Thesis & Dissertations

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Open Access
Assessing the preceptorship model in clinical teaching of undergraduate nursing and midwifery students in Malawi
(2021-06-01) Mhango, Lucky
Preceptorship is one of the models applied in clinical teaching where nursing educational institutions rely on registered nurses (RNs) trained as preceptors to take the role of clinical instructors. Malawi adopted the preceptorship model in response to a critical shortage of human resources. This study, therefore, aimed at assessing the preceptorship model in clinical teaching of undergraduate nursing and midwifery students in Malawi. This explanatory sequential mixed methods study was conducted at four public tertiary hospitals; a mental hospital, Christian Health Association of Malawi (CHAM) hospital and five district hospitals. A total of 87 preceptors completed a Clinical Preceptor Experience Evaluation Tool (CPEET) and 12 participated in face-to-face individual interviews. Quantitative data were analysed through descriptive statistics while qualitative data were analysed by thematic content analysis. Results revealed that a preceptorship model is an effective approach to clinical teaching with benefits to both the students and preceptors. Post hoc comparisons using the Tukey HSD test indicated that the role domain mean scores for the respondents with 4-5 years of post-registration experience (M = 6.61, SD = 0.36) was significantly different (p=0.02) than those with >9 years (M = 6.13, SD = 0.60). These results showed that respondents with 4-5 years of experience were more confident than those with >9 years of experience. The study revealed some constraints in the implementation of the preceptorship model and the main challenges included the high preceptor-to-student ratio due to staff shortages, lack of resources and poor collaboration with faculty members. These factors compromised the effectiveness of the preceptorship model in facilitating student learning.
Open Access
Assessing the promotion of clinical reasoning in classroom teaching among student nurses: A case of St Joseph's College of Nursing
(2015-12-01) Banda Bonyonga, Mtinkheni Wezi
The assessment of how clinical reasoning is promoted among student nursing and midwifery technicians followed the anecdotal reports from the public on the poor quality of client care provided by the nurses in the health facilities. These observations by the stakeholders pointed to the teaching and learning processes involved in the preparation of the nursing midwifery technicians. If the level of performance of the nursing midwifery technician is in question then the teaching and learning processes involved needs to be assessed because the educational level at which a student nurse is prepared makes the difference on how the nurse performs her duties in practice. This led to a concurrent exploratory mixed method study with the purpose of determining how clinical reasoning was promoted in classroom teaching among the student nurses. The population consisted nurse educators (n=18) and student nurses (n= 90). Quantitative data was collected from the educators and student nurses using questionnaires to determine the teaching styles of the educators, learning preferences and clinical reasoning levels of the student nurses. Qualitative data determined the educators and student nurses perceptions on the teaching and learning experiences from eight educators and three students’ focus groups. Quantitative data were analyzed using the statistical package SPSS Version 20.0 and descriptive statistics were run for frequencies, means and standard deviations. Content analysis was used for qualitative data. The results indicated that there was lack of diversity in the use of teaching styles among the nurse educators. The Expert Teaching Style was the most preferred (mean= 4.06 and SD=.981); the less preferred (mean= 3.55 and SD=1.24) was the Facilitator Teaching Style. The dominant teaching method was the lecture method; student nurses preferred lecture method but felt that interactive teaching methods were important in their learning processes and development of clinical reasoning abilities. Students also lacked diversity in their learning preferences as they (54.7%) preferred to learn together in a classroom environment. The learner centered learning environment where individual thinking, expression of own opinions and learning from peers was the least preferred (6.67%) by the learners. These results are in agreement with the learner dependence from the qualitative results. Therefore based on these results there is need for improvement of the teaching/learning processes in order to improve quality of nursing care provided in the health facilities in Malawi.
