Clinical practice is the core of nursing education during which the student is socialized into the nursing profession. During this period, there is transfer of knowledge and skill from qualified nurses and other members of the multidisciplinary team to student nurses. The purpose of this study is to describe and explore student nurse’s experiences of clinical accompaniment in a public hospital in Gauteng Province by means of a qualitative approach that included the exploratory, descriptive and contextual study. Three focus group interviews were conducted with students and one with clinical accompanists. Qualitative methods included categorizing and coding. The major findings of the research revealed that participants regarded relationships and communication as important for clinical accompaniment. Both student nurses and unit supervisors expected nurse facilitators to accompany students in clinical settings; but some hospital staff members did not perceive clinical accompaniment to be their task. / Health Studies / M.A. (Public Health)

A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. Difficulties in the development of valid and reliable assessment measures in nursing competency continue to pose a challenge in nursing education. A holistic approach in the assessment of competency comprises knowledge, skills and professional attitudes, wherein the notion of competency incorporates professional judgement and management skills in the clinical situation. Therefore, the thesis aims to develop a holistic clinical assessment tool with a reasonable level of validity and reliability to meet the needs of clinical education. The conceptual framework underlying this research is formed by establishing a theoretical connection between the practice of learning, and of pedagogy and assessment. This research consists of five studies. In Study I, a systematic review was conducted to explore the current assessment practices and tools for nursing undergraduates. In Studies II, III and IV, a qualitative approach with focus group discussions was adopted to explore the views of final-year undergraduate nursing students, preceptors, clinical nurse leaders and academics on the clinical assessment. Based on the multiple perspectives, it therefore addresses concerns in clinical assessment. In Study V, a holistic clinical assessment tool was developed, for which a psychometric testing was conducted. The systematic review indicated that limited studies adequately evaluate the psychometric properties of the assessment instrument. The qualitative studies have raised an awareness of professional and educational issues in relation to clinical assessment. Workload, time, availability of resources, adequate preparation of preceptors, and availability of valid and reliable clinical assessment tools were deemed to influence the quality of students’ clinical learning and assessment. In addition, the presence of support systems and formal educational programs for preceptors influenced their preparation and self-confidence. Nursing leaderships in hospitals and educational institutions have a joint responsibility in shaping the holistic clinical learning environment and making holistic clinical assessment for students. The involvement of all stakeholders in the development of a valid and reliable assessment tool for clinical competency is also essential to the process. The Holistic Clinical Assessment Tool (HCAT) was developed by the author based on the systematic review, qualitative findings and the core competencies of registered nurse from the professional nursing boards. The HCAT consists of 4 domains and 36 assessment items. Furthermore, testing of the psychometric properties indicated that the HCAT has satisfactory content validity, construct validity, internal consistency and test-retest reliability. In conclusion, the HCAT is meritorious in that it carries the potential to be used as a valid measure to evaluate clinical competency in nursing students, and provide specific and ongoing feedback to enhance the students’ holistic clinical learning experience. The HCAT not only functions as a tool for self-reflection for the students, but also guides the preceptors in clinical teaching and assessment. In addition, the HCAT can be used for peer-assessment and feedback. It is imperative that the clinical and academic institutions establish various levels of ongoing support for both students and preceptors in the process of clinical assessment.

Clinical learning experiences form an integral part of the student nurse's training, for it is in the clinical setting that students acquire the knowledge, skills and values necessary for professional practice. The purpose of this research was to explore student nurses experiences during clinical practice. A qualitative, exploratory, descriptive and contextual design was utilised, employing the phenomenological method. Unstructured interviews were conducted with student nurses in their final year of the four year nursing programme at a nursing college campus in the Limpopo Province. Tesch's method of data analysis was used. The findings indicate that there are aspects which impact negatively on student nurses' clinical learning experiences, such as lack of teaching and learning support, lack of opportunities for learning, poor theory-practice integration, and poor interpersonal relationships between the students, college tutors and ward staff. Recommendations to enhance the clinical learning experiences of student nurses were made. / Health Studies / M.A. (Health Studies)

The purpose of the study was to determine and understand the challenges that student nurses encounter in the clinical learning environment (CLE) in Limpopo Province, South Africa and how these challenges can be addressed. A quantitative, descriptive, cross-sectional survey was used. The population consisted of levels 2, 3 and 4 year student nurses from three campuses of Limpopo College of Nursing. The researcher used a self- developed questionnaire for data collection. Out of 206 questionnaires, 152 were returned fully completed, yielding 74% effective response rate. The study revealed some of the challenges which negatively affect students’ education and clinical learning and strategies were devised to address these challenges / Health Studies / M.A. (Nursing Science)

