D.Cur. / Nurse educators have a multifaceted and ambiguous professional as well as personal role. They teach nursing theory, accompany student nurses in the clinical area and are expected to carry out research. Very few — in the nursing colleges — are actually involved in scientific study and relate this to unavailability of resources like sponsorship and time, to support such efforts. Added to this is their personal role as spouse or partner, as parent, as significant other and as friend. Faced with the challenges of the change from curative to the primary health care approach to health services delivery, and according to provincial legislation, the restructuring and rationalisation of health services, induding rationalisation of nursing colleges, the nurse educator is negatively affected by these changes and gets stressed. As a result of the complex and changing social, economic and political dimate, these challenges pose a threat to the nurse educator, who perceived herself as being unable to cope. Change occurs continuously in nursing, and therefore in nursing education, because of the dynamic health care system. Change, for better or for worse, can be stressful. It puts big demands on a person's ability to cope. The nurse educator in this changed climate, being unable to cope, gets stressed, and if any stressful situation is allowed to progress to distress, the health — mental, physical and spiritual — of the nurse educator might be adversely affected. Supporting the nurse educator to cope with this change may help her to accept the dynamic changes taking place around her. Learning to cope will not only give nurse educators control over their lives and well-being, but would leave them free to concentrate on helping themselves and others and teaching student nurses. The purpose of this research was to generate and describe a support approach and to describe guidelines to operationalise the support approach, for the psychiatric nursing clinical specialist to utilise for the nurse educator who is working in a nursing college that is earmarked for rationalisation, in order to promote, maintain and restore mental health as an integral part of health. Based on the above discussion, the following questions were addressed in this research: How do nurse educators experience life in all its dimensions? What support do they think they should receive? What approach can be described to support the nurse educator? What guidelines can be described to operationalise the support approach? A qualitative, explorative, descriptive and contextual research design was followed. The research was conducted in four phases with a pilot study preceding the first phase of the research. In phase one, phenomenological interviews were conducted with seven nurse educators to explore their experience of life in all its dimensions. Data was analysed according to Tesch's method. Based on the results of analysed data, fear and uncertainty, anger and hope/hopefulness were the identified themes. In phase two, focus group discussions were held with the same group of nurse educators to explore their views on what could be done to support them. Selfmanagement, justice and fairness and enrichment were the identified themes. In phase three themes from phase one and phase two were utilised to form a bridge, leading to the description of an approach to support nurse educators. Phase four dealt with the description of guidelines to operationalise the support approach. Recommendations and limitations of the research were also discussed.

M.Cur. / The purpose of nursing, as a human clinical health science, is to give a comprehensive, purposeful service to mankind in totality. This service must be supported by sound theoretical background. In ~he nurse's training, theoretical knowledge must be integrated with the practical situation to encourage the development of the student as a professional person, to an experienced practitioner. For the purpose of this study, a descriptive contextual research was done to determine to what extent the present block system training program facilitates the integration of theory and practice to the first year student. Through relevant literature search and by using the Nursing for the Whole Person theory, the model for accompaniment and the curriculum development model, a conceptual framework was compiled.

M.Cur. / The purpose of this research is to describe a model as framework for the nursing lecturer to utilize in the empowerment of the nursing education student as a reflective learning accompanist in nursing education. Because of the rapid changing political situation in the Republic of South Africa, unprecedented changes are occurring in education and health services. A greater degree of multi-cultural student numbers is experienced in classrooms at tertiary education institutions. Because of the increased accessibility to health services, these specific services are overcrowded by clients/patients. The overcrowding results in a shortage of trained nursing staff. More nursing students register at tertiary institutions, leading to a greater need for nursing education lecturers. These two aspects were identified as the most important causes of this specific research study in nursing education. It is assumed that the nursing lecturer, as reflective learning accompanist, empowers nursing education students to facilitate reflective thinking in their nursing students, by means of reflective learning accompaniment. This serves to improve nursing education, as well as the maintenance and improvement of nursing within a context of an increased need for health services. By means of more efficient education in the development of nursing education students, as reflective learning accompanists in nursing education, the increased demand for more comprehensive and more efficient health care services is addressed. In order to facilitate reflective thinking, the nursing lecturer must empower the developing nursing education student by means of reflective learning accompaniment in order to facilitate reflective thinking.

