Evaluating The Influence Of Clinical Experience On The Academic Performance Of Student Midwives

Project and Seminar Material for Nursing (Science)

Evaluating The Influence Of Clinical Experience On The Academic Performance Of Student Midwives


Abstract


The purpose of this study was to identify influence of clinical experience on the academic performance of student midwives in School of Nursing Afikpo in Ebonyi State and Department of Nursing Sciences, University of Nigeria, Enugu Campus in Enugu State. Three research questions guided the study. The research design used was descriptive cross-sectional survey method. A face and content validated questionnaire with 18 items was used for the collection of data. Data derived from the questionnaire were analyzed descriptively. The result of the study from both schools showed that: the schools have practical laboratories and libraries; students attend clinical experiences regularly; ward nurses were involved in students’ clinical training. The result further showed that in both schools there were inadequate equipment in the clinical areas; teachers were not involved in clinical supervision of students; teachers were not able to finish teaching their courses; non participation of students in planning of their programme and also supervisors’ were not able to give proper supervision to the students. Based on the findings, it was recommended that adequate experienced and qualified nurse educators and clinical instructors should be employed and maintained by the competent authorities. Proper supervision of students by experienced teachers, nurses and clinical supervisors should be advocated. Nursing and Midwifery Council of Nigeria should provide a clearly written standard guidelines and policies on clinical training of nursing students to ensure proper acquisition of nursing skills which will be inferred in nursing practice.


Chapter one


Introduction

1.1 Background of the Study

Attitude plays a major role in leading human toward achieving the desired goals, awareness of its consequences, and effective processing of complex information. Students’ attitude towards clinical practice could be affected by a clinical environment, student staff interaction, clinical preceptors, and the availability of necessary equipment in a hospital setting

Lack of interest in what people do could decrease the quality of work. More than half of all healthcare providers are Midwives and Nurse in the healthcare setting. Hence, if the attitude of Nursing and Midwifery professionals is not favorable, the quality of health care could be compromised in a significant manner. In Nigeria, students join Nursing and Midwifery degree programs directly after completing secondary education which demands intensive clinical training to acquire Nursing and Midwifery competencies

In nursing programmes, students are exposed to both theoretical and practical components. The combination of theory and practice in the clinical setting is seen by Mabuda, Potgieter, and Alberts (2008) as the “art and science of nursing” (p. 19). Clinical learning is a vital component of nursing education. In addition to providing opportunities to develop competence in nursing skills, the clinical environment engenders in nursing students a sense of identity as professionals in the real world. This is because to complete the practical component of their training; the nursing students are assigned to a hospital or clinic under the supervision of experienced nurse practitioners and/or educators. Clinical supervision is defined as “a process of professional support and learning in which nurses are assisted in developing their practice through regular discussion time with experienced and knowledgeable colleagues” (Fowler, 1996, as cited in Brunero & Stein-Parbury, 2008, p. 87). Brunero and Stein-Parbury (2008) stated that clinical supervision “provides nurses with the opportunity to improve patient care in particular for a given patient and in general in relation to maintaining standards of care” (p. 87). For clinical learning and supervision to occur successfully, Mabuda, Potgieter, and Alberts (2008) appointed to the need for the clinical environment to be conducive to learning as well as to be supportive. This is because such an environment would have an effect on nursing students’ achievement and satisfaction (Mabuda, Potgieter, & Alberts, 2008).


1.2 Statement of the Problem

Since the inception of the nursing programme at the institution used for the study, nursing students are assigned to hospitals for seven weeks clinical experience. When asked by their supervisors during and after their posting, these nursing students share their views of their clinical environment, their encounters with the patients and their relatives, and their successes and challenges. Despite the nursing students’ informal responses, as well as their performance at the end of the course, there has not been any formal quantitative research done on this topic.
A review of the literature shows that a few studies have been done in this area around the world. For instance, in Africa, Adjei, Sarpong, Attafuah, Amertil, and Akosah (2018) explored the perceptions of student nurses in a private university in Ghana. Similarly, Mabuda, Potgieter and Alberts (2008) investigated the experiences of student nurses during clinical practice at a nursing colleges.

