Health Professions Education and Research, Nov 21, 2023
Background: Virtual interprofessional education (VIPE) presents an opportunity to develop interpr... more Background: Virtual interprofessional education (VIPE) presents an opportunity to develop interprofessional competencies in undergraduate medical students. This paper describes the feasibility of implementing VIPE in an undergraduate medical program. Methods: A multiple-methods research design incorporating quantitative and qualitative elements was used to describe undergraduate medical students' experiences of an international VIPE intervention. Eleven universities and students in 14 different health professions participated in synchronous and asynchronous sessions. A number of 41 medical students completed an online post-assessment survey, of which six volunteered to participate in a focus group discussion related to their VIPE experience. Descriptive statistics were used to evaluate the post-assessment survey, while inductive thematic analysis was applied for qualitative data. Results: The quantitative responses indicated an awareness of interprofessional education (IPE) competencies, such as role clarification, team functioning, interprofessional communication, personcenteredness and values and ethics. The focus group discussions supported the quantitative outcomes where the themes reflected the significance and influence of the educational program, clarifying engagement and recommendations for the future of VIPE. Conclusion: The findings of this study demonstrate the feasibility and value of VIPE as a reasonable alternative to face-to-face IPE. VIPE may have additional benefits such as cross-institutional and international engagement. This evaluation also provided valuable lessons for the more widespread implementation of VIPE.
African Journal of Health Professions Education, Sep 6, 2016
Clinical teaching is a technique used in the education of nurses. It involves the exposure of stu... more Clinical teaching is a technique used in the education of nurses. It involves the exposure of students to authentic clinical environments and guiding them to attain specific requirements applicable in that particular environment. [1] The clinical environment is a platform for the application of knowledge and skills that have already been introduced in the classroom. Nursing students in the clinical environment integrate knowledge and skills learnt in a contextualised learning environment, which should support them in their educational objectives. [2] Competent professional nurses could enhance the quality of the clinical environment as a learning platform. The competency of the professional nurse in the clinical environment is essential for the success of the nursing student. They should possess attributes that enhance clinical teaching. [3] Some of the attributes include the ability to identify brief periods during which to teach students, awareness of their own professional role and responsibility, and ability to manage the teaching platform for the development of the nursing student. If professional nurses are aware of their professional role in the clinical environment, it enhances their functionality. A review of the literature highlights that professional nurses are involved in clinical teaching, which is conducted through various models, depending on the context or setting. Models used in clinical teaching include: apprenticeship, internship, supervision, and preception. [4] Professional nurses tend to move towards the supervisory model of clinical teaching, especially for students in basic nursing or pre-registration programmes. This model involves the allocation of nursing students to a qualified professional nurse who, in the course of clinical practice, shares knowledge and skills with the students. However, while in the clinical area, students are expected to observe and absorb the lessons learnt while participating in activities overseen by a qualified professional nurse. The learning includes
Health sciences educator's simulation debriefing practice needs: A mixed methods study
PubMed, 2023
Background: Simulation debriefing influences learning from healthcare simulation activities. Heal... more Background: Simulation debriefing influences learning from healthcare simulation activities. Health sciences educators must be competent in conducting simulation debriefing for healthcare students. A structured faculty development intervention for health sciences educators must be informed by educator needs to enhance its utility. This paper describes the needs of health sciences educators regarding simulation debriefing at a faculty of health sciences. Materials and methods: A parallel convergent mixed methods study design was applied on a selected population of 30 health sciences educators at the University (x) who integrate immersive simulation for first- to final-year students in their undergraduate programs. The Objective Structured Assessment of Debriefing tool underpinned observations which informed the quantitative strand of the study, while semi-structured interviews were conducted as part of the qualitative strand. Descriptive statistics and thematic analysis were used to analyze the data. Results: Health sciences educators struggled to establish the learning environment for simulation (median 1), facilitate learning (median 3), and evaluate their debriefing activities. However, they were able to apply an appropriate approach toward simulation (median 4). They identified the need to be educated on the fundamentals of simulation-based education. Conclusion: A continuing professional development program must be developed aimed at transforming approaches toward facilitating learning, explaining the fundamentals of simulation-based education, modeling of best-practices related to debriefing, and applying appropriate strategies for evaluating debriefing activities.
