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References and Appendices

References and Appendices

References and Appendices

References refers to a list of all intext cited works. 

The researcher is supposed to develop a reference list at the end of your proposal. This list enables the reader or user  of this proposal to conveniently retrieve each of the sources of information that the researcher reviewed.

Whenever you use someone else’s words or ideas in your research paper, you must indicate that this information is borrowed by quoting the source of information in the paper itself (in text referencing), and at the end of the paper (reference list). This applies to written sources you have used such as books, articles web pages, e.t.c

Reference is used to tell the reader where ideas from other sources have been used in the research paper.

Referencing is a crucial part of successful academic writing, avoiding plagiarism and maintaining academic integrity in your assignments and research.

Purpose/Importance of Referencing: WHY DO WE REFERENCE?

  1. Giving Credit to Others: Referencing is a way of acknowledging and giving credit to the original authors or creators of ideas, theories, and works that you incorporate into your own writing. Example: If you use a quote from a book in your research, proper referencing indicates who wrote that quote originally.
  2. Enhancing Credibility and Authority: By citing reputable sources, referencing lends credibility and authority to your arguments. It shows that your ideas are supported by established knowledge and research. Referencing gives your argument evidence, credibility and authority. Example: Referring to well-known studies or academic papers in your field strengthens the reliability of your statements.
  3. Providing a Trail to the Original Source: References act as signposts, guiding readers to the original works. This allows interested readers to move deeper into the topic by exploring the sources you used. Example: A reader who gets interested in your work can trace it back to the specific research study through your references.
  4. Avoiding Plagiarism: Failure to acknowledge the work of others may lead to plagiarism. Proper referencing is essential to avoid unintentional or intentional plagiarism, demonstrating academic integrity. Example: Copying and pasting a paragraph from a source without proper citation is considered plagiarism.
  5. Distinguishing Your Ideas: Referencing allows you to differentiate your original thoughts from those borrowed from external sources. It is a way of distinguishing your ideas from those of other sources.
  6. Facilitating Fact-Checking: Proper referencing enables others to fact-check your work. Interested readers or researchers can verify the accuracy of your statements by consulting the original sources. Example: Including page numbers in your citations allows readers to locate specific information in the referenced source.

Referencing styles 

A referencing style is a set of rules on how to acknowledge the thoughts, ideas and works of others in a particular way. 

In your document, referencing is done at two levels; first you need to give a brief  reference in the body of text called “in-text citation”, and secondly a detailed  reference is provided at the end of the document in the form of a list.

Types of referencing styles 

The two commonest styles used are;

  1. APA (American psychological Association) style.

  2.  MLA (Modern Language Association) style.

Other styles are;

  • Vancouver style / author-number system)
  • Chicago style
  • Turabian style

 

APA STYLE OF REFERENCING

APA style uses the author/date method of citation in which the author’s last name and the year of the publication are inserted in the actual text of the paper. It is the style recommended by the American Psychological Association and used in many of the social sciences

It is the Author Prominent Style of Referencing

General Rules for In-text Citation:
  1. In-text citation utilizes the last name (surname) of the author, followed by a comma and the year of publication. Example:

 (Ghaznavi, 2003).

2. If a page number follows the publication year, a comma is added. Example:          

(Ghaznavi, 2003, p. 40).

3. Alternatively, the author’s name can be written outside the bracket. Example: 

Ghaznavi (2003, p. 40) observes…

4. Punctuation marks come after the citation, not before.

 When you provide an in-text citation in the body of your writing, any punctuation marks, such as commas or periods, should come after the citation.

For example:

  • Correct: “This is an important point (Smith, 2021).”
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    Incorrect: “This is an important point, (Smith, 2021).”

In the correct example, the period is placed after the citation within the parentheses/brackets. This is to ensure that the citation is clearly associated with the information it is referencing, and punctuation does not interfere with the citation’s structure.

 

General Rules for APA Reference List 

  1. Detailed references are listed on a separate page titled ‘References,’ centered and in bold.

2. Only sources cited in the work are listed.

3. Double line spacing is used between each entry.

4. Each reference has a hanging indent, where the first line is flushed to the left margin, and remaining lines are indented.

Additional Referencing Rules:
  1. The list is alphabetically arranged based on the first author’s surname or the first significant word of the title.
  2. If sources from the same author have different publication years, references are listed alphabetically by the first author’s name and then chronologically.
  3. Titles of larger sources (books, journals) are italicized, while titles of parts within a larger work are enclosed in double quotation marks without italics.
  4. Unused but consulted sources can be mentioned under “Bibliography” on a separate page.

 

In-text Citation and Reference List Entry for Two Authors:

  • In the in-text citation, only the surnames of the two authors are used, separated by ‘&’. Example: 

(Alvi & Zaidi, 2009).

  • In the reference list, both the surname and initials of the two authors are used, separated by ‘&’. Example: 

Alvi, M. H. & Zaidi, R. (2009).

 

 

In-text Citation and Reference List Entry for Three to Five Authors:
  • In the in-text citation, only the surnames of the three authors are used, first two separated by a comma (,) and the last two by ‘&’. Example: 

(Alvi, Ghaznavi, Hashmi, Siddiqui & Zaidi, 2009).

  • If the same source is cited again in the text, it will appear like this: Example:

 (Alvi et al., 2009).

  • In the reference list, both the surname and initials of all the authors are used, the last two separated by ‘&’, and the remaining by commas. Example: 

Alvi, M. H., Ghaznavi, K., Hashmi, M., Siddiqui, D. & Zaidi, R. (2009). <title>.

 

In-text Citation and Reference List Entry for 6 to 7 Authors:
  • In the in-text citation, only the surname of the first author is written, followed by ‘et al.’ Example:

 (Alvi et al., 2009).

  • In the reference list, both the surname and initials of all the authors are used, the last two separated by ‘&’, and the remaining by commas. Example:

 Alvi, M. H., Ghaznavi, K., Afridi, S., Zaidi, R., Hashmi, M. & Siddiqui, D. (2009).

In-text Citation and Reference List Entry for 8 or More Authors:
  • In the in-text citation, only the surname of the first author is written, followed by ‘et al.’ Example:

 (Alvi et al., 2009).

  • In the reference list, write the names of the first six and the last author. The last two names are separated by “……..,” and the remaining by commas. Example: 

Alvi, M. H., Ghaznavi, K., Afridi, S., Zaidi, R., Hashmi, M. & Siddiqui, D.,…., Qureshi, T.R. (2009).

 

Harvard Style of referencing

  • Harvard is actually a generic term refers to all the referencing styles that are “author date” based style
  • This style is most commonly used in U.K and Australia
  • Developed by Harvard University in the UK and published by the Harvard Law Review Association.
  • The Harvard style and its many variations are used in law, natural sciences, social and behavioural sciences, and medicine.

Harvard Style of referencing-General Rules, citation

  •  In in-text citation only the last name (surname) of the author is used, author’s name and year of publication are not separated by a comma (,). For example: (Ghaznavi 2003)
  • A comma (,) is put after the publication year if a page number is mentioned after it. (Ghaznavi 2003, p 40)
  •  It is also allowed to write the author’s name out of the bracket. For example: Ghaznavi (2003, p 40) observes ………..
  •  Punctuation marks such as comma or full stop are used after the citation and not before them.

General Rules- Harvard Style referencing

  • Detailed references are listed on a separate page at the end of the document.
  • The title ‘References’ is given to the list, placed in center and in bold font.
  •  Only those sources are to be listed that has been cited in your work.
  •  No reference carries hanging indent.
  •  Author’s name and the year are not separated by a comma or a full-stop.
  • Each reference ends up with a full stop (.).
  •  
  • If you have used the sources of the same author/s with different years of publication, the references are alphabetically listed first by the first author’s name then chronologically by publication year.
  •  In the reference list, the name of an author is written in a way: last name is written first and afterwards initials of the first name/s are written; no full stop is put after the initials.
  • For Example:

Khalid Ghaznavi is written as Ghaznavi K

Mohsin Hasan Alvi is written as Alvi MH

  • The names of the authors are usual presented in capital letters
 
Revision Questions

1. What are the similarities between APA an Harvard styles of referencing?
2. What are the major differences?
3. Examine the differences between list of references and bibliography?

Similarities between APA and Harvard styles of referencing:

  1. Purpose: Both APA and Harvard styles aim to provide clear and consistent guidelines for citing sources in academic writing. They help to ensure that readers can easily identify and locate the sources used in a research paper or other academic work.

  2. Author-date system: Both APA and Harvard styles utilize the author-date system for in-text citations. This means that the author’s last name and the year of publication are included in parentheses within the text to indicate the source of the information.

  3. Alphabetical arrangement: Both APA and Harvard styles require that the reference list or bibliography be arranged alphabetically by the author’s last name. This makes it easy for readers to find the full bibliographic information for each source.

Major differences between APA and Harvard styles:

  1. In-text citations: APA and Harvard styles differ in the specific format for in-text citations. APA uses the author-date system with parentheses around the author’s last name, the year of publication, and the page number (if applicable). Harvard style omits the parentheses and uses a comma after the author’s last name, followed by a period, the year of publication, and a colon before the page number (if applicable).

  2. Reference list vs. bibliography: APA uses a reference list, which includes all sources cited in the paper, whether they are books, articles, websites, or other formats. Harvard uses a bibliography, which includes only sources that are referred to or mentioned in the paper.

  3. Formatting: APA and Harvard styles have different formatting requirements for the reference list or bibliography. APA uses specific indentation rules, double spacing, and a hanging indent for each entry. Harvard uses a consistent indentation for all entries, single spacing, and no hanging indent.

5 differences between list of references and bibliography:

  1. Scope: A list of references includes all sources that are cited in the paper, while a bibliography includes only sources that are referred to or mentioned in the paper.

  2. Completeness: A list of references should include complete bibliographic information for each source, while a bibliography may include abbreviated or incomplete information, depending on the style guide.

  3. Purpose: A list of references is primarily used to provide a record of the sources used in the paper, while a bibliography may also serve as a guide for further reading or research.

  4. Ordering: A list of references is normally ordered alphabetically by author’s last name, while a bibliography may be organized differently, such as by topic or chronology.

  5. Labeling: A list of references is  labeled as “References,” while a bibliography may be labeled as “Works Cited,” “Bibliography,” or “Literature Cited.”

Appendices

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Research Methods and Instruments For Data Collection

Research Methods and Instruments For Data Collection

3.6 Research instruments

Research instruments refers to the tools you are going to use to answer your objectives

Methods and Instruments Used to Collect Data:

The primary methods employed for data collection consist of:

  • Interview Method: Face-to-face interviews, key informant interviews, or communication through mediums like phones. It is direct interaction between the researcher and participants, involving face-to-face discussions, interviews with key individuals who possess relevant information, or communication through mediums such as phones.
  • Questionnaire Method: A systematic approach to data collection that utilizes a set of pre-determined questions presented to respondents, aiming to gather information in a structured and standardized manner.
  • Documentary (Reading Document) Method: The examination and analysis of existing documents or written materials to extract relevant information for research purposes.
  • Focus Group Discussion: A qualitative research method involving a group of individuals discussing specific topics guided by a moderator, with the aim of gathering diverse opinions and insights.
  • Observation Method: A research technique where the researcher systematically observes and records behaviors, events, or activities to collect data in a firsthand, unobtrusive manner.

Research (Data Collection) Instruments/Tools:

The key tools utilized for data collection include:

  • Interview Guides: Structured sets of questions or topics designed to guide an interviewer during face-to-face or key informant interviews.
  • Self-administered Questionnaires: Questionnaires designed for respondents to complete independently, without direct interaction with an interviewer.
  • Key Informant Guides: Structured outlines or questions used when interviewing key informants, individuals with specialized knowledge or experience relevant to the research.
  • Group Discussion Topics: Specific subjects or issues designated for exploration during a focus group discussion to stimulate conversation and elicit diverse perspectives.
  • Observation Checklist/Schedule: A systematic list or plan used by researchers to observe and record specific behaviors, events, or characteristics during the observation method.
  • Library Search: A systematic exploration of existing literature and information sources within a library to gather relevant data for research.
  • Tests: Structured assessments or examinations conducted to measure specific abilities, knowledge, or characteristics of individuals.
  • Use of Diary: The recording of regular, chronological entries detailing events, behaviors, or experiences over time, serving as a method of data collection in research.

The selection of the data collection method is guided by:

  • Accuracy of Information: The degree to which the chosen data collection method ensures precise, reliable, and truthful information from the participants, influencing the method’s appropriateness for the research.
  • Practical Considerations: Factors such as time, available resources, equipment, and personnel, which impact the feasibility and suitability of a particular data collection method for the research.
  • Response Rate of Respondents: The anticipated level of participation and willingness of the target respondents to engage with the chosen data collection method, affecting the method’s effectiveness in gathering sufficient and representative data.
  • Geographical Area Coverage: The extent to which the selected data collection method can efficiently collect information across the intended geographical area, considering the distribution and accessibility of the target population.
Characteristics of a Good Research Instrument
  • The Instrument must be valid and reliable
  • It must be based upon the Conceptual framework.
  • It must gather data suitable for and relevant to the research topic.
  • It must gather data would test the hypotheses or answer the questions under investigation
  • It should be free from all kinds of bias. 
  • It must contain clear and definite directions to accomplish it. 
  • It must be accompanied by a good cover letter. 
  • It must be accompanied, if possible, by a letter of recommendation from a sponsor/school. 

Advantages and Disadvantages of Common Research Instruments/Tools:

1. Questionnaire:
Advantages:
  • Easy administration to respondents across large areas.
  • Respondents can answer at their own convenience.
  • Quick data collection, saving time.
  • Enhances anonymity, allowing respondents to freely address sensitive questions.
  • Eliminates interview bias.
  • Hard to design but easy to use.
Disadvantages:
  • Unsuitable for illiterate respondents.
  • Risk of misinterpretation of questions.
  • Lack of opportunity for researcher probing.
  • Low response rates.
  • No observation of facial expressions.
  • Inflexible tool in terms of respondent approach.
How to Construct a Questionnaire:
  • Keep it brief and attractive.
  • Begin with simple questions, ensuring logical sequencing.
  • Include researcher’s address and a clear title.
  • Provide an introduction, emphasizing the study’s significance, confidentiality, and instructions.
  • Use simple language, avoiding technical terms.
  • Ask specific questions related to research objectives.
  • Avoid leading and double questions.
  • Place sensitive questions at the end.
  • Include a variety of question types.
Types of Questions on a Questionnaire:

i) Open-Ended Questions:

  • Enable detailed responses.
  • Solicit unique viewpoints.
  • Easy to design.
  • Ideal when no predetermined answer is known.

