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Where Is the Grade Coming from? Problems and Challenges in Evaluating the Clinical Performance of Nursing Students

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Open Journal of Nursing 2015年第5期5卷 470-481页

作者： Gladys Msiska Pam Smith Tonks Fawcett tiwonge mbeya munkhondya Kamuzu College of Nursing The University of Malawi Zomba Malawi Nursing Studies The University of Edinburgh Edinburgh UK

Evaluating the clinical performance of nursing students effectively and fairly is a challenge which continues to confront nurse education and there is evidence of both faculty and student concerns. This paper reports part findings of a hermeneutic phenomenological study which explored the clinical learning experience of Malawian undergraduate student nurses. The study took place at a University Nursing College in Malawi, using a purposive sample of thirty student nurse participants. Conversational interviews were conducted to obtain participants’ accounts of their clinical learning experience and a framework developed by modifying Colaizzi’s procedural steps guided the phenomenological analysis. Several issues emerged from this study, but for this paper the assessment issues which the study revealed were discussed. It revealed concerns of unfairness and lack of objectivity during the evaluation of the clinical performance of nursing students. It also revealed that interpersonal relationships significantly influenced the evaluation process. Consequently, nursing students become preoccupied with building relationships with qualified nurses knowing the impact of such relationships on the clinical grade. The findings reveal that students employ various strategies in order to obtain good grades and this illustrates students’ overall preoccupation with “making the grade”. It is argued that the evaluation of the clinical performance of nursing students is a vital component of nursing education and it must be conducted in a manner that enables nurse educators to effectively determine the clinical proficiency of nursing students.

关键词： Nursing Education Clinical Evaluation Clinical Learning Phenomenological Research

Experience of Conducting Objective Structured Clinical Evaluation (OSCE) in Malawi

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Open Journal of Nursing 2014年第10期4卷 705-713页

作者： tiwonge Ethel mbeya munkhondya Gladys Msiska Evelyn Chilemba Maureen Daisy Majamanda Kamuzu College of Nursing University of Malawi Lilongwe Malawi

In Malawi various nursing educational institutions have increased the enrollment of nursing students in order to respond to the rampant nursing shortage prevalent in the Malawian clinical settings. With this increase in intake, nurse educators are met with so many questions as to whether the nurses being trained are competent and fit for practice. To ensure that these nurses have appropriate competences, Objective Structured Clinical Evaluation (OSCE) has been embraced as a key strategy to evaluate student’s competence. The paper describes the lessons learnt from conducting OSCE to undergraduate student nurses at Kamuzu College of Nursing in Malawi. The paper considers the background and context of the school, the preparation of students, the formulation of OSCE tasks, recruitment of examiner and simulated patients and the evaluation of the OSCE. The paper concludes that OSCE can be a worthwhile valid strategy of teaching and assessing nursing students as long as it is properly designed. Nonetheless, profound commitment of all stakeholders involved is very vital.

关键词： OSCE Student Nurses Undergraduates

Family Centered Care versus Child Centered Care: The Malawi Context

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Health 2015年第6期7卷 741-746页

作者： Maureen Daisy Majamanda tiwonge Ethel mbeya munkhondya Miriam Simbota Maria Chikalipo Kamuzu College of Nursing University of Malawi Blantyre Malawi

Family Centered care is a model that is practiced and encouraged in child health care. It considers family as partners and collaborators in care of children. It aims at involving family in all aspects of child care. Family centered care also mentions involvement of child. However, emphasis is given more on family than child and does not take into account the older child’s capacity for independent decision making and right to privacy. As such, child’s needs are missed out. With child centered care, children are involved and supported at all levels of care based on their age and developmental stage. This paper aims to stress the importance of involving children within family centered care. Involving children in their care, makes them feel less threatened by the health care professional and their self esteem is promoted. Currently, no studies have been identified in Malawi that demonstrates full partnership between the family, child and the nurse. Furthermore, Family Centered Care and Child Centered Care as models are not fully practiced. It is therefore important to practice both family and child centered care in child health care if the needs of both family and children are to be addressed concurrently.

关键词： Family Centered Care Child Centered Care Child Involvement Child Participation

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马拉维初产妇分娩恐惧与产前准备的质性研究

International Journal of Nursing Sciences 2020年第3期7卷 303-312页

作者： Berlington M.J.munkhondya tiwonge Ethel munkhondya Gladys Msiska Ezereth Kabuluzi 姚菊琴王红红 Xiangya School of Nursing Central South UniversityHunanChino Kamuzu College of Nursing University of MalawiP/Bag 1LilongweMalawi

目的本研究旨在探索初产妇在孕晚期36~40周的分娩恐惧以及分娩准备的状况。方法采用目的性抽样方法,对18名初产妇进行深度采访,并纳入了21名陪产人员和13名医务人员进行小组讨论。参与者来自马拉维利隆圭的2所社区医院的妇产科候诊室。... 详细信息

