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SELF-DIRECTED LEARNING READINESS IN CLINICAL LABORATORY
SCIENTISTS:
DEVELOPING SKILLS FOR PRACTICE
by:
LORI RICE-SPEARMAN, B.S., M.S.
A DISSERTATION
IN
FAMILY AND CONSUMER SCIENCES EDUCATION
Submitted to the Graduate Faculty
of Texas Tech University in
Partial Fulfillment ofthe Requirement for
the Degree of
DOCTOR OF PHILOSOPHY
Approved
Karen Alexander
Chairperson of the Committee
Sue Couch
Robin Satterwhite
LesLee Taylor
Fred Hartmeister, Dean of the Graduate School
August 2010
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Copyright 2010
Lori Rice-Spearman
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ACKNOWLEDGEMENTS
Gratitude is extended to the members of my doctoral committee, Dr. Sue Couch,
Dr. Robin Satterwhite, and Dr. LesLee Taylor for their advisement, encouragement, and
friendship throughout my doctoral studies and preparation of this document. Sincere
appreciation is expressed to Dr. Karen Alexander, chair of my committee, who has been
instrumental in shaping my progress throughout my doctoral program and helpful in
providing insight and guidance. I would also like to sincerely thank Dr. Virginia
Felstehausen for helping me begin this path. Her wisdom and kindness will never be
forgotten.
Acknowledgement and appreciation are extended to Dr. Lucy Guglielmino and
Dr. Allison Meshbane who permitted me to use the instrument and provided assistance
with the statistical portion of this study. I am grateful to Dean Paul Brooke for his
support and encouragement throughout this journey. Special gratitude is expressed to Dr.
Hal Larsen who saw something in me before I could see it in myself and who never let
me give up on my dream.
I am blessed to be part of an extraordinary team. Dr. Joel Hubbard, Dr. Barbara
Sawyer, Dr. Tootie Tatum, Wade Redman, Ericka Hendrix, Jacquie Chestnutt, Dr. Katie
Bennett, and Brooke Stewart-Israel, thank you for your feedback, encouragement, and
support. Jenny Bonner and Dina Barhorst, thank you both for your support and
encouragement and taking time out of your very busy lives to provide assistance
throughout my doctoral work and this study.
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Tish Nash, Deborah Finlayson, Cray Pickering, Melanie Ragain, and Debbie
Scioli, you have supported me, encouraged me, and celebrated with me every step of the
way.
To my family, incredible sacrifices were made so that I could have this
opportunity to fulfill my dream. Mom you have been my “prayer warrior” and a source of
strength throughout this process and my life. You showed me how to be a daughter,
mother, wife, sister, and friend. Dad you are my rock. You would never let me give up
and you helped me to keep the doctoral process in perspective. Sammy you continued to
love me and support me even on the worst of days. I am blessed to have been raised in a
Christian home surrounded by a loving family.
Craig Allan, Kyle Samuel, and Kacy Lauren, your love, support, and
encouragement never wavered. Because of your great sacrifice and understanding, I must
share the credit for this endeavor with each of you. Last, but certainly not least, I am
grateful to my husband Doug – you have been with me every step of the way. I wonder if
you had any idea what you were getting into with me when we did our Chemistry
homework together in 1983 – a marriage, three beautiful children, and a lifetime of
memories.
Without my family, friends, and colleagues, I would not have completed my
doctoral education. I am blessed.
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TABLE OF CONTENTS
ACKNOWLEDGEMENTS .................................................................................... ii
ABSTRACT .......................................................................................................... vii
LIST OF TABLES ...................................................................................................x
LIST OF FIGURES ............................................................................................... xi
LIST OF APPENDICES ....................................................................................... xii
CHAPTER
I. INTRODUCTION .................................................................................1
Background ............................................................................................1
Purpose of the Study ..............................................................................4
Research Questions ................................................................................5
Hypotheses .............................................................................................6
Assumptions ...........................................................................................6
Limitations .............................................................................................7
Definition of Terms................................................................................7
Summary ................................................................................................9
II. REVIEW OF LITERATURE ..............................................................10
Conceptual Framework for Understanding
Self-direction in Learning ..............................................................10
Candy’s Learner-control Continuum .............................................13
Personal Responsibility Orientation Model ...................................14
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Garrison’s Three Dimensional Model .................................................16
Self-directed Learning in Health Professions Education .....................17
Nursing ...........................................................................................17
Medicine ........................................................................................19
Dentistry .........................................................................................19
Pharmacy........................................................................................20
Summary ..............................................................................................21
III. RESEARCH DESIGN AND METHODOLOGY ..............................23
Introduction ..........................................................................................23
Research Design...................................................................................23
Instrument ............................................................................................23
Considerations and Limitations ...........................................................25
Sample..................................................................................................26
COHORT #1 ..................................................................................26
COHORT #2 ..................................................................................27
Treatment ................................................................................27
Protection of Rights of Human Subjects ..............................................30
Data Collection Procedures ..................................................................31
Data Analysis .......................................................................................31
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IV. RESULTS ...........................................................................................33
Descriptive Statistics ............................................................................33
COHORT #1 ........................................................................................33
COHORT #2 ........................................................................................34
Hypothesis Testing.........................................................................36
Hypothesis I ..............................................................................37
Hypothesis II .............................................................................38
Summary ..............................................................................................38
V. SUMMARY, DISCUSSION, AND IMPLICATIONS .......................40
Background ..........................................................................................40
Summary of the Study .........................................................................41
Conclusions and Discussion ................................................................43
Limitations ...........................................................................................46
Future Implications for Practice ...........................................................46
Recommendations for Future Research ...............................................49
Conclusions ..........................................................................................50
LIST OF REFERENCES .......................................................................................52
APPENDICES .......................................................................................................57
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ABSTRACT
The dynamic environment in health care, increasing body of knowledge, and
complexity of practice make it vital that clinical laboratory scientists maintain
competency by continuing to learn throughout their careers. The ability of clinical
laboratory scientists to become self-directed learners is one way of ensuring continued
competence in knowledge and skills in the clinical laboratory.
Self-directed learners are individuals who take the initiative for their learning;
diagnose their learning needs; formulate learning goals; identify human and material
resources; choose and implement learning strategies; and assess learning outcomes
(Knowles, 1975). The Self-Directed Learning Readiness Survey (also known as the
Learning Preference Assessment-LPA) can be used by students and educators to assess a
learner’s attitudes, skills, and behavior toward taking responsibility for their own
learning.
The purpose of this study was to examine the self-directed learning readiness of
baccalaureate students at the beginning and at the end of one year in a clinical laboratory
science program that deliberately introduced self-directed learning (SDL) activities into
the curricula. The SDL activities included (1) a unit of study in the first semester that
introduced the concept of self-directed learning, strategies for success, and resources; (2)
a self assessment of learning style; (3) scheduled, focused meetings with a faculty advisor
that included questions regarding development of appropriate learning strategies, setting
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goals, and analysis of current learning processes that may not be successful thus far for
the student; and (4) weekly formative assessments that were focused on an integrative
and cumulative approach to learning within the clinical laboratory science curriculum.
Clinical Laboratory Science students (n=50) participated in this study. Cohort #1
was the comparison group (n=25) and Cohort #2 received the treatment (n=25). Before
treatment, both cohorts were similar demographically and had similar overall grade
point averages.