However, there is a risk of irrelevant data.

ii) Closed Questions:

  • Offer specific choices.
  • Difficult to construct but easier to administer and analyze.
  • Save time and provide standard answers.

Types of Closed Questions:

  • List Type Questions.
  • Multiple Choices.
  • Scale Type.
  • Ranking Type.
  • Quantity Type.
2. Interview Instrument (Interview Guide/Schedule):
Advantages:
  • Higher response rate.
  • Suitable for non-literate respondents.
  • Allows probing.
  • Enables observation of respondent’s non-verbal cues.
  • More control over data collection pace.
  • Identity of respondent is known.
  • Provides an opportunity for follow-up.
Disadvantages:
  • Expensive and time-consuming, especially with a scattered population.
  • Respondents may lack time for interviews.
  • Prone to biases.
  • Limited anonymity.
  • Respondents may give pleasing answers.
  • Embarrassing questions may hinder open responses.
  • Difficulty in tracing respondents.
Techniques of Interviewing:
  • Establish a good rapport.
  • Introduce yourself and state the interview’s purpose.
  • Ask one question at a time, following the guide.
  • Repeat questions if necessary.
  • Allow sufficient time for responses.
  • Avoid suggesting answers.
  • Maintain a neutral attitude on controversial issues.
  • Use tact to keep the interview focused.
  • Take shorthand notes.
  • Adapt to the respondent’s schedule.
3. Observation Schedule/Checklist:
Advantages:
  • Oldest research method.
  • Provides reliable, first-hand information.
  • Enables coding and recording real-time behavior.
  • Facilitates clarification of questions.
  • Elicits a high response rate.
  • Allows detailed information gathering using the senses.
Disadvantages:
  • Risk of respondents putting on a show.
  • Time-consuming.
  • Expensive.
  • Inability to observe past events.
  • Influenced by observer weaknesses.
4. Tests:
  • Used for educational research to assess achievement or intelligence quotient.
5. Focus Group Discussion (FGD):
Advantages:
  • Gathers a variety of opinions.
  • Reaches a large number in a short time.
  • Encourages mutual checks among group members.
  • Involves directly affected individuals.
  • Provides comfort for those hesitant in larger groups.
Disadvantages:
  • Lacks anonymity.
  • Expensive and time-consuming.
  • Sensitive matters may limit open discussion.
  • Risk of dominance by one participant.
  • Group influence may generate desirable ideas.
6. Telephone Survey:
Advantages:
  • Higher response rate than mail surveys.
  • Time-efficient.
  • Eliminates interviewer bias.
  • Covers a broader geographical area.
  • Offers comfort to shy respondents.
  • Cost-effective and convenient.
  • Allows probing during conversation.
Disadvantages:
  • Excludes respondents without telephones.
  • Difficulty in accessing phone numbers.
  • Prone to human weaknesses.
7. Mail Survey:
  • Questionnaires mailed to respondents.
  • Applicable for widespread geographical studies.

For additional advantages and disadvantages, refer to those of a questionnaire.

8. Diary Method:
  • Records events or occasions in a diary.
  • Provides valuable data on individual work patterns.

Research Methods and Instruments For Data Collection Read More »

Sample Size Determination

Sample Size Determination

Sample Size Determination

Sample size determination, also known as sample size calculation or sample size estimation, is the process of determining the number of individuals or items to be included in a sample from a larger population for a research study. 

  • Sample size is abbreviated as n 
  • Study/Accessible Population is abbreviated as N   
  • Margin of error is abbreviated as e (0.05 at 95% Confidence level)

FACTORS TO CONSIDER WHILE DETERMINING THE SAMPLE SIZE

  1. Research Objectives: Different objectives may require different sample sizes to achieve meaningful results. 📚
  2. Population Size: Larger populations necessitate larger sample sizes to ensure representativeness. 🏢
  3. Sampling Error: Smaller margins of error require larger sample sizes. ±📏
  4. Confidence Level:Higher confidence levels generally result in larger sample size requirements. 🎯 expressed as a percentage (e.g., 95% confidence level). 
  5. Research Design: The chosen research design, whether experimental, observational, qualitative, or quantitative, can impact sample size. Each design has its own requirements. 📊🔍
  6. Data Collection Methods: The methods used to collect data, such as surveys, interviews, or observations, can influence the sample size. 📝🎙
  7. Budget and Resource: Practical limitations, including budget constraints and available resources, can also influence your sample size decisions. 💰
  8. Time: The time available to conduct the study can impact the sample size. Tight timelines may necessitate smaller, more manageable samples. ⏰
  9. Ethical Considerations: Ethical principles, such as minimizing harm to participants, can influence sample size decisions, particularly in sensitive research areas. 🤝
  10. Statistical Software and Tools: The availability of statistical software and tools for sample size calculations can streamline the process, ensuring accuracy in your estimates. 📈🖥️

HOW TO DETERMINE SAMPLE SIZE

1. Census (for Small Populations):

A census involves including every member of the population in your sample. This method is highly advantageous for small populations because it eliminates sampling errors and provides data on every individual in the population.

NOTE: census is only feasible for small populations. Conducting a census for large populations may not be cost-effective and practical.

 

2. Transfer from a Similar Study:

Another approach is to transfer the sample size from a similar study with comparable objectives and characteristics. This strategy can save time and resources.

A potential disadvantage is that you might repeat the mistakes made in the previous study. Ensure the previous study was methodologically sound.

3. Using Internet Sample Size Calculators: This method utilizes the Internet sites that help one to determine the sample.

One Examples is: https://www.calculator.net/sample-size-calculator.html

 

4. Utilizing Published Tables:

Researchers can make use of published tables designed for sample size determination. One such example is the Krejcie & Morgan table of 1970, which helps researchers determine the sample size for a given population. Another example is Glenn(1992).


 WHERE:
  • N is the Population
  • S is the Sample size you need to draw.

For example a For a population of 45 people, Krejcie & Morgan table advises a Sample of 40 people.

For 10 people, Sample is 10, requiring a Census due to the small number of people.

These tables are a valuable resource and provide guidance on sample size selection, taking into account factors like population size, confidence levels, and error margins.

 

5. Applying Standardized Formulas:

A widely accepted method involves applying standardized sample size formulas, such as the one developed by

  1.  Kish and Leslie in 1965.

The formula is as follows:

 n = Z²pq / d², 

where 

  1. Target Population: 500 diabetic patients attending Goma Health Center in Mukono District.
  2. Confidence Level: 95%
  3. Margin of Error: 5% (0.05)
  4. Prevalence: historical data indicating that around 40% of patients at Goma Health Center are diabetic (p = 0.40).

Using Kish and Leslie Formula:

n = Z²pq / d²

Where:

  • n = Sample size
  • Z = Z-score for the desired confidence level (1.96 for 95% confidence)
  • p = Assumed true population prevalence of diabetic patients
  • q = Complement of p (1-p)
  • d = Margin of Error (0.05)

n = (1.96)² X 0.40 X (1 – 0.40) / (0.05)²

n ≈ 346.18

In this scenario, you would need a sample size of approximately 347 diabetic patients attending Goma Health Center in Mukono District to estimate the true population prevalence with a 95% confidence level and a 5% margin of error.

 

II. Yamane formula, developed by Taro Yamane in 1967.

 The formula is as follows:

n = N / (1 + Ne²)

Where:

  • n = Sample size
  • N = Population size (500)
  • e = Desired level of precision (0.05)

n = 500 / (1 + 500 X (0.05)²)

n ≈ 333.33

In this scenario, you would need a sample size of approximately 333 diabetic patients attending Goma Health Center in Mukono District to achieve the desired level of precision (5%).

6. USING UNMEB GUIDELINES

3.4.2 SAMPLING PROCEDURE

A sampling procedure is a defined and systematic method for selecting a subset (sample) from a larger group (population) for the purpose of conducting research or collecting data. 

 

It involves the steps and techniques used to ensure that the sample accurately represents the population, allowing researchers to draw meaningful conclusions from the sample’s data.

Sample Size Determination Read More »

ASSESSMENT AND EVALUATION

ASSESSMENT AND EVALUATION

ASSESSMENT AND EVALUATION

INTRODUCTION

Education is an activity in which a variety of resources are put, these resources include money, time, labor, instructional materials, etc. We need to find out whether we are benefiting from putting all these resources into the education of our learners. To do this, we use measurement, assessment, testing, and evaluation.

Evaluation

Evaluation is the systematic process of collecting, analyzing, and interpreting information that determines the effectiveness (value) of an educational program in the light of evidence obtained through research, assessment, measurement, testing, experimenting, and consulting. Thus, evaluation can also be defined as the process of judging the value or worth of an individual’s achievements. It attempts to provide useful feedback information to stakeholders. It facilitates the judgment of what extent the educational objectives have been met.

Assessments

In education, the term assessment means the process of documenting in quantitative terms the knowledge, skills, and values attained by the learner. Currently in Ugandan higher institutions, there is continuous assessment being emphasized. The results of continuous assessment help teachers keep an accumulative record that may be used to assess the overall performance of the learner.

Testing

This is a way of discovering by questions or practical activities what someone knows or what someone can do. Educationally, we test our learners to find out how much knowledge and skills they possess, and what values and attributes they have developed.

Measurement

This refers to assigning numbers to a learning program or event in order to describe or represent the amount of abilities, characteristics, and potential possessed by a learner. Measurement describes a situation in quantitative terms, while evaluation judges its worth or value in qualitative terms, such as good or poor.

PURPOSE / AIMS OF ASSESSMENT AND EVALUATION

PURPOSE / AIMS OF ASSESSMENT AND EVALUATION

  1. Diagnosis: It helps us to understand the problem existing within the program; therefore, appropriate action can be taken.

  2. Placement and Promotion (Selection): It helps us correctly find where the individual should belong, i.e., who can be promoted to another class or who goes for which course based on aggregates, e.g., primary leavers are selected according to aggregate got, i.e., whether a student of aggregate 6 can go to Kisubi or whether a student who did MEG can do law.

  3. Certification: It is the only way one can satisfy the assessment committee to provide evidence about the attainment of a particular skill, e.g., a degree certificate, driving permit, etc.

  4. Standards: It helps the teachers to establish a reference point, i.e., the minimum entry point, e.g., At UNMEB exams, a standard is 50% in every paper, which was determined based on how students used to score in the past.

  5. Prediction: The stakeholders are able to determine the future potentials/weaknesses of individuals, e.g., a student who performs well in Physics is likely to be an engineer.

  6. Refinement: The information from the evaluation can help us to improve on the programs by identifying where we are weak. E.g., a teacher looks at the students’ work and sees what topic they have failed, then the teacher tries to simplify his/her teaching.

  7. Norms referencing: It helps us to compare an individual against other individuals or against the system. E.g., a student in the 5th position out of 40 students can be determined by assessments.

  8. Remediation: Results of assessment are a basis for correcting learning responses and clarification of misconceptions. A teacher might decide to organize a remedial class to correct the challenges that students faced during assessments.

  9. Motivation: Feedback from assessment is motivation for future aspiration among learners. For example, a student can be motivated to read harder after good performance in an exam.

FACTORS TO CONSIDER WHEN SELECTING A TOOL OF ASSESSMENT

  1. Purpose of evaluation: In the evaluation of learners’ progress, one should first identify the learning outcomes to be measured. For example, in nursing education, outcomes could be that learners should possess knowledge in disease management, skills in nursing procedures, and a good attitude in patient care.

  2. Availability of assessment tools: No single evaluation tool is adequate for assessing learners’ progress; make sure you use a variety of techniques to obtain a complete picture of the students’ achievements. Use what is available and can be administered to the learners. For example, a theory exam can evaluate learners’ knowledge, and a practical exam evaluates their skills and attitudes.

  3. Validity: It is a concern about how well the test measures what it is supposed to measure. For example, measuring students’ intelligence using a tape measure around the circumference of the head will not provide accurate measurements of intelligence, so the validity of this tool will be weak.

  4. Reliability: It measures how consistent the scores obtained by different examiners are, determining how stable a measurement is.

  5. Practicality: Refers to the action of the assessment method and its relevance to the overall learning goals in the course, addressing whether or not the workload for the instructor is reasonable.

  6. Ease of interpretation of results: The evaluation tool used should enhance the teacher’s ability to interpret the results for student performance.

  7. Time frame: The available time determines which evaluation tool to use, allowing students to complete the assigned tasks in an appropriate time.

  8. Costs and resources available: The evaluation should use techniques that are economical and require little funds, human resources, and time.

TYPES/FORMS OF ASSESSMENT/EVALUATION

TYPES/FORMS OF ASSESSMENT/EVALUATION

There are two major forms to evaluate a student’s learning:

  1. Formative Assessment:
    • This is a form of assessment that allows the teacher to check for student understanding along the way, as the lesson or unit is being taught.
    • In the day-to-day teaching, teachers continuously check on how students are learning. This includes the questions they ask when teaching, the exercises they give, homework, weekly tests, etc.

    Functions of Formative Assessment:

    • It gives teachers the ability to provide constant feedback to the students.
    • It allows the students to be part of the learning environment and to develop self-assessment strategies that will help with the understanding of their own thought process.
    • Yields decisions on the improvement of content delivery.
    • It determines which objectives individual students have achieved.
    • It ensures that students have learned certain things before they progress to the next level.
  2. Summative Assessment:
    • This refers to the assessment of participants where the focus is on the outcome of a program. It evaluates student learning, skill acquisition, and academic achievement at the conclusion of a defined instructional period, e.g., PLE, UACE, end-of-year exams.

INTERPRETATION OF MEASUREMENT

There are two types of interpreting measurements:

  1. Norm-Referenced Measurement:

    • The norm-referenced approach involves comparing the scores of an individual with those of other learners in the same category.
    • It helps differentiate among individuals by comparing the position of one individual against others in the same group.
    • For example, a score of 70% by Agnes may place her in the 2nd position in that group, while a score of 84% by Mary in another group may place her in the 10th position.

  2. Criterion-Referenced Measurement:

    • These measurements are designed to measure student performance against a fixed set of predetermined criteria or learning standards.
    • It does not concern itself with other students but rather focuses on an individual.
    • It’s concerned about what one can and cannot do.
    • For example, the UNMEB examination system has a pass mark of 50%, where one can be considered to have failed (if below 50%) or passed (if above 50%).

CLASSROOM ASSESSMENT TECHNIQUES/TOOLS THAT CAN BE USED IN HEALTH TRAINING INSTITUTIONS

There are various ways through which assessment and evaluations can be conducted in classrooms. These include:

a) Observation

b) Oral examinations

c) Written examinations

d) Practical examinations

OBSERVATION

Observation involves assessing one’s academic progress based on observation by the teacher.

 It can involve seeing students’ behavior and listening to oral contributions to evaluate the learners’ attitude, learning speed, style, intelligence, personal abilities, and progress. This technique can detect problems immediately so that corrective measures can be employed, but it’s prone to prejudice and bias from the teacher as the observer.

