D.Cur. / Since 1994, the government has engaged in extensive transformative processes that included the reviewing and restructuring of all relevant legislation, organisations, institutions and statutory bodies. These transformative demands resulted in the development and implementation of a new constitution and ensuing transformative legislation and policies. It is for this reason that the Department of Health, in attempting to transform the health system in South Africa, developed a strategy known as the Health Sector Strategic Framework, which sets out a 10-point plan. This plan states amongst others, that health professions and professional bodies develop Continuing Professional Development (CPD) systems/programmes. Over and above this other transformative developments in the education and labour frameworks, professional conduct hearings and national and international benchmarking influenced the need for a CPD system for nurses and midwives in South Africa. The problem statement is that there is no formalised and regulated CPD system for nurses and midwives in South Africa. The following research questions are relevant: • What is the international trend with regard to CPD for nurses and midwives? • What is the national trend with regard to CPD for healthcare professionals in South Africa? • What will a CPD system for nurses and midwives in South Africa comprise? • How will a CPD system for nurses and midwives in South Africa be implemented to ensure credibility? The overall aim of this study was to develop a CPD system for nurses and midwives in South Africa. To accomplish this overall aim the following objectives were formulated: • To explore and describe existing knowledge frameworks on Continuing Professional Development for nurses and midwives in selected countries, internationally and for health professionals in South Africa • To describe the draft CPD system for nurses and midwives in South Africa • To describe a final CPD system for nurses and midwives in South Africa. This study was conducted within the context of the South African professional, ethical and legal framework for Continuing Professional Development for nurses and midwives in South Africa. A descriptive, exploratory and contextual design was conducted. The description of a draft CPD system was based on the theoretical framework. The draft CPD system was developed from 9 June 2000 until May 2003 and exposed to critical reflection by the stakeholders of the SANC, the profession at large and the human resource directorates in each of the nine (9) provinces in South Africa. The researcher developed the final CPD system for nurses and midwives in South Africa. This final CPD system was exposed to critical reflection to confirm face and content validity, followed by a refinement of the CPD system. Emerging from this research and based on the feedback of the validators/appraisers, recommendations are made with reference to practice, nursing and midwifery education and research: The implementation of a formal, coordinated and regulated CPD system for nurses and midwives in South Africa is necessary as part of a quality promotion initiative and to meet the requirements of the transformative legislation especially pertaining to the labour and education legal framework.

The substandard care noted and reported on in midwifery practice at level one midwifery care institutions in South Africa raises a concern about the effectiveness of the assessment strategies used at nursing institutions in enhancing midwifery programme outcomes. The concern is mainly directed particularly at the performance of the newly qualified professional nurses as they are the ones that practise at level one institutions, had just gone through training and been found to be competent practitioners. The success of any training programme and specifically midwifery practice as in the content of this study is dependent on the effectiveness of the assessment techniques or strategies used; hence assessment is considered integral to monitoring the quality of the midwifery care programme. The current study used a quantitative research design to explore and describe the role of assessments in enhancing midwifery programme outcomes at a public nursing education institution in the Eastern Cape Province. Recommendations to enhance the role of assessments for the benefit of midwifery programme outcomes at a public nursing education institution that were made were guided by the findings of the study. Participants were non-randomly selected and were personally provided with a self-developed questionnaire to complete. 134 participants returned fully completed questionnaires while approximately 25% of the selected sample did not return theirs. Data was captured on an excel spread sheet and analysed using Cronbach’s alpha programme under the guidance of the statistician and supervisor. Findings of the study were that: • the participants perceived the role of assessments as positively enhancing the midwifery programme outcomes, • though they also agreed and strongly agreed that there were major factors that prevented enhancement of midwifery programme outcomes. Ethical considerations were autonomy, beneficence, justice and non-maleficence. The validity and reliability of the data- collection instrument was ensured. Furthermore, recommendations were made for nursing education, clinical practice and future research. The study was conducted during the period of July 2014 to January 2016.