Studies have also been done in the Middle East by Sharif and Masoumi (2005) who explored nursing students’ experiences of clinical practice in Shiraz University of Medical Sciences in southern Iran; while Jamshidi, Molazem, Sharif, Torabizadeh, and Kalyani (2016) examined the challenges of nursing students in clinical learning Shiraz University of Medical Sciences in Iran. Other studies were done by Tiwaken, Caranto, and David (2015) who examined the lived experiences of student nurses during clinical practice in Bonafide Benguet State University-College of Nursing in the Philippines in Asia. While in Europe, Mattila, Pitkajarvi, and Eriksson (2010) studied the clinical practice experiences of international student nurses in the Finnish health care system. In all these studies done in different parts of the world, the researchers used mostly the qualitative approach to explore nursing students’ experiences during and/or after clinical practice.

There is a significant incoherence between theory and clinical practice and one of the cause of this discrepancy could be attitude. A positive attitude towards clinical practice enhances effective clinical learning. Whereas, a negative attitude hampers the acquisition of essential clinical skills. Thus, identifying the gap in clinical practice is noteworthy for improving the quality of Nursing and Midwifery educations


1.3 Objective of the Study

The objective of the study are;

  1. To ascertain the attitude of midwife towards clinical experience
  2. To ascertain the relationship between clinical experience and academic performance of midwife student
  3. To identify issues encountered by the nursing students during their clinical practice placement.

1.4 Research Question

The following questions were developed for the study:

  1. What is the attitude of the midwife towards clinical experience
  2. Is the any relationship between clinical experience and academic performance of midwife student.
  3. Are the any challenges encountered by the nursing students during their clinical practice placement

1.5 Significance of the Study

It is believed that the study will provide results on the clinical placements and experiences of the nursing students that will be beneficial to different stakeholders (nursing educators & students). First, the nursing educators at the institution used for the study may find the results useful since it will reveal the nursing students’ perceptions of their clinical practice experience, and possible ways of improving areas of weaknesses. Second, by fixing problem areas in the course, it might enhance the learning experience for the nursing students in the future.


1.6 Scope and Limitation of the Study

The scope of the study covers evaluating the influence of clinical experience on the academic performance of student midwives. . The researcher encounters some constrain which limited the scope of the study;

a. Availability of Research Material:

The research material available to the researcher is insufficient, thereby limiting the study

b. Time:

The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.


1.7 Definition of Terms

Clinical Experience:

Clinical experience means providing direct behavioral health services on a full-time basis or equivalent hours of part-time work to children and adolescents who have diagnoses of mental illness and includes supervised internships, supervised practicums, and supervised field experience for the purpose of Medicaid.

Midwife:

A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife is similar to that of a nurse, in contrast to obstetricians and perinatologists who are physicians

Academic Performance:

Academic performance or “academic achievement” is the extent to which a student, teacher or institution has attained their short or long-term educational goals.


Chapter Five


Summary, Implication, Conclusion and Recommendation

5.1 Summary

This study assessed the influence of clinical experience on the academic performance of students midwives, Afikpo and Department of Nursing Sciences, University of Nigeria, Enugu Campus. It was designed to determine the:

  1. Administrative factors that could affect the clinical training of nursing students in the schools and in the clinical areas.
  2. Training/Supervisory factors that could affect the clinical training of nursing students in the schools and in the clinical areas.
  3. Students’ factors that may affect clinical training in nursing institutions.
  4. Whether there are significant statistical differences in the factors affecting clinical training of nursing students between the two nursing institutions of study.

Literature was reviewed according to the objectives of the study. The research design used was a descriptive cross-sectional survey design. 311 respondents (teachers and students) were recruited for the study. A validated questionnaire constructed by the researcher was used for the collection of data.

Both schools have practical laboratories but school (B) does not have enough equipment and space in the practical laboratory while school (A) has enough equipment in the school, but do not have enough equipment in the wards. Their supervisors do not evaluate students during clinical period. Students attend clinical experiences regularly and attempt clinical assignments/texts given to them. Based on the findings, it was recommended that adequate experienced and qualified nurse educators and clinical instructors should be employed and maintained by the competent authorities. Proper supervision of students should be advocated. N&MCN to provide a clearly written standard guidelines and polices on clinical training of nursing students.