ORAL EXAMINATIONS

Oral examinations involve a face-to-face question and answer between the teacher (examiner) and the student (examinee). 

The teacher asks questions and finally scores the candidate based on the quality of the responses from the learner. Examples include interviews, quizzes, panel discussions, case presentations, etc. In nursing, traditional oral practical exams were conducted where the teacher would vary questions asked from one student to another.

WRITTEN EXAMINATIONS

Teacher-made tests are the most widely used written examination for assessing learning. The construction of these tests fundamentally depends on the teacher and can be categorized into two types: Objective and Subjective tests.

OBJECTIVE TESTS

Objective tests predominantly assess using short responses or answers. They include multiple-choice, true/false (binary test), matching, and completion (fill-in) questions.

Multiple Choice Questions (MCQ’s):

 MCQs present a statement or question to which several responses are given, with only one response being correct. The statement/item is referred to as the stem, the correct response as the Key, and other options or alternative responses as destructors.

Guidelines for Preparing Meaningful MCQs

  • Use simple vocabulary.
  • Ensure the stem is clear and specific.
  • Make sure the destructors are capable of separating.
  • Avoid questions that measure opinions or judgments.
  • Use numerical answers in ascending order.
  • Avoid providing insight/idea to the answer while writing the stem.
  • When using words like NOT or EXCEPT, they should be bolded or underlined.

Matching Items

Matching items present students with a list of statements and a list of responses, with a set of directions for matching them.

Guidelines for Preparing Matching Tests

  • Use homogeneous options/items.
  • Provide clear directions to students on how to match the responses.
  • Avoid the use of specific determiners that may provide clues to the responses.

Binary Test

This type involves a statement or item to which judgment is made either in agreement or disagreement, typically with forms like true or false, agree or disagree, and yes or no.

Guidelines for Binary Test Preparation

  • Use clear and understandable language. Try always to avoid words that are partly true and partly false.
  • Avoid using negative statements. e.g. Kerosene is not a solid. True/False.
  • Avoid long, complex sentences.
  • Avoid including 2 or more ideas in one sentence e.g Gentamycin is an antibiotic  that is given by I.V. true/false
  • Don’t use terms that provide clues about the right answer. Words like NEVER, NONE, OR, e.t.c. which are likely to be false. On the other hand, words like Sometimes, Usually, Likely…
  • Avoid copying statements from textbooks.
  • Vary options to avoid guesswork.
  • Have an equal number of true and false questions to prevent guesswork.

Completion/Fill-in-Blanks Tests

Such a test requires that spaces are left between the items so that the respondent can fill them in with one word or many words.

Guidelines for Fill-In Test Preparation (Completion/Fill-in-Blanks Tests)

Such a test requires that spaces are left between the items so that the respondent can fill them in with one word or many words.

  • Construct items that measure important objectives in the area of study.
  • Pose specific problems to the examinees so they give brief and specific responses.
  • Use precise and accurate language in the questions.
  • Ensure the expected answers from students are factually correct.
  • Avoid using too many blanks.
  • Put blank spaces at the end rather than starting questions with them.
  • Avoid using exact statements as they appear in the notes to prevent guesswork.
  • Preferably use statements that require one correct answer, not many.
  • Have a wide scope of content coverage.
  • Avoid questions that require lengthy answers; use statement definitions instead, e.g., the process of allocating marks to different questions in a test is called.
Merits of Objective Tests
  • Easy to assess, correct, and mark.
  • Balancing and controlling the level of difficulty is feasible.
  • Provides a high level of reliability.
  • Encourages extensive work from students.
  • Reduces speculation among students.
  • Offers a wide scope of content and syllabus coverage.
Demerits of Objective Tests
  • Difficult to prepare.
  • Susceptible to guesswork.
  • Does not encourage higher-order thinking like subjective tests.
  • Does not provide an opportunity for planning and organizing.
  • Measures superficial knowledge of the student.
SUBJECTIVE TESTS

This is a mode in which each question or item requires an elaborate description and explanation. Therefore, there is no exact or simple answer. They include short-answer and essay items.

Short-Answer Items:

  • Requires students to supply a word, short phrase, number, or other type of brief response. E.G List 4 characteristics of adult learners

Essay Items:

  • Essay items require students to write paragraphs or develop themes as responses. They involve a wider variety of thinking skills, as students must recall, select, organize, and apply.

Guidelines for Preparing a Good Subjective Assessment

  • Keep questions focused and specific.
  • Use grammatical expressions at the level of the students (e.g., list, outline, state). Avoid vague expressions like mention, identify, tell us, show us.
  • Consider the available time for taking the test.
  • Allocate marks for each item (e.g., a) Define the term memory (1 mark), b) Describe the relationship between memory and learning (5 marks).
  • Avoid compounding items (e.g., Discuss the structure, function, and adaptations of the liver [25 marks]). Break it into parts (a) Describe the structure of the liver [7 marks], b) Outline the functions of the liver [10 marks], c) Illustrate the adaptations of the liver for its functions [8 marks].
Advantages of Subjective Tests
  • Measures the evidence of clear understanding of the content.
  • Relatively easy to construct and prepare.
  • Allows for critical and high-order thinking.
  • Assesses the ability to organize one’s own ideas.
  • Tests skills of analysis and planning.
  • Measures divergence in thinking.
Limitations
  • Poor content coverage.
  • Promotes speculations among test takers.
  • Time-consuming to score and not always reliable.
  • May be influenced by bias, such as handwriting, language used, or the test taker’s personal information.
  • Can be misinterpreted by the test taker.
PRACTICAL EXAMINATIONS
  • Practical examinations are used to evaluate nursing competence in practical skills.  Currently, Objective Structured Clinical/Practical Examination (OSCE/OSPE) is the test method used in nursing education to assess practical skills.
  • Examiners use a checklist to evaluate trainees, providing the same problem and tasks to all students within the same time frame. The tasks simulate real clinical situations, including history taking, physical examinations, simple procedures, interpretation of lab results, patient management problems, communication, and attitude, among others. All students are assessed on the same criteria using a checklist by the same examiners.

ASSESSMENT AND EVALUATION Read More »

Lesson Plan

Lesson Plan

Lesson Plan

Lesson plan is a plan prepared by a teacher to teach a lesson in an organized manner.

It is obtained from the scheme of work which was designed earlier.(Scheme of work)

SAMPLE OF A LESSON PLAN.

LESSON PLAN 1

SET: DN-2
COURSE UNIT: MEDICAL NURSING II
TUTOR: NASES REVIJONI

DateTimeAverage Age of StudentsExpected Number of StudentsNumber of Students Present
29/10/20238:00-9:00 AM
(1 HOUR)		Above 20 years5 

Topic: DIABETES MELLITUS (DM)

Objectives:

By the end of this lecture, students should be able to:

 

  1. Define Diabetes Mellitus
  2. State the 3 causes of DM
  3. Describe the 2 types of Diabetes Mellitus
  4. List 5 predisposing factors to Diabetes Mellitus

Teaching Methods/Techniques:

  1. Interactive lecture
  2. Brainstorming technique
  3. Question and answer technique

Teaching Aids:

  1. References
  2. Laptop
  3. Projector
  4. Flip chart containing lesson objectives & pointer

References:

  1. David, K. M. (2018). General Principles of Insulin Therapy in Diabetes Mellitus. 2UpToDate. Retrieved from https://www.uptodate.com/contents/general-principles-of-insulin-therapy-in-diabetes-mellitus.

  2. Stephen R. Bloom (Ed.). (2009). Toohey’s Medicine, a Textbook for Students in the Healthcare Professions (15th ed.). London, USA: Churchill Livingstone.

  3. Uganda Catholic Medical Bureau (2015). Nursing and Midwifery Procedure Manual (2nd ed). Kampala, Uganda: Print Innovations & Publishers, pp. 166-168.
Time and StepContentTutor’s ActivitiesStudent’s Activities
1
(02 minutes)		Greeting
Roll call		– Greets students
– Makes roll call by calling students’ names		– Respond to greeting
– Respond to their names
2
(05 minutes)		Review of previous lesson– Reviews previous lesson by asking students about what was covered in that lesson.– Respond to teacher’s questions
3
(05 minutes)		Introduction of the lesson objectives on Diabetes Mellitus– Displays flip chart containing lesson objectives
– Chooses one student to read what has been displayed
– Provides clear linkage between previous and current lesson		-look at flip chart
contents
-reads what is displayed
on flipchart and others
listen
-listen to the linkage
between previous and
current lesson
4
(13 minutes)		Signs and symptoms of DM– Asks students to contribute to
signs and symptoms of DM using
mind-mapping brain storming
technique
-Clarifies the signs and
symptoms of DM		-come and write their
contributes on white
board in a ‘mind-map
– listen and take notes
5
(25 minutes)		Pathophysiology of DM

– Asks students the meaning of
patho-physiology
-Clarifies the meaning of patho-
physiology
-Tells students to form pairs and
allocated specific signs of DM
for discussion of how they
manifest in DM (patho-
physiology)
– calls back discussion and gets
students’ responses

-Respond to the meaning
of patho-physiology
-listen to the
clarification
-form pairs to disouss
how signs of DM
manifest
-present the allocated
task that has been discussed in there group.
– look at the displayed chart.
– listen to teacher’s explanations.
– draw flow diagram on patho-physiology of DM.
6
(10 minutes)		Evaluation and Conclusion of Lesson

-Evaluates lesson by asking
questions as per objectives
-Summarizes the lesson on DM
-reads assignment to students;
1.List down the normal ranges
of:

  • -Random blood sugar (RBS)
  • -Fasting blood sugar (FBS)

2.Apart from diagnostic testing,

  • identify 4 relevant tests

necessary to be done on a DM patient and their rationale
-Thanks students for their
participation

-Student respond to questions asked
-Students listen to teachers summary
-Students listen and note down the assignment
-Student respond to teacher’s appreciation
    

CHALK/WHITEBOARD PLAN

 
DateContentNew Words
29/10/2022Greeting, Roll call, Review of previous lesson, Introduction of the lesson objectives on Diabetes Mellitus, Signs and symptoms of DM, Patho-physiology of DMDiabetes Mellitus, patho-physiology, mind-mapping, brain storming, allocations.
COMMENTS/SELF EVALUATION
StrengthChallengesWay Forward
TeamworkLimited resourcesResource mobilization and optimization

CLINICAL SESSION PLAN

This is a plan prepared by a teacher to conduct a practical session in an organized manner. Its different from lesson plan as shown below.

NURSES REVISION SCHOOL OF HEALTH SCIENCES

CLINICAL SESSION PLAN 1

COURSE: DIPLOMA IN NURSING

COURSE UNIT: MEDICAL NURSING II

LECTURER: NASESI REVISION

DateTimeAverage Age of StudentsExpected Number of StudentsNumber of Students Present
29/10/202230 minutesAbove 20 years5 

Topic: INSULIN ADMINISTRATION

Objectives: By the end of the clinical session, students should be able to;

  1. Assemble requirements needed to administer insulin.
  2. Administer insulin to a diabetic patient using the demonstration and return demonstration technique.

Teaching Methods/Techniques: Demonstration and return demonstration technique.

Teaching Aids:

  • Procedure checklist
  • Prescription note/patient’s chart
  • Simulated Patient
  • Glucometer plus strips
  • Prickers
  • Sliding scale chart
  • Insulin vial and syringes
  • 2 pairs of surgical and disposable gloves
  • A tray and tray cover
  • Galipot of antiseptic solution
  • Galipot of cotton swabs
  • Receiver for used swabs
  • Safety box
  • Screen
  • Hand washing equipment

References:

  • Uganda Catholic Medical Bureau (2015). Nursing and Midwifery procedure manual (2nd ed). Kampala, Uganda: Print innovations & publishers. Pg 166-168
Step and TimeContentTutor’s ActivitiesStudents’ Activities
1 (05 minutes)Pre-conferencing about procedure on insulin administration– Greets students – Briefs students on the procedure of insulin administration – Assembles requirements – Cautions students on infection prevention and ethical issues– Respond to greeting – Listen to the tutor’s briefing on the procedure of insulin administration – Observe the requirements needed – Listen to the cautions on the procedure
2 (10 minutes)Demonstration of the procedure on insulin administration

– Demonstrates procedure step by step while briefing students on key steps;

  • Step 1: Obtains consent
  • Step 2: Observes Privacy
  • Step 3: Hand washing
  • Step 4: Brings requirements to bed side
  • Step 5: puts on gloves
  • Step 6: Measuring RBS and estimates the dose of insulin to be given.
  • Step 7: Withdrawing the medicine into the syringe
  • Step 8: Select the site and disinfect it
  • Step 9: Administers the drug
  • Step 11: Place a swab over the needle and withdraws the needle quickly and smoothly
  • Step 12: Thanks and leaves the patient comfortable
  • Step 13: Record the drug given in the patient’s chart and signs
  • Step 14: Clear away the equipment
– Observe attentively tutor performing the procedure of insulin administration
3 (10 minutes)Return demonstration of the procedure on insulin administration– Requests one student to do a return demonstration on insulin administration – Allocates tasks on the procedure to other students – Observes the student performing the procedure – Scores the student using a checklist and also allocates other 2 students to score their colleague– One volunteers to perform a return demonstration – Everyone performs the allocated task – Performs a return procedure on insulin administration while others observe – The 2 students also score their colleague as he/she performs step by step
4 (05 minutes)Post-conferencing– Asks the volunteer student to evaluate him/herself – Requests other students to critique the volunteer student – Gives feedback about the procedure of insulin administration – Encourages the students to keep practicing when they get time in order to perfect– The volunteer students evaluate him/herself – Other students evaluate their colleague – Students listen to the students’ feedback

COMMENTS/SELF EVALUATION

StrengthChallengesWay Forward
Effective pre-conferencing to prepare studentsTime constraints during practical sessionsAllocate more time for practical sessions
Clear and organized demonstration of the procedureEnsuring that every student gets the opportunity to perform the return demonstrationRotate students to perform return demonstrations
Encouraging self-evaluation and peer evaluationScoring can be subjective; may need a more objective scoring systemImplement a standardized scoring system and provide clear criteria for scoring
Active student participation during the sessionAvailability of required equipment and materials for practical sessions may be a challengeEnsure that all necessary equipment is readily available
Providing constructive feedback to studentsMaintaining students’ motivation and enthusiasm for continuous practiceOrganize periodic practice sessions to sustain students’ interest

Lesson Plan Read More »

SCHEME OF WORK

SCHEME OF WORK

SCHEME OF WORK

Scheme(teacher’s scheme) of work is, therefore, their plan of action, which should enable them to organize teaching activities ahead of time.

