FACTORS INFLUENCING APPLICATION OF CLINICAL INSTRUCTIONS IN NURSING PRACTICE AMONG NURSING STUDENTS IN MADONNA UNIVERSITY

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CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Learning is a change in behaviour over time that is brought about by experience during training in educational encounter (Akubuiro and Joshua, 2003). Training as part of education, is the acquisition of knowledge, skills and competence as a result of the teaching of practical skills and knowledge that relate to specific useful competences (Angel, 2007). Training helps the learner to acquire certain useful skills and develop critical mind for the learner’s self development. Therefore, the knowledge that comes from training is more of knowledge of how to do or perform specific tasks. Thus, the modification in behaviour as the product of training can occur following newly acquired skills, knowledge, perception, facts, principles and new information at hand (Adeyanju, 2004).

Nursing education is a term used to describe the overall body of knowledge that applies to nursing profession. It encompasses a variety of knowledge, skills, concepts, and practices which revolve around the unique concepts of nursing, health, the person and the environment (Melone, 2010). Nursing education consists of acquisition of a body of knowledge that is partly delivered in a classroom setting which forms the theoretical bases of nursing knowledge and an organized and supervised clinical training experiences that take place in the clinical settings where the nurse- patient relationship is experienced directly or indirectly (Shariff and Masoumi, 2005).

Sonwuttanayut (2003) noted that the training process in nursing education should aim at enabling the students to gain skills and experiences up to their highest potentiality. This shall focus on the learners as being the most important in the process. In addition, basic knowledge, attitude, skills and the ability to apply knowledge into the actual practice of nursing should be developed and inculcated into the student nurses in these processes. Training can be reinforced with learning aids and equipment of different varieties simply because they stimulate, motivate as well as arrest learners’ attention for a while during the instructional process.

Clinical training which is part of nursing education takes place in hospitals, other health care institutions, communities and homes under the direction and supervision of trained personnel in nursing profession. Clinical training as an integral part of nursing education as identified by Smith and Fifz-Patrick, (2006), prepares student nurses with the ability of “doing” as well as “knowing” the clinical principles in nursing practice. The clinical experience which is a vital part of nursing education stimulates students to use their critical thinking skills for problem solving. It provides the students opportunity for their active self-learning, self development and ability to apply their knowledge from theoretical context situation to emergency and general public health care.

In line with this therefore, clinical education must be to help the students to acquire the necessary nursing skills and the ability to perform in order to establish their capacity to handle changing realities and situations in nursing practice, (Melone, 2010). The nursing skills to be acquired consist of series of courses in the nursing curriculum and manuals. These are designed to equip students with the required clinical nursing skills needed for optimal practice, (Rennie, 2009). These include nurse-patient relationship skill, interactional skills, basic physical examination skills, clinical encounter across the life span, therapeutic communication skills, positive attitudinal skills etc. These courses span throughout the years of studies. Students must successfully complete all the components of the clinical courses to progress as nurses. Examining the development of necessary nursing skills during training, Ericsson (2004) indicates that nursing skill acquisition is a continuous learning process. This indicates that extensive experiences and supervision from mentors, preceptors, supervisors, teachers, considerable time on task and involvement of students are necessary to achieve a considerable nursing skill performance. There is also supporting evidence that the students’ interest and the practice environment e.g. hospital, exert an influence on the development of nursing skill (Ericsson 2009). In this case, students’ goals should include increased self knowledge and scientific awareness in addition to their gradual improvement in professional nursing practice.