Process of change in nursing education in the Arab Gulf region.
A three-phased, cross-sectional study was conducted in the nursing schools in two Arab Gulf countries (the UAE and Bahrain) to assess the process of change in Nursing education. The illuminative approach to evaluation using a case study design was used. Different methods were utilized to collect data, namely interviews, documentary analysis and self-administered questionnaires. In the initial phase of the study, the directors of the Schools of Nursing were involved. A theoretical sample of a wide range of tutors, students and counselors was included. The interviews were conducted using a semi-structured interview format. Seventeen faculty members from Bahrain, and seventeen from two institutes of nursing in the UAE, namely Abu Dhabi and Sharjah, were interviewed. Students were interviewed from three academic levels of the program. Thirteen students in Bahrain and nineteen in the UAE participated in the interviews. The N-Vivo qualitative program was used to analyze the qualitative interviews. In the second phase of the study, all faculty who taught case-based courses in Bahrain and the UAE were asked to participate in the study; 24 from the UAE and 30 from Bahrain. A 20% random sample of students from the three academic levels in the UAE and 25% from the two academic levels in Bahrain was used. Sixty-four students from the UAE and forty-six from Bahrain answered the self-administered questionnaire. The questionnaire used data extrapolated from the qualitative interviews. The SPSS (version 11) was used to analyze the self-administered questionnaire. T-test and correlation tests were employed at this stage to analyze data. In both countries, innovation attributes, especially complexity and incompatibility with the students' and the faculty's background, were perceived by both faculty and students as hindering the dissemination of innovation. In both countries a strong training program that tackled concerns of both old and new faculty members was lacking. Planning for a sustainable system and team approach to change was lacking in both countries to varying degrees. Differences were noted between the UAE and Bahrain in the introduction and implementation of change. The UAE faculty perceived their involvement in the choice of a case-based curriculum as a major facilitating factor. Other factors perceived by the UAE faculty as facilitating the process of change were the planned series of workshops, involvement of the faculty in decision-making and the secondment of an external expert during the implementation of the innovation. The Bahrain faculty perceived the leadership style of forcing change as deterring the process of change. The institutional context, the lack of planning, the lack of a common meaning of change among faculty and other stakeholders, and the lack of structured professional development program were other factors perceived as hindering change. The study led to the development of a framework for introducing educational change in the Arab Gulf region. It is hoped that the framework would help decision-makers and leaders of educational institutions understand change better and be able to introduce and monitor change effectively. The major recommendations tackled developing a continuing staff development program, building multidisciplinary teams, planning and monitoring the change process and establishing a common meaning of change from the beginning of any change. Conducting further research on the perceptions of key political stakeholder towards change and researching the managerial practices of nursing leaders could serve as an initial step towards the validation of the suggested framework.