E-learning in nursing education in Rwanda: A middle-range theory

Background: The rapid development of technology has compelled tertiary institutions to devise innovative teaching strategies to meet the students’ needs and market’s demands. Recently, the Covid-19 pandemic is forcing educational instructions to shift from in-person to online learning. E-learning is one of the areas advancing rapidly and which provide promises in nursing education. The aim of this study was to develop a middle-range theory to guide the utilisation of an e-learning platform in nursing education in the context of Rwanda.Methods: A grounded theory approach, following Strauss and Corbin, was used. The study population included nurse educators, nursing students, Information and Communication Technologies (ICT) managers, and experts in e-learning and nursing education. The sample size consisted of 40 participants. Data were collected using in-depth interviews, focus group discussion and document analysis. Data analysis was guided by Strauss and Corbin’s grounded theory framework, which facilitated the middle-range theory development.Results: Implementation of e-learning in nursing education emerged as the central concept in this model. E-learning was viewed as a mechanism to advance the country’s political agenda to integrate technology in higher education, a tool to widen access to nursing education, a student-centred approach, and blended learning. The implementation of e-learning was facilitated by catalyst agents such as institutional support, e-readiness, partnerships and collaboration, policies and regulations, effective working learning management system, and bridging the digital divide. Integration of e-learning in nursing education was expected to improve nursing education quality and increase competent nurses and midwives graduates.Conclusions: This study highlights the importance of e-learning in nursing education. The adoption of the innovative, technology-enabled nursing education models would augment capacity to scale up nursing and midwifery education, enhance the quality and relevance of training, and adopt equity-focused policies. This model is a tool to facilitate the establishment of a supported network learning space in nursing education in a fluid and dynamically changing nursing practice context.