Magister Curationis - MCur / The clinical Skills Laboratory Method (SLM) is currently utilised at some universities in South Africa. This is an innovative clinical teaching and learning strategy that allows learner nurses to set their own goals and take responsibility for their learning. In 2007, the method had been introduced to the new first-year learners and subsequently the second, third and fourth year student levels followed. The skills laboratory method consists of five phases: orientation, visualisation, guided practice, independent learning, and assessment. It allows learners the opportunity to observe, practise, and develop their clinical skills in a safe and risk-free environment. In addition, it might assist learners with developing their critical thinking, critical reasoning, and decision-making abilities. As a clinical facilitator at a university, the researcher observed that certain problems occurred in relation to the implementation of the phases. The purpose of this study was to explore and describe learners’ perceptions of the manner in which the facilitators implemented the SLM and to describe guidelines for facilitators to improve the comprehensive implementation of the SLM of an undergraduate nursing programme. A quantitative, explorative, and descriptive research design was used to investigate how learner nurses perceive the skills laboratory method and to what extent the phases of the method were implemented. The accessible population (N = 980) consisted of learner nurses who were enrolled for a Bachelor of Nursing degree at a university in the Western Cape Province. In this study systematic stratified random sampling were used because class lists of all registered learner nurses from first to fourth year were available. The researcher identified every fourth learner (k = 4) of the four years respectively (n = 276). The researcher collected the data personally by means of a survey questionnaire with closed-ended questions that required responses to be indicated according to a 5-point Likert scale. It took approximately 15 - 20 minutes to complete the questionnaire. Descriptive statistics and a factor analysis were performed to reduce the data with the purpose of making it more interpretable. Data was analysed with the assistance of a statistician who used the Statistical Package for Social Sciences Version 21 (SPSS). For interpretation purposes, the researcher presented the statistical information in tables and figures. Twelve factors emerged from the factor analysis: (i) information received during orientation, (ii) introduction during orientation, (iii) orientation to resources in the skills laboratory, (iv) facilitator interaction during visualisation, (v) progression of demonstrations, (vi) authenticity of simulation, (vii) progression of guided practices, (viii) facilitator feedback during guided practice, (ix) encouragement during independent practice, (x) support during independent practice, (xi) planning of assessments, and (xii) facilitator’s role during assessments.The findings indicated that although facilitators did implement the phases of the SLM, some facilitators omitted or did not fully adhere to all the steps in each of the five phases. Factors such as the information and organisation during the orientation phase, knowledge and behaviour of facilitators throughout the phases, teaching strategies used by facilitators during demonstrations, and feedback to learners during assessments required attention. Twelve guidelines were described from those findings with the aim of improving the comprehensive implementation of the SLM and it was recommended that facilitators implement those factors to ensure positive learning experiences for learner nurses. The researcher ensured validity and reliability during the study and adhered to ethical considerations.

Magister Curationis - MCur / Clinical facilitators act as leaders who influence the learning of learner nurses. As leaders, they are involved in the provision of guidance and accompaniment of learners in the clinical learning environment. Learning environments are surroundings, forces, and external stimuli that influence learners, either positively or negatively. Therefore, it is very important that learners are managed in such a way that clinical practice increases professional competency, including independence and self-directedness. One way of achieving this goal is to adjust a leadership style of a clinical supervisor according to the maturity level of a learner in the clinical learning environment. The leadership styles and maturity levels as outlined by the Hersey- Blanchard Theory informed this study. At hospitals in the Western Cape, learner nurses are accompanied by clinical facilitators who act as leaders in the clinical practice according to their learner nurse maturity level. The relationship between leadership styles of clinical facilitators and the maturity levels of learner nurses in the clinical learning environment at Western Cape Hospitals is unknown. The purpose of the study was to explore and describe the relationship between the leadership styles of clinical facilitators and the maturity level of learner nurses in the clinical learning environment of Western Cape hospitals. In this study; a quantitative, descriptive, explorative, and comparative design was followed. The accessible population was all the clinical facilitators (N = 30) allocated to 2nd, 3rd and 4th year learner nurses (N = 641) at Western Cape hospitals. Stratified sampling was used and the sample size was calculated by applying the proportional allocation of sample sizes. A similar questionnaire for clinical facilitators and nursing students was developed from a literature review and based on a 4-point scale. It took around 30 minutes to complete the questionnaire. Most of the components (sections) of both instruments obtained a Cronbach’s alpha (α) above the acceptable standard value of .7. Data was analysed by using the Statistical Package for the Social Sciences (SPSS) Version 21 software program. A descriptive and inferential data analysis was conducted and the Pearson’s correlation calculated. Reliability and validity of the research process was ensured and ethical principles adhered to. Out of four components, two indicated a weak positive relationship between the leadership style of a facilitator and the maturity level of a learner nurse. Most learner nurses indicated that they were mature (able and willing) while the clinical facilitators indicated that they focused more on the selling and participation styles of leadership. The general results indicated that there was a weak positive relationship (r = 0.15) between the leadership style of the clinical facilitators and the maturity level of learner nurses.