D.Cur. / The overall aim of the study is to describe a model to facilitate reflective thinking of learners in clinical nursing education. This aim is realised through exploration and description of the meaning of reflective thinking in phase one of the study using Wilson (1963). Theoretical validity was ensured. The results of phase one provided a conceptual framework to direct data collection in phase two by exploring and describing the perceptions of nurse educators with regard to how reflective thinking of learners can be facilitated in clinical nursing education. An etic approach to qualitative data analysis as described by Morse (1994) was used, with matrices (Miles & Huberman, 1994) to provide meaningful categories, subcategories and themes. Both the results of phase one and two provided the main concepts, which were classified and defined within Dickoff, James and Wiedenbach (1968:435)'s six components of the survey list. Conceptualisation of the six components constitutes phase three of the study. Lastly phase four deals with the description and evaluation of the model with guidelines to operationalise the model. Nurse educators, who are facilitators, are challenged with the responsibility to establish quality clinical nursing education in line with the international norms, ethics, legal and professional standards. They are challenged with the creation of the environment conducive to facilitate reflective thinking through interaction. The facilitative interactive methods of teaching and assessment based on the constructivistic approach to learning demands dialogue, discourse and narratives, and therefore problem-based learning, outcomes-based education and community-based education using the PHC principles forms an integral aspect in creating the environment conducive to the facilitation of reflective thinking in clinical nursing education. These teaching and learning approaches needs active involvement of the learner in constructing his/her own clinical knowledge, skills, attitudes and values through collaborative, co-operative shared activities in partnership with all other stakeholders responsible to provide clinical learning opportunities for learners to integrate theory to practice. The affective component of both the facilitator and the learner actually drives the process of reflective thinking in a specific cultural context. The traditional methods of teaching and evaluation hinder the facilitation of reflective thinking. Models and conceptual frameworks that address reflective thinking in nursing does not address how reflective thinking can be facilitated, hence the research question is "how can reflective thinking of learners be facilitated in clinical nursing education"? The explorative, descriptive, qualitative, theory generative and contextual design is used to describe a model to facilitate reflective thinking of learners in clinical nursing education, with guidelines to operationalise the model. Paradigmatic perspective with regard to man (facilitator and the learner), environment (clinical nursing education), reflective thinking (purpose) and the interactive facilitation as the dynamic of the study are described within Theory for Health Promotion in Nursing (1991). The constructivistic perspective provides the theoretical framework. The qualitative approach that is exploratory and descriptive for theory generation provides the methodological assumption. The results of concept analysis and the results of the perceptions of nurse educators with regard to how reflective thinking of learners can be facilitated in clinical nursing education provide conceptual meaning and identification. The identified major and minor concepts are classified and defined using Dickoff, James and Wiedenbach (1968:435)'s six components of the survey list. Through synthesis, at the end of each conceptualisation, concluding relational statements are described from which the model is inferred. The model is described using Chinn and Kramer (1991:107-125)'s method of theory generation and evaluation. Experts in qualitative research and model development do refinement of the model. The facilitator is responsible to create the environment that is stimulating and conducive for learning. The learner on the other hand is responsible for selfdirected, self-regulatory learning where active participation in the construction of own learning through interaction is the hallmark, in order to facilitate reflective thinking in clinical nursing education. Interactive facilitation is the dynamic through which reflective thinking has to be facilitated. Clinical nursing education provides the context. The procedure to facilitate reflective thinking of learners in clinical nursing education is through the three phases of reflective thinking guided by the adapted educational process in the format of the nursing process. Once the purpose of the model is achieved (reflective thinking), the learners will be expected to improve practice through rational decision making and solving of problems. They will be expected to practice independently and autonomously, and to view clinical situations holistically with changed perspective based on the existing conception. Learners will have acquired skills for lifelong learning. The described guidelines will assist nurse educators with the operationalization of the model in order to provide quality assurance in clinical nursing education, with subsequent provision of quality nursing care and the improvement of the credibility of the profession.