目的本研究旨在探索初产妇在孕晚期36~40周的分娩恐惧以及分娩准备的状况。方法采用目的性抽样方法,对18名初产妇进行深度采访,并纳入了21名陪产人员和13名医务人员进行小组讨论。参与者来自马拉维利隆圭的2所社区医院的妇产科候诊室。运用半结构化访谈进行数据收集,使用NVivo1l软件进行数据整理,采用内容分析法进行资料分析。结果研究结果呈现出4种类属,分别为“矛盾的怀孕感受”“依赖于传统生育经验”“产前指导不足”“不一致陪产人员角色”。研究显示,马拉维农村初产妇主要接受传统生育指导,而不是接受专业护理人员的咨询和指导。她们会经历分娩恐惧并且缺乏正确的分娩心理准备。结论初产妇对于分娩的恐惧来自于个人、家庭、效果欠佳的传统生育经验传授以及不足的专业产前指导,同时陪产人员也可能会增加产妇的分娩压力。本研究结果强调了陪产人员可以作为初产妇容易得到的心理社会支持资源。研究建议除了传统的分娩准备经验传授,应加强专业的产前指导,并且对陪产人员的适宜性和有效性进行仔细评估。

关键词：分娩恐惧马拉维产科护理定性研究女性

Factors Militating against the Delivery of Compassionate Care: A Malawian Perspective

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Open Journal of Nursing 2018年第12期8卷 889-904页

作者： Gladys Msiska Andrew Simwaka Berlington munkhondya Ezereth Kabuluzi tiwonge Ethel munkhondya Kamuzu College of Nursing The University of Malawi Lilongwe Malawi

Background/Objectives: Malawi is one of the countries in the world with the worst maternal mortality rate. In view of this, women are encouraged to deliver at a health facility assisted by a skilled birth attendant. However, this initiative can only be effective when health care workers manifest a professional demeanor which conveys care and compassion to patients/clients. The objective of the study was to foster the development of compassionate care among nurses/midwives working in selected maternal and child health care clinical settings. Methods: The study employed an action research (AR) approach. Focus group discussions (FGDs) were conducted with nurse/midwives from the selected health facilities. Purposive sampling was utilized to obtain the sample of participants to the eight FGDs and thematic analysis was used to analyze the data. Results: The data collected from nurses/midwives clearly indicate that it is not possible to effectively render compassionate care under the present work conditions. The study reveals the following factors which hinder the delivery of compassionate care: severe nursing shortages, gross lack of essential supplies and equipment, negative attitudes of nurses/midwives and unsupportive leadership which demotivates nurses/midwives. Conclusion: The study reveals problems which hinder the delivery of compassionate care, and there is need to address these problems. This will enhance the effectiveness of hospital delivery by a skilled birth attendant as a safe motherhood initiative aimed at lowering the high maternal mortality rate.

关键词： Compassion Compassionate Care Nursing/Midwifery Practice Action Research

Sources of Stress among Undergraduate Nursing Students during Clinical Practice: A Malawian Perspective

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Open Journal of Nursing 2019年第1期9卷 1-13页

作者： Gladys Msiska Martha Kamanga Evelyn Chilemba Annie Msosa tiwonge Ethel munkhondya Kamuzu College of Nursing University of Malawi Lilongwe Malawi

Purpose: The purpose of this study was to explore undergraduate nursing students’ perceptions of their clinical learning experience, and the reported findings emerged from narratives of their experience. Design: This was a hermeneutic phenomenological study which took place at a university nursing college in Malawi. Participants for the study were purposively selected from third- and fourth-year undergraduate nursing students and the data were collected through in-depth interviews. A framework developed by modifying Colaizzi’s procedural steps guided the phenomenological analysis. Findings: The study reveals factors which cause stress among undergraduate nursing students during their clinical practice. The following themes emerged from the study: lecturer/nurse interaction with students: stress associated with patient care and stress associated with objective structured clinical examination (OSCE). The lecturer is perceived to significantly induce stress, and this is common when the student perceives that the lecturer’s interaction is in a “policing” manner. The primary stressors associated with patient care include lack of life-saving medication which sometimes leads to death of a patient, taking care of critically ill patients unsupervised, and fear of contracting infections such as HIV and tuberculosis, and death of a patient. Factors associated with stress during OSCE include use of examiners whom students are not familiar with and the conduct of OSCE in the skills lab which has better resources than the clinical settings where students practice. Conclusions: The study reveals sources of stress during nursing students’ clinical practice and its effects on their learning and motivation. Consistent with existing literature, these findings confirm that nursing students experience considerable levels of stress during clinical practice. Recommendations: The study suggests that nursing education can be quite a stressful experience to the learners. It is therefore essential that nurse educators should address the va

关键词： Stress Clinical Practice Clinical Learning Student Nurses Nursing Education