Students' perspectives on the primary health care practice learning enviroment
Primary Health Care (PHC) practice environments provide unique opportunities for students to learn clinical skills and acquire professional competence. To enhance clinical learning, the PHC practice learning environment must be supportive to the students’ learning needs and also for professional nurses to educate students. The researcher’s interest to conduct this study was raised by the negative feedback received from students and their supervisors, following the students’ required primary healthcare clinical placement. The study focused on the views of the students regarding the PHC practice learning environment, as they are at the centre in clinical practice. The aim of the study was to describe the primary healthcare practice learning environment from the students’ perspective. The description of the students’ perspectives on the primary health care practice learning environment could help improve the supportive relationship between the Free State School of Nursing, the Primary Health Care (PHC) clinical facilities and the students, and consequently enhance clinical learning. A quantitative, descriptive, cross-sectional design was followed to describe the perspectives of student nurses. The study population consisted of the 3rd year students from the Eastern, Northern and Southern campuses of a Free State School of Nursing, who completed their second year primary health care clinical practice in 2016. A structured self-administrative questionnaire was developed from MacKenzie’s (2010) qualitative study on the problems of undergraduate student nurses’ learning experiences in primary healthcare clinics and relevant literature to collect data. A total number of 146 students voluntarily completed the questionnaire. Descriptive statistics were used to analyse data. The results showed that the students were mostly supported before clinical placement, on the commencement of clinical placement and during clinical placement. However, the percentage of positive responses received during clinical placement was lower than that of the support received before and on the commencement of clinical placement. Furthermore, the respect professional nurses showed towards patients and their families, the relationships students had with other members of the multidisciplinary team, communication between lecturers and professional nurses, the availability of human and material resources all needed much improvement. On a positive note, the services at PHC practice learning environments were found to be adequate. A comparison of certain statements between the three campuses showed that Campus C students responded positively in most statements. On the whole, the finding of this study shows that the PHC practice environments do not adequately support students’ clinical learning. The Campus C PHC practice learning environment was found to better enhance the students’ clinical learning, than the Campus A and B practice learning environments. Recommendations that were made based on the results of this study included the adequate preparation of professional nurses by the lecturers before clinical placement. To improve supervision during clinical placement, preceptorship and mentorship programmes were recommended. Furthermore, creating a practice learning environment that nurtures clinical learning (good role modelling by professional nurses; the approachable attitude of nurses towards students and the providing of a high standard of care by professional nurses) could benefit students. The effective communication between lecturers and professional nurses is crucial to enhance clinical learning. The researcher therefore, suggests that future research focuses on the development and implementation of relevant/collaborative clinical practice environment programmes and assessment tools.