Nursing and midwifery students\u27 experiences and perception of their clinical learning environment in Malawi: A mixed-method study

© 2020 The Author(s). Background: The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives\u27 experiences and perception of the clinical learning environment in Malawi. Methods: A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results: A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = \u3c 0.001), and task orientation (β =0.16 p = \u3c 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion: Although satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement

Transition-to-practice guidelines: Enhancing the quality of nursing education

Background. A de-link between initial training and transition to practice has been reported. Effective transitioning to practice enhances competences and confidence among newly graduated nurses.Objectives. To develop transition-to-practice guidelines as a tool to complement efforts to improve nursing education in Malawi.Methods. A multi-method design was used within the framework of the Stufflebeam context, input, process, product (CIPP) model. Analysis of reports from a nursing conference derived four core concepts, highlighting the context within which goals for transition-to-practice guidelines needed to be focused on. A panel discussion suggested guidelines based on these concepts. Review meetings and a review of the literature, local policies and standards were conducted to provide input to enhance credibility and reproducibility of the proposed guidelines. Consensus workshops involving nurse educators, nursing clinical preceptors, nurse practitioners and policymakers were conducted as a process evaluation for the guidelines.Results. Four core concepts emerged from the process of guideline development. Eleven guideline statements were formulated as a product of the guideline development process. Although newly graduated nurses are exposed to various clinical settings during college training, nurses’ skills and clinical judgement are still rather weak and need more formal support. The guidelines provide assistance for transition to practice among newly graduated nurses.Conclusion. Nursing education is a complex process that starts at student recruitment and should effectively progress until transition to practice. Transition-to-practice guidelines to complement other guidelines in nursing education are timely in Malawi

Transitiontopractice guidelines: Enhancing the quality of nursing education

Background. A de-link between initial training and transition to practice has been reported. Effective transitioning to practice enhances competences and confidence among newly graduated nurses.Objectives. To develop transition-to-practice guidelines as a tool to complement efforts to improve nursing education in Malawi.Methods. A multi-method design was used within the framework of the Stufflebeam context, input, process, product (CIPP) model. Analysis of reports from a nursing conference derived four core concepts, highlighting the context within which goals for transition-to-practice guidelines needed to be focused on. A panel discussion suggested guidelines based on these concepts. Review meetings and a review of the literature, local policies and standards were conducted to provide input to enhance credibility and reproducibility of the proposed guidelines. Consensus workshops involving nurse educators, nursing clinical preceptors, nurse practitioners and policymakers were conducted as a process evaluation for the guidelines.Results. Four core concepts emerged from the process of guideline development. Eleven guideline statements were formulated as a product of the guideline development process. Although newly graduated nurses are exposed to various clinical settings during college training, nurses’ skills and clinical judgement are still rather weak and need more formal support. The guidelines provide assistance for transition to practice among newly graduated nurses.Conclusion. Nursing education is a complex process that starts at student recruitment and should effectively progress until transition to practice. Transition-to-practice guidelines to complement other guidelines in nursing education are timely in Malawi

Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: a mixedmethod study

Background: The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives’ experiences and perception of the clinical learning environment in Malawi. Methods: A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results: A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p = < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion: Although satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement.publishedVersio

Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: a mixedmethod study

Background: The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives’ experiences and perception of the clinical learning environment in Malawi. Methods: A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results: A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p = < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion: Although satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement

Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: A mixed method study

The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives’ experiences and perception of the clinical learning environment in Malawi. Methods: A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results: A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p = < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion: Although satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placemen

What place does nurse-led research have in the COVID-19 pandemic?

Aim Reflect upon the visibility of nursing-led research during the COVID-19 pandemic. Background The emerging SARS-CoV-2 infection has galvanised collaborative and multidisciplinary efforts in clinical and research practice worldwide. The scarce evidence-base to manage patients with COVID-19 has included limited nurse-led research. Introduction Clinical research nurses have greatly contributed to the delivery of COVID-19 research, yet the number of COVID-19 nursing-led research papers appears to be limited, with even fewer nurse-led research projects funded. Methods Authors’ views and PubMed search on ‘COVID-19 and nursing’. Findings There is a dearth of nursing-led research. Most papers describe the nursing contribution to COVID-19 care, changes in nursing working arrangements, and emotional burden. There are opportunities to explore the consequences to vulnerable population groups of public health measures implemented to stop the progress of the COVID-19 pandemic. Discussion Workforce gaps, limited integration in research structures and clinical redeployment may have hampered nurse-led research. COVID-19 may exacerbate staffing deficits by disrupting the education pipeline, obstructing the transition from clinical to academic practice, particularly in areas where clinical academic roles are yet to emerge. Conclusion The absence of nurse-led research in COVID-19 can be explained by chronic, underlying factors and the features of the pandemic response. Emerging models of care, effective staffing, and inequalities related to COVID-19 appear obvious research areas. Nursing leadership needs to strengthen its political voice and lobbying skills to secure nurse-led research funding Implications for Nursing Policy Embracing international nursing research, strengthening collaborations, and lobbying policymakers for investment in nurse-sensitive research would enhance the response to COVID-19