Data were analyzed using independent t-tests and findings demonstrated that
statistically significant differences did not exist between Cohort #1 post-test SDLR
scores and Cohort #2 post-test SDLRS scores after treatment. A statistically significant
difference did exist related to GPA for students enrolled in the clinical laboratory
science program who experienced self-directed learning activities compared to the GPA
of students who did not experience self-directed learning activities. The GPA for
students enrolled in the Clinical Laboratory Science program who experienced self-
directed learning activities was higher than those students who did not receive the
treatment.
This study and its analysis of self-directed learning as a teaching method and
recognition of learner self-direction as characteristics of the learner has practical
applications for educators. Self-directed learning methods can be effective teaching
strategies to use within and outside the classroom to enhance self-direction in learning.
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There is evidence of using SDL in Clinical Laboratory Science education
curricula as a tool for developing critical thinking skills necessary for expert performers
as they develop as students and professionally in the years after graduation.
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LIST OF TABLES
2.1. Perspectives on Self-directed Learning .....................................................17
4.1. Breakdown of Cohorts ...............................................................................33
4.2. Summary Pretest SDLRS for Cohorts .......................................................35
4.3. Summary Pretest and Post-test SDLRS for Cohort #1 ..............................35
4.4. Summary Pretest and Post-test SDLRS for Cohort #2 ..............................36
4.5. Post-test SDLRS for Cohort #1 and Cohort #2 ..........................................37
4.6. GPA Comparison for Cohort #1 and Cohort #2 ........................................38
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LIST OF FIGURES
1. Candy’s Learner Control Continuum...............................................................14
2. Personal Responsibility Orientation Model .....................................................15
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LIST OF APPENDICES
A. Self-Directed Learning Readiness Survey .................................................58
B. Self-Directed Learning Module .................................................................63
C. VARK ........................................................................................................71
D. Advising Syllabus ......................................................................................76
E. Texas Tech University Health Sciences Center InstitutionalReview Board Approval ............................................................................85
F. Consent to Participate ................................................................................87
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CHAPTER I
INTRODUCTION
The dynamic environment in health care, increasing body of knowledge, and
complexity of practice make it vital that clinical laboratory scientists maintain
competency by continuing to learn throughout their careers. Estimates show that the
knowledge base in the clinical sciences doubles approximately every four years (Mertz,
2007). The ability of clinical laboratory scientists to become self-directed learners is one
way of ensuring continued competence in knowledge and skills in the clinical laboratory.
The National Accrediting Agency for Clinical Laboratory Scientists Standards for
Clinical Laboratory Science Education requires programs to include in their curricula
exposure to continued learning in the profession; few programs, however, have indicated
how the curricula assist the students to achieve this outcome and the skills required for
the undergraduate clinical laboratory science student to develop into a self-directed
learner.
Background
Individuals entering an undergraduate program in clinical laboratory science are
university students who have spent their prior years completing core curriculum
coursework and prerequisite coursework on a general academic campus to prepare for the
program in clinical laboratory science. The nature of the core curriculum coursework and
prerequisite coursework is one that does not develop learning skills focused on
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competency in cumulative knowledge and skills. The student completes a checklist of
coursework and has little opportunity in the formal education setting to seek independent
learning experiences outside the prescribed coursework. About 90% of all adults conduct
at least one self-directed learning project per year. Typical learners engage in five
projects, spending an average of 100 hours on each project (Tough, 1978).
It is suggested that individuals engaged in learning in the formal educational
setting are less likely to engage in self-directed learning experiences outside of the formal
setting. The origins of self-directed learning (SDL) can be traced to John Dewey who
cautioned that the teacher should be the one who guides but does not interfere with or
control the process of learning (Dewey, 1938). Dewey's theory is that experience arises
from the interaction of two principles-- continuity and interaction. Continuity is that each
experience a person has will influence his/her future, for better or for worse. Interaction
refers to the situational influence on one's experience. A learner’s present experience is a
function of the interaction between one's past experiences and the present situation. The
value of the experience is to be judged by the effect that experience has on the
individual's present, their future, and the extent to which the individual is able to
contribute to society (Dewey, 1938). Throughout, there is a strong emphasis on the
subjective quality of a student's experience and the necessity for the teacher to understand
the student’s past experiences in order to effectively design a sequence of educational
experiences to allow the learner to fulfill his/her learning objectives. SDL is the ability to
direct and regulate one’s own learning experience (Brookfield, 1993).
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Experiential learning or learning based on student experiences is the foundation of
the concept that one is able to take responsibility for one’s own learning - the foundation
of self-directed learning. Experiential learning is a term used to describe two types of
learning – self-teaching and experiential education. Self-teaching is learning that comes
about through reflection on everyday experiences and is organized by learners themselves
(Smith, 2003). Experiential education is learning through programs and activities
structured by others. An experiential educator's role is to organize and facilitate
experiences under the assumption that this will lead to genuine (meaningful and long-
lasting) learning.
Contemporary adult learning theorists recommend that adult learning experiences
include active learner involvement, collaborative faculty-student relationships and
facilitation of SDL (Brockett & Heimstra, 1991; Knowles, 1975). Knowles describes
activities associated with SDL as “a process in which individuals take the initiative, with
or without the help of others, in diagnosing their learning needs, formulating learning
goals, identifying human and material resources for learning, choosing and implementing
appropriate learning strategies, and evaluating learning outcomes”(Knowles, 1975, p. 18).
When traditional university students enter an undergraduate preprofessional
program in clinical laboratory science, there is usually a period of transition to adapt to
the health professions education environment. The student is required to maintain
acceptable attendance in the classroom and laboratory, begin the process of developing
professional skills, assimilate large volumes of information, form study habits that ensure
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cumulative comprehension of knowledge and skills, and develop self-directed learning
(SDL) techniques that enable the student to succeed within the clinical laboratory science
program and in the practice of the profession. Knowles (1975) states that the goal of
education is to teach the student how to learn on his/her own. This should be a goal in
pre-professional schools, such as allied health, nursing, pharmacy, dentistry, and
medicine. These learners must develop the attitudes and skills required for continued
professional learning using the SDL mode, if they choose to use that learning mode
(Wiley, 1982). Lowery (2003) asserts that adult educators have found that some adults
are incapable of engaging in self-directed learning because they lack independence,
confidence, or resources. Increasingly, health professions programs in medicine, nursing,
dentistry, and pharmacy are attempting to examine SDL readiness of their students and
related activities within their curricula to determine the value and appropriateness of SDL
in the health professions. These examinations will be addressed more fully in Chapter II,
Review of Literature.
Purpose of the Study
The purpose of this quasi-experimental study was to examine the self-directed
learning readiness of baccalaureate students at the beginning and at the end of one year in
a clinical laboratory science program that has deliberately introduced SDL activities into
the curricula. The SDL activities included the following:
1. a unit of study in the first semester that introduces the concept of self-directed
learning, strategies for success, and resources;
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2. a self assessment of learning style;
3. scheduled, focused meetings with a faculty advisor that include questions
regarding development of appropriate learning strategies, setting goals, and
analysis of current learning processes that may not be successful thus far for
the student; and
4. weekly formative assessment that is focused on an integrative and cumulative
approach to learning within the clinical laboratory science curriculum.
The self-directed learning readiness (SDLR) survey assesses a learner’s attitudes, skills,
and behavior toward taking responsibility for their own learning. The SDLR score and
GPA were compared at the end of the year to determine if SDLR was linked to academic
success in the clinical laboratory science program.
