004).
Cadorin et al. (2017) add that the self-direction of nursing students is gauged and presented through their degree of SDL readiness. According to Wang (2013), Self-Directed Learning Instruments are applied to assist in comparing the approaches used by the nurses and their self-directed learning abilities before and after the teaching of the evidence-based nursing course. There is a high reasonableness that there will be an increase in the self-directed learning abilities after the implementation of the approach (Huston, 2014).
The nursing training acquaints the students with the clinical skills and competencies that make sure that they have continued to progress in the nursing profession. The nurses are supposed to make sure that they have continued to update the skills and knowledge that they have in their specialties. The nurses have been certifying the acquisition of new knowledge that has continued to assist them in their daily handling of patients (Wittmann-Price, 2014). The scarcity of the professional nurses and trainers has continued to be a major issue that is having an impact on the quality and the efficiency of the training that is being offered (Leininger, 2005). Additionally, the fewer resources are being utilized in the course of the training thus making it less efficient thus contributing to the inability to attain the required quality of the education.
Therefore, in nursing, the self-directed learning readiness is a method and a philosophy that is one of the most effective approaches that are implemented in the fostering of deeper understanding, learning, and improving the self-directed learning abilities to the professionals. Therefore, it improves on the professional performance (Jeffreys, 2010). The availability of technology is also likely to make changes in the mode of communication between the professional by ensuring that they have healthy discussions that will ensure that they have progressed in the career (O’Neil, 2014).
One of the attributes of self-directed learning is reflective practice. The study by Omar, Al-Kathiri, and Al-Ajmi (2017) indicate that a student’s ability to concentrate on reflection plays a vital role in nurturing self-directed learning. In fact, students who take part in reflective practices as a part of their learning routine record better willingness, self-management, and control in their learning as opposed to those that do not. Omar, Al-Kathiri, and Al-Ajmi (2017) highlight that significant educational discourses indicate that the learning process should be self-directed to some extent. Poor reflective practices diminish the capacities of a student to focus on reflection. A part of self-management emphasizes on the ability to integrate learning experiences to individual everyday life. That way, a student will demonstrate a greater capacity to link their actions and improve the outcomes of their practice based on the intuitions of their reflective moments. One of the models of reflective practice is self-evaluation. Self-evaluation seeks to critically analyze and evaluate actions and experience based on the theoretical perspectives of the learner. The components of reflection build an essential platform to help develop a link between theory and action. A student’s perception towards their reflection practice will also determine their willingness to engage in self-directed learning. Thus, it would be inconsistent to support reflective learning when it poses no relations with the importance of taking part in self-directed learning. A significant aspect of reflection indicates that innovative understanding and intentions of the learning process trigger the need to indulge in reflective practices. Thus, the development of a student’s reflective capacities is instrumental for learning purposes.
It also fosters a student-centered learning approach that helps students to attain meaning from their experience in the quest to develop professional knowledge.
One of the tenets of creating a self-directed learning approach is to support the flexibility of the student’s curriculum. The study by Phillips, Turnbull and He (2015), offers insight on how distance learners manage to meet their academic goals, despite not having a formal classroom environment. According to Phillips, Turnbull and He (2015), self-control, the desire to learn and self-management attributes are essential in instilling the responsibility of learning amongst learners. Ideally, the flexibility that comes with distance learning is evidence that poor self-management will diminish a student’s capacity to concentrate on their education. A support system that fosters self-directed study modes is an effective way to encourage learners to create a balance between their learning and that which is backed by instructors. The motivations of students, particularly at the postgraduate level are distinctively different from that of those at undergraduate and post-graduate levels. Phillips, Turnbull and He (2015) contends that in non-teaching hospital facilities, postgraduate derive their motivation from the need to grow in their career and expand their knowledge. Nonetheless, it was also identified that previous learning experiences and environments have a profound impact on a student’s ability to develop readiness for SDL.
The teaching methods, the source of motivation and metacognitive skills are some of the attributes that researchers ought to focus on when identifying the self-readiness of an individual in learning. Similarly, the personalities traits of a person will determine whether they can make informed decisions regarding their learning patterns and hence, identify a need to build their careers. The complexities of the modern learning environment imply that programs need to be structured in such a way that they foster the reading culture of students.
Self-directed learning is dependent on the persistence of the learner and the development of an urge to grow professionally. When the motivation to enhance individual knowledge is strong, then it is likely that the student would also maintain their persistence for the learning process. Nonetheless, it was identified that despite the urge to pursue SDL, some of the students face hurdles that inhibit them from fully concentrating on their education (Embo, Driessen, Valcke & Van der Vleuten, 2010). For instance, having a demanding job or family may have an impact on the student’s capacity to manage oneself. Some of the students interviewed in the study by Phillips, Turnbull and He (2015) acknowledged that personal responsibilities made it impossible for them to focus on SDL. In such instances, identifying a viable way to minimize the pressure experienced when pursuing self-directed learning. Most importantly, it is essential to realize that good study habits take time to be established (El-Gilany & Abusaad, 2013). Thus, a student’s lifestyle may have an impact on the way they perceive SDL. In fact, self-management and self-control attributes of SDL derive their principles from the development of good learning habits. It would be impossible to inculcate the urge to learn when it is evident that the student had poor learning habits from a tender age. A majority of the students will struggle with unfamiliar methodologies of going through course materials when they have been nurtured to thrive on spoon-feeding reading techniques.
The passion of an individual for a career is also a critical element to consider when evaluating the willingness to pursue SDL. For instance, the study by Williams et al. (2012), indicates that workers who are motivated in their jobs develop the urge to improve their knowledge and proficiency in their jobs. Thus, such learners are always willing to take part in training, self-directed learning and any other activity that would have a positive impact on their career.
A student’s passion for their profession implies that they would develop the passion for discovering new things and engaging in further learning for enhancing their knowledge. Evaluating the learner’s passion for learning also helps to gauge their self-confidence and intelligence with regards to the implementation of a model to ensure that they take part in SDL. Students SDL readiness differs depending on their passion levels for their career. Malekian et al. (2016), alludes that the ability to exceed the expectations of their job is dependent on the strategies that their institutions implement during their learning. To this effect, the desire for education is an attribute that is nurtured from the onset of the learning process in nursing school.
Another attribute affecting the desire to learn is the student’s performance. Students who post good results depict a greater urge for SDL compared to those that perform poorly. Such students demonstrate a greater willingness to discover new things in the course of their learning, which may also have a profound impact on their academic performance. The study by Malekian et al. (2016) indicates that SDL is directly correlated to academic GPA. Well performing students have a greater motivation and desire to pursue learning as compared to those that perform dismally. Nonetheless, it is essential to note that the experience of a nurse does not impact on their readiness and willingness to take part in SDL. However, contrary to the findings, Malekian et al. suggest that nurses with longer working experiences were less likely to engage in SDL.
Nurse’s ability to engage themselves in SDL is considered as an essential attribute for their professional practice. Nurses are expected to continue updating and developing their knowledge and understanding throughout their career. However, the ability of a nurse to take part in SDL plays an influential role in determining whether they would enhance their knowledge and capacities in their professions.
The subject of SDL has influenced the prevalence of extensive studies conducted in an attempt to establish correlations between equally significant components such as SDL readiness, inclinations for configuration, and education partiality of nurses. Based on the literature review, it is apparent that readiness is crucial for self-directed learning processes and outcomes. Evidently, scholars with levels of readiness for SDL have negative outcomes since they encounter complexities such as augmented anxiety (Alkorashy & Assi, 2016). Conversely, students with high readiness for self-directed learning have increased possibilities for success in their projects. However, increased association with teachers makes them susceptible to high anxiety levels based on the situations (Alkorashy & Assi, 2016). Nonetheless, among the dimensions and factors of importance discussed for SDLR include desire for learning, self-management, and self-control.
Practicing nursing professionals are expected to demonstrate their capacities to keep up with the changing. The outcomes of evaluating self-guided learning are helpful for both instructors in their selection of fitting educating and learning techniques for their students. Furthermore, it guarantees medical practitioners eventually become self-coordinated students and aid the development of certainty and demonstrable skill (Naglaa et al., 2017; Fisher & King., 2010; Alkorashy & Assi, 2016). The literature review seeks to demonstrate that nurses demonstrate competence and show self-control, self-management, and a desire to learn new things that emerge and have an impact on their ability to deliver on their mandate while in their line of work. The three dimensions used to assess the readiness of health care professionals to participate in learning that would help nurses to build on their skills and competencies, the dimensions are 1) desire for learning, 2) self-management, and 3) self-control.
Desire for LearningThe desire for learning is an essential attribute to consider when evaluating a person’s willingness and capacity to learn. In their study, Naglaa et al. (2017) utilized the desire for learning subscale as a factor that would be efficient in the determination of the participants’ motivation for learning and their abilities to utilize this motivation. Typically, Alkorashy and Assi (2016), Fisher et al. (2010), Fisher et al. (2001), Naglaa et al. (2017), and Cadorin et al. (2017) agree that the desire for learning subscale acts as an implication of a students’ yearning or preferences for realizing their learning objectives through taking responsibility.
The study by Malekian, Ghiyasvandian, Cheraghi, and Hassanzadeh, (2016) illuminated that nurse’s attitude, personal characteristics and personalities had significant impacts on their development for the desire to learn. Particularly, the study quotes that self-directed nurses are more accountable and motivated learners. They do not depend on instructions to form opinion son the importance to take part in learning activities. Kar et al. (2014), also highlights that learner’s desire to learn is an essential requisite to form an informed opinion on the abilities to build on the competencies of nurse professionals. Kar et al. (2014), also links the willingness of such nurses to enhanced performance and growth in their career. A comparison with the study by Williams, Boyle, Winship, Brightwell, Devenish, and Munro (2012), documents that the desire to learn is the ultimate formula to self-directed learning. Willimas et al. (2012), decries that a majority of paramedics in the UK are used to “spoon-feeding” of knowledge rather than self-directed knowledge. Lack of individualized learning settings hampers the growth and development of the paramedic career. The development of a competent workforce is dependent on its ability to develop self-directed learning from the onset of their career. Moreover, the fact that the desire to learn stems from the motivation of the student, it is likely that those without the desired levels of motivation lack the autonomy and self-actualization capacities. In SDL, learners are responsible for controlling the learning process. Their desire to learn defines their ability to undertake new initiatives to engage in knowledge garnering methods without necessarily being coerced by circumstances of their instructors.
Sufficient data supports the fact that those without a desire to learn perform dismally in their careers. As initially mentioned, the modern medicine world is highly dynamic. New methods of treatment delivery have transformed how the healthcare industry operates. The study by Madhavi and Madhavi (2017) also found out that in instances when the desire to learn is low, the students perform dismally. Interestingly the study by Madhavi and Madhavi (2017) connotes that the design of the curriculum has a significant impact in determining a leaners desire to take part in SDL. When the design of the curriculum fails to inculcate the responsibility of taking part in SDL, even the desire to take part in it dwindles. A learner should derive the inspiration and motivation to take part in SDL based on their understanding of the materials and resources given to them for the learning process. The curriculum should be designed in a way that propels the candidates to initiate learning processes that complement their reading culture.
Self-Management
Self-management domain of SDL connotes that SDL can identify their educational needs and thus set appropriate goals to manage their time and energy during their learning process. Moreover, self-management plays a vital role in enabling learners to manage their time and energy to activities that foster constructive feedbacks. Naglaa et al. (2017) explicate the self-management subscale as a concept of the scholars’ capacity to execute their particular learning objectives, and viably deal with the learning assets accessible to them. Moreover, the subscale incorporates parts, for example, capacity to oversee time adequately, capacity to apply orderly and deliberate ways to deal with learning, set circumstances for acquiring knowledge, organizing and looking for extra information and assets, and critical thinking as part of their decision-making. It portrays the scholars defining objectives and overseeing accessible assets and support. In addition, the scholars accept essential accountability for strategizing, executing, and assessing the learning procedure.
Malekian et al. (2016) and Williams et al. (2012) also link self-management to a high desire for self-directed learning. Williams et al. (2012), goes ahead to document that: individuals who score high on self-management develop a greater capacity to implement their own learning goals. Moreover, such persons demonstrate the ability to effectively manage their time and apply systematic and methodical approaches for the learning process. Young learners score lowly in self-management practices compared to their old counterparts (Malekian et al., 2016). When the subscale for self-management is low, the outcomes also reflect on the practice and abilities of the student. The self-management subscale of SDL scores indicates that nurses have a higher chance of growing professionally. Thus, the inability to demonstrate self-management implies that the candidate would also perform dismally in their professional domain.