 It is a summarized forecast of work that the teacher considers adequate and appropriate for the class to cover within a given period from those topics already set in the syllabus.

A scheme of work can be made to cover one week, one month, one term, or even one year, depending on the duration of a given program. Ideally, schemes of work should be prepared before classes begin.

COMPONENTS OF A SCHEME OF WORK

  1. Name of Organization/Institution: Refers to where one is working or training.
  2. Tutor’s Name: The person owning/designing the scheme of work.
  3. Trainees Level: Refers to the grade level in training, e.g., diploma in midwifery.
  4. Subject/Course Unit: This refers to the subject being schemed, which may be theory or practical, e.g., teaching methodology.
  5. Duration/Period of Preparation: Refers to the time frame the scheme of work will be completed. It includes the year of study and semester of that particular group of learners.
The table is then drawn with 10 columns containing the following:

  1. Week: Most institutions are specific in time allocation, and each week should be spelled out in the week column. Weeks should be separated by a line running across the page, especially when the same scheme of work form contains more than one week.

  2. Number of Periods: The subject may have one, two, or more periods in one week. Some periods may be single, double, or triple. When two spaced periods are indicated on the timetable in the same week, then there should be two distinct rows for two periods. The numbering process should be repeated for the other weeks.

  3. Topic/Sub-topic: The topics in the syllabus need to be rearranged in the order in which they are supposed to be taught, e.g., teaching-learning process. This should be clear and definite. The instructor should single out all the sub-topics/lesson titles in a particular syllabus topic.

  4. Objectives: Each sub-topic/lesson title should be followed by an objective(s), which is meant to pinpoint the anticipated learning behavior of the learners.

  5. Content: What subject matter will be covered in that period. It includes all the important headings based on the objectives.

  6. Methods/Techniques: Teaching methods and techniques to be used. This depends on the set objectives of that period.

  7. Teaching Aids: Resource materials for specific content coverage used in scheming are necessary and should be noted down with their relevant pages for ease in reference during lesson planning. References include chalkboards, books, handouts, reports, etc.

  8. Teacher’s References: The various sources of reference that the teacher used to gather the content of that lesson.

  9. Students’ References: What references does the teacher recommend students to use for further reading and when doing assignments? These need to be part of the teacher’s references that are accessible to learners, simpler to understand, and rich in content.

  10. Remarks/Comment: Remarks in the scheme of work should be made immediately the lesson is over. The teacher is supposed to indicate whether what was planned for the period has been covered, whether there was overplanning or a failure of the lesson and reasons for either case.

                               SCHEME OF WORK

SCHOOL: NURSES REVISION SCHOOL OF  HEALTH SCIENCES
TUTOR’S NAME: NASES REVIJONI
COURSE: DIPLOMA IN NURSING
COURSE UNIT: MEDICAL NURSING II
YEAR OF STUDY: YEAR TWO, SEMESTER ONE
NO. OF PERIODS PER WEEK: 3 (1 HOUR EACH)

WeekNumber of PeriodsTopicSub-topicObjectivesContentMethods/TechniquesTeaching AidsTeacher’s ReferencesStudents’ ReferencesRemarks/Comment
11MEDICAL CONDITIONS OF THE ENDOCRINE SYSTEMDiabetes mellitus (DM)By the end of the week, students should be able to:
  1. Define DM
  2. State the 3 causes of DM
  3. Describe the 2 types of DM
  4. List five predisposing factors to DM
  • – Definition of DM
  • – Causes of DM
  • – Types of DM
  • -Predisposing factors
Interactive lecture, Brainstorming technique, Question and answer techniqueWhiteboard illustrations, Flip chart containing lesson objectives & pointerWorkman and Donna. 2006, Berkow and Beers. 1999, Stephen. 2009, UCG. 2016Workman and Donna. 2006, Stephen. 2009, Signs and symptoms of DM, Brainstorming technique, Whiteboard illustrations, 2 Flip charts containing Workman and Donna. 2006, Workman and Donna. 2006Remarks should be made immediately after the lesson. The teacher should indicate whether what was planned for the period has been covered, whether there was overplanning or a failure of the lesson and reasons for either case.
 2MEDICAL CONDITIONS OF THE ENDOCRINE SYSTEMSigns and symptoms of DMBy the end of the week, students should be able to:
  1. State 5 signs and symptoms of DM
  2. Describe the pathophysiology
  • Signs and symptoms of DM
  • Pathophysiology of DM
  • Diagnostic investigation
Interactive lecture, Brainstorming technique, Question and answer techniqueWhiteboard illustrations, Flip chart containing lesson objectives & pointerWorkman and Donna. 2006, Berkow and Beers. 1999, Stephen. 2009, UCG. 2016Workman and Donna. 2006, Stephen. 2009, Signs and symptoms of DM, Brainstorming technique, Whiteboard illustrations, 2 Flip charts containing Workman and Donna. 2006, Workman and Donna. 2006Remarks should be made immediately after the lesson. The teacher should indicate whether what was planned for the period has been covered, whether there was overplanning or a failure of the lesson and reasons for either case.

REFERENCES:

  1. Berkow, R., & Beers, M. H. (1999). The Merck Manual of Medical Information. West Point, USA: Merck Research Laboratories.

  2. David, K. M. (2018). General Principles of Insulin Therapy in Diabetes Mellitus. UpToDate. Retrieved from https://www.uptodate.com/contents/general-principles-of-insulin-therapy-in-diabetes-mellitus.

  3. Stephen R. Bloom (Ed.). (2009). Toohey’s Medicine, a Textbook for Students in the Healthcare Professions (15th ed.). London, USA: Churchill Livingstone.

  4. Uganda Catholic Medical Bureau (2015). Nursing and Midwifery Procedure Manual (2nd ed). Kampala, Uganda: Print Innovations & Publishers, pp. 166-168.

  5. Uganda Clinical Guidelines (2016). National Guidelines for the Management of Common Conditions. Kampala, Uganda: Ministry of Health.

  6. Workman, L. M., & Donna, D. I. (2006). Medical-Surgical: Critical Thinking for Collaborative Care (5th ed, Volumes 1 & 2). PA, USA: Elsevier Saunders.

 

That’s for week 1, you can add week 2, and follow the above guide! Ref: Also note that references are part of the scheme of work!

LESSON PLAN

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SCHEME OF WORK Read More »

Planning teaching

Planning Teaching

PLANNING TEACHING

Teaching plan is a document that outlines the structure and details of a single session. 

A good teaching plan is a comprehensive write-up of the step-by-step teaching methods, the estimated duration of each segment of teaching, and the materials and resources needed for the session.

Importance of Drawing a Teaching Plan/Lesson Plan

Teaching planning is essential as it provides a guide for the day’s lessons and gives the teacher a clear direction for the day’s activities. Here are some key reasons for its importance:

  • It organizes the subject matter effectively.
  • It prevents thoughtless teaching.
  • It fosters the proper atmosphere for the learning process.
  • It ensures that the learning objectives (integral components of the lesson plan) are central to all classroom activities.
  • It allows the teacher to design an assessment plan to evaluate whether the class has met its targets.
  • It provides clarity on when to start the evaluation and when to proceed to the next lesson.
  • Lesson plans promote organized teaching and save time.
  • They enable the teacher to select appropriate teaching strategies.
  • They make the teacher more prepared and confident while teaching the lesson.

Note: FAIL TO PLAN = PLAN TO FAIL

Factors to Consider When Planning Teaching

  1. Needs, Capabilities, and Interests of the Learner: It’s important to understand the individual needs, capabilities, and interests of your students. This knowledge guides your teaching approach and ensures that your lessons are engaging and relevant to your learners.

  2. Psychological Knowledge of the Learner: Familiarize yourself with what your students already know or have learned from their previous teachers. This knowledge is crucial for effective instruction and helps you build upon their existing knowledge.

  3. Learning Experience: Define the learning experiences you want your students to gain. This will help you determine the most suitable method for delivering the content and engaging your students effectively.

  4. Social and Physical Environment of the Learner: Create a conducive environment for learning the subject matter. Ensure that the classroom environment supports the learning objectives, making it easier for students to focus and participate.

  5. Lesson Plan Materials/Tools: Utilize a variety of resources and materials to enhance your lesson plan’s success. Consider using audio/visual aids, the latest technologies, and library resources to support your teaching materials.

  6. Goals and Results (Learning Objectives): Clearly outline the goals and expected results for your lesson plan and your students. This provides a clear direction for both you and your learners.

  7. The Content/Subject Matter: Possess a thorough understanding of the content you’ll be teaching. Study the topic, and ensure you have mastery of the subject matter to effectively convey it to your students.

  8. Evaluation and Feedback: Continuously evaluate and correct your lessons. Use methods like questions, quizzes, and feedback from both teachers and students to ensure that learning is taking place and that you have achieved your goals.

CURRICULUM

Curriculum refers to the subjects comprising a course of study in a school or college. A curriculum is also a plan or program of all experiences which the learner encounters under the direction of a school.

TYPES OF CURRICULA

  1. Official curriculum/Intended curriculum: This is the curriculum as written down on paper in syllabuses.

  2. Actual curriculum/Operational curriculum: This is what is implemented in practice in schools.

  3. Assessed/examined curriculum: This is that part of the taught curriculum that is actually assessed.

  4. Null curriculum: This is curriculum that we do not teach, thus giving students the message that these elements are not important in their educational experiences or in our society, such as critical thinking, inquiry, and intellectual development.

DETERMINANTS OF CURRICULUM:

Curriculum determinants are the factors influencing a particular type of curriculum design.

  1. Educational philosophy: Educational philosophy is a crucial determinant of the curriculum development process by helping clarify our thought and mind process. The purpose of nursing education is to bring about desirable behavioral changes in nursing students to enable them to render comprehensive nursing.

  2. Educational psychology: This enables us to follow the psychological development of learners and helps us know whether the children have developed adequately to be able to understand certain concepts. For example, in the first year, nurses start with microbiology, anatomy, and physiology, and then advance to medical and surgical content in the second year.

  3. Society: There are many aspects of society that need consideration in curriculum making, such as culture, health needs, socioeconomic issues e.t.c Therefore there is need to include what is applicable and relevant to the society.

  4. Student: Since modern curriculum is student-centered, nursing education must address the needs of the students without neglecting patient’s rights. Additionally, it should prepare students for the future by enabling them to fulfill other roles in addition to those of a professional nurse.

  5. Knowledge: Knowledge that students need to acquire. Increased specialization has led to individuals focusing on specific segments of knowledge. For example, midwives may not study surgical nursing and medical nursing because they specialize in midwifery. This has led to an explosion of knowledge and specialization. Therefore, specific criteria should be established for selecting the knowledge to be included in a particular curriculum.

  6. Resources: The development of a viable curriculum depends on the availability of tangible and intangible resources. Tangible resources include teachers, textbooks, and physical facilities, while intangible resources encompass motivation, interest, and intelligence.

ELEMENTS/COMPONENTS OF THE CURRICULUM

The most commonly used model, known as Wheeler’s model, comprises five components:

  1. AIMS, GOALS, AND OBJECTIVES: Aims, goals, and objectives pertain to a terminal point towards which we are working or heading.

    • Aims: Aims are the broadest statements that convey the values held for an educational program. For example, the aim of universal primary education in Uganda today is to enhance socio-economic development.

    • Goals: Goals are a more specific form of aims. They describe the purposes of a course and provide curriculum planners with a foundation for selecting curriculum content. For instance, the goal of universal primary education is to ensure that all school-age children attend school to acquire basic education.

    • Objectives: Objectives are specific statements outlining what learners should be capable of doing after experiencing the curriculum or a portion of it. Objectives are categorized at two levels: Curriculum and instructional objectives.

  2. CONTENT: Content refers to subject matter or what knowledge, concepts, principles, generalizations, theories, techniques, and procedures are to be used in a particular subject. In curriculum, the criteria for selection of content are:

    1. Validity: Content is valid if it promotes the outcomes it is supposed to promote. This is the extent to which selected content is true.

    2. Significance: Refers to the suitability of the material chosen to meet certain needs and ability levels of the learners.

    3. Needs and interests of the learner: Learnability; It must also be consistent with social realities.

     

  3. LEARNING EXPERIENCES: Learning experiences are the interactions between the learner and the environment within the school setting, determining what the learners will be able to do by the end of the course. Criteria for selecting learning experiences consider the following:

    • Conformity with objective: The experiences must align with the curriculum objectives to give students the opportunity to practice the desired behaviors.
    • Learnability: Learning experiences should be adjusted to the learners’ abilities and differences, starting from where the student knows.
    • Interest: Students are likely to interact with stimulating situations.
    • Relevance to life: Learners must see the purpose of education in their everyday lives.
    • Consistency with social reality: Learning experiences must align with the actual situation at home or in society.
    • Variety: Creativity in choosing from a range of educational experiences aiming at the same objectives.
    • Satisfaction: Learning experiences should provide satisfaction from carrying out the desired behavior implied by the objectives.

     

  4. EVALUATION: Evaluation is the process of determining how far or to what extent the learning experiences developed, organized, and exposed are actually producing the desired outcomes. It enables comparison of actual outcomes with expected outcomes (or objectives) and leads to conclusions for further action.

SYLLABUS

A syllabus is a document that communicates information about a specific course unit and defines expectations and responsibilities. It provides relevant qualifications for teaching the class.

Elements of syllabus:

  1. General course information, That tells students what the course is about, why the course is important, and generally what they can expect from the course. This section will include;
  • the course title,
  • course description, 
  • course learning outcomes or objectives.

        2. Specific course information, That tells students exactly what will be           required of them throughout the course , when in the term they will be         required to do what and how their work in the course will be                             evaluated.   This section will include;  

  • content to be covered in specified time,
  • detailing required assignments,
  • assignment descriptions, required 
  • recommended texts,
  • required examinations,
  • course calendar, and
  • grading overview and criteria.

SCHEME OF WORK

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Study Population & Sampling

Study Population & Sampling

Study Population & Sampling

Study population and sampling are helpful to the researcher in that it helps to  classify the population that you expect to study. You are supposed to create a state that take population and provide a brief justification for this population and why you think it is the best population for this study

DEFNITIONS:

A sample: Is a subset (a part) of a population. Ideally, a researcher should use the whole population to collect data but resources may not be enough. Hence one has to resort to using a sample.

A study sample: Is a subset of the accessible population that participates in the study.

Sampling: is an act of selecting a small number of subjects upon which a study is conducted to represent the population. The result of the sample is assumed to represent the whole population. Sampling is not necessary if the population is small.

In normal circumstances, the bigger the sample size, the higher the level of accuracy.

Sample size: these are the number of respondents to get involved in the study, For example, a sample size of 150 people.

