Assessment of clinical learning is imperative in order to ensure that those who become registered nurses are safe and competent practitioners. Assessment of clinical skills requires evaluation of the development of appropriate knowledge, skills and attitudes. Literature however reveals that the measurement of clinical skills performance continues to pose a challenge for nurse educators, the debate around the best assessment method in clinical learning, as well as, validity and reliability in assessing clinical learning is ongoing. This study was therefore aimed at exploring and describing current practices in assessment of clinical learning in a nursing diploma programme in Kigali Health Institute in Rwanda. The study was a quantitative descriptive exploratory design. Data were collected through the use of questionnaires. Nurse educators, students and external examiners were asked to report on the assessment strategies commonly used in Kigali Health Institute, their views about assessment strategies, and the strengths and weaknesses of clinical assessment strategies used in a nursing diploma programme in assessing practical competences of nursing students. The total number of participants who returned questionnaires in this study was 117. The results of this study revealed the commonly used assessment strategies included OSCEs (100%), case presentations (66%), direct observations (38%), standardized patients (31 %) and reflective diaries (2%). Furthermore, assessments were based on clinical learning outcomes. Assessments were conducted formatively and summatively to ensure validity in assessments and to ensure that a variety of clinical learning areas were assessed. Although there was no documented structured process of conducting clinical assessments, the findings revealed that the process included a number of phases; planning, preparation, implementation and evaluation phases. There were measures in place to ensure validity and reliability in assessments. The need for a policy on clinical learning assessment emerged so as to serve as a guide to ensure consistency in conducting assessments. The need to build the capacity of nurse educators and external examiners also came up as very few had educational preparation for their roles. Most of them were specialists in the discipline not in nursing education. The findings also revealed that not all nurse educators were involved in decision making regarding clinical assessments for quality assurance purposes. Issues such as welcoming of students on the assessment day, giving of instructions to students, time spent on performing tasks, feedback to students, returning to tasks which were not completed and improvising during assessments due to limited resources emerged as areas of concern. Recommendations made are related to the assessment process, the building of capacity of nurse educators and external examiners, preparation of students for clinical learning assessment, and further research for the in-depth exploration of this area. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2007.

In the past, clinical skills were wholly performed at bedside in which patients were used as teaching aids. The profound change in professional education and health care systems had made this teaching method less effective. Therefore clinical skills laboratory (CSL) is widely adopted as a strategy to support student development of clinical skills. However, there is little empirical evidence about perceptions of students and nurse educators engaged in day to day learning and teaching in the CSLs. This study was therefore aimed at exploring the perceptions of students and nurse educators about teaching and learning in the clinical laboratory in Kigali Health Institute in Rwanda. This study was a quantitative descriptive exploratory design. Data were collected trough the use of questionnaires. Students, nurse educators were asked to rate their views on a 5 points Likert scale about antecedents, teaching and learning strategies used in the CSL, teaching and learning process, benefits of the teaching and learning in the CSL and limitations. Three open ended questions were asked to nurse educators about the benefits of teaching and learning in the CSL, limitations and their recommendations for effective use of the CSL. A document review was done to complete data. The total number of participants who returned questionnaires in this study was 214 students and 17 nurse educators. The results of this study revealed that students and nurse educators view the teaching and learning valuable, the location of the CSC was important factor in students teaching and learning, resources were available and the CSL administration ensured smooth running of the CSL. However there was a lack of enough staff for effective teaching and learning in the CSL. The findings revealed that innovative teaching and learning strategies (demonstration, peer learning, small group, reflective learning and self directed learning) were used in the CSL. The CSL was accessed through booking and time tabled sessions and students support from nurse educators was ensured. The CSL was seen by both students and nurse educators as a learning environment which supports the linking of theory and practice, ensure students practicing skills, offer to student a safe environment to learn. However there was a gap in teaching and learning communication skills. There was limitation for teaching and learning as it is costly in staffing resources and maintenance, not clearly stated in the curriculum and KHI academic policy, time consuming for nurse educators and requires expertise from nurse educators to cope with students needs. The findings espouse many previous study findings in nursing education domain. The results reflected that the location or accessibility of the CSL, as well as the availability of material and human resources, having a CSL coordinators is critical to ensure effecting teaching and learning in the CSL, the teaching and learning process favour innovative teaching strategies, other researches in the area revealed benefits and limitation of the CSL. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.