Barriers and outcomes of therapeutic communication between nurses and patients in Africa: a scoping review.

BACKGROUND: Therapeutic communication (TC) promotes effective patient care, emotional wellbeing, and improves patient outcomes. The purpose of this review was to synthesise evidence on barriers and outcomes of TC between nurses and patients in Africa and to inform future studies and systematic reviews. METHODS: Search for the records was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Results and findings from published studies and grey literature were included. A total of 16 articles met the eligibility criteria and were included in the review. This scoping review followed the guidelines by Askey and O'Malley. RESULTS: Barriers associated with TC were grouped under five main themes: sociodemographic factors, patient-related factors, nurse-related factors, environmental and health service-related. Age, and religious beliefs were the main sociodemographic factors that hindered TC while stress and inadequate knowledge and skills were identified among the nurse-related barriers to TC. Extreme weather conditions and mosquito infestation were environmental factors while lack of access to TC educational programmes on TC was a health service-related factor that interfered with TC. Both positive and negative outcomes of TC were also identified. CONCLUSION: Continuous professional development on TC is necessary to improve nurses' attitudes and update their skills to enable them to render culturally competent nursing care to patients.

Self-management needs, strategies and support for sickle cell disease in developing countries: a scoping review protocol.

INTRODUCTION: Sickle cell disease (SCD) poses a significant global health burden, particularly affecting individuals in developing countries with constrained healthcare resources. While research on self-management in the context of SCD is emerging, it has predominantly focused on primary studies, and there is a notable dearth of evidence synthesis on SCD self-management in developing countries. This scoping review aims to identify and map self-management needs of individuals living with SCD, the strategies they employed to meet those needs, and the support systems available to them. METHODS AND ANALYSIS: The review will be conducted following the Arksey and O'Malley's (2005) 29 framework to comprehensively examine the landscape of SCD self-management research. Searches will be performed in PubMed, Scopus, Embase and Dimensions AI, with additional searches in other databases and grey literature. Indexed literature published in English from inception to January 2024 will be included. Reference list from included studies will also be searched manually. Two teams will be constituted to independently screen titles, abstracts and full text against the eligible criteria. Data will be extracted from included studies onto a customised data extraction form. ETHICS AND DISSEMINATION: Ethical approval is not required for this review due to the fact that it synthesises information from available publications. The findings will be disseminated through publication in a peer-reviewed journal. Also, the findings will possibly be presented at relevant international and national conferences. This protocol has already been registered with the Open Science Framework. The study characteristics such as design and setting will be descriptively analysed and presented as graphs, tables and figures. Thematic analysis will also be conducted based on the study objectives and presented as a narrative summary.

Curriculum framework to facilitate critical thinking skills of undergraduate nursing students: A cooperative inquiry approach.

AIM: Critical thinking (CT) is vital in assisting nurses to function efficiently in the ever-changing health care environment. A CT-based curriculum framework provides the impetus necessary to drive the acquisition of CT skills of students. Yet, there is no known CT-based framework contextualized to developing countries where seniority tradition is a norm. Therefore, the aim of this study was to develop a CT-based curriculum framework to facilitate the development of CT skills of nursing students in developing countries. DESIGN: Cooperative inquiry. METHODS: Using purposive sampling, 11 participants comprising students, educators and preceptors developed a CT-based curriculum framework. RESULTS: Findings were organized into a framework illustrating interconnected concepts required to foster CT skills of nursing students. These concepts include authentic student-facilitator partnership, a facilitator that makes a difference; a learner that is free to question and encouraged to reflect; a conducive and participatory learning environment; curriculum renewal processes and contextual realities.

Nursing Students' Perception of Clinical Teaching and Learning in Ghana: A Descriptive Qualitative Study.

Background: Clinical teaching and learning are critical in bridging the theory-practice gap in nursing education. This study aimed at exploring nursing students' perception of clinical teaching and learning in Ghana. In particular, this study sought to (1) describe the factors that promote clinical teaching, (2) examine students' perception of clinical teaching, (3) describe the impact of clinical learning on students, and (4) explore ways of improving clinical teaching and learning. Methods: A descriptive qualitative study was conducted with 16 final-year nursing students using telephone-based interviews. Individual in-depth interviews were conducted with a semistructured interview guide, and data were analysed by the qualitative thematic analysis. Results: The findings indicate that being taught new things, being supervised, and having autonomy were the most significant factors that promoted clinical learning. Participants also reported that clinical experience created learning opportunities that helped develop clinical competence. They described learning experiences in the clinical setting as good, albeit gaps in practice. Poor staff attitude, lack of equipment, poor student attitude, inadequate learning opportunities, and lack of clinical supervisors were perceived as challenges in the clinical environment. Conclusions: Efforts to consciously teach, supervise, and challenge students to have independence in the clinical area will promote clinical teaching and learning. Therefore, nursing educational institutions and all other stakeholders need to collaborate in eliminating the numerous challenges students encounter in the clinical environment.

