Best Clinical Nursing Education Practices in Sub-Saharan Africa: An Integrative Literature Review

Purpose: The purpose of the study is to evaluate available evidence on clinical nursing education practices in Sub-Saharan Africa and to describe the best clinical nursing education practices in Sub-Saharan Africa to inform practice in the sub region. 

Methods: Ganong (1987) framework of integrated literature review was used to review articles published from January 2004 to May 2015 in Science Direct, EBSCO host, PubMed, Wiley Online Library and Google Scholar . Articles were included if they were published in English, on clinical nursing education practices, on pre-registration nursing education and on Sub-Saharan Africa. Author and setting, journal and year, design, population and sample, data collection and analysis method, focus of clinical nursing education, findings and recommendations were extracted from the included articles using Sparbel and Anderson’s (2000) data collection tool.

After scanning the titles of 261 975 articles pulled out by various key search words, 204 abstracts were read and 119 full articles retrieved for evaluation. 42 (16 quantitative, 17 qualitative, 3 mixed method and 6 programme evaluation reports) peer reviewed articles were finally included in the study through the consensus of three authors. A five staged thematic analysis (data reduction, data display, data comparison, drawing of conclusions and verification) was used to analyse the data in this study.

Results:  Majority (85.7 %) of the articles included in this study are from Southern Africa, 11.9% from East Africa and 2.4% from West Africa. Curationis recorded the most publications (47.6%) of articles included in this study). Out of the one hundred and sixteen (116) authors that appeared on the articles included in this study, majority (90) came from Sub-Saharan Africa whereas 26 were from institutions outside Sub-Saharan Africa. Out of the 35 multi-authored articles, fourteen (14) were authored from the same institution whereas thirteen (13) articles were published by authors from two different institutions, two (2) articles each were published by authors from three and four different institutions whereas four (4) articles were published by authors from more than four institutions.

The following best clinical nursing education themes were identified and described: Having a well-developed clinical education programme in place; synergy between Nursing Education Institutions (NEI) and clinical facility; roles of institutions, clinical instructors and students in clinical teaching and learning and Continuous Professional Development of clinical instructors.

From the findings of the study, best clinical nursing education practices in Sub-Saharan Africa were described in three phases: before, during and after clinical placement in addition to the effective communication, consultation and collaborative practices before, during and after clinical placement. 

Conclusion:  As very important as these practices are to clinical nursing education in SSA, the researchers hold the view that they may not be very responsive to the peculiar health needs of Sub-Saharan Africa as they are universal and not unique to Sub-Saharan Africa. This is asa result of the Eurocentric nature of Clinical nursing education research publications in Sub-Saharan Africa are Eurocentric and are not effectively meeting the peculiar health needs of Sub-Saharan Africa.

We therefore recommend that nursing education institutions within Sub-Saharan Africa appraise and inculcate the findings from this study into their clinical nursing education programmes while evaluating the programmes and products on how responsive they are to the peculiar health needs of the sub-region. Further studies should be conducted on how nursing education curriculum could be designed to meet the peculiar health needs of Sub-Saharan Africa. The eastern and western parts of Sub-Saharan Africa need to conduct and publish more works on clinical nursing education within their sub-regions. < style="text-align: justify;">As very important as these practices are to clinical nursing education in SSA, the researcher holds the view that they may not be very responsive to the peculiar health needs of Sub-Saharan Africa as they are universal and not unique to Sub-Saharan Africa. Clinical nursing education research publications in Sub-Saharan Africa are Eurocentric and are not effectively meeting the peculiar health needs of Sub-Saharan Africa.

We therefore recommend that nursing education institutions within Sub-Saharan Africa appraise and inculcate the findings from this study into their clinical nursing education programmes while evaluating the programmes and products on how responsive they are to the peculiar health needs of the sub-region. Further studies should be conducted on how nursing education curriculum could be designed to meet the peculiar health needs of Sub-Saharan Africa. The eastern and western parts of Sub-Saharan Africa need to conduct and publish more works on clinical nursing education within their sub-regions.