Research Questions
1. Do self-directed learning readiness scores differ for undergraduate students
transitioning from a traditional academic environment into a pre-professional
program of study when they are deliberately exposed to self-directed learning
activities in the clinical laboratory science curriculum when compared to the
scores of undergraduate students transitioning from a traditional academic
environment into a pre-professional program of study who have not been
exposed to self-directed learning activities?
2. Do self-directed learning activities impact grade point average (GPA) in
students enrolled in clinical laboratory science curricula?
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Hypotheses
The following two null hypotheses were tested in the study:
1. No statistically significant differences exist in self-directed learning readiness
scores for undergraduate students transitioning from a traditional academic
environment into a pre-professional program of study when they are
deliberately exposed to self-directed learning activities in the clinical
laboratory science curriculum when compared to the scores of undergraduate
students transitioning from a traditional academic environment into a pre-
professional program of study who have not been exposed to self-directed
learning activities.
2. No statistically significant differences exist in GPA for students enrolled in
the clinical laboratory science program who experienced self-directed learning
activities compared to the GPA of students who did not experience self-
directed learning activities.
Assumptions
The following assumptions were made for this study:
1. An individual’s readiness for self-directed learning can be determined
through the use of the Self-Directed Learning Readiness Scale
questionnaire (Guglielmino, 1977).
2. Participants will respond truthfully on the questionnaire.
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3. Entering grade point averages (GPA) are relatively the same for each
Cohort.
Limitations
The following limitations to the generalizability of the study were identified:
1. The sample was comprised of clinical laboratory science students at one
university. The sample was a sample of convenience, not selected to be
representative of students across the nation.
2. The sample utilized self-reported data; therefore, accuracy depended upon
the honesty of the respondents.
3. The research design was subject to pretest sensitization where the threat of
improved performance on a post-test was a result of having taken a pretest
(Gay, 2006).
Definition of Terms
The following definitions were used for the purposes of this study:
Autodidaxy: The learner conceives, plans and executes learning projects outside
the formal educational setting (Candy, 1991).
Comprehensive Knowledge: Comprehensive knowledge is an understanding and
application of an entire field of study.
Critical Thinking: A disciplined process, by the learner, of actively and skillfully
conceptualizing, applying, analyzing, synthesizing, and/or evaluating information
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gathered from, or generated by, observation, experience, reflection, reasoning, or
communication , as a guide to belief and action (Scriven & Paul, 2004).
Education: A process for managing external conditions that facilitate learning
(Boshier, 1983).
Experiential Learning: A term used to describe two types of learning – self-
teaching and experiential education (Smith, 2003).
Guided Discovery: Guided discovery nurtures students’ mental processes of
constructing their own understanding of a subject (Clark, 1999).
Integrative Curriculum: An integrative curriculum organizational approach is one
which cuts across subject-matter lines to focus upon comprehensive life problems or
broad-based areas of study that bring together the various segments of the curriculum into
meaningful association (Good, 1973).
Learning: An internal change process (Boshier, 1983).
Self-directed Learning (SDL): Self-direction in learning is a combination of
forces both within and outside the individual that stress the learner accepting ever-
increasing responsibility for decisions associated with the learning process (Brockett &
Hiemstra, 1991). Self-directed learning is a personal process of learning how to learn,
how to change, and how to adapt (Rogers, 1983).
Self-regulated Learning: Self-regulated learning involves the active process of
goal-directed, self-control of behavior, motivation and cognition for academic tasks by an
individual student (Pintrich, 1995).
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Summary
The research problem of this study was to investigate the efficacy of deliberately
introducing tools associated with learner self-direction as a teaching method for preparing
clinical laboratory science students for entry-level practice. Essential for development of
learner self-direction is active learner involvement and collaborative faculty-student
relationships. The focus of this study was to examine self-directed learning readiness
between students who experience a traditional CLS curriculum and students who
experience a curriculum adjusted to deliberately introduce self-directed learning
concepts.
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CHAPTER II
REVIEW OF LITERATURE
The review of literature for this study was focused on research from primary
sources in the field of adult education, specifically self-directed learning. A review of the
conceptual framework for understanding self-direction in adult learning was conducted
with an emphasis in three areas: establishing the knowledge base in self-direction;
quantitative approaches to studying self-direction; and expanding the knowledge base
through qualitative approaches. Further inspection was focused on the process of
facilitating self-directed learning and enhancing learner self-direction. A secondary focus
of the review of literature was on the research based literature primarily associated with
the analysis and application of self-directed learning concepts in health professions
education.
Conceptual Framework for Understanding Self-direction in Learning
Chickering (1964) presented and discussed five characteristics identified by the
faculty at Goddard College as the characteristics that would describe an independent
(self-directed) learner:
1. Interdependent: Is attuned to the whole; is amiable and peace loving; relates to
others but does not depend on them; recognizes responsibilities.
2. Venturesome: Confronts questions and problems willingly; is open to
experience; is self-starting; is able to disagree; discovers new possibilities.
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3. Resourceful: Knows how to use resources for learning; recognizes when help
is needed; digs up material; is able to organize.
4. Persistent: Can stick to a position; is working for his/her own satisfaction; has
the energy and determination to keep at a job; has quiet self-confidence.
5. Reflective: Has a sense of what is important; has direction; knows his own
strengths and weaknesses; discovers through investigation; is flexible in view
of new evidence. (p. 39)
Self-direction in learning from the life-long learning perspective of Kidd (1973)
emphasizes that the purpose of adult education is to make the subject a continuing, inner-
directed self-operating learner. Knowles (1975) stressed the phases of a learning process
and provided a broad definition of self-directed learning as a process in which individuals
take the initiative, with or without the help of others, in diagnosing their learning needs,
formulating learning goals, identifying human material resources for learning, choosing
and implementing appropriate learning strategies, and evaluating learning outcomes.
Guglielmino (1977) concluded that a self-directed learner is:
One who exhibits initiative, independence, and persistence in learning;
one who accepts responsibility for his/her own learning and viewsproblems as challenges and not obstacles; one who is capable of self-
discipline and has a high degree of curiosity; who has a strong desire to
learn or change and is self-confident; who is able to use basic study skills,organize his/her time and set an appropriate pace for learning, and to
develop a plan for completing work; one who enjoys learning and has atendency to be goal-oriented. (p. 73)
The learning process perspective introduced by Tough (1979) focused on the
learning process in which the learner assumes primary control. His research emphasized
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the concept of self-planned learning. Mocker and Spear (1982) introduced a different
construct by suggesting that self-directed learning is a function of learners’ perceived
control versus institution control over the purposes and processes of learning. Mocker
and Spear included self-directed learning in a descriptive model of lifelong learning
based entirely on the locus of control for decision making about the objectives and means
of learning. The model suggested a two-by-two matrix of learner and institution; the self-
directed learning situation occurs when learners, not the institution, control both the
learning objectives and the means of learning. The following situations occupy the other
cells of the matrix: (1) formal learning, in which institutions, not learners, control
objectives and the means of learning; (2) nonformal learning, in which learners control
the objectives and institutions control the means; and (3) informal learning, in which
institutions control the objectives but learners control the means of learning. Gibbons
and Phillips (1982) offered a different view in which self-education could only occur
outside of formal institutions, not inside them. They offered that true self-education
could only occur when the learner is not compelled to learn and others are not compelled
to teach them.