Population: Is the total of items or subjects in a set; with relevant characteristics that a researcher needs. It is the total number of potential respondents for the study.

Target population: The large set of the population to which the results will be generalized – all teenagers with asthma, for example.

Accessible population: Is the subset of the target population that is available for study – teenagers with asthma living in the investigator’s town this year, for example.

Homogeneous population: consists of subjects with specific characteristics in common.

Heterogeneous population: consists of subjects differentiated by specific identifiable features, for example, age, sex, educational background.

Sample study considers a subset of the population while census study considers/examines all members of a population.

Why (Importance of) sampling?

  • To manage effectively large and dispersed populations.
  • To minimize the cost of conducting the study.
  • To save time.
  • To improve on the accuracy of findings.
  • To carry out a less demanding study.
  • To reduce the level of destruction in case where sampling involves destroying items sampled.
  • Common in medical research.
Methods-of-Sampling-Random-and-Non-Random-Sampling

Methods of sampling/Sampling Methods.

Sampling methods: A sampling method is a procedure for selecting sample elements from a population.
  1.   Random or Probability Sampling Methods
  2.  Non-random or Non-probability sampling methods.

The choice of a sampling method depends on a number of factors. Some factors are the following:

  • The type of population one is to sample from.
  • The degree of accuracy one wants.
  • The resources available, especially time and money.
  • The homogeneity of the population.
  • The urgency of the findings.

Random sampling method

 Every element in the population has the same probability (equal chances) of selection.

Advantages of Random methods:

  • Offers equal chances to all members in the set to be selected.
  • Eliminates bias.
  • Improves the validity of the study.
  • Easy to administer.
  • Provides statistical means of manipulating data.

Disadvantages of Random methods:

  • They require a sample frame of all members of a finite population (a list of members).
  • There may be a possibility of un-proportional representation of strata in heterogeneous populations (over-representing or under-representing).

Random sampling methods include:

  • Simple random sampling.
  • Stratified random sampling.
  • Systematic sampling.
  • Multistage sampling.
  • Territorial sampling.
  • Cluster sampling.
Simple random sampling: 

The principle of simple random sampling is that every object has the same probability of being chosen (purely random).

There are many ways to obtain a simple random sample. One way would be the use of a lottery method.

Procedure of the lottery:

  • Each member of the population is assigned a unique number or name. The numbers are written on similar pieces of paper, which are folded, placed in a bowl, and thoroughly mixed.
  • Then, a blindfolded researcher selects one at a time without replacement until he/she has the required number of subjects in the sample.

Summary of Simple random sampling technique:

  • Determine the population of interest by specific characteristics.
  • Decide on the sample size.
  • Create a sample frame (list all subjects).
  • Select subjects randomly from the sample frame (using the lottery or a random number table).

Advantages of simple random sampling: See those for random sampling above.

Disadvantages of simple random sampling: In case of a heterogeneous population, one subgroup may be under or over-represented leading to bias.

Stratified random sampling
Stratified random sampling: 

A population may have subgroups in which a researcher is interested. For example, one may want to ensure that both girls and boys are represented in the sample.

The population is thus divided into subgroups or layers (strata) to represent the subgroups before the sample is drawn.

What is important is that the percentage of the subgroups in the sample must be the same as that in the population. For example, if the percentage of boys and girls in the population are 70% and 30% respectively, then the sample must also have 60% boys and 30% girls.

NB. This method uses stratifying techniques to overcome the weakness of simple random.

Stratified random sampling technique:

  • Decide on a sample size,
  • Create strata based on sound criteria (e.g., tribe),
  • Decide on the number of representatives to pick from each stratum, and
  • Randomly carry out the sampling.

Example: Consider a school with a total of 1000 students, where 600 are boys and 400 are girls, and suppose that a researcher wants to select 100 of them for a research study.

  • The population has 600/1000 x 100 = 60% boys.
  • The population has 400/1000 x 100 = 40% girls.

The sample of 100 must, therefore, have 60% boys = 60/100 x 100 = 60 boys.

Similarly, the subgroup of girls will have 40% girls in the sample = 40 girls.

Randomly carry out 60 boys from the strata of boys and 40 girls from the girls’ strata to make a sample size of 100 needed by the researcher.

Systematic sampling: 

This method relies on arranging the target population according to some ordering scheme and then selecting elements at regular intervals through that ordered list. However, to avoid bias, the starting element has to be randomly chosen.

The number in the population is divided by the required sample to get the interval.

Example: Suppose you want to sample 8 houses (sample size) from a street of 120 houses (population).

120/8 = 15 (interval), so every 15th house is chosen after a random starting point between 1 and 15. If the random starting point is 11, then the houses selected are; 11, 26, 41, 56, 71, 86, 101, and 116.

NB. This method is not purely random because some elements have more chances of being chosen than others. For example, in the above example, houses 1-15 have more chances of being selected than houses 16-120.

Systematic sampling is the best method for a big homogeneous population. It is easy to administer.

Summary of Systematic sampling process:

  • Define the population.
  • List the sample frame of all members in a certain order.
  • Determine the interval (population/sample size).
  • Systematically sample the population using the interval beginning with a random starting element.
Cluster sampling
Cluster sampling:

Cluster sampling is a type of sampling that involves dividing the population into groups (clusters). Then, one or more clusters are chosen at random (from all clusters, a random sample is made) and everyone within the chosen cluster is sampled.

NB

  • The clusters are the ones that are randomly chosen.
  • All subjects in the random clusters are used for the study.

This method is useful when it is impossible to make a list of subjects scattered over a large area. Instead of making a list, a map of the area showing political, geographical, or other types of sub-division can be used in what we call cluster or area sampling.

Multi-stage sampling or multi-stage cluster sampling
Multi-stage sampling or multi-stage cluster sampling: 

Using all the sample elements in all the selected clusters, as seen in cluster sampling above, may be prohibitively expensive or unnecessary. Under these circumstances, multi-stage cluster sampling becomes useful.

Instead of using all the selected clusters, the researcher randomly selects elements from each cluster; however, several levels of cluster selection are applied before the final sample elements are reached.

For example, household surveys begin by dividing metropolitan regions into ‘districts’ (first stage). The selected districts into blocks, and the blocks are chosen from each selected district (second stage).

 Next, dwellings are listed within each selected block, and some of these dwellings are selected (third stage). This method makes it unnecessary to create a list of every dwelling in the region and necessary for only selected blocks.

Non-Random Sampling Methods:

These are sampling methods where some elements of the population have no chance of selection; or where the probability of selection can’t be accurately determined. They are mainly used in qualitative studies.

Advantages of Non-random sampling methods:

  • They are cheap.
  • They have a less complicated approach to sampling.
  • They offer faster results.
  • They usually do not need to have a list of all members of the population.

Disadvantages of Non-random sampling:

  • These methods are not random, thus prone to human error and bias.
  • They are better applied when research findings are not generalized beyond the sample.
  • Statistical analysis of sample results is not appropriate when non-random sampling methods are used. For example, a researcher cannot use statistical methods to define a confidence interval around the sample mean.
Types of non-sampling methods:
Convenient Sampling:
Sampling depends on the convenience of the researcher. The sample is selected on the basis of how accessible, convenient, and cooperative a subject may be. For example, if there are ten parishes, one can choose two parishes that are nearest to one.
 
Purposive/Judgmental Sampling:
The sampling depends entirely on the researcher’s interest and judgment. For example, one can choose to select only nurses on duty.
 
Snowball Sampling Method:
The respondents to be included in the study are recommended by colleagues who know they can offer good data. Each person interviewed suggests the next respondent to interview.
 
Quota Sampling:
Is a non-probability version of stratified sampling. In quota sampling, a population is first segmented into mutually exclusive sub-groups, just as in stratified sampling. Then judgment is used to select the subjects from each segment based on a specified proportion.
 
Accidental Sampling:
The respondents included in the study are not deliberately selected, but the sample is incidental to prevailing circumstances. For example, if you stand in front of the university gate and interview every student who passes by.

NB

i) Sampling errors arise from drawing wrong conclusions or generalizing issues based on findings drawn from a small sample. The errors are normally less when the sample size is big, and sampling is random.

ii) Non-probability sampling does not allow the estimation of sampling error.

Sampling Errors:

The two main errors in sampling are; random error and systemic error.

  • Random Error: A wrong result due to chance. This can be overcome by increasing the sample size.
  • Systemic Error: A wrong result due to bias.

Study Population & Sampling Read More »

Research Designs/Study Design

Research Designs/Study Design

RESEARCH DESIGNS/STUDY DESIGN

Study or Research design defines the approaches, methods and the rationale of picking that appropriate research design
  •  Eg descriptive cross sectional design
  •  Approaches can be Quantitative/qualitative or both
  •  Note that it is advisable to use one of these at our level.

Research design acts as a blueprint for conducting a research study, outlining how variables will be operationalized for measurement, the selection of the sample of interest, data collection methods, and the intended means of data analysis.

 Zikmund (1988) defines research design as a master plan that specifies the methods and procedures for measuring, collecting, and analyzing data.

At the core of a research design are answers to crucial questions:

  •  How will the study be conducted?
  • What procedures will be adopted to obtain answers to research questions?
  • What kind of data needs to be collected?
  • How will the tasks required to complete the various research components be carried out?

🏗 Importance of Research Design 📊

  1.  Foundation for Research: 🏠 Acts as the solid base upon which the entire
    research stands. Acts as a firm foundation for the research.
  2.  Smooth Research Operations: ⚙️ Ensures all research activities run smoothly and efficiently. Because you know what next!
  3. Efficiency Maximization: 💪Provides maximum information with minimal effort, time, and cost. It makes research as efficient as possible by giving maximum information with minimum expenditure of effort, time and energy.
  4. Blueprint for Research: 📐 Just as an architect needs a blueprint for building a house, research needs a proper design for conducting a study.
  5.  Simplifies work: 😍This is by ensuring that limitations are predetermined and solutions are already at hand, so you overcome them.

A well-planned research design is like a strong foundation for your study,
making the research process efficient and effective. 🌟🧱📈

🧐 FACTORS THAT INFLUENCE CHOOSING A RESEARCH DESIGN 📝

  1. Researcher’s Knowledge 🧠: The researcher’s familiarity with a particular design.

    • Example: If a researcher is well-versed in qualitative research methods, they may choose to conduct an ethnographic study to gain an in-depth understanding of a specific community.

  2. Resource Availability ⏳💼: Availability of time, human resources, and willing respondents.

    • Example: In a time-sensitive study, a researcher might opt for a cross sectional design due to its efficiency in data collection and analysis.

  3. Ethical Considerations 🤝📜: Ethical aspects, including the ethical treatment of respondents.

    • Example: In a study involving vulnerable populations, such as children, ethical considerations may lead the researcher to choose a design that prioritizes the protection of participants, like an experimental design.

  4. Feasibility and Relevance 🎯📊: The practicality and relevance of the design to the study.

    • Example: A large-scale public health survey may require a design that is both feasible and relevant, such as a cross-sectional study that provides a snapshot of health trends in a population.

  5. Geographical Scope 🌍🗺: The extent of the geographical area to be covered.

    • Example: A study investigating regional variations in climate change impacts might choose a design that covers multiple countries and regions to capture a broad geographical scope, such as a comparative case study.

  6. Equipment Availability 🛠💻: Access to necessary research equipment and tools.

    • Example: Research requiring advanced scientific equipment, like electron microscopes, would naturally be influenced to adopt experimental research designs.

  7. Research Type 🔍📈: The specific type of research, e.g., cross-sectional or longitudinal.

    • Example: If a researcher aims to understand changes over time, they may select a longitudinal design to follow the same group of participants at multiple points in time.

  8. Control 🎮🔒: The level of control the researcher can maintain over the study.

    • Example: In a medical study testing a new drug’s effectiveness, a randomized controlled trial (RCT) design would provide a high level of control over the research conditions and variables.

  9. Population Type 👥🌐: The characteristics of the population under study.

    • Example: Research on consumer preferences might employ a certain design to ensure the population’s characteristics are accurately represented in the study.

Types of research designs

There are three main overall methodologies (or designs): Qualitative , quantitative and Mixed.

  1. Qualitative Research Designs:

    • Qualitative research designs are primarily exploratory and descriptive in nature.
    • They aim to understand and interpret the underlying meaning of phenomena.
    • Qualitative studies often involve collecting non-numerical data such as text, images, or observations.
    • Common qualitative research designs include phenomenology, ethnography, grounded theory, and case studies.

  2. Quantitative Research Designs:

    • Quantitative research designs focus on collecting and analyzing numerical data.
    • They are structured, objective, and use statistics to establish relationships between variables.
    • The primary goal of quantitative research is to measure, describe, and explain phenomena through numerical data.
    • Common quantitative research designs include descriptive, analytical, experimental, and correlational studies.

  3. Mixed Research Designs:

    • Mixed research designs combine elements of both qualitative and quantitative research within a single study.
    • These designs aim to provide a comprehensive understanding of complex research questions.
    • Researchers typically collect and analyze both numerical and non-numerical data, often in two distinct phases, with one method informing the other.
    • The choice of mixed design depends on the research objectives and the need for a holistic approach to the research question.
Below are some Research designs under each design
There are many types of research designs, very many, we are going to explain the most commonly used/ examined research designs.
MethodologyResearch Design
QuantitativeExperimental
 Analytical
 Descriptive
 Correlational
 Quasi & Comparative
QualitativePhenomenology
 Ethnography
 Grounded Theory
 Case Study
Mixed/OtherCross-Sectional Study
 Longitudinal Study
 Retrospective Study
 Cohort Study
 Randomized Controlled Trial
 Comparative Study

Qualitative vs. Quantitative Research Designs

Qualitative research deals with phenomena that are difficult or impossible to quantify mathematically, such as beliefs, meanings, attributes, and symbols. 

Quantitative research deals with phenomena that are possible to be quantified mathematically. For example, experimental studies are quantitative in nature.

