Assessing challenges of clinical education in a baccalaureate nursing program in Ghana

Background: A 2010 study of preceptorship as a clinical teaching model in Ghana revealed weaknesses related to high student-preceptor ratios and inadequate support from faculty in the educational institution. A four-cycle community-based participatory action research study was designed to further delineate clinical teaching and learning issues and partner with Ghanaian stakeholders in critical analysis of possibilities for positive change in clinical nursing education. The purpose of this paper, taken from Cycle One of the study, is to provide understanding of the challenges of the current clinical teaching model(s) used in the study institution from the perspectives of students and faculty. Early engagement of external stakeholders is described. Methods: Each university target group was invited to complete a semi-structured questionnaire. Interviews were conducted with representatives from the Ministry of Health, the Nursing and Midwifery Council of Ghana, and the Ghana Registered Nurses’ and Midwives’ Association. Clinical documents were examined. Results: Clinical teaching and learning issues identified included the need for: a) more effective clinical teaching and supervision; b) adequate equipment for practice; c) meaningful evaluation of performance; d) enhanced collaboration between the school and clinical settings; and, e) reduced travel time to clinical opportunities. External stakeholders became aware and supportive of the research endeavour. Conclusions: Participants acknowledged changes are needed in order to improve clinical nursing education in Ghana. Clinical teaching and learning issues were identified and formed a baseline from which more in-depth discussion of resources, constraints and possibilities for change could ensue in subsequent cycles of the study.