Nursing Education Institutions Research Articles

Experiences of homosexual patients' access to primary health care services in Umlazi, KwaZulu-Natal.

BackgroundHomosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate health care. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the studyThe aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province of KwaZulu-Natal (KZN).MethodA qualitative, exploratory, descriptive study was conducted which was contextual in nature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.ResultsTwo major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.ConclusionParticipants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

The value of the pre-hospital learning environment as part of the emergency nursing programme

BackgroundProfessional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the hospital environment (emergency department and critical care unit) and pre-hospital environment (road ambulance services) to ensure they gain the necessary clinical exposure in order to learn the relevant and necessary skills and knowledge which in turn will help them become safe and independent emergency nurse practitioners. Controversy about the value of placing emergency nursing students in the pre-hospital environment has raised questions from specifically the private healthcare sector. During the pre-hospital placement, emergency nursing students are absent from the hospital environment which is costly and, according to the healthcare services, unnecessary. ObjectiveThe study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme. MethodsA qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of self-reported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews. The data was analysed using content analysis. ResultsFour major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. ConclusionThe research findings support the value and continuation of utilising the pre-hospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.

Effective Clinical Learning Environment as Perceived by Nursing Students at AL Dawadmi, Applied Medical Sciences college: Actual versus Preferred Characteristics

It is widely accepted that clinical placements are a vital part of the education of undergraduate nursing students. A supportive clinical learning environment is very important for the transfer of learning in a clinical context. This study aimed to describe and compare the actual and preferred characteristics of effective clinical learning environment as perceived by undergraduate nursing students. A convenience sample of 75 nursing students affiliated to the nursing department in ALDawadmi Faculty of Applied Medical Sciences, female branch, Shaqra University, Saudi Arabia, was included. Data were collected by using the Clinical Learning Environment Inventory (CLEI). The results of the present study revealed that satisfaction subscale was perceived by undergraduate nursing students as the most important actual and preferred characteristic of effective clinical learning environment. Also individualization subscale was perceived by nursing students as the least important domain in both the actual and preferred form. The study recommended that work based assessment plays an important role in the education process, so it is necessary to assess the learning environment from different perceptions and collaboration between the nursing education institutions and health care agencies is essential to ensure the availability of effective clinical learning environment, which meet the needs of undergraduate nursing students.

Social accountability and nursing education in South Africa

BackgroundThere is global emphasis on transforming health workforce education in support of universal health coverage.ObjectiveThis paper uses a social accountability framework, specifically the World Health Organization's six building blocks for transformative education, to explore key informants’ perspectives on nursing education in South Africa.MethodsUsing a snowballing sampling technique, 44 key informants were selected purposively on the basis of their expertise or knowledge of the research area. Semi-structured interviews were conducted with the key informants after informed consent had been obtained. The interviews were analysed using template analysis.ResultsSouth Africa has strategic plans on human resources for health and nursing education, training, and practice and has a well-established system of regulation and accreditation of nursing education through the South African Nursing Council (SANC). Key informants criticised the following: the lack of national staffing norms; sub-optimal governance by both the SANC and the Department of Health; outdated curricula that are unresponsive to population and health system needs; lack of preparedness of nurse educators; and the unsuitability of the majority of nursing students. These problems are exacerbated by a perceived lack of prioritisation of nursing, resource constraints in both the nursing education institutions and the health training facilities, and general implementation inertia.ConclusionSocial accountability, which is an essential component of transformative education, necessitates that attention be paid to the issues of governance, responsive curricula, educator preparedness, and appropriate student recruitment and selection.

Core nursing practice and educational requirements according to nursing unit and clinical career in tertiary hospital

3) Purpose: The purpose of this study was to provide fundamental data to develop an educational program for the development of nurses' core competences, and to improve the curriculum in nursing education institutions. Met hods: This study, based on a descriptive survey, was conducted with 1,019 nurses working in a tertiary hospital in Seoul. Among 47 core nursing practice items, core nursing practices as perceived by the participants and relevant educational requirements were measured on a four-point scale. The collected data were analyzed using descriptive statistics for the mean and standard deviation, one way ANOVA, and Duncan test as post-hoc test. Results: Regarding the core nursing practice perceived as by the nurses, there were statistically significant differences in 43 out of 47 items according to nursing unit, and in 15 items according to clinical career. Regarding the educational requirements for core nursing practice, there were also statistically significant difference for the same items as perception differences according to nursing unit and clinical career. Conclusion: The results of this study suggest further study on the development of educational programs to advance the clinical expertise of nurses and for the development of curriculum reflecting the actual conditions and requirements in clinical nursing practice fields.