Background The lack of standards for evaluating the quality of undergraduate nursing programmes h... more Background The lack of standards for evaluating the quality of undergraduate nursing programmes hampers the evaluation of e-learning programmes in low-and middle-income countries. Fragmented approaches to evaluation coupled with a lack of uniform criteria have been a major deterrent to the growth of e-learning. Adopting standards from high-income countries has contextual challenges in low-and middle-income countries (LMICs). Holistic approaches coupled with uniform standards provide information to stakeholders hence the quality of the programmes is measurable. The e-learning situation in low-and middle-income countries provided an impetus to develop and validate these standards. Design A modified Delphi technique. Review methods Fourteen experts with experience and expertise in e-learning and regulation of undergraduate nursing from fourteen countries from LMICs participated in three rounds of the modified Delphi process. A predescribed set of standards was shared electronically for independent and blinded ratings. An 80% threshold was set for consensus decisions. The standards were modified based on experts' comments, and two subsequent rounds were used to refine the standards and criteria. Results At the end of round one, the expert consensus was to keep 67, modify 39 and remove three criteria. At the end of the second round, the consensus was to modify 38 and remove one criteria. In the third round, experts agreed that the standards were feasible, usable, and practical in LMICs. A total of six broad standards with 104 criteria were developed. Conclusion The Technological bloom permeating all spheres of society, including education is an essential component in the development of e-learning programmes. E-learning in nursing education requires critical evaluation to ensure quality in undergraduate nursing programmes. The intricacies of the Low and middle-income context were taken into consideration in developing the standards to offer sustainable evaluation of the quality of e-learning in LMICs, and local solutions to local problems.
Background: Clinical learning is fundamental to undergraduate health professions students. There ... more Background: Clinical learning is fundamental to undergraduate health professions students. There are several calls for the transformation of health professions education, which have direct implications on clinical learning. Clinical placement models provide structure to clinical learning. Therefore, this scoping review could contribute to supporting curriculum transformation to enhance optimal learning in the clinical environments for undergraduate health professions students. Objectives: This scoping review identi ed the characteristics of research evidence related to mapping the purpose, methodologies used, outcomes, and speci c recommendations associated with clinical placement models in undergraduate health professions education. Design: A scoping review methodology was used in this study. A search string developed from the title of the review was used to search online databases to identify research published between January 2000 and March 2020. Results: Forty-eight articles reporting on ten clinical placement models were included in this review. The majority of these articles originated from Australia and predominantly report on nursing. The aims of these articles aligned with the evaluation of the implementation of a clinical placement model. Seven categories of outcomes of the clinical placement models are reported namely, relationships, in uence, environment, facilitation, inputs, knowledge scores, and student perceptions.
Standards for Scaffolding in Health Sciences Programmes: A Delphi Consensus Study
Journal of Medical Education and Curricular Development
Introduction Health sciences programmes operate in complex, unpredictable contexts, underscoring ... more Introduction Health sciences programmes operate in complex, unpredictable contexts, underscoring the need for comprehensive scaffolding of the learning processes. Yet, the scaffolding approaches remain fragmented, and lack a shared approach to how programmes could integrate scaffolding across the curricula. The literature argues that standards result in the comprehensive implementation of educational practices. There are no reported standards related to scaffolding practices in these programmes. OBJECTIVES To develop standards for scaffolding in health sciences programmes utilising a consensus approach through a modified Delphi Technique. METHODS Following the recommendations on Conducting and REporting of DElphi Studies (CREDES), an online modified Delphi technique was applied. Evidence on the application of scaffolding in health sciences programmes, obtained through an integrative review, was synthesised to draft standards. Using purposive and snowball sampling, an international p...
Background Before the Coronavirus COVID-19, universities offered blended learning as a mode of st... more Background Before the Coronavirus COVID-19, universities offered blended learning as a mode of study. However, with the closure of all educational institutions, after the pandemic, most of these institutions were required to transition to e-learning to support continuous student learning. This transition was challenging to most institutions, as there were no standards to ensure the quality of e-learning. During this literature review, the researcher aimed to explore relevant literature and provide insight into the standards for undergraduate e-learning programmes in the health professions. Design An integrative review of literature.