AspectQualitativeQuantitative
Nature of DataNon-numerical (text, words)Numerical (numbers, measurements)
Number of RespondentsFewer respondentsLarger number of respondents
Research AimFormulation of hypothesesTesting formulated hypotheses
Researcher’s KnowledgeLimited knowledge on the topicMore knowledgeable about the topic
Nature of Data CollectionSubjective (relies on respondents)Objective (researcher gathers data)
Conclusiveness of ResultsInductive (results inconclusive)Deductive (results are conclusive)
Questioning ApproachGeneral and broad questionsSpecific and narrow questions
Bias in ResearchHighly biasedLess biased (researcher in control)

Experimental Study Design:

Experimental study design involves introducing an intervention assumed to be the ’cause’ of change and waiting until it has produced or has been given sufficient time to create that change. Some essential experimental study designs include the following:

i) After-only design: In this approach, the researcher knows that the population has been exposed to an intervention. They aim to study its impact on the population. Information about the baseline is usually gathered from respondents’ recall of the situation before the intervention or from existing records. This design is commonly used in impact assessment studies.

ii) Before-and-after design: This design addresses the issue of retrospectively constructing the ‘before’ observation by establishing it before introducing the intervention to the study population. Subsequently, when the program is fully implemented or assumed to have its effect on the population, an ‘after’ observation is conducted to determine the intervention’s impact.

iii) Control group design: In the control group design, the researcher selects two population groups – a control group and an experimental group. These groups are expected to be as comparable as possible in every respect except for the intervention. The experimental group receives or is exposed to the intervention, while the control group is not. Initially, the ‘before’ observation is made on both groups simultaneously. Subsequently, the experimental group is exposed to the intervention. When it is assumed that the intervention has had an impact, an ‘after’ observation is conducted on both groups. Any difference in the ‘before’ observation between the groups concerning the dependent variable(s) is attributed to the intervention.

General Characteristics of Experimental Designs:
  • Direct manipulation of independent variables in a controlled environment.
  • Examination of the effect of independent variable(s) on one or more dependent variables.
  • Focus on testing hypotheses.
  • Total control of extraneous variables.
  • Generation of empirical findings with internal and external validity.
  • Some experimental designs use control and experimental groups (pure experimental design).
Advantages of Experimental Design:
  • i) It enables the researcher to control the situation, helping answer the question, “What causes something to occur?”
  • ii) It allows identification of cause-and-effect relationships between variables and distinguishes placebo effects from treatment effects.
  • iii) Experimental research designs support the ability to limit alternative explanations and infer direct causal relationships in the study.
  • iv) This approach provides the highest level of evidence for single studies.
Disadvantages of Experimental Design:
  • i) Experimental design can be artificial, and results may not generalize well to the real world.
  • ii) The artificial settings of experiments may alter participants’ behaviors or responses.
  • iii) Experimental designs can be costly if they require special equipment or facilities.
  • iv) Some research problems cannot be studied using experiments due to ethical or technical reasons.
  • v) It can be challenging to apply ethnographic and other qualitative methods to experimentally designed studies.

Cross-Sectional Study Design

Cross-sectional study design is a research approach that involves different groups of people who vary in the variable of interest but share other characteristics, such as socioeconomic status, educational background, and ethnicity. For instance, researchers may select groups of people who are quite similar in most aspects but differ only in age. This allows any observed differences between groups to be attributed to age rather than other variables.

Cross-sectional studies are typically observational and are commonly used in descriptive research.

Characteristics of Cross-Sectional Studies:
  • Researchers record existing information within a population without manipulating variables.
  • Data collection occurs at a single point in time.
  • This research design describes characteristics within a population but does not establish cause-and-effect relationships between different variables.
  • It enables researchers to investigate multiple aspects simultaneously, such as age, income, and gender.
What Cross-Sectional Studies Can Reveal:
  1. Cross-sectional studies provide a snapshot of outcomes and associated characteristics at a specific point in time.
  2. Unlike experimental designs that involve active intervention to induce and measure change or create differences, cross-sectional studies focus on studying and drawing inferences from existing differences among people, subjects, or phenomena.
  3. Data is collected at a particular moment in time.
  4. While longitudinal studies require multiple measurements over an extended period, cross-sectional research aims to identify relationships between variables at a single moment.
  5. Groups chosen for study are deliberately selected based on existing differences in the sample rather than random sampling.
  6. This method can estimate the prevalence of an outcome of interest because the sample typically represents the entire population.
  7. Cross-sectional designs often use survey techniques for data collection, making them relatively cost-effective and efficient.
Disadvantages and Challenges of Cross-Sectional Design:
  1. Finding individuals, subjects, or phenomena that are very similar except for a specific variable can be challenging.
  2. Results are static and time-bound, offering no insights into the sequence of events or historical contexts.
  3. Cross-sectional studies cannot establish cause-and-effect relationships.
  4. This design provides only a single snapshot of analysis, which may yield different results if conducted at another time.
  5. There is no follow-up to the findings.
Characteristics of Cross-Sectional Research Design:
  • No time dimension.
  • Focuses on existing differences rather than changes following intervention.
  • Groups are selected based on existing differences rather than random allocation.

Note: Cross-sectional research design differs from longitudinal research, which involves taking multiple measurements over an extended period of time.

Longitudinal Research Design: 

This is a study design that involves a series of sample measurements taken over a period of time. The study focuses on specific respondents or a sample over a specified period, examining changes in behavior.

Examples:

  1. A study of a specific group of children’s academic performance over time.
  2. A study of the stages of human development by following a child from birth to adulthood.

Longitudinal studies provide deeper insights into issues. However, they can be expensive in terms of both time and money. Such studies may face setbacks if a respondent dies or transfers.

Longitudinal studies are further subdivided into Panel and Trend studies.

Panel Study: Involves using the same group or individual throughout the study period. One sample is studied continuously.

Trend Study: Involves different homogenous groups or samples in phases over the study. The results obtained from the study are then analyzed and compared to investigate trends of change. For example, one can observe the trend of change in the behavior of 1st-year students admitted in 2001 and 1st-year students admitted in 2002 using a trend longitudinal study.

What Longitudinal Studies Tell You:
  1. Longitudinal data help analyze the duration of a specific phenomenon.
  2. Enables researchers to approach causal explanations usually achievable only through experiments.
  3. Permits the measurement of differences or changes in a variable from one period to another, describing patterns of change over time.
  4. Facilitates predicting future outcomes based on earlier factors.
What Longitudinal Studies Don’t Tell You:
  1. The data collection method may change over time.
  2. Maintaining the integrity of the original sample can be difficult over an extended period.
  3. It can be challenging to show more than one variable at a time.
  4. This design often requires qualitative research data to explain fluctuations in the results.
  5. A longitudinal research design assumes that present trends will continue unchanged.
  6. It can take a long time to gather results.
  7. A large sample size and accurate sampling are needed to reach representativeness.

Case Study/Case Report Designs: 

A case study is an in-depth examination of the behavior of a specific phenomenon, such as a person, a group of people, an object, or a situation within a limited environment. The findings from a case study can be generalized to represent other cases within a population of interest. For instance, one can study the behavior of a child or a group of children from birth to adulthood and then generalize the results to other children.

What Case Studies Don’t Tell You (Disadvantages):
  1. A single or a small number of cases offer limited grounds for establishing reliability or for generalizing the findings to a broader population of people, places, or things.
  2. Intensive exposure to the study of a case can bias a researcher’s interpretation of the findings.
  3. This design does not facilitate the assessment of cause-and-effect relationships.
  4. Vital information may be missing, making the case challenging to interpret.
  5. The case may not be representative or typical of the larger problem under investigation.
  6. If a case is selected because it represents a very unusual or unique phenomenon or problem for study, then the interpretation of the findings can only apply to that specific case.

Retrospective and Prospective Study: 

A retrospective study is a longitudinal study that examines data from the past. For example, a researcher may review medical records from previous years to identify trends. In essence, retrospective studies “look back” in time. On the other hand, prospective studies “look forward” by collecting data as events unfold.

Retrospective Study Example in Health: A retrospective study in health might involve examining historical medical records of cancer patients to determine the effectiveness of a particular treatment protocol used in the past. Researchers can analyze the outcomes of these patients based on the treatment they received and other variables to gain insights into the treatment’s success rates.

Prospective Study Example in Health: A prospective study in health could involve tracking a group of pregnant women from early pregnancy through childbirth and beyond. Researchers would collect data on factors like prenatal care, diet, and lifestyle, and follow the women to monitor pregnancy outcomes, birth complications, and the health of their babies after birth. This type of study helps in understanding the factors that influence maternal and child health during and after pregnancy.

Cohort Study Design:

A cohort is a group of individuals who share a common characteristic or experience. For instance, a group of people born on the same day or during a specific period, like 1981, can form a birth cohort. The cohort design is a type of observational study in which one or more groups (cohorts) are followed over time, and subsequent assessments are made to determine the association between the initial characteristics or risk factors of the participants and specific outcomes or diseases. As the study progresses, the outcomes of participants in each cohort are measured, and researchers analyze the relationships with particular characteristics.

Example of a Cohort Study:

To investigate whether tobacco exposure is associated with the development of lung cancer, an investigator forms two groups (cohorts) of adolescents. One group consists of individuals who have never smoked tobacco and continue to refrain from smoking (unexposed), while the other group comprises tobacco smokers (exposed). The investigator then follows both groups for a specified period and observes how many individuals in each cohort develop the disease and how many do not. Below is a table illustrating the outcomes:

CohortDevelop DiseaseDo Not Develop DiseaseTotalIncidence of Disease
Smoke tobacco84291630000.028
Do not smoke tobacco87491350000.0174
Advantages of Cohort Studies:
  • Subjects in cohorts can be matched to limit the influence of confounding variables.
  • Cohort studies can demonstrate that potential causes precede the outcomes.
  • Original or secondary data can be used in this design.
  • Cohort studies are often less expensive and easier to conduct than randomized controlled trials.
Disadvantages of Cohort Studies:
  • Identifying cohorts can be challenging due to confounding variables.
  • Lack of randomization may lead to imbalances in patient characteristics.
  • Blinding or masking is difficult in cohort studies.
  • Outcomes of interest may take time to occur.

Additionally, they might take a long time to complete, potentially impacting the validity of findings. The lack of randomization in cohort studies also reduces their external validity compared to randomized studies.

Randomized Controlled Trial (RCT):

The primary difference between a Randomized Controlled Trial (RCT) and a cohort study is the random selection of samples. RCTs involve the random allocation of participants to different clinical interventions, including a control group. These trials seek to measure and compare the outcomes following the interventions. RCTs are purely experimental and quantitative in nature.

Example: In a study to determine whether painkillers are necessary for males who have just undergone circumcision, 200 eligible men were randomly assigned to two groups. One group received Panadol tablets as pain relief immediately after surgery, while the other group received a placebo. The results showed that a majority (90%) of patients given Panadol reported no pain, whereas over 90% of patients on the placebo reported significant pain.

Advantages of RCT:
  • RCTs are considered the most reliable form of scientific evidence.
  • They reduce spurious causality.
  • RCTs influence healthcare policy and practice.
Limitations of RCT:
  • The external validity of RCT results may be limited.
  • Ethical concerns may arise in some situations.
  • The time required to observe outcomes can be extensive.

Case Series/Clinical Series:

A case series is a descriptive study that follows a group of patients or subjects with known exposure, such as individuals who have received similar treatments or whose medical records are examined for exposure and outcomes. Case series can generate hypotheses for further studies but cannot establish causal relationships.

Internal validity in case series studies is generally low because they lack a comparator group exposed to the same intervening variables.

Correlation Study Design:

A correlation study investigates whether two variables are correlated, meaning an increase or decrease in one variable corresponds to a change in the other. However, correlation does not imply causation. Three types of correlation exist: positive, negative, and no correlation.

A correlation coefficient, which ranges from +1 to -1, is typically used to quantify the strength and direction of the correlation between variables.

There are three primary types of correlation:

  1. Positive Correlation: This type of correlation occurs when an increase in one variable is associated with an increase in another, and a decrease in one variable is linked to a decrease in the other. For example, an individual’s wealth may exhibit a positive correlation with the number of rental houses they own. This suggests that as wealth increases, so does property ownership.

  2. Negative Correlation: Negative correlation is observed when an increase in one variable is connected to a decrease in another, and vice versa. For instance, there might be a negative correlation between the level of education in a country and its crime rate. If education levels improve in a country, the crime rate tends to decrease. However, it’s essential to note that this does not mean that a lack of education directly causes crime. Both factors might share a common underlying cause, such as poverty.

  3. No Correlation (Uncorrelated): In cases of no correlation, changes in one variable do not correspond to changes in the other, and vice versa. For example, among millionaires, there may be no correlation between their level of wealth and their level of happiness. This indicates that an increase in wealth does not necessarily lead to an increase in happiness.

Comparative Study Design:

Comparative studies involve examining two or more cases, specimens, or events that share similarities in some aspects but differ in others. The goal is to determine the reasons for these differences and to generalize findings to larger groups from which the cases originated. The plausibility of generalization increases when several cases from the same group are considered.

Ethnographical Research Design:

Ethnographical research, often referred to as ethnography, involves the in-depth study of naturally occurring behavior within a particular culture or social group. Its primary aim is to understand the relationship between culture and behavior. Culture in this context refers to the beliefs, values, and attitudes of a specific group of people. Ethnographic research methods were developed by anthropologists to study and describe human cultures.

Characteristics of good ethnography, as described by Spindler & Hammond (2000), include:

  1. Extended Participant Observation: Researchers immerse themselves in the culture or social group they are studying and observe behavior over an extended period.

  2. Long Time at Site: Researchers spend a significant amount of time within the community or culture being studied to gain a deep understanding of their way of life.

  3. Collection of Large Volume of Materials: This includes detailed notes, audio recordings, video tapes, and other data, often without having specific hypotheses or predefined categories at the outset of the study.

Phenomenological Research Design:

Phenomenological research is the study of phenomena, which can be events, situations, experiences, or concepts as they are perceived by individuals. This approach aims to understand and describe the essence of lived experiences from the perspective of the participants. Phenomenology begins with the acknowledgment that there is a gap in our understanding and that clarification will be beneficial.

In phenomenological research, researchers seek to explore the essence and meaning of experiences as they are lived. It often involves in-depth interviews and analysis to uncover the common themes and structures that underlie these experiences. This research design is valuable in understanding how individuals make sense of the world and their experiences.

Grounded Theory Research Design:

Grounded theory is a systematic research methodology that aims to develop theories or concepts that are grounded in data. It was developed by sociologists Barney Glaser and Anselm Strauss in the 1960s. The primary goal of grounded theory is to generate new, abstract theories based on empirical observations, rather than testing existing theories.

Key features of grounded theory research include:

  • Data-Driven Approach: Grounded theory starts with data collection and analysis. Researchers gather and analyze data without preconceived notions or hypotheses.

  • Constant Comparison: Data is constantly compared to previously collected data, allowing researchers to identify patterns and categories.

  • Theory Development: Through iterative data analysis, researchers develop theories or concepts that explain the phenomenon under investigation.

  • Sampling: Researchers use purposeful sampling to select participants and gather data that is relevant to the research question.

Grounded theory is widely used in the social sciences, particularly in fields like sociology and psychology, to develop new theories and understand complex social phenomena.