5.2 Conclusion

The study was to determine the factors that affect clinical training of nursing students in School of Nursing Afikpo in Ebonyi State and Department of Nursing Sciences, University of Nigeria, Enugu Campus in Enugu State. Three research questions and three null hypotheses were formulated to guide the study. The result of the findings showed that there were administrative, training/supervisory and students’ factors that can adversely affect clinical training of nursing students in both nursing institutions.


5.3 Implications for Nursing

The implications of the findings to nursing education and practice are:

  1. Large space in the schools’ practical laboratory will enable the students to have a clear view of what the teacher is demonstrating thereby students learn the required skills better.
  2. Lack of adequate equipment in the nursing school practical laboratory and in the clinical areas jeopardizes psycho-motor skill development.
  3. Library with adequate nursing text books in the schools helps both the students and teachers as a reference base when they make use of them.
  4. None involvement of teachers in the supervision of students in their clinical areas creates theory- practice gap leading to poor or wrong learning of nursing skills.
  5. Students not supervised during their clinical experience expose both students and patients to serious dangers leading to poor acquisition of nursing skills and poor quality nursing care.
  6. Not giving students assignments/tests and also not evaluating students during their clinical experience period do not give room for proper evaluation of the students’ strengths and weaknesses during training.
  7. Lack of mentors and preceptors in the clinical areas leads to poor drilling or coaching of students on the required nursing skills.
  8. Inadequate number of clients in the wards restricts students’ actual practice with real life objects which hinders proper skill acquisition.
  9. None involvement of students in planning their activities leads to lack of interest in actual carrying out of the plan.
    Students’ attendance to their clinical experiences as scheduled exposes them to many real-life situations which will help them to concretize what they learnt in the classroom.
  10. Students doing practice on their own helps them to learn better and remember easily what they have been taught.
    Using the procedure book helps the students and teachers to follow each nursing procedure as programmed and helps one to be acquainted with the nursing knowledge and skills.
  11. The significant statistical differences identified in this study showed that procedure for clinical training in schools of nursing is different from that of the university-based nursing programme. This calls for a way of resolving the issues identified by N&MCN.

5.4 Recommendations

It is evidenced that some clinical experience influences the academic performance of student midwives in School of Nursing, Afikpo (SON-A) and Department of Nursing Sciences, Enugu Campus (DNS-UNEC) are poor and inadequate therefore, may hinder nursing skill acquisition. It is therefore recommended that:

  1. Adequate, experienced and qualified nurse educators and clinical instructors are necessary in any nursing institution and such should be employed and maintained by the competent authorities.
  2. School authority should plan and follow their curriculum based on N&MCN programme in such a way that teachers can finish their courses earlier before students go for such clinical experience so as to be equipped with enough knowledge and information.
  3. The school authority should realize that the duration of clinical experience period at each session at a stretch influences the level of overall students’ clinical skill acquisition. Therefore, clinical experience period should not be too short a period.
  4. Nurse educators should teach and follow up students to the clinical areas using the set up guidelines for theory and clinical teaching to prevent theory- practice gap and not go there to police the students.
  5. All involved in the training and supervision of students should be updated with current trends in nursing and research through seminars/conferences so that they can impart such knowledge to the students.
  6. Qualified preceptors and clinical instructors should be employed and motivated for clinical facilitation/supervision of students during their clinical experiences.
  7. Adequate number of qualified nurses should be employed to work in different places where student nurses do their clinical experience to facilitate supervision and teaching in the clinical areas.
  8. Adequate and spacious practical laboratories should be constructed and equipped with enough equipment to enhance skill acquisition in school
  9. Provision of adequate equipment and supplies in the wards are important to facilitate competent teaching and learning in the clinical areas.
  10. Enough clients are needed in the clinical areas to facilitate and concretize knowledge and nursing skills in school (A).
  11. Behaviour modification to change inferiority complex, bias and other negative attitudes that hinder students, teachers and clinical staff nurses interactions and communication in the clinical areas should be taught during training.
  12. Supervisors should evaluate students’ performance regularly to elicit areas of weakness and give proper corrections and directions.
  13. Mentorship relationship help students in their professional development and skill acquisition; therefore, such people should be provided in the clinical areas.
  14. Nursing students should be involved actively in planning their programmes to ensure their active participation and interest in such activities.
  15. Clinical orientation of students before clinical practice should be organized in such a way that all the students should participate actively.
  16. N&MCN to provide a clearly written standard guidelines and polices on clinical training of student nurses.

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