Continuous professional development has become an essential part of contemporary nursing practice. Continuous professional development implies that accident and emergency (A&E) practitioners can never stop learning. A&E practitioners therefore must be prepared to seek new challenges and reflect honestly upon their performance and experiences and adjust their practice in order to obtain and maintain quality service delivery. Network sampling was done and a focus group was used to collect data. This study sought to identify components for a structured reflective tool to enhance continuous professional development of A&E practitioners. Reflection was seen as an important learning strategy and components for a structured reflective tool to enhance continuous professional development of A&E practitioners were identified. In addition essential elements that should be in place prior to the implementation of reflection into clinical practice were identified. Copyright / Dissertation (MCur)--University of Pretoria, 2009. / Nursing Science / unrestricted

Abstract The purpose of this study was to describe perceptions and explain background factors relating to the clinical learning environment and mentoring of culturally and linguistically diverse nursing students. The study included two phases: instrument development and a cross-sectional study. The instrument development phase consisted of a conceptualization process, which included two systematic reviews with thematic synthesis; generation of items for two new instruments, Cultural and Linguistic Diversity scale and Cultural and Linguistic Diversity in Mentoring scale, and psychometric testing of these newly developed scales. The cross-sectional phase was completed by collecting data from: (a) students (n = 329) studying in English-language nursing degree programmes from eight Finnish universities of applied sciences during autumn 2015 and spring 2016; and (b) mentors (n = 323) of culturally and linguistically diverse students from five Finnish university hospitals during spring 2016. In addition to the two newly developed instruments, two commonly used instruments Clinical Learning Environment, Supervision and Nurse Teacher scale and Mentors’ Competence Instrument were used for the main data collection. The data was analyzed using descriptive statistics, a nonparametric test and a binary logistic regression analysis. The psychometric properties of the instruments had good validity and reliability. Students’ perceptions on the level of their clinical learning environment and mentoring were lower than their mentors’ perceptions of their own mentoring competence. The level of language was the most common factor relating to the outcomes of culturally and linguistically diverse students’ clinical learning environment and mentoring. Future studies on culturally and linguistically diverse nursing students in the clinical environment should have a marked emphasis on improving proficiency in the native language, which should be implemented in the organizational structure of the clinical placements. This should include providing additional education for clinical mentors to enhance their mentoring competence with culturally and linguistically diverse students. / Tiivistelmä Tämän tutkimuksen tarkoituksena oli kuvata ja selittää eri kulttuureista ja kielellisistä taustoista tulevien hoitotyön opiskelijoiden kliinistä oppimisympäristöä ja ohjausta. Tutkimuksessa oli kaksi vaihetta: mittarin kehittäminen ja poikkileikkaustutkimus. Mittarin kehittämiseksi ilmiö käsitteellistettiin, mikä toteutettiin kahtena systemaattisena katsauksena. Katsausaineistot analysoitiin temaattisella synteesillä. Tämän jälkeen muodostettiin mittarit operationalisoimalla käsitteet väittämiksi. Mittareita kehitettiin kaksi: Kulttuurinen ja kielellinen monimuotoisuus- mittari sekä Kulttuurinen ja kielellinen monimuotoisuus opiskelijaohjauksessa -mittari. Mittareiden kehittämisvaiheessa niiden psykometriset ominaisuudet testattiin. Poikkileikkaustutkimus toteutettiin keräämällä kyselyaineisto (a) opiskelijoilta, jotka opiskelivat englannin kielellä opetettavissa sairaanhoidon tutkinto-ohjelmissa kahdeksassa suomalaisessa ammattikorkeakoulussa syksyn 2015 ja kevään 2016 aikana (n = 329); sekä (b) eri kulttuureista tulevien opiskelijoiden ohjaajilta viidestä suomalaisesta yliopistosairaalasta kevään 2016 aikana (n = 323). Aineistot kerättiin ensimmäisessä vaiheessa kehitetyillä mittareilla sekä kahdella yleisessä käytössä olevalla mittarilla, Terveysalan koulutukseen liittyvän harjoittelun ohjauksen laatu -mittarilla sekä Opiskelijanohjausosaaminen -mittarilla. Aineisto analysoitiin käyttämällä kuvailevaa tilastoanalyysiä, ei-parametrisiä testejä ja binääristä logistista regressioanalyysiä. Tutkimuksessa kehitettyjen mittareiden psykometriset ominaisuudet olivat hyvät. Opiskelijoiden ohjaajat arvioivat oman osaamisensa korkeammalle kuin opiskelijat. Opiskelijat arvioivat sekä heidän kliinisen oppimisympäristönsä että ohjauksensa tason ohjaajien arvioita alhaisemmaksi. Kielitaito oli yleisin tekijä, joka vaikutti opiskelijoiden näkemyksiin kliinisestä oppimisympäristöstä ja ohjauksesta. Englannin kielellä opetettavissa tutkinto-ohjelmissa tulisi painottaa opiskelijoiden riittävää paikallisen kielen kielitaitoa. Tämän lisäksi kliinisen harjoittelun ohjaajien tulisi saada koulutusta eri kulttuurillisista taustoista tulevien opiskelijoiden ohjaukseen.

