Abstract
Clinical learning refers to a hands on, supervised learning experience where students in health care fields like nursing, medicine, or therapy practice patient care skills in a real-world clinical setting, allowing them to apply theoretical knowledge and develop practical competencies by directly interacting with patients under the guidance of experienced professionals. The purpose of the study was to assess the factors affecting the effectiveness of clinical learning among student nurses and midwives attending Fort Portal Regional Referral Hospital so as to provide recommendations to enhance the quality of clinical learning, and ultimately strengthen the
capacity of future health care professionals in delivering high quality of patients care. A descriptive cross-sectional study design was carried out encompassing both quantitative and qualitative methods among 63 student nurses and midwives attending fort portal regional referral hospital, a stratified random sampling and purposive sampling for key informants. Data were collected using a semi structured self-administered questionnaires, key informant guide and quantitative data were analyzed using Microsoft Excel version 2016 and a descriptive statistics including frequencies, percentages and tables. Qualitative data were analyzed using texts. Findings on factors affecting the effectiveness of clinical learning among student nurses and midwives revealed were demographic characteristics: Age 50(79.3%),female gender 39(61.9%),First year and second year students 37(58.7%), student related factors: Lack of preparedness for clinical practice 30(47.6%), Lack of confidence in performing procedures 38(60.3%), School related factors: Lack of school tutor supervision during clinical placement 40(63.4%), Lack of school support during clinical placements 49(77.8%), Health facility related factors: Inadequate medical resources 42(66.7%),inadequate frequency of guidance from clinical mentors 43(68.2%) The researcher concluded that: Students and demographic characteristics that affected clinical learning were: Age where by majority of respondents were aged 18yrs-23yrs which implies that most of the students are of young age that require additional support in handling high pressure during clinical learning because they can easily be diverted and interrupted compared to adult students, First year students lack adequate skills and competence during clinical learning since they covered less in scope of the practicum demands and procedures they should learn from practice, and a significant number of the students were not well prepared for practice which hindered their level of preparedness during clinical learning and the lack of confidence that resulted in fear to performing clinical procedures hence affecting effectiveness of clinical learning. School related factors: There were inadequate supervision by mentors which revealed supervision gap that led to lack of confidence and being underprepared for real world health care challenges, also inadequate institutional support that caused a gap in academic follow-ups and student counselling to enhance engagement during clinical rotation. Health facility related factors: There were inadequate medical equipment which hampered the students’ ability to perform clinical procedures hence affecting the effectiveness of clinical learning and a lack of frequent engagement by clinical mentors and instructors which hindered students’ confidence and perfection in clinical learning, The researcher recommended ministry of education to enforce national standards for clinical education and support ongoing research in the clinical education policies. Heads of training institutions to provide simulation based-learning to prepare learners for clinical setting and offer academic guidance to enhance collaboration with clinical sites. Health facility directors to provide adequate resources and assign motivated and trained staff as clinical mentors. Clinical mentors should act as professional role models and offer timely feedback to students. Students should adopt an active role in their learning by setting clear learning achievable objectives. Implication to nursing practice: Nurses in practice should know that the student’s clinical learning at the practicum site is not as effective as intended to be. If it remains so the learners will remain incompetent and half baked, affecting patients care today and after they have qualified. Nurses should improve on the way they guide and mentor students on practicum placements so as to make their learning effective.