Submitted in fulfilment of the requirements for the Degree in Master of Technology: Nursing, Durban University of Technology, 2012. / Background : Work Integrated Learning is an educational approach that aligns academic and workplace practices for the mutual benefit of students and workplaces. Work Integrated Learning like in any other nursing course is essential in primary health care as required by the South African Nursing Council. In the clinical setting, students develop clinical and diagnostic reasoning; they also learn how to make the appropriate clinical decisions which they need as qualified primary health care practitioners. This is achieved through instruction and guidance by lecturers, mentors and clinical staff. However it has been noted that the clinical learning environment confronts students with challenges that are absent from the classroom situation. So this study seeks to explore and describe the experiences of post basic nursing students in primary health care clinics so as to address the challenges that are faced within the clinical settings. Aim of the study The aim of the study was to explore and describe primary health care post basic nursing students’ experiences during clinical placements. Methodology : A descriptive exploratory qualitative approach was used to guide the study. In-depth interviews were conducted with ten primary health care post basic nursing students who were allocated for Work Integrated Learning at the clinics in District A and District B in 2011. The main research question for this study was asked: ‘What are the experiences of primary health care post basic nursing students regarding Work Integrated Learning?’ Results : The findings of this study revealed that Work Integrated Learning is vital for the development of clinical skills amongst primary health care post basic nursing students. However, shortage of staff, inadequate material/ non-human resources, lack of supervision in the clinical facilities, distant clinical facilities and insufficient practice in the clinical skills laboratory were identified as challenges that students experience during Work Integrated Learning placement.

The aim of this study is to determine the effectiveness of simulation training in improving the clinical competence of pupil nurses. A quantitative, quasi-experimental, non-equivalent control group before-after design is used. The method of data collection is observation using check lists. The population for this study includes the second-year pupil nurses (N=43) following the two-year programme leading to enrolment as a nurse at the Gauteng learning centre of a private hospital group during 2011-2012. The results reveal that although there is proof that clinical training in simulation improves the competence levels of the experimental group in the procedure administration of oral medication over a period of time, there is no proof that this is true for the procedure observation of patients’ neurological functions and, therefore, the researcher cannot come to a definite conclusion about the effectiveness of simulation training / Health Studies / M.A. (Health Studies)

The aim of this study is to determine the effectiveness of simulation training in improving the clinical competence of pupil nurses. A quantitative, quasi-experimental, non-equivalent control group before-after design is used. The method of data collection is observation using check lists. The population for this study includes the second-year pupil nurses (N=43) following the two-year programme leading to enrolment as a nurse at the Gauteng learning centre of a private hospital group during 2011-2012. The results reveal that although there is proof that clinical training in simulation improves the competence levels of the experimental group in the procedure administration of oral medication over a period of time, there is no proof that this is true for the procedure observation of patients’ neurological functions and, therefore, the researcher cannot come to a definite conclusion about the effectiveness of simulation training / Health Studies / M.A. (Health Studies)

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room, for example, is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite the numerous studies that have been undertaken in this field, few studies that have investigated the operating room as a clinical learning environment in the South African healthcare system have been published. The aim of this study was to determine students’ perceptions of the operating room as a clinical learning environment in a private hospital context. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Data was collected from nursing students undertaking their training at a private nursing education institution. Ten nursing students participated in an open-ended questionnaire (N=10), and twelve students participated in the focus group discussion (N=12). From the results, four themes emerged, namely, ‘interpersonal factors’, ‘educational factors’, ‘private operating room context’, and ‘recommendations’. This study has highlighted some of the challenges experienced by students in the private sector operating room context. Despite the potential learning opportunities, the key findings reveal negative perceptions of students regarding learning experiences. However, the opinion that the operating room offers an opportunity to gain skills unique to this context, as well as facilitates the integration of theory and practice, was also expressed. Some students reported that the emphasis on profitability and cost to patient, and the lack of a mentoring process in this context posed a constraint to learning. Exploration into the specific preparatory needs of students specific to learning outcomes before operating room placement should be considered. It would also be necessary to improve collaboration between lecturers, mentors and theatre managers so that a structured teaching programme may be developed for students entering the perioperative environment. / AFRIKAANSE OPSOMMING: Studente onderneem hul kliniese plasing in verskeie kliniese omgewings vir die blootstelling aan en aanleer van vaardighede wat verband hou met daardie spesifieke konteks. Die operasiesaal, byvoorbeeld, is ’n kliniese omgewing wat die geleentheid bied om kritiese vaardighede te ontwikkel wat verband hou met die perioperatiewe versorging van die pasiënt. Ten spyte van die talle studies wat in die operasiesaal onderneem was, het slegs ’n paar studies uit ’n Suid-Afrikaanse gesondheidsorg oogpunt, die operasiesaal as ’n kliniese opleidings omgewing ondersoek. Die doel van hierdie studie was om studente se persepsies van die operasiesaal as ’n kliniese omgewing in ’n privaat hospitaal konteks te bepaal. ’n Ondersoekende, verklarende en beskrywende ontwerp wat kwalitatiewe data genereer, is gebruik. Data is ingesamel van verpleegstudente wat hul opleiding by ’n privaat verpleegonderrig instelling ontvang. Tien verpleegstudente (N=10) was genooi om ’n onbepaalde vraelys te voltooi en twaalf student (N=12) het aan die fokusgroep bespreking deelgeneem. Vier temas het na vore gekom, naamlik ‘interpersoonlike faktore’, ‘opvoedkundige faktore’, ‘privaat-operasiesaal konteks’, en ‘aanbevelings’. Hierdie studie het ’n paar van die uitdagings uitgelig wat die studente in ’n privaat sektor operasiesaal ondervind. Ten spyte van die potensiële leergeleenthede teenwoordig in die privaat sektor operasiesaal, toon die belangrikste bevindings egter die negatiewe persepsies van studente jeens hierdie kliniese omgewing. Die opinie is egter ook uitgespreek dat hierdie omgewing ook ’n geleentheid aanbied om unieke vaardighede aan te leer. Dit bied ook ’n geleentheid om teorie en praktiese kundigheid te integreer. Sommige studente rapporteer dat die klem op winsgewendheid en koste vir die pasiënt, asoók die gebrek aan mentorskap in hierdie kliniese omgewing ’n beperking plaas op die leerproses. Die spesifieke voorbereidings behoeftes van studente insake leeruitkomste voordat plasing in die operasiesaal omgewing geskied, moet eers deeglik ondersoek word. Dit is ook nodig om die nodige samewerking tussen dosente, mentors en operasiesaal bestuurders te verbeter sodat ’n gestruktureerde onderrig program ontwikkel kan word vir studente wat die perioperatiewe omgewing betree.

