Philosophiae Doctor - PhD / In this doctoral thesis, I explored how the national guidelines for higher education to institutionalise service-learning as a particular type of community engagement were implemented in South African higher education institutions. Whilst the particular School of Nursing where the study was conducted was cognisant of the national policy imperative on service-learning as stipulated in the guidelines of the Higher Education Quality Committee (HEQC), operationalisation within the academic programmes had not been addressed. An intervention study was thus undertaken to develop a service-learning implementation framework for the School of Nursing using the multi-phased design and development model of Rothman and Thomas (1994). The factors that influenced the implementation of the HEQC’s service-learning policy guidelines in the nursing programmes were explored during the first phase: problem analysis and project planning. During this phase, the research focused on the readiness of the school to institutionalise service-learning at organisational and individual level because service-learning scholars advocate a systems approach to service-learning institutionalisation. At organisational level, the research question investigated whether the higher education institution had created an enabling environment for the school to institutionalise service-learning successfully in the academic. The factors that were associated with readiness at organisational (school) level were those cited as critical success factors for service-learning institutionalisation by Furco (2002) or better known in South African terminology as service-learning good practice indicators. Individual readiness was determined in terms of service-learning scholarship and willingness to participate in service-learning -capacitating activities.

Background: While serious illness communication is an important aspect of nursing care, it is recognized as an area of practice for which nursing students are not adequately prepared. Communication tools such as the Serious Illness Conversation Guide (SICG) may help address these gaps in knowledge and skill. Aim: The aim of this study is to explore undergraduate nursing students’ experiences engaging in serious illness communication and their perceptions about participation in a SICG workshop that aimed to improve such communication. Methods: A qualitative descriptive approach was used. One-on-one, semi-structured interviews were conducted with eight undergraduate nursing students at McMaster University who had attended SICG training. Critical incident technique was used to elicit participant accounts of engaging in serious illness communication at their professional practice placements. Data were analyzed using qualitative techniques. Participants were surveyed to assess perceptions of the SICG workshop. Findings: Three themes related to undergraduate nursing students’ experiences engaging in serious illness communication after receiving SICG training were: a) serious illness communication is challenging to enact, b) finding moral and ethical ground, and c) fitting into the culture of the professional practice setting. Three themes related to nursing students’ perceptions of the SICG workshop were: a) applicability of SICG training to practice, b) strengths of SICG training, and c) limited opportunities to develop competence. Conclusions: Nursing students are challenged by serious illness communication in their practice. Findings support the integration of educational resources aimed to better prepare them for critical communication knowledge and skills on entry-to-practice. / Thesis / Master of Science in Nursing (MSN)

Philosophiae Doctor - PhD (Nursing) / Literature attest that holistic approach to care is the best way to ensure that all human needs, including spiritual needs are taken care of. As such holistic approach to care accepts the notion of "wholeness" nature of the patient. However, in practice patient's holistic needs, which are essential for optimum health, are not routinely addressed when practicing nursing. This implies that regardless of the nurses doing their best to attend to patient's health needs, patients still do not achieve their required optimum health. Furthermore, in the face of good nursing education programmes, attempts to meet the patient's care needs as advocated, a gap still exists in rendering nursing services that truly promote health in a holistic manner. Confusion regarding the scope and holistic nature of nursing, relates not only to nursing organisations having failed to define nursing with clarity concerning the spiritual dimension of care; but they have also not succeeded in implementing nursing that is truly holistic. In this study, it is argued that where spiritual care aspects in nursing remain at the periphery, holistic nursing cannot be truly attained. According to Burkhardt and Hogan promoting one's spirituality within a nursing paradigm can be one way to promote and optimise health, particularly in response to illness. In view of the existing gap between teaching-learning of spiritual care and espoused theory of holistic nursing, a need to develop a theory that would guide and assist nurse educators and nursing students in the teaching and learning of spiritual care was imperative. The aim of this research was to generate a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution by answeringthe research question "how can a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution in the Western Cape be generated? Ethical procedures were applied in accordance to stipulations of the University Research Ethics Committee. The credibility of the study was ensured by application of Guba's model of trustworthiness for qualitative data.

