ABSTRACT
Clinical teaching and learning are integral components of nursing education. Most clinical teaching and learning activities occur in the clinical setting where theory is translated into practice in healthcare providing institutions. The broad objective of this study is to determine the nursing students’ perceptions of clinical nursing training in selected nursing school in Alimosho Local Government, Lagos State. A descriptive cross-sectional design was adopted for the study. This design was considered appropriate for the present study because it allowed the investigator to describe the current and prevailing information about nursing student’s perception of clinical training and reveal areas that need change. The target population for the study included all the 200 level to 300 level nursing students in the totaling one hundred (100) from the Lagos State College of Nursing, Alimosho, Igando, Lagos State. The total population of two hundred (100) student nurses was used for the study because of its small size. The instrument used for data collection was the researcher’s designed questionnaire. Data obtained in this study was analyzed using SPSS version 24. The findings reveal that the findings of this study showed that the respondents had positive perception about clinical posting and were able to identify the impact of clinical posting on career development. In addition, the role of clinical posting in skill development as well as the factors influencing the level of satisfaction with clinical posting was identified by the respondent. The study recommends that health education courses, training and workshops should be done for the clinical supervisors to orient clinicians making the transition from role expert (teaching at the nursing college) to clinical teacher in the postnatal ward.
Keywords: Student’s, Perception, Clinical Nursing Training, Nursing Schools, Lagos State
TABLE OF CONTENTS
Title
Page
i
Declaration
Page
ii
Certification
iii
Dedication iv
Acknowledgement
vi
Table of
Contents vii
List of
Tables ix
Abstract x
CHAPTER ONE: INTRODUCTION
1.1
Background to the Study 1
1.2
Statement of the Problem 4
1.3
Objectives of the Study 6
1.4
Research Questions 6
1.5
Research Hypotheses 7
1.6
Significance of the Study 7
1.7
Scope of the Study 7
1.8
Operational Definition of Terms 8
CHAPTER TWO: LITERATURE
REVIEW
2.1
Conceptual Review 9
2.1.1
Global View of Nursing Education 9
2.1.3
Pattern of Clinical Training in Nursing Education 11
2.1.4
Components of Clinical in Nursing Training 12
2.15
Clinical Placement 12
2.1.6
Preparation/Guidelines for Clinical Placement 14
2.1.7
Concept of Clinical Learning Environment 16
2.1.8
Clinical Teaching 17
2.1.9
Teaching styles used during clinical teaching 19
2.1.10
Format for Clinical Supervision 22
2.1.11
Clinical Evaluation 23
2.1.12
Formative Evaluation 24
2.1.13
Opportunities available for students nurses in clinical site-based learning 26
2.1.14
Factors Influencing Students experience
of clinical training 26
2.1.15
Concept of Perception 28
2.2
Theoretical Review 29
2.2.1
James Gibson’s Ecological Theory of Perception 29
2.2.2
Application of the theory to this study 31
2.3
Empirical Studies 31
2.4
Summary of Reviewed Related Literature 35
Summary
of Literature Review
CHAPTER THREE: RESEARCH
METHODOLOGY
3.0
Introduction 37
3.1
Research Design 37
3.2
Research Settings 37
3.3
Target Population 38
3.4
Sample and sampling techniques 40
3.5
Simple random sampling 41
3.6
Instrument for Data Collection 41
3.7
Validity and Reliability of Instrument 42
3.8
Method of Data collection 42
3.9
Method of Data analysis 43
3.10
Ethical Consideration 43
CHAPTER FOUR:
PRESENTATION OF RESULTS
4.1
Data Analysis 44
CHAPTER FIVE: SUMMARY OF
FINDINGS, CONCLUSION
AND RECOMMENDATION
5.1
Discussion of Findings 47
5.2
Summary 49
5.3
Conclusion 49
5.4
Implications of the Study 50
5.5
Recommendations 51
5.6
Limitation of the Study 52
REFERENCES 53
APPENDIX 59
LIST OF TABLES
Table
1: Demographic Characteristics of Respondents 44
Table
2: Mean and standard deviation of nursing students’ opinion 44
Table
3: Mean and standard deviation of nursing student’ view 44
Table
4: Mean and standard deviation nursing
students’ view 45
Table
5: Mean and standard deviation nursing students’ 46
LIST
OF FIGURES
James
Gibson’s Ecological Perceptual Cycle 30
CHAPTER
ONE
INTRODUCTION
1.1 Background to
the study
Clinical teaching and learning are
integral components of nursing education. Most clinical teaching and learning
activities occur in the clinical setting where theory is translated into
practice in healthcare providing institutions. Although the clinical environment
is a significant place to apply the theories learned in the classroom, there
remains a gap in the magnitude of applying the theory to practice. (Effective
application of theory to practice depends on many factors, including creating
learning opportunities for students and support by preceptors. (Mazionienie, 2018). A conducive clinical
environment is critical in enhancing the learning experiences of students. For
instance, in an environment where simulation learning is limited or not
available at all, learning occurs in the actual hospital environment. However,
most clinical training facilities in sub-Saharan Africa are constrained by
logistics and equipment, which tends to affect students’ learning experiences. (Mazionienie, 2018).
