Table 1 Identification of Lessons Learnt from Phase I and Phase II
Clinical Education Model | Lessons Learnt from Scoping Review | Lessons Learnt from Survey | Lessons Learnt from Qualitative Findings | Common Lessons Learnt from Phase I and Phase II |
|---|---|---|---|---|
Support from NEI | • A training programme should be developed for preceptors • NEIs should collaborate with clinical institutions in drawing clinical curriculum • Utilise videos in teaching nursing skills • NEIs should improve the application of stimulation • Put students in groups for skills laboratory training • Duration of clinical placement should be consistent with the curriculum as stipulated by Nursing and Midwifery Council of Ghana. • Electronic feedback platform should be used for monitoring students while they are in clinical placement area • Objective Structured Clinical Examination (OSCE) should be used in assessing students • Competence assessment tools are effective in monitoring students progress in skills development | • Pre-publish placement dates to students and clinical facilities should prepare a rotational plan for NEIs to avoid overcrowding. • Ensure adequate duration of clinical placement according to the standard stipulated by Nursing and Midwifery Council of Ghana. • Lecturers should visit the clinical site for supervision • Lecturers should be involved in clinical facilitation • Lecturers should introduce students to “self-directed learning” in the classroom • Communicate clinical placement objectives with clinical facilities before clinical placement • Provide skills laboratories with adequate space and materials • Engage staff for clinical teaching of students in the skills laboratory • Involve preceptors in the development of clinical assessment tools • Transport students to and from the clinical area promptly. | • Intake of students should be according to lecture hall space, facilities for skills training and number of lecturers • There should be a formative assessment of students during clinical placement by preceptors • Appoint adequate number of lecturers for classroom and skills laboratories teaching • NEIs should recruit and train registered nurses to assume the role of preceptors. • NEIs should train simulated patients • There should be capacity building workshops for assessors • Lecturers should take part in clinical supervision • There should effective transportation system • There should be adequate duration for clinical placement as stipulated by Nursing and Midwifery Council of council • Intra-semester clinical placement should be in “block” • NEIs should be adequately equipped skills laboratory | • Improving teaching and learning of clinical skills • communication and collaboration between NEI and service setting • clinical supervision of students • Planning of clinical placement for students • Ensuring effective clinical assessment |
Support from service setting | • There should be constructive feedback from clinical faculty (nurses, preceptors and clinical supervisors) • Provide material resources for nursing procedures • The clinical facilities should employ adequate number of registered nurses • Steps should be taken to enlist the support of nurses and clinical supervisors in clinical teaching of students • There should be effective communication with student • There should be pre-briefing and debriefing sessions with students during clinical placement • Preceptors should have characteristics such as effective communication skills, coaching skills and role modelling. • Peer learning i.e. pairing of students from same level of study for the same shift during clinical placement should be encouraged | • Clinical facilities should develop a clinical manual containing all rules regarding clinical practice and procedures • Preceptors should clarify the learning needs of students • The clinical facilities provide adequate equipment for demonstrations and return demonstration • Preceptors should have effective communication with students • Preceptors should develop a remedial plan for students who are unable to gain competence in a particular skill • Sign learning contracts with students to guide skills teaching and achievement of competences. | • Effective communication with academic institutions of clinical learning outcomes of student • Rotational plan for various academic institutions that send students for clinical placement • Engaging more registered nurses to support students in clinical learning • Provision of material resources for students to learn skills • Encouraging nurses to initiate personal strategies to enhance clinical learning at the ward level • Peer learning i.e. the pairing of students who are at the same level of study but in different schools to enable them to learn from each other • Preceptors should conduct formative assessment • Organize clinical meetings with students during clinical placement | • Preparation to receive students • Communication between service settings and NEI, and service setting and students • Support of Students during clinical placement • Provide material and human resources • Clinical assessment |
• Student in clinical for role taking practice | • Students should indicate readiness for clinical learning through observation, listening and asking questions • Students should attend pre-briefing and debriefing sessions during clinical placement • Students should be self-confident and motivated | • Students should accept constructive criticism and make efforts to learn • Sign a performance contract before clinical assessment • Students should communicate effectively with clinical staff • Students should avail themselves for clinical assessment | • Students should attend clinical conferences and ask questions • Students should seek counselling when they have problems in the placement area • Students should respect laid down rules of clinical placement | • Attendance • Positive mindset • Commitment |
Support from Nursing Council | • NM&C should monitor NEIs through scheduled visits | • Assist academic institutions set-up skills laboratories that have essential equipment and materials | • NM&C should set-up an accreditation system for clinical facilities • NM&C should make recommendations for student intake based on the availability of facilities • Monitor NEIs to provide adequately equipped skills laboratory • NM&C should improve conduct of Licensing Examination | • Monitoring to ensure that NEIs meet and maintain a minimum standard • Advice to the Minister of Health • Clinical assessment of students |