The design of faculty development courses requires a contextually aware theoretical foundation. T... more The design of faculty development courses requires a contextually aware theoretical foundation. Therefore, the study aimed to determine the feasibility of a specific conjecture map as a model for designing online health professions education faculty development courses in sub-Saharan Africa through a heuristic evaluation approach. The authors hypothesise that using heuristic evaluation strengthens an educational model's theoretical basis and feasibility.Twenty-five health professions educators from nine sub-Saharan African countries participated in this multi-phased study. In the first phase, the participants completed a survey evaluating the model and the accompanying author-generated heuristics. Then, participants' recommendations were used to make revisions. In the subsequent phase, participants reviewed these revisions and commented on the feasibility of the model within their local context.All six heuristics were revised following the initial phase, where 80 problems ha...
BackgroundSpecialist health professionals improve health outcomes. Most low-income and middle-inc... more BackgroundSpecialist health professionals improve health outcomes. Most low-income and middle-income countries do not have the capacity to educate and retain all types of specialists across various health professions. This study sought to explore and describe the opportunities available for specialist health professions education and the pathways to becoming a specialist health professional in East and Southern Africa (ESA). Understanding the regional capacity for specialist education provides opportunities for countries to apply transnational education models to create prospects for specialist education.MethodsA document analysis on specialist training programmes for health professionals was conducted in twenty countries in ESA to establish the capacity of specialist education for health professionals. Data were collected from policy documents, grey literature and websites at the country and institution levels.FindingsWe found 288 specialist health professions education programmes ...
African Journal of Health Professions Education, 2022
Background. Educational institutions were compelled to adapt their educational strategies during ... more Background. Educational institutions were compelled to adapt their educational strategies during the COVID-19 pandemic. The innovation of boot camps as a strategy for learning and teaching clinical skills was applied by a school of nursing immediately after the hard lockdown in South Africa. Objectives. To describe the outcomes of implementing an innovative educational strategy for the learning and teaching of clinical skills in an undergraduate nursing programme. Methods. The study comprised a parallel convergent mixed-methods design. Qualitative data were collected from educators (n=7) involved with the boot camps, while the quantitative data comprised module evaluations by 219 students and summative practical assessment scores. Thematic analysis through an inductive approach was applied for the qualitative data, while central tendency and frequencies were used to analyse the quantitative data. Results. Three themes emerged from the narrative data, i.e. rationalising the boot camp...
African Journal of Health Professions Education, 2020
Nursing education institutions (NEIs) must ensure that their pre-registration students reflect nu... more Nursing education institutions (NEIs) must ensure that their pre-registration students reflect nursing administration-related competencies at graduation. [1-3] Such competencies include the ability to effectively and efficiently manage human resources, [4,5] reason through complex situations, [6] distribute clinical resources, monitor and evaluate healthcare [3] and communicate effectively. [7] These competencies are pertinent in low-resource settings, which are characterised by critical human resource shortages, lack of staff mentorship programmes and limited resources for on-the-job training in nursing administration, compounded by a greater need for quality healthcare provision. [8] Numerous NEIs in Africa, guided by regulatory requirements, have included nursing administration-specific learning outcomes in their preregistration programmes. [2,9,10] This inclusion has necessitated the teaching and assessment of elements of nursing administration at pre-registration level, with the anticipation that graduates from such programmes will effectively manage healthcare units, such as primary healthcare clinics and hospital units. [11] However, the complex clinical environment compromises the quality of teaching, learning and assessment of nursing learning outcomes in sub-Saharan Africa. [8,9] The majority of the NEIs in Africa offer nursing education through vocational programmes long after the call by the World Health Organization (WHO) to transform health professions education to be competency driven. [8,12,13] Such vocational programmes are presented through teacher-centred, rigid, content-based curricula that are underpinned by behaviourism. Nursing students in typical vocational programmes have a limited amount of class time, but extensive placement in the clinical environment. The latter would be advantageous for students to gain real-life experiences, but poor planning limits the value of the clinical placement to enhance students' nursing administration clinical experience. The staff in the clinical environment perceive nursing students as supernumerary staff, who are expected to shadow professional nurses in practice and even relieve them of their professional duties. [14,15] Consequently, newly graduated nurses struggle Background. Nursing education institutions (NEIs) must ensure that their graduates are competent in nursing administration. The adoption of nursing administration-related learning outcomes in pre-registration nursing programmes in Africa has created a platform for the teaching and assessment of nursing