http://ir.mu.ac.ke:8080/jspui/handle/123456789/29 Thu, 06 Aug 2026 19:34:43 GMT 2026-08-06T19:34:43Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10402 Situational analysis of clinical learning environment for the undergraduate nursing students at selected health facilities in Central and Eastern Kenya Jemesunde, Millicent Kapigen Background: Clinical learning environment has an impact on the learning outcomes and performance. Nursing students, nurse educators, nurse preceptors and administrators play a major role in clinical learning. However, the extent to which these roles are effectively performed depends on the quality of clinical learning environment and the level of support provided. Learning opportunities change, therefore, should be identified. Challenges can hinder skill acquisition, reduce confidence, and compromise students’ readiness for independent practice. Identification of strategies can strengthen clinical learning. However, gaps persist in many settings. A situational analysis of the clinical learning environment can help in establish the state of clinical learning environment. Objectives: To assess the role of stakeholders, explore opportunities, explore challenges and evaluate strategies used to improve clinical learning in selected health facilities in Central and Eastern Kenya. Methods: The study used mixed methods cross-sectional study design with empiricism and grounded theory approach. No hypothesis was used, the study sought to answer research questions in line with the objectives. Taro Yamane formula was used to get a sample size of 235 students and 153 nurse preceptors. A census was used for the 23 nurse educators and 7 administrators from selected universities and hospitals. Stratified random sampling was used for students according to the year of study as well as nurses according to the wards. Proportionate random sampling was used to select participants from each stratum. A semi-structure questionnaire and key informant interview guide were used to collect data. SPSS Version 26 was employed to analyze quantitative data. Qualitative data collected were put in broad categories of themes and analyzed in frequencies. Results: The findings showed that majority of students, preceptors, and educators were aware of their roles in the clinical learning environment, while the majority of the administrators said: “I appoint the clinical coordinators and approve placement of students in the clinical rotations.” Likert Score means for nursing students, nurse preceptors and nurse educators for the opportunities available in the clinical learning environment indicators were 3.8±0.3, 3.9±0.5 and 3.8±0.3 respectively indicating that the respondents’ opinions oscillated between neutral and agree. The majority of the administrators said, “... the goals of clinical learning are in line with the Nursing Council of Kenya and that means we have no problem with the regulatory body as far as clinical learning is concerned.” The means for the challenges in clinical learning environment indicators were 2.9±0.4, 2.9±0.7 and 2.9±0.5 respectively indicating that the respondents’ opinion oscillated between neutral and disagree. According to administrators, space is a challenge as one said, “... the clinical sites are not adequate in number and also too small in size to accommodate all the nursing students from the universities.” 36 (20.8%) of the students said that the learning resource centres should be located within the hospitals, 71 (50%) of nurse preceptors said clinical instructors should be proactive in supervising students. On the other hand, 6 (26.1%) of the nurse educators said the number of trained mentors should be increased to supervise students closely. Majority of administrators said, “... proper means of communication between students and supervisors would minimize frustrations and misunderstandings that can hinder smooth learning during clinical rotations.” Conclusion: This study concludes that all stakeholders are aware of their key roles on clinical learning environment. The clinical learning experience of nursing students is significantly influenced by opportunities and challenges identified in clinical learning environment. The most crucial strategy is the need to improve collaboration between universities and hospitals to ensure proper planning of students’ placement in clinical learning environment. Recommendations: The study recommends that stakeholders be encouraged to understand one’s own role within the clinical learning environment. Learning opportunities should be supported and evaluated periodically. Challenges are addressed by adequate preparation of stakeholders. Collaboration between stakeholders is important. Thu, 01 Jan 2026 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/10402 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10224 Implementation of diploma nurse-training curriculum in selected nurse training institutions in South- Rift Region, Kenya Towett, Philip Background: Graduates of the Kenya Registered Community Health Nursing (KRCHN) diploma program are vital to the frontline healthcare workforce, delivering important services in various clinical settings. Successful implementation of the KRCHN diploma curriculum requires adequate resources, trained educators, supportive clinical placements, and technology integration to develop skilled nurses. However, concerns exist about the gap between theory and practice, questioning the readiness of newly qualified nurses to provide quality care. There is also limited research on the implementation of the diploma nurse training curriculum in Kenya. Objectives: The study aimed to evaluate the implementation of the diploma nurse training curriculum in selected nurse-training institutions. Specific objectives were to assess the adequacy of teaching resources, nurse educators’ level of preparedness, the capacity of clinical placement sites for developing students' clinical skills, and the integration of emerging healthcare trends and technologies into the