SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 1

Self-directed learning in healthcare industry

Vera Kovaleva

University of Twente

Author Note

Vera Kovaleva, Faculty of Behavioral Sciences, University of Twente

Correspondence concerning this article should be addressed to Vera Kovaleva, Faculty

of Behavioral Science, University of Twente, P.O. Box 217, 7500 AE Enschede, The

Netherlands. Phone: +31 53 000 0000; Fax: +31 53 11 1111; E-mail:

v.kovaleva@student.utwente.nl.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 2

Abstract

Developing employees in healthcare industry requires enriching working processes with self-
directed learning. Longlife learning for healthcare professionals is a part of modern highly
competitive world. Therefore, human resource development in healthcare industry requires
understanding predictors of self-directed learning. A research was conducted among 494
healthcare employees, 18-64 years old with a work experience from zero up to 48 years. In
total 20 variables, 15 of which formed four predictors, were analysed. Three predictors of
self-directed learning were investigated: job mobility, learning potential and proactive
personality. It was concluded that proactive personality is a strong predictor of self-directed
learning, while learning potential was not confirmed as predictor. At the same time higher job
mobility predicts lower self-directed learning potential. Therefore, proactive personality
should be given special attention in self-directed learning development for healthcare
professionals.

Keywords: self-directed learning; healthcare employees; predictors of self-directed learning;

adult learning.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 3

Contents

1. Introduction 4
2. Theoretical framework 4
3. Research question 5
4. Method 6
5. Results 7
6. Discussion 9
References 12
Appendix 13

Abstract

Contents
1. Introduction
2. Theoretical framework
3. Research question and hypotheses
4. Method
-Participants & Design
-Instruments & Data analysis
-Procedure
5. Results
6. Discussion
-Factors influencing self-directed learning
-Theoretical & practical implications
-Limitations and future research
References
Appendix
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 4

Self-directed learning in healthcare industry

1. Introduction
Self-directed learning (SDL) is a powerful adult learning theory in the area of adult
education (Ellinger, 2004), which started as a discipline of adult learning in the 1920s. SDL
was an attempt to define adult education as a unique field of practice, one that could be
differentiated from learning in general and childhood education in particular. Merriam (2001)
noted that there is no single theory or model which can fully describe the nature of self-
directed learning, because it is a complex phenomenon. According to Merriam (2001), self-
directed learning can be described as a mosaic of definitions, knowledge, models and theories
that describe this phenomenon.
Self-directed learning is a type of learning in which learners have the agency to plan,
carry out, and evaluate their own learning and may be done with or without the help of others
(Ellinger, 2004). In 1975 Knowles defined SDL as a process led under the initiative or their
own, with or without help of other people, setting the learning goals, creating the learning
strategy and implementing the learning process itself. Over 16 years, in 1991, Brockett and
Hiemstra noted that learner self-direction can be described as a personality construct. As
Knowels, they underlined the learner’s personal responsibility for the educational process.
Self-directed learning, where learners have the leading role in their lifelong education,
is an important part of human resource development (HRD) in modern companies.
Guglielmino’s (1977) described a wide range of stakeholders, among which are company
leaders and human resource professionals who are creating both formal and informal learning
structures which support professionals in their lifelong learning, which is crucial for the
modern fast-changing world. Therefore, the company which supports SDL, can become an
important partner for its employees by supporting their lifelong development and creating
necessary environments. Wildemeersch et al. (2000) states that being not the exclusive partner
in a person’s lifelong learning process, a company still plays one of the most important roles
in education of such kind, because the market positions of the company are connected with
the skillfulness and educational level of its employees.

