Clinical education in undergraduate nursing in Ghana: A gap analysis

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Abstract

Background: Nursing education comprises theory and practice as two complementary parts. In Ghana, the clinical education space is inundated with many challenges disrupting the intended purpose of clinical education. The challenges are multifactorial and include student issues, nurse and educator concerns, management and resource issues. To find solutions, there is a need for a critical analysis of the current clinical educational practices to inform the development of feasible and sustainable approaches for nursing education. This article, therefore, reports on a gap analysis of clinical education in Ghana. Method: A qualitative descriptive design underpinned the study and was executed through key informant interviews, focus group discussions and document analysis. A total of seventy-three participants, drawn from four nursing education institutions and eight clinical sites, located in four administrative regions in Ghana, participated in the study. These participants comprised four principals, four heads of accounts, eight clinical coordinators, eight nurse educators, twelve preceptors, and thirty-seven final-year registered general nursing students. Data analysis was done deductively against the Global Pillars for Nursing Education thematically yielding three themes and eleven sub-themes. Results: For Pillar 1, the study revealed a lack of a comprehensive competency-based assessment, ineffective interprofessional communication, and a non-stimulating clinical education climate. For Pillar 2, disregard for available admission standards and non-integration of interprofessional education into the Diploma in Nursing curriculum were found. In the case of Pillar 3, insufficient clinical experience of nurse educators was detected, financial resources to support clinical activities optimally were insufficient, and there was a lack of independence of nursing schools to support nursing education effectively. Conclusion: This study brought to the fore the gaps in the nursing education system in terms of learning outcomes, the nursing education programme, and the educational institution in Ghana. This indicates that although clinical education occurs in the clinical setting, the challenges emanate from multiple facets of the nursing education system. To enhance clinical learning and teaching in undergraduate nursing education, strategies should target specific problems that may stem from any aspect of the nursing education system through a comprehensive framework that aims to enhance clinical learning and teaching. Clinical Trial Number: Not applicable.

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