Open Access
Clinical supervision experiences of third year nursing students by staff nurses at Mzuzu Central Hospital
(2017-02-01) Malikha, Evelyn
Nursing Students require clinical supervision in order to be supported and guided in acquisition of competences and skills for their professional growth. Nursing students at Mzuzu Central Hospital are no exception. Anecdotal report showed that nursing students were not guided by staff nurses during the clinical practice at MCH and this motivated the researcher to do an investigation. Insufficient clinical supervision hampers student professional growth and development, creating clinically incompetent practitioners with harmful percussion for their patient and the profession. The purpose for this study was to explore the experiences of Mzuzu University third year undergraduate nursing students’ clinical supervision during their clinical learning at MCH. Clearance to conduct the study was obtained from COMREC, MCH research committee and from participants’ consent agreement. A qualitative descriptive study was done among the third year undergraduate nursing students during their clinical practices at MCH. Target population was the entire third year undergraduate nursing student (40) doing clinical practice at MCH. Purposive sampling method was used to recruit 13 participants for the study upon reaching data saturation. A semi- structured interview guide was utilized to collect data and analysis was done using themes. Findings reveal that poor student –supervisor relationship, inadequate resources in the placement area, and the growing numbers of students in the placement area contributed to inadequate clinical supervision of nursing students by clinical staff. It was also evident that clinical staffs at MCH were struggling as they were understaffed and some were not competent enough to supervise the students which made things difficult as it was not easy to support students as expected. Therefore, recommendations such as clinical staff orientation in clinical supervision through in service training and supervisor –student ratio as NMCM recommends are made by the researcher to the learning institution as well as the clinical teaching facility.
Open Access
Experiences of nursing students at Kamuzu College of Nursing in the provision of compassionate care, Lilongwe, Malawi
(2017-01-01) Bwanali, Squaiker Alice
Over the recent years, there has been a general public concern that compassionate care is lacking in nursing, leading to poor health care outcomes. In response to the plethora of reported negative patient experiences relating to lack of compassionate care, professional drivers in nursing have been requested to re-endorse the concept of compassion as a core and underpinning philosophy, fundamental to the profession. Literature has shown that student nurses do provide compassionate care. However, this is not reflected in their practice when they qualify. The purpose of this study was to investigate the experiences of nursing students in providing compassionate care at KCN, Malawi. A qualitative narrative study was conducted among 3rd and 4th year undergraduate students at KCN, a constituent college of the University of Malawi. Purposive sampling method was used to recruit twelve participants for the study. Using a semi-structured interview guide, individual in-depth interviews were conducted to collect data while analysis was done using thematic analysis. Clearance from COMREC and consent from participants were obtained prior to data collection. Findings revealed that there is lack of compassionate care in Malawian nursing practice, however, students are knowledgeable of the concept of compassionate care before graduating. Additionally, it was revealed that both theory and practice play a role in cultivating a culture of compassionate care. Furthermore, the study revealed that stories of lecturers caring experiences and working with positive role models in clinical practice facilitates development of compassionate care while lack of support systems in practice and harsh experiences during training hinders development and provision of compassionate care. This calls for professional drivers in nursing like nurse educators and managers to emphasize the need for compassion in nursing training and practice. Recommendations are made for nurse educators, curriculum planners, clinical staff and the regulatory body on their role in promoting compassionate care. More studies need to be conducted on what compassionate care entails within Malawian culture and how it can be nurtured and measured in nursing education.
Open Access
Exploring instructional leadership practices of principals in selected nursing and midwifery colleges under Christian Health Association of Malawi
(2021-04-01) Master Phiri, Liviness
Instructional leadership is crucial to the success of colleges since it creates a climate that is conducive to teaching and learning. However, there is a dearth of literature from developing countries including Malawi. On the other hand, the job description of CHAM college principals directly captures instructional leadership attributes. However, it is not known whether CHAM college principals practice instructional leadership as stipulated in their job description and from literature. This study explored instructional leadership practices of principals in selected Christian Health Association of Malawi (CHAM) nursing and midwifery colleges using Hallinger and Wang instructional leadership model. Qualitative research approach was used. Data were collected from 6 principals through individual in depth interviews. The participants consisted of four males and two females. Three particiapnts had served as principals for less than 2 years and the other three had served as college principals for 3 to 4 years. The data were analyzed using thematic template analysis. The study findings showed that principals in the study try to implement some instructional leadership practices in line with the model developed by Hallinger and Wang. However, principals are not able to monitor instructional program. The study also revealed that most of the principals lacked resources and experienced increased workload which hindered their implementation of instructional leadership activities. Therefore, necessary measures should be taken so that college principals can focus on the instructional leadership activities according to Hallinger and Wang (2015) model aimed at improving student learning in colleges.