administration. Challenges aligned with low-resource NEIs, such as rigid content-based vocational programmes, limit the value and utility of the teaching of nursing administration, resulting in graduates who are not able to manage healthcare units effectively. Therefore, this study explored students' experiences of a nursing administration module with the hope that alignment of the outcomes, content and assessments would be pivotal in the module review to improve nurses' efficiency in managing health units. Objectives. To describe student nurses' perceptions regarding the alignment of learning outcomes, content and assessment of a nursing administration module in an NEI in a low-resource setting. Methods. A sequential mixed methods design was executed in three phases. Data were collected through documents, self-administered questionnaires and focus group discussions with students enrolled in a 3-year pre-registration programme at an NEI in a low-resource setting. The gathered documents were enumerated and mapped against the specific elements of a curriculum as described by Harden and Dent. The quantitative data were analysed through descriptive statistics, focusing on frequencies. The data generated from the focus groups were transcribed verbatim, and thematic analysis through an inductive reasoning approach was used. Results. The study revealed a non-alignment among learning outcomes, content and assessment of the administration module, causing students to struggle in meeting the expected learning outcomes of the module. In as much as the curriculum documents specified the learning outcomes, the classroom teaching seemed only to be aligned with the described curriculum. In addition to other challenges, the contextual characteristics of the related clinical environment did not support application of what was learnt in the classroom. The assessment practices mirrored the expectations of the curriculum, but were not aligned with contextual realities. Conclusion. Nursing students struggle to meet expected learning outcomes related to nursing administration due to the non-alignment among learning outcomes, content and assessment of the module. NEIs in low-resource settings must radically transform their pre-registration nursing curricula to incorporate contemporary issues and clinical contextual realities to enhance the utility of nursing administration learning outcomes.
African Journal of Health Professions Education, Dec 1, 2020
Nurses and midwives contribute ~66% of the health workforce in Africa, [1] and are usually the fi... more Nurses and midwives contribute ~66% of the health workforce in Africa, [1] and are usually the first, and often the only, health professionals to be accessed by members of their communities. [2] The efficient education, successful deployment and ongoing retention of the nursing and midwifery workforce are key strategies to ensure a well-functioning healthcare system aimed at the ultimate goal of universal health coverage. [3,4] However, regional and international indicators reflect a protracted shortage of nurses and midwives in the healthcare system. [5] An estimated additional 5.7 million nurses are required to meet the health needs of the global population by 2030. [1] The need for more nurses correlates with the need to improve the numbers and quality of nurse educators, especially in Africa, where there is a substantive need. [6] African literature describes the quantity, quality and competences of nurse educators in nursing education institutions (NEIs). In particular, Seekoe [7] reports the needs of newly appointed nurse educators in South African (SA) universities and colleges regarding teaching, research, community engagement and work ethic. These needs may be similar throughout many African settings and influence the quality of nursing education. Consequently, nursing education stakeholders, such as the World Health Organization (WHO), have called for greater investments in nursing and midwifery education, strengthening of educational infrastructure and upskilling of nurse educators to ensure increased graduation outputs. [8] Background. The efficient education, deployment and ongoing retention of the nursing and midwifery workforce are key strategies to ensure a wellfunctioning healthcare system. The African region, however, has relatively few funded programmes to develop educational research capacity in novice academics while also addressing their leadership and educational needs. Objectives. To evaluate the outcomes of a faculty capacity development programme on nursing and midwifery educators in sub-Saharan Africa (SSA). This study explored the scope of scholarship outcomes, career trajectories and leadership outcomes. Methods. A mixed methods study collected quantitative and qualitative data from nursing and midwifery educators (N=26) who enrolled for the sub-Saharan Africa-FAIMER Regional Institute (SAFRI) fellowship between 2009 and 2019. Data from project abstracts presented at a local conference and a subsequent electronic survey were included for review and analysis. Deductive thematic analysis was used to report the findings. Results. Most projects (n=24) focused on undergraduate programmes at the home institutions. All the projects were presented at a local conference and 4 projects were published in peer-reviewed journals. The projects impacted on community and curriculum change, led to improvements in teaching and research and various strategies to improve learning and assessment at home institutions. The reported outcomes relating to the career trajectories of 7 fellows indicate that the programme accrued benefits to their institutions and the community, to students and their peers, and that they experienced personal benefits. Conclusion. The SAFRI fellowship vision is evident in the projects and subsequent actions of its nursing and midwifery fellows. Nurse educators' engagement with pedagogical evidence and design strategies has culminated in knowledge to solve some of the education-related challenges in their nursing education institutions.
