The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)

The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)