Recruitment and retention strategies for expert nurses in abortion care provision

Objective(s)The purpose of this thematic analysis is to describe recruitment, retention and career development strategies for expert nurses in abortion care provision. Study designThematic analysis influenced by grounded theory methods were used to analyze interviews, which examined cognitive, emotional, and behavioral processes associated with how nurses make decisions about participation in abortion care provision. The purposive sample consisted of 16 nurses, who were interviewed between November 2012 and August 2013, who work (or have worked) with women seeking abortions in abortion clinics, emergency departments, labor and delivery units and post anesthesia care units. ResultsSeveral themes emerged from the broad categories that contribute to successful nurse recruitment, retention, and career development in abortion care provision. All areas were significantly influenced by engagement in leadership activities and professional society membership. The most notable theme specific to recruitment was exposure to abortion through education as a student, or through an employer. Retention is most influenced by flexibility in practice, including: advocating for patients, translating one's skill set, believing that nursing is shared work, and juggling multiple roles. Lastly, providing on the job training opportunities for knowledge and skill advancement best enables career development. Conclusion(s)Clear mechanisms exist to develop expert nurses in abortion care provision. ImplicationsThe findings from our study should encourage employers to provide exposure opportunities, develop activities to recruit and retain nurses, and to support career development in abortion care provision. Additionally, future workforce development efforts should include and engage nursing education institutions and employers to design structured support for this trajectory.

Building capacity of training institutions and Ministries of Health in sub-Saharan Africa: The PEPFAR approach

Background: Sub-Saharan Africa faces a health workforce crisis with only 3% of the world’s health care workers for 24% of the global burden of disease and only 1% of the world health expenditure. Recent data indicate that nurses in select African countries were not able to perform critical health care delivery tasks, highlighting the need for relevant nursing and midwifery curricula. The PEPFARfunded Nurse Education Partnership Initiative (NEPI) aims to scale up nursing and midwifery preservice education programs to address essential health challenges through the introduction of competencybased curricula where students are taught, learn, and are evaluated based on how well they can put clinical skills into practice, and through clinical simulation where students gain patient care experience using lifelike models. Structure/Method/Design: NEPI is partnering with governments in five African countries and collecting best practices in nursing curriculum development and clinical teaching and learning methodologies. Baseline assessment of teaching programs and outputs, as well as a desk and data survey of best practices in curriculum development, clinical simulation and training evaluation, were conducted to inform innovation in nursing education across the continent. New topics that require training were also identified, particularly Option B+ for PMTCT. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): Intersectoral collaboration has produced four competency-based preservice curricula, expanding the availability of comprehensively trained nurses to address general health and maternal and child health challenges in Zambia, Lesotho, and Malawi. Simulation laboratories were installed at six nursing education institutions in Lesotho and one refurbished in Malawi; over 1500 nursing students have utilized these laboratories to enhance their skills. A curriculum for Option B+ is being developed to respond to the urgent need for its scale up. Summary/Conclusion: Nurse and midwives with the right knowledge, skills, and abilities are key to a country’s mandate to deliver effective primary health care services and tackle priority health challenges. Competency-based curricula, including the Option B+ curriculum under development, and the expanded use of clinical simulation will facilitate increased learning and skill transfer when students care for patients in today’s complex, health care environment. Various evaluation methods will assess the effectiveness of these interventions and inform scale up.

Pre-registration nursing students' perceptions and experiences of violence in a nursing education institution in South Africa

Violence is a growing problem worldwide in the field of health care and within the nursing profession. A study comprising a survey and focus groups with nursing students, and interviews with nurse educators was conducted to examine nursing students' perceptions and experiences of violence at a nursing education institution in the Western Cape, South Africa. A self-administered questionnaire was distributed to all nursing students. Two hundred and twenty three (n = 223) respondents completed the questionnaire. Focus groups were conducted with purposively sampled student participants and semi-structured interviews with nurse educators. The findings indicated that the nature of the violent incidents experienced by students on campus, especially in the residences, ranged from verbal abuse to violation of students' property and personal space, and could be attributed primarily to substance abuse. Violence among student nurses could negatively affect learning. In a profession in which nurses are exposed to violence in the workplace, it is important that violence in the learning environment is actively prevented and respect of individual rights, tolerance and co-operation are promoted.