curriculum. Methods: This study was based on John Dewey’s experiential learning theory, highlighting the value of hands-on experiences. A mixed-methods approach employed a descriptive cross-sectional design in selected nurse training institutions in the South-Rift region. The study included 159 senior nursing students selected through random sampling, along with purposively selected nurse educators, principals, and nurse managers. Data collection utilized questionnaires, Key Informant Interviews, and Focus Group Discussions. Quantitative data was analyzed with descriptive and inferential statistics, while qualitative data was thematically analyzed. Findings were presented in tables and narrative form. Results: Educators and students rated classroom resources as most inadequate (M=3.77, SD =1.06) and (M=3.95, SD = 0.43), but differed on the lowest adequacy, with library resources and simulation equipment, respectively. Students’ concern was the adequacy of simulation equipment (M=3.50, with the highest SD=1.43). Students rated educators’ preparedness highest for effective teaching methodologies (M = 4.18, SD = 1.06), use of practical examples (M = 4.00, SD = 1.09), and timely feedback (M = 3.97, SD = 1.25). Mentorship and guidance received lower ratings (M = 3.55, SD = 1.13). Educators rated integrating practical case studies into their teaching (M = 4.56, SD = 0.50), evidence-based methodologies (M = 4.27, SD = 0.65), and continuous professional development (M = 4.25, SD = 0.57) highly. Concerns were noted regarding institutional support for development (M = 3.88, SD = 0.86). Nurse managers noted knowledge gaps among some educators, especially when guiding students in areas outside their specialty. Students rated the adequacy of exposure to real patient care low (M = 3.71, SD = 1.13821) and supervision effectiveness (M = 3.79, SD = 1.37502). Educators also reported insufficient clinical exposure (M = 3.79, SD = 0.63). Nurse managers highlighted challenges with high student-to-instructor and student-to-patient ratios that affected clinical learning. Students rated use of technology-enhanced learning tools like simulators (M=3.8, SD = 0.94), while educators rated (3.59, SD= 0.62), suggesting moderate and low utilization of digital learning methods, respectively. Nurse managers noted that students lacked adequate exposure to emerging healthcare technologies. Conclusion: The successful implementation of the diploma nurse-training curriculum relies on adequate teaching resources, nurse educators’ preparedness, a supportive clinical environment, and adaptability to emerging technologies. However, resource shortages, inadequately prepared educators, and the deficiency in the capacity of clinical sites hinder optimal curriculum implementation. Recommendations: The Nursing Council of Kenya should ensure training institutions and clinical sites uphold standards for training safe, competent nurses. Institutions must invest in teaching resources, support educator development, utilize digital learning tools, and adhere to guidelines for student-to-instructor ratios. Further research on the relationship between students’ self-efficacy and curriculum implementation is also recommended. Thu, 01 Jan 2026 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/10224 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10153 Academic achievement in biomedical sciences and its correlates among students of bachelor of nursing science program in Uganda Clement, Munguiko Background: Biomedical science courses such as anatomy, physiology, and biochemistry are critical components of nursing education, providing the foundational knowledge necessary for effective clinical practice. Despite their importance, academic achievement in these courses among nursing students remains low globally, with failure rates ranging from 20% to 50%. However, in Uganda, the extent of this problem and the factors associated with it remain poorly understood. Objectives: This study aimed to examine the level of academic achievement and sociodemographic, student educational and institutional factors influencing it among students in Bachelor of Nursing Science (BNS) program in Uganda. Methods: This mixed-methods study, guided by Critical Realism philosophy and Constructivist learning theory, was conducted at four purposively selected Ugandan public universities between March and July 2024. It employed cross-sectional and descriptive qualitative design for the quantitative and qualitative study aspects respectively. The qualitative study included 12 purposively sampled teaching staff, while the quantitative study used a census approach to enroll 208 students. Data were collected through key informant interviews and a self-administered questionnaire. Quantitative analysis involved Welch’s analysis of variance, Pearson correlation, and a linear mixed-effects model, while qualitative data were analyzed thematically. Results: The study found that academic achievement in biomedical sciences among nursing students had improved over time but remained context-dependent, with an overall failure rate of 8.41%. Physiology had the highest mean GPA (2.86 ± 0.768), while anatomy had the lowest (2.62 ± 0.825), leading to an overall GPA of 2.80 ± 0.788. Most students scored C (37%) and D (33.7%) letter grades. Similarly, one teaching staff stated: “There is a little bit of improvement in performance now”. Older age (e.g., 35+, β = -0.70, 95% CI: -1.25--0.16) and coming from a region outside central Uganda (e.g., Northern region, β = -0.43, 95% CI: -0.74--0.12) were sociodemographic factors associated with lower GPAs. Selecting nursing as a lower-choice career option (e.g., fourth choice, β = 0.62, 95% CI: 0.30-0.93) and using uncollaborative learning methods (e.g., rarely participating in group discussion, β = -0.61, 95% CI: -1.21- -0.12) were student educational factors associated with higher and lower GPAs respectively. Previous secondary education performance did not significantly influence academic achievement in biomedical