Abstract:
This study used a mixed-methods design (QUAN + QUAL) to assess the capacity
of clinical placement sites in Bomet and Kericho Counties to support nursing
students' skills development. Clinical placements are crucial for translating
theoretical knowledge into practical skills, but their quality can be affected by
resource limitations. Data was collected from students, nurse educators, nurse
managers, and principals of nurse training institutions using questionnaires, Key
informant interviews, and Focused Group Discussions, which achieved a response
rate of 89.5 per cent (N=213). Students reported high confidence in basic nursing
procedures (M=4.03), indicating successful skill acquisition. However, the
development of full competence was significantly hindered by overcrowding,
resulting in high student-to-patient and student-to-instructor ratios. Qualitatively,
Nurse Managers reported that hospital staff were overwhelmed, leading to
inconsistent mentorship. A positive correlation (r=0.488, p<0.01) was found
between clinical competency development and curriculum implementation,
underscoring the necessity of effective capacity management. Stakeholders
emphasised the need for increased investment in simulation-based learning to
bridge the theory-practice gap. The study concludes that while the system
successfully builds basic student confidence, the quality of competence
development is severely compromised by resource limitations and pervasive
clinical overcrowding. Urgent systemic reform is required. The study strongly
recommends that clinical placement sites establish a formal capacity
management system based on effective student-to-patient ratios, standardise
and resource a protected clinical mentorship program, and strategically invest in
modern simulation infrastructure to secure the competence of future nurses.
