Distance education Doctoral program for nurses as offered by the University of South Africa (U N IS A )

Background Inform ation Unisa The purpose of this article is to provide brief overviews of distance education, the development of the University of South Africa (Unisa) and the Departm ent of Advanced Nursing Sci­ ences at this university. Doctoral programs as offered by this Department will be discussed in some detail. Distance edu­ cation courses are offered throughout the world, but doctoral programs, especially in the field o f Nursing Sciences, are not offered by all distance education institutions. There are numerous forms o f and definitions for distance edu­ cation. They all have only one thing in common, namely the physical distance between the students and the teachers, and usually the absence of students from classrooms and even from entire university cam puses. Pym (in R einert & Fryback 1997:42) aptly described distance education as “ ...a set o f teaching and learning strategies fo r connecting people who have learning needs with the resources required to meet those needs". Distance education has been offered in many forms for nearly 150 years (Rowntree in Reinert & Fryback 1997:42). In 1873 the University of the Cape of Good Hope, later to be renamed the University o f South A frica (Unisa), modelled after the University of London as it existed at that time, was founded. Initially this University acted solely as an examin­ ing body, but commenced teaching external students by means of correspondence methods in 1946. Students can write their examinations at more than 450 ex­ amination centers throughout the world. During 1998, Unisa conferred a total o f 12 402 diplomas and degrees, including 400 M asters’ and 83 Doctoral degrees, o f which three were awarded by the Department of Advanced Nursing Sciences.


Background Inform ation Unisa
The purpose of this article is to provide b rief overview s of distance education, the developm ent o f the University o f South Africa (Unisa) and the D epartm ent o f A dvanced N ursing Sci ences at this university.D octoral program s as offered by this Departm ent will be discussed in som e detail.Distance edu cation courses are offered throughout the world, but doctoral program s, especially in the field o f N ursing Sciences, are not offered by all distance education institutions.There are num erous forms o f and definitions for distance edu cation.They all have only one thing in com m on, nam ely the physical distance betw een the students and the teachers, and usually the absence o f students from classroom s and even from entire u niv ersity cam puses.Pym (in R ein ert & F ryback 1997:42) aptly described distance education as " ...a set o f teaching a nd learning strategies f o r connecting people who have learning needs with the resources required to m eet those needs".D istance education has been offered in many forms for nearly 150 years (Rowntree in Reinert & Fryback 1997:42).In 1873 the U niversity o f the Cape o f G ood Hope, later to be renamed the U niversity o f South A frica (U nisa), modelled after the U niversity o f London as it existed at that time, was founded.Initially this U niversity acted solely as an exam in ing body, but com m enced teaching external students by means of correspondence methods in 1946.Students can write their exam inations at m ore than 450 ex amination centers throughout the world.D uring 1998, Unisa conferred a total o f 12 402 diplom as and degrees, including 400 M asters' and 83 Doctoral degrees, o f w hich three were awarded by the D epartm ent o f A dvanced N ursing Sciences.
The D e p a rtm e n t of A d va n c e d Nursing

Sciences, Unisa
This D epartm ent was established during 1975, adm itting its first students during 1976 and boasting its first graduates during April 1978 graduation cerem onies.The Departm ent offers undergraduate and diplom a distance education courses only to registered professional nurses w ishing to obtain post basic qualifications in H ealth Services M anagem ent, N urs ing E ducation, C om m unity H ealth N ursing, O ccupational Health N ursing and G erontological N ursing by pursuing un dergraduate degree and/or diplom a courses.This Departm ent fulfils the South African Nursing Council's (SANC's) require ments, enabling the successful candidates to register their ad ditional qualifications with the SANC.At post graduate level the Departm ent offers a research based M aster's degree (for students possessing Honours degrees), a course content M aster's degree comprising five papers and a research dissertation (for students without Honours degrees) and a M aster's degree specializing in Clinical Nursing Care -only available to students working in selected services where preceptors can be provided.During 1999 the total number of students registered for the different courses were: The total num ber of successful candidates until the end of 1998 amounted to 25.During 1999 the students registered for the D Litt et Phil degree were 37 -from the RSA (17), Botswana (4), Lesotho (4), Malawi (1), Swaziland (5), Zam bia (1), Zimbabwe (3) and the United States of America (1 who moved to New York from Botswana during his studies).
The fields in which these 37 students were conducting their research could be categorized as falling into: Students select their own fields o f research usually in accord ance with needs perceived by their employers, or their coun tries' identified health and/or nursing care priorities.