2. Theoretical framework
Organizations are motivated to provide environments that encourage individual
learning and development since it can increase employees’ and overall performance (Ellinger,
2004). In present days organizations use this practice when they want their employees to be
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 5

competitive in the modern fast-changing world, full of technological innovations, job mobility
and raising personal influence in work (Raemdonck, 2006). Employees benefit from SDL
because individuals who are in charge of their own learning are more likely to be employed
and advanced in their employment (Ellinger, 2004). Merriam (2001) identifies three goals of
SDL: the development of the learner’s capacity to be self-directed, the fostering of
transformational learning and the promotion of emancipatory learning and social action. Self-
directed learning, where learners have the leading role in their lifelong education, is an
important part of human resource development (HDR) in modern companies.
The company who supports SDL, can become an important partner for its employees
by supporting their lifelong development and creating necessary environments. Among the
main characteristics of the companies which support self-directed learning, are: tolerance for
errors, encouraging experiments and creativity, using delegation and trusting their employees,
supporting their learning initiatives, openness for new ideas, strong collaboration and
teamwork culture (Confessore and Kops, 1998, as cited in Ellinger, 2004).
The goal of this study is to investigate the relation between SDL, job mobility,
learning potential, and proactive personality. Prior studies that attempted to link different
variables with SDL have resulted in confusing and opposing results (Ellinger, 2004).
Therefore, more research is needed in order to learn more about SDL and how organizations,
especially healthcare organizations, can benefit from SDL.

3. Research question
For the present study the research question was formulated as follows: “What is the
relationship between job mobility, learning potential, proactive personality and engaging in
self-directed learning among healthcare employees?”. To investigate this research question,
three hypotheses were formulated.
Hypotheses:
 Employees who have higher job mobility engage more in self-directed learning;
 Employees who have higher learning potential engage more in self-directed learning;
 Employees who have a more proactive personality engage more in self-directed
learning.
There are many parameters that can influence self-directed learning. One of them is
proactive personality. A proactive individual is one who usually takes personal initiative in
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 6

any situation (Raemdonck et al., 2012). This is helpful for SDL because learners need to take
personal responsibility for their own learning (Raemdonck et al., 2012; Ellinger, 2004).

4. Method
Participants & Design
The sample included 494 employees (80% female) from Dutch health care industry.
Employees ranged in age from 18 to 64 years (M = 40.77 years, SD = 12.95). The majority
reported secondary vocational education and professional university as their highest
educational degree (47.25% and 26.88% of the participants respectively). Participants’ work
experience in health care raged from zero to 45 years (M = 15.27 years, SD = 11.35). The
majority reported that their job fits the category of accompanist or service coordinator
(60.62% and 12.37% of the participants respectively). Job mobility was actual for 58.5% of
participants.

Instruments & Data analysis

In line with the research question, the study investigated a number of predictors of
self-directed learning: job mobility, proactive personality and learning potential. Job mobility
is measured by one item. The question for this item is: “Do you pursue a different position for
your future career?”. The answer was “yes” for 58.5% of the respondents.
Proactive personality was measured by three items. These items included answers to
statements: “I excel in detecting opportunities”, “I spot a good opportunity, long before others
do” and “Nothing is more exciting than to see my ideas become reality”. Cronbach’s alpha for
proactive personality variable is equal to 0.88.
Learning potential was measured by six items. These items included answers to
statements: “I am committed to seek learning opportunities”, “My supervisors often schedule
meetings during which we can learn from each others' experience”, “I learn something new
every day”, “This job offers opportunities for promotion”, “In my job I have opportunities to
educate and develop myself” and “My boss wants me to participate in courses”. Cronbach’s
alpha for learning potential is equal to 0.92.
Finally, self-directed learning as a dependent variable consists of five items. Self-
directed learning includes statements: “I do not give up when I am learning something
difficult”, “I know which steps to take when I want to learn something new”, “I sense myself
when it is time to learn additional things for work”, “I test myself to know if I've learned
something thoroughly” and “I always find the time if I want to learn something new”.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 7

Cronbach’s alpha for self-directed learning is equal to 0.73. Overall, all variables mentioned
above, have a valid level of reliability.

