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.

A qualitative exploratory, descriptive and contextual research design was used to conduct a study. In-depth individual phenomenological interviews with students purposively selected were conducted. Data saturation was reached after interviewing eight students. The following categories emerged: the participants experienced problem-based learning (PBL) as challenging, problematic group collaboration and cohesion, PBL as a good strategy. The challenges experienced included: unfamiliarity with the strategy, inadequate resources in the library, inaccessible computer laboratories because of limited space and operational hours, time pressures and overload. Clinical learning is not given adequate attention and some professional nurses in the clinical areas are not supportive to the university students as compared to college students. Positive conclusions about PBL include that students need the strategy as it promoted critical thinking, improved communication and presentation skills, helped teamwork and learning from others. / Health Studies / M.A. (Health studies)

Biological nursing science, also known as Bioscience, is a difficult subject or module in nurse training and education worldwide. In the four-year comprehensive nursing diploma programme, Biological Nursing Science (BNS) is one of the core subjects taught in the first year. One of the major bioscience concepts integrated in the undergraduate nursing curriculum is Anatomy and Physiology (A&P). It is essential for students to pass A&P before enrolling for GNS because the two subjects provide details of the normal structures of the body and how they function, which is the foundation of GNS. The failure of students in BNS (Anatomy and Physiology) enrolled for the Diploma in Nursing (General, Psychiatry and Community) and Midwifery is of great concern to the nurse educators and campus principals at the KwaZulu-Natal College of Nursing. The results for the BNS module between 2014 and 2017 indicated that students had problems with the course. Accordingly, the researcher wished to determine the factors that contributed to student failure in BNS (Anatomy and Physiology) in the KwaZulu-Natal College of Nursing. The aim of the study was to identify factors that contributed to the BNS failure rate and make recommendations to improve the pass rate in BNS. The researcher used Jeffreys’ (2013) NURS model as the conceptual framework to examine the influence of student profile characteristics, academic factors, environmental factors and psychological outcomes on Anatomy and Physiology performance. A quantitative, non-experimental, descriptive research design was selected to describe, explain, and predict factors contributing to students’ failure in BNS. Data was collected from 114 respondents by means of a Likert scale-based self-administered structured questionnaire.The study found that shorter breaks between lectures, which caused exhaustion; the one-day study time between examinations; two hours for the subject examination, and educators not involving students in lessons or providing after-class sessions were among the factors contributing to the high failure rate. It is recommended that the curriculum allow sufficient notional hours for teaching; learner support programmes be introduced to assist students who need help; examination timetables be adjusted to allow adequate study and preparation time, and educators involve students in active learning. Recommendations are also made for further research. / Health Studies / M.A. (Health Studies)

An exploratory, descriptive design in the phenomenological approach was used to describe and explore how student tutors' experienced the process of evaluation of their clinical teaching in a specific distance-learning programme. The researcher conducted a tape-recorded focus group interview with seven participants who voluntarily agreed to participate. After transcription, the data was analysed using Tesch's (1992:92) method of analysis to code the data into themes in order to identify commonalities. The findings of this study indicated that participants experienced the evaluation process positively and negatively. The negative experiences included difficulty in obtaining access to evaluators, practica facilities, and inconsistencies of evaluators. Recommendations were made for improving evaluation of teaching skills of student tutors in this distance programme. / Health Studies / M. A. (Health Studies)

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 the study was to develop a short course to inculcate the spirit of Ubuntu amongst the student nurses at Limpopo College of Nursing at Limpopo Province. A sequential explanatory research design was used and data was collected from one hundred and fifteen student nurses at the three (3) campuses for quantitative phase by means of structured interviews and ten (10) level III student nurses from each campus for qualitative phase by means of focus group discussions and reflective diaries. Ten (10) lecturers at the three campus participated in focus group discussions. Quantitative data analysis was done through descriptive analysis and findings were presented in frequencies, tables and charts. The qualitative data analysis was done through Tesch’s eight steps. There were similarities and differences in the themes and subthemes that were presented by all participants. There were also conflicting views from the same participants during qualitative and quantitative phases. The excerpts were presented to support all themes. The study found that Ubuntu needs to be inculcated through formal teaching and mentoring and that Ubuntu should be included in curriculum. Limpopo College of Nursing consists of student nurses from diverse cultures most of which are: Tsonga, Venda and Northern Sotho. They render nursing care to people of diverse cultures as globalisation has encouraged people to travel to different places. Media portrayal of the nursing care in public hospitals and clinics in South Africa is that of negativity. This is partially valid because, for example, the deterioration in nursing care in the public hospitals and clinics is as well evident in Limpopo Province in Mopani District (Bond 2002:1; Mohale & Mulaudzi 2008:61). Furthermore, Ubuntu is not effective if there is no correlation of theory and practice and evaluation of it in the clinical areas. Based on the findings and conclusion of the study, a short course on Ubuntu was developed after the consensus was reached among the participants and the experts who were consulted. / Health Studies / D. Lit. et Phil. (Health Studies)