Self-management subscales have significant impacts on the growth and development of the career of medical professionals in health facilities. The subscale illuminates that the learning capacity of a student is dependent on their ability to manage themselves. Thus, novice practitioners who start a course in healthcare should be nurtured to enable them to develop independent practices of working as health professionals. Poor self-management skills incapacitate the abilities of students to focus on SDL. It also diminishes the urge and motivation to ensure that one is aware of the importance of enhancing their competences even when at work. Conversely, Naglaa et al. (2007), note that strong self-management skills have positive influence on individuals, mainly as a complement to their confidence and levels of maturity. Even so, any signs of poor self-management aptitudes among students are an indication of the need for support, which acts as the foundation for any developments in this domain. More so, increased support and resources should accompany each other as prerequisites for sovereign practice and learning.
Self-Control Self-control subscale is an essential determinant for SDL. Self-control plays a vital role in enabling the student to determine their learning goals and outcomes. The components of the subscale focus on essential attributes such as goal setting and even setting the timelines and appropriate actions to ensure that they are met. According to Naglaa et al. (2017), the self-Control subscale applies in the determination of scholars’ capabilities to evaluate themselves and utilize the results in determining their learning objectives and prospected products. More specifically, self-control is about learners having full control of their edification contexts as a significant factor and determinant of whether they achieve their goals or not. However, Naglaa et al. (2017) adds that having full control does not mean that a student is sovereign. Instead it entails collaborating with other individuals or groups without going out of the predefined learning contexts. Alkorashy and Assi (2016), also mention that increased self-control is a significant aspect used in gauging a students’ SDL readiness. In fact, heightened levels of SDLR reflect and allude to students’ augmented emphasis on self-control and self-responsibility, especially in nursing where these scholars can practice adult roles without any complexities and as a form of preparation for the start of their careers.
The study by Wlliams et al. (2012), mentions that self-control is a critical subset to determine whether a person can meet their goals and objectives. An individual’s self-control is a critical parameter in evaluating their willingness to take part in an activity or action. Similarly, self-control scales help formulate the appropriate strategies to evaluate the willingness of a student to excel in their career and hence grow professionally. Some of the critical elements that are embroiled in the subscale include the capacity to manage time, the ability to focus on improving their skills and knowledge and finally, a learner’s willingness to shun activities that may have a detrimental effect on their ability to develop their professional knowledge. Self-control indicated that learners could be autonomous even in non-teaching institutions. Thus, an individual’s high score for self-control is a critical determinant for their willingness to take part in SDL. Modern education curriculums should foster the development of self-control by providing learning environments that trigger an interest to engage further in SDL.
Accordingly, nursing policies and processes are designed in the classroom. The development of SDL is dependent on the foundation that was laid to help grow the competencies of the students to undertake self-learning. The subscales of SDL form instrumental elements that may be used to identify the readiness of students to take part in SDL. Lack of self, management, self-control and a desire for learning imply that the students are unwilling to take part in SDL processes. The outcomes of the process are incompetent workforces that are incapable of meeting the emerging needs of their patients. The creation of a framework of SDL is expected to instill discipline amongst students. The outcomes of the studies of the literature review also support the view that the desire to learn, self-control and management skills all have a significant effect on the readiness of a student to take part in SDL (Timothy, Chee, Beng, Sing, Ling, & Mun, 2010). Poor time management and the lack of skills for what to pay attention to have all been blamed for the incapacities to develop subscales for SDL. It is imperative that learners be prepared for lifelong learning processes to enable them to handle the emerging complexities of their ever-changing working environment.
Readiness to take part in SDL is a direct measure of the willingness of professionals to enhance their professional background. As Williams et al. (2012) suggest the changing landscape of today’s working environment demands that workers equip themselves with relevant skills to fulfill their job requirements. A majority of work procedures are being transformed and rather becoming automated using various technological devices. The same is being experienced in the medical world whereby technology has emerged to be a feasible method of changing how individuals attend to their work. Thus, unless students take part in learning, they are unlikely to keep up with the changing landscape of the events that take place in their careers. Self-directed learning helps learners to ensure that their knowledge and skills do not become obsolete. It helps professionals to build on their competencies thus make their work easier. Practicing nurses recognize that their career demands them to be life-long learners. Thus, SDL is fostered throughout their learning period to help build their competencies and abilities to deliver on their responsibility when in their line of work. Moreover, nurses who indulge in SDL portray greater levels of responsibility with regards to critical decision-making, adherence to nursing competencies and policies as well as build their confidence in their work. The attribute to be able to take part in SDL may be used to identify a nurse’s competency with regards to prompt decision making when the life of the patient is at risk (Pilling-Cormick, & Garrison, 2013). Notably, among the advancements on the matter include systematic reviews of implements focused on the detection and comprehension of SDL abilities, as highlighted by publications (Cadorin et al., 2017). Even so, there remains an urge for better comprehension of SDLR, in areas such as Saudi Arabia, since, as indicated by the assessment, it can result in the development of erudition atmospheres that accommodate learner-centered methodologies that advocate for nurses sovereignty and responsibility of their knowledge acquisition in the future. Resolutely, the stimulation of self-directed learning among nursing scholars and practitioners is based on consistent research and analysis of their readiness in self-directed learning, which this study addresses in the subsequent sections. As shown in the literature review, nurses’ willingness to take part in SDL is clear evidence of the urge to ensure quality delivery of services to patients.
Summary
The purpose of this chapter was to discuss the literature review of this study and includes the self-directed learning redness and the sub scales which are desire for learning, Self-management and Self-control. The conceptual framework has been presented and clarifies the relations among the variables. Even so, the review of literature was instrumental in the discovery of certain factors. Despite the increased prevalence of research trend, there are increased gaps and areas that need further research. Essentially, contemporary healthcare organizations have been subject to increased changes that prompt the consideration of self-directed learning abilities and skills as requirements for both nursing students and nurses. Notably, these capabilities and aptitudes are determinants of their reactiveness in dealing with the complex challenges.

CHAPTER III: METHODOLOGY
This section contains the methods and materials used in the study. It included the selected design, setting, data collection instruments and procedure, sample and sampling technique, ethical approval and data statistical analysis.
Study Design
The descriptive Cross-sectional Comparative design was used in this study. Descriptive research is used to describe characteristics of a population or phenomenon being studied (Shields, Patricia & Rangarjan, 2013). Comparative research, simply put, is the act of comparing two or more things with a view to discovering something about one or all of the things being compared (Heidenheimer, et al. 1983).
Study Setting
The study was conducted in two hospitals in Riyadh, Saudi Arabia namely, King Khalid University Hospital, and King Salman Hospital.
King Khalid University Hospital, a teaching hospital affiliated to Ministry of Education at Riyadh region and one of King Saud University Medical City facilities. It is a tertiary care hospital with an 800-bed facility with all general and subspecialty medical services. It contains a special outpatient building, more than 20 operating rooms, and a fully equipped and staffed laboratory, radiology, and pharmacy services in addition to all other supporting services. This hospital offers free health services, vital to any society, which possesses highly qualified consultants, carefully chosen physicians, and the finest nursing staff and general personnel possible. KKUH possesses the most current technological equipment, and annually serves the needs of a host of ambitious students at the College of Medicine. KKUH has several specialized departments like: Medical Imaging (Radiology), Laboratory, Nursing Department, Rehabilitation, Anesthesia, Pharmacy, Infection Control, Clinical Physiology Department, Physiotherapy. (King Saud University Medical City,2016). The selection of the King Khalid University Hospital as setting was made because of its being one of the biggest government teaching hospitals in the Region of Riyadh with international accreditations and one of King Saud Medical City University facilities.
King Salman Hospital as non-teaching hospital affiliated to Ministry of Health at Riyadh region, established in 1985. It is a tertiary care hospital with a 450 bed capacity. This hospital offers free health services 24 hours a day; all care is free of charge for eligible Saudi patients including medication. Kingdom of Saudi Arabia – Ministry of Health Portal. (2017). King Salman Hospital was selected because of its being one of the government non-teaching hospitals that affiliated to Ministry of health in the Region of Riyadh. Both are accredited by (CBAHI) the Saudi Central Board for Accreditation of Health Care.
Sample
The target population for the study was all the registered nurses in the clinical and administrative ladders working in selected tertiary government teaching and non-teaching hospitals at Ministry of Health. While the accessible population includes all registered staff nurses in the selected clinical units working at King Salman hospital and King Khalid University Hospital, as part of the inclusion criteria. Participants can also read and write in English, working in the current setting for not less than 6 months and willing to participate in the study. The reason for choosing nurses who are working currently in their setting for not less than one 6 months is that they need time to become familiar with their practice setting and available resources and opportunities for professional development.
Sampling technique
Non-Probability Quota Sampling Technique was used to determine the subjects and structure the sampling plan for this study. Three steps were followed in creating a quota sample: (a) Firstly, relevant stratification and dividing the population accordingly was done; (b) the next step was to calculate a quota for each stratum; and final step entailed inviting cases until the quota for each stratum was met. (All the available include the inclusion criteria).
Sample size
Sample size determined through (Confidence Level: 95%, Confidence Interval:3). KKUH, from a Population N: 1290, the sample size through the calculation it was 584 nurses. The proportion of sample from each unit calculated as in table (1), example Medical units Population=438, where its proportion from total population equal (438/1290*584) = 198.
Table (1) Sample size using quota sampling technique at KKUH
Quota sample Population Units type
198 438 Medical units
150 332 Surgical units
88 194 Pediatrics units
67 148 Maternity units
81 178 Intensive care units
584 1290 Total

Sample size determined through (Confidence Level: 95%, Confidence Interval: 3). KSH, from a Population N: 279, the sample size through the calculation it was 221 nurses. The proportion of sample from each unit calculated as in table (2), example Medical units Population=53, where its proportion from total population equal (53/279*221) =42.
Table (2) Sample size using quota sampling technique at KSH
Quota sample Population Units type
42 53 Medical units
47 59 Surgical units
27 34 Pediatrics units
34 43 Maternity units
71 90 Intensive care units
221 279 Total
Response Rate:

Table (3) Participants Response Rate:
Hospital Distributed Sheets Returned
Sheets Excluded
Sheets Analyzed Sheets
KKUH 584 (100%) 514 (88.01%) 70 (11.99%) 442(75.68%)
KSH 221 (100%) 215 (97.28%) 15 (06.79%) 200(90.50%)

Participants Response Rate (KKUH): the total of (584) questionnaire sheets distributed among nurses meeting the inclusion criteria. The number of returned sheets was (514) with response rate (88.01%), from these returned sheets (70) sheets were excluded for their incompletion or invalidity, the total number of valid questionnaire sheets which were utilized in data analysis (442) with response rate (75.68%).
Participants Response Rate (KSH): The total of (221) questionnaire sheets distributed among nurses meeting the inclusion criteria. The number of returned sheets was (215) with response rate (97.28%), from these returned sheets (15) sheets were excluded for their incompletion or invalidity, the total number of valid questionnaire sheets which were utilized in data analysis (200) with response rate (90.50%).
Instrument
This study utilized a two (2)-part tool. First part covered the demographic characteristics of the respondents. The second part covered the self-directed learning activities. Such that, the Self-directed Learning Readiness (SDLR) Tool utilized, originally authored by Fisher (Fisher, 2001): (Fisher, 2010). The SDLR Tool is a self-directed learning readiness 40-item SDLR scale was developed by Fisher et al. for nursing education to enable nursing educators make informed judgment during the diagnosing of their student attitudes, personality characteristics and abilities. The mentioned factors are considered necessary for SDL.
A 5-point Likert scale ranging with the values (1, strongly disagree; to 5, strongly agree) that contains three domains: desire for learning (12 items), self-management (13 items), and self-control (15). Overall scores range 40-200; higher scores reflect stronger SDLR. This scale reliable and valid with Chronbach’s alpha of the SDLRS was 0.87 for Self-management, 0.85 for ‘Desire for learning and 0.80 for ‘Self-control.’ The Chronbach’s alpha for the total scale was 0.87 validity of the scale confirmed by fisher in a study aimed to re-examine the factor structure of the subscales and provide evidence of its validity (Fisher, 2010). The tool can be utilized in the clinical setting among nurses and have been used in a study about Iranian Clinical Nurses’ Readiness for Self-Directed Learning (Malekian et al. 2016). Also have been used in studies conducted in KSA such as study titled Readiness for Self-Directed Learning among Bachelor Nursing Students in Saudi Arabia: A Survey-Based Study (Alkorashy,2016). Permission from the author was sought in the use of the tool.
Data Collection Procedure
-Official approval to conduct the study was taken from the administration of selected setting.
The official permission from the authors was taken to adopt the survey in collecting the data for the current study.
-Ethical issues about participants’ consent to take part in the study, choose to withdraw from taking part in the study at any stage, ensure that participants anonymity in the study is maintained, by removing any identifiable information.