PREPARATION OF CLINICAL PRECEPTORS

Nursing students in South Africa are mostly dissatisfied with clinical teaching and accompaniment in clinical practice. Consequently final year students feel ill prepared for their roles as registered nurses. Many factors, for example the shift from hospital based training to higher education, staff shortages, high acuity levels, greater treatment sophistication etc contribute to the dilemma of inadequate support of students during clinical placements. Preceptors that are either appointed by the nursing education institution or health service may address the issue of inadequate support of students. However, preceptors should be well trained to facilitate learning in the complex and dynamic clinical environment. This article gives an outline for the preparation of preceptors and includes selection criteria for candidates, the content of a training programme, as well as the assessment of programme outcomes.

GUIDELINES FOR THE PREPARATION OF NURSE EDUCATORS OR HEALTH PROFESSIONAL EDUCATORS

The move of nursing education to higher education is regarded as one of the most transformative achievements in nursing in South Africa. In South Africa, as in countries across the globe, nursing is faced with human resource challenges. Such challenges are not limited to nurse shortages but to a shortage of nurse educators which is anticipated to be further impacted by the high number of nurse educators who are close to retirement. The shortage of nurses in the country therefore necessitated an increase in the recruitment of potential nurses, and a concomitant increase in the number of nurse educators to prepare these nurses. A team elected by the Forum for University Nursing Deans in South Africa (FUNDISA) was tasked firstly to explore the relevance and quality of the preparation of nurse educators before attending to the up-scaling of production of nurse educators.The task team conducted a survey amongst newly-qualified educators, heads of Nursing Education Institutions (NEIs) employing newly-qualified educators, and heads of nursing schools in Higher Education Institutions (HEIs) which prepare nurse educators. A workshop was also conducted at a FUNDISA business meeting to analyse current nursing education programmes within HEIs. Many gaps were identified across the nursing education programmes offered and recommendations for improvement were made by participants. The Task Team then met to develop guidelines for educators of health professionals based on the survey and workshop input.The guidelines developed by the task team include requirements for entry to the programme; the prescribed body of knowledge for health professional education including theoretical foundation of Health Professional Education, curriculum development, didactics, clinical teaching and learning, management of health professional education and the history and contemporary issues related to nursing education; practical requirements; level descriptors and a range competencies.

THE PRIVATE SECTOR CONTRIBUTION TO NURSING EDUCATION (1990 – 2010)

The purpose of this article is to describe the contribution of private hospital groups and individuals to the education and training of nurses in South Africa over the last 20 years.The sector has two major components: the private hospital groups and the individual entrepreneurs, and these are described separately. In total, the sector concentrates on non-professional categories and produces 68% of Enrolled Nurses, 82% of Enrolled Nursing Assistants and 48% of Bridging Students. The three private hospital groups train primarily for their own needs and continually try to improve quality through innovations such as introducing Continuing Professional Development. Their challenges include a lack of clarity from the regulator, and staffing. The 41 members of the association for entrepreneurial providers train for the market-place and are involved in communities to a limited extent. They face the same challenges as the rest of the sector.The private sector should be seen as a strategic partner in the quest to meet the demand for qualified nursing staff. Looking at the future of the nursing profession and the demand for nurses successfully to implement the National Health Insurance, the contribution by the independent nursing education institutions cannot be ignored.

Clinical learning in nursing education as a factor to enhance organizational socialization in newcomer nurses

Background : Clinical learning in nursing education has a pivotal role in enhancing clinical competences of nursing students. Moreover it provides an anticipatory knowledge of the organizational contexts in which nursing care is delivered. The aim of this study was to demonstrate the role of clinical learning in nursing education to enhance post-graduation organizational entry. Method : A retrospective cross-sectional design was used. A sample of 250 newcomer nurses was enrolled in hospital settings. The mean age was 32.1 years (SD 7.95) and 79.2% participants were female. An adaptation of 3 items of Clinical Learning Environment and Supervision Scale, Organizational Socialization Inventory and validated items to assess turnover intention and therapy errors rate were used. Structural Equation Modelling was performed. Results : Clinical learning experienced in undergraduate education positively correlated with newcomers' organizational socialization (β = 0.41, p < .001), organizational socialization contributed to reducing turnover intention (β = -0.67, p < .001) and therapy errors rate (β = -0.24, p = .003). The model’s fit was good (RMSEA = 0.050, CFI = 0.971, TLI = 0.963, SRMR = 0.045). Conclusion : Undergraduate nursing education is an important phase to enhance an effective organizational socialization. Nursing education institutions and health care settings need to conjointly work to provide effective clinical settings for nursing education, in order to enhance both clinical learning and organizational outcomes.

看護学校における口腔ケア, 歯・口腔領域に関する教育について

看護学校における口腔ケア, 歯・口腔領域に関する教育について

A model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.

South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997). The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa. To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa. A qualitative and theory-generating design was used (following empirical findings regarding needs analysis) in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied. The structure of the model is multidimensional and complex in nature (macro, mesoand micro) based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation. The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.

