School of Nursing

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Browsing School of Nursing by Author "Botma, Yvonne"

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    Adult learning: what nurse educators need to know about mature students
    (AOSIS, 2015) Spies, Cynthia; Seale, Ielse; Botma, Yvonne
    Background: Most nurse educators regard students who enter postgraduate studies as adult learners capable of self-direction and independent learner behaviour. Therefore, a mismatch between the nurse educator’s expectation of adult learners and actual adult learner conduct may result in disappointment and even frustration for both educator and learner. Purpose: This article is a report of a secondary analysis of data that were collected to explore the high-fidelity simulation learning experiences of a group of postgraduate nursing students. The secondary analysis was done to determine whether adult learners who bring professional knowledge and experience to a postgraduate learning environment displayed adult learner conduct as proposed by educational theorist Malcolm Knowles. Method: Using a qualitative descriptive research design, data were gathered from 18 postgraduate nursing students who participated in high-fidelity simulation in a nursing school at a higher education institution in South Africa. The nominal group technique was used to collect the students’ ideas about improving their simulation learning experiences. A secondary qualitative analysis of the primary nominal group data was done. Findings: Data either confirmed or belied adult learner behaviour. Although the findings suggested self-directed and independent learner behaviour, they also revealed behaviour evident of dependence on the educator. Conclusion: Mature students have well established ways of thinking and doing that may hinder learning. Educators have to support adult learners in developing effective learning techniques in order to maximise the benefits of their experience and knowledge by fostering independence and self-direction.
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    Bridging the gap between self-directed learning of nurse educators and effective student support
    (AOSIS, 2015) Van Rensburg, Gisela H.; Botma, Yvonne
    Background: Self-directed learning requires the ability to identify one’s own learning needs, develop and implement a plan to gain knowledge and to monitor one’s own progress. A lifelong learning approach cannot be forced, since it is in essence an internally driven process. Nurse educators can, however, act as role models to empower their students to become independent learners by modelling their own self-directed learning and applying a number of techniques in supporting their students in becoming ready for self-directed learning. Objectives: The aim of the article is to describe the manifestations and implications of the gap between self-directed learning readiness of nurse educators and educational trends in supporting students. Method: An instrumental case study design was used to gain insight into the manifestations and implications of self-directed learning of nurse educators. Based on the authentic foci of various critical incidents and literature, data were collected and constructed into a fictitious case. The authors then deductively analysed the case by using the literature on self-directed learning readiness as departure point. Four constructs of self-directed learning were identified, namely internal motivation, planning and implementation, self-monitoring and interpersonal communication. Supportive strategies were identified from the available literature. Results: Nine responses by nurse educators based on the fictitious case were analysed. Analysis showed that readiness for self-directed learning in terms of the identified constructs was interrelated and not mutually exclusive of one other. Conclusion: The success of lifelong learning is the ability to engage in self-directed learning which requires openness to learning opportunities, good self-concept, taking initiative and illustrating independence in learning. Conscientiousness, an informed acceptance of a responsibility for one’s own learning and creativity, is vital to one’s future orientation towards goal-directed learning. Knowledge and understanding of one’s own and students’ selfdirected learning abilities are critical for nurse educators. In the nursing profession, it has been shown that self-directed learning by the nurse educators has a direct relationship towards the development of a lifelong learning approach by their students. Supporting students towards becoming self-directed learners throughout their professional life, in turn, will impact directly on the quality of nursing and midwifery practice.
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    Clinical placement models for undergraduate health professions students: a scoping review
    (BMC, 2021) Nyoni, Champion N.; Hugo-Van Dyk, Lizemari; Botma, Yvonne
    Background: Clinical learning is fundamental to undergraduate health professions students. There are several calls for the transformation of health professions education, which have direct implications on clinical learning. Clinical placement models provide structure to clinical learning. Therefore, this scoping review could contribute to supporting curriculum transformation to enhance learning in the clinical environments for undergraduate health professions students. Objectives: This scoping review identified the characteristics of research evidence related to mapping the purpose, methodologies used, outcomes, and specific recommendations associated with clinical placement models in undergraduate health professions education. Design: A scoping review method was used in this study. A search string developed from the title of the review was used to search online databases to identify research published between January 2000 and March 2020. Results: Forty-eight articles reporting on ten clinical placement models were included in this review. The majority of these articles originated from Australia and predominantly report on nursing. The aims of these articles aligned with the evaluation of the implementation of a clinical placement model. Seven categories of outcomes of the clinical placement models are reported namely, relationships, influence, environment, facilitation, inputs, knowledge scores, and student perceptions. Conclusions: As clinical learning is fundamental to undergraduate health professions education, clinical placement models should prioritise the development of competence among undergraduate students. Insights into outcomes reported in literature could guide educators in fostering optimal learning in students who may then be able to influence community health outcomes positively.