An ongoing debate within the literature is the discussion of self-directed learning
as an instructional method or personality characteristic. As discussed earlier, self-
direction in learning has a strong foundation as an instructional process in which the
learner assumes a primary role in planning, implementing, and evaluating the experience.
This research approach operationalizes self-directed learning as an instructional process.
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Fellenz (1985) attempted to introduce the concept that self-direction could be viewed in
two ways - the first is that self-direction is adopted during the process of learning; the
second is that self-direction is a psychological state attained by an individual in the
personal development process. Oddi (1987) further distinguished between the process
perspective and the personality perspective with development of the Continuing Learning
Inventory in an effort to develop a theoretical framework for understanding personality
characteristics of self-directed continuing learners.
Candy’s Learner Control Continuum
Candy (1988) offered further support for distinction between the two concepts
through a critical analysis of the literature and synthesis of research findings in self-
direction. His findings revealed that self –direction has a foundation as a personal quality
or attribute and as the independent pursuit of learning outside formal instructional
settings. Candy goes further to suggest a third construct of learner control or self-
direction as a way of organizing instruction. Candy asserts that the phrase “self-
direction” referenced in the literature can be narrowed down to four ideas. The first and
second focus on self-direction as a method or process: (1) the level of control the learner
has over the mode or style of the instruction; (2) autodidaxy (“teach-yourself, or the
independent/self-guided pursuit of learning). The third and fourth are focused on self-
direction as an outcome: (3) the goal of self-management of learning or taking
responsibility for his/her own learning; (4) self-determination of his/her destiny. Figure 1
illustrates Candy’s Learner Control Continuum (Jennings, 2007, p. 518).
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Figure 1. Candy’s Learner Control Continuum
Personal Responsibility Orientation Model
Brockett and Hiemstra (1991) suggest a model in which self-direction in learning
is viewed as being comprised of both instructional method processes (self-directed
learning) and personality characteristics (learner self-direction). The Personal
Responsibility Orientation (PRO) model of self-direction in adult learning is designed to
recognize both. Figure 2 illustrates Brockett & Hiemstra’s PRO model (Brockett &
Hiemstra, 1991, p. 25).
The foundation of the model is based in personal responsibility in which the
learner assumes ownership for their own thoughts and actions. Within the context of
learning, it is the ability and/or willingness of individuals to take control of their own
learning that determines their potential for self-direction. Brockett & Hiemstra assert that
the term self-direction in learning is a broad concept that includes both self-directed
learning and learner self-direction. Self-directed learning is the external factors that
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Figure 2. Personal Responsibility Orientation Model
facilitate the learner taking primary responsibility for planning, implementing, and
evaluating his/her own learning. Learner self-direction is the internal factors or
personality characteristics that predispose the learner toward accepting responsibility for
his/her thoughts and actions as a learner. Brockett & Hiemstra (1991) assert that learners
have choices about the direction he/she pursues as a learner and responsibility for
accepting the consequences of the actions as a learner are linked to these choices. The
PRO model serves as a construct for further understanding of self-direction and serves as
a framework for theory, research, and practice.
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Garrison’s Three Dimensional Model
Garrison's Three Dimensional model of SDL also includes the perspectives of SDL as
a personal attribute as well as a learning process. According to Garrison (1997), SDL is
accomplished by three dimensions interacting with each other: self-management, self-
monitoring, and motivation. In educational settings, self-management involves the learner
assessing available resources and determining their own needs. Garrison explained
resources as tools accessible to the learner that facilitate learner understanding. Self-
monitoring involves the learner assessing their progress and achievement towards
meeting his/her learning goals. The motivation dimension relates to the external and
internal forces that impact the learner’s desire to obtain his/her learning goals. The focus
of Garrison’s (1997) model is on resource use, learning strategies use, and motivation to
learn. Table 2.1 is a summation of the perspectives associated with self-directed learning
(Song & Hall, 2007, p. 28). Garrison further explained that learner control did not mean
independence, but rather collaboration with other people within the context. Like Candy
(1988), as well as Brockett and Hiemstra (1991), Garrison (1997) also recognized the context
factor in his model in that he specified self-management of resources in a given context.
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Table 2.1. Perspectives on Self-directed Learning
Perspectives Description Candy (1991) Brockett &
Hiemstra (1991)
Garrison (1997)
Personal
Attribute
Moral, emotional,
and intellectual
management
Personal
Autonomy
Self-management
Goal Orientation
(personal attribute)
Self-management
(use of resources)
Motivation
Process Learner
autonomy over
instruction
Learner Control
Autodidaxy
Process Orientation
(learner control)
Self-monitoring
Context Environment
where learningtakes place
Self-direction is
context bound
Social Context: role
of institutions andpolicies
Self-directed Learning in Health Professions Education
Self-directed learning readiness (SDLR) has been studied across a broad spectrum
of adult groups within health professions education, including nursing, medicine,
pharmacy, and dentistry all of which have licensure requirements that mandate
continuing education in the profession.
Nursing
The earliest investigation with nurses was a diagnostic study by Savoie (1980)
utilizing the self-directed learning readiness score to predict success in continuing
education courses for nurses where learners were expected to assume a high degree of
self-direction. This study found a positive relationship between SDLRS scores and
course grades. Box (1983) investigated the difference among first-level students, second-
level students, and graduates of an associate degree nursing program and found that
SDLRS scores correlated to grade-point average. There were no significant differences
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in SDLRS scores among the three groups. Box also noted a positive correlation between
SDLRS scores and grade point average. Wiley (1982) investigated the effects of a
process-oriented, self-directed learning project and the personal preference for structure
on self-directed learning readiness among 104 undergraduate nursing students aged 20-21
years old. Wiley noted that SDLRS scores did not increase from pretest to post-test for
this group of undergraduate students. Crook (1985) examined the predictive validity of
the SDLRS to predict success in the undergraduate nursing classroom. There was a
significant correlation found between SDLRS score and peer nomination (fellow
classmates who identified a member as “self-directed”) and end of year grades. Murray
(1988) utilized a pretest post-test design to determine the effects of participation of
undergraduate nursing students in a clinical internship on SDL. It was found that the
experimental group who participated in the clinical internship differed significantly
between the pretest and post-test SDLRS scores. In addition it was noted that the SDLRS
scores were related to GPA and a desire for advanced education in nursing. Palumbo
(1989) utilized a pretest post-test design to measure change in SDLRS scores of
undergraduate nurses over time (1.5 years). There was a significant change in the SDLR
scores. Fisher, King, and Tague (2001) attempted to develop a SDLRS specific to
nursing practice utilizing the Delphi technique used by Guglielmino. Williams (2004)
utilized the SDLRS scores to examine the effect on nursing students exposed to a
problem based learning program on self-directed learning. No significant findings were
reported.
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Medicine
Frisby (1991) conducted one of the earliest studies investigating self-directed
learning readiness in medical students among two groups: the independent study students
and the lecture-discussion students. Frisby found no difference among the two groups.
Shokar, Shokar, Romero, and Bulik (2002) examined SDLRS scores and outcomes
among medical students at the University of Texas Medical Branch at Galveston. The
mean SDLRS score of the 182 medical students tested was 235.81, well into the above-
average range for the SDLRS and significantly higher than the mean of the general
population ,214, established by Guglielmino. Their scores also correlated positively with
their final clerkship grades and their clinical preceptor scores.