Patients' experiences of being nursed by student nurses at a teaching hospital.

Teaching hospitals are medical institutes at which most nursing education institutions provide their students with practical nursing experience. Although the focus of care is the patient, attention is sometimes focused more on the nursing students rather than on the patients who are undergoing care at the hands of both the nursing professionals and students. However, proper nursing care should also take into account the experiences of patients during the care process in the health facility. The study had three objectives: to describe the experiences of patients nursed by student nurses in a teaching hospital in the Western Cape; to identify patterns in the experiences of patients receiving patient care from student nurses; and to analyse aspects of the experiences that may need further attention for the training of student nurses. A descriptive phenomenological approach was used to explore the experiences of patients nursed by student nurses. Participant selection took place purposively from different wards of the identified teaching hospital, and thematic saturation was achieved at 10 participants. The data were collected through in-depth interviews and analysed using thematic content analysis. Three main themes were discovered after data analysis: methods of identification of student nurses by patients; positive perceptions of student nurses by patients; and negative perceptions of student nurses by patients. The findings will inform the clinical supervisors and educational institutions of aspects of the nursing training of student nurses that need improvement and those that require enforcement.

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions

BackgroundAngola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola.MethodsAfter consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis.ResultsFourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources, bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes.ConclusionsPublic health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country.

Conceptualisation of knowledge construction in community service-learning programmes in nursing education.

Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogical strategy that encourages students to make meaningful connections between the content in the classroom and real-life experiences as manifested by the communities. Through CSL, learning is achieved by the active construction of knowledge supported by multiple perspectives within meaningful real contexts, and the social interactions amongst students are seen to play a critical role in the processes of learning and cognition. This article reflects facilitators’ perspective of the knowledge construction process as used with students doing community service learning in basic nursing programmes. The aim of this article was to conceptualise the phenomenon of knowledge construction and thereby provide educators with a shared meaning and common understanding, and to analyse the interaction strategies utilised by nurse educators in the process of knowledge construction in community service-learning programmes in basic nursing education. A qualitative research approach based on a grounded theory research design was used in this article. Two nursing education institutions were purposively selected. Structured interviews were conducted with 16 participants. The results revealed that the knowledge construction in community service-learning programmes is conceptualised as having specific determinants, including the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue, interactive learning in communities of learners, active learning, continuous reflection as well as collaborative and inquiry-based learning. Upon completion of an experience, students create and test generated knowledge in different contextual health settings. It was concluded that knowledge is constructed by students as a result of their interaction with the communities in their socio-cultural context and is mediated by their prior concrete experiences. The implication of this is that students construct knowledge that can be applied in their future work places.

Student Nurses' Experiences of The Clinical Psychiatric Learning Environment in an Education Institution

This study investigated lived experiences of student nurses working in a clinical psychiatric learning environment in South Africa. Participants were 29 fourth-year student nurses in the clinical psychiatric learning environment at a nursing education institution (females = 27; males =2). They engaged in focus group discussion on their experiences of the clinical psychiatric learning environment. The data were thematically analyzed using Tesch's method of open coding. The student nurses experienced the environment as growth enhancing on a professional and personal level.

The status of academic integrity amongst nursing students at a nursing education institution in the Western Cape

Honesty is regarded as a basic ethical value in all educational programmes, and academic integrity is of undisputed importance in educational environments. The literature reviewed revealed that academic dishonesty is wide-ranging and also encountered in the nursing education environment. This phenomenon is of concern to the nursing fraternity because of the proven positive correlation between unethical academic practices and future unethical professional behaviour. Limited research data regarding academic dishonesty at nursing education institutions in South Africa and this correlation motivated the present study. The purpose was to examine the status of academic integrity amongst nursing students at a nursing education institution in the Western Cape. Formulated objectives guided investigation of several variables which impact upon academic integrity, for example the incidence of and student perceptions around academic dishonesty. A quantitative, descriptive survey design was used, with a self-reported questionnaire (based on literature review and study objectives) designed to obtain information about academic dishonesty. Provision was also made for qualitative input from the respondents by including three open-ended questions. It was found that academic dishonesty was a reality at the nursing education institution where this study was done. Cheating associated with plagiarism and assignments was identified as the main problem area. An unacceptably high level of dishonesty in completion of practical records was also an area of concern. The main recommendations are development and implementation of a code of honour and implementation of comprehensive academic integrity policies at the nursing education institution, with practical measures aimed at combating cheating in tests and examinations.

Implementing community-based education in basic nursing education programs in South Africa

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.