Background Africa, like other parts of the world, continuously strives to deliver quality health ... more Background Africa, like other parts of the world, continuously strives to deliver quality health professions education. These efforts are influenced to a larger extent by the socio-economic and cultural context of the region, but also by what happens globally. The global disruption caused by the COVID-19 pandemic in 2020 necessitated the implementation of emergency remote teaching to continue delivering on the mandate of educating future health professionals. The purpose of this research was to describe the response of selected health professions education institutions in Southern Africa to the impact of COVID-19 and their preparedness for remote learning and teaching. Methods A case study design was applied using an adapted ADKAR model as a conceptual framework for data interpretation. The purposively selected study population consisted of educators, students, and administrators in undergraduate medical and nursing programmes from six institutions in five countries. Results A total...
Fidelity of implementing a competency‐based nursing programme during the COVID ‐19 pandemic: A case study
Nursing Open
Aim The study describes the fidelity of implementing a competency-based nursing education (CBNE) ... more Aim The study describes the fidelity of implementing a competency-based nursing education (CBNE) programme during the COVID-19 pandemic in a low-resource setting. Design A descriptive case study research design integrating mixed methods underpinned by the fidelity of implementation framework was applied to assess teaching, learning and assessment during the COVID-19 pandemic. Methods A survey, focus group and document analysis were applied to collect data from 16 educators, 128 students and eight administrators of a nursing education institution and accessing institutional documents. Data were analysed through descriptive statistics and deductive content analysis and packaging the outcome of the study according to the five elements related to the fidelity of implementation framework. Results The fidelity of implementing the CBNE programme was satisfactorily maintained as described in the fidelity of implementation framework. However, sequenced progression and programmatic assessments were not aligned with a CBNE programme within the context of the COVID-19 pandemic. Patient or Public Contribution This paper proposes strategies to enhance the fidelity of implementing competency-based education during educational disruptions.
Standards for Undergraduate Nursing E-Learning Programmes in Low Resource Settings: A Feasibility Study
Faculty development practitioners should be encouraged to create a sustainable and accessible env... more Faculty development practitioners should be encouraged to create a sustainable and accessible environment for capacity building in health professions education (HPE). Nine experts in the sub-Saharan African region followed two rounds of a modified Delphi process to achieve consensus on the components of an online health professions education faculty development programme. As a result, four components to consider in the development, implementation and evaluation of online faculty development programmes were identified: environmental, curricular, activities and research. These components support further research into developing a contextually relevant and sustainable online health professions education faculty development model in the region.
Background: Mentally fit preceptors may be more capable and flexible in providing students with s... more Background: Mentally fit preceptors may be more capable and flexible in providing students with system, emotional and cognitive support in the clinical learning environment (CLE) in the face of any life-threatening outbreaks. Existing professional development programmes for preceptors emphasise the development of preceptor competence in a normal CLE with minimal focus on their ability to engage with adverse events that challenge their mental health.Objective: The study sought insight from preceptors’ experiences during the coronavirus disease 2019 (COVID-19) pandemic to identify their professional development programme needs while providing support to students during accompaniment.Method: A mixed methods convergent parallel design was used to collect data from 24 preceptors at a nursing education institution (NEI). Eleven preceptors responded to the survey that included the coronavirus disease 2019 (COVID-19) Stress Scale (CSS) and Burnout Assessment Tool (BAT) to collect quantitati...
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