Scaling up nurse education: An evaluation of a national PhD capacity development programme in South Africa, in the context of the global shortage of nursing graduates

Abstract

. Abstract BackgroundThe global shortage of nursing professionals educated at baccalaureate level and beyond has been highlighted. Within America, services are preparing to treat an additional 32 million individuals under the new Health Reform Bill. Within South Africa the existing nursing education outputs do not meet service demands. Many countries are addressing these shortages by developing advanced nursing roles which require research degrees. Objective:To evaluate a national nursing PhD development programme within the context of a nurse education strategy and a national health insurance plan. Design:A comparative effectiveness research design was employed. Setting:The setting was South Africa between 2011 and 2013, a county with 51.7 million inhabitants, 18 universities, with eight offering nursing degrees and 12 public nursing colleges offering diplomas. 2Participants included PhD candidates, programme facilitators, supervisors and key stakeholders. Methods:Data from a day long workshop was analysed using an inductive thematic analysis. Three years of evaluation reports were analysed. A mapping of the alignment of the PhD topics with priorities was conducted. A comparison of the development of nurse education of the national and international funder and an interpretation of the findings within the context of the programmes curriculum, the national nurse education strategy and the National Health Insurance plan was conducted. ResultsThe evaluation rated the programme highly. Three themes were identified from the workshop. These were, -support‖ with the sub-themes of burden, leveraging and a physical supportive place; -planning‖ with the sub-themes of the national context and practice, and -quality‖ with the sub-themes of processes as well as monitoring and evaluation. The mapping of PhD topics revealed that research was in line with development priorities.However, in order to match the underpinning values (sustainability, partnership and effectiveness) of the funders, further investment and infrastructural changes were found to be necessary to sustain the programme and its impact To address sustainability and capacity in nations scaling up nurse education and healthcare insurance it was recommended that top-up degrees for diploma educated nurses be developed along with the implementation of a national nursing strategy for PhD and post-doctoral research encompassing practice implementation and collaboration. IntroductionA global shortage of nursing professionals educated at baccalaureate level and beyond exists and the impact of this shortage is apparent on each continent. Nickitas and Feeg (2011) found that less than 1% of nurses have a doctoral degree and that forecasters predict substantial shortfalls in future nurse academics and as a consequence future nurse practitioners.Many countries are addressing these shortages in healthcare provision by ensuring that the basic nursing education qualification is at degree level and by developing advanced nursing roles which have a wider remit and which require ...

Describing the implementation of an innovative intervention and evaluating its effectiveness in increasing research capacity of advanced clinical nurses: using the consolidated framework for implementation research

“…The implementation did provide an ideal microclimate for learning and development. Of those who did participate, in support of previous literature, this study found allocating time for research was still an ongoing challenge [5, 8, 9, 11, 12, 18, 19]. It is still difficult for research to be seen as a priority given clinical commitments in spite of supports at senior level.…”

“…While there is an identified inconsistency in the meaning of the term research capacity building, within this paper it refers to involvement at all levels of the research process from question design to dissemination [5, 8]. Research capacity building has been identified as a priority in nursing research and development [5, 9]. However, within nursing to date the emphasis in research capacity building has been mainly in nurse academics [5, 9, 10], rather than in nurses with a clinical role [7, 9, 11, 12].…”

“…Many barriers to participation have been identified. Personal barriers include nurses’ attitudes [13, 14], poor knowledge about research [7, 12–16], lack of opportunity or experience [14, 15, 17], need for research skills [9, 14, 17, 18], lack of qualifications [12], lack of interest [7], lack of confidence [14, 15] and lack of motivation [13–15, 19]. At organisational level, other barriers to research have been identified and include, lack of research supervision [7], lack of support [7, 11, 13–17, 20], lack of reward [11], power hierarchies [12, 14], lack of mentorship [12], lack of time [7, 11–13, 15, 17, 18, 20, 21], and poor resources and funding [11–16, 18, 22].…”

“…Whether this is to provide direct support to single researchers, finding funding for research facilitator posts or other resources [8, 25], investments in infrastructure or other aspects of an initiative [20, 25] or building elements of sustainability and continuity [11]. Support can also be provided through the development of an educational programme or educational providing opportunities [8, 9, 13, 19, 23, 25, 30] or through the use of journal clubs [13] newsletters and monthly research meetings [19]. But overall it is evident that the leadership model utilised should provide a good support management system that will, in addition to the above, increase awareness of research within units [8, 25] so as to increase the capacity of individuals to engage in research.…”

Conceptual frameworks and terminology in doctoral nursing research

“…An increase in the number of nurses undertaking a PhD globally (Evans and Stevenson 2011) and strategies to develop programmes, for example, in countries such as South Africa (Comiskey 2015), together with the growth of the Professional Doctorate (Smith 2013) is helping nursing to be taken seriously as a research based profession in two key ways. Firstly, in developing an evidence base that can help the profession deliver on the drive to increase quality, innovation, productivity and preventative measures (Department of Health 2010).…”