Teaching and Learning of Clinical Competence in Ghana: Experiences of Students and Post-Registration Nurses

Abstract

Despite the growing demand for competent nurses to fill the shortage gap, nursing education institutions have not always been able to equip students with the requisite clinical competence needed in the practice setting. Several studies have described the experiences of undergraduate nursing students in the clinical learning environment. No study was found on the experiences of diploma nursing students and post-registration nurses regarding the teaching and learning of clinical competence in Ghana. This study, therefore, sought to describe the experiences and perceptions of diploma nursing students and post-registration nurses regarding the teaching and learning of clinical competence in Ghana. A qualitative descriptive research design was employed in this study. Fifty-five (55) participants, comprising 40 students and 15 post-registration diploma nurses, from six research sites were recruited into focus group discussions (FGDs) using a maximum variation purposive sampling technique. A thematic framework method was used to analyze the data with the aid of ATLAS.ti software. Three themes emerged from the focus group discussions: nursing education institutional factors; clinical placement design, implementation, and system challenges; challenges of clinical teaching and learning. We conclude that the current approach to clinical nursing education, such as the overreliance on clinical placement and the use of more teacher-centered teaching approaches, are ineffective in facilitating the development of clinical competence. A review of the nursing curriculum, inculcating evidence-based simulation modalities, and an adequate investment in nursing education may be required to ensure effective nursing education in the study setting.

Frameworks for the design, implementation, and evaluation of simulation‐based nursing education: A scoping review

“…Yet, NEIs continue to rely heavily on the traditional approach to clinical education to help students develop clinical competence. Furthermore, the lack of equipment and other learning resources within skills laboratories and NEIs as a whole has been identified as a factor that continues to promote the overdependence on traditional, clinical educational strategies (Salifu et al, 2019; Salifu et al, 2022).…”

“…Even when less crowded with students, decisive interventions are required to support student learning during clinical placements. In the absence of such interventions—as is the case in most low‐resource settings—qualified nurses are unlikely to fully support student learning as they tend to prioritize direct patient care over clinical teaching (Salifu et al, 2019; Salifu et al, 2022). Concerns have also been raised over the safety and the ethical implications associated with using real patients for clinical teaching and student learning, especially as patient acuity among hospital inpatients is increasing because of the shift from hospital to community care (American Association of Colleges of Nursing, 2017; Amilia & Nurmalia, 2020; Kpodo et al, 2016).…”

A Simulation-Based Clinical Nursing Education Framework for a Low-Resource Setting: A Multimethod Study

“…Phase two was conducted in two parts. The first part entailed a qualitative descriptive study comprising of FGDs of 15 post-registration diploma nurses and 40 nursing students (20 second- and 20 third-year students) from six different sites (three NEIs, which were all accredited diploma-awarding public nursing colleges and their primary clinical sites) in three geographical zones of Ghana, a low-resource setting [ 12 ]. The second part comprised of semi-structured interviews with nine nurse educators from the three NCs [ 40 ].…”

“…Data from the situational analysis were analysed using the framework approach of data analysis [ 42 ] with the aid of ATLAS.ti. The findings of the situational analysis are published in two different papers [ 12 , 40 ].…”

“…Historically, the military and aviation industries have long used simulation to train pilots and other technical staff in both skills and safety procedures [ 9 ]. This is because decreasing clinical placement facilities, increasing student enrolment numbers, poor clinical supervision, lack of resources, and ethical concerns about using patients for practice have all impeded the development of clinical competence in the clinical practice setting (CPS) [ 10 , 11 , 12 ]. Furthermore, the current clinical skills teaching strategies (demonstration and lectures) commonly used by nurse educators, especially in low-resource settings, are ineffective in fostering clinical competence development [ 11 , 12 , 13 , 14 ].…”