Exploring the Pedagogical Practices used in Competence Based Education Training of Nurses and Midwives in Uganda
Abstract
In Uganda CBE was introduced in 2006 and since then no study has been done to find out its suitability in the preparation of competent nurses and midwives. In recent years, there is increased attention given to Competence Based Education (CBE) in nursing and midwifery training programs as means of improving quality healthcare services. The use of suitable pedagogical practices in CBE training is critical for assisting students to effectively learn important concepts needed for their practice. The purpose of this study was to explore the suitability of pedagogical practices utilized in the CBE training programs in Uganda. The study was conducted from March to June 2015, at Mulago National Referral Hospital (MNRH). Concurrent mixed methods were used to gather both quantitative and qualitative data from respondents. A total of 193 participants were drawn from nurses and midwives trained under the CBE program and other key stakeholders, namely school principals, nursing and midwifery tutors, hospital administrators/medical consultants, officials at both Uganda Nursing and Midwifery Examination Board (UNMEB) and Uganda Nurses and Midwives Council (UNMC). Results by the majority of nurses and midwives who benefitted from the CBE training, revealed that the pedagogical practices used were suitable to enable them become competent nurses and midwives. However, the opinion of some key stakeholders differed. They noted that the implementation of suitable pedagogical practices in CBE training faced numerous challenges that needed to be addressed. These challenges included inadequate resources in terms of medical supplies and equipment as well as insufficient support given to trainees during clinical training due to shortage of staffing. This resulted into big workloads due to large student numbers, coupled with insufficient follow up by their tutors who are poorly motivated and have negative attitudes towards students. The study recommended the necessity to sensitize all implementers and stakeholders on the best pedagogical practices for CBE programs. There is also need to improve resources and conditions of students’ practicum training sites as well as to recruit more clinical instructors to specifically support the increasing numbers of students during their practicum training sites.
https://doi.org/10.26803/ijlter.17.1.8
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Alinier, G., Hunt, B., Gordon, R., & Harwood, C. (2006). Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education. Journal of Advanced Nursing, 54(3), 1359-1369. doi: doi: 10.1111/j.1365-2648.2006.03810.x
Anthopoulou, K., Valkanos, E., & Fragkoulis, I. (2017). The Professional Development of Adult Educators: The Case of the Lifelong Learning Centres (L.L.C) in the Prefecture of Evros, Greece. International Journal of Learning, Teaching and Educational Research, 16(11), 77-91. doi:10.26803/ijlter.16.11.5
Ayo, S., & Ndetaulo, E. (2009). Factors influencing clinical teaching of midwifery students in a selected clinical setting in Tanzania.
Barksdale, J. D., Newhouse, R., & Miller, A. J. (2014). The Patient-Centered Outcomes Research Institute (PCORI): Information for academic nursing. Nursing Outlook, 62(3), 192-200. doi:https://doi.org/10.1016/j.outlook.2014.03.001
Bensah, E. C., Ahiekpor, J. C., & Boateng, C. D. (2011). Migrating from subject-based to competency-based training in Higher National Diploma Chemical Engineering: The case of Kumasi Polytechnic. Education for Chemical Engineers, 6(3), e71-e82. doi:https://doi.org/10.1016/j.ece.2011.04.001
Billett, S. (2016). Learning through health care work: Premises, contributions and practices. Medical Education, 50(1), 124-131. doi:DOI:10.1111/medu.12848
Cant, R. P., & Cooper, S. J. (2010). Simulationâ€based learning in nurse education: systematic review. Journal of Advanced Nursing, 66(1), 3-15.
Chapman, H. (1999). Some important limitations of competency-based education with respect to nurse education: an Australian perspective. Nurse Education Today, 19(2), 129-135.
Cheraghi, M. A., Salasli, M., & Ahmadi, F. (2008). Factors influencing the clinical preparation of BS nursing student interns in Iran. International Journal of Nursing Practice, 14(1), 26-33.
Deißinger, T., & Hellwig, S. (2011). Structures and functions of Competency-based Education and Training (CBET): A comparative perspective.