Open Access
Exploring perspectives of tutors on factors leading to non-usage of formative assessment at St Joseph College of Nursing in Malawi
(2019-06-01) Tukula, Alice Chifundo
This qualitative study explored tutors’ perspectives concerning leading factors to non-usage of formative assessment (FA) at St Joseph College of Nursing in Chiradzulu District in Malawi. The aim of the study was to explore factors leading to non-usage of formative assessments during teaching and learning at the college. The specific objectives of the study were to assess tutors’ knowledge of the different types of formative assessments; assess tutors’ knowledge on impact of formative assessments on student academic performance; assess tutors’ knowledge on good practices of formative assessment; identify tutors’ classroom assessment practices in formative assessments; and to identify barriers to effective utilisation of formative assessment. A purposive sample of 15 tutors was involved, with fifteen (15) in-depth interviews conducted and data was analyzed manually using content analysis. Results of the study revealed key issues of formative assessment. For example, while participants displayed little knowledge about types of formative assessment, the assessment emerged as a tool for improving learning because it helps learners to establish whether or not content taught in class has been grasped. Results further indicated that tutors are knowledgeable about good practices of FA. Practices such as conducting frequent assessments, giving timely feedback, and using a variety of assessment strategies were reported as good practices in assessment. Results also indicated that St Joseph College tutors do not frequently assess learners in class and that; large classes, inadequate time and inadequate teaching resources are factors that hinder tutors from using formative assessment in the classroom. Based on the results, it is recommended that continuous professional development trainings should be done for tutors to understand formative assessment and its impact on student learning.
Open Access
Factors hindering implementation of learner-centred teaching strategies in Christian Health Association of Malawi nursing colleges
(2015-12-01) Nyirenda Chirwa, Mercy Patricia
Meaningful learning requires learner-centred teaching strategies, which focuses on the needs of the learners. The study therefore, aimed to explore factors hindering implementation of learner-centred teaching strategies. A descriptive cross sectional design was used. A total of 72 nurse educators participated in the study and completed questionnaires. This was complemented by observation checklists for data gathering: eleven lessons were observed while the nurse educators taught their different courses.. The study found that a combination of learner and teacher-centred approaches were used by the nurse educators. However, classroom observation revealed that traditional lecture methods dominated most classrooms. The main challenges were lack of training for nurse educators in learner-centred teaching strategies; negative nurse educators and students attitudes towards the learner-centred teaching strategies and large numbers of students per class. It is assumed that training and support may improve educators’ attitudes and teaching methods. Therefore, the study recommended that a policy should be in place that promotes learner-centred teaching and learning strategies, adequate resources and ongoing support to educators for instance training in learner-centred teaching strategies. Furthermore, the results showed that there was a significant relationship (p<0.05) between nurse educators and students attitudes towards learner-centred teaching strategies. In addition, there was a significant correlation (p=0.01) on lack of resources to implement learner-centred teaching strategies and lack of orientation to these teaching strategies in the training. Nonetheless, the study showed no significant correlation (p>0.05) between years of experience; educational level and knowledge of learner centred teaching strategies as well as its use.
