Scaling Up Nurse Education: An Evaluation of a National PhD Capacity Development Programme in South Africa

Background: The global shortage of nursing professionals educated at baccalaureate level and beyond has been highlighted and the impact of this shortage is apparent in each continent. The consequence of this is a substantial shortfall in nurses with postgraduate research degrees to meet the demands of academia, advanced nursing roles and knowledge generation. Within South Africa nursing education outputs do not meet demands, reflecting the global statistic of less than 1% of nurses having a doctoral degree. A national PhD capacity development programme was introduced to scale up nurse education and to address these nursing shortages.

Objective: To evaluate a national PhD programme within the context of a nurse education strategy and a national health insurance plan in South Africa.

Design: A comparative effectiveness research (CER) design was employed.

Setting: The setting was in South Africa between 2012 and 2014, a country with 51.7 million inhabitants and approximately 130,000 registered nurses.

Participants: Participants included three cohorts of PhD candidates, programme facilitators, supervisors and key stakeholders.

Methods: Data from a one day consultative workshop were analysed using an inductive thematic analysis. Data from evaluation reports, compiled over a three year period, were analysed using descriptive statistics. A mapping of the alignment of the PhD topics with healthcare priorities, and a comparison of the development of nurse education, of the national and international funder were conducted.

Results: The evaluation reports rated the programme highly. Three themes were identified from the workshop. These were, “support” with the sub-themes of burden, leveraging and a physical supportive place; “planning” with the sub-themes of the national context and practice, and “quality” with the sub-themes of processes and monitoring and evaluation. The mapping of PhD topics revealed that research was in line with development priorities. However, further investment and infrastructural changes were necessary to sustain the programme and its impact.

Conclusions: To address sustainability and capacity in nations scaling up nurse education and healthcare insurance, it was recommended that top-up degrees for diploma educated nurses be developed along with, the implementation of a national nursing strategy for PhD and post-doctoral training encompassing clinical practice implementation and collaboration.