Dentistry
Hendricson (2006), as a member of the American Dental Education Association
Commission on Changes and Innovation in Dental Education, examined the development
of problem-solving, critical thinking, and self-directed learning in dental education
programs. One of the objectives of the Commission was to provide guidance to dental
schools related to curriculum design. The Commission issued a white paper summarizing
the evidence related to educational best practices for helping dental students acquire the
capacity to function as an entry-level general dentist or to be a better candidate to begin
advanced studies. Three issues were addressed, with special emphasis on the third: 1)
What constitutes expertise, and when does an individual become an expert? 2) What are
the differences between novice and expert thinking? and 3) What educational best
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practices can help our students acquire mental capacities associated with expert function,
including critical thinking and self-directed learning? The purpose of the review was to
provide a benchmark that faculty and academic planners could use to assess the degree to
which their curricula included learning experiences associated with development of
problem-solving, critical thinking, self-directed learning, and other cognitive skills
necessary for dental school graduates to ultimately become expert performers as they
develop professionally in the years after graduation. The Commission asserted that the
capacity for self-directed learning is required to implement the reflective judgment
process and underlies many of the dispositions needed for critical thinking. SDL is the
ability to direct and regulate one’s own learning experience (Brookfield, 1993).
Essentially the same educational strategies have been proposed to develop critical
thinking and self-directed learning. These best practices include providing students with
frequent opportunities to use the reflective judgment process to analyze problems
presented in case scenarios. The data seeking and analysis required to accomplish the
reflective judgment process are thought to help students acquire SDL skills in a “learn by
doing” approach, and there is evidence that students who routinely use this process to
explore problems develop more sophisticated SDL than do students in lecture-based
curricula (Blumberg, 2000).
Pharmacy
Finally, Huynh et al. (2007) studied the predictors of readiness for self-directed
learning among third and fourth year pharmacists. Accreditation Council for Pharmacy
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Education Standards requires schools and colleges of pharmacy to support the
development of self-directed lifelong learners. The objective of this study was to
characterize the self-directedness of third and fourth year student pharmacists and to
identify characteristics that are associated with readiness for self-directed learning. The
Self-directed Learning Readiness Scale was administered to third and fourth year student
pharmacists. A total of 77 (67.0%) third-year student pharmacists and 100 (84.7%) fourth
year student pharmacists completed the questionnaire. No significant difference was
found between the mean scores on SDLRS for third (157 ± 21) and fourth (154 ± 20)
year student pharmacists (p = 0.39). Huynh asserts that readiness for self-directed
learning may be an intrinsic characteristic that is relatively stable and not readily
influenced by external factors.
At the time of this project, no study has been identified involving the analysis of
self-directed learning readiness among clinical laboratory science students, nor has the
impact of deliberate inclusion of self-directed learning activities in clinical laboratory
science curricula been examined.
Summary
Candy (1991), Brockett and Heimstra (1991), and Garrison (1997) have
established a theoretical framework for investigating both instructional method processes
(self-directed learning) and personality characteristics (learner self-direction). This is
evident in the broad context of adult education and the more specific examination of self-
directed learning and learner self-direction in health care professions education. Studies
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have been conducted that have examined the effects of self-directed learning as a learning
process (Savoie, 1980; Box, 1984; Frisby, 1991; and Hendricson, 2006) and examination
of developing attributes or characteristics that lead to learner self-direction (Wiley, 1982;
Murray, 1988; and Palumbo, 1989). Finally, there is evidence of using SDL in health care
education curricula as a tool for developing critical thinking skills necessary for expert
performers as they develop as students and professionally in the years after graduation.
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CHAPTER III
RESEARCH DESIGN AND METHODOLOGY
Introduction
The purpose of this quasi-experimental study was to examine the self-directed
learning readiness of baccalaureate students at the beginning and at the end of one year in
a clinical laboratory science program that has deliberate self-directed learning activities
incorporated into the curricula.
Research Design
For this research project pretest scores and post-test scores of two cohorts were
compared. Cohort #1 was the control group which did not receive the treatment. Cohort
#2 did receive the treatment. The independent variable in this study was the treatment,
which was the exposure to deliberate self-directed learning activities incorporated into
the curricula. The dependent variable was the post-test SDLRS of the students.
Instrument
With the influences of Cyril Houle and Allen Tough, Lucy Guglielmino, (1977)
developed the Self-Directed Learning Readiness Survey (also known as the Learning
Preference Assessment-LPA) to assess a learner’s attitudes, skills, and behavior toward
taking responsibility for their own learning. This affective instrument was designed as a
self-report survey that focuses on eight areas related to self-directed learning: love of
learning, life-long learning, self-concept, self-understanding, tolerance of ambiguity in
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learning experiences, responsibility related to learning, initiative to organize learning
activities, and creative approaches to learning activities. The self-directed learning
readiness scale (SDLRS) is a self report questionnaire with 58 likert type items (1=almost
never true of me; I hardly ever feel this way to 5=almost always true of me; there are very
few times when I don’t feel this way) designed to determine the extent to which
individuals perceive themselves as possessing the skills and attitudes associated with
SDL (Guglielmino, 1977) (Appendix A). The SDLRS test results are an overall score of
self-directed learning readiness which ranges from a low of 58 (indicating a low level of
ability to direct one’s own learning) to a high of 290 (indicating a high level of ability to
direct one’s own learning). The average score for adults completing the SDLRS is 214
(Guglielmino, 1977).
This Likert–type response survey was developed from a three round Delphi study
that included fourteen identified experts in the field of self-directed learning and adult
learning. The first instrument was field tested on 307 individuals in Georgia, Canada,
and Virginia. To estimate internal reliability, Guglielmino used the Cronbach-Alpha
procedure on the obtained scores. The reliability estimate was 0.87. Guglielmino
identified eight independent factors through factor analysis. Some items were added and
restructured, and the second sampling was over 3,151 individuals. The reliability
estimate was determined to be 0.94 (McCune, Guglielmino, & Garcia, 1990). Most
published studies on populations over twenty years of age report similar reliability figures
that fall within a range of 0.72 – 0.96. In addition, to internal reliability estimates,
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Finestone (1984) and Wiley (1982) reported test-retest reliability coefficients of 0.82 and
0.79. Merriam and Caffarella (1999) and Merriam, Caffarella, & Baumgartner (2007)
reviewed studies that examined the validity and reliability of the instrument. They
concluded that the SDLRS was the most appropriate tool for measuring learner beliefs,
values, attitudes, and behaviors related to self-directed learning. Delahaye and Choy
(2000) conducted a comprehensive review of the SDLRS and examined content,
construct, and criterion validity along with stability (test-retest) and internal consistency.
Delahaye and Choy found the instrument to be valid and reliable for the assessment of
learner self-perception of self-directed learning.
Considerations and Limitations
Delahaye and Choy (2000) asserted that the weaknesses of the survey were the
self-report aspect that has the potential to lead to biases such as “telling the researcher
what they want to know,” inconsistent self concept, and pretest post-test effect if used in
that manner. Gay (2006) asserts that testing is more likely to be threatened when the time
between the pretest and post-test is short and the information for testing is factual. For
this study, the pretest and post-test were administered approximately 10 months apart.
The information related to the survey is not fact based. The participant is self-reporting
their self-directed learning skills and attitudes. Despite these concerns, the SDLRS is
considered the most widely used instrument in evaluating learning self-direction. It has
been translated into more than 20 languages and applied internationally.