Subjects who are meeting the inclusion criteria were invited to fill the questionnaire sheets during their on-duty shifts.
-Data collection plan was developed with an arrangement with official bodies in the selected setting so that data collection (sheets distribution and collection) was completed within the planned time and target numbers.
Methods of Data Analysis
The data was coded, entered, verified and analyzed using the latest version of the Statistical Package for Social Science (SPSS-22). Descriptive and inferential statistical analysis was used to reach the results of this study. For sub-problem number 1, frequency and percentages will be employed; while sub-problem number 2 , weighted mean utilized and standard deviation. For sub- problem number 3, t-test and p-value were used while Pearson r Moment Correlation Coefficient will be employed for sub problem number 4.
Ethical consideration
The study proposal was submitted to the Institutional Review Board (IRB) and the Ethical Committee of the Research Centers of the two hospitals, to assure the feasibility and suitability of the study and guarantee that it meets all ethical considerations. The participants who meet the inclusion criteria were invited to participate in the study. In this process, an information sheet explained the Introduction, Purpose, process, risk, benefit, alternative procedures, if any are disclosed, assurance of anonymity and confidentiality of the study was provided to all the participants. They signed a consent form attached to the questionnaire. The participants were informed that they had the right to withdraw from the study at any time and for any reason.
Summary:
This chapter describes the methodology of the study, this includes the study design which is the descriptive cross sectional comparative design, the study was conducted in two hospitals KKUH as teaching hospital, and KSH as non- teaching hospital . The data for this study had been collected using a self – reported questionnaire which is the self-directed learning readiness (SDLR) tool , The sample selection has been explained also method of data collection and as well as provide an account of the statistical procedures applied to break down the data.
CHAPTER IV: RESULTS
This chapter is a presentation of findings of the data, both descriptive and inferential according to the research questions specifically: 1) What are the self-directed learning readiness activities among nurses?; 2) What are the self-directed learning readiness activities among nurses working in teaching hospital?; 3) What are the self-directed learning readiness activities among nurses working in non-teaching hospital?; 4) Are there significant differences in the nurses’ self-directed learning readiness between the two teaching and non-teaching hospitals?; and 5) Is there a relationship between the selected demographic characteristics and the self-directed learning activities?
Socio-Demographic Characteristics of the participants:
Table (4) below is the presentation of the socio-demographic characteristics of the nurses in terms of age, gender, civil status, job title and specialization in the teaching and non-teaching hospitals.
Table (4) Socio-Demographic Characteristics of the participants.
KKUH +KSH (642) KKUH
(442) KSH
(200)
Demographic characteristics F
% F % F %
Age 21-30 213 33.2 106 24.0 107 53.5
31-40 250 38.9 193 43.7 57 28.5
41-50 140 21.8 105 23.8 35 17.5
51 and above 39 6.1 38 8.6 1 .5
Gender Male 41 6.4 20 4.5 21 10.5
Female 601 93.6 422 95.5 179 89.5
Civil Status Single 193 30.1 112 25.3 81 40.5
Married 447 69.6 329 74.4 118 59.0
Divorced 1 .2 0 0 1 .5
Widowed 1 .2 1 .2 0 0
Job title Staff Nurse 1 343 53.4 195 44.1 148 74.0
Staff Nurse 2 233 36.3 211 47.7 22 11.0
Charge Nurse 39 6.1 14 3.2 25 12.5
Head Nurse 19 3.0 14 3.2 5 2.5
Others 8 1.2 8 1.8 Specialization Medical 187 29.1 149 33.7 38 19.0
Surgical 159 24.8 117 26.5 42 21.0
Pediatric 93 14.5 66 14.9 27 13.5
Maternity 83 12.9 50 11.3 33 16.5
ICU 120 18.7 60 13.6 60 30.0

Legend :F=Frequency.
Table (4) showed the socio-demographic characteristics of the nurses and it’s found that with a total of 642 nurses; where (93.6%) were females, and 6.4% were males. With respect to civil status it has shown that (69.6%) of the nurse’s social status were married, and (30.1%) were single. With regard to age groups we find that (38.9%) of nurses belonged to age group 31 to 40 and (33.2%) were in age group 21-30 and only (6.1%) were 51 years and above. Moreover, in job title were (53.4%) their job title were staff nurse 1 and (36.3%) were staff nurse 2, but only (6.1%) of nurses had a job title charge nurse and (3%) as head nurse. Lastly, regarding specializations, (29.1%) of the nurses were medical and (24.8%) were surgical, also (14.5%) were pediatric.
Also showed the socio-demographic characteristics of the nurses in teaching hospital (KKUH) and non-teaching hospital (KSH).
At KKUH: it’s found that with a total of 442 nurses; where (95.5%) were females and (4.5%) were males. With respect to Civil status it has shown that (74.4%) of the nurse’s social status were married, and (25.3%) were single. With regared to age groups we find that (43.7%) of nurses belonged to age group 31 to 40 and (24%) were in age group 21-30 and only (8.6%) were 51 years and above. Moreover, in job title were (47.7%) their job title was staff nurse 2 and (44.1%) were staff nurse 1, but only (3.2%) of nurses had a job title charge nurse and (3.2%) as head nurse. Lastly, regarding specializations (33.7%) of the nurses were medical and (26.5%) were surgical, also (14.9%) were pediatric.
At KKUH: it’s found that with a total of 200 nurses; where (89.5%) were females and (10.5%) were males. With respect to Civil status it has shown that (59%) of the nurse’s social status were married, and (40.5%) were single. with regared to age groups we find that (53.5%) of nurses belonged to age group 21 to 30 and (28.5%) were in age group 31-40 and only (0.5%) were 51 years and above. Moreover, in job title were (74%) their job title was staff nurse 1 and (12.5%) were charge nurse, but only (11%) of nurses had a job title nurse staff 2 and (2.5%) as head nurse. Lastly, regarding specializations, (21%) of the nurses were surgical and (19%) were medical, also (13.5%) were pediatric.
The following findings pertain to each research question.
Research Question Number 1: What are the self-directed learning readiness (SDLR) activities among nurses? Table 5 shows the SDLR readiness activities in the two selected hospitals.
Table (5) Self-directed learning readiness activities among nurses in the two hospitals
Self-directed learning readiness activities SD D U A SA M SD Rank
N N N N N I solve problems using plan. 10 10 42 414 166 4.115 0.717 13
I prioritize my work. 16 66 21 279 260 4.092 1.033 14
I do not manage my time well. 143 196 65 163 75 2.737 1.361 37
I have good management skills. 5 46 75 391 125 3.911 0.813 31
I set strict time frames. 3 25 69 421 124 3.994 0.707 25
I prefer to plan my own learning. 6 56 58 398 124 3.9 0.841 32
I am systematic in my learning. 3 21 88 407 123 3.975 0.708 29
I am able to focus on a problem. 5 43 51 404 139 3.98 0.797 28
I need to know why. 6 28 57 371 180 4.076 0.789 15
I critically evaluate new ideas. 3 17 77 419 126 4.009 0.682 23
I prefer to set my own learning goals. 7 28 62 394 151 4.019 0.778 21
I learn from my mistakes. 5 32 36 303 266 4.235 0.828 4
I am open to new ideas. 2 20 52 329 239 4.22 0.747 6
When presented with a problem I cannot resolve, I will ask for assistance. 12 44 81 290 215 4.016 0.951 22
I am responsible. 5 19 43 282 293 4.307 0.787 1
I like to evaluate what I do. 3 17 43 344 235 4.232 0.727 5
I have high personal expectations. 5 30 68 355 184 4.064 0.804 17
I have high personal standards. 2 24 78 363 175 4.067 0.754 16
I have high beliefs in my abilities. 7 30 71 353 181 4.045 0.823 19
I am aware of my own limitations. 5 37 50 322 228 4.139 0.846 11
I am confident in my ability to search out information. 12 39 67 350 174 3.989 0.888 27
I do not enjoy studying. 132 247 66 139 58 2.601 1.276 38
I have a need to learn. 19 34 66 360 163 3.956 0.913 30
I enjoy a challenge. 3 35 68 385 151 4.006 0.776 24
I want to learn new information. 2 17 45 318 260 4.273 0.732 2
I enjoy learning new information. 6 4 48 339 245 4.266 0.704 3
I set specific times for my study. 4 23 110 404 101 3.896 0.72 33
I am self-disciplined. 4 17 59 367 195 4.14 0.734 10
I like to gather the facts before I make a decision. 3 22 42 395 180 4.132 0.713 12
I am disorganized 248 241 59 67 27 2.04 1.129 40
I am logical. 12 42 82 393 113 3.861 0.846 35
I am methodical. 10 19 131 386 96 3.84 0.766 36
I evaluate my own performance. 2 23 60 426 131 4.03 0.685 20
I prefer to set my own criteria on which to evaluate my performance. 3 50 92 378 119 3.872 0.817 34
I am responsible for my own decisions/actions. 3 18 38 371 212 4.201 0.71 7
I can be trusted to pursue my own learning. 3 12 66 367 194 4.148 0.708 9
I can find out information for myself. 6 17 64 400 155 4.061 0.727 18
I like to make decisions for myself. 3 44 71 360 164 3.994 0.827 25
I prefer to set my own goals. 3 20 40 368 211 4.19 0.723 8
I am not in control of my life. 209 185 69 142 37 2.397 1.297 39
Overall mean 3.9 0.43
Legend: SD= standard deviation.
Table (5) showed that the overall levels of nurses self-directed learning readiness was (3.9) based on the scoring of the scale and this considered quite high, moreover, the self-directed learning readiness highest level was for the item “I am responsible” with (4.3) mean and SD (0.78). Then comes next the item “I want to learn new information” with mean (4.27) and SD (0.73). In contrast, Item “I am disorganized” had the lowest level with mean (2.04) and SD (1.12) then comes second from the last the item “I am not in control of my life” with mean (2.39) and SD (1.29).
Table (6) Top 5 and bottom 5 of SDLR activities among nurses in the two hospitals
Self-directed learning readiness activities SD D U A SA M
SD
Rank
N N N N N I am responsible. 5 19 43 282 293 4.31 0.787 1
I want to learn new information. 2 17 45 318 260 4.27 0.732 2
I enjoy learning new information. 6 4 48 339 245 4.27 0.704 3
I learn from my mistakes. 5 32 36 303 266 4.24 0.828 4
I like to evaluate what I do. 3 17 43 344 235 4.23 0.727 5
I am methodical. 10 19 131 386 96 3.84 0.766 36
I do not manage my time well. 143 196 65 163 75 2.74 1.361 37
I do not enjoy studying. 132 247 66 139 58 2.6 1.276 38
I am not in control of my life. 209 185 69 142 37 2.4 1.297 39
I am disorganized 248 241 59 67 27 2.04 1.129 40
Legend: SD= standard deviation.
Table (6) showed the Top 5 and bottom 5 of SDLR activities among nurses in the two hospitals, the top 5 SDLR activities sequentially were I am responsible, I want to learn new information, I enjoy learning new information, I learn from my mistakes and I like to evaluate what I do .The bottom 5 of SDLR activities sequentially were I am disorganized, I am not in control of my life, I do not enjoy studying, I do not manage my time well and I am methodical.
Research Question Numbers 2: What are the self-directed learning readiness activities among nurses working in teaching hospital?
Table 7 shows the SDLR readiness activities in the teaching hospitals.