Open Access
Factors influencing clinical teaching at Bwaila and Kamuzu Central Hospitals by registered nurse midwives
(2015-05-01) Kaunga Kalua, Beatrice
Clinical teaching is teaching which takes place in a clinical area for an individual or a group of students and usually involves patients and clinical procedures. Registered nurse midwives in this study provided clinical teaching to nursing students. As clinical teachers, registered nurse midwives play a crucial role in the development of the nursing students professionally. However, evidence from literature indicates that although clinical teaching enhances clinical learning, registered nurse midwives are confronted with different challenges as they engage in the experience. For example, lack of training in clinical teaching, shortage of nursing personnel and increased numbers of students to teach. The objectives of the study were to describe the role of registered nurse midwives in clinical teaching, identify factors that promote clinical teaching, describe benefits of clinical teaching to registered nurse midwives, and describe challenges faced by registered nurse midwives during clinical teaching. This descriptive study used quantitative methods and data were collected using a structured questionnaire. Data were analyzed using SPSS version 16.0. Descriptive statistics were computed and results were reported as frequencies and percentages. The study showed the following results: 100% of the respondents were aware of their role in clinical teaching and appreciated that clinical teaching offered them the opportunity to reflect on and improve their practice. Ninety-nine percent of the respondents also indicated that they were proud to see students developing professionally. However, the following are some of the challenges that were met by registered nurse midwives in the course of teaching students: 98% of the respondents were not trained in clinical teaching, 97% indicated increased workload due to shortage of the nursing staff, 85% said they had inadequate clinical resources and teaching space, 91% had large numbers of students to be taught and supervised by a single clinical supervisor, and these registered nurse midwives did not receive rewards for the service (91%). The results call for the government through Ministry of Health and Ministry of Education to continue training of more nurse midwives into the healthcare system as it is currently doing to increase nursing staff in the country. In addition, the government in collaboration with nursing colleges should train all registered nurse midwives to be fully prepared clinical teachers to equip them with necessary skills for teaching roles. Nursing colleges should also increase their effort in sourcing resources to be used by students in the clinical area in combating inadequacy of the resources during clinical placements. Regarding increased workloads due to increased intakes of the students in the colleges, registered nurse midwives as clinical facilitators should just be encouraged and motivated through use of incentives in their role as there are no immediate solutions to the problem.
Open Access
Factors that contribute to effective clinical teaching of student nurse/midwife technicians in Malawi
(2015-11-01) Chalera, Jane
Clinical teaching is an essential task in the production of competent nurse/midwife technicians. There is the increased disease burden in Malawian hospitals in the face of the shortage of nursing staff and at the same time there is increased student intake in nursing colleges with inadequate faculty members (Muula & Maseko, 2005). All these factors negatively affect clinical teaching. A quantitative, descriptive cross sectional design in data collection and analysis was used to investigate factors that contribute to effective clinical teaching of student nurse/midwife technicians in Malawi. Structured questionnaires were used on 130 nurse educators who consented to take part in the study. A response rate of 94% was achieved. SPSS version 19.0 was used to analyse the data. Results of this study revealed the factors that contribute to effective clinical teaching as: clinical teaching environment (79.9%, n=104), use of innovative clinical teaching methods(18.6%, n=24), adequate clinical teaching resources (10.2%, n=13), small number of nursing students (71.2, n=93), year of study (44.1%, n=57) and learning outcomes for the clinical setting (54.2%, n=70).Among the recommendations is empowering nursing students to actively participate in their own learning and evaluation of own achievement of clinical objectives as these are critical to their development as competent, self-directing professionals, capable of assuming responsibilities inherent in the ever-changing and expanding health care system.
Open Access
Faculty and students’ perspectives regarding effective leadership in nursing colleges: a case of Kamuzu College of Nursing and Daeyang College of Nursing in Malawi
(2016-05-01) Kapasule Uzeni-Phiri, Nemma
Leadership in the nursing colleges is regarded as the single most important factor in the success or failure of institutions. It is not surprising that the ways in which nursing colleges might improve performance across all their activities has increasingly been viewed in terms of leadership. This study aimed at exploring the perspectives of faculty and students regarding effective institutional leadership in nursing colleges. The objectives were to, establish faculty and students’ understanding regarding institutional leadership and leadership styles; understand faculty and students’ perspectives on the effect of institutional leadership on motivation of subordinates: to establish students’ and faculty understanding of students learning in relation to institutional leadership. This study utilized a comparative descriptive qualitative approach. Purposive sampling technique was employed and a semi-structured questionnaire was used as an instrument to obtain data from 19 responds through face-to-face interviews. Qualitative data was analyzed using thematic content analysis approaches. Results show that transformational leadership style is the most effective form of leadership in the nursing colleges of Malawi. In addition, the study revealed that institutional leadership has an effect on faculty and students’ motivation in relation to the extent of enthusiasm towards teaching and learning respectively. Therefore people in leadership should be sensitive to the needs of both faculty and students to effectively improve students’ learning outcomes. Nursing College leadership should strive to accord a free working and learning environment without fear and favor in order to keep both students and faculty motivated to learn and teach.
