Influence of Students Perception/Staff Attitude in the Clinical Areas on Student’s Learning in Mathare Teaching and Referral Hospital, Nairobi, Kenya

Abstract

Clinical learning environment is a very important aspect of nursing teaching. In Europe as well as USA, the principle of nursing education is based on a 50% theoretical class work and 50% practical through clinical experience. In Kenya, the learning is different where 69.5% is class work and 21.5% is the clinical area placement. Kenya government designed a one-year internship for all BScN students before they are entered into nursing council register to give the student enough experience before they enter into the field. Clinical learning is described as the "heart" of professional practice. Practice placement constitutes an important aspect of students` learning through influencing students' acquisition of skills and knowledge for quality care provision in the right environments. The future of nursing profession is based on capacitating the student nurse with the ability to make critical decision at work. Noteworthy, many aspects affect student learning in clinical placement. Among them is shortage of qualified staff which is the case in the study area-Mathare Teaching and Referral Hospital. This study focused on factors that influence students learning in the clinical placement and aimed to determine the effect of student's perspectives and staff attitude towards learning in placement areas on learning among bachelor of nursing (BScN) students. A self-administered questionnaire was used to collect data that was analyzed by using statistical package of social sciences (SPSS) version 20. Study findings were presented by use of tables, charts and text. The findings revealed that most students (64.8%) were pursuing nursing training out of individual choice and felt that nursing was a calling to them but some (25.9%) would go to another career given a chance. Most (61.1%) students were apprehensive about clinical placement and the work they would be involved in. Reception in the hospital department by supervision staff was generally fairly satisfactory however 5.6% students reported lack of satisfaction. Nursing staff in the clinical area were generally friendly and concerned; and staff supervision in the clinical area was generally helpful and caring but not always available. The clinical placement areas need to enhance nurse-under-placement and receptors relationship to enhance uptake of the real life experience of the nursing profession.

Attitude of Nursing Students Towards Work in the Clinical Learning Environment

“…For nursing students to be adequately prepared for professional practice, they must be comprehensively prepared theoretically and practically (hands-on Patients) as just the theoretical preparation alone is inadequate (Aragaw, Sinishaw, Daba & Mekie, 2019;Jamshidi, Molazem, Sharif, Torabizadeh, & Kalyani 2016). Nursing is unarguably more of a practice-oriented discipline which implies that knowledge gained during practical placement prepares the student nurses more professionally than the theoretical knowledge gained in the classroom environment (Mugoh & Kamau 2020;Awuah-Peasah, et al, 2013;Mamaghani, et al, 2018). However, for students' nurses to be fully equipped for professional practice, both aspects of the training must be given equal attention so as to eliminate the theory-practice gap which has been a challenge in nursing education.…”

“…According to Tiwaken, Caranto and David (2015), student nurses must be exposed to both facets equally and one of the best ways of realizing this is by giving them the opportunity to put what they have learnt in the classroom into practice through clinical placement in the various clinical settings such as hospitals wards, primary health care institutions, special clinics, communities and nursing homes, comprehensive care clinics/patients support clinics, maternal and child welfare clinics etc. under the strict direction and supervision of faculty members, instructors, preceptors and nurse clinicians (Mugoh & Kamau 2020;Nabolsia, et al, 2012).…”

“…Despite the importance of clinical experience, posting or placement in acquisition of nursing skills, numerous studies have revealed challenges in nursing students' attitude towards clinical work/placement (Jamshidi, et al, 2016;Rajeswaran 2016;Drateru, 2019;Agu, 2017). According to Aragaw, et al (2019) & Mugoh and Kamau (2020), attitudes plays a principal role in guiding human behavior toward achieving goals. The attitudes of nursing students toward clinical work has been noted to be a topic of interest for research because whatever attitude students display to clinical work, be it the positives or negatives, it can either enhance effective clinical learning or mar the acquisition of essential clinical skills (Mugoh & Kamau, 2020).…”

“…According to Aragaw, et al (2019) & Mugoh and Kamau (2020), attitudes plays a principal role in guiding human behavior toward achieving goals. The attitudes of nursing students toward clinical work has been noted to be a topic of interest for research because whatever attitude students display to clinical work, be it the positives or negatives, it can either enhance effective clinical learning or mar the acquisition of essential clinical skills (Mugoh & Kamau, 2020). Aragaw et al (2019) reported negative attitudes towards clinical work/posting among nursing students.…”

“…Despite these positive experiences, literature has also revealed that nursing students also display nonchalant and negative attitude to clinical work as some consider nursing task stressful and anxiety provoking (Jamshidi et al, 2016;Mugoh & Kamau, 2020;Mlek, 2011). Mukumbang and Adejumo (2014) reported that some patients complained of poor professional behavior and negative attitudes displayed by the student nurses when they deliver their care.…”