Table 1
Cronbach’s Alpha

Self-directed learning 0.73

Proactive personality 0.88

Learning potential 0.92

Analysis of influence of predictor variables on dependent variable was performed via

multiple linear regression.

To instruments The first cluster of questions was about objective factors parameters,

such as age, sex, educational level or job position.

Procedure

For present research healthcare employees were asked to answer a number of

questions about different aspects of their work. Another part of the questions was asked

mainly about subjective attitude to different characteristics of the job or attitude towards it.

Instrument Subjective questions consisted of 20 items which formed one dependent and four

independent variables. Three out of four independent variables were analysed in the present

study.

5. Results

RQ, Structure of results session

DATA ANALYSIS To investigate the research question and determine whether proactive

personality, learning potential and job mobility predict self-directed learning, a multiple linear

regression analysis and correlations were analysed. The Results section includes the overview

and analysis of each predictor variable and its influence on the dependent variable.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 8

Descriptive statistics and correlations

This analysis revealed that the overall model was significant, R2 = 0.45, F (3, 422) =

116.69, p < 0.001. Investigation of the parameters showed that proactive personality

positively impacted on self-directed learning B = 0.14, SE = 0.03, t (425) = 4.97, p < 0.001.

Also, learning potential has B = -0.01, SE = 0.03, t (425) = -0.42, p = 0.672. With a P-value

more that 0.05 this result is not significant and learning potential in this analysis does not

predict an impact on self-learning development. This means that, on average, individuals with

higher proactive personality, score higher on self-directed learning than people with lower

proactive personality. Finally, job mobility has B = -0.75, SE = 0.04, t (425) = -16.83, p <

0.001. This means that job mobility has a negative effect on self-directed learning: the higher

job mobility, the less self-directed learning potential. (Table 2)

Table 2
Standardized Estimates Resulting from the Linear Regression Analysis with Self-directed
Learning as the Dependent Variable
 p
Learning potential -0.13 0.672

Proactive pesonality 0.137 0.001

Job mobility -0.75 0.001

Correlation between job mobility and self-directed learning is -0.65. Associated P-

value is 0.01. Correlation between job mobility and learning potential is -0.01. Associated P-
value is 0.93, which is not significant correlation. Correlation between job mobility and
proactive personality is -0.18. Associated P-value is 0.01.
Correlation between self-directed learning and learning potential and is -0.03.
Associated P-value is 0.49. Correlation between self-directed learning and proactive
personality is 0.28. Associated P-value is 0.01. Correlation between learning potential and
proactive personality is -0.08. Associated P-value is 0.12, which is not significant correlation.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 9

Table 3
Pearson Correlations and Descriptive Statistics of Study Variables
Job Self- Learning Proactive
mobility directed potential pesonality
learning
1.Job mobility

2.Self-directed -0.65
learning

3.Learning potential 0.01 -0.03

4.Proactive -0.18 0.28 -0.08

pesonality
Mean 0.59 3.71 3.85 3.07

SD 0.49 0.59 0.69 0.81

Types of questions and analyses

To answer the research question: “What is the relationship between job mobility,
learning potential, proactive personality and engaging in self-directed learning among
healthcare employees?”, three hypotheses were investigated. To analyse the first hypothesis:
“Employees who have higher job mobility engage more in self-directed learning”, answers to
one question were gathered. Participants answered the question about their job mobility: “Do
you pursue a different position for your future career?”. Possible answers were “yes” or “no”.
To investigate the second hypothesis: “Employees who have higher learning potential
engage more in self-directed learning”, an independent variable called “learning potential”
was constructed out of six items. To investigate the third hypothesis: “Employees who have
more proactive personality engage more in self-directed learning”, an independent variable
called “proactive personality” was constructed out of three items.
Analysis of the answers to the questions which were included in items was conducted
by linear multiple regression, Cronbach’s Alpha, standard deviation, Pearson correlations and
factor analysis.

