Abstract
Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community-based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE) programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin's (1990) grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.
Highlights
To address population needs and eco nomic constraints, health care systems are changing in order to address eq uity, cost effectiveness and quality-re lated issues
This study suggested that successful implementation of community-based education (CBE) required col laboration amongst the stakeholders; true partnership be tween academics and communities to ensure that all parties benefit mutually from the programme; financial commit ment, as well as, philosophical commit ment to ensure sustainability of the programme; pro viding appropriate infrastructure to support the CBE initiatives
The service-rendering by the students during experiential learning is especially directed to the disadvantaged commu nity, and in line with the focus speci fied in the White Paper for the Trans formation of the Health System of South Africa (South Africa, 1997b)
Summary
The two schools offer health care services based on their students’ required experiential learning, and on the needs of the disadvantaged community. Differences included: a) types assignments, b) dura tion o f time spent in the community during the entire educational program, c) timing o f the first community expo sure, d) organisation and sequencing of learning experiences in the curricu lum, e) the degree to which the commu nity was used as a learning environ ment, f) level of involvement in student experiences by members of the com munity, g) the level o f involvement of other health team members and other members of the multidisciplinary team, h) the level of involvement from other sectors such as agriculture, econom ics, and political science, and I)teaching/leaming approaches used.
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