Open Access
Nurse educator perspectives on job retention among government seconded nurse educators in Christian Health Association of Malawi Nursing/Midwifery Colleges
(2019-05-01) Khonje Telalini, Flora
Educational outcomes are key to any programme success. Retention of nurse educators as a human resource trend and issue to consider when crafting employment policies and strategies for managing people at work. However, it has been observed that retention of nurse educators in CHAM nursing colleges is low over the years. The purpose of the study was to explore factors influencing retention of government seconded nurse educators in CHAM Nursing/Midwifery colleges. The study used a qualitative approach. An exploratory research design was used to obtain data from 13 nurse educators working at St Luke’s, Nkhoma Colleges of Nursing/Midwifery and Kamuzu Central Hospital. A purposive sampling method was used to recruit participants for the study. An interview guide was used to collect data through face to face in-depth interviews. Data was analyzed manually by means of content analysis. Findings of the study revealed six major themes: Academic work environment, Nurse Educators ’incentives, working conditions, policy decisions, empowerment of educator leader and retention strategies. Incentives were motivators according to the participants’ narratives since absence of top up allowances, accommodation; transport as well as staff development opportunities made nurse educators to leave the teaching service in CHAM colleges and these are factors for low retention rates of nurse educators in CHAM colleges. It is imperative for CHAM colleges to improve on nurse educator’s perks and other benefits in order to attract, satisfy and retain the majority of government seconded nurse educators in CHAM colleges.
Open Access
Nurse Educators’ engagement in research in Christian Health Association of Malawi Nursing Colleges
(2018-12-01) Nyirenda, Victoria
Engagement of nurse educators in research is required to enable students to develop a clear understanding of how to take care of patients. The study aimed at assessing the extent of nurse educators' engagement in research in CHAM Colleges. The study used the quantitative approach. A descriptive research design was used to obtain data from 98 nurse educators in CHAM Colleges. Data was analyzed in SPSS. Data was presented in frequency tables and graphs. The findings revealed that only n=37 (37.8%) respondents have ever conducted research. Majority of the respondents have been involved in research activities in one way or the other though involvement was low. However, a good number of the respondents do apply research findings in the teaching practice n= 68 (69.4%). The results also revealed the two greatest barriers in engaging research which were inadequate research grants n= 52 (53.1%) and n= 43 (43.9%) inadequate training on research methods. The findings suggest increase intakes of post graduate nurse educators, adequate funding, provision of research grants and building research capacity in order for nurse educators to engage in research.
Open Access
Perceptions of lecturers in teaching large classes at Kamuzu College of Nursing
(2015-10-01) Matiki Chizimba, Dorothy
Over the past 5 to10 years, nursing training institutions in Malawi including Kamuzu College of Nursing have been experiencing pressure from a number of societal forces such as increased demand for accessibility to tertiary education and shortage of nurses to increase student enrolment. The increased enrolment coupled with limited teaching resources and faculty consequently led to large classes. The purpose of this study was to investigate the perceptions of lecturers in teaching large classes at Kamuzu College of Nursing. A qualitative descriptive exploratory study was done among faculty members who teach large classes at Kamuzu College of Nursing, a constituent college of the University of Malawi. Purposive sampling method was used to recruit 15 participants for the study. A semi- structured interview guide was utilized to collect data and analysis was done using thematic content analysis. Clearance from COMREC and consent from participants were also obtained. Findings revealed that large classes affected students‟ learning and lecturers‟ functioning; teaching and assessment methods used by lecturers; and also resource availability. Students were affected with reduced teacher-student interaction and reduced clinical learning experiences among others. On the other hand, teachers had to cope with large numbers of scripts to mark which affected timeliness of feedback to students. Traditional teaching methods such as lecture were highly used for teaching and low quality multiple choice examinations had replaced essays. Recommendations for government, college management and lecturers were made.