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Sample
The convenience sample consisted of all the Clinical Laboratory Science students
enrolled in the first year of the undergraduate baccalaureate Clinical Laboratory Science
program within the School of Allied Health Sciences at the Texas Tech University Health
Sciences Center Lubbock campus. The inclusion criteria were students who met the
requirements for admission to the Clinical Laboratory Science program which included
the following:
1. a minimum cumulative and science GPA of 2.5,
2. completion of prerequisite coursework,
3. completion of an application that includes an essay, and
4. participation in a structured interview conducted by members of the Clinical
Laboratory Science admissions committee.
COHORT #1
Students in the first cohort (comparison group) were administered the (pretest)
Self-Directed Learning Readiness Survey the first day of class, August 2007. The first
cohort did not participate in a curriculum that included deliberate self-directed learning
activities. The curriculum experienced by Cohort #1 was the traditional CLS curriculum
utilized by university-based CLS programs in the U.S. The (post-test) Self-Directed
Learning Readiness Survey was administered again to the first cohort at the completion
of one year (two semesters) of the CLS curriculum. The sample size was 29 students.
Four participants did not complete the post-test. One student withdrew from the program
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and three students were dismissed due to poor academic performance. The final sample
for Cohort #1 was 25 students.
COHORT #2
Students in the second cohort were administered the (pretest) Self-Directed
Learning Readiness Survey the first day of class, August 2008. The second cohort
participated in a curriculum designed to improve self-directed learning readiness by
incorporating self-directed learning activities (treatment).
Treatment
The treatment included SDL activities comprised of a learning module in the first
semester that introduced the concept of self-directed learning (Appendix B); a self
assessment of learning style using the VARK (Appendix C); an Advising Syllabus that
provided a structured advising schedule led by an assigned faculty member (Appendix
D); and weekly formative assessments that were structured to develop cumulative
learning within the clinical laboratory science curriculum.
1. A learning module on the SDL process was prepared for implementation of
the treatment. Preparation of the module began with a review of the linear
model of the SDL process developed by Knox (1973) that identified five
components: (1) identification of needs, (2) awareness of the facilitators and
barriers to learning, (3) selection of objectives, (4) selection of learning
activities, and (5) evaluation of learning. In addition, Brockett & Heimstra
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(1985) identified strategies that educators can use to facilitate self-directed
learning: (1) help the learner identify a starting point for the project, (2) create
a partnership with the learner, (3) make the learner aware of objectives,
learning strategies, and resources, (4) teach inquiry skills, decision making,
personal development, and self-assessment, and (5) create an environment of
openness and trust. The learning module to introduce the concept of SDL
consisted of objectives, content, and resources and was presented to Cohort #2
early in the fall semester.
2. The VARK is a self assessment tool to determine a student’s learning
preference. The acronym VARK stands for Visual, Aural, Read/write, and
Kinesthetic sensory modalities that are utilized by the learner for gathering
and processing information. Fleming and Mills (1992) suggested the four
categories that seemed to reflect the experiences of the students in the process
of learning. Each category is defined as follows:
a. Visual (V): This is a preference for information to be presented in
map, diagram, or chart form rather than in words or lecture form.
b. Aural/Auditory (A): This is a preference for information that is “heard
or spoken”. Lectures, tutorials, group discussion, and email are
effective tools for learning.
c. Read/write (R): This preference is for information displayed as words
with an emphasis on text-based input and output, reading, and writing
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in all its forms. PowerPoint, Internet, and dictionaries are effective
tools for learning.
d. Kinesthetic (K): This preference refers to the use of experiences and
practice (simulated and real) to understand information. Case studies,
videos, and laboratory sessions are effective tools for learning.
For the purposes of this study, the VARK was used in one-to-one student
counseling with a faculty advisor. Each student completed the questionnaire
and was advised he/she could select more than one option for any question. If
the student determined all of the options were appropriate, he/she were asked
to indicate what their first preference might be. Most of the students
completed the questionnaire in four to six minutes. After the questionnaire
was completed each student was asked to sum the occurrences of his/her
preferences for each mode. This procedure resulted in four scores, one for
each modal preference. Students could select more than one option for each
question and omit questions. The sum of the four preference scores on the
questionnaire varied among individual students. The scores were then perused
by the student and advisor and a modal preference was determined based on a
simple numerical dominance of one mode over others.
3. The Advising Syllabus (Appendix D) is a structured advising schedule led by
an assigned faculty member. Preparation of the Advising Syllabus began with
a review of instructional methods that facilitate development of self-directed
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learning. After the Advising Syllabus was prepared, it was given to two
experienced advisors for review. The advisors made a few suggestions for
revision, and those suggestions were incorporated into the final draft. Prior to
the implementation of the Advising Syllabus, faculty were trained in a 4 hour
workshop that addressed topics on how to conduct focused meetings that
include questions regarding development of appropriate learning strategies,
setting goals, and analysis of current learning processes that may not have
been successful for the student.
4. Weekly cumulative, formative assessments were developed to promote
cumulative learning within the clinical laboratory science curriculum for each
semester (fall and spring).
The (post-test) Self-Directed Learning Readiness Survey was administered again
to the second cohort at the completion of one year (two semesters) of the CLS curriculum
(May 2009). The sample size was 27 students. Two participants did not complete the
post-test. Both withdrew from the program due to personal reasons. No students were
dismissed due to poor academic performance. The final sample size for Cohort #2 was
25 students.
Protection of Rights of Human Subjects
University procedures were followed by requesting permission to pursue research
involving human subjects. This study qualified for expedited review at Texas Tech
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University Health Sciences Center (TTUHSC). Permission from the Institutional Review
Board was granted for data collection (IRB# L09-043) (Appendix E).
Data Collection Procedures
The SDLR questionnaire (pretest) was administered by the researcher during
orientation (fall term) for Cohort #1 and Cohort# 2. The students were informed of their
choice to voluntarily participate and consent to participate was obtained (Appendix F).
After completion of two semesters (fall and spring terms) the SDLRS questionnaire
(post-test) was administered by the researcher at the end of the spring term.
Data Analysis
Statistical package GraphPad InStat, version 3, is a statistical tool to help
researchers calculate frequently used statistical tests efficiently. The following two null
hypotheses were tested in the study:
1. No statistically significant differences exist in self-directed learning readiness
scores for undergraduate students transitioning from a traditional academic
environment into a pre-professional program of study when they are
deliberately exposed to self-directed learning activities in the clinical
laboratory science curriculum when compared to the scores of undergraduate
students transitioning from a traditional academic environment into a pre-
professional program of study who have not been exposed to self-directed
learning activities.
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Biographical data (gender, entering GPA, and exit GPA) were analyzed by computing
measures of central tendency and measures of dispersion. These were utilized to
determine homogeneity of Cohort #1 (comparison group) and Cohort #2 (treatment
group). To test the hypothesis the pretest SDLRS scores for Cohort #1 and Cohort #2
were analyzed by conducting independent samples t-tests to determine if the cohorts are
equivalent at the start of the study. Levene's test was calculated to determine
homogeneity of variance. In addition, t-test (0.05 level of significance) was computed to
compare post-test SDLRS test scores. Cohort #1 and Cohort #2 were determined to be
equivalent on the pretest scores.
2. No statistically significant differences exist in GPA for students enrolled in
the clinical laboratory science program who experienced self-directed learning
activities compared to the GPA of students who did not experience self-
directed learning activities.
To test the hypothesis the GPA at the end of one year (two semesters) for students in
Cohort #1 and Cohort #2 were analyzed. The t-test (one tailed at .05 level of
significance) was computed.
