Academic journal article Educational Technology & Society

What Drives Nurses' Blended E-Learning Continuance Intention?

Academic journal article Educational Technology & Society

What Drives Nurses' Blended E-Learning Continuance Intention?

Article excerpt


Currently, blended learning combining face-to-face and online elements provides learners with a hybrid learning environment (Delialioglu, 2012), and it has been widely used in nursing education because of the flexibility afforded by this type of learning (Jonas & Burns, 2010; Smyth, Houghton, Cooney, & Casey, 2012). However, nurse staffing shortages and increased workload have gradually interrupted nurses' family life and learning (Jonas & Burns, 2010; Tsang, Chen, Wang, & Tai, 2012), thus nurses still experience difficulty accessing further education even if they complete the courses via blended learning which combines a few days in authentic classrooms/laboratories and most time online. As compared to blended learning, blended electronic learning (e-learning) combines asynchronous and synchronous e-learning to provide learners with access to asynchronous and synchronous communication (Donnelly, 2010), thus it can assist instructors in achieving more effective teaching strategies and help for attracting more learners by offering better flexibility of the learning process (Zuvic-Butorac, Nebic, Nemcanin, Mikac, & Lucin, 2011). Hence, introducing blended e-learning in nursing education may further become a more flexible solution for nurses' continuing education programs, especially for nurses with high workload and family commitments.

Essentially, there is increasing attention to blended e-learning as a flexible way of developing continuing education programs for nurses, and it has been accepted by its intended nurses (Hoffman et al., 2011; Jonas & Burns, 2010; Smyth et al., 2012). Noteworthily, while users' initial acceptance of the information system (IS)/information technology (IT) is the first step towards its success, the eventual success of the IS/IT depends on its continued usage (Wu, 2013). However, far less emphasis has been placed on understanding whether nurses intend to continue using blended e-learning after having initially accepted it. Besides, prior studies (e.g., Liang, Wu, & Tsai, 2011; Tung & Chang, 2008) have explained nurses' e-learning acceptance based on their utilitarian perceptions of the IS/IT, but simply focusing on nurses' extrinsic motivators of e-learning may not be enough. Virtually, users' IS/IT adoption may not be only determined by their utilitarian perceptions of the IS/IT but also by a good fit between their tasks and the IS/IT (Zhou, Lu, & Wang, 2010) and the influences of other users (Lee, 2010). Presently, the expectation--confirmation model (ECM), proposed by Bhattacherjee (2001a), is one of the most widely applied models in a variety of domains on continued IS usage (Kang, Hong, & Lee, 2009), and it can be used as the base for this study's research model. Accordingly, this study's purpose was to integrate user network and task -technology fit (TTF) as antecedents to fill the gaps of ECM in explaining nurses' intention to continue using the blended e-learning system within medical institutions.

Theoretical background, hypotheses, and research model


Based on the expectation-confirmation theory (ECT) in the field of consumer behavior, Bhattacherjee (2001a) developed the ECM of IS continuance. ECM makes changes to the ECT by transforming the difference between pre-consumption expectation and experienced performance into a pure post-acceptance model in the field of IS continued use, and it posits that users' intention to continue IS/IT usage is dependent on perceived usefulness (PU; i.e., post-adoption expectation), the extent of users' confirmation, and users' satisfaction with the IS/IT (Bhattacherjee, 2001a, 2001b). PU is defined as "the degree to which a person believes that using a particular system would enhance his/her job performance" (Davis, 1989, p. 320). Confirmation refers to the degree of users' perception of the congruence between expectation of IS/IT use and its actual performance (Bhattacherjee, 2001a). …

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