Open Access
Perceptions of student nurses on teaching and learning in skills laboratory at Nkhoma College of Nursing and Midwifery Lilongwe, Malawi
(2015-11-01) Karonga, Emily Flonie
In the past teaching and learning of clinical skills were wholly practiced at bedside in which patients were used as teaching aids and then changed to practical room which was teacher dominated. The profound change in nursing education and health care system had made these teaching methods less effective, as a result skills laboratory teaching and learning has been adopted as a strategy to support students’ development of skills before clinical placement. A descriptive quantitative study was conducted to describe perceptions of student nurse/midwives on teaching and learning in skills laboratory at Nkhoma College of Nursing and Midwifery in Lilongwe, Malawi. Data were collected from 91 students using a questionnaire and analyzed using SPSS software package version 16.0. Percentages and frequencies were used to summarise results. The results showed that, all the participants indicated that demonstration was predominantly used and the majority 92.4% (n=84) identified the demonstration to be the most useful learning strategy while small group discussion, self directed learning, peer learning, role play and reflection were viewed least useful. The majority 86% (n=78) needed educational video films while 13.2% (n=12) needed real objects such as dead body and placenta. Benefits of learning in skills laboratory included; participants became competent 87.9% (n=80), gained confidence 85.7% (n=78) and patients’ safety 29.7% (n=27). However, limited time for practice 81.3% (n=74), inadequate learning resources 42.9% (n=39), overcrowding of students during skills laboratory sessions 36.3% (n=33) and inadequate supervision 26.4% (n=24) were some of the challenges faced during learning. The recommendations made included; Opening time for skills laboratory should be revisited, enough resources should be available, in-service training for nurse educators should be conducted on effective use of the skills laboratory, replication of the same study at different nursing colleges with a larger sample and investigating the impact of skills laboratory teaching and learning on clinical performance.
Open Access
Perceptions of tutors of Holy Family College of Nursing and Midwifery on utilization of learner-centred teaching methods, Phalombe, Malawi
(2021-04-01) Matewere, Ireneo Wayula
Learner-centered teaching implies a paradigmatic shift in the roles of a teacher from being a source of knowledge to that of a facilitator in the process of knowledge construction. Changing teaching methods is quite some work and the teachers need to be convinced that the outcome therefrom is worthy of it. Literature shows that perceptions which teachers hold about the processes of learning and teaching greatly influence how the teachers teach. Anecdotal records, as well as observation of classroom teaching, demonstrate that tutors at Holy Family College of Nursing and Midwifery dominantly use traditional teacher-centered teaching methods. In Malawi studies on perceptions of tutors on utilization of learner-centered teaching methods are scarce. The purpose of this study was to explore perceptions of tutors on utilisation of learner-centered teaching methods. Specifically, the objectives were to: describe views of tutors at Holy Family College of Nursing and Midwifery on the usage of learner-centered teaching methods, explain perceived benefits of utilising learner-centred teaching methods to examine perceived facilitators to utilisation of learner-centred teaching methods and assess perceived barriers to utilisation of learner-centred teaching methods. A descriptive qualitative approach was used. The researcher interviewed 12 participants. Out of the 12 participants, 9 were female and 3 were male. All the participants had a minimum of 2 years teaching experience. Ten of the participants had Bachelors’ Degree and two had a Master’s Degree. The ages of the participants ranged from 30 to 50 years. The interviews were guided by a semi-structured interview guide. The interviews lasted between 45 minutes and 2 hours. Thematic approach was used to analyse data. Audio-taped data were transcribed verbatim. The transcription was done by listening to the tape-recorded interviews several times until all issues were captured. The issues were then organised into themes and subthemes. The study found out that the participants perceived that utilizing learner-centered teaching methods assisted learners to apply knowledge into practice, promoted critical thinking and deep lifelong learning and helped learners to take responsibility for their own learning. The study also found that giving specific guidance to learners, tutor innovativeness and learner involvement are perceived facilitators to effective utilisation of learner-centered teaching methods. The study further revealed that minimal learner-learner interaction, teaching to cover content, teacher dominance and some teachers clinging to power are teacher-related barriers to effective utilisation of learner-centered methods. And then the study further found that negative attitude of some learners towards learner-centered methods, challenges with accessing information and lack of seriousness towards learner-centered methods are learner-related barriers. The study further found that utilisation of learner-centred teaching methods was time-consuming and required more information resources. Findings of the study revealed that the participants were motivated to continue utilising learner-centred teaching methods because they encourage deep life-long learning and application of knowledge into practice in spite of the challenges like scarcity of information resources and insufficient time.
