Guidelines to facilitate clinical nursing education of nursing students in the training health facilities of Oshana and Oshikoto regions, Namibia
Loading...
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Namibia
Abstract
The development of the guidelines was necessitated by the challenges experienced during facilitation of clinical nursing education. To meet these challenges, guidelines are required to serve as a guiding tool for registered nurses in their facilitation roles. Nursing is a practice-based profession; thus, student nurses who are attached to the clinical health facilities need to acquire the necessary clinical skills and competencies in nursing practice under the guidance and supervision of registered nurses. However, despite the teaching responsibility of registered nurses, not all are acquainted with teaching methods since nursing education is not part of the undergraduate nursing curriculum. Moreover, it seems that not all registered nurses hold postgraduate qualifications in Nursing Education or Clinical Instruction that could equip them with the necessary knowledge and skills to facilitate clinical nursing education. This consequently results in inconsistency in the way registered nurses facilitate clinical nursing education in the clinical environment. The purpose of the study was to develop guidelines to facilitate clinical nursing education of nursing students in the training health facilities of Oshana and Oshikoto regions, Namibia. A pragmatism perspective was adopted for this study. A convergent parallel mixed method approach was used to obtain data. The Practice Oriented Theory formed the conceptual framework that guided the study while the ADDIE Model and Ministry of Health and Social Services (MoHSS) framework guided the development of the guidelines. This research study was undertaken in the following three phases: Phase 1: To achieve objectives 1,2,3 and 4 of the situational analysis, a mixed methods research approach with descriptive and exploratory designs. Objective 1: A narrative type literature review was conducted to describe best practices in clinical nursing education. Sources published from 2010, were consulted. The said literature review revealed best practices in clinical nursing education as: effective communication, intersectoral collaboration, stakeholders’ involvement, clinical learning environment, qualities of a facilitator and shared vision. Objectives 2 and 3 aimed to explore and describe the experiences of registered nurses (n= 43), lecturers (n =5) and nursing students (n= 28) on facilitation of clinical nursing education. Data were collected through five (5) focus group discussions with registered nurses and three (3) focus group discussions with nursing students, and five (5) individual interviews with lecturers from the training institution. Participants were purposively selected for these two objectives. Data from focus group discussions and interviews were analysed according to Tesch’s steps of qualitative data analysis. Three themes and twenty sub-themes emerged. The findings revealed that participants (respectively) experienced nursing students’ challenges, registered nurses’ and lecturers’ challenges as well as support system challenges that affect facilitation of clinical nursing education. Objective 4: Focused on assessing the clinical environment where clinical nursing education takes place. For this objective a quantitative and descriptive design was used. Quantitative data were collected using self administered questionnaires from registered nurses (n=172) and nursing students (n=108) who were recruited through simple random sampling. A 5-point Likert scale was used to score various variables. The data were analysed using the Statistical Package for Social Sciences (SPSS) computer software version 25.0. The results showed that there were poor interpersonal relationships, support system challenges and a lack of continuing professional development. Phase 2, focused on the conceptual framework that guided the study. The conceptual framework according to Practice Oriented Theory as proposed by Dickoff et al., (1968) was used. The survey list of Dickoff et al., (1968) was used for this purpose. Thus, the agent was the (researcher, registered nurse, nurse educator), recipient (nursing), dynamic (best practices and challenges), procedure (process followed to develop guidelines) and terminus (developed guidelines). Phase 3, concentrated on the development of guidelines for registered nurses regarding the abovementioned aim. The development of the guidelines was based on research evidence from Phase 1 and guided by ADDIE model and MoHSS framework for guidelines development. Four guidelines were developed to strengthen best practices in clinical nursing education and address the identified challenges. In conclusion, clinical nursing education and facilitation are important components in preparing nursing students for the activities they will perform as registered nurses after graduation. However, this study has demonstrated that there are challenges in clinical practice that need to be addressed as they have the potential to negatively affect the facilitation of clinical nursing education. The study recommended that similar studies be conducted using a broader scope of training health facilities and training institutions in Namibia, to gather more information on clinical nursing education. It vii is further recommended that the facilitation of clinical knowledge and skills be based on theories and research to avoid transferring traditionally outdated nursing knowledge and skills to nursing students. The study also recommended that the developed guidelines be validated and operationalised in the practical setting.
Description
A dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Nursing Science
Keywords
Nursing education, Health facilities, Oshikoto region