Table (7) Self-directed learning readiness activities among nurse’s levels among nurses in teaching hospitals
Self-directed learning readiness activities SD D U A SA M
SD
Rank
N N N N N I solve problems using plan. 2 5 14 292 129 4.224 0.6 10
I prioritize my work. 6 29 8 206 193 4.247 0.883 9
I do not manage my time well. 117 165 26 101 33 2.475 1.299 37
I have good management skills. 2 7 54 292 87 4.029 0.651 29
I set strict time frames. 1 8 39 302 92 4.077 0.62 22
I prefer to plan my own learning. 1 28 29 290 94 4.014 0.744 32
I am systematic in my learning. 2 3 37 309 91 4.095 0.591 21
I am able to focus on a problem. 1 5 27 310 99 4.133 0.578 18
I need to know why. 2 3 29 283 125 4.19 0.617 13
I critically evaluate new ideas. 2 6 41 303 90 4.07 0.622 25
I prefer to set my own learning goals. 1 18 32 287 104 4.075 0.697 23
I learn from my mistakes. 2 3 13 221 203 4.403 0.629 2
I am open to new ideas. 1 5 24 240 172 4.305 0.646 7
When presented with a problem I cannot resolve, I will ask for assistance. 8 15 27 230 162 4.183 0.833 14
I am responsible. 1 3 9 220 209 4.432 0.596 1
I like to evaluate what I do. 1 2 17 261 161 4.31 0.588 6
I have high personal expectations. 4 14 39 262 123 4.1 0.752 20
I have high personal standards. 2 15 49 264 112 4.061 0.734 26
I have high beliefs in my abilities. 3 5 35 273 126 4.163 0.667 17
I am aware of my own limitations. 0 3 20 252 167 4.319 0.591 5
I am confident in my ability to search out information. 7 8 30 278 119 4.118 0.734 19
I do not enjoy studying. 93 193 46 78 32 2.464 1.208 38
I have a need to learn. 5 15 43 279 100 4.027 0.749 30
I enjoy a challenge. 1 8 42 298 93 4.072 0.628 24
I want to learn new information. 0 5 13 249 175 4.344 0.594 3
I enjoy learning new information. 1 2 13 260 166 4.33 0.579 4
I set specific times for my study. 3 9 68 282 80 3.966 0.691 33
I am self-disciplined. 1 2 27 284 128 4.213 0.587 12
I like to gather the facts before I make a decision. 2 3 16 298 123 4.215 0.58 11
I am disorganized 164 182 37 36 23 2.032 1.118 40
I am logical. 5 11 63 303 60 3.91 0.687 34
I am methodical. 6 4 85 299 48 3.857 0.663 36
I evaluate my own performance. 2 11 28 323 78 4.05 0.615 27
I prefer to set my own criteria on which to evaluate my performance. 3 27 62 276 74 3.885 0.775 35
I am responsible for my own decisions/actions. 1 2 13 281 145 4.283 0.563 8
I can be trusted to pursue my own learning. 1 4 26 301 110 4.165 0.581 16
I can find out information for myself. 0 12 45 294 91 4.05 0.644 27
I like to make decisions for myself. 0 25 36 287 94 4.018 0.722 31
I prefer to set my own goals. 0 12 20 285 125 4.183 0.636 14
I am not in control of my life. 159 147 24 90 22 2.251 1.272 39
Legend: SD= standard deviation.
Table (7) showed that the overall levels of nurses self-directed learning readiness in teaching hospitals was (3.95) based on the scoring of the scale and this considered quite high, moreover, the self-directed learning readiness highest level was for the item “I am responsible” with (4.43) mean and SD (0.59). Then comes next the item: “I learn from my mistakes” with mean (4.4) and SD (0.629). In contrast, Item “I am disorganized” had the lowest level with mean (2.03) and SD (1.11) then comes second from the last the item “I am not in control of my life” with mean (2.25) and SD (1.27).
Table (8) Top 5 and bottom 5 of SDLR activities among nurses in teaching hospital
Self-directed learning readiness activities SD D U A SA M
SD
Rank
N N N N N I am responsible. 1 3 9 220 209 4.432 0.596 1
I learn from my mistakes. 2 3 13 221 203 4.403 0.629 2
I want to learn new information. 0 5 13 249 175 4.344 0.594 3
I enjoy learning new information. 1 2 13 260 166 4.33 0.579 4
I am aware of my own limitations. 0 3 20 252 167 4.319 0.591 5
I am methodical. 6 4 85 299 48 3.857 0.663 36
I do not manage my time well. 117 165 26 101 33 2.475 1.299 37
I do not enjoy studying. 93 193 46 78 32 2.464 1.208 38
I am not in control of my life. 159 147 24 90 22 2.251 1.272 39
I am disorganized 164 182 37 36 23 2.032 1.118 40
Legend: SD= standard deviation.
Table (8) showed the Top 5 and bottom 5 of SDLR activities among nurses in the two hospitals, the top 5 SDLR activities sequentially were I am responsible ,I learn from my mistakes ,I want to learn new information ,I enjoy learning new information ,I am aware of my own limitations. The bottom 5 of SDLR activities sequentially were I am disorganized , I am not in control of my life , I do not enjoy studying , I do not manage my time well and I am methodical.
Research Question Numbers 3. What are the self-directed learning readiness activities among nurses working in non-teaching hospital?
Table 9 shows the SDLR readiness activities in the non- teaching hospitals.Table (9) Self-directed learning readiness activities among nurse’s levels among nurses in non-teaching hospitals
Self-directed learning readiness activities SD D U A SA M SD Rank
N N N N N I solve problems using plan. 8 5 28 122 37 3.875 0.879 17
I prioritize my work. 10 37 13 73 67 3.75 1.239 28
I do not manage my time well. 26 31 39 62 42 3.315 1.317 37
I have good management skills. 3 39 21 99 38 3.65 1.045 33
I set strict time frames. 2 17 30 119 32 3.81 0.841 23
I prefer to plan my own learning. 5 28 29 108 30 3.65 0.981 33
I am systematic in my learning. 1 18 51 98 32 3.71 0.86 31
I am able to focus on a problem. 4 38 24 94 40 3.64 1.066 36
I need to know why. 4 25 28 88 55 3.825 1.034 22
I critically evaluate new ideas. 1 11 36 116 36 3.875 0.783 17
I prefer to set my own learning goals. 6 10 30 107 47 3.895 0.921 16
I learn from my mistakes. 3 29 23 82 63 3.865 1.064 19
I am open to new ideas. 1 15 28 89 67 4.03 0.907 8
When presented with a problem I cannot resolve, I will ask for assistance. 4 29 54 60 53 3.645 1.084 35
I am responsible. 4 16 34 62 84 4.03 1.046 8
I like to evaluate what I do. 2 15 26 83 74 4.06 0.944 7
I have high personal expectations. 1 16 29 93 61 3.985 0.905 11
I have high personal standards. 0 9 29 99 63 4.08 0.798 6
I have high beliefs in my abilities. 4 25 36 80 55 3.785 1.046 26
I am aware of my own limitations. 5 34 30 70 61 3.74 1.14 29
I am confident in my ability to search out information. 5 31 37 72 55 3.705 1.106 32
I do not enjoy studying. 39 54 20 61 26 2.905 1.369 38
I have a need to learn. 14 19 23 81 63 3.8 1.186 24
I enjoy a challenge. 2 27 26 87 58 3.86 1.018 20
I want to learn new information. 2 12 32 69 85 4.115 0.952 3
I enjoy learning new information. 5 2 35 79 79 4.125 0.907 2
I set specific times for my study. 1 14 42 122 21 3.74 0.758 29
I am self-disciplined. 3 15 32 83 67 3.98 0.967 13
I like to gather the facts before I make a decision. 1 19 26 97 57 3.95 0.917 14
I am disorganized 84 59 22 31 4 2.06 1.155 40
I am logical. 7 31 19 90 53 3.755 1.114 27
I am methodical. 4 15 46 87 48 3.8 0.956 24
I evaluate my own performance. 0 12 32 103 53 3.985 0.817 11
I prefer to set my own criteria on which to evaluate my performance. 0 23 30 102 45 3.845 0.903 21
I am responsible for my own decisions/actions. 2 16 25 90 67 4.02 0.935 10
I can be trusted to pursue my own learning. 2 8 40 66 84 4.11 0.929 4
I can find out information for myself. 6 5 19 106 64 4.085 0.884 5
I like to make decisions for myself. 3 19 35 73 70 3.94 1.021 15
I prefer to set my own goals. 3 8 20 83 86 4.205 0.887 1
I am not in control of my life. 50 38 45 52 15 2.72 1.296 39
Legend: SD= standard deviation.
Table (9) shows that the overall levels of nurses self-directed learning readiness in non-teaching hospitals was (3.77) based on the scoring of the scale and this considered quite high, moreover, the self-directed learning readiness highest level was for the item “I prefer to set my own goals” with (4.20) mean and SD (0.88). Then comes next the item “I enjoy learning new information” with mean (4.12) and SD (0.907). In contrast, Item “I am disorganized” had the lowest level with mean (4.12) and SD (1.15) then comes second from the last the item “I am not in control of my life” with mean (2.72) and SD (1.29).
Table (10): Top 5 and bottom 5 of SDLR activities among nurses in non- teaching hospital
self-directed learning readiness activities among nurses SD D U A SA M
SD
Rank
N N N N N I prefer to set my own goals. 3 8 20 83 86 4.205 0.887 1
I enjoy learning new information. 5 2 35 79 79 4.125 0.907 2
I want to learn new information. 2 12 32 69 85 4.115 0.952 3
I can be trusted to pursue my own learning. 2 8 40 66 84 4.11 0.929 4
I can find out information for myself. 6 5 19 106 64 4.085 0.884 5
I am able to focus on a problem. 4 38 24 94 40 3.64 1.066 36
I do not manage my time well. 26 31 39 62 42 3.315 1.317 37
I do not enjoy studying. 39 54 20 61 26 2.905 1.369 38
I am not in control of my life. 50 38 45 52 15 2.72 1.296 39
I am disorganized 84 59 22 31 4 2.06 1.155 40
Legend: SD= standard deviation.
Table (10) showed the Top 5 and bottom 5 of SDLR activities among nurses in the two hospitals,
The outcomes showing that nurses prefer to set own goals, they derive joy in learning new information, are willing to derive knowledge by learning new information, that they can be trusted do conduct their personal learning and are curious to discover new information without any one’s help.
The bottom 5 SDLR activities sequentially were being disorganized, the lack of control for life, lack of pleasure or joy in studying, and the inability to manage time effectively or even focus on a particular problem.
Research Question Number 4. Are there significant differences in the nurses’ self-directed learning readiness between the two teaching and non-teaching hospitals?

Table (11) Differences in SDLR between teaching and non-teaching hospitals
self-directed learning readiness activities among nurses Non-Teaching Hospital Teaching Hospital T-test P-value
Mean Standard Deviation Mean Standard Deviation I solve problems using plan. 3.875 0.879 4.224 0.6 -5.859 0.000**
I prioritize my work. 3.75 1.239 4.247 0.883 -5.784 0.000**
I do not manage my time well. 3.315 1.317 2.475 1.299 7.554 0.000**
I have good management skills. 3.65 1.045 4.029 0.651 -5.603 0.000**
I set strict time frames. 3.81 0.841 4.077 0.62 -4.499 0.000**
I prefer to plan my own learning. 3.65 0.981 4.014 0.744 -5.172 0.000**
I am systematic in my learning. 3.71 0.86 4.095 0.591 -6.586 0.000**
I am able to focus on a problem. 3.64 1.066 4.133 0.578 -7.583 0.000**
I need to know why. 3.825 1.034 4.19 0.617 -5.552 0.000**
I critically evaluate new ideas. 3.875 0.783 4.07 0.622 -3.386 0.001**
I prefer to set my own learning goals. 3.895 0.921 4.075 0.697 -2.724 0.007**
I learn from my mistakes. 3.865 1.064 4.403 0.629 -7.985 0.000**
I am open to new ideas. 4.03 0.907 4.305 0.646 -4.386 0.000**
When presented with a problem I cannot resolve, I will ask for assistance. 3.645 1.084 4.183 0.833 -6.876 0.000**
I am responsible. 4.03 1.046 4.432 0.596 -6.17 0.000**
I like to evaluate what I do. 4.06 0.944 4.31 0.588 -4.086 0.000**
I have high personal expectations. 3.985 0.905 4.1 0.752 -1.674 0.095
I have high personal standards. 4.08 0.798 4.061 0.734 0.294 0.769
I have high beliefs in my abilities. 3.785 1.046 4.163 0.667 -5.513 0.000**
I am aware of my own limitations. 3.74 1.14 4.319 0.591 -8.463 0.000**
I am confident in my ability to search out information. 3.705 1.106 4.118 0.734 -5.583 0.000**
I do not enjoy studying. 2.905 1.369 2.464 1.208 4.107 0.000**
I have a need to learn. 3.8 1.186 4.027 0.749 -2.935 0.003**
I enjoy a challenge. 3.86 1.018 4.072 0.628 -3.236 0.001**
I want to learn new information. 4.115 0.952 4.344 0.594 -3.706 0.000**
I enjoy learning new information. 4.125 0.907 4.33 0.579 -3.453 0.001**
I set specific times for my study. 3.74 0.758 3.966 0.691 -3.723 0.000**
I am self-disciplined. 3.98 0.967 4.213 0.587 -3.757 0.000**
I like to gather the facts before I make a decision. 3.95 0.917 4.215 0.58 -4.424 0.000**
I am disorganized 2.06 1.155 2.032 1.118 0.294 0.769
I am logical. 3.755 1.114 3.91 0.687 -2.149 0.032*
I am methodical. 3.8 0.956 3.857 0.663 -0.88 0.379
I evaluate my own performance. 3.985 0.817 4.05 0.615 -1.11 0.267
I prefer to set my own criteria on which to evaluate my performance. 3.845 0.903 3.885 0.775 -0.569 0.570
I am responsible for my own decisions/actions. 4.02 0.935 4.283 0.563 -4.406 0.000*
I can be trusted to pursue my own learning. 4.11 0.929 4.165 0.581 -0.915 0.361
I can find out information for myself. 4.085 0.884 4.05 0.644 0.568 0.570
I like to make decisions for myself. 3.94 1.021 4.018 0.722 -1.109 0.268
I prefer to set my own goals. 4.205 0.887 4.183 0.636 0.353 0.724
I am not in control of my life. 2.72 1.296 2.251 1.272 4.301 0.000*
P-value is significant at level 0.05
Table (11) showed whether there are difference between teaching hospitals and non-teaching hospitals, with regard to Self-directed Learning Readiness and results it has shown that most of the items have significant differences between teaching hospitals and non-teaching hospitals , however , we find that there were several items that don’t have significant differences “I have high personal standards.” With p-value above 0.05. In addition, the items “I am disorganized”, “I prefer to set my own criteria on which to evaluate my performance”, “I can be trusted to pursue my own learning.”, “I can be trusted to pursue my own learning” and “I like to make decisions for myself” have no significant differences between the two hospitals.
