Yvonne Botma

A conceptual framework for educational design at modular level to promote transfer of learning

Students bridge the theory–practice gap when they apply in practice what they have learned in class. A conceptual framework was developed that can serve as foundation to design for learning transfer at modular level. The framework is based on an adopted and adapted systemic model of transfer of learning, existing learning theories, constructive alignment and the elements of effective learning opportunities. A convergent consensus-seeking process, which is typical of a qualitative approach, was used for expert review. The final conceptual framework consists of two principles: establishing a community of learning and the primacy of a learning outcome. The four steps entail the following: (1) activation of existing knowledge; (2) engaging with new information; (3) demonstrating competence; and (4) application in the real world. It is envisaged that by applying the framework educators in health care will design for transfer of learning, resulting in quality of care and optimal patient outcomes.

Cyclic efforts to improve completion rates of masters’ degree students in nursing

Supervisors at Higher Education Institutions are challenged to shorten throughput of Masters degree students in nursing as researchers are needed to improve the art and science of the nursing profession. Globally the completion time for a postgraduate degree in the health sciences varies between 4.7 and 5.5 years. The purpose of the study was to describe strategies that were implemented to shorten completion time and attrition rate of postgraduate students. A cyclic technical, scientific collaborative mode within an action research methodology was used to identify factors impeding completion time in this study. Contrary to other studies, supervision was not an inhibiting factor in this study. Physical, technical, academic and financial aspects were identified by postgraduate students through questionnaires and informal discussion groups with supervisors as well as progress reports. Strategies were implemented to address these. Following implementation of all strategies, 42% of the postgraduate students in the School of Nursing completed their Masters degree within two years. This implies a 34% improvement. Although the completion rate improved it was still unsatisfactory and new challenges were identified during the second cycle, for example, the number of inexperienced supervisors increased and they needed mentoring. Speed mentoring is a possible solution to the problem.

Abortion-related services: Value clarification through ‘Difficult Dialogues’ strategies

Midwives play a pivotal role in women’s health in the face of increased deaths related to backyard abortions. Since the commencement in South Africa of the Name of the Act No. 92 of 1996 that allows abortion services, there has been a moral divide among healthcare workers in South Africa. This article reflects the opinions of preregistration midwifery students regarding abortion-related services. Narrative data were collected from 34 preregistration midwifery students and were analysed using open coding. The opinions of the students before the value clarification exercise were categorised into against abortion, for abortion and abortion under special conditions. After the value clarification process, the views were translated into pro-life choice, reserved judgement and autonomy. The results demonstrate that the integration of the value clarification process into midwifery preregistration education saw transformative learning and intellectual growth among learners in this study. We recommend that current social issues should engage students in transformative learning activities that entail a process of value clarification.

Bridging the gap between self-directed learning of nurse educators and effective student support

Background Self-directed learning requires the ability to identify one’s own learning needs, develop and implement a plan to gain knowledge and to monitor one’s own progress. A life-long learning approach cannot be forced, since it is in essence an internally driven process. Nurse educators can, however, act as role models to empower their students to become independent learners by modelling their own self-directed learning and applying a number of techniques in supporting their students in becoming ready for self-directed learning. Objectives The aim of the article is to describe the manifestations and implications of the gap between self-directed learning readiness of nurse educators and educational trends in supporting students. Method An instrumental case study design was used to gain insight into the manifestations and implications of self-directed learning of nurse educators. Based on the authentic foci of various critical incidents and literature, data were collected and constructed into a fictitious case. The authors then deductively analysed the case by using the literature on self-directed learning readiness as departure point. Four constructs of self-directed learning were identified, namely internal motivation, planning and implementation, self-monitoring and interpersonal communication. Supportive strategies were identified from the available literature. Results Nine responses by nurse educators based on the fictitious case were analysed. Analysis showed that readiness for self-directed learning in terms of the identified constructs was interrelated and not mutually exclusive of one other. Conclusion The success of lifelong learning is the ability to engage in self-directed learning which requires openness to learning opportunities, good self-concept, taking initiative and illustrating independence in learning. Conscientiousness, an informed acceptance of a responsibility for one’s own learning and creativity, is vital to one’s future orientation towards goal-directed learning. Knowledge and understanding of one’s own and students’ self-directed learning abilities are critical for nurse educators. In the nursing profession, it has been shown that self-directed learning by the nurse educators has a direct relationship towards the development of a lifelong learning approach by their students. Supporting students towards becoming self-directed learners throughout their professional life, in turn, will impact directly on the quality of nursing and midwifery practice.

Adult learning: What nurse educators need to know about mature students

Background Most nurse educators regard students who enter postgraduate studies as adult learners capable of self-direction and independent learner behaviour. Therefore, a mismatch between the nurse educator’s expectation of adult learners and actual adult learner conduct may result in disappointment and even frustration for both educator and learner. Purpose This article is a report of a secondary analysis of data that were collected to explore the high-fidelity simulation learning experiences of a group of postgraduate nursing students. The secondary analysis was done to determine whether adult learners who bring professional knowledge and experience to a postgraduate learning environment displayed adult learner conduct as proposed by educational theorist Malcolm Knowles. Method Using a qualitative descriptive research design, data were gathered from 18 postgraduate nursing students who participated in high-fidelity simulation in a nursing school at a higher education institution in South Africa. The nominal group technique was used to collect the students’ ideas about improving their simulation learning experiences. A secondary qualitative analysis of the primary nominal group data was done. Findings Data either confirmed or belied adult learner behaviour. Although the findings suggested self-directed and independent learner behaviour, they also revealed behaviour evident of dependence on the educator. Conclusion Mature students have well established ways of thinking and doing that may hinder learning. Educators have to support adult learners in developing effective learning techniques in order to maximise the benefits of their experience and knowledge by fostering independence and self-direction.