The number of new graduates greatly affects the existence of any profession and for the nursing profession this rings very true. However, in this caring and nurturing profession many undergraduate nursing students indicate that they consider leaving the profession due to exposure to intra-professional violence. Intra-professional violence may take many forms, is perpetrated by different individuals and have negative effects on patients, staff and institutions therefore it should be identified and managed. In South Africa it has, so far, been a topic which has not received much attention. Purpose Determine the presence of intra-professional violence experienced by undergraduate nursing students in South Africa and then create an awareness of intra-professional violence to eliminate the occurrence thereof. Design A quantitative, non-experimental, explorative and descriptive design was used. Methods The data was collected by means of a questionnaire. The questionnaire was distributed to undergraduate nursing students at nine NEI in South Africa. Findings Although characteristics of oppressed group behaviour are present in undergraduate nursing students it to a low extent. Undergraduate nursing students are experiencing intra-professional violence in the clinical learning environment from different perpetrators. The most likely perpetrator is the registered nurse. The intra-professional violence does cause stress but are deemed controllable according to the undergraduate nursing students. Furthermore the results show that the presence of stress results in an increased control of intra-professional violence. The most likely coping mechanism for intra-professional violence is to do nothing. Conclusion The findings correlated with international results and indicate that intra-professional violence is experienced by undergraduate nursing students in South Africa. Oppressed group behaviour is a contributing factor, but is not the sole cause. Undergraduate nursing students do need education about intra-professional violence and engaging coping mechanisms. Clinical relevance If intra-professional violence is controlled, interpersonal relationships can improve. This would create an environment in which learning can be promoted and undergraduate nursing students will be able to develop their clinical skills with confidence. Furthermore, attrition will decline and nursing shortages can be countered. / Dissertation (MCur)--University of Pretoria, 2012. / Nursing Science / unrestricted

Background: There has been an increasing shift in patient care from the acute hospital setting to the community. Nurses play an essential role as part of the community health care workforce; however, only a limited number of baccalaureate nursing students tend to choose a career in community health nursing after graduation. There is currently a gap in knowledge surrounding nursing students’ perception of a career in Community Health Nursing and the issues influencing their career choice upon graduation. Purpose: To explore issues that influence career choice in community health nursing from the perspective of baccalaureate nursing students. Research Methodology: The study was guided by a descriptive qualitative research approach. Individual semi-guided interviews and focus groups were conducted with 11 nursing students and a group of key stakeholders to share their thoughts on pursuing a career in community health nursing and the factors that enabled or hindered their decision making. Thematic analysis of the interview and focus group data generated relevant themes. Findings: Five major themes were revealed from study. These are 1) defining community health nursing, 2) the clinical practicum experience, 3) stereotypes of community health nursing, 4) societal trends and expectations, and 5) issues influencing career choice in community health nursing. Discussion and Implications: The personal and contextual factors influencing the perceptions and attitudes of students towards pursuing community health nursing were discussed. Existing literature was integrated into the discussion of the many factors that both motivated and hindered baccalaureate nursing students from pursuing community health nursing. The underrepresentation of new graduates in community health nursing calls for directed efforts by community health nursing organizations and the university to improve the situation. Conscientious efforts need to be made to provide students with knowledge and information surrounding the roles of community health nurses and the opportunities for nursing students and nurses in community health nursing settings. Conclusion: There is a need to increase awareness about community health nursing in order for nursing students to understand the importance and impact it has on the health status of communities and healthcare delivery infrastructure. Nursing education programs would be an ideal platform for this awareness-raising and facilitate student nurses decision to pursue community health nursing as a career.

No description available.

Magister Curationis - MCur / According to Benner (2001 ), an individual moves through five stages: novice, advanced beginner, competent, proficient and expert. Competence is the measure or degree of a person's ability to cope with all aspects of the environment. It is expected that when an individual achieves competence, they possess the necessary knowledge, skills, abilities, attitudes and professionalism required to perform a certain function. The purpose of the study was to compare the perceptions of the Community Service Practitioners (Degree versus Diploma) regarding their clinical competence in providing nursing care and to establish and compare the perceptions of Professional Nurses regarding the clinical competence of the Community Service Practitioners they supervise (Degree versus Diploma) in providing nursing care. The null-hypothesis stated that there is no difference in the clinical competence of Community Service Practitioners who completed a Degree nursing programme as compared to those who completed a Diploma nursing programme leading to registration as a Professional Nurse (R425). The research methodology was quantitative, using a comparative, descriptive, cross-sectional design. The target population of the study included a sample of all Community Service Practitioners who worked in Regional Hospitals in the Western Cape and the Professional Nurses who supervised them. Convenience sampling was used to select the sample for this research and data were collected by means of a five-point Likert-scale questionnaire for the Professional Nurses supervising the Community Service Practitioners and a three-point Likert-scale questionnaire for the Community Service Practitioners. Data was organized and analyzed by using Statistical Package for Social Sciences (SPSS), Version 21. Descriptive statistics were used and findings were illustrated by means of descriptive tables and figures. The Mann-Whitney U test was used to calculate the null-hypothesis, which was retained. The results of the study indicated that there is no difference in the clinical competence, which included knowledge, skills and attitude, of Community Service Practitioners who completed an undergraduate Degree compared to those who completed a Diploma in nursing.