6. Discussion
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 10

This study has examined the relationship between job mobility, learning potential,
proactive personality and engaging in self-directed learning among healthcare employee. We
expected that employees who have (1) higher job mobility, (2) higher learning potential and
(3) more proactive personality engages more in self-directed learning. The relationship
between job mobility, learning potential, proactive personality and self-directed learning was
not confirmed by our findings. According to data analysis, learning potential does not have an
impact on self-learning development, while proactive personality and job mobility can have
such an impact. On average, individuals with higher proactive personality, score higher on
self-directed learning than people with lower proactive personality. And, on average,
individuals with higher job mobility, score lower on self-directed learning than people with
lower job mobility.

Theoretical & practical implications

The present study investigated the influence of job mobility, learning potential and
proactivity of a healthcare employee on their self-directed learning potential. The research
contributes to a paradigm of continuing medical education (CME), which is highly self-
directed and aiming to constantly develop and improve competencies of healthcare
professionals (Bennett et al., 2000). According to Bennett et al. (2000), CME includes a wide
range of learning activities that healthcare professionals engage in the context of life-long
education. The results of present study can help in planning learning activities in healthcare
industry by taking into account that proactive personality positively influences on self-
directed learning, while higher job mobility has a negative influence on it.
For practitioners and education professionals this means that possibly employees with
a high job mobility will need a different education strategy or strategy for developing their
self-directed learning. Possible way of developing continuing medical education for
professionals with a higher job mobility can be connected with use of machine learning
technologies. According to Gureckis & Markant (2012) machine learning helps to implement
self-directed learning more efficiently by using cognitive models to find out what information
is the most needed by the individual. This can help healthcare professionals with high job
mobility and lower score of self-directed learning to learn while moving to different places,
from travelling to conferences to changing constantly the location of hospital or branch inside
healthcare organization.
The present study gives educational designers in healthcare industry a clear focus in
human resource development approaches on the connection between job mobility, proactive
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 11

personality and self-directed learning. Concretely, this implies the need for HR-practices
where healthcare employees take initiative to undertake learning activities and plan future
careers.

Limitations and future research

The present study has some limitations. The first limitation is some predictor variables
(proactive personality, learning potential, job mobility) were measured with different quantity
of items in scales – from 1 to 6 items for one predictor variable, thus causing different “depth”
of the variables. The results can be verified by constructing more unified variables. For
example, in future in-depth research it is possible to investigate self-directed learning when
each of the predictor variables (job mobility, learning potential, proactive personality) is
constructed of 3 items or of 6 items.
Secondly, the present study builds on subjective answers of employees to questions.
For constructing a more objective picture in the future research it is possible to add to
subjective answers some objective information about different characteristics of healthcare
jobs. Thirdly, the sample was drawn from only one branch of the healthcare industry. Future
studies may include healthcare professionals from different branches of the industry.
Furthermore, in future research should investigate a broader range of predictor variables of
self-directed learning, including some very specific for healthcare. For example, one of the
predictor variables can be the level of professional burnout among disaster medicine doctors.
Finally, a broader research can be a step towards developing different strategies of
self-directed learning for professionals in different branches of healthcare industry. Besides,
subjective reflection of healthcare employees can be investigated according to specific
corporate aspects – from small local hospitals to a big international healthcare organizations.
On the other hand, research should include objective factors outside the company context:
family composition, income level, country of origin, chronic diseases of healthcare
employees.
Current study contributes to an understanding of the predictors which influence the
self-directed learning of healthcare employees. To form a more voluminous picture,
subsequent studies should complement the research data by investigating a range of objective
factors inside and outside healthcare organizations that might influence self-directed learning
of healthcare professionals.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 12