Using the right method of evaluation for clinical competence in nursing education plays a major role in obtaining appropriate results and making correct judgements. Nurse educators favour the Objective Structured Clinical Assessment (OSCA) for this purpose. The objective of this study was two-fold; firstly to explore and describe the experiences of nurse educators and student nurses of the OSCA within a private nursing college in Gauteng. The second objective was to develop implementation guidelines for the use of the OSCA as an assessment method. A qualitative, exploratory, descriptive, and contextual design was used and employed individual in-depth interviews, as well as field and direct observations to collect data. A purposive sampling method was used to select participants for the study and the sample comprised of ten nurse educators and ten student nurses to represent the population. Data were analysed thematically and resulted in seven themes and eighteen categories relating to nurse educators’ and student nurses’ experiences of the OSCA. Nurse educators had a predominantly negative view of the OSCA as an assessment method related to the ability of the OSCA to assess all learning assessment method related to the ability of the OSCA to assess all learning domains, the quality, structure, and organisation of the assessment, the simulated nature of OSCA, the availability of resources, as well as the feedback, communication and remedial action during the process. Challenges were experienced with the assessment tools as well as the educator as instrument. Educators raised a concern regarding the students’ readiness for evaluation. Student nurses related their experiences prior to the OSCA, their experiences of the educator, the structure and organisation of the OSCA, and their experience related to the communication and feedback of the results. Students related mixed emotional experiences as recipients of the assessment, as well as the relevance and benefits of the OSCA / Health Studies / M.A. (Nursing Education)

Background: Literature has shown that negative attitudes and unwillingness to care for HIV-infected patients are prevailing among healthcare workers. This study aimed to assess the attitudes and willingness of student nurses towards caring for HIV-infected patients in some public hospitals in Gert Sibande district, Mpumalanga. Method: A contextual exploratory quantitative descriptive survey was conducted among student nurses enrolled for a four-year nursing qualification in a nursing college at Mpumalanga province. Self-administered questionnaires were completed after obtaining an informed consent. Results: A total of 122 (70.9%) students participated in this survey. Findings showed that most participants had positive attitudes 66 (52.7%) and were willing 121 (99.1%) to care for HIV-infected patients. Significant associations were revealed between participants’ previous HIV testing (p=0.012), age group (p=0.009), and their willingness to provide care to HIV-infected patients. Conclusion: Results showed a generally positive attitude and willingness by participants to care for HIV-infected patients. / Health Studies / M.A. (Health Studies)

The purpose of this study was to describe the perceptions/views of student nurses, nurse educators and unit supervisors on accompaniment of student nurses in clinical settings of the Northern Province of the RSA A quantitative descriptive cross-sectional survey was used in this study to describe the perceptions/views of student nurses, nurse educators and unit supervisors on apcompaniment of student nurses in clinical settings. Data was collected during February and March 200 I when student nurses, nurse educators and unit supervisors in the Northern Province completed questionnaires. The study revealed positive and negative perceptions regarding accompaniment of student nurses in clinical settings, including that: • accompaniment in the clinical settings enhanced student nurses' clinical learning experiences • the presence of nurse educators in the clinical settings improved student nurses' accompaniment • facilitators played an important role in the accompaniment of student nurses • accompaniment enhances correlation of theory and practice / Health Studies / MA (Advanced Nursing Sciences)

The aim of this study was to determine the role of the nurse educator in supporting pupil nurses. A quantitative, descriptive survey design was used with a questionnaire as data collection instrument. The sample included pupil nurses following the two year programme for enrolment as a nurse at one of the sub-campuses in Kwa-Zulu Natal. The results revealed that support was offered in the classroom and in the clinical field, though some of the pupil nurses were not happy with the clinical allocations. It was revealed that they were sometimes used as part of the workforce. There was a significant difference between means for the four aspects of support (classroom teaching, clinical teaching, assessment and motivation). The mean ranking for classroom and clinical teaching, were significantly higher than for assessment and motivation. Recommendations with reference to nursing education and further research regarding specific aspects of pupil nurse support were made. / Health Studies / M.A. (Health studies)