Clinical preceptorship in Ghana in the era of COVID-19 pandemic: an interventional study.

BACKGROUND: Innovations in clinical nursing education are critical in enhancing the experiences of students, especially in the era of coronavirus pandemic. This study aimed at investigating nurse preceptors' perceptions of use, intention to use and self-efficacy towards digital technology in preceptorship in the Cape Coast Metropolis of Ghana. METHODS: A concurrent type of mixed-methods design with a non-randomised interventional study using three-phase multi-methods technique was conducted among nurse preceptors in the Cape Coast Metropolis in the Central Region of Ghana. Forty-five nurse preceptors participated in a pre and post training intervention while seven were purposively selected for the qualitative interview. Complimentarity method of triangulation was used in the analysis. The quantitative data were analysed with STATA version 16 and presented using frequencies, percentages, means with standard deviations and McNemar's test while qualitative data were analysed using the six steps approach to qualitative data analysis by Braun and Clarke. RESULTS: Perceived usefulness statement "using technology will improve clinical teaching" increased from 19 (42.22%) at baseline to 44 (97.78%) post intervention. Perceived ease of using technology statement "I would find it easy to get this technology to do what I want it to do" also increased from 36 (80.00%) to 41 (91.11%) post intervention. Self-efficacy increased from 40 (88.89%) to 43 (95.56%) after the intervention. There was a statistically significant difference between pre-training and post-training scores regarding tablet (p = 0.016) and experience with online library resources (p = 0.039). The qualitative results yielded three themes, namely: strengths of using technology; constraints in the learning environment; and future of technological approach to clinical teaching. CONCLUSIONS: The training intervention improved participants intentions, self-efficacy, perceived use and perceived ease of use of technology. However, there are constraints in the clinical learning environment including students and preceptor-related factors, and institutional factors that needs to be addressed as part of efforts to implement technology in clinical teaching in this era of COVID-19 pandemic and beyond.

Critical thinking disposition of nursing students: A quantitative investigation.

AIM: The aim of this study was to assess the critical thinking (CT) disposition of students in a nursing school. This assessment is part of a larger study aimed at developing a CT-based curriculum framework for an undergraduate nursing educational program in a developing country. DESIGN: A quantitative descriptive cross-sectional design was used to assess the CT disposition of undergraduate nursing students. This cross-sectional study identified strengths and weaknesses of nursing students relative to critical thinking mindset. METHODS: The California Critical Thinking Disposition Inventory (CCTDI) was used to assess the CT disposition of 112 undergraduate nursing students from March to May 2018. The CCTDI contains 75 items of six-point Likert scale of seven subscales. Data were analyzed through the use of descriptive statistics, the independent t-test and ANOVA. RESULTS: Most participants (73%) demonstrated a positive inclination towards critical thinking on the overall CCTDI score. Students' mean score was highest on the confidence in reasoning subscale while lowest on truth-seeking. A statistically significant difference (p = 0.03) was found in the years of study on the inquisitiveness subscale. CONCLUSIONS: These findings indicate the need for educators to devise strategies to assist students to seek accurate information building on students' positive CT disposition.

A Multisite Study on Knowledge, Perceived Motivators, and Perceived Inhibitors to Precepting Nursing Students within the Clinical Environment in Ghana.