The analysis of the post-test SDLRS for Cohort #1 and Cohort #2 provided data to
determine if self-directed learning activities incorporated into the curricula of clinical
laboratory science programs had an effect on self-directed learning readiness. The
analysis of the GPA for Cohort #1 and Cohort #2 provided data for analysis to determine
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if self-directed learning activities were related to the grade point average of the study
participants.
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CHAPTER IV
RESULTS
This chapter reports the findings of the study that investigated the effects of
incorporating self-directed learning activities on the SDLR scores and grade point
average (GPA) of clinical laboratory science students. The chapter identifies each of the
hypotheses posed in the study, describes how the data were analyzed, and explains the
results. Statistical analysis, including descriptive statistics, the Self-Directed Learning
Readiness Survey, GPA, and t-tests were used to answer the two hypotheses identified in
Chapter 1.
Descriptive Statistics
Students enrolled in the Clinical Laboratory Science program participated in this
study. Table 4.1 provides a breakdown of the students in Cohort #1 and Cohort #2. All
50 students signed consent forms to participate in the study.
Table 4.1. Breakdown of Cohorts.
Cohort #1 Cohort #2
Female 15 19
Male 10 6
Total Number of Students 25 25
Mean Entering GPA 3.31 3.30
COHORT #1
Students in the first cohort (comparison group) were administered the (pretest)
Self-Directed Learning Readiness Survey the first day of class, August 2007. The first
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cohort did not participate in a curriculum that included deliberate self-directed learning
activities. The curriculum experienced by Cohort #1 was the traditional CLS curriculum
utilized by university-based CLS programs in the U.S. The (post-test) Self-Directed
Learning Readiness Survey was administered again to the first cohort at the completion
of one year (two semesters) of the CLS curriculum. The sample size was 29 students.
Four participants did not complete the post-test. The final sample for Cohort #1 was 25
students. The mean entering grade point average (GPA) for Cohort #1 was 3.31. The
entering GPA for each student was calculated based on prerequisite coursework required
for admission into the CLS program.
COHORT #2
Students in the second cohort were administered the (pretest) Self-Directed
Learning Readiness Survey the first day of class, August 2008. The second cohort
participated in a curriculum designed to improve self-directed learning readiness by
incorporating self-directed learning activities (treatment). The mean entering GPA for
Cohort #2 was 3.30. The entering GPA for each student was calculated based on
prerequisite coursework required for admission into the CLS program.
The self-directed learning readiness scale (SDLRS) is a self report questionnaire
with 58 likert type items (1=almost never true of me; I hardly ever feel this way to
5=almost always true of me; there are very few times when I don’t feel this way)
designed to determine the extent to which individuals perceive themselves as possessing
the skills and attitudes associated with SDL (Guglielmino, 1977/1978). The SDLRS was
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administered to Cohort #1 and Cohort #2 at orientation August 2008 and August 2009
respectively. Table 4.2 provides a summary of data of the pretest SDLRS for Cohort #1
and Cohort #2.
Table 4.2. Summary Pretest SDLRS for Cohorts.
Parameter Cohort #1 Pretest Cohort #2 Pretest
Mean 236.76 221.12
Number of Participants 25 25
Standard Deviation 19.197 20.397
Standard Error 3.839 4.079
Minimum Score 188.00 172.00
Maximum Score 277.00 256.00
Median 236.00 224.00
Lower 95% Confidence Interval 228.84 212.70
Upper 95% Confidence Interval 244.68 229.54
Cohort #1 did not participate in a curriculum that included deliberate self-directed
learning activities. The curriculum experienced by Cohort #1 was the traditional CLS
curriculum utilized by university-based CLS programs in the U.S. Table 4.3 provides a
summary of data of the pretest and post-test SDLRS for Cohort #1.
Table 4.3. Summary Pretest and Post-test SDLRS for Cohort #1.
Parameter Cohort #1 Pretest Cohort #1 Post-test
Mean 236.76 228.40
Number of Participants 25 25
Standard Deviation 19.197 20.881
Standard Error 3.839 4.176
Minimum Score 188.00 175.00Maximum Score 277.00 270.00
Median 236.00 230.00
Lower 95% Confidence Interval 228.84 219.78
Upper 95% Confidence Interval 244.68 237.02
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The pretest and post-test scores for Cohort #1 were compared using the paired t-test. The
two-tailed P value at 0.05 level of significance was 0.0158. The t = 2.599 with 24
degrees of freedom. The statistical difference between the means is considered
significant.
Cohort #2 participated in a curriculum designed to enhance self-directed learning
readiness by incorporating self-directed learning activities (treatment) into the CLS
curriculum. Table 4.4 provides a summary of data of the pretest and post-test SDLRS for
Cohort #2.
Table 4.4. Summary Pretest and Post-test SDLRS for Cohort #2.
Parameter Cohort #2 Pretest Cohort #2 Post-test
Mean 221.12 226.32
Number of Participants 25 25
Standard Deviation 20.397 21.704
Standard Error 4.079 4.341
Minimum Score 172.00 165.00
Maximum Score 256.00 256.00
Median 224.00 229.00
Lower 95% Confidence Interval 212.70 217.36
Upper 95% Confidence Interval 229.54 235.28
The pretest and post-test scores for Cohort #2 were compared using the paired t-test. The
two-tailed P value at 0.05 level of significance was 0.1708. The t = 1.412 with 24
degrees of freedom. The statistical difference between the means is not considered
significant.
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Hypothesis Testing
The hypotheses for this study were designed to examine if including deliberate
self-directed learning activities into the CLS curriculum would affect the extent to which
individuals perceive themselves as possessing the skills and attitudes associated with
SDL. Two null hypotheses were addressed. Results were identified as being statistically
significant at or beyond the 0.05 level.
Hypothesis I
No statistically significant differences exist in self-directed learning readiness
scores for undergraduate students transitioning from a traditional academic environment
into a pre-professional program of study when they are deliberately exposed to self-
directed learning activities in the clinical laboratory science curriculum when compared
to the scores of undergraduate students transitioning from a traditional academic
environment into a pre-professional program of study who have not been exposed to self-
directed learning activities.
The independent samples t-test was calculated to compare the post-test SDLRS
for Cohort #1 and Cohort #2. Table 4.5 provides calculation details. The two-tailed p
value at 0.05 level of significance was calculated 0.7314 with tcv = 0.3453 with 48
degrees of freedom. The calculated value did not exceed the critical value at a level of
significance at 0.05; therefore the null hypothesis was not rejected.
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Table 4.5. Post-test SDLRS for Cohort #1 and Cohort #2.
Parameter Cohort #1 Post-test Cohort #2 Post-test
Mean 228.40 226.32
Number of Participants 25 25
Standard Deviation 20.881 21.704
Standard Error 4.176 4.341
Minimum Score 175.00 165.00
Maximum Score 270.00 256.00
Median 230.00 229.00
Lower 95% Confidence Interval 219.78 217.36
Upper 95% Confidence Interval 236.02 235.28
Hypothesis II
No statistically significant differences exist in GPA for students enrolled in the
clinical laboratory science program who experienced self-directed learning activities
compared to the GPA of students who did not experience self-directed learning activities.