Table (12) Differences in SDLR between teaching and non-teaching hospitals (categories)
Categories Non-Teaching Hospital Teaching Hospital T-test P-value
Mean Mean Self-Management 3.76 4.03 -6.612 0.00
Desire for Learning 3.81 4.05 -5.88 0.00
Self-control
3.75 3.83 -1.942 0.053
Self-directed learning readiness activities 3.77 3.96 -5.158 0.00
P-value is significant at level 0.05
Table (12) showed that there were significant differences in self-directed learning readiness activities between teaching and non-teaching hospitals with P-value (0.00), where the mean score for the teaching hospitals self-directed learning readiness activities scale is higher. Similarly, we see that there were significant difference between teaching and non-teaching hospitals with respect to Self-Management scale with p-value (0.05), also there were a significant difference with respect to Desire for Learning scale. In contrast, we find that there were no significant differences between teaching and non-teaching hospitals with respect to Self-control scale p-value (0.053). Research Question Number 5. Is there relationship between the selected demographic characteristics and the self-directed learning readiness?
From table 13 to table 18 answered question number 5.
Table (13) Relationship between demographic variables and self-directed learning activities (matrix)
  How old are you Indicate your gender Civil Status Job title in Nursing Department Specialization self-directed learning readiness activities Self-Management Desire for Learning Self-control
How old are you Pearson Correlation 1 .031 .274** -.024 .040 .045 .083* .038 .003
Sig. (2-tailed) .434 .000 .552 .314 .256 .035 .331 .943
N 642 642 642 642 642 642 642 642
Indicate your gender Pearson Correlation   1 -.015 .004 -.010 .017 .067 -.021 -.002
Sig. (2-tailed) .697 .915 .793 .673 .088 .594 .957
N 642 642 642 642 642 642 642
Civil Status Pearson Correlation     1 -.059 .011 .037 .022 .034 .045
Sig. (2-tailed) .138 .783 .352 .586 .386 .256
N 642 642 642 642 642 642
Job title in Nursing Department Pearson Correlation       1 -.137** .065 .090* .086* .007
Sig. (2-tailed) .001 .099 .023 .029 .859
N 642 642 642 642 642
Specialization Pearson Correlation         1 -.131** -.199** -.129** -.035
Sig. (2-tailed) .001 .000 .001 .373
N 642 642 642 642
self-directed learning readiness activities Pearson Correlation           1 .929** .919** .899**
Sig. (2-tailed) .000 .000 .000
N 642 642 642
Self-Management Pearson Correlation             1 .819** .734**
Sig. (2-tailed) .000 .000
N 642 642
Desire for Learning Pearson Correlation               1 .720**
Sig. (2-tailed) .000
N 642
Self-control Pearson Correlation                 1
Sig. (2-tailed) N Correlation is significant at level 0.05
Table (13) showed the relationship between demographic variables and the self-directed learning activities ,and we see that self-directed learning readiness activities only has significant relationship with specialization , with respect to the self-management scale, we find there were three variables that have a significant relationship, which are Age, Job title and specialization. Similarly, for the scale desire for learning, we see only two variables which have a significant relationship which are job title and specialization. In contrast, the self-control scale we see that there was no significant relationship with any of the demographic variables.
Table (14) Relationship between demographic variables and self-directed learning activitiesDemographic variables Self-directed learning readiness activities Pearson correlation
Mean Standard Deviation Age 21-30 3.86 0.42 0.045
31-40 3.95 0.36 41-50 3.85 0.54 51 and above 4.01 0.38 Gender Male 3.87 0.45 0.017
Female 3.9 0.43 Civil Status Single 3.88 0.44 0.037
Married 3.91 0.43 Divorced 3.85 . Widowed 4.13 . Job title in Nursing Department Staff Nurse 1 3.87 0.51 0.065
Staff Nurse 2 3.93 0.32 Charge Nurse 3.92 0.37 Head Nurse 4.08 0.26 Others 3.82 0.2 Specialization Medical 3.91 0.43 -0.131**
Surgical 3.95 0.45 Pedia 3.93 0.42 Maternity 4.07 0.33 ICU 3.67 0.39 Table (14) showed that there were a significant relationship between self-directed learning readiness activities scale and specialization (-0.131**) at the level of (0.01). However, there was no significant relationship with the other demographic variables age (0.045), gender (0.017), civil status (0.037) and job title (0.065) .
Table (15) Relationship between demographic variables and self-managementDemographic variables Self-directed learning readiness activities Pearson correlation
Mean Standard Deviation Age 21-30 3.87 0.48 .083*
31-40 3.99 0.42 41-50 3.92 0.58 51 and above 4.09 0.44 Gender Male 3.82 0.59 0.067
Female 3.95 0.48 Civil Status Single 3.93 0.47 0.022
Married 3.95 0.49 Divorced 3.77 . Widowed 4.31 . Job title in Nursing Department Staff Nurse 1 3.9 0.57 0.090*
Staff Nurse 2 3.99 0.35 Charge Nurse 3.95 0.41 Head Nurse 4.2 0.27 Others 3.85 0.21 Specialization Medical 3.99 0.46 -0.199**
Surgical 4.01 0.48 Pedia 3.97 0.42 Maternity 4.13 0.41 ICU 3.62 0.49 Table (15) showed the Relationship between demographic variables and SDLR (self-management) and we find that there were significant relationship between age (.083*), job title(0.090*) and specialization (-0.199**) with self-management , however, both gender (0.067) and civil status (0.022) have no significant relationship.
Table (16) Relationship between demographic variables and desire for learningDemographic variables Self-directed learning readiness activities Pearson correlation
Mean Standard Deviation Age 21-30 3.92 0.52 0.038
31-40 4.04 0.4 41-50 3.91 0.59 51 and above 4.07 0.4 Gender Male 4.01 0.48 -0.021
Female 3.97 0.49 Civil Status Single 3.95 0.5 0.034
Married 3.98 0.49 Divorced 3.83 . Widowed 4.42 . Job title in Nursing Department Staff Nurse 1 3.93 0.56 0.086*
Staff Nurse 2 4.02 0.39 Charge Nurse 4.01 0.41 Head Nurse 4.15 0.36 Others 3.93 0.27 Specialization Medical 3.99 0.48 –0.129**
Surgical 4.04 0.5 Pedia 4.02 0.42 Maternity 4.14 0.39 ICU 3.73 0.53 Table (16) Showed the Relationship between demographic variables and SDLR (desire for learning) and we find that there were significant relationship between job title (0.086*), specialization (–0.129**) and desire for learning, however, we find that age (0.038), gender –(0.021) and civil status (0.034) have no significant relationship.
Table (17) Relationship between demographic variables and self-controlDemographic variables self-directed learning readiness activities Person correlation
Mean Standard Deviation Age 21-30 3.79 0.42 0.003
31-40 3.84 0.39 41-50 3.73 0.53 51 and above 3.91 0.43 Gender Male 3.81 0.44 -0.002
Female 3.8 0.44 Civil Status Single 3.77 0.44 0.045
Married 3.82 0.44 Divorced 3.93 . Widowed 3.73 . Job title in Nursing Department Staff Nurse 1 3.81 0.51 0.007
Staff Nurse 2 3.79 0.34 Charge Nurse 3.83 0.42 Head Nurse 3.92 0.28 Others 3.7 0.16 Specialization Medical 3.79 0.45 -0.035
Surgical 3.82 0.46 Pedia 3.84 0.49 Maternity 3.95 0.35 ICU 3.68 0.38 Table (17) showed the Relationship between demographic variables and SDLR (self-control) and we find that there were no significant relationship between the demographic variables and the self-control.
Table (18) Relationship between demographic variables and self-directed learning activities (summary)
Demographics characteristics self-directed learning readiness activities Self-Management Desire for Learning Self-control
Age 0.045 .083* 0.038 0.003
Gender 0.017 0.067 -0.021 -0.002
Civil Status 0.037 0.022 0.034 0.045
Job title in Nursing Department 0.065 .090* .086* 0.007
Specialization -.131** -.199** -.129** -0.035
Table (18) showed the relationship between demographic variables and the self-directed learning activities ,and we see that self-directed learning readiness activities only has significant relationship with specialization , with respect to the self-management scale, we find there were three variables that have a significant relationship, which are Age, Job title and specialization. Similarly, for the scale desire for learning, we see only two variables which have a significant relationship which are job title and specialization. In contrast, the self-control scale we see that there was no significant relationship with any of the demographic variables.
Summary of Findings:
The findings in this chapter includes the descriptive and the inferential statistics of the study, 642 nurses participated in the study, 442 were from teaching hospital and 200 were from non-teaching hospital, the overall levels of nurses self-directed learning readiness is (3.9) this considered quite high. There were significant differences in self-directed learning readiness activities between teaching and non-teaching hospitals with P-value (0.00), where the mean score for the teaching hospitals self-directed learning readiness activities scale is higher than the non-teaching hospital. It was found out that there was a significant relationship between self-directed learning readiness activities scale and specialization and there was no significant relationship with the other demographic variables.

CHAPTER V: DISCUSSION
The study relied on the responses from the nurses in both teaching and non-teaching hospitals in Saudi Arabia. The cross-sectional Comparative design used in the survey provided an avenue to help identify the attitudes of nurses in both teaching and non-teaching environments. Similarly, it provided a platform to form a better opinion regarding the views of the nurses on SDL. The fact that the nurses who took part in the study were registered nurses implied that the outcomes of the survey process would help yield a non-biased result that would give all the participants a leveled ground to assess their attitudes and preferences for SDL and possibly its importance to their lives. The discussion evaluated specific SDL attributes depending on the research question, to help form better responses regarding the attitudes of the nurses with regard to the learning process. Overall, the results garnered from the survey were positive. The vast majority of the participants possess the required levels of SDL readiness irrespective of their background and learning environment. However, the outcomes of the study illuminated that working in a teaching hospital prepared nurses more for SDL readiness, as opposed to when they are in the normal facilities.
Discussion on Research Question 1:
The findings of the study identified that SDLR activities amongst nurses are dependent on their eagerness to understand the reasons behind particular events. The survey by Hendry and Ginns (2009), also reiterates that one of the challenges has been the ability to develop students capacities to solve intricate problems using self-taught mechanisms. A person’s interest to learn a new concept plays an instrumental role in enabling them to create time for further understanding and hence self-directed learning readiness (Alotaibi, 2016). Such individuals are also likely to foster innovation. The mean from the study on the ability to evaluate new ideas was 4.009 and 0.0682. The ability to learn new concepts also conforms to a person’s interest to learn new ideas. Thus, Kek and Huijser (2011) agree that students who have the urge to learn new concepts are more likely to be successful nurses as opposed to those that are shy on new ideas. Similarly, in their rotated factor matrix, Fisher et al. (2001) highlight some of these factors as aspects that have positive correlations with SDLR. Some of the items identified by Fisher et al. (2011), as instrumental factors for high degrees of SDLR included the urge that individuals need to learn ne formation, enjoying challenges, critically evaluates new ideas, gathering facts before decision-making, and learning from mistakes, among others. In the context of the research question, these findings agree with the results of the subject study, especially as activities that nurses engage in for improved SDLR.