BACKGROUND: Preceptorship constitutes an important component of the educational process of training nursing students. The purpose of this study was to assess the knowledge, perceived motivators, and perceived inhibitors to precepting nursing students at the clinical placement sites in the Cape Coast Metropolis of the Central Region of Ghana. METHODS: A descriptive cross-sectional study was conducted among 442 nurses and midwives aged 27-56 years with at least three years of work experience. Data were collected with a questionnaire and analyzed using frequency counts, percentages, exploratory factor analysis, and point biserial correlation. RESULTS: The results indicate that the participants had a high knowledge of preceptorship of up to 91.2% (n = 404). A significant proportion of up to 88.2% (n = 390) had an intention to precept nursing students in the near future. The three important perceived motivational factors to precepting nursing students were the learning and professional needs of students, helping students to develop skills, and experience and formal recognition of the role of preceptorship. The main perceived inhibitors to engage in a preceptorship role were lack of preparation for the role, lack of support from faculty and nurse managers, and additional work burden. The results further indicate a significant strong positive correlation between experience and professional recognition of preceptorship and the intention to precept nursing students in the near future (r = 0.99, p=0.037). CONCLUSIONS: The nurses and midwives who participated in the study are knowledgeable about preceptorship and have the intention to precept nursing students. Having enough experience on the job and being formally recognized as a preceptor may motivate these professionals to precept nursing students. However, there are critical perceived barriers that need to be addressed, to enable more nurses and midwives with the desire to precept students to engage in the preceptorship role.

Preceptorship of Student Nurses in Ghana: A Descriptive Phenomenology Study.

BACKGROUND: Preceptorship plays an integral part in the clinical training of nursing and midwifery students, especially in high-income countries where it is a well-accepted concept. However, in Ghana, most nurses and midwives do not view preceptorship as part of their role. AIM: The aim of this study was to explore the lived experiences of preceptorship of student nurses and the challenges confronting the preceptorship role. METHODS: A descriptive phenomenological study was conducted with 22 purposively selected preceptors aged 34 to 56 years from five clinical placement sites in the Cape Coast Metropolis in the Central Region of Ghana. Most of the participants had been preceptors for two to 18 years. In-depth interviews were conducted with the aid of a semistructured interview guide and analysed by qualitative thematic analysis inspired by Braun and Clarke's description of the method. RESULTS: The essence of the phenomenon has been captured in three main themes: (1) being excited about the role as it offered opportunities to learn and build relationship with students. (2) Encountering challenges including student's unwillingness to learn, absenteeism, and disrespect and also lack of interest of staff to assist students, time constraints, workload, burnout, parallel schedules of preceptors, and large student numbers, and (3) the need for effective collaboration between educational institutions and hospitals. CONCLUSIONS: Though preceptors were excited about precepting student nurses, the challenges associated with it are multidimensional which requires effective collaboration between educational institutions and clinical placement sites.

Critical thinking skills of nursing students: Observations of classroom instructional activities.

Aim: Critical thinking (CT) is vital for nursing practice. Nursing schools should provide learning experiences that enable nursing students to acquire CT skills. Yet, these authors are not aware of any study that has directly observed instructional activities related to CT skills acquisition in the classroom environment. The aim of this study was to explore instructional activities in the classroom environment in relation to acquisition of CT skills of students. Design: Qualitative non-participant observation. Methods: Using a purposive sampling, 10 classroom teaching sessions were observed and mediating factors of CT skills acquisition of students noted. Data were analysed thematically. Data were collected from October-December 2017. Results: Three key themes of instructional activities relating to acquisition of CT skills of students emerged, namely educators' behaviour, students' characteristics and university-wide factors/administrative support. Class sizes ranged from 34-162 students with an average of 95.

Nurse educators' perceptions of critical thinking in developing countries: Ghana as a case study.

The ability to critically evaluate information for the purpose of rendering health care is a prerequisite for modern nurses in a complex and ever-changing health care environment. The nurse educators' perceptions influence the utilization of critical thinking strategies in the classroom. The purpose of this study was to assess nursing faculty's perceptions of critical thinking. Using a questionnaire 106 nurse educators from two types of nursing educational program self-reported their perceptions. Data were collected from November 2013 to March 2014. Results were presented using frequencies, percentages, and t-test. The findings revealed that majority (95.3%) of nurse educators could not provide definitions that captured both affective and cognitive aspects of critical thinking. However, the majority of nurse educators had positive perceptions of critical thinking. Nurse educators in universities had more positive perceptions of critical thinking than those in the nurses' training colleges (P=0.007). The results suggested that the current nursing programs are not preparing nurses with the necessary critical thinking skills for the complex health care environment. Professional development programs in critical thinking should be instituted for nurse educators to assist them in developing appropriate teaching strategies to foster students' acquisition of critical thinking skills.