Multiple factors have been reported to
affect student learning in the clinical area. (These include individual- level
factors, the nature of the hospital environment, socioeconomic, and nurse
educator factors. A study conducted by Rajeswaran (2022) in Botswana discovered that nursing
students could not translate the theory into practice because they lacked
adequate supervision in the clinical setting, which resulted in low performance
in clinical practice. Nursing education consists of acquisition of a body of
knowledge that is partly delivered in a classroom setting which forms the
theoretical basis of nursing knowledge, and an organized and supervised
clinical training experience that takes place in the clinical setting where the
nurse-patient relationship is experienced directly or indirectly (Sheriff &
Masoumi, 2018). Clinical nursing training is the most critical step in
transforming nursing education, because that is really at the heart of getting
the nurse ready for clinical setting; and for providing safe and excellent
patients care. Students must be offered clinical experiences that are of
highest quality and of interest.
Clinical nursing training provides a practical
approach for training prospective nursing students to acquire practical skills
for practice as nurses (Emerson, 2022). The heart and soul of nursing education
is the clinical practicum where nursing knowledge is shaped into professional
practice (Diekelmann, 2014). Thus, basic knowledge and skills; and the ability
to apply knowledge into the actual practice of nursing is developed and
inculcated into the student nurses during clinical training. Barnes, Sutphen,
Leonard and Day (2019) also stated that clinical nursing education is a
fundamental part of nursing education and forms more than half part of nursing
curriculum. Historically, clinical training is derived through training
apprenticeships as in the era of Florence Nightingale in which an aspiring
student learns many facts of the profession from the “Master”. Even before the
days of Florence Nightingale and continuing into this century, students have
learned the practice of nursing from family members while caring for the
patients. Therefore, the clinical setting remains the most effective caring
situation for demonstrating theoretical possibilities and transforming the
novice to beginning nurse (Karen, 2023). A study carried out at School of
Nursing Oakland University on “getting the most out of students’ clinical
experience” highlighted that student nurses are provided with several
opportunities for clinical experiences. The students argued that more can be
learned in these experiences than can be taught in classroom setting though
both aspects are important and designed to complement each other (Crotty,
2023). The benefit of clinical nursing training in nursing education cannot be
overemphasized and this is achieved through clinical placement, teaching,
supervision and evaluation (Duteau, 2019).
During clinical placement, students are posted and
rotated to different clinical learning environments such as the outpatient
department, emergency units, clinical wards, other specialist units in the
hospital, other health care institutions, health centers and communities under
the direction and close supervision of experienced personnel in nursing profession.
In the clinical learning environment, student nurses are offered an opportunity
to work directly with competent professional nurses for patients in a
particular area of expertise. Teaching in clinical learning environment
presents educators with challenges that are different from those encountered in
the classroom because clinical setting requires different approaches to
teaching (Benis, 2023). One crucial element in students’ clinical training is
the supervision system. For student
nurses, supervision is a process where the learner is guided and supported
through clinical professional knowledge and skill (United Kingdom for Central
Council, 1995). The goal of supervision in clinical environment is to ensure
that student learning occurs and that students are safe. Evaluation of clinical
performances of the student nurses is an integral part of all programmes in
nursing profession. It also plays a major role in the society by certifying
competent nurse who can render quality nursing care to the public. Clinical
evaluation is a more formal assessment of the students’ performances in the
clinical nursing training (Raisler, O’Grandy & Lori, 2023).
As a learner in the clinical environment, the student
nurse is an embodied spirit, a union of body and rational soul. His body
experiences sensation and feels pleasure and pain. His soul is a spiritual act,
the source of intellectual abstraction, self reflection and free rational
volition (Balagot, 2012). He is the central focus in clinical nursing training
therefore his perceptions of the whole process need to be ascertained.
Perception is an individual’s awareness, insight and opinion about a situation.
The nursing students are also the customers and consumers in the clinical
nursing training. Their perception is a legitimate indicator of the quality of
the training. And their benefits from the training will depend on how they
perceive the clinical training experiences. If the students perceive the
clinical nursing training as meaningful and helping, they will be motivated to
learn and the experiences will be beneficial. If they have low perception about
them, the reverse will be the case. However, little has been done empirically
on nursing students’ perceptions of clinical nursing education in nursing
training institutions in Nigeria. The few published ones used only
university-based student nurses and did not include the hospital-based student
nurses. Thus this study examined the nursing students’ perceptions of clinical
nursing training in selected nursing programmes in Alimosho, Lagos State. It
also exposed areas of the clinical training that are deficient.