Submitted in fulfillment for the requirements of M Technology : Nursing, Department of Nursing, Durban University of Technology, Durban, South Africa, 2015. / Background All nursing students need to undergo clinical training for them to be competent practitioners when they qualify. According to the South African Nursing Council (SANC) training facilities are accredited only if the clinical training component is effective. Therefore, it is important that students are accompanied in order for them to grow professionally and have values as future health care professionals. In nursing education, a student throughout the nursing training course receives instruction both theoretically and clinically in the subjects prescribed in the curriculum by the SANC. Clinical instruction is effected through clinical teaching and learning, which is a requirement by the nursing regulatory body, the SANC. For an undergraduate programme a student has to spend a minimum of 1000 hours per year in clinical placement to meet programme outcomes. It is the responsibility of all nursing schools, colleges and universities to ensure that each student meets these requirements. For this to be effective it has to be facilitated by lecturers and clinical instructors, through teaching and learning strategies to enable students to perform the clinical skill with knowledge and eventual competence. Therefore, clinical instructors are there to ensure that the students are competent in all skills, such as cognitive, affective as well as psychomotor skills. This will be beneficial to the programme in reduction of rates of failure and dropout and again by producing competent practitioners. A positive relationship and collaboration between the clinical training institutions and clinical placement facilities is vital for student achievement, especially because the clinical instructors assist students in correlating theory and practice. This study sought to assess the clinical training component of an undergraduate programme at this UoT in KwaZulu Natal. Findings may inform an improved clinical instruction programme as no such study had been undertaken. Methods A qualitative and quantitative design was used to explore feelings, perceptions as well as experiences of staff and student nurses with regard to clinical training component. Stratified random sampling was used to select student nurses according to levels of training and questionnaires were used to collect data. All permanently employed staff who had been working over six months were selected since they were directly or indirectly involved in the clinical facilitation. A focus group interview was conducted for the clinical instructors and questionnaires were used for the lecturers to collect data. Themes and sub-themes emerged and on analysis they were compared to the findings from the quantitative survey. Results and discussion The results revealed that collaboration of clinical placement facilities and training institutions is important for student’s support since all parties are able to communicate freely and students benefit. Students stated that they did not get enough support since the clinical facilitators were short staffed and they were also allocated to facilities that were far from the campus. The respondents cited problems during clinical accompaniments as there were very high expectations by staff members in the placement areas regarding student support. Lecturers were also expected to involve themselves in clinical accompaniment to bridge theory-practice gap. The employment of mentors will assist in student support as the mentors will be at placement areas and the staff and students easily contact them. Conclusion From the interviews the researcher managed to come up with important aspects that should be included in an accompaniment tool when developed, which should be user friendly to both lecturers and clinical facilitators. It will thus assist students with critical skills including critical thinking when performing any patient related nursing skill. It was recommended that the UoT management support staff by attending to their concerns including finding more clinical placement facilities close to the campus.

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)

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)