Research Designs/Study Design Read More »

immunization schedule

Uganda National Immunization Schedule

Immunization in Uganda - A Comprehensive Guide for Health Workers

The Uganda National Expanded Programme on Immunization (UNEPI)

The Uganda National Expanded Programme on Immunization (UNEPI), officially launched in October 1993, was established to address critical challenges in immunization services. These included low immunization coverage, the use of non-potent vaccines, inadequate skills among health workers, limited community participation, and a lack of regular monitoring and evaluation. The re-launch of the program in 1997 marked a significant turning point, leading to great improvements in routine immunization coverage and a reduction in the incidence of Vaccine Preventable Diseases (VPDs) like measles.

UNEPI Strategic Objectives

The core objectives that guide UNEPI's work are:

  • To formulate and update national immunization policy, standards, and guidelines.
  • To ensure a consistent and reliable supply of potent and effective vaccines.
  • To increase both access to and demand for immunization services from the community.
  • To build technical and management capacity for the immunization program at all levels of the health system.
  • To continuously monitor disease trends and program performance to guide actions.

UNEPI Strategies

To achieve its objectives, UNEPI employs a multi-faceted approach:

  1. Service Delivery: Providing routine immunization through the national health delivery system, including static (at the facility) and outreach services.
  2. Logistics: Providing and maintaining an effective cold chain and logistics system at all levels.
  3. Communication: Improving the communication skills of health workers to effectively engage with parents, leaders, and communities.
  4. Supervision: Strengthening technical and administrative support supervision to ensure quality.
  5. Training: Providing technical guidance for both pre-service training of health workers and continuous on-the-job training.
  6. Partnerships: Strengthening partnerships with other child health programs, NGOs, civil society, religious organizations, and the private sector.
  7. Advocacy & Social Mobilization: Enhancing public education and community involvement to increase vaccine uptake.
  8. Injection Safety: Promoting and ensuring safe injection practices and proper waste management.
  9. Surveillance: Maintaining a robust surveillance system for vaccine-preventable diseases using the Integrated Disease Surveillance and Response (IDSR) approach.
  10. AEFI Management: Promoting the monitoring, investigation, and management of Adverse Events Following Immunization (AEFI).
  11. Supplemental Activities: Carrying out mass vaccination campaigns (Supplemental Immunization Activities - SIAs) against targeted diseases as needed.
  12. Innovation: Adopting internationally recommended approaches like Reaching Every District/Reaching Every Child (RED/REC) and developing strategies to reach hard-to-reach populations.
  13. Disease Control Goals: Strengthening specific disease control measures, including for measles, maternal and neonatal tetanus elimination, and polio eradication.

Roles and Responsibilities in Immunization Service Delivery

Central Level (UNEPI and National Medical Stores)

  • UNEPI: Policy and guideline formulation, strategic planning, resource mobilization, technical support and supervision, capacity building, and national monitoring and evaluation.
  • National Medical Stores (NMS): Procurement, storage, and distribution of vaccines, injection materials, and other logistics to the district level.

District Level

  • Implementation of national policies and plans.
  • Forecasting, ordering, and storing vaccines and logistics.
  • Distribution of supplies to lower-level health facilities.
  • Cold chain maintenance and repair.
  • Support supervision and on-the-job training for health facility staff.
  • Monitoring performance data (e.g., coverage, dropout rates, vaccine wastage) for action.
  • Conducting active surveillance for diseases like Acute Flaccid Paralysis (AFP), Neonatal Tetanus (NNT), and measles.

Health Facility Level (The Frontline)

This is where nurses and midwives play their most direct role.

  • Providing daily immunization services (static and outreach).
  • Counseling and health-educating parents/caretakers.
  • Screening every child visiting the facility for their immunization status to reduce missed opportunities.
  • Estimating vaccine needs, ordering, and storing them correctly.
  • Maintaining the vaccine refrigerator temperature between +2°C and +8°C and recording it twice daily.
  • Monitoring and reporting performance data (coverage, wastage, dropouts).
  • Tracking defaulters through home visiting and community engagement.
  • Working with community mobilizers like Village Health Teams (VHTs).
  • Ensuring safe injection practices and proper disposal of sharps in a safety box.

Community Level (VHTs, Parents/Caregivers)

  • Taking children for all scheduled immunizations and ensuring completion.
  • Participating in planning for outreach services.
  • Mobilizing other parents and community members for immunization.
  • Keeping the child's health card safe and presenting it at every health facility visit.

The Uganda National Immunization Schedule

The immunization schedule is the standard plan that guides all health workers in the country. It details the vaccines, doses, intervals, and administration sites. This schedule can change over time based on epidemiological data and new scientific discoveries.

Visit/Contact When it is Given (Age) Vaccine Given & Dose Disease(s) Prevented How it is Given (Route and Site)
1st AT BIRTH
(Within 24 hours is best)		 Oral Polio Vaccine 0 (OPV0) Polio 2 Drops in the mouth (Oral)
BCG Tuberculosis (severe forms like TB meningitis) 0.05ml Injection on right upper arm (Intradermal)
Hepatitis B (Birth Dose) Hepatitis B (prevents mother-to-child transmission) Injection on left upper thigh (Intramuscular)
Injectable Polio Vaccine (IPV1) Polio Injection on right upper thigh (Intramuscular)
2nd AT 6 WEEKS
(One and a half months)		 Pentavalent 1 (DPT-HepB-Hib 1) Diphtheria, Pertussis (Whooping cough), Tetanus, Hepatitis B, Haemophilus influenzae type B Injection on left upper thigh (Intramuscular)
Pneumococcal Conjugate Vaccine (PCV1) Meningitis and Pneumonia (caused by S. pneumoniae) Injection on right upper thigh (Intramuscular)
Rotavirus vaccine 1 Diarrhoea caused by Rotavirus Slow release into the mouth (Oral)
Oral Polio Vaccine 2 (OPV2) Polio 2 Drops in the mouth (Oral)
3rd AT 10 WEEKS
(Two and a half months)		 Pentavalent 2 (DPT-HepB-Hib 2) Diphtheria, Pertussis, Tetanus, Hepatitis B, Haemophilus influenzae type B Injection on left upper thigh (Intramuscular)
Pneumococcal Conjugate Vaccine (PCV2) Meningitis and Pneumonia Injection on right upper thigh (Intramuscular)
Rotavirus vaccine 2 Diarrhoea caused by Rotavirus Slow release into the mouth (Oral)
Injectable Polio Vaccine (IPV2) Polio Injection on right upper thigh (Intramuscular)
4th AT 14 WEEKS
(Three and a half months)		 Pentavalent 3 (DPT-HepB-Hib 3) Diphtheria, Pertussis, Tetanus, Hepatitis B, Haemophilus influenzae type B Injection on left upper thigh (Intramuscular)
Pneumococcal Conjugate Vaccine (PCV3) Meningitis and Pneumonia Injection on right upper thigh (Intramuscular)
Rotavirus vaccine 3 Diarrhoea caused by Rotavirus Slow release into the mouth (Oral)
5th At 6 months Malaria Vaccine 1 Malaria Injection on right upper arm (Intramuscular)
6th At 7 months Malaria Vaccine 2 Malaria Injection on right upper arm (Intramuscular)
7th At 8 months Malaria Vaccine 3 Malaria Injection on right upper arm (Intramuscular)
8th AT 9 MONTHS Measles-Rubella vaccine 1 Measles, Rubella Injection on left upper arm (Subcutaneous)
Yellow Fever vaccine Yellow Fever Injection on right upper arm (Subcutaneous)
9th AT 18 MONTHS Measles-Rubella vaccine 2 Measles, Rubella Injection on left upper arm (Subcutaneous)
Malaria Vaccine 4 Malaria Injection on right upper arm (Intramuscular)
Single dose 10 Year old girls Human Papilloma Virus (HPV) Vaccine Cancer of the cervix Injection on the upper arm (Intramuscular)
TETANUS-DIPHTHERIA (Td) FOR WOMEN OF CHILDBEARING AGE (15-49 years)
Td1 At first contact or as early as possible in pregnancy Tetanus Diphtheria (Td) Vaccine Tetanus, Diphtheria in the mother;
Prevents Neonatal Tetanus in the baby		 Injection on the upper arm (Intramuscular)
Td2 At least 1 month after Td1
Td3 At least 6 months after Td2
Td4 At least 1 year after Td3
Td5 At least 1 year after Td4

Vaccines and Practical Administration

Vaccines Used in the Immunization Schedule

BCG (Bacillus Calmette-Guérin) Vaccine

This is a live attenuated (weakened) bacterial vaccine. It is used in the immunization program to protect the child against tuberculosis. BCG is given in a single dose at birth or first contact. The vaccine is very sensitive to light and loses much of its potency when exposed to light. It is given by injecting the child in the skin (intradermally) at the right upper arm. The amount of 0.05 ml is recommended for children up to eleven (11) months of age, and 0.1 ml for children after eleven years.

Polio Vaccine

Polio vaccine is a live attenuated virus vaccine used in the immunization program to protect the child against poliomyelitis. The Sabin type is given orally (by mouth) in Uganda. Some countries use another type called Salk vaccine, which is given by injection.

Oral polio vaccine is given four times beginning:

  • at birth (polio 0);
  • at 6 weeks polio 1;
  • at 10 weeks polio 2, and
  • at 14 weeks polio 3 respectively.

2 drops in the mouth are recommended for each dose. It should be noted that booster doses are sometimes given to all children below five years of age in the entire country regardless of immunization status. This is done during national immunization days (NIDs), whose primary objective is to eradicate poliomyelitis. It is nice to remember that polio vaccine is made up of three polio viruses, and the oral polio vaccine is given four times to enable each of three viruses to stimulate the production of antibodies.

Pentavalent Vaccine

Pentavalent vaccine has 5 vaccines which include DPT and Hep.b & Hib. The DPT vaccine is commonly referred to as a triple vaccine because it is used to prevent three diseases, namely diphtheria, pertussis, and tetanus. The diphtheria and tetanus parts of the vaccine are made from the respective toxins, while the pertussis vaccine is made of killed bacterial antigen. It has become necessary to add hepatitis B and haemophylus influenza type b vaccines to DPT to form what is now known as the Pentavalent vaccine (five vaccines).

These are given three times because they do not stimulate the body to produce antibodies as well as the live attenuated vaccines. When the second and the third dose are given, the body’s memory of the earlier dose quickly leads to the production of more antibodies. The Pentavalent vaccine is given by injecting the child intramuscularly (in the muscle) at the left upper thigh.

It is given three times beginning:

  • at 6 weeks,
  • at 10 weeks, and
  • at 14 weeks, respectively.

A dose of 0.5 ml is recommended each time given.

Tetanus Toxoid Vaccine

This is a toxoid vaccine used in the immunization program to prevent children against neonatal tetanus. UNEPI targets all women of childbearing age (15-49 years) and pregnant mothers for tetanus toxoid (TT) vaccination. It is better and safe to give two doses of TT vaccine to any pregnant woman if you are not sure she has had TT in a previous pregnancy. The aim is to use the TT vaccine to provide passive immunity for unborn babies, through the transfer of the mother’s antibodies. This type of immunity reduces with time and is normally boosted by giving the child Pentavalent vaccines at 6 weeks after birth.

Pneumococcal Conjugate Vaccine (PCV 10)

PCV 10 consists of sugars (polysaccharides) from the capsule of the bacterium streptococcus pneumonia, which are conjugated to a carrier protein.

The PCV 10 contains serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, and 23F. It is highly effective and protects children younger than 2 years of age against severe forms of pneumococcal disease, such as meningitis, pneumonia, and bacteremia. It will not protect against these conditions if they are caused by agents other than pneumococcus or pneumococcal serotypes not present in the vaccine.

The World Health Organization and Ministry of Health recommend that infants be given three doses of PCV vaccine, at 6 weeks, 10 weeks, and 14 weeks. PCV should be integrated with DPT-HepB-Hib vaccination.

Rotavirus Vaccine

Rotavirus vaccine is a vaccine used to protect against rotavirus infections. These viruses are the leading cause of severe diarrhea among young children. The vaccines are safe. This includes their use in people with HIV/AIDS. The vaccines are made from weakened rotavirus.

The World Health Organization recommends the first dose of vaccine be given right after 6 weeks of age. Two or three doses more than a month apart should be given, depending on the vaccine administered. The vaccine is not recommended for use in children over two years of age.

Malaria Vaccine (RTS,S/AS01)

The malaria vaccine, known by its brand name Mosquirix™, is a landmark achievement in public health. It is a recombinant protein-based vaccine that targets the Plasmodium falciparum parasite, the most deadly species causing malaria in Africa. It works by preventing the parasite from infecting the liver and maturing, thus stopping the disease before it can cause symptoms. It is given in a four-dose schedule starting at 6 months of age, with subsequent doses at 7, 8, and 18 months. It is administered as an intramuscular injection in the upper arm.

Human Papillomavirus (HPV) Vaccine

The HPV vaccine is a crucial tool for cancer prevention. It is a recombinant vaccine that protects against specific high-risk types of HPV that are responsible for the vast majority of cervical cancer cases. In Uganda, it is targeted at 10-year-old girls before they are likely to be exposed to the virus through sexual activity. Providing the vaccine at this age ensures the strongest possible immune response. It is administered as an injection in the upper arm.

Administration of Vaccines: General Principles

Immunization coverage should be high to reduce disease transmission. As health workers, we should aim to achieve immunization coverage of over 80%. All children should be immunized at every opportunity. There is no contraindication for immunization. If immunization is done daily, this improves immunization coverage. Children with minor illnesses should be immunized. The misconception that sick children should not be immunized should be discarded. Very sick children admitted to the hospital should be immunized on discharge. Malnourished children should also be immunized. The danger of vaccine of any given type to the malnourished child is much less than the infection itself. For children with HIV/AIDS, BCG can spread rapidly and thus should be treated as an opportunistic infection.

Administering Vaccines: Practical Steps

Preparing Vaccines

Vaccines used in the immunization program are in different forms. Some vaccines are in powder form and must be dissolved in the diluent supplied with them, while others come in liquid form and will not need a diluent. There is a need to prepare the vaccine before immunization.