References

Bennett N., Davis D., Easterling W., Friedmann P., Green J., Koeppen B., Mazmanian P.,
Waxman H. Continuing Medical Education: A New Vision of the Professional
Development of Physicians. Academic Medicine, vol. 75, no. 12 / December 2000.
Brockett R., Hiemstra R., 1991. Self-Direction in Adult Learning: Perspectives on Theory,
Research, and Practice. London: Routledge.
Ellinger A., 2004. “The Concept of Self-Directed Learning and Its Implications for Human
Resource Development”, Advances in Developing Human Resources Vol. 6, No. 2
May 2004 158-177 DOI: 10.1177/1523422304263327
Gureckis T., Markant D., 2012. Self-Directed Learning: A Cognitive and Computational
Perspective. Perspectives on Psychological Science, September 2012. DOI:
10.1177/1745691612454304
Knowles, M,1975. Self-directed learning. New York: Association Press.
Merriam S., 2001. “Andragogy and Self-Directed Learning: Pillars of Adult Learning
Theory”, New Directions for Adult and Continuing Education 2001(89):3 – 14,
March 2001. DOI: 10.1002/ace.3.
Raemdonck I., 2006. “Self-directedness in learning and career processes. A study in lower-
qualified employees in Flanders”.
Raemdonck, I., Leeden, R. V., Valcke, M., Segers, M., & Thijssen, J. (2012). Predictors of
self‐directed learning for low‐qualified employees: A multi‐level analysis. European
Journal of Training and Development, 36(6), 572-591.
doi:10.1108/03090591211245495
Wildemeersch D., Finger M., Jansen T., 2000. Adult Education and Social Responsibility:

Reconciling the Irreconcilable?

SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 13

Appendix

Table 4
Factor Loadings Resulting from a Principal Component Factor Analysis Using Oblique
Rotation (N = XX)
Explained variance = 57.69

Factor loadings
Learning Proactive Job Feedback Self-
Item potential pesonality complexity from others directed
learning
I am committed to ,852 -,010 -,112 -,054 -,010
seek learning
opportunities
My supervisors often ,827 -,027 ,074 ,026 ,056
schedule meetings
during which we can
learn from each
others' experience
I learn something ,807 -,006 ,027 ,037 -,038
new every day
This job offers ,800 ,036 ,037 ,034 -,044
opportunities for
promotion
In my job I have ,020 -,095 -,032 -,013
opportunities to
,787
educate and develop
myself
Item12Reversed ,779 -,024 ,130 ,012 ,061
I excel in detecting -,005 ,998 -,003
,033 -,059
opportunities
I spot a good ,021 ,828 ,018 ,020 ,027
opportunity, long
before others do
Nothing is more -,013 ,723 -,010 -,053 ,038
exciting than to see
my ideas become
reality
In my job I have to -,065 ,018 ,895 ,050 ,013
use several complex
skills
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 14

My job description is ,006 ,010 ,774 -,009 -,018

such that I cannot
complete my work
from beginning to
end
It took me more than ,081 -,024 ,759 -,045 -,018
6 months to fully
master my job
I receive feedback ,010 ,008 -,080 ,721 -,033
on my performance
from other people in
my organization
(such as my manager
or coworkers).
I receive information ,010 -,033 ,006 ,714 -,015
from my manager
about my job
performance
regularly
Other people in the ,010 ,019 ,059 ,652 ,041
organization, such as
coworkers, provide
me with information
about the
effectiveness (e.g.,
quality and quantity)
of my job
performance.
I do not give up ,010 -,025 -,029 -,027 ,722
when I am learning
something difficult
I know which steps ,010 ,017 ,001 -,013 ,638
to take when I want
to learn something
new
I sense myself when ,010 -,011 -,001 -,032 ,608
it is time to learn
additional things for
work
I test myself to know ,010 ,021 -,060 ,058 ,573
if I've learned
something
thoroughly
I always find the ,010 ,014 ,052 ,007 ,447
time if I want to
learn something new
Note. factor loadings over .40 appear in bold.
SELF-DIRECTED LEARNING IN HEALTHCARE INDUSTRY 15