Since the inception of the student supernumerary status, both globally and in South Africa, nursing and midwifery educators have been concerned about the clinical competencies of their students. Student clinical competency levels in South Africa are critical to midwifery practice, especially as most litigation against the Department of Health in South Africa concerns negligence in midwifery practice. In addition, the litigations mostly involve newly qualified midwives, thus suggesting a link with practice competency levels. Several challenges exist in the academic and practice environments regarding student learning, practice and clinical preparedness. Lack of support during clinical placement and a lack of facilities for use during clinical practice modules are among these challenges. Some students, due to the challenges they face with clinical learning and practice, fail to meet the practical competencies for examination entry requirements. Consequently, some of these students have to repeat the year or exit the programme. The current study sought to identify how to assist midwifery educators in their activities to prepare students for clinical placement readiness. The first objective of the study was to explore and describe the perceptions of midwifery educators regarding the need for additional measures to enhance the clinical preparedness of basic midwifery students before they are allocated to the clinical areas. The second objective sought to make recommendations that would further assist the midwifery educators to clinically prepare midwifery students before being allocated and placed in different clinical areas. A qualitative, explorative, descriptive and contextual research design was used for the study and the study was conducted at a nursing college in the Eastern Cape Province from August 2014 to January 2016. The research population consisted of midwifery educators at a nursing college and a purposive sampling technique was used guided by set criteria. Data were collected using focus group interviews. Four focus groups were used making a total of 17 participants. The principles applied for data analysis were those of Tesch’s method of data analysis, which were used to develop the themes and sub-themes. An independent coder assisted with the coding of the data for the purposes of trustworthiness. In addition, Lincoln and Guba’s model of trustworthiness consisting of the criteria of credibility, transferability, dependability and conformability was used to confirm the validity of the study while the ethical principles adopted were informed consent, justice, non-maleficence, privacy and confidentiality. The study found that the participants perceived numerous challenges that hindered the clinical preparedness of their students. These related to increased workload, lack of support from management and a lack of commitment on the part of students towards their studies. The participants also identified inconsistencies in clinical practice between the clinical midwives and the educators, and even among the educators themselves. This lack of consistency in turn causes confusion among the students and thus impacts negatively on their clinical practice preparedness. Based on these findings recommendations for clinical nursing practice, nursing education and research were made.

In nursing education, experiential learning is an important part of the curriculum and accounts for almost half of the requirements for the nursing programmes. A positive relationship with and collaboration between the training institutions and clinical placement facilities are vital for student achievement. Nurse educators are also expected to involve themselves in clinical accompaniment to bridge the theory-practice gap. Student nurses placed in midwifery clinical learning environments experience difficulty in meeting their experiential learning outcomes and programme requirements. Due to the overcrowded clinical facilities, they compete for the limited learning opportunities and resources which make the integration of theory and practice difficult. Therefore, this leads to delay in the commencement of community service by some of the nursing students as they do not graduate because of not achieving midwifery clinical outcomes and programme requirements. The purpose of the study is to assess factors affecting experiential learning for midwifery students at the public college of nursing in the Eastern Cape and the main objectives of the study were to: • Identify the challenges affecting the quality of learning in the clinical learning environment. • Determine the nature of supervision for experiential learning of midwifery students. • Determine the role of a nurse educator in the experiential learning of student nurses in midwifery clinical learning environment. Methods and analysis A quantitative, descriptive survey was conducted by making use of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale. The CLES+T is a reliable and valid evaluation scale for the gathering of information on the clinical learning environment and supervision of student nurses. The CLES+T evaluation scale was completed by 115 student nurses within the selected sites. The CLES+T evaluation scale is subdivided into three main sections with additional sub-sections: (1) the learning environment (2) the supervisory relationship and (3) the role of the nurse teacher (lecturer).