A framework to expand public services to children with biomedical healthcare needs related to HIV in the Free State, South Africa.

The study undertook the development of a framework for expanding the public services available to children with biomedical healthcare needs related to HIV in South Africa. The study consisted of various component projects which were depicted as phases. The first phase was a descriptive quantitative analysis of healthcare services for children exposed to or infected by HIV, as rendered by the public health sector in the Free State Province. The second stage was informed by health policy research: a nominal group technique with stakeholders was used to identify strategies for expanding the healthcare services available to these children. The third phase consisted of workshops with stakeholders in order to devise and validate a framework for the expansion. The theory of change logic model served as the theoretical underpinning of the draft framework. Triangulated data from the literature and the preceding two phases of the study provided the empirical foundation. The problem identified was that of fragmented care delivered to children exposed to or infected with HIV, due to the ‘over-verticalization’ of programmes. A workshop was held during which the desired results, the possible factors that could influence the results, as well as the suggested strategies to expand and integrate the public services available to HIV-affected children were confirmed. Thus the framework was finalised during the validation workshop by the researchers in collaboration with the stakeholders.

Sustaining a newly implemented competence-based midwifery programme in Lesotho: Emerging issues

The need to develop midwives who improve maternal and neonatal outcomes underpins decisions to adopt competence-based education models in low- and middle-income countries. Competence-based education means a shift in the training of midwives to include student self-directed performance-oriented training. Sustaining the implementation of a curricular innovation, such as a competence-based curriculum, requires new skills and resources by countries adopting such innovation. The skills and resources needed to sustain such a curricular innovation are influenced by issues that arise during implementation of the curricular innovation. Through structured interviews with stakeholders in midwifery education and document analysis in a small sub-Saharan African country, we reveal emerging issues that threaten the sustainability of a newly implemented competence-based midwifery curriculum. In this article, we argue that monitoring and supporting the implementation of a curricular innovation, is essential in enhancing midwifery education institutions ability to sustain curricular innovation. Regulation through professional bodies and councils enhance institutional, programmatic and classroom accountability.

Monitoring preceptors' supportive role: A measuring instrument for increased accountability

PURPOSE This article describes the development of a measuring instrument to monitor support offered by preceptors during their accompaniment of students in clinical facilities. DESIGN A quantitative methodological study design was used to develop the instrument. METHODS Data were collected by means of a self-completed questionnaire. Total sampling of 192 undergraduate nursing students was done. Descriptive data analysis was conducted regarding the biographical characteristics, Cronbachs alpha was computed to determine the reliability, and an exploratory factor analysis was done to describe the construct validity of the developed instrument. RESULTS The Cronbachs alpha of 0.98 indicates high reliability and high internal consistency. Three constructs regarding clinical support, namely cognitive-, emotional- and system support were identified by means of the exploratory factor analysis. CONCLUSION The new conceptualisation of support gives insight into the value of the preceptors role. The instrument designed for this study could be used to assess and monitor the support offered by preceptors while they accompany students in clinical practice. CLINICAL RELEVANCE Considering the need to strengthen nursing and midwifery education systems, this instrument contributes to measuring and monitoring clinical accompaniment of students by preceptors.

Application of the Donabedian quality assurance approach in developing an educational programme

Abstract Educators find it difficult to transfer their education theoretical knowledge into practice. In this conceptual article the Donabedian framework of structure, process and outcome that is traditionally used to evaluate quality of healthcare was applied in an educational environment to develop a programme to introduce interprofessional education in health sciences. The authors worked from the premise that theory should guide action and action should inform theory. Consequently, a grid was developed to link the underpinning theories or frameworks with each step of the Donabedian process. The realisation of each theory is described under the process or implementation phase. A number of programme evaluation models or frameworks are available but theory realisation in programmes are not included generally in the criteria. This article may provide some structure for educators who need to develop a new programme within a complex environment.

SUGGESTED COMPETENCES FOR A PRECEPTOR TRAINING PROGRAMME

Purpose: Facilitating learning in the clinical context is a complex act for which preceptors should be trained. However, there is no consensus on what should be included in a training programme for preceptors. The purpose of the article is to describe the competences of a preceptor that emanated from a consensus reaching process among nurse educators in South Africa. Methodology: Nurse educators reached consensus on the core competences of a preceptor through nominal groups. Non-probability convenient sampling was used to sample nurse educators from universities as well as public and private nursing colleges. The two nominal groups generated data that were combined to identify the content of preceptor training programme. Results: Key findings were that preceptors should be able to facilitate learning through a variety of techniques and perform valid and reliable assessment. Preceptors should support students in finding and implementing best available evidence of care for a specific patient. Conclusion and recommendation: It is the responsibility of nursing education institutions to produce clinically competent nurses. A competent nurse is able to think critically, reason clinically, make sound clinical judgments, and reflect on the thinking processes applied. Preceptors, therefore, should support nursing students in these thinking processes and create opportunities where they can practice under supervision to become competent nurses. The training programme should enable preceptors to facilitating learning in the clinical environment through a variety of techniques, conduct valid and reliable assessments, and support students in implementing best practice guidelines.