Selected outcomes of community-oriented, problem-based nursing programmes in South Africa

Abstract

Whilst there is a significant body of research on the outcomes of problem-based learning (PBL) programmes (Albanese and Mitchell, 1993; Vernon and Blake, 1993), there is little information regarding the outcomes of community-oriented programmes (COL) for nursing students. Between 1994 and 1997, four university schools of nursing implemented problem-based, community-oriented learning (COL) programmes. This research sought to describe, evaluate and compare the outcomes of graduates from these four universities with graduates who had followed conventional programmes.

Research objectives: These were to describe and explore the incorporation of illness prevention and health promotion of graduates from PBL/COL programmes and non-PBL/COL programmes in South Africa, as described by the graduates and their supervisors. Secondly, to describe whether and how the graduates from PBL/COL and non-PBL/COL programmes engaged themselves in continued learning.

Research methodology: This was a qualitative evaluation study, which is descriptive and comparative in nature. In-depth interviews were held with the graduates and their supervisors about six months after completion of their training. Use was made of Miller and Crabtree's (1994) Template Analysis Style and of Benner's (1984) interpretative approach to analyze data. Analysis was done using the NVIVO computer programme. This programme was used to manage the categories which were developed with regard to each concept as the analysis proceeded.

Findings: Both the graduates and the supervisors appeared to have difficulty describing activities relating to health promotion and illness prevention. Only three types of health promotion were described--mass education, increasing personal skills and creating a supportive environment. The most commonly mentioned means of illness prevention were health education and medical-surgical asepsis. A few graduates described activities which indicated that they had taken context into consideration during patient care.