A quantitative, descriptive non-experimental design was used to identify the factors that influence clinical teaching of midwifery students in selected postnatal clinical settings in Tanzania. Structured questionnaires were used to collect data from midwifery tutors/preceptors. The major findings of the study showed that both the professional and educational qualification of tutors was low; tutors and preceptors were overworked due to shortage of staff; the school skills laboratory and postnatal wards lacked equipment and necessary supplies; there were no clinical accompaniment guidelines, and overcrowding of postnatal patients. Recommendations included developing the clinical teaching guidelines, employing more tutors, preceptors and clinical staff; improving the tutors'/ preceptors' educational and professional qualifications and updating the qualifications of ward supervisors and clinical facilitators. / Health Studies / M.A. (Health Studies)

A quantitative, descriptive non-experimental design was used to identify the factors that influence clinical teaching of midwifery students in selected postnatal clinical settings in Tanzania. Structured questionnaires were used to collect data from midwifery tutors/preceptors. The major findings of the study showed that both the professional and educational qualification of tutors was low; tutors and preceptors were overworked due to shortage of staff; the school skills laboratory and postnatal wards lacked equipment and necessary supplies; there were no clinical accompaniment guidelines, and overcrowding of postnatal patients. Recommendations included developing the clinical teaching guidelines, employing more tutors, preceptors and clinical staff; improving the tutors'/ preceptors' educational and professional qualifications and updating the qualifications of ward supervisors and clinical facilitators. / Health Studies / M.A. (Health Studies)

Attrition in Higher Education continues to present academics, researchers and professionals with an ongoing dilemma. Achieving a fair balance between the academic rigour of meritocracy and the wider access agenda of social inclusion, demands that entrance criteria incorporates measures beyond the traditional prior academic attainment. Emotional Intelligence has been presented in the literature as a valid and reliable predictor of retention and performance in industry and researchers have suggested that similar benefits may be found in education. In this dissertation, the construct of Emotional Intelligence was explored, reviewing contemporary models and their respective measurement tools. A self report tool for measuring ‘trait’ Emotional Intelligence was selected from the review and used to examine the predictive relationship between emotional intelligence and the outcomes at the end of the first year of undergraduate nurse education namely: clinical practice performance; academic performance and course attrition by nursing and midwifery students. The sample group consisted of a cohort of student nurses and midwives (N = 178) who commenced their training in 2007. A significant predictive relationship was found between emotional intelligence and clinical practice performance (r = 0.75, N = 116, p < 0.05); emotional intelligence and academic performance (r = 0.16, N = 168, p < 0.05) and emotional intelligence and attrition (r = 0.31, N = 178, p < 0.05). Age was also found to predict attrition (r = 0.25, N = 178, p < 0.05) while prior academic attainment was found to predict academic performance (r = 0.20, N = 168, p < 0.05). The dissertation proposes the inclusion of measures of emotional intelligence as an aid to recruitment and selection processes in nurse and midwifery education. It also recommends that other practice based vocational programmes, within the higher education sector, consider exploring emotional intelligence in their recruitment and selection processes.

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)

The purpose of the study was to determine the reasons for student midwives’ absenteeism during midwifery classroom facilitation and clinical placement, and the effects of such absenteeism. A quantitative, descriptive, correlational design was adopted to examine the relationship between absenteeism (independent variable) and student midwives’ performance (dependent variable). Data were collected by means of a three-part questionnaire related to respondents’ demographic data, theory facilitation and clinical placement. Data analysis was done using Statistical Package Microsoft Excell 365 Pro Plus, Version 2019. The study revealed that despite the shortage of staff, the most related factor to absenteeism was the negative staff attitude and lack of clinical accompaniment. These discouraged regular attendance, thus affecting the performance of student midwives. With regards to college resources (classroom facilitation), the study revealed that irrespective of how many days a student midwife missed lectures, academic performance declined. Also, the unavailability of study areas and libraries (after 4 pm), Wi-Fi and internet facilities both in the college grounds and clinical areas contributed to absenteeism. Moreover, health issues, social issues and inadequate transport also contributed to absenteeism to some extent. / Health Studies / M.A. (Health Studies)

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)