Admission requirements
Any student wishing to be admitted to the

Duration of course
The minimum duration is two years, but most students re quire more than four years to complete their research and submit their theses for examination.After a period o f four years has elapsed, the prom oter needs to submit a written motivation as to why the student should be allowed to regis ter for periods exceeding four years.Annual re-registration depends on progress reports submitted by the promoter(s).The rationale underlying this requirement is that inform a tion changes rapidly and students who take too long to com plete their research and their theses run the risk of presenting outdated data.Most students are full time employees occu pying demanding positions which leave limited time for pur suing their doctoral studies.Mainly those students who can m anage to obtain study leave ranging from six to twelve months manage to complete their doctoral research and the ses within five years.
Organization of course: role of student and of promoter(s)

Health Education 3
The prom oter and joint prom oter are appointed in accord ance with their research interests and expertise, taking their respective academic responsibilities into account.The D Litt et Phil degree as offered by the D epartm ent o f Advanced Nursing Sciences, Unisa, would seem to be similar to the D Phil degree offered in the USA, as described by Gorney-Fadiman (1981:654).In cases where students register at Unisa from foreign countries, these students are encouraged to con duct research in their respective countries, and co-promoters are appointed from the countries concerned if at all possible.
In this way students are encouraged to conduct research mean ingful and applicable to their own countries, the research ca pacities o f the countries concerned are developed, and the members of staff can knowledge and expertise about the health care situations in a numbers o f different countries.
The initial role o f the student really amounts to reading and compiling the chapters o f the proposed thesis.Registered doctoral students can access the Unisa library by means of the Unisa Web-page, by fax, telephone or by e-mail.Once the student's registration has been processed the Unisa li brarian will compile a list of available literature, based on keywords supplied by the student, using a variety of com pu ter retrieval systems.This is supplied free o f charge to the student, who then selects those items deemed relevant to the particular research.Books can be borrowed and photocopies o f articles obtained free o f charge from the Unisa library (the student only pays for the return postage o f the books).Na tional and international interlibrary loan facilities can also be utilized -free o f charge.
The student is expected to subm it chapter-by-chapter for re view and com m ents by both the prom oter and co-promoter.After data collection, statisticians and com puter operators analyze the data and provide the student w ith com puter print outs.It is up to the student to interpret the statistical find ings and to obtain statistical, typing as w ell as editorial ex pertise to present an acceptable thesis.Editorial assistance is a requirem ent as m ost students present their theses in Eng lish which m ight be their second or even third language.The students need to inform the university in writing by specified dates should they consider handing in their theses for exam i nation.The prom oters need to approve each student's appli cation.Subsequent to such approval, exam iners are appointed.

Exam ination
No form al exam ination is conducted.(U ntil the beginning of the 1990s each doctoral candidate was subjected to an oral examination by internal and external exam iners, but this was discontinued due to financial and tim e constraints).
Four bound copies o f the com pleted thesis are subm itted for examination by the prom oter, co-prom oter and at least two additional external exam iners from tw o different universi ties.In the case w here a co-prom oter had been appointed from a field other than nursing, at least one external exam iner will be appointed from the sam e field.The four exam in ers submit their independent reports to a non-exam ining chair person w ho prepares a com bined report for the exam ination committee.The exam iners' reports need to specify what contributions the thesis could m ake tow ards the science o f nursing.Each exam iner needs to indicate w hether the thesis can be accepted unam ended, w hether specific aspects require amendments or whether it should be rejected.Examiners are also encouraged to indicate w hether the thesis, or parts thereof, would be suitable for publication.No mark is allo cated, and no distinctions can be awarded, because a D Litt et Phil degree is accepted as being worthy o f a distinction.Should there be marked differences among the examiners, an additional exam iner might be appointed, or the student could be offered an oral examination opportunity, or the exam ina tion com m ittee may decide to offer the student one more chance to am end the thesis.In the case o f minor am end ments the prom oter and co-prom oter need to inform the com mittee when the candidate had fulfilled the specifications, but in the case o f m ajor changes/improvements the thesis needs to be resubm itted for re-exam ination by four or more examin ers.
Currently publications in scholarly journals are not required, prior to aw arding the D Litt et Phil degree, but this possibil ity is being investigated.Students are encouraged to publish relevant aspects of their theses, and where applicable, pro moters and/or co-prom oters act as co-authors.Publication in accredited journals and peer reviews prior to submitting the thesis for exam ination purposes could add another dim en sion to the quality assurance aspect of the distance education D Litt et Phil program.In this way the research results could also be dispersed to a wider academ ic forum.

