Background: A 2010 study of preceptorship as a clinical teaching model in Ghana revealed weaknesses related to high student-preceptor ratios and inadequate support from faculty in the educational institution. A four-cycle community-based participatory action research study was designed to further delineate clinical teaching and learning issues and partner with Ghanaian stakeholders in critical analysis of possibilities for positive change in clinical nursing education. The purpose of this paper, taken from Cycle One of the study, is to provide understanding of the challenges of the current clinical teaching model(s) used in the study institution from the perspectives of students and faculty. Early engagement of external stakeholders is described. Methods: Each university target group was invited to complete a semi-structured questionnaire. Interviews were conducted with representatives from the Ministry of Health, the Nursing and Midwifery Council of Ghana, and the Ghana Registered Nurses' and Midwives' Association. Clinical documents were examined. Results: Clinical teaching and learning issues identified included the need for: a) more effective clinical teaching and supervision; b) adequate equipment for practice; c) meaningful evaluation of performance; d) enhanced collaboration between the school and clinical settings; and, e) reduced travel time to clinical opportunities. External stakeholders became aware and supportive of the research endeavour. Conclusions: Participants acknowledged changes are needed in order to improve clinical nursing education in Ghana. Clinical teaching and learning issues were identified and formed a baseline from which more in-depth discussion of resources, constraints and possibilities for change could ensue in subsequent cycles of the study.

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Managerial competencies of nurse managers are believed to influence the efficiency of healthcare. Amidst the global shortage of nurses and the rising cost of healthcare, it is imperative to assess the managerial competencies of nurse managers. Using the Katz Skills Model as the organising framework, this study assessed the managerial competencies of nurse managers at the unit level. A quantitative cross-sectional design was used to collect data from 121 nurse managers in 10 hospitals in the eastern region of Ghana. The nurse managers showed knowledge and the ability to apply different managerial competencies depending on the situation. They were more inclined to apply technical skills, followed by human skills and conceptual skills. Experience as a nurse, experience as a nurse manager, qualifications, and training in management together predicted their technical skills (R2 = 0.154, p = 0.002) and conceptual skills (R2 = 0.174, p < 0.001). However, only training in management contributed significantly to the managerial competencies of the nurse managers. At the 0.05% alpha level, increasing qualifications above an advanced diploma was associated with having better technical skills. The study presents new empirical evidence congruent with the Katz Skills Model that nurse managers require the knowledge and ability to apply technical, human, and conceptual skills in the performance of their managerial functions, and that no particular competency is ideal for every situation.

Background: The role of Nurse Managers (NMs) is dynamic, multifaceted and complex thus, exposing NMs to high levels of work-related stress which seriously impact general wellbeing, and organizational outcomes.Methods: A quantitative cross-sectional approach was employed to examine the phenomenon of stress among NMs in 38 selected hospitals. Census approach was used to collect data from 267 NMs. Descriptive and inferential statistics were performed to describe the sample and established the predictors of stress.Results: The main causes of stress among NMs are a shortage of staff (94.4%), poor working conditions (91.8%), inadequate management support (89.9%) and heavy workload (89.15%). NMs experienced all the types of stress (psychological, emotional and physical). The major stress coping mechanisms are time management (91.8%), effective communication (91%) and delegation of duties (89.5%) while excessive eating (18.4%) is the least strategy used. Sociodemographic characteristics together explained 6.4% of stress among NMs [R2 = .064, F(6,241) = 2.676, p = .016].Conclusions: Senior managers of hospitals should create a favourable working environment for nurses and the appointment of NMs should be based on experience and competence. Implication for Nursing Practice: Stress among healthcare managers especially, NMs is very common. This current study has extensively proven that stress among NMs affects their general health as well as patient safety and quality of care. Training on stress management should be organized regularly for hospital staff particularly, NMs to enable them to cope better with stress.

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