D.Cur. (Professional Nursing Science ) / The nursing practice needs critical thinkers because of diverse and rapidly changing developments and desired outcomes in health care. These developments are based on health and informational changes, organisational and cultural change sin nursing education, changes in the scope o fpractice, and increasing patient acuity and the movement of patient care from acute care facility to community selling have increased demands for nurses to think critically, evaluate and quickly choose patient strategy. a need for effective clinical decision making and a need for clinical judgement (Sedlack, 1997:11). Old standards of simply being able to score well on standardized test of basic skills, though still appropriate. cannot be the sole means by which we judge the academic success or failure students. The implication of SAQA Act (/995) and the Education White Paper(1997) on transformation of higher education bring with them challenges for reaching and assessment of tertiary education graduates. The white paper stressed the importance of the development of the ability to think independently and with innovation. The South African Nursing Council (SANe, 1984:3) states explicitly in the philosophy about nursing education, that the development of critical analytically thinking is imperative. Therefore it is imperative for nurse educators to use specific assessment strategies that will assess if students have acquired critical thinking skills. The purpose of this study is to explore and describe strategies to assess critical thinking in a four year program leading to registration as a nurse (General, Psychiatry and Community) and Midwifery in South Africa)

M.Cur. (Nursing Education) / Although all students planning to do the B.Cur.-degree at the Rand Afrikaans University are subjected to a selection procedure, the attrition rate for the course is considerable. In 1975, only nine of the original 23 students graduated, and in 1976 only ten of the original 31 students were able to complete the course. An attempt was made to evaluate the present selection process which consists of a slidingscale and a structured interview. The sample consisted of all students registering for the B.Cur.-degree from 1975 to 1980. Findings are based on data gathered from selection records and records of academic achievement as well as a structured interview with all applicants. The findings consist of the following - if the slidingscale is to be used in future, students in the catagories 50-59 and 60-69 may be reconsidered for entrance - in the catagories 90-99 and 100+, 46,9 per cent of the students resigned in their first year and research in this connection would be of value the fact that a course is selected as a major, does not seem to be related to academic success, especially during the first year of study - there seems to be a significant positive relationship between the structured interview and academic success. Although research of this specific nature has not yet been replicated, the findings could, however, be seen as representative of B.Cur. students in the Republic of South Africa.

M.Cur. / The entire country is currently in a process of reconstruction that inevitably lead to reconstruction within the health care system. The ANC (African National Congress) formulated a National Health Plan based on primary health care that is a practical expression of providing an effective and equitable health care to all inhabitants of the country. Recognising the need for transformation, a process was initiated by the African National Congress (ANC) to develop an overall National Health Plan based on the Primary Health Care approach (ANC, 1994: 7) . In the light of these present needs, the vision is to develop a strategy to empower our professional nurses that can effectively implement primary health care whilst operating within the limitations of the existing resources (Human Resource Committee for Health, 1994:5). The context of the study is applicable to the Northern Region of the North West Province. There are various courses available to empower professional nurses to primary health care, but for the purpose of the study is the Diploma Course in Clinical Nursing Science, Health Assessment, Treatment and Care described