sciences, despite its role in admission decisions (r = 0.1163). Not receiving feedback (e.g., lecturers not giving feedback on progressive test, β = -0.54, 95% CI: -0.93 --0.14) and using problem-based teaching method (β = 0.48, 95% CI: -0.05 --1.91) were some of the institutional factors associated with GPA. Conclusion: Academic achievement in biomedical sciences among BNS students in Uganda is reported to have improved but remains suboptimal, with overall failure rate of 8.41%. Key factors that influence academic achievement include socio-demographics (age, region of origin), student educational choices and learning approaches (career preference, collaborative learning), and institutional practices (feedback to students, competence-based teaching methods). Notably, prior academic performance at high school did not significantly predict success in biomedical science courses at university, despite its use as a criterion for university admission. Recommendations: To improve academic achievement, universities should provide targeted academic support to older students and those from regions outside central Uganda, strengthen career guidance at secondary level to align students’ interests with nursing education, encourage group discussions and peer-led learning strategies to enhance student engagement and comprehension, ensure regular and timely feedback on assessments to support learning progress, and promote the contextually appropriate use of problem based learning. Universities and government could also consider reviewing the current admission criteria of students into the BNS program. Thu, 01 Jan 2026 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/10153 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10142 Basic nursing training and leadership preparedness of nurse managers in South Rift and South Nyanza, Kenya Chebet, Annah Towett Background: Effective leadership and management are vital for strengthening global health systems, yet they remain under-prioritized in low- and middle-income countries (LMICs). Despite the essential role of nurse leaders in maintaining service delivery amid evolving epidemiological demands, training deficiencies often leave them feeling underprepared for managerial responsibilities. In Kenya, Mid-Level Nurse Managers (MLNMs) are central to hospital unit operations; however, significant knowledge gaps exist regarding whether basic nursing training sufficiently prepares them for these leadership roles. Objectives: The objectives were to assess nurse managers' level of preparedness for MLNMs’ leadership role, determine the level at which basic nursing training prepares nurses for MLNMs’ leadership roles, assess the contribution of role-induction programs to MLNMs’ leadership role preparedness, and determine MLNMs’ training needs for leadership role preparation. Methods: The study was grounded on Henri Fayol’s management theory and Frederick Taylor’s principles of scientific management. A mixed-methods study design employing a descriptive, cross-sectional approach was conducted in 9 hospitals and 4 Diploma nursing training institutions selected in South Rift and Nyanza, using a multi-level sampling process. The study population involved 68 purposively selected MLNMs and 7 Nursing Directors (NDs). Data was collected using pretested instruments adapted from validated tools, including self-administered questionnaires, Focus Group Discussions (FGDs), Key Informant Interviews (KII), and a document review checklist. Quantitative data was analyzed using frequency tables, percentages, mean, and mode, while Qualitative data was analyzed thematically. Results: More than half (56.9%) of the MLNMs perceived their level of preparedness for leadership roles as above average, 24.6% excellent, 15.4% average, and 3.1% below average. About 57%, 41%, and 2% of respondents rated their satisfaction with nursing training for leadership roles as satisfied, somewhat satisfied, and dissatisfied, respectively. This is largely due to a focus on theory (65%) through lectures, a change in assessment focus, and a one-month clinical rotation in leadership. Role induction programs contributed to leadership role preparation as follows: formal leadership training (M=4.84, SD = .412, Skw -2.502), Mentorship (M=4.69, SD = .499, Skw -1.196), Supportive supervision (M=4.66, SD = .565, Skw -1.430), ‘On-the-job (M=4.60, SD = .552, Skw -.955), and Preceptorship (M=4.35, SD = .734, Skw -.899). Nurse managers stated that formal leadership training, on-the-job training, mentorship, and supportive supervision significantly contribute to preparedness for the leadership role. They noted being appointed to leadership directly or through progressive promotion without structured leadership role preparation. Managers felt least prepared for budgeting and expressed a need for formal training in resource management. Conclusion: Majority of the respondents rated their leadership preparedness as suboptimal. Basic nursing training was inadequate due to overemphasis on theory, a shift in assessment focus, and limited clinical experience. Formal leadership training, on-the-job training, mentorship, preceptorship, and supportive supervision play a significant role in improving leadership readiness. To effectively fulfill their leadership roles, MLNMs require formal leadership training, resource management training, particularly in budgeting, and training in emotional intelligence. Recommendation: Hospital management teams (HMTs) should develop strategies to enhance the leadership preparedness of MLNMs. Nursing training institutions should reassess the leadership and management aspects of basic nursing programs, focusing on budgeting content and the length of clinical rotations for leadership training. Moreover, HMTs should introduce formal leadership training, structured role-induction programs, and training in emotional intelligence to build the capacity of their MLNMs. Thu, 01 Jan 2026 00:00:00 GMT http://ir.mu.ac.ke:8080/jspui/handle/123456789/10142 2026-01-01T00:00:00Z