Open Access
Perceptions on the common roles of qualified nurses/midwives towards student nurses learning in the clinical setting at Queen Elizabeth Central Hospital
(2016-03-01) Luhanga Nyirenda, Florence
The aim of the study was to explore the perceptions on the common roles of qualified Nurses/Midwives of Queen Elizabeth Central Hospital specifically in Chatinkha Maternity wards towards teaching student nurses in the clinical setting. Fifteen qualified nurses/midwives who were working with students from the training institutions of southern Malawi were interviewed. The fifteen qualified nurses/midwives were conveniently sampled and data was collected using a semi-structured interviews. Data was tape recorded and analysed by using eight steps of content analysis. Five main themes emerged: experience of qualified nurses/midwives to teach students /nurses in the clinical area, poor orientation of qualified nurses/midwives towards clinical teaching, inadequate resources, congested clinical learning environment and increased workload for qualified nurses/midwives. The study revealed that most nurses/midwives were more than willing to teach student nurses. It also revealed that nurses/midwives do quite a number of activities in clinical teaching such as orienting students in the ward, demonstrate different procedures to students, and teach them how to manage the wards and subordinates, supervise their procedures and managerial tasks like staff allocations, writing rosters, delegating duties to subordinates among several others. The study also revealed that they lacked proper orientation in clinical teaching, and no preconference meetings between the hospital and the colleges before sending students to the clinical setting.
Open Access
Role of stressors and job satisfaction in health surveillance assistants in Malawi
(2019-05-01) Ntopi, Simon Willard
This study explored Health Surveillance Assistants’ (HSAs) role stressors and job satisfaction. The term community health workers (CHWs) is used as an umbrella term to embrace different health workers that work at the community level, including HSAs. The HSAs have been associated with many health gains, such as the reduction of child mortality. In the past their role was mainly preventive but now the curative role has been added. Following the addition of the curative role, many additional tasks have continuously been added to their existing roles. This is reported to have overloaded the HSAs. Therefore, the purpose of this study was to explore role stressors and job satisfaction in HSAs. Data were collected from 462 HSAs from the districts of Mangochi, Lilongwe and Mzimba. A self-administered questionnaire was hand delivered to a total of 462 HSAs with a response rate of 93.5%. The collected data was analyzed with the aid of the computer software package Statistical Package for the Social Sciences (SPSS) version 23. Statistics used for the analysis included: Mean, Standard Deviation and Analysis of Variance (ANOVA). The key findings of this study are that HSAs in Malawi have lower role ambiguity (16%) and moderate levels of role conflict (28%) and role overload (32%) and high job satisfaction (83%) (all 75th fractional rank percentile scores). In addition, HSAs role ambiguity (P= 0.001) and role overload (P=0.001) were significantly negatively related to job satisfaction, while role conflict (P=0.472) was insignificantly related to job satisfaction. HSAs tasks of vaccination and growth monitoring were frequently prioritized tasks (vaccination= 77.3%, growth monitoring = 73.7%). Among the three role stressors role ambiguity was the most important predictor (r = -0.34 and P=.01) of job satisfaction while advancement was the most important factor for job satisfaction (r =-0.34 and P= .01). Since role ambiguity was the major predictor of job satisfaction in this study, the supervisor was found as the most important factor for role ambiguity. The major recommendation to the policy makers at the Ministry of Health is that they need to take seriously the supervision of the HSAs in order to prevent and control role stressors and increase job satisfaction in HSAs.

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