Dole, S., Bloom, L., & Kowalske, K. (2016). Transforming Pedagogy: Changing Perspectives from Teacher-Centered to Learner-Centered. Interdisciplinary. Journal of Problem-Based Learning, 10(1), 1 - 15. doi:https://doi.org/10.7771/1541-5015.1538
Eta, V. E., Atanga, M. B., Atashili, J., & D’Cruz, G. (2011). Nurses and challenges faced as clinical educators: A survey of a group of nurses in Cameroon. Pan African Medical Journal, 8(1), 28.
Feldman, J., & McPhee, D. (2007). The science of learning and the art of teaching. Clifton Park, NY: Thomson Delmar Learning.
Frank, J. R., Snell, L. S., Cate, O. T., Holmboe, E. S., Carraccio, C., Swing, S. R., . . . Dath, D. (2010). Competency-based medical education: theory to practice. Medical teacher, 32(8), 638-645.
Frenk, J., Chen, L. C., Bhutta, Z. A., Cohen, J. J., Crisp, L. N., Evans, T. G., . . . Zurayk, H. (2010). Health Professionals for a new century: transforming education to stengthen Health systems in an independent world. The Lancet, 376 (9756), 1923-1958. doi:doi:http://dx.doi.org/10.1016/S0140-6736(10)61854-5
Grundy, L. (2001). Pathways to fitness for practice: National Vocational Qualifications as a foundation of competence in nurse education. Nurse Education Today, 21(4), 260-265. doi:10.1054/nedt.2000.0555
Gruppen, L. D., Mangrulkar, R. S., & Kolars, J. C. (2010). Competency–Based Education in the Health Professions: implications for Improving Global Health. Commission on Education of Health Professionals for the 21st Century Working Paper.
Hakimzadeh, R., Ghodrati, A., Karamdost, N., Ghodrati, H., & Mirmosavi, J. (2013). Factors affecting the teaching-learning in nursing education. GSE Journal of Education, 2013, 174-184.
Hanrahan, M. (2007). The effect of learning environment factors on students’ motivation and learning. International Journal of Science Education, 20 (6), 737-753. doi:https://doi.org/10.1080/0950069980200609
Harden, R. M. (2009). Outcome- based education: Part 1- An introduction to outcome- based education. 1, 14.
HCCA. (2012). Competency Based Training and Assesment: Home and Community Care (HCCA) community care worker human resource kit 2007. last updated November 2012.
Ironside, M. P., McNelis, M. A., & Ebright, P. (2014). Clinical education in nursing: Rethinking learning in practice settings. Nursing Outlook, 62 (3), 185 -191. doi:https://doi.org/10.1016/j.outlook.2013.12.004
Jhpiego. (2010). Training Skills for Health Care Providers. Reference Manual, one(Third Edition), 167.
Kigonya, E. (2004). Medical education in Uganda-A critique. East and Central African Journal of Surgery, 9(2), 1-4.
Kolb, D. A. (1981). Experiential learning theory and the learning style inventory: A reply to Freedman and Stumpf. Academy of Management Review, 6(2), 289-296. doi:doi: 10.5465/AMR.1981.4287844
LaLiberte, T., & Hewitt, A. (2008). Impact: The Importance of Competency- Based training for direct support Professionals Institute on Community Integration (UCEDD), 20(2), 1 - 208.
Lauder, W., Roxburgh, M., Holland, K., Johnson, M., Watson, R., Porter, M., . . . Behr, A. (2008). Nursing and Midwifery in Scotland: Being Fit for Practice. The Report of the Evaluation of Fitness For Practice Pre-Registration Nursing and Midwifery Curricula Project. Retrieved from University of Salford, Manchester: http://www.nes.scot.nhs.uk/practice_education/work/evaluation/
Mabuda, B. T. (2009). Student nurses’ experiences during clinical practice in the Limpopo Province South Africa. University of South Africa, Pretoria.
Magobe, N. B., Beukes, S., & Muller, A. (2010). Reasons for students' poor clinical competencies in the primary health care: clinical nursing, diagnosis treatment and care programme. Health SA Gesondheid, 15(1), 1-6.