Engaging students in class when first-hand experience is not available is challenging. Three teaching strategies, flipped classroom, a guest speaker, and technology, engaged students during a global health class. Students were given a graded preclass assignment, which was used to guide the class session when an expert physician from Zambia joined us using technology. On the day of class, students were engaged and asked questions of the physician related to global health and culture. Combining the three strategies was an innovative and effective way to engage students, with many sharing with faculty that this was their favorite class day.

Abstract Purpose: Mental illness in the United States is a well-documented prevalent health concern. Mental health conditions are extensive and subject to mental illness stigma that negatively impacts client care. Aims: This quality improvement project aims to implement the NAMI In Our Own Voices presentation in conjunction with a ninety-minute anti-stigma educational session to reduce mental illness stigma among nursing students. Methods: This quality improvement project utilizes a pretest-posttest study design to evaluate the implementation of the National Alliance on Mental Illness In Our Own Voices presentation in conjunction with a ninety-minute anti-stigma educational session’s impact on mental illness stigma reduction. The Open Minds Stigma Scale for Health Care providers will be used to determine the level of stigma reduction in undergraduate baccalaureate nursing students. Results: Results are pending project implementation approval from the National Alliance on Mental Illness. Conclusion: No conclusion can be determined at this time as study results are pending.

A recurring theme in the literature is that simulation is a positive teaching strategy when compared to other methods of instruction and produces positive student outcomes (Jefferies, 2016). Simulation provides educators a way to reproduce a clinical teaching experience in a safe, supportive learning environment. The purpose of this quantitative research study was to determine whether an obstetrical simulation educational experience is an effective strategy for educating undergraduate nursing students in the management of a postpartum hemorrhage. A quasi-experimental study using a pre-test and post-test design was employed in a Women’s Health Course and Pediatrics course over one semester. A single convenience sample (N=81) of junior baccalaureate nursing students was used for this study. There were 41 students in the control group and 40 in the experimental group. Both the control and experimental groups received the traditional didactic session, case study, skills lab instruction, and clinical. In addition, the experimental group received the postpartum simulation. This simulation study tested the differences in knowledge, satisfaction, and confidence level between junior nursing students who did and did not participate in the simulation. There were three instruments used during this study; a pre-test/post-test for knowledge acquisition, the National League for Nursing (NLN) (2005) student satisfaction and confidence level survey, and the Creighton Competency Evaluation Instrument (C-CEI) (Todd, Manz, Hawkins, Parsons, & Hercinger, 2008). The pre-test/post-test measured the knowledge acquisition obtained from the didactic session. NLN (2005) student satisfaction and confidence level survey measured students’ satisfaction and confidence level from either the interactive skills lab sessions or the simulation. The C-CEI tool measured the students’ performance during the simulation. There were four categories: assessment, communication, clinical judgment, and patient safety that the researcher measured the students’ performance during the simulation. Data for the knowledge acquisition, revealed both the experimental and control groups significantly increased between the pre-test and the post-test. The post-test showed statistically significant differences between groups, with the control group outperforming the experimental group. As such, the data demonstrate that the simulation did not have a significant effect on knowledge. Data from the NLN (2005) student satisfaction and confidence level survey were analyzed using a two group MANOVA. Although the results of the MANOVA were not significant, as a follow up analysis, the individual questions were used as the dependent variables in a MANOVA. When the individual questions were used as the dependent variables in a MANOVA, the experimental group performed significantly better in two out of the five questions on student satisfaction and five out of the nine questions on student self-confidence. There was a strong positive correlation between satisfaction with current learning and self–confidence. Data for the students’ performance were analyzed using the C-CEI tool. A perfect score on the C-CEI instrument was 14 points, 100%. The overall group average was 8.1 points or 58%. Of the four sections in the C-CEI tool, the lowest mean was Communication (0.5185), followed by Patient Safety (mean = 0.5333). Although student groups were able to communicate with the patient effectively 67% of the time, none of the simulation groups provided an organized report to the healthcare provider with minimal prompting. During the postpartum simulation, 33% of the students administered medications safely. The wrong dosage and incorrect technique were seen in 67% of the simulations. Communication and safe medication practice are essential to ensuring patient safety; it is important that faculty prepare nursing graduates to provide safe care. Even though there were limitations to this study, a convenience sample at one public university, the findings are informative and have implications for future teaching and learning strategies. The results of this study add to the body of knowledge that supports the use of simulation as a teaching strategy in undergraduate nursing education. / Educational Leadership