  • Preparing Polio Vaccine: To prepare this vaccine the following should be done: If a dropper is separate, attach it securely to the vial (bottle). Keep polio vaccine shaded from sunlight during the immunization session. Place the vial on a frozen icepack or place it in the sponge hole placed at the mouth of the vaccine carrier, which is provided for this purpose to maintain the temperature.
  • Preparing BCG and Measles Vaccines: The following should be done: Use the diluent provided for each vaccine. The diluent should be cold, +4°C – +8°C. Use different 9 ml syringes for mixing measles and BCG vaccines. Draw up the full required amount of the diluent provided as per instruction on the vial. Draw and expel mixture back into the bottle three times or until the vaccine is mixed. Do not shake the vial. BCG and measles vaccines should be placed on a frozen icepack or use the sponge in the vaccine carrier for maintaining the correct temperature. Draw 0.5 ml of measles vaccine (recommended dosage). Draw 0.05 ml of BCG vaccine for babies up to 11 months old and 0.1 ml for babies above 11 months of age (recommended dose).
  • Preparing DPT and TT: DPT and TT come in liquid form. You will not need to dissolve or mix them. Remove the metal top from the vial. Draw 0.5 ml into the sterile syringe. Remove bubbles. Keep the vaccine shaded from the light.
  • Preparing PCV 10: Ensure availability of a clean vaccine carrier and a sponge. The vaccine carrier should be able to close tightly. Condition icepacks prior to packing vaccines in a vaccine carrier to prevent freezing of PCV, TT, and DPT-Hep B-Hib. On a table with a plastic sheet: – Vaccines, diluent, and droppers – Thermometer – Cotton swab in a clean container – Clean water in a clean container for cleaning injection sites – A tin of vitamin A and a pair of scissors – AD syringe and needles – Child health cards – Child register.

Important Points to Remember Before Administering

  • Never take two vials of the same vaccine out of the vaccine carrier at the same time.
  • Do not mix vaccines until mothers and children are present.
  • Mix one vial of a particular vaccine at a time.
  • Keep opened vials of polio, measles, and BCG vaccines on a frozen icepack or use the sponge in the vaccine carrier. Their temperature must be carefully maintained.
  • Do not keep vials of DPT and TT vaccines directly on the frozen icepack.
  • Open the vaccine carrier when necessary.
  • NEVER SHAKE VACCINE VIALS!!!

After preparing vaccines, the next step is to administer them. Before administering vaccines, you should always remember the following important points:

  • Use one sterile syringe and needle per vaccine (antigen) per child or mother.
  • Avoid holding loaded syringes in your hand for long to avoid exposing the vaccine to heat or direct sunlight.
  • Inform each parent what type of vaccine you are giving the child, the possible reactions to it, what to do about the reactions, and when to bring the child back for more immunization.
  • Listen to parents and encourage questions.
  • Remove any child’s clothes that are in your way when vaccinating.
  • During immunization, ask the mother to hold the child firmly to restrict their movement during immunization.
  • Administer the vaccine.
  • Give specific health information about each vaccine.

Administration Techniques

  • Administering BCG:

    1. Clean the skin with cotton wool soaked in clean water and let it dry.
    2. Hold the middle of the child’s upper right arm firmly with your left hand.
    3. Hold the syringe by the barrel with the millimeter scale upward and the needle pointing in the direction of the child’s shoulder. Do not touch the plunger.
    4. Point the needle against the skin, barrel turned up about 3 cm above the thumb. Gently insert its tip into the upper layer of the skin (intradermally).
    5. Make sure that the needle is in the skin (intradermally) and not under the skin. If the needle goes under the skin, take it out and insert it again. If you bend the needle, replace it with another sterile one.
    6. Holding the barrel with your index and middle finger, put your thumb on the plunger.
    7. Holding the syringe flat (parallel to the surface of the skin), inject the vaccine intradermally.
    8. If the vaccine is injected correctly into the skin, a wheal, with the surface pitted like an orange peel, will appear at the injection site. An indication that the vaccine has been injected incorrectly is that the plunger will move much more easily when the needle is injected under the skin than when it is injected in the skin. If there is no local reaction, re-immunize the child.
    9. Give the mother health information about BCG, i.e., in 7-9 days, a small sore will appear at the site where the injection was given. The sore might ooze a bit and will last for 6-8 weeks. Keep the baby’s arm clean with soap and water. Do not put dressing or medicine on the sore. The sore will not hurt and it will heal by itself.
    10. Change the syringe and needle after each vaccine and each child.
    11. Fill in the immunization tally sheet in the BCG section.
    12. Administer the next vaccine.

  • Administering DPT Vaccine:

    1. Ask the mother to hold the child across her laps so that the front of the child’s thigh is facing upwards. Then ask her to hold the child’s legs from moving.
    2. Clean the site to be injected with a cotton swab moistened in clean water and let it dry.
    3. Place your thumb and index finger on each side of the place you intend to inject. Stretch the skin slightly.
    4. Quickly push the needle deeply into the muscle (intramuscular). Pull the plunger back; if there is blood in the syringe, withdraw the needle and discard the vaccine. Obtain a sterile syringe with a needle and new vaccine.
    5. If no blood appears in the syringe, inject 0.5 ml of vaccine.
    6. Withdraw the needle.
    7. Rub the injection spot quickly with a clean piece of cotton swab.
    8. Give health advice about DPT. Tell the mother that: DPT may cause some tenderness at the site which will go away after a few days, and may cause fever but it will subside in 24 hours.
    9. Fill the immunization tally sheet appropriately.
    10. Use another needle and syringe to vaccinate another child.

  • Administering PCV Vaccine:

    1. Explain to the mother that the child is going to be given two types of vaccines in the form of injections. One will be given in the right and the other in the left thigh.
    2. Explain to the parent the disease prevented by the vaccine, the number of doses in order to achieve the protection, and reassure her that there is no danger in giving two injections in one visit.
    3. Explain to the mother the likely side effects and how to manage them, then wash hands with soap and water, drip dry.
    4. Open the vaccine carrier and pick one vial of PCV and quickly check the expiry date and status of the vial.
    5. Observe the vial content for unusual appearance and particles. If either is observed, the vial must be discarded.
    6. Shake the vaccine vial gently to obtain a uniform solution.
    7. Draw 0.5 ml of the vaccine from the vial using an AD syringe and return the partially used vial in a sponge in a vaccine carrier.
    8. Instruct the mother on how to hold the child for vaccine administration.
    9. Clean the right upper outer thigh with a swab soaked in water and administer the vaccine intramuscularly.
    10. Press the injection site firmly for a few seconds. Do not massage.
    11. Dispose of the used syringe and needle immediately into the safety box. Do not put swabs in the safety box. Do not recap the needle.
    12. If a vial is opened for one child and another child is not immediately available to be vaccinated with the remaining vaccine dose in the vial, write on the vial the time it was opened and ensure that the vial is kept cool in the sponge pad and away from any potential contamination for 6 hours.

  • Administering Oral Polio:

    1. Ask the child’s mother whether the child has diarrhea. If yes, note this on the child’s card and tell the mother that this dose of polio needs to be repeated after one month. This child with diarrhea should have a total of 4-9 doses of polio vaccine depending on whether the child got polio 0 or not.
    2. Use the dropper or device supplied with the vaccine.
    3. If the child will not open the mouth, gently squeeze his/her cheeks to open his mouth.
    4. Put 2 drops of vaccine on the child’s tongue.
    5. Fill in the immunization tally sheet appropriately.
    6. Note that every child below 5 years of age should receive an extra 2 doses of oral polio vaccine (OPV) each year during national immunization days (NIDs), whether she/he was immunized before or not.

  • Administering Measles:

    1. Use a sterile syringe and needle for each injection. Draw 0.5 ml dose of mixed measles vaccine.
    2. Ask the mother to expose the child’s left outer upper arm and hold the child firmly to restrict their movement.
    3. Clean the injection site with a cotton swab soaked in clean water and let it dry.
    4. With the fingers of one hand, pinch the skin on the outer side of the upper arm.
    5. Hold the syringe at an acute angle to the child’s arm. Inject the vaccine subcutaneously.
    6. To avoid injecting the vaccine into a vein, withdraw the plunger slightly before injecting the vaccine. Never give the vaccine if blood is seen in the syringe.
    7. Press the plunger gently, inject 0.5 ml of vaccine.
    8. Withdraw the needle. If a drop of blood appears at the injection site, ask the mother to wipe it away with a piece of cotton wool.
    9. If blood is drawn back in the syringe, the vaccine should not be given. Use another needle and syringe to obtain new vaccine.
    10. Record the immunization in the immunization tally sheet.

  • Administering TT Vaccine:

    1. Pregnant mothers should be given two doses of TT vaccine (0.5 ml) a month apart. However, if it is not possible to establish whether the mother had previously been immunized with TT or whether the mother was a default from a previous dose, two doses should be given a month apart.
    2. Use a sterile syringe and needle for each injection.
    3. Clean the thigh with cotton wool moistened in clean water.
    4. Hold the thigh muscle between your thumb and forefinger.
    5. With your other hand, inject the vaccine intramuscularly.
    6. Withdraw the needle.
    7. Discard the needle and syringe into a safety box. Ensure you do not put swabs in the safety box. Safety boxes are collected and burned.
    8. Fill the immunization tally sheet.

    • Equipment/Logistics Needed for Safe Vaccination

    A well-prepared immunization session requires specific equipment to ensure vaccines are kept potent and administered safely.

    • Vaccine Carrier with Conditioned Ice Packs: A portable, insulated container to maintain the cold chain during an immunization session.
    • Foam Pad/Sponge: A slotted sponge placed in the top of the vaccine carrier to hold opened multi-dose vials and protect them from heat and direct sunlight.
    • Vaccines and their specific Diluents: The correct vaccines and diluents for the session.
    • Syringes and Needles: Including single-use Auto-Disable (AD) syringes and separate mixing syringes.
    • Safety Box (Sharps Container): A puncture-proof container for the immediate and safe disposal of used needles and syringes.
    • Cleaning Supplies: Cotton swabs and a bottle of clean water for cleaning injection sites.
    • Documentation Tools: Child health cards, immunization register, and tally sheets.
    • Supplemental Supplies: Vitamin A capsules and a pair of scissors to open the blister packs.
    • Cold Boxes and Ice Packs: Larger insulated containers used for transporting vaccines from a district store to a health facility.

    Post-Vaccination Counselling and Health Education

    Communication with the parent or caregiver after vaccination is a critical nursing role. It builds trust and ensures proper follow-up care.

    • Reassure parents of the vaccine's safety and explain the common, minor side effects, such as swelling and redness at the injection site, slight fever, or soreness.
    • Advise parents on how to manage these side effects (e.g., giving paracetamol for fever).
    • Offer integrated health education on topics like nutrition, hygiene, and the importance of breastfeeding.
    • Always ask mothers if they have any concerns and take the time to answer their questions respectfully.
    • Clearly inform the mother about the date of the next visit required for immunization.
    • Administer Vitamin A supplementation to children according to the national schedule (e.g., at 6 months and 12-59 months). If a child receives their first measles dose at 6 months, inform the mother the second dose is due at 18 months.

    Record Keeping: The Foundation of Program Monitoring

    Accurate record keeping is mandatory for the immunization program. All vaccines administered must be recorded in tally sheets and registers to monitor performance, check a child's immunization status, calculate coverage rates, and plan for future needs.

    The Immunization Register

    • The register must be clearly labeled with the name of the health facility.
    • It should include the names of the children (not parents), their date of birth, and their medical file/card number.
    • For each vaccine (BCG, Polio, Pentavalent, Measles, etc.), enter the date the dose was given. If a dose was missed or not given, it should be clearly indicated, often with a zero (0).
    • Note: Supplemental doses like extra OPV or Vitamin A given during campaigns are typically recorded on the child's health card, not in the main immunization register.

    Health Cards

    • Each child must have their own health card.
    • The card must contain essential identifying information: child’s name, mother’s name, date of birth, village, and the primary health unit.
    • It serves as the child's personal record of all vaccines received, including dates. Other health information, like Vitamin A administration, is also recorded here.
    • Always ensure the child’s card is up-to-date before administering any vaccine.

    The Refrigerator and Cold Chain Management

    The Vaccine Refrigerator

    The refrigerator is the most critical piece of equipment for storing vaccines at the health facility. It must be properly maintained and kept in good working condition at all times. All refrigerators must be maintained at a temperature between +2°C and +8°C.

    Types of Refrigerators Used in Immunization:
    • Solar direct drive (SDD) vaccine refrigerator.
    • Gas refrigerators (using Kerosene or paraffin).
    • Electric vaccine refrigerator.

    The refrigerator should also be able to freeze ice packs. These ice packs are used to keep vaccines cool in vaccine carriers during outreach sessions. Ice packs inside a vaccine carrier are referred to as Conditioned Icepacks.

    Preventive Maintenance and Repair

    All refrigerators should be serviced and maintained regularly (e.g., every 3 months). During maintenance, the following activities are done:

    • The refrigerator is cleaned thoroughly.
    • The thermostat setting is checked for accuracy.
    • The defrosting system is checked.
    • The cooling system and compressor are checked and cleaned.
    • The electrical connection or gas/kerosene system is checked.

    Managing Adverse Events Following Immunization (AEFI)

    An AEFI is any untoward medical occurrence which follows immunization and does not necessarily have a causal relationship with the use of the vaccine. It is important to respond appropriately to any AEFI.

    • Fever: Advise parents to give the child paracetamol (acetaminophen) in the correct dose for their weight. Do not give aspirin to children. Encourage plenty of fluids.
    • Swelling or Redness at the Site of Injection: This is usually a normal, mild reaction. Reassure the parent it will go away on its own. Do not give any drug or apply any substance to the site.
    • Swelling of the Limbs or Face, or Difficulty in Breathing: This is a sign of a potential severe allergic reaction and is a medical emergency. Do not give any drug. Advise the parent to seek medical attention at the nearest health facility immediately.
    • Loss of Weight, Generalized Body Swelling, Poor Feeding, or Coughing: These are unlikely to be side effects of vaccination and are more likely symptoms of an underlying condition like malnutrition or another illness. Refer the child to the health facility for assessment and treatment.
    • Diarrhea: This is most likely not related to vaccination. Ensure the child receives oral rehydration solution (ORS) or other appropriate fluids to prevent dehydration.

    Conducting Mass Vaccination Campaigns

    Mass vaccination campaigns, such as National Immunization Days (NIDs) or outbreak responses, require careful planning and execution.

    1. Planning and Training: Plan the campaign, identify target populations, and train healthcare workers on all procedures.
    2. Community Mobilization: Inform communities well in advance about the campaign's purpose, date, and location.
    3. Logistics: Ensure all necessary equipment (vaccines, syringes, safety boxes, cold chain equipment) is in place.
    4. Safety Measures: Implement infection control, safe waste disposal, and crowd control measures at vaccination sites.
    5. Vaccination Site Setup: Organize sites for an efficient flow of people from registration to vaccination to a post-vaccination observation area.
    6. Vaccine Administration: Follow standard procedures, ensuring one sterile syringe and needle per injection.
    7. Monitoring and Reporting: Monitor the campaign’s progress, track doses administered, and ensure AEFIs are reported and managed promptly.
    8. Documentation: Maintain detailed records of all vaccines administered, including tallies and vaccine wastage.
    9. Post-Campaign Evaluation: Evaluate the campaign’s success and identify areas for improvement.
    10. Follow-Up: After the campaign, ensure routine immunization services continue and that children receive follow-up doses as needed.

    Uganda National Immunization Schedule Read More »

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