1.2
Statement of the problem
From the international perspective,
students ‘instruction and supervision in clinical setting appear to have been
shifted to clinical nurses only (Neary, 2022). Nurses who lack fundamental
skills in nursing research, academic training and experiences in preceptor-ship
and supervision still constitute the large group of nurses who often hold
functions as clinical instructors, supervisors and evaluators. From the
researcher’s observation in her areas of study too, students are sometimes left
in hands of any available nurse on duty for supervision and teaching as opposed
to sound selection criteria. Nurse educators and clinical instructors sparingly
go to the clinical environments for teaching and supervision probably due to
poor planning and busy tight academic schedule. Such things confuse the
students, inhibit learning and make clinical training disjointed and laborious
(Carr & Schoott, 2012). Consequently many students complain of one thing or
the other about their clinical training.
Furthermore, the nursing students as learners in the
clinical learning environment are the central focus and key players in clinical
nursing training and their perception is legitimate indicator of the quality of
clinical nursing training. But workplace incivility and aggression threaten the
socio-emotional and physical safety of student nurses in the clinical
environment. This was demonstrated by students who reported ostracizing,
hostile and dismissive behavior from staff (Anthony & Yastik, 2021). They
further reported that university-based student nurses felt particularly
persecuted by non university trained nurses who believed that university
trained nurses did not know much about real practical nursing. As a result,
many students reported an adverse impact on their future careers and employment
decision. The questions are: What are the nursing students’ perceptions of
their clinical nursing training? Was it high/positive, meaningful and helping
or was it low/negative and deficient? These are some fundamental questions the
researcher wants to address in the present study. In the light of the current
demand for measures of nursing students’ perceptions of clinical nursing
training and the scarcity of focused research in this area in Nigeria, this
study is both relevant and timely. All these prompted the researcher’s desire
to investigate the nursing students’ perceptions of clinical nursing training
in selected nursing programs in Lagos State.
1.3
Objectives of the Study
The broad objective of this study is
to determine the Nursing Student’s
Perception of Clinical Nursing Training in Lagos State College of Nursing
Alimosho Igando, Lagos State
Specifically, the objectives are:
1. To
assess student nurses perception on clinical posting in various health care
settings.
2. To
assess the perceive impact of clinical posting on student nurses career
development.
3. To
identify potentials for improvement in clinical posting among student nurses.
4. To
assess the role of clinical posting in skill development among student nurses.
5. To
determine factors that influence student nurses satisfaction with clinical
posting.
6. To
determine the challenges of clinical posting among student nurses.
1.4
Research questions
The following research questions were
formulated as a guide to the researcher.
1. What
is the nursing students’ opinion of their placement in the clinical setting/
learning environment?
2. How
do the nursing students’ view their clinical teaching?
3. What
is the students’ view about their clinical supervision?
4. How
do the nursing students perceive their clinical evaluation?
5. What
is the students’ overall perception of clinical nursing training?
1.5
Research Hypotheses
H0:
There is no significant difference between adolescent perception of clinical
posting and nursing care skill development
H1:
There is significant difference between adolescent perception of clinical
posting and nursing care skill development
1.6
Significance of the study
The findings will reveal the nursing
students’ opinion on the different aspects of their clinical training. It will
be of great benefit to the student nurses, nurse clinicians/administrators,
nurse educators, clinical instructors and supervisors, other health care
professionals, hospital management and policy makers. To the student nurses and
other health care professionals in the areas of study, the findings will be a
source of reference on students’ perceptions of clinical nursing training and
could stimulate further researches among interested individuals. To the nurse
clinical administrator, clinical instructors, supervisor, nurse educators,
hospital management and policy makers, the result of this study will help them
improve and strengthen the aspects of the clinical placement, teaching,
supervision and evaluation that are deficient
1.7 Scope of the
study
The study will be carried out to the students of Lagos
State College of Nursing, Igando, Alimosho, Lagos State of Nigeria. The study
is also delimited to determining how the student nurses perceive their clinical
placement, teaching, supervision and evaluation.
1.8
Operational Definition of Terms
· Clinical Nursing
Training: In this study means the sum total of the
experiences of the student nurses in the clinical setting in terms of their
placement, teaching/learning, supervision and evaluation.
·
Perception
of clinical nursing training: In this study implies
the nursing students’ view and opinion about their placement,
teaching/learning, supervision and evaluation in the clinical setting.
·
Perception
on Clinical Placement: In this study refers to
the students’ view and feelings about how they are posted and rotated in the
clinical setting and the environment in which they are posted.
·
Perception
of Clinical Evaluation: In the context of this
study, refers to the students’ view about how they were tested and examined for
clinical skills and those that examine them.
·
Selected
Nursing Programme: In this study means
university-based and hospital-based basic nursing programmes.
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