Qualified nurses cannot perform tasks and procedures with confidence due to ineffective mentoring by a clinical nurse during training. Effective mentoring by the clinical nurse, with an additional accredited qualification in his/her field should assist in the development and confidence of the student nurse. The purpose of this study was to explore the learner’s experience of mentoring and facilitation by the clinical nurse, challenges and their view of the clinical nurse, and if this could be a predictive factor to their level of an independent nurse practitioner at the end of training. A non-experimental, descriptive qualitative design was used to identify the experience of the students and newly qualified nurses regarding the amount and quality of facilitation given by the clinical nurse in practice. The research population consisted of all categories of student nurses currently in training as well as qualified nurses within the past year from different facilities. An online semi-structured questionnaire survey was distributed among 45 participants and feedback received by 32 anonymous participants in the public and private sector. The findings of the study indicated that not all newly qualified nurses are able to practice as independent nurses, there’s a lack in mentoring and facilitation by clinical nurses during training and that a clinical nurse should have an additional qualification to better the learner experience. / Health Studies / M.A. (Nursing science)

A quantative descriptive study was used to describe the factors that influence the output in the four (4) year nurse training programme. Data was collected by using a self administered questionnaire to 73 participants sampled by stratified random sampling in the Southern Campus of Free State School of Nursing in the Free State Province. Data was analysed by using SPSS computer version 15. The findings of this study revealed that there were difficult subjects like Fundamental Nursing Science, General Nursing Science, Basic Nursing Science, Psychiatric Nursing Science and Midwifery. These were identified per year level of study. The study revealed that difficulty experienced by students resulted in them failing the indicated subjects. Recommendations were made as to how to address the identified factors especially those regarding subjects that were failed in each level, different teaching strategies that could be used to improve the throughput. / M. A. (Health Studies) / Health Studies

Clinical practice is the core of nursing education during which the student is socialized into the nursing profession. During this period, there is transfer of knowledge and skill from qualified nurses and other members of the multidisciplinary team to student nurses. The purpose of this study is to describe and explore student nurse’s experiences of clinical accompaniment in a public hospital in Gauteng Province by means of a qualitative approach that included the exploratory, descriptive and contextual study. Three focus group interviews were conducted with students and one with clinical accompanists. Qualitative methods included categorizing and coding. The major findings of the research revealed that participants regarded relationships and communication as important for clinical accompaniment. Both student nurses and unit supervisors expected nurse facilitators to accompany students in clinical settings; but some hospital staff members did not perceive clinical accompaniment to be their task. / Health Studies / M.A. (Public Health)

This research is concerned with the assessment of student nurses' practice, implementation of which has been considered problematic since the move of initial training into higher education. It examines clinical nurses' accounts of assessment, and rejects an approach based on identification of competencies as too rationalistic for a situated practice. Insights from, in particular, Foucault, Deleuze, and Derrida were used to analyse practitioners' alternative discourse of practice, and the processes of self-constitution and decision-making. Eighteen practitioners from different settings were interviewed in depth about how they determine acceptable performance. Three participants were interviewed twice to develop ideas arising from the first round of conversations. Practitioners' accounts challenged the conventional understanding of assessment, and the construction of practice implicit in current policy. The analysis suggests a more fluid, un-predetermined understanding, characterised by hesitation and uncertainty, though without losing a concern with safe practice. Several implications for policy and practice are presented. These require a shift of authority towards practitioners' situated judgements and away from predetermined outcomes, both in respect of programme planning and policy guidelines on the specification of standards. A new alliance is proposed to encourage a more authentic engagement with the process from both clinical and educational practitioners.

Department of Advanced Nursing Science / MCur

The overall purpose of this study was to explore and describe the factors that affect theory-practice integration of student nurses at a selected campus of a nursing college in the Limpopo Province. Quantitative, descriptive, explorative and cross-sectional designs were used to accomplish the objectives of the study. Data collection was done using structured questionnaires with a few open-ended questions. The respondents were student nurses (n=106) and nurse educators (n=9). The findings revealed that failure of biological and natural sciences subjects, the use of traditional teaching strategies, inadequate use of simulation laboratory, inadequate clinical supervision, a shortage of resources, nature of the assessment process, extent of interest in the subject (s) taught, inability to draw clinical experiences during theoretical teaching, overpopulation of student nurses in the clinical area, negative attitude of ward staff and differences between the simulated skills and the actual clinical procedures in the ward affect theory-practice integration. / M.A. (Health Studies) / Health Studies