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    Development and testing of a competence assessment instrument for undergraduate nursing students
    (University of the Free State, 2017-01) Piek, Nicola; Botma, Yvonne
    English: Nursing roles and responsibilities in South Africa are evolving, demanding nursing practitioners to become more autonomous, responsible and accountable. Competent nursing practitioners who are able to apply their knowledge, skill and attitude in clinical practice are in great demand. Competence is therefore regarded as a prerequisite for nursing students entering the workforce as nurse practitioners. Competent student nurses demonstrate thinking processes such as critical thinking, clinical reasoning, sound clinical judgment and metacognition as they assess, diagnose and treat patients. In order for competent student nurses to apply these thinking processes the basis of foundational knowledge, conditional knowledge, functional knowledge and metacognitive knowledge need to be in place. At present there is no assessment instrument based on the thinking processes to assess the competence of student nurses in South Africa. The aim of this study was to develop a valid and reliable instrument to assess nursing students‟ competence through their demonstration of clinical judgment and metacognition in clinical settings A quantitative methodological study was done to prove the developed assessment instrument as reliable. Sixteen existing competence assessment instruments were accessed and analysed. Consequently a thematic analysis of nine of the existing competence assessment instruments delivered an assessment instrument comprised of 38 items, classified according to thinking processes. A panel of experts enhanced face and content validity of the developed assessment instrument before the instrument was implemented. Twenty respondents each assessed 15 second-year undergraduate nursing students who participated in a standardised patient simulation activity via video footage. A Cronbach Alpha coefficient test, Intraclass correlation coefficient (ICC) test and a Kendall‟s coefficient of concordance (W) test determined reliability of the developed assessment instrument. A Cronbach Alpha coefficient of .90 is indicative of good internal consistency and proves the developed assessment instrument as reliable. The ICC value of .85 indicates excellent inter-rater reliability as a continuum of all the respondents and further contributes to the reliability of the developed assessment instrument. However the W values of the developed assessment instrument were low and ranged between .04 and .40 per item. The low W values were attributed to the fact that some respondents were inconstant in assessing students, the fact that respondents could not validate the reasoning of students, and the large number of assessors (20) in comparison to other inter-rater studies that have three assessors at the most. The competence of student nurses needs to be assessed in order to determine if they can apply their knowledge and reasoning in clinical practice. The value of this research is that the developed assessment instrument may aid nurse educators or preceptors to identify the specific learning need of a student. Furthermore the developed assessment instrument will give an indication of the competence of student nurses. This knowledge will encourage nurse educators to build in and expand teaching strategies that develop thinking processes into their pedagogies. It is recommended that future research, such as an exploratory and confirmatory factor analysis, be done in order to determine the construct validity of the developed assessment instrument. This will significantly enhance the validity of the developed assessment instrument.