Advantages and Disadvantages of a distance education doctoral program
The m ajor personal advantage for the student o f pursuing this distance education D Litt et Phil program is the ability to continue with his/her life and work obviating family disrup tions by relocating to a university city, or even to a different country.Sim ilarly the health care services are not disrupted by the absence o f numbers of senior personnel.Students who continue with their jobs while pursuing their studies are more likely to rem ain in their countries once they have ob tained their doctoral qualifications than those who relocate to other countries or continents for study purposes.Because the students rem ain within their comm unities, their fields of re search are usually relevant to their specific com m unities' needs.
Ironically the very advantage o f being able to continue with one's work and life whilst pursuing doctoral studies, is also its major disadvantage.This is the case because the studies are then simply just added on top o f all the other responsibili ties, whilst students who relocate to universities to pursue full time doctoral studies, need not fulfil their jo b obligations during this period, and sometimes other persons fulfil their family obligations as well.Thus the students pursuing dis tance education courses can be expected to take much longer to complete their studies than those who pursue full time stud ies at residential universities.Students who have made sub stantial progress with their studies are encouraged to apply for study leave, ideally once they have collected and analyzed their data.Study leave definitely enhances the students' chances o f achieving success, although a number o f students have m anaged to com plete their studies without any study leave whatsoever.
Another disadvantage is the "distance" involved in distance education.Although students are encouraged to meet their promoters personally, this is not always possible.Telephone, fax and e-m ail contacts are encouraged.These can all be problematic in Africa where even e-mails often function by land lines which are disrupted every tim e any length o f cop per wire "goes m issing" .Postal services, including door-todoor deliveries can be expensive, unreliable and it can take weeks for a posted chapter to reach the promoter, and weeks to return.Postal delays can be dem otivating for many stu dents, but items w hich get lost in the post are the major prob lems delaying progress.
The answer would seem to send all com pleted chapters by email.D eciphering e-mail attachm ents sent from different parts of the continent using different programs pose challenges to both students and promoters.1989:269).The necessity to lim it the num ber of distance education students might be more obscure than in the case of face-to-face teaching situations.However, it would definitely seem to be in the interest of both the students and the faculty members that the total number o f students should be limited to manageable proportions for the faculty in general and for each specific promoter.

Conclusion & Recommendations
The Departm ent o f A dvanced Nursing Sciences, University o f South Africa, does have the infrastructure and the exper tise to offer D Litt et Phil distance education programs.Stand ards are maintained by selecting candidates who have acquired a M aster's or equivalent degree and who managed to submit an acceptable research proposal.Promoters and co-prom oters m onitor each student's progress and obtain subject spe cific expertise, such as statistical consultants whenever deemed desirable.Prom oters' annual progress reports can be used to prevent students m aking unsatisfactory progress from re-reg istering year after year.At least two external exam iners are appointed to exam ine each thesis, in addition to the student's appointed prom oter and co-promoter.The major advantage o f distance education programs is that the students can con tinue with their life and work uninterruptedly but the major disadvantage is that the students need to focus on their stud ies in addition to all their other job and home related respon sibilities.Students who have made substantial progress and who manage to obtain study leave seem to be able to finalize their theses within shorter periods o f time than those who do not succeed in getting any study leave.
Further research would seem to be needed to establish the specific needs o f students and to provide meaningful support structures enabling more students to finish their research pref erably within four or five years.Further research would seem to be w arranted to investigate the successful doctoral candi dates' professional and academic activities subsequent to ob taining the D Litt et Phil degree.
However, the D epartm ent o f A dvanced Nursing Sciences, Unisa, would need to seriously reconsider its role, function, m ission and vision to provide meaningful learning experi ences for its increasing num ber of postgraduate students, es pecially the doctoral candidates.