Ministry of Health. (2007). Uganda Human Resource for Health Strategic Plan 2005-2020: Responding to Health sector Strategic Plan and Operationalising the HRH Policy.
MoES. (2012). Skilling Uganda; BTVET strategic plan 2012/13 to 2021/2. Kamplala: Ministry of Education and sports. .
Morolong, B., & Chabeli, M. (2005). Competence of newly qualified registered nurses from a nursing college. Curationis, 28(2), 38-50.
Mutwali, I. M., Al_Raheem, N. A., Elhassan, W. A. M., Ibrahim, S. S., Abdulhamid, A., Fadulalbary, E., & Aglan, A. (2015). Communication skills training through an inter professional education initiative for undergraduate mult-professional students. International Journal of Learning, Teaching, and Educational Research, 13(2), 195-207.
Newble, D., & Cannon, R. (2000 ). A handbook for teachers in universities and colleges (4 ed.). Abingdon, England: Routledge Falmer.
Okoronkwo, I. L., Onyia-Pat, J.-L., Agbo, M.-A. E., Okpala, P. U., & Ndu, A. C. (2013). Students’ perception of effective clinical teaching and teacher behaviour. Open Journal of Nursing, 3(01), 63.
Parternership, G. S. (2017). Ten Principles of Competency-Based Learning. http://greatschoolspartnership.org/wp-content/uploads/2017/01/GSP_Ten_Principles_of_CBL.pdf
Pijl-Zieber, E. M., Barton, S., Konkin, J., Awosoga, O., & Caine, V. (2014). Competence and competency-based nursing education: finding our way through the issues. Nurse Education Today, 34(5), 676-678.
Rainey, M. A., & Kolb, D. A. (1995). Using experiential learning theory and learning styles in diversity education. The importance of learning styles: Understanding the implications for learning Westport, USA course design, and education.
Redman, R. W., Lenburg, C. B., & Walker, P. H. (1999). Competency assessment: Methods for development and implementation in nursing education. Online Journal of Issues in Nursing, 4(2), 1-7.
Ricketts, B. (2011). The role of simulation for learning within pre-registration nursing education—a literature review. Nurse Education Today, 31(7), 650-654.
Sullivan, R., & McIntosh, N. (1996). The Competency -Based Approach To Training Medical Journal of Indonesia, 5(2), 95-98. doi:DOI: http://dx.doi.org/10.13181/mji.v5i2.853
Thanh, P. T. H. (2010). Implementing a student-centred learning approach at Vietnamese higher education institutions: Barriers under layers of Casual Layered Analysis (CLA) Journal of Futures Studies, 15( 1 ), 21-38.
Uys, L. R., & Gwele, N. S. (2005). Curriculum Development in Nursing. Process and Innovation. Newyork: Routledge.
Van Horn, R., & Freed, S. (2008). Journaling and dialogue pairs to promote reflection in clinical nursing education. . Nursing Education Perspectives, 29(4), 220-225.
Wall, P., Andrus, M. P., & Morrison, P. (2014). Bridging the Theory Practice Gap through Clinical Simulations in a Nursing Under-Graduate Degree Program in Australia. International Journal of Learning, Teaching and Educational Research, 8(1), 127-135.
WHO. (2009). Nursing and Midwifery Human resources for Health : Global standards for the Initial Educaion of professional Nurses and Midwives. Retrieved from http://www.who.int/hrh/nursing_midwifery/en/
Zakari, N., Hamadi, H., & Salem, O. (2014). Developing an understanding of research-based nursing pedagogy among clinical instructors: A qualitative study. Nurse Education Today, 34(11), 1352-1356. doi:DOI: 10.1016/j.nedt.2014.03.011
Zhong, G., & Xiong, X. (2010). Analysis of Factors Influencing Current Practice of Clinical Medicine Education. . Asian Social Science, 6(7), 189. doi:DOI: http://dx.doi.org/10.5539/ass.v6n7p189
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