As identified in the survey by Kar et al. (2014) a positive perception of the learning process is a critical element for the development of SDLR. Similarly, students with greater levels of discipline with regards to the learning process depict a higher readiness for SDL. It is evident that the curricula designed for such students nurtured them to focus on the essence of improving their professional skills. Even without teacher-centered approaches, the students portrayed attributes that encouraged them to learn. Nonetheless, the outcomes of the survey implored that one should not necessarily conclude that disciplined and well-organized students have the urge to learn. In fact, the findings of the study indicated that the correlation between the need to learn was dismal at only 0.489. To this effect, the outcomes of the study refute the claims by Malekian et al. (2016), which insinuated that the readiness to learn is also a by-product of an individual’s character. It is evident that most nurses posted positive characteristics and personal attributes. However, that did not have an impact in transforming their attitudes towards the need to learn. It implies that a majority (1-0.489) 0.511, did not find it essential to enhance their nursing skills. It is true that an individual’s attributes have a profound impact in determining their readiness to learn. Nonetheless, it does not necessarily imply that they need to learn. Some of the reasons stem from the nature of their working environment, the market demands, and relevance of the skills that they possess to their work. The reliability score for readiness of learning for the categories of the nurses surveyed stood at 0.927, way above 0.70.
While it is true that nurses understand that their career undergoes radical changes, a lack of an environment to nurture a culture of learning makes it impossible for them to realize the gains of taking part in knowledge improvement. For others, the demands of their work make it impossible for them to focus on learning despite their urge and willingness to learn. In line with the outcomes of the study by Malekian et al. (2016), unmarried couples and those with ample time can create provisions and time for learning. For others, the degree of responsibility at their work place makes it impossible for them to allocate time for learning. Hence, the readiness for learning amongst such nurses is much lower.
These challenges are apparent in other past studies, particularly as factors that contribute of low SDLR. For instance, in their study, Alkorashy and Assi (2016) noted that low SDLR among their participants affected their learning as nursing students. Upon gathering additional information, the research team highlighted that the low levels of readiness were attributed to poor management skills, moods, culture, values, insolences, and lack of necessary skills for the management of self-learning (Alkorashy & Assi, 2016). Resolutely, the variation in SDLR degrees might vary based on individual differences among the nurses, which results in variations in goals, motivation to acquire more knowledge, and collective attitude to engage in activities that influence learning, which imminently affect the SDLR levels
Discussion on Research Question 2:
Teaching hospitals are known to create an avenue upon which learning of their employees becomes a lifelong process. It is expected that the outcomes of learning readiness amongst nurses and that of those in teaching hospitals be different. Partially, the findings are based on the learning environment and the culture that their work has exposed them. Overall readiness levels for nurses in teaching hospitals are 3.95 as compared to 3.77 for nurses in non-teaching hospital. As initially mentioned, learning is a lifetime process. For nurses who are exposed to teaching hospitals, learning takes place all the time. As a result, they learn new things to implement in their working environment and thus make their work easier in delivering services to patients. The learning process is natural and does not necessarily require the intervention of an instructor or the implementation of rules to encourage them to learn.
The research by Lestari, and Widjajakusumah, (2009), indicates that student-centered learning is dependent on the type of culture inculcated in an individual depending on the people around them and their environment. The outcomes of the study also identified that those in learning environments were more ready to learn new things as opposed to those in non-teaching facilities. Partially, a lack of guidance may be to blame for the inability to develop learning cultures (Lestari & Widjajakusumah, 2009). Nonetheless, self-directed learning and readiness can only be nurtured in an atmosphere that supports a student-centered approach. True to this, Williams et al. (2012) also identified that students were more likely to depict readiness for learning when the environment is conducive. Establishing SDL entails shaping the trends and attitudes of the learners to realize that learning should be a part of their day-to-day life as long as they are in the nursing career.
The SDLR activities amongst nurses in teaching hospitals indicated that nurses must set aside adequate time to develop a working schedule that fosters new learning and grasping of critical ideas. Apparently, being in a teaching hospital facility implies that the nurses are likely to develop positive relations with their instructors and always ask for correction when wrong Kek & Huijser, (2011) Alotaibi, (2016). The scales for inquiring when a person is unsure of a concept scored means 4.183 and SD of 0.833. Mohammad, Asha, and Jado (2014) also attest that the guidance of instructors helps build self-confidence and the desire for self-directed learning abilities.
Self-directed learning activities in teaching hospitals are more likely to prosper as opposed to environments that do not engage in teaching. Nurses working in teaching hospitals learn how to be self-directed, acquire life-long skills that encourage them to remain focused on learning and foster independent learning abilities. Some of the elements that stood out in the survey included the capacity to solve problems, good self-management skills, and the abilities to develop systematic learning behavior. The findings illuminated that the nature of the working environment for the nurses would help them to support medical education, innovation and approach their work with an open mind to solve problems that they faced when in their working environment (Yuan, Williams, Fang & Pang, 2012).
However, even so, Alkorashy and Assi (2016) introduce a different dimension on the subject by noting that the levels of motivation among students in an academic environment vary. Therefore, failure to acknowledge these dissimilarities would result in increased complexities that even the nature of the teaching hospitals cannot counter. Typically, the learning needs of nurses and nursing students vary so does their insolences and conduct concerning edification and teaching. Moreover, even in the teaching hospitals, the responses to instructional processes and the collective can influence variations. Consequently, the research team highlighted that in addition to the fulfilling the learning needs of students, there is an urge to comprehend the varying needs.
The mean scores for problem-solving behavior excellent management skills and abilities to create a self-learning environment were much higher for students in teaching hospitals as compared to those who work in facilities that do not provide teaching services. The mean scores respectively stood at 3.875, 3.315 and 3.65 for non-teaching hospitals and 4.224, 4.029 and 4.014 for teaching hospitals. The results of the study are evidence that teaching hospitals create an ideal environment for the development of SDL. It is essential to learn that teaching institutions indulge in research work throughout the time. As a result, they implement working policies that help build the competencies of their employees in delivering the best services. Thus, the readiness of a nurse to learn is also dependent on the nature of their working environment. If the environment fails to put in place appropriate measures to ensure that its employees grow as independent learners, it would be a challenge to inculcate the responsibility.
Discussion on Research Question 3:
Several activities can be used to identify the readiness for SDL. The survey conducted analyses on whether an individual can solve problems using a plan. The outcomes of the study posted a mean of 3.875 and standard deviation of 0.879 for students in non-teaching hospitals. The other attributed evaluated in the process was the ability for an individual to prioritize their work. Work prioritization will help in the identification of a person’s passion for their position. People who prioritize their work also identify the need to build their career through learning. The ability to set strict time frames is a subcomponent for self-control and management. When an individual sets strict time frames to do activities, they are guided by viable plans, all of which define their daily routines amongst others. Such people are unlikely to be swayed by unplanned activities that may hurt their productivity. Similarly, such individuals can develop appropriate methods for SDL irrespective of other people’s influences. The nurses who took part in the surveys also mentioned that they prefer to set their own goals and to remain in control of their lives.
The outcomes of the study are consistent with the findings of the literature review, whereby it was established that an individual’s character lays the foundation for SDL readiness. It would be a major challenge to inculcate a sense of responsibility and hence the willingness to take part in SDL when a person is incapable of remaining in charge of their life. Williams et al. (2012) mentioned that the activities, which define an individual’s readiness for SDL offer accurate information regarding their capacities to build a learning culture irrespective of the levels of their experience.
Still, Fisher et al. (2001) highlighted different types of self-management and control that are contributory aspects of high SDLR. According to their findings, being in a non-teaching environment cannot result in readiness and learning difficulties as long as the students or nurses manage their time well, are self-discipline, organized, have strict time frames, are methodical, and use plans and strategies to address challenges. Individuals with such attributes can be trusted to pursue their personal learning practices.
The outcomes of nurses in teaching facilities and those in non-teaching facilities prove the presence of an instructor sets the difference for the success of nursing students (Kek & Huijser, 2011). Non-teaching facilities lack the required personnel to guide students. Alotabi (2016) had emphasized that the approaches to learning and the learning environments differ in various aspects. Mohammad, Asha, and Jado (2014) also agree that the values held by individuals differ in settings that do not promote learning activities. As a result, the learning environment is an essential catalyst that motivates nurses to develop the urge to learn.
Experts mention that successful people derive their success from the ability to manage themselves effectively. One of the parameters of ideal personal management is the capacity to set personal goals and work towards their attainment. The outcomes of the study revealed that the nurses preferred setting their goals at a mean value of 4.12 and SD of 0.88. The mean value for nurses who admitted to being disorganized was a low of 1.272. In line with the outcomes of the literature review, the social conditions for self-directed learning emphasize that such learners are goal-oriented, learning-oriented, and action-oriented. Individuals who are goal oriented engage themselves in activities that yield positive outcomes of the processes that they do. Similarly, such persons plan themselves to ensure that they attain autonomy and develop independent study methods that may not disorient their daily activities. According to Malekian et al. (2016), autonomy plays a key role in enabling individuals to develop independence in thoughts. It also determines a person’s capacity to implement decisions without the influence of others. The activities that define individual readiness for SDL seek to gauge how much ready a person is, to ensure that they are not swayed by peer pressure and other tasks in their quest to develop discipline for SDL. The role of SDL in nursing is to make sure that as nurses work in their daily environments, they understand the changes that take place that may have an impact on their work. Adequate career and life preparation imply that nurses have to acquire a consistent body of fixed knowledge to help them meet the demands of their job.
Fostering SDL skills means that instructors have to inculcate more than only reducing support and guidance to students. The activities outlined indicate that learners ought to develop a feasible way to help them acquire knowledge and use their memory to put in practice. The teaching and learning experiences are meant to enhance the abilities of the learners to foster self-regulation and discipline to concentrate on their career and education. The ability or willingness of an individual to focus on learning is dependent on their potential elf direction and determination. The attributes can only be nurtured when persons are aware of the form of activities that they need to engage in to ensure that they remain in control of how they respond to situations that require them to learn independently.
It is essential to realize that learning out of the classroom context demands significant levels of discipline and the capacity to determine whether an individual can solve a task. Users must set goals and develop metacognition that would enable them to remain independent when it comes to personal learning (Ng & Confessore, 2010). Research also emphasizes that autonomous learners tend to be self-directed, independent and demonstrate the willingness to collaborate with others for the sake of attaining their objectives. The results are consistent with Ng and Confessore (2010) study, which also outlined that SDL, is dependent on the way an individual schedule their daily activities and commitment to the process. SDL is a behavioral construct that fosters the development of behavioral changes that encourage learners to indulge in the improvement of their professional knowledge. Thus, the readiness of a nurse to indulge in SDL emanates from their traits, self-management, and control abilities. Students who often procrastinate and avoid their work frequently lessen their capacities to complete even the little tasks delegated to them. Thus, it would be a difficult feat for such students to indulge in activities, which have a positive outcome for their reading activities.
Discussion on Research Question 4:
Teaching and non-teaching hospitals provide different environments for nurse readiness for SDL. Outcomes from the second research question illuminated that nurses who work in teaching hospitals are more likely to be alert and ready to pursue SDL as compared to those in non-teaching hospitals. A primary reason for the difference emanates from the fact that teaching hospitals inculcate a culture of readiness to indulge in reading. The study posted significant differences for readiness in learning amongst students in teaching hospitals.
It was identified that those in teaching hospitals exercised greater self-control and self-management with regards to the readiness to learn. The Desire to Learn scale also tilted in favor of individuals who were in teaching hospitals. The mean for SDLR amongst students in teaching hospitals was 3.96 as opposed to 3.77 for non-teaching hospitals. Consequently, the average for students in teaching hospitals for self-management was 4.0 as opposed to 3.76 for those in non-teaching hospitals. Subsequently, the desire for learning and self-control for nurses in teaching hospitals were 4.05 and 3.83 respectively as opposed to 3.81 and 3.75, for non-teaching hospitals.
Naturally, teaching hospitals give responsibilities to nurses such that they can indulge in learning throughout the career. The strategy has been efficient in enabling nurses to develop a natural sense of responsibility amongst them while in their line of duty. The nature of teaching hospitals implies that nurses must develop a method to ensure that they can build on their competencies through self-study. Irrespective of the busy schedules, the nurses are expected to demonstrate that they can respond to emerging issues in nursing through developing their professional knowledge. Ng and Confessore, (2010) describe that nurses feeling comfortable in themselves is one of the elements that define their willingness and readiness to indulge in SDL.
Subsequently, teaching hospitals make the learning process a natural process of nurse’s work. It provides learners with the platform to engage actively in learning even in their own free time. Nurses also challenge themselves to ensure that their skills in their working environment are relevant. According to Alkorashy and Assi (2017), the utilization of student-centered approach towards learning, such as the one in teaching hospitals, creates more opportunities for improved SDL. The use of SDL stands out mainly in the aspects of analytical aptitudes, solving problems, and constant learning. Additionally, the learning-based environment acts as a source of motivation for individuals to be responsible for their edification and have better control of their knowledge acquisition practices. Consequently, an advanced comprehension of SDLR could result in positive alterations in the educational atmosphere resulting in an enhanced learner-center framework. More so, Alkorashy and Assi (2017) also agree that such a platform strengthens the sovereignty of nurses and prompts a sense of accountability.