M.Cur. / It is quite explicit that transformation in nursing education on clinical accompaniment of the critical care nursing students in the private hospital critical care units is inevitable. It is needed to accommodate the demands made that nurses should make rapid decisions in the crisis situations, taking responsibility that were previously of those of the physicians resulting in the increased complexity of decision-making. The decision-making skills demands that the nurses should develop the ability for the analytical, critical evaluation, critical thinking and ability of independent judgement of the scientific data as stated by the South African Nursing Council Regulation 2118 (1983:2). It also demands that the registered nurses working in the critical care units be suitably trained by completion of the Intensive Care Nursing Science course as specified by the South African Nursing Council Regulation 85 as amended (Nursing Act of 1978). The critical care nurses are required to integrate both the knowledge of the highly sophisticated technological equipment and also the understanding of the complex patient's problems. It is also explicit that, there is a need to develop the guidelines on clinical accompaniment of the critical care nursing students in the private hospital critical care units as no written guidelines are available. The overall objective of the study is to describe the guidelines on clinical accompaniment of the critical care nursing students in the private hospital critical care units. The guidelines will be utilised as a point of departure for the facilitation of attainment of quality/excellency in nursing education, skills or competency of the critical care nursing students in the private hospital critical care units.

Text in English / The purpose of this study, was to identify and describe factors, which facilitate or impede learning in clinical learning settings. The study adopted an exploratory descriptive approach, incorporating both quantitative and qualitative designs. Data collection tool, comprised of two sections: Section 1 focused on demographic characteristics. While section 2 addressed study variables of clinical setting, staffing, patient care/ practice standards, nurse manager's commitment and interpersonal relationships. The last section had two parts; part 1 being close ended Likert type scale ranging from strongly agree to strongly disagree. Part 2, was open ended, and solicited respondents' feelings opinions and experiences on factors they perceived to facilitate or impede clinical learning. The findings indicate that the majority of settings studied did not provide adequate factors to facilitate clinical learning. Factors such as availability of learning experiences, acceptable unit organization, space and resource availability, and accessibility to students, adequate staffing with qualified staff who actively participate in teaching, appropriate and quality patient care role modelled, lecturer availability and involvement in clinical teaching, team building and inclusion of students in the team, committed nurse managers involved in students' learning, conducive relationships among staff, students and patients, comfort relationships, advocacy and creating conducive relationship by the nurse manager, were identified as necessary for learning. These factors however, were found to be either lacking, inadequate or inaccessible to students. Findings were based on data from a quota sample of 202 participants proportionately drawn from students, nurse managers and nurse lecturers. The study made recommendations to improve and enhance the conduciveness of clinical practice settings used for learning in Botswana. / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)

Text in English / The purpose of this study, was to identify and describe factors, which facilitate or impede learning in clinical learning settings. The study adopted an exploratory descriptive approach, incorporating both quantitative and qualitative designs. Data collection tool, comprised of two sections: Section 1 focused on demographic characteristics. While section 2 addressed study variables of clinical setting, staffing, patient care/ practice standards, nurse manager's commitment and interpersonal relationships. The last section had two parts; part 1 being close ended Likert type scale ranging from strongly agree to strongly disagree. Part 2, was open ended, and solicited respondents' feelings opinions and experiences on factors they perceived to facilitate or impede clinical learning. The findings indicate that the majority of settings studied did not provide adequate factors to facilitate clinical learning. Factors such as availability of learning experiences, acceptable unit organization, space and resource availability, and accessibility to students, adequate staffing with qualified staff who actively participate in teaching, appropriate and quality patient care role modelled, lecturer availability and involvement in clinical teaching, team building and inclusion of students in the team, committed nurse managers involved in students' learning, conducive relationships among staff, students and patients, comfort relationships, advocacy and creating conducive relationship by the nurse manager, were identified as necessary for learning. These factors however, were found to be either lacking, inadequate or inaccessible to students. Findings were based on data from a quota sample of 202 participants proportionately drawn from students, nurse managers and nurse lecturers. The study made recommendations to improve and enhance the conduciveness of clinical practice settings used for learning in Botswana. / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)