The purpose of the study was to explore and describe the perceptions of the pupil nurses at their second year level towards clinical support at the private hospital in the Limpopo Province. Qualitative approach including exploratory, descriptive and contextual study design was followed. The target population for this study included pupil nurses at their second year level (n=20) following a two year programme leading to enrolment as a nurse from a private nursing education institution in the Limpopo Province. Data was collected utilizing written narratives, and focus group interviews. Field notes and audio tape were used to capture data. Data saturation was reached on twelve participants. Data were thematically analysed using Tesch’s method of open coding. The results revealed lack of clinical support. Lack of clinical support was attributed to inadequate educators for accompaniment, registered nurses’ uncaring attitude and not fulfilling their mentorship role, and pressure on pupil nurses to meet the high clinical demands. Pupil nurses were found not to be assuming full responsibilities over their practical learning. Therefore, it is mandatory as nurse educators, managers and researchers to take note of the gaps identified and intervene utilising recommendations provided to enhance clinical support. / Health Studies / M.A. (Nursing Science)

The purpose of midwifery nursing education is to prepare midwives who are fully qualified to provide high-quality, evidence-based mother and child health care services. A quantitative descriptive explorative design was used to identify and explore midwifery students’ experiences of clinical teaching at Sovenga Campus, (Limpopo College of Nursing), Limpopo province. Structured questionnaires were used to collect data. The research sample consisted of fifty (50) midwifery students from Sovenga Campus. Ethical principles were adhered to. Validity and reliability were maintained. The findings showed that learning opportunities are being utilised and clinical accompaniment by tutors has improved. The findings indicated that clinical teaching in midwifery units does not include implementation of the maternity guidelines and protocols’ being used .A recommendation was that tutors be included in student orientation and the planning of monthly unit in-service programmes. / Health Studies / M.A. (Nursing Science)

Text in English / The current changes in health care systems challenges knowledgeable, mature and independent practitioners to be able to integrate theoretical content with practice. The study aims to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on the rendering of family planning services to clients which is a component of Community Nursing Science. The findings of the study reveal that there is a need for an integrated holistic curriculum which will address the needs of the community. It was concluded that a problem-based and community-based curriculum, safe and patient-friendly clinical environments, intersectoral collaboration between college and hospital management and student involvement in all processes of teaching and learning will improve the integration of theory and practice. There also appears to be a need for tutors to be more involved in clinical teaching, accompaniment and the continuous evaluation of students. / Health Studies / M.A. (Nursing Science)

Text in English / The current changes in health care systems challenges knowledgeable, mature and independent practitioners to be able to integrate theoretical content with practice. The study aims to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on the rendering of family planning services to clients which is a component of Community Nursing Science. The findings of the study reveal that there is a need for an integrated holistic curriculum which will address the needs of the community. It was concluded that a problem-based and community-based curriculum, safe and patient-friendly clinical environments, intersectoral collaboration between college and hospital management and student involvement in all processes of teaching and learning will improve the integration of theory and practice. There also appears to be a need for tutors to be more involved in clinical teaching, accompaniment and the continuous evaluation of students. / Health Studies / M.A. (Nursing Science)

The purpose of midwifery nursing education is to prepare midwives who are fully qualified to provide high-quality, evidence-based mother and child health care services. A quantitative descriptive explorative design was used to identify and explore midwifery students’ experiences of clinical teaching at Sovenga Campus, (Limpopo College of Nursing), Limpopo province. Structured questionnaires were used to collect data. The research sample consisted of fifty (50) midwifery students from Sovenga Campus. Ethical principles were adhered to. Validity and reliability were maintained. The findings showed that learning opportunities are being utilised and clinical accompaniment by tutors has improved. The findings indicated that clinical teaching in midwifery units does not include implementation of the maternity guidelines and protocols’ being used .A recommendation was that tutors be included in student orientation and the planning of monthly unit in-service programmes. / Health Studies / M.A. (Nursing Science)

This qualitative study was aimed at exploring and describing the theoretical and practical experiences of second-year critical care nursing students. Purposive sampling was done, and unstructured interviews and narrative descriptions were used as data collection tools. An adaptation of Johns's Framework, the Guideline for the Facilitation of Reflection as Teaching Strategy, was used during interviews to guide participants in reflecting on theory-practice integration. Multiple strategies were used to ensure the trustworthiness of the study. Concerning patient data, communication, and the administration of life-saving medications, theory-practice integration did occur. Regarding treatment and the outcome of nursing interventions, it seemed that knowledge deficiencies and a lack of exposure to practical situations contributed to the inability to apply theory to practice. This apparent inability evoked negative feelings, such as guilt. Discrepancies between practice and theory taught led to confusion. Guided reflection assisted students in gaining a new perspective on nursing and theory-practice integration. / Health Studies / M.A. (Health Studies)