Postscript:
All persons interested in doctoral education for nurses should access the following Internet address: http://www.umich.edu/~indenThis organization's Web page is based at the University of M ichigan's Nursing Faculty.Browsing through the contents and accessing specific information will enable the users of this W eb-page to becom e fam iliar with, and to access ad dresses, of most universities offering doctoral programs for nurses throughout the world.All the papers presented at the 1997 and 1999 conferences (including this one) can be accessed from this Web-page.(Professor Shaké Ketefian, the Chairperson o f INDEN, granted permission for the publica tion o f all conference papers appearing at this Internet site, because this Web-page does not operate as any formal publi cation of academic papers.It strives to provide a service to all nurse academics throughout the world).INDEN would welcome new members and all academic institutions offering doctoral programs in nursing could benefit from becoming active members and sharing in its lively e-mail correspond ence, as well as participating in its biennial international con ferences which are planned to coincide with those of the In ternational Council of Nurses (ICN) as far as possible.The 2001 INDEN conference will probably precede the ICN con ference in Copenhagen 10-15 June 2001.Information will be published at this Web-site.
Professor Shaké Ketefian, the Chairperson o f INDEN, can be contacted directly at the following e-mail address (but kindly indicate "INDEN Enquiries" as the subject of the e-mail to facilitate the answering process): ketefian@ umich.edu "Faculty costs need to be identified because without time fo r the appropriate mentoring o f stu dents, perform ance o f students will suffer.Student advisement and dissertation su p e n 'ision require fa cu lty time and space considerations, as well as the individual intellectual output o f fa c u lty m e m b e r s " (G erm ain , D e atric k , H ag o p ia n & W hitney 1994: 121).
Evaluation o f a PhD Program : pav ing the way.N ursing Outlook, M ay/June 1994: 117-121.GORNEY-FADIM AN M J 1981: A student's perspective on the d o c to ra l d ilem m a. N u r s in g O u tlo o k , N o v em b er 1981:650-654.v GRACE HK 1989: Issues in doctoral education in Nursing.Journal o f Professional N ursing, 5(5):266-270.d in g and socialization in the doctoral program at the U niversity o f W isco n sin -M a d iso n .J o u r n a l o f P ro fe ssio n a l N u rsin g , 9(5):161-266.M URPHY JF 1981: D octoral education in, of, and for nurs ing: an h isto ric a l analy sis.N u rsin g O u tlo o k, N o v em ber 1981:645-649.REINERT B R & FRYBACK PB 1997: D istance learning and n u rsin g e d u c a tio n .J o u r n a l o f N u rs in g E d u c a tio n , 36(9):421-427.SIM SEN BJ; H O L R O Y D E & SELL IC K K 1996: Post graduate ed ucation expectations: a survey o f H ong Kong graduate nurses.Journal o f A dvanced Nursing, 24:827-835.Statistics obtained from U n isa's Bureau for M anagem ent Information (June 1999).UNISA C A LE N D A R 1999.Part 8 .Pretoria: Unisa. 1999 IntroductionThe distance education (D Litt et Phil) doctoral program has been offered by this Department since the 1980s -instituted to meet the need for further education by the successful M as te r's students.A need for doctoral programs in nursing was also identified by the nursing services in the Republic of South Africa (RSA) who required nurse leaders prepared at doc toral level, especially for policy formulations.The first suc cessful candidate graduated during 1984.
The fundam ental role o f the prom oter is to "prom ote" the student's quality o f w ork so that it reaches the outstanding quality o f w ork dem anded from doctoral theses.A t U nisa, a D Litt et Phil degree will only be aw arded if it is regarded as being at the level o f attaining a distinction (75% or more) in ALL respects, academ ic contribution, editorial and technical standards and research merit.Usually students com pile the first three chapters and the re search instrum ents prior to conducting the actual research.Statisticians are consulted once the research instrum ent has been com piled, as to the feasibility o f its com puterized statis tical analyses.The pattern adopted by m ost students imply that Chapter 1 provides the general background inform ation and rationale for conducting the specific research, C hapter 2 reviews literature relevant to the research, Chapter 3 discusses and justifies the research m ethodology adopted, then the re search findings are analyzed and discussed in tw o or more chapters followed by the final chapter com prising the lim ita tions, conclusions and reco m m en d atio n s o f the research.Should the student have developed a m odel or a course for a specific group o f nurses, this needs to be tested prior to sub mitting the thesis for exam ination.A bibliography contain ing accurate details o f all references used throughout the the sis must be included.The research instrum ents, letters re questing and granting perm ission for conducting the research, and any other docum ents relevant to the research should be attached as appendages.(Those students who em bark on quali tative research approaches m ay follow different procedures).
However, as more and more Internet cafes are being established throughout Africa, this possibility is becom ing a reality -at least for students living and working in areas with access to the Internet, and with reliable electricity supplies.Because o f the distance between the prom oter and the stu dent, and because neither of them is involved solely in re search, much o f the excitem ent inherent in successful research might never be actualized.The student and the mentor can never be fully im m ersed in research, and might not "... expe rience the excitem ent o f knowledge building, an excitement that comes from seeing one project lead to another in an evolv ing program or research"(K eller & Ward 1993:266).Stu dents following distance education D Litt et Phil programs might not have the advantage o f working with more senior researchers nor o f teaching m ore junior researchers.In this way the opportunity to learn from both junior and senior col leagues might be severely limited.
im portance for the future expansion o f the profes sion.A lthough the distance education D L itt et Phil program offered by the D epartm ent o f A dvanced N ursing Sciences, U nisa, does have its disadvantages, at least it does seem to succeed in prom oting a num ber o f nurse leaders' research capacities in a num ber o f A frican countries."A profession not rooted in system atic research is a self-contradiction, a myth, rather than a reality...The silent revolution in all the professions cam e about as a result p rim arily o f knowledge enlarged through research" (M erton in M urphy 1981:646).
cially if their numbers could increase substantially.Any ef fort to increase the num ber o f successful doctoral candidates can result in enhanced health care for A frica's people.The ultimate contribution o f any doctoral nursing program might need to be judged by its actual and potential contribu tion towards the nursing profession's development.Enabling nurses to do independent research at doctoral level, m ight be o f pivotal