Enrolled bridging course learners’ perspectives related to factors influencing their learning in the clinical environment

Hess, Cecilia (2012-12)

Thesis (MCurr)--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: Exposure to the clinical learning environment forms an essential part of nursing education. Being a nurse lecturer in the private sector, the researcher observed that bridging course learners do not always perform academically as satisfactorily as they should. For the purpose of the current study, the researcher investigated enrolled bridging course learners’ perspectives related to factors influencing their learning in the clinical environment. The study focused on bridging course learners in the private sector. The objectives of the study were to determine whether the following was valid for the population under consideration: - a shortage of staff is a barrier to learning in the clinical environment; - an orientation programme has been implemented for bridging course learners in the clinical environment; - bridging course learners in the clinical environment have to take charge of wards; - the attitude of staff members is a barrier to the learners’ learning experience. - there is a learner/mentor relationship in the clinical environment; - opportunities to gain practical competence exist in the clinical environment. An exploratory descriptive design with a predominantly quantitative approach was applied. The population for the study consisted of bridging course learners at the three private nursing colleges in the Cape metropolitan area (N = 89). Due to the small size of the population, all available learners who voluntarily gave consent were included in the study. The sample size for this study constituted 62% (n = 55) of the target population. A semi-structured questionnaire was used to collect data, and both open and closed ended questions were used. Reliability and validity were assured by means of a pilot study and the use of experts in the field of nursing education and statistics. Data were collected personally by the researcher. Ethical approval was obtained from the Committee for Human Science Research at the Faculty of Medicine and Health Sciences at Stellenbosch University. Statistical associations were determined using the Spearman and Mann-Whitney U tests. The results of this study are presented in percentages and tables. The majority (n = 46/84%) of the participants disagreed that the staffing in units was sufficient. Most (n = 40/73%) participants disagreed with the statement that working conditions were conducive to learning. Qualitative analysis revealed that the participants perceived the clinical environment to be hostile, and the majority (n = 47/85%) of the participants agreed that staff members had a negative attitude towards them. Furthermore, only five (n = 5/9%) participants indicated that they always spent time with their mentor, and the majority (n = 36/65%) of the participants disagreed with the statement that they could achieve specific outcomes before moving to another ward. A shortage of staff, being placed in charge of wards in the absence of a registered nurse, negative attitudes of staff members, and the lack of a mentor–learner relationship were identified as factors that impacted negatively on learning in the clinical environment. Several recommendations, grounded in the study findings, were identified, including: - Sufficient staff should be on duty to improve the learning environment, in order for learners to achieve their outcomes according to the curriculum. - Learners should receive adequate supervision and support. - Sufficient time should be allocated for practical procedures, such as releasing learners on practical days to practise procedures. Factors influencing enrolled bridging course learners’ learning experiences in the clinical environment were identified. Strategies to address these factors may improve their clinical experiences and ultimately their clinical competence.

AFRIKAANSE OPSOMMING: Blootstelling aan kliniese leer omgewing is ’n grondliggende deel van verpleegonderrig. As ’n verpleeglektrise in die privaat sektor, het die navorser tot die gevolgtrekking gekom dat oorbruggingsleerders nie akademies na wense presteer nie. Vir die doel van hierdie studie het die navorser die faktore geëvalueer wat die kliniese onderrig van oorbruggingsleerders gedurende hul plasing in die kliniese omgewing beïnvloed. Die ondersoek konsentreer op oorbruggingsleerders wat in die privaat sektor werk. Die oogmerke van die studie was om te bepaal of: - ’n personeeltekort onderrig in die kliniese omgewing belemmer; - daar ’n oriënteringsprogram vir oorbruggingsleerders bestaan; - oorbruggingsleerders die bevel oor eenhede moet oorneem; - leerders personeelgesindhede as ’n hindernis ervaar; - daar ’n leerder/mentor-verhouding in die kliniese omgewing is; - geleenthede vir praktiese onderrig geskep word. ’n Beskrywende, verkennende studie met ’n oorwegend kwantitatiewe benadering is uitgevoer. Die studiebevolking was oorbruggingsleerders (N = 89) wat die drie privaat verpleegkolleges in die Kaapse metropool verteenwoordig. As gevolg van die klein populasie het alle leerders wat vrywillig hul toestemming verleen het, aan die studie deelgeneem. Gevolglik is ’n steekproef (n = 55/62%) van die teikenpopulasie geneem. Die navorser het ’n semi-gestruktureerde vraelys gebruik om data in te win en beide oop en toe vrae was gevra. Betroubaarheid en geldigheid is deur middel van ’n proefstudie sowel as die gebruik van deskundiges op die gebied van verpleegonderrig en statistiek verseker. Die navorser het die data persoonlik ingesamel. Etiese goedkeuring is van die Gesondheidsnavorsingsetiekkomitee van die Fakulteit Geneeskunde en Gesondheidswetenskappe van die Universiteit Stellenbosch verkry. Statistiese korrelasies is met behulp van die Spearman- en Mann-Whitney-U-toetse ondersoek. Die resultate van die studie word in die vorm van persentasies en tabelle aangebied. Die meeste deelnemers (n = 46/84%) reken daar is nie voldoende personeel in die sale nie. Voorts dink die meeste (n=40/73%) ook dat werksomstandighede nie onderrig bevorder nie. Kwalitatiewe ontleding toon dat die deelnemers die kliniese omgewing as bedreigend beskou, en die meeste (n = 47/85%) is dit ook eens dat personeel ’n negatiewe houding teenoor hulle openbaar. Slegs vyf deelnemers (n = 5/9%) het aangedui dat hulle altyd tyd saam met hulle mentor deurbring, terwyl die meeste (n = 36/65%) erken dat hulle nie hulle studie-uitkomste bereik alvorens hulle na ’n ander saal oorgeplaas word nie. Die studie bevind dat ’n personeeltekort, om in bevel van eenhede geplaas te word in die afwesigheid van ‘n geregistreerde verpleegkundige, personeel se negatiewe houding, en die gebrek aan ’n mentor/leerder-verhouding van die faktore is wat onderrig in die kliniese omgewing benadeel. Verskeie aanbevelings word op grond van die studiebevindinge gedoen. Dit sluit die volgende in: - Daar behoort genoegsame personeel aan diens te wees om die onderrigomgewing vir leerders te verbeter en hulle sodoende in staat te stel om hul studie-uitkomste volgens die kurrikulum te behaal. - Behoorlike toesig oor leerders moet verseker word. - Leerders behoort op praktiese dae van ander werk vrygestel te word ten einde hul prosedures te voltooi. Faktore wat die leer ervaring van oorbruggings leerders in die kliniese omgewing beinvloed was identifiseer. Strategieë wat hierdie faktore adresseer, kan hulle kliniese ervaring asook hul kliniese vaardigheid verbeter.

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