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    Development and testing of a tool to measure the supportive role of nursing preceptors
    (University of the Free State, 2016-01) Hugo, Lizemari; Botma, Yvonne
    English: South Africa needs competent nursing practitioners who are able to apply their minds in order to meet the high patient care demands. Nurse educators must support nursing students, our future nurse practitioners, in the clinical facility because they experience various unfamiliar and even traumatic situations. Effective system, tangible, cognitive and emotional support offered by preceptors enable students to transfer their classroom learning into practice and become competent nurse practitioners who are able to think critically, reason clinically and demonstrate sound clinical judgment. For effective precepting to take place, preceptors should consider a number of factors such as the student characteristics, educational outcomes, transfer climate as well as the physical environment and adapt their precepting style and technique according to the circumstances and students’ learning needs. At present, there is no measurement instrument to evaluate the all four types of support that preceptors offer to students in the clinical practice. A quantitative methodological study was done to standardise the newly developed instrument by determining its reliability and validity. Forty-two existing questionnaires on student support by preceptors were accessed and analysed. Consequently, sixty-nine relevant items were included in a draft questionnaire. Face and content validity were enhanced before testing the draft questionnaire. One hundred and ninety-two nursing students in an undergraduate programme were asked to evaluate their preceptors over two consecutive months. Reliability was determined by Cronbach’s alpha test and validity was determined by an exploratory factor analysis. A 0.98 Cronbach alpha value indicates a high reliability. The factor analysis identified three factors, namely system, cognitive and emotional support. Twenty-four items were evaluated by comparing cut-off values of >_ 0.4 and >_0.5. Twelve items were eliminated based on the cut-off values, leaving fifty-seven items to be included in the final questionnaire. Students need support to develop their thinking operations and to transfer classroom learning to clinical practice. The value of this research is that the developed tool provides an assessment or diagnostic instrument to determine the quality of precepting as experienced by nursing students. Lack of competence in a specific facet or domain may be diagnosed and training should be offered in order to improve the quality of precepting. It is recommended that further research, such as a confirmatory factor analysis, be executed in order to confirm the value of the tool in assessing and diagnosing the quality of preceptorship in South Africa.
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    A strategy for meaningful simulation learning experiences in a postgraduate paediatric nursing programme
    (University of the Free State, 2016-01-31) Spies, Cynthia; Botma, Yvonne
    English: Learning through simulation is a relatively young science in nursing education. Although the benefits of simulation as an effective learning strategy in nursing education are supported by extensive research on the subject, the development of meaningful simulation learning experiences can be challenging, especially to nurse educators who do not feel prepared for this type of educational approach. The purpose of this study was to develop a strategy for meaningful simulation learning experiences in a postgraduate paediatric nursing programme. An educational action research design, based on a social constructivist paradigm, was used to answer the research question: How can meaningful simulation learning experiences be achieved in the postgraduate paediatric nursing programme? Through the process of three action cycles extending over a period of two years, a strategy was developed, refined and finalised, based on data gathered from two separate groups of paediatric nursing students. The first group of participants consisted of 21 students, and the second group of participants consisted of 18 students. Qualitative data were gathered by means of the nominal group technique, field/reflective notes, recording of debriefing sessions and focus group interviews. In the third cycle, in addition to qualitative data, quantitative data were gathered by means of a simulation evaluation questionnaire. At completion of the two-year project, a final strategy for meaningful simulation learning experiences emerged, based on a synthesis of data gathered. Aspects relating to meaningful simulation learning experiences included a safe learning environment, authenticity, a responsive simulator, cognitive processes such as reflection-on-action, independent thinking, and meaningful knowledge construction. Furthermore, the students valued simulation learning experiences as opportunities to improve competence, psychomotor skills, self-confidence and teamwork. They learned to integrate theory and practice and experienced a paradigm shift that influenced their view of the conditions under which nursing care should be provided to children. A major hindrance to learning through simulation was the students’ dependence on an educator and reluctance in taking ownership of their own learning. This finding related to a discovery made in the first action cycle, which was that nurse educators should be careful to assume that postgraduate nursing students, who are considered mature individuals, naturally have the characteristics of adult learners. Apart from a strategy consisting of specific action items and expected outcomes upon their implementation, seven characteristics of meaningful simulation learning experiences were identified, namely constructively aligned instruction, challenging learning tasks, a non-judgmental student-centred approach to students, collaboration through a community of learning, deliberate practice, an authentic learning environment, and relevant student preparation. The strategy developed in this study endorses the use of constructivist learning theory and Kolb’s experiential learning theory to achieve meaningful simulation learning experiences. The study contributes to the practice of simulation in nursing education because it gives nurse educators a theoretically and empirically founded plan for implementing simulation in a way that students find meaningful and conducive to learning. The paediatric nursing students experienced a paradigm shift in terms of their practice as healthcare providers to children, which translated into strengthened nursing values and renewed motivation to transfer their learning to the practice setting.