The independent samples t-test was calculated to compare the GPAs at the
conclusion of one year (two semesters) for Cohort #1 and Cohort #2. Table 4.6 provides
calculation details. The one-tailed p value at 0.05 level of significance was 0.0334 with
tcv = 1.875 with 48 degrees of freedom. The calculated value did exceed the critical
value at a level of significance at 0.05; therefore the null hypothesis was rejected.
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Table 4.6. GPA Comparisons for Cohort #1 and Cohort #2.
Parameter Cohort #1 GPA Cohort #2 GPA
Mean 3.2868 3.5332
Number of Participants 25 25
Standard Deviation 0.5162 0.4064
Standard Error 0.1032 0.0813
Minimum GPA 2.160 2.900
Maximum GPA 4.000 4.000
Median GPA 3.440 3.510
Lower 95% Confidence Interval 3.074 3.365
Upper 95% Confidence Interval 3.500 3.701
Summary
This chapter presented the findings of the study that investigated the effects of
incorporating self-directed learning activities on the SDLR scores and grade point
average (GPA) of clinical laboratory science students. Fifty students from the Clinical
Laboratory Science Program participated in the study. Students completed a pretest and
post-test SDLRS that were used in the data analysis. In addition, entering GPA and
concluding GPA (after two semesters) was collected and used in the data analysis.
Hypothesis I was not rejected and Hypothesis II was rejected.
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CHAPTER V
SUMMARY, DISCUSSION, AND IMPLICATIONS
This chapter presents a summary of the study, including the problems, purpose, findings,
implications, and conclusions based on the analysis of the data. Limitations and
recommendations for future research are also presented.
Background
A goal of health care education is to develop curricula that promote critical
thinking skills necessary for expert performers as they develop as students and
professionally in the years after graduation. The dynamic environment in health care,
increasing body of knowledge, and complexity of practice make it vital that clinical
laboratory scientists maintain competency by continuing to learn throughout their careers.
The ability of clinical laboratory scientists to become self-directed learners is one way of
ensuring continued competence in knowledge and skills in the clinical laboratory.
Guglielmino (1977) found that a variety of attitudes, habits, knowledge, and skills are
involved in readiness for self-directed learning. The Self-Directed Learning Readiness
Survey (also known as the Learning Preference Assessment-LPA) can be used by
students and educators to assess a learner’s attitudes, skills, and behavior toward taking
responsibility for their own learning.
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Summary of the Study
This study identified as its purpose to examine the self-directed learning readiness
of baccalaureate students at the beginning and at the end of one year in a clinical
laboratory science program that deliberately introduced SDL activities into the curricula.
The SDL activities included (1) a unit of study in the first semester that introduces the
concept of self-directed learning, strategies for success, and resources; (2) a self
assessment of learning style; (3) scheduled, focused meetings with a faculty advisor that
include questions regarding development of appropriate learning strategies, setting goals,
and analysis of current learning processes that may not be successful thus far for the
student; and (4) weekly formative assessment that is focused on an integrative and
cumulative approach to learning within the clinical laboratory science curriculum. The
self-directed learning readiness (SDLR) score was utilized to assess the learner’s
attitudes, skills, and behavior toward taking responsibility for their own learning. GPA at
the end of the year was used to determine if SDL activities was linked to academic
success in the clinical laboratory science program.
Clinical Laboratory Science students (n=50) participated in this study. Cohort #1
was the comparison group (n=25) and Cohort #2 received the treatment (n=25). Before
treatment, both cohorts were similar demographically and had similar overall grade point
averages.
Hypothesis I stated that no statistically significant differences exist in self-
directed learning readiness scores for undergraduate students transitioning from a
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traditional academic environment into a pre-professional program of study when they are
deliberately exposed to self-directed learning activities in the clinical laboratory science
curriculum when compared to the scores of undergraduate students transitioning from a
traditional academic environment into a pre-professional program of study who have not
been exposed to self-directed learning activities.
Data were analyzed using the independent t test and findings demonstrated that
statistically significant differences did not exist between Cohort #1 post-test SDLR scores
and Cohort #2 post-test SDLRS scores after treatment.
Hypothesis II stated that no statistically significant differences exist in GPA for
students enrolled in the clinical laboratory science program who experienced self-directed
learning activities compared to the GPA of students who did not experience self-directed
learning activities. The independent t-test was calculated to compare the GPAs at the
conclusion of one year (two semesters) for Cohort #1 and Cohort #2. A statistically
significant difference did exist related to GPA for students enrolled in the clinical
laboratory science program who experienced self-directed learning activities compared to
the GPA of students who did not experience self-directed learning activities. The finding
supports the idea that students enrolled in the Clinical Laboratory Science program who
experienced self-directed learning activities have a higher GPA than those students who
did not experience self-directed learning activities.
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Conclusions and Discussion
Findings related to Hypothesis I showed no statistically significant differences
between Cohort #1 post-test SDLR scores and Cohort #2 post-test SDLR scores after
treatment. This supports the findings of Wiley (1982) who investigated the effects of a
process-oriented, self-directed learning project and the personal preference for structure
on self-directed learning readiness among 104 undergraduate student aged 20-21 years
old. Wiley noted that SDLR scores did not increase from pretest to post-test for this
group of undergraduate students. Williams (2004) utilized the SDLRS to examine the
effect on nursing students exposed to a problem based learning program of self-directed
learning for one year. No significant findings were reported. In similar studies
examining the change in SDLR scores related to exposure to alternate self-directed
learning activities, Frisby (1991) investigated self-directed learning readiness in medical
students among two groups: the independent study students and the lecture-discussion
students. Frisby found no difference in SDLR scores among the two groups. These
findings suggest that exposure to SDL activities does not increase SDL readiness in
students. In contrast, Palumbo (1989) utilized a pretest post-test design to measure
change in SDLR scores of undergraduate nurses over time (1.5 years). There was a
significant change in the SDLR scores. Murray (1998) utilized the pretest post-test design
to determine the effect of participation of undergraduate nursing students in a clinical
internship on SDL. It was reported that the experimental group who participated in the
clinical internship differed significantly between the pretest and post-test SDLR scores.
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The findings suggest that the construct of the SDL activities and length of exposure does
matter and that the process for developing SDL activities to enhance SDL is complex.
Hypothesis II showed a statistically significant difference did exist related to GPA
for students enrolled in the clinical laboratory science program who experienced self-
directed learning activities compared to the GPA of students who did not experience self-
directed learning activities. This supports the findings of Murray (1988) who noted
participation in SDL related activities such as a clinical internship were related to GPA.
These finding suggests that assessment and outcomes may drive the self-directed learning
process in formal education settings. Miflin (2000) reported that students base their self-
study decision on what they expected the test to be. Schmidt (2000) noted that
assessment drives student learning in student oriented curricula to the “same extent” as in
conventional curricula. The gain in GPA for Cohort #2, who received the treatment of
exposure to SDL activities, is worth noting and contributes to the knowledge that self-
directed learning as an instructional method does improve student outcomes. In addition,
the weekly cumulative, formative assessments, which were part of the treatment for
Cohort #2, were developed to promote cumulative learning within the clinical laboratory
science curriculum for the fall and spring semesters may also have improved the ending
GPA for Cohort #2.
The Self-Directed Learning Readiness Survey was used to assess the learner’s
attitudes, skills, and behavior toward taking responsibility for their own learning. A
statistically significant difference was identified, specifically there was a drop in mean
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SDLR score for the comparison group from 236.76 to 228.40 (8.36 points). The pretest
post-test group mean SDLR scores for Cohort #2 revealed no statistically significant
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