Conversely, nurses working in non-teaching hospitals lack the motivation to pursue higher learning. In fact, such facilities require a program that would help them to create ample time to go through their books and hence the ability to improve their practices. Similarly, such institutions rarely invest in research and development that would in turn, foster their employees to delve into similar roles. As a result, the nurses get overwhelmed at work and fail to respond to their books as is recommended. Lack of a formal learning environment implies that the nurses have to devise their methods of learning. The implications are that if the nurse lacks the requisite behavioral traits to encourage them to pursue learning autonomously, they develop a disinterest. The findings of the survey are consistent with the outcomes of Williams et al. (2012), who mentioned that learning behavior is inculcated from the surrounding of an individual. Nurses who work in non-teaching settings derive no inspiration to grow their knowledge and skills in their career. Alternatively, their careers may also be too demanding, thereby diminishing the chance to focus on any other activities besides their work. Subsequently, Malekian et al. (2016), mentioned that if such nurses are also married, their readiness for self-directed learning despite their willingness is equally small.
Similarly, Philips, Turnbull, and He (2015) give instances for nurses who learn in non-formal learning environments must develop better strategies to ensure that they remain proactive in their learning process. The three liken distance learning to non-teaching hospitals, whereby learners are forced to develop self-discipline and strategies to ensure that they demonstrate readiness for SDL (Jossberger, Brand‐Gruwel, Boshuizen, & Van de Wiel, 2010). The development of the learning culture amongst nurses working in teaching hospitals emanates from the fact that it remains as a part of their daily routine. As a result, a majority is always willing to embrace new information and ideas to make their work easy. The reverse is true for nurses who work in facilities that do not have provisions for learning. Evidence-based practices can be easily designed in teaching hospitals, as the outcomes of research are used first-hand in the hospitals. The non-teaching hospitals lack the framework and foundation to promote research activities and thus nurture readiness for learning.
However, there were no significant differences in some of the attributes investigated in the study. As initially mentioned, even after providing an ideal learning environment, learning activities can only be fostered when a person’s traits encourage them to pursue the process (Hendry & Ginns, 2009). Individuals who cannot be trusted with their learning and lack organization are unlikely to succeed. Alotabi (2016) admits that the environment may change such character traits, especially with the support of instructors. The converse is also true, whereby nurses are likely to feel relaxed when the situation does not provide any challenging elements to foster their learning methods (Mohammad, Asha & Jado (2014).
The scores for the models that help to assess readiness for SDL also indicate that nurses from non-teaching hospitals perform dismally. Kar et al. (2014) decry that as long as a nurse lacks the support to encourage them to indulge in learning processes; they are likely to miss the basic elements that form the foundation for SDL. One of the solutions suggested by Madhavi and Madhavi (2017), to counter such challenges is that non-teaching hospitals may develop appropriate methods to ensure that their nurses take part in relevant research and innovation. The strategy would be useful in enabling them to pursue a trend that supports reading culture and hence develops a readiness for learning. The readiness for learning in health environments should be a pre-requisite that ought to be involved in the nursing curriculum (McLoughlin & Lee, 2010). The dynamics associated with the profession demand that nurses continue to grow their knowledge and skills on their job. As a result, future studies must also take into account the impacts of the nursing curriculum to their learning process. The curriculum will help to create a proper readiness assessment that fosters curriculum development and boosts their development of preparedness for SDL. Thus, it is essential that nurses who work in teaching hospitals should be indulged in activities that will help them to develop a readiness for SDL. Similarly, it is ideal that such facilities emphasize on the essence of boosting student-centered behavior, which lacks in hospitals that do not provide teaching.
Discussion on Research Question 5:
Demographic attributes of an individual play influential roles in determining a person’s willingness to indulge in learning. Sufficient data have linked age and other factors as some of the elements that affect an individual’s ability to concentrate on learning. The same applies to the nature of the job that a person holds. The results of the survey indicated that self-directed learning readiness activities amongst individuals aged 21-30 were a mean of 3.86. For those aged 31 to 40, the mean was 3.95, while that of people aged 41 to 50 was 3.85. Elderly individuals older than 51 years recorded an average of 4.01 and standard deviation of 0.38. The willingness amongst seniors to learn stems from the fact that such people want to familiarize themselves with their working environment in the old age. New information keeps coming up, and they are also forced to adapt to the changing working conditions. Unfortunately, young people lack the demeanor and interest to learn beyond the conventional classroom environment. The outcomes of the study prove the findings of the research by Harber (2011), on generational differences and their workplace. Generations have varying perceptions of their place of work. Traditional baby boomers, which includes the individuals that are older than 50 years are loyal employees who want to ensure that they deliver the best services to their ability (Harber, 2011). Such people are always willing to learn irrespective of their working environment. A reason why majorities pay attention to learning is the fact that they are used to protocol and following orders rather than being innovators, the strategies have been influential in enabling them to focus on the need to improve their skills. Young learners rank lowly because of the number of distractions that they face in daily life.
At their age, they are also still exploring alternative forms of works and may not necessarily be attached to their jobs. However, it is essential, to note that the young generation accounts for the highest number of innovators even in the medical world. Thus, it would be misleading to attach the conclusion that they lack the readiness to learn. The ideal phrase is that they lack the motivation to pester them to continue learning.
Similarly, family environments and student outcomes indicate that a student is more likely to derive inspiration for learning when the situation favors them. When the parents of a student are focused on the success of their children, they are likely to encourage SDLR activities (Mohammad, Asha & Jado, 2014). The outcomes of the study process found out that nurses with more significant responsibilities at work were more likely to engage in SDLR activities. Alotabi (2016) posits that the challenge comes from the fact that they have to meet demands of their working environment . Similarly, a person whose job requires them to be academically updated is more apt to engage in research compared to one whose roles in their area of work are less demanding (Hendry & Ginns, 2009).
The gender of individuals is also another attribute to consider when evaluating readiness for learning amongst people. The mean scores for male learners were 3.87 while that of the female was 3.9. Several reasons may dispute or support the outcomes of the findings. The study by Malekian et al. (2016), had outlined that female nurses would demonstrate lower readiness for learning than their male counterparts would. A significant part was linked to the marriage status and hence, the responsibilities that they held at home with regards to the upbringing of their families. The responsibilities would overwhelm thus making it impossible to plan their daily activities appropriately to schedule SDL.
Nonetheless, the study by Madhavi and Madhavi (2017) also states that women are less likely to demonstrate readiness for learning because of the degrees of responsibilities that they engage in on a daily basis. Men may have more time for planning and reading, but some fail to use their time wisely. Thus, the dissenting opinions of the authors imply that the outcomes of the study set a new trend concerning the gender status of nurses and their readiness for learning in Saudi Arabia.
The third element investigated the civil status of the participants of the study and their willingness for learning. Widowed persons posted the highest mean with regards to readiness for learning with a value of 4.13. Subsequently, married individuals had an average of 3.91 with regards to their willingness for learning. Divorced persons had 3.85 while single people had 3.88. The differences may be attributed to a variety of factors. An individual’s peace of mind is an essential pre-requisite for the development of readiness for learning (Philips, Turnbull, and He, 2015). Thus, people undergoing divorce may face challenges with the ability to manage their time well. They are left with significant responsibilities that require them to attend to personal and family issues. Thus, their readiness for SDL is likely to be low. Interestingly, married people may also be overwhelmed by activities, thereby giving them little time to focus on improving their knowledge and skills of their work. The high value of readiness for SDL amongst widows may be a by-product of their need to engage themselves in productive work, and hence a strategy to eliminate feelings of loneliness and boredom. Such individuals would embrace readiness for SDL to ensure that they remain in control of their daily lives and activities.
The title of individuals at work has an impact in determining their readiness for SDL. For instance, head nurses recorded the highest mean for the willingness to learn with a mean of 4.2.
The greater the responsibility, the more a person ought to engage themselves in activities that would propel them towards embracing information that would help them improve their profession. Junior employees depend on the directives of the head nurse on the activities that they ought to engage in amongst other roles. As a result, the head nurse must be conversant with new information and details that would be useful for the nursing process. The mean values for the readiness to learn increase with the rank of individuals.
Finally, the specialization of a nurse also has an impact in determining their areas of expertise. Nurses working in the maternity and surgical sections posted means of 4.1 and 4.01 respectively, with regards their SDL readiness. The complexity of a specialization and the emergence of new solutions in the particular specialization are known to have a significant effect in determining whether an individual will engage in further learning. When the demand of a person’s career is overwhelming, the individual is likely to indulge in activities that would help them to improve their ability to deliver quality services effortlessly. The outcomes of the process are that those who work in less demanding specialization will have less readiness for SDL. Activities involved in the pediatric wards, maternity and surgical may prompt persons to demonstrate a greater readiness for learning.
Still, as highlighted by Alkorashy and Assi (2017), there is a significant association between age and SDLR, which applies for all the subscales apart from self-management. According to their hypothesis, the SDLR of nurses and nursing students improves with age and learning experience (Alkorashy & Assi, 2017). Therefore, this affirms the findings of the study that complexities and experiences of specialization prompt nurses to engage in activities that will facilitate the acquisition of increased knowledge.
Summary of Discussion
The outcomes of the survey process identified that a variety of aspects have an impact in determining individual readiness for SDL. The study proved that gender responsibilities have a significant impact on the ability to focus on learning. Similarly, a person’s age will affect how they perceive SDL. Generational preferences stood out as elements that define nurse’s readiness for SDL. Finally, the specialization of a nurse was also found to affect their perception of the willingness of SDL. Mainly, those who work in delicate and demanding departments find it necessary to improve their knowledge and hence the readiness for SDL. The outcomes of the study indicated that individual willingness and commitment to their career played key roles in determining their readiness for SDL. Thus, irrespective of the demographic attributes the working environment: whether teaching or non-teaching and the specialization of individuals play influential roles in determining the readiness for SDL.
CHAPTER VI: CONCLUSION, RECOMMENDATION AND LIMITATION
Conclusion:
This study aims to determine the self-directed learning readiness (SDLR) among nurses in teaching and non-teaching hospitals in Saudi Arabia. Also to find out the significant differences in the nurses’ self-directed learning readiness between the two teaching and non-teaching hospitals In addition to identified the relationship between the selected demographic characteristics and the self-directed learning activities.
Nurse’s ability for SDL is not necessarily dependent on their skills and knowledge of the practice. Rather, it is a by-product of several factors, all of which have an impact in determining an individual’s readiness for SDL. The study identified that SDL readiness activities amongst nurses included the ability to plan properly, organize, and exercise self-discipline amongst others. Poor management and control were found to be ideal parameters for gauging a person’s readiness for SDL.The study identified that SDL readiness activities amongst nurses in teaching facilities include the ability to solve problems, demonstrating sound management skills, capacity to set strict timeframes and being systematic in learning. Interestingly, teaching hospitals reinforced the nurse’s ability to demonstrate readiness for SDL. They were found to provide the ideal environment for learning as it remains a part of its culture. Nurses in teaching and non-teaching hospitals show the same activities for readiness in SDL; As a result, the pre-requisites for SDL are the same. However, the learning environment determines whether a person would focus on learning without the influence of their working environment.
There were significant differences concerning the willingness of the nurses found in teaching and non-teaching hospitals. It was identified that nurses working in teaching hospitals were more proactive regarding their readiness for SDL. As a result, their mean scores for SDL readiness were higher than those found in non-teaching hospitals. The results were attributed to the fact that the culture, environment, and protocol for working differ in the two hospitals, and hence the readiness of the nurses to take part in SDL activities.
The outcomes of the survey also proved that demographic characteristics also have a significant effect on the readiness of nurses with regards to SDL. The results were consistent with those of the literature review whereby it was identified that young professionals depicted lower readiness for learning. It also showed that married individuals post lower readiness for SDL compared to their single counterparts. The expertise and ranks of the nurses were also new features that the study introduced, People of higher ranks find it essential to remain up to date, and hence deliver solutions that would propel their organizations to success. As a result, their readiness for learning was much higher than those of junior nurses. Finally, the complexity of specialization was also a unique feature that determined the readiness of persons for SDL. It was identified that those working in delicate departments were more willing to engage in SDL compared to those working in general departments.
Recommendations:
The following are recommended based on the study findings:
Hospital administration
1-The Hospital administration is encouraged to create environments that foster learning. It was identified that teaching hospitals offered an ideal environments and hence the development of readiness for SDL amongst nurses.
2-Health care organizations have the responsibility in supporting and monitoring continuity the professional development of nurses, such as provide financial support for nursing filed to develop establishment education activities and events.
