Developing academic and clinical collaboration guidelines for nurse training at a public nursing college in KwaZulu-Natal, South Africa

Abstract

Introduction and background Global reports of theory, practice gaps, decreased levels of competency and challenges with utilising clinical reasoning amongst newly qualified nurse graduates, have created a major concern in a complex healthcare environment, which requires efficiency. In South Africa, like most African countries, the healthcare system is predominantly nurse-driven, requiring nurses to have the necessary competencies and expertise to effectively manage the country’s disease burden and meet the healthcare needs of the South African community. Challenges have however, been identified in the clinical training of nurses which may impact on their graduate competency. These challenges may be attributed to deficiencies in the integration of theory and practice, and clinical support provision for nursing students. Aim of the study The aim of the study was to develop academic and clinical collaboration guidelines for nurse training at a public nursing college in KwaZulu-Natal, South Africa. Objectives of the study The objectives of the study were: to gain in-depth insight into the practices for clinical education of nursing students at a public nursing college in KwaZulu-Natal; explore and describe the role of the nursing educator with regards to clinical accompaniment and clinical teaching; explore and describe the experiences of the clinical ward staff in supervision and mentoring of nursing students; explore and describe the experiences of student nurses regarding clinical teaching and learning and develop guidelines for academic and clinical collaboration for nurse training in public nursing colleges. Research Method A qualitative exploratory design with a constructivist approach was utilised. Ethics approval was obtained from the: Durban University of Technology Institutional Research Ethics (Irec. No. 200/21). All participants, which comprised 49 academic staff, 43 professional nurses and 21 students registered in the Diploma in Nursing Programmes, were purposively sampled. Data were collected using focus group discussions and one-on-one semistructured interviews conducted between January and May 2022 and analysed manually using the content analysis strategy and following the eight-step analysis procedure by Tesch (1990). Findings The study findings revealed five themes namely: ineffectual clinical training structure; inadequate collaboration and supportive relationship between the academic institution and clinical placement area; clinical placement institutional challenges, clinical preparedness of students prior to clinical allocations and graduate competency not guaranteed on completion of training. These factors posed challenges to nursing students meeting their mandatory training objectives during their placements. The guiding principles of Schünemann, Fretheim and Oxham (2006), were utilised to develop guidelines for facilitating academic and clinical collaboration for nurse training at a public nursing college in the province of KwaZulu-Natal, South Africa. The Delphi technique was utilised to incorporate inputs from expert members on the group. Conclusion Challenges being experienced during the clinical learning placements of nursing students at this college, could result in theory and practice gaps during and after training. The guidelines developed, aims at enhancing the collaborative relationships between the academic and clinical partners in nurse training and can be used by the management of both structures who are responsible for nurse training, to improve the clinical training platforms. Recommendations The study recommendations are aimed at strengthening clinical training platforms for students at Public Nursing Colleges and includes: improving collaborative relationships between the academic and clinical partners in nurse training; planning together with clinical stakeholders for all resources required; prioritising nursing students meeting their clinical objectives and developing mutual nurturing relationships. A need exists to address challenges of student supervision, mentoring, negative staff attitudes and a lack of standardised clinical practice between the academic and clinical training partners. A review of the system of clinical preparation, accompaniment, and supervision of nursing students is critical.