Abstract
Clinical learning opportunities are vital components in nursing education as they contribute to the successful clinical competency development of student nurses. They expose the student nurses to a variety of clinical experiences and afford them the opportunities to practise actively, therefore, developing and acquiring higher-order thinking skills, such as critical, reflective, and innovative thinking, clinical reasoning, and judgment. Student nurses, therefore, make critical decisions and effectively solve patients’ real-life complex problems. However, the overcrowding in the academic hospital under study, caused by placement of students from different nursing education institutions as well as students from other academic health disciplines, led to inadequate clinical learning opportunities for the student nurses, which in turn led to a lack of clinical opportunities for the integration of theory into practice and the development of higher-order thinking skills.
The study was conducted at a nursing education institution and the affiliated public academic hospital in Gauteng, where student nurses are allocated for clinical learning opportunities and work integrated learning. A purposive sampling method was used to select nurse educators, CETU personnel, and operational managers who are involved in facilitation and coordination of student nurses’ clinical learning and are permanently employed either at the nursing education institution or the affiliated public academic hospital in Gauteng.
The purpose of this study was to develop and evaluate strategies for constructive clinical placement, which will enhance clinical learning opportunities for student nurses in a public academic hospital in Gauteng. A qualitative, exploratory, descriptive, and contextual research design was used. The study was divided into four Phases. Phase 1 focused on the exploration, description, and clarification of the conceptual meaning of a clinical learning opportunity using the concept analysis method of Walker and Avant (2019). Phase 2 explored and described the perceptions of nurse educators, clinical education teaching units (CETU) personnel, and operational managers on how clinical learning opportunities can be enhanced. The research method in Phase 2 comprised the description of the population, sample and sampling method, method of data collection, data analysis, and measures to ensure trustworthiness, using Lincoln and Guba’s principles. Matrix building of method of data analysis was adopted to analyse the data. Phase 3 was the conceptualisation of the findings of Phase 2, and the integration of such into the existing
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relevant literature. This was followed by the final Phase 4 of the development and evaluation of strategies to enhance clinical learning opportunities for student nurses. The study was conducted in line with the Department of Health’s [DoH] 2015) ethical norms, standards, and guidelines.
The conceptual and operational meaning of a clinical learning opportunity was developed to provide clear definition and understanding of the concepts within the context of the study. The perceptions of the participants on how clinical learning opportunities could be enhanced were explored and described. In total, 52 nurse educators are involved in the training of student nurses registered in the diploma programme under Regulation 425 who are placed in the public academic hospital under study, 14 CETU personnel responsible for clinical facilitation and coordination of the student nurses, and 54 operational managers of different wards where student nurses are placed for clinical and experiential learning. The findings were then conceptualised within relevant literature with the resultant development of themes, which included promoting interprofessional collaborative clinical learning, problem-based learning and community-based research in clinical areas and integrating emerging technologies to enhance clinical learning opportunities for student nurses. This assisted in the development of strategies to enhance clinical learning opportunities for student nurses, using the strategy development framework of Muller, Bezuidenhout and Jooste (2019). The developed strategies were further evaluated for clarity, simplicity, generality, accessibility, and the importance thereof. Moreover, the consistency, consonance, advantage, and feasibility of the developed strategies to enhance clinical learning opportunities for student nurses were assessed.
Keywords: Clinical learning opportunities, Enhance, Public academic hospital, Strategies, Student nurse