Nursing administration
1-The nursing administration is also encouraged to foster the development of policies that encourage nurses to improve their knowledge and skills at work.
2-Involve nurse’s staff to put action plan and to be apart from decisions making related to their unit will give them Incentive to be knowledgeable, therefore the desire of learning will increase.
3-planning for improvement nurse’s staff competences in the form of training will fosters SDLR and will have effects on the nurse capacity to engage in learning.
Nursing education
1-Nursing education should also take into consideration the outcomes of the study , the curriculum must put in place methods that would make nurse students self-sufficient and dependent.
2-The pre-requisites for SDL learning demand that the process is nurtured from an earlier age. Nurses can only demonstrate readiness for SDL when their earing traditions inculcated the discipline and willingness to learn even outside the formal learning environment.
Nursing Practice
1-The nursing practice thrives from emerging research and the development of evidence-based practice to improve how learners respond to emerging issues. Thus, the nursing practice should foster reflection, self-management, self-control, and desires for learning as critical elements to consider when evaluating potential nursing students.
2-Nursing practice would be instrumental in ensuring that nurses who join the career understand that the job entails lifelong learning processes and need to be updated to improve the practice , which cannot go ignored.
Nursing Research
1-Nursing research can take part in evaluating some of the distinguishing factors that emerged in the study such as the role of expertise and specialization in demonstrating readiness for SDL. Arguably, the activities in some departments are more intensive than others are. As a result.
2-The researchers can design appropriate strategies to enable them to develop appropriate frameworks for the learning process of the nursing workforce. The impacts of nursing research will be instrumental in brewing a collaborative approach to ensure that the readiness for learning remains a natural process for all the nurses.
Limitations:
The primary limitation of this study generalizability of the research findings due to study sittings was limited to only two hospitals in Saudi Arabia; the two hospitals represented a teaching and a non-teaching facility. The cross-sectional design does not help determine causal inference; also the Quota sampling can limit the generalizability because the selection of sample elements within a given category of the quota frame may be biased and nonrandom sampling method.
Future researchers should consider using samples of individuals from several facilities, to help bring out a general outlook of the readiness of nurses to pursue SDL. Additionally, future researches may concentrate their details on finer details of the research process rather than focus on a broad aspect that yielded several research questions. Another limitation of the study the use of self-report questionnaire which lead to Social desirability bias.
Generally, SDL readiness amongst nurses shows the level of discipline and commitment that nurses regarding improving their quality of work. The medical world is expected to demonstrate its competency in yielding new solutions for emerging conditions. It should also demonstrate its competence in the development of ample solutions that would have positive outcomes for patient conditions. The readiness for SDL should be a natural process for the nurses. However, life pressure, responsibility and the motivation for the learning process may significantly affect individual readiness for SDL.
The outcomes of the research will be helpful in enabling the nursing fraternity to understand more about the behavior of their nurses with regards to the readiness for SDL.
The results will be influential in the formulation of policies that determine the development of nursing curriculum, or affect how nursing administrators design work. The strategies would be influential in creating the ideal environment whereby nurses can enhance their skills and knowledge in the course of their profession.
Summary:
This chapter discussed the conclusion, recommendations as well as the limitation of the current study. It was concluded in this study that demographic characteristics have a significant effect on the readiness of nurses with regards to SDL. It was found that nurses working in teaching hospitals were having higher readiness for SDL than nurses working in non-teaching hospitals. We recommend the nursing administration to encourage development of policies that encourage nurses to improve their knowledge and skills at work, also the Hospital administrations needs to provide support for nursing filed such as the financial support.

REFERENCES
Alkorashy, H. E., & Assi, N. A. (2016). Readiness for Self-Directed Learning among Bachelor
Nursing Students in Saudi Arabia: A Survey-Based Study. International Journal of Nursing
Education and Research, 4(2), 187. doi:10.5958/2454-2660.2016.00038.7
Alotaibi, K. N. (2016). The learning environment as a mediating variable between self-directed learning readiness and academic performance of a sample of saudi nursing and medical emergency students. Nurse education today, 36, 249-254
Behaviorism-Learning-theories (2007). Behaviorism.Retrieved October 4, 2016, from
https://www.learning-theories.com/behaviorism.htmlCadorin, L., Bressan, V., & Palese, A. (2017). Instruments evaluating the self-directed learning abilities among nursing students and nurses: a systematic review of psychometric properties. BMC medical education, 17(1), 229.
De Bruijn, E., & Leeman, Y. (2011). Authentic and self-directed learning in vocational education: Challenges to vocational educators. Teaching and Teacher Education, 27(4), 694-702.
Definition of self-control in English:. (n.d.). Retrieved April 30, 2016, from http://www.oxforddictionaries.com/definition/english/self-control?q=Self-controlDefinition of self-management in English:. (n.d.). Retrieved April 30, 2016, from http://www.oxforddictionaries.com/definition/english/self-management
Desire to know. (n.d.) WordNet 3.0, Farlex clipart collection. (2003-2008). Retrieved April 30 2016 from http//www.thefreedictionary.com/desire+to+know
Edwards, R., Hanson, A., & Raggatt, P. (Eds.). (2013). Boundaries of adult learning (Vol. 1). Routledge.
El-Gilany, A. H., & Abusaad, F. E. S. (2013). Self-directed learning readiness and learning styles among Saudi undergraduate nursing students. Nurse education today, 33(9), 1040-1044.
Embo, M. P., Driessen, E. W., Valcke, M., & Van der Vleuten, C. P. (2010). Assessment and feedback to facilitate self-directed learning in clinical practice of Midwifery students. Medical teacher, 32(7), e263-e269.
Fisher, M.J. & King, J. (2010) The Self-Directed Learning Readiness Scale for Nursing Education revisited: A confirmatory factor analysis. Nurse Education Today, 30(1): 44-48.
Fisher, M., King, J. & Tague, G. (2001) Development of a self-directed learning readiness scale for nurse education. Nurse Education Today, 21(7): 516-525.
Harber, J., G. (2011) “Generations in the Workplace: Similarities and Differences. Electronic Theses and Dissertations. Paper 1255.http://dc.etsu.edu/etd/1255
Heidenheimer, Arnold J.; Hugh Heclo; Carolyn Teich Adams (1983). Comparative Public Policy. St. Martin’s Press. ISBN 978-0-312-00493-4.
Hendry, G. D., & Ginns, P. (2009). Readiness for self-directed learning: validation of a new scale with medical students. Medical Teacher, 31(10), 918-920.
Huston, C. J. (2014). Professional issues in nursing: Challenges & opportunities.
Jeffreys, M. R. (2010). Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. New York:: Springer Pub. Co.
Jossberger, H., Brand‐Gruwel, S., Boshuizen, H., & Van de Wiel, M. (2010). The challenge of self‐directed and self‐regulated learning in vocational education: A theoretical analysis and synthesis of requirements. Journal of vocational education and training, 62(4), 415-440.
Kar, S. S., Premarajan, K. C., Ramalingam, A., Iswarya, S., Sujiv, A., & Subitha, L. (2014). Self-directed learning readiness among fifth semester MBBS students in a teaching institution of South India. Education for Health, 27(3), 289.
Kek, M., & Huijser, H. (2011). Exploring the combined relationships of student and teacher factors on learning approaches and self‐directed learning readiness at a Malaysian university. Studies in higher education, 36(2), 185-208.
King Saud University Medical City (2016). Retrieved October 07, 2016, from http://medicalcity.ksu.edu.sa/arKingdom of Saudi Arabia – Ministry of Health Portal. (2017). Retrieved December 17, 2017, from https://www.moh.gov.sa/Jossberger, H., Brand‐Gruwel, S., Boshuizen, H., & Van de Wiel, M. (2010). The challenge of self‐directed and self‐regulated learning in vocational education: A theoretical analysis and synthesis of requirements. Journal of vocational education and training, 62(4), 415-440.
Kar, S. S., Premarajan, K. C., Ramalingam, A., Iswarya, S., Sujiv, A., & Subitha, L. (2014). Self-directed learning readiness among fifth semester MBBS students in a teaching institution of South India. Education for Health, 27(3), 289.
Leininger, G. (2005). Culture Care Diversity & Universality :A Theory of Nursing. Jones & Bartlett.
Lestari, E., & Widjajakusumah, D. (2009). Students’ self-directed learning readiness, perception toward student-centered learning and predisposition towards student-centered behavior. South East Asian Journal of Medical Education 3(1), 52-58.
Madhavi, K. P., & Madhavi, B. D. (2017). Readiness for self-directed learning among undergraduate medical students of Andhra Medical College, Visakhapatnam. International Journal Of Community Medicine And Public Health, 4(8), 2836-2840.
Malekian, M., Ghiyasvandian, S., Cheraghi, M. A., & Hassanzadeh, A. (2016). Iranian
ClinicalNurses’ Readiness for Self-Directed Learning. GJHS Global Journal of Health
Science, 8(1), 157. doi:10.5539/gjhs.v8n1p157
McLoughlin, C., & Lee, M. J. (2010). Personalised and self regulated learning in the Web 2.0 era: International exemplars of innovative pedagogy using social software. Australasian Journal of Educational Technology, 26(1).
Mohammad, F., Asha, I. K., & Jado, S. M. A. (2014). The effect of TASC wheel on developing self-directed learning readiness and academic self efficacy on a sample of 7th graders in Jordan. Education, 135(2), 237-251.
Naglaa, A. E., Samah, M. S., and Al-Battawi, J. A. I. (2017). Self – Directed Readiness among Nursing Students at King Abdulaziz University, Saudi Arabia. IOSR Journal of Nursing and Health Science. 6(6): 14-24
Nothnagle, M., Goldman, R., Quirk, M., & Reis, S. (2010). Promoting self-directed learning skills in residency: a case study in program development. Academic Medicine, 85(12), 1874-1879.
King Saud University Medical City (2016). Retrieved October 07, 2016, from http://medicalcity.ksu.edu.sa/arOmar, S. H., Al-Kathiri, F. A., & Al-Ajmi, S. A. (2017). Level of Reflective Practice amongst Saudi Female Postgraduate Students at KSU. English Language and Literature Studies, 7(3), 28.
O’Neil, C. A. (2014). Developing online learning environments in nursing education. New York, NY: Springer.
Pavlov, I. P., & Anrep, G. V. (2003). Conditioned reflexes. Courier Corporation. Retrieved October 6, 2016. https://www.learning-theories.com/behaviorism.html.
Pilling-Cormick, J., & Garrison, D. R. (2013). Self-directed and self-regulated learning: Conceptual links. Canadian Journal of University Continuing Education, 33(2).
Phillips, B. N., Turnbull, B. J., & He, F. X. (2015). Assessing readiness for self-directed learning within a non-traditional nursing cohort. Nurse education today, 35(3), e1-e7.
Reio, T. ( 2004 ). Prior knowledge, self-directed learning readiness, and curiosity: antecedents to classroom learning performance. Int J Self-Directed Learn, 1 pp. 18–25
Robertson, J. (2011). The educational affordances of blogs for self-directed learning. Computers & Education, 57(2), 1628-1644.
Shields, Patricia and Rangarjan, N. 2013. A Playbook for Research Methods: Integrating Conceptual Frameworks and Project Management. Stillwater, OK: New Forums Press.
Skinner, B. F. (2011). About behaviorism. Vintage. Retrieved October 6, 2016. https://www.learning-theories.com/behaviorism.html.
Smolenski, M. C. (2013). Health policy and advanced practice nursing: Impact and implications.
Terry, A. J. (2012). Clinical research for the doctor of nursing practice. Sudbury, MA: Jones & Bartlett Learning.
Timothy, T., Chee, T. S., Beng, L. C., Sing, C. C., Ling, K. J. H., Li, C. W., & Mun, C. H. (2010). The self-directed learning with technology scale (SDLTS) for young students: An initial development and validation. Computers & Education, 55(4), 1764-1771.
Wang, V. C. (2013). Handbook of research on technologies for improving the 21st century workforce: Tools for lifelong learning. Hershey, PA: Information Science Reference.
Watson, J. B. (2013). Behaviorism. Read Books Ltd. Retrieved October 6, 2016. https://www.learning-theories.com/behaviorism.html.
Williams, B., Boyle, M., Winship, C., Brightwell, R., Devenish, S., & Munro, G. (2012). Examination of self-directed learning readiness of paramedic undergraduates: A multi-institutional study. Journal of Nursing Education and Practice, 3(2), 102.
Wittmann-Price, R. A. (2014). Nursing education: Foundations for practice excellence. Philadelphia: F.A. Davis.
Yuan, H. B., Williams, B. A., Fang, J. B., & Pang, D. (2012). Chinese baccalaureate nursing students’ readiness for self-directed learning. Nurse education today, 32(4), 427-431.