Model for training of reflective neonatal nurses in a South African context

Abstract

In post-basic education of neonatal nurses the challenge is in how to prepare reflective practitioners for their role in neonatal nursing practice. Generic outcomes from SANC and higher education are available that promote the education of reflective neonatal nurses, but do not give much clarity on exactly how this is to be achieved. This prompted the research question: ‘How can professional nurses in a South African context be educated to become reflective neonatal nurses?’ This study aims to develop a model for the education of reflective neonatal nurses in a South African context. To achieve the aim of the study, an exploratory and descriptive design was used, which was in essence qualitative and contextual in nature, to develop the model. The model was developed following the process for developing nursing theory: a topic of interest was selected, which was a framework of several concepts; relationships between the concepts supported by evidence was identified and clarified; and relational statements were organised to describe the components of the conceptual model. The structural components of the model were identified as a purpose (specific learning-, critical- and end-product outcomes of education of reflective neonatal nurses); a framework (higher education, nursing education and neonatal nursing practice in a South African context); dynamics (reflective learning); a recipient (neonatal nurses as students); an agent (neonatal educator); and a procedure (education programme). The study had three phases that had different goals, but occurred simultaneously, overlapping and interrelating in the process of developing the model. The first phase was identifying and clarifying the concepts related to educational aspects of importance in education of reflective neonatal nurses. It was based on theoretical inquiry, concept analysis and inductive and deductive reasoning to describe the framework of education (higher- and nursing education), reflective learning, neonatal nursing students, role of the educator and educational approaches. The second phase was identification and clarification of concepts in neonatal nursing practice related to education of reflective neonatal nurses. This was done by means of inductive and deductive reasoning, based on the extensive experience and knowledge of the researcher in the field, followed by literature control and confirmed by peer review of neonatal nursing Model for education of reflective neonatal nurses in a South African context experts and/or educators. As a result the competences and professional characteristics expected of reflective neonatal nurses were synthesised and the content outline of an educational programme was deduced. The third phase was constructing and describing a model for educating reflective neonatal nurses in a South African context, which involved developing relational statements linking the concepts clarified in the previous two phases. Experts in model development, higher education, nursing education and / or neonatal nursing practice evaluated the model in this phase. Ethical considerations of relevance in this study were especially informed consent by the participants (peer- and expert review), and to give credit to all sources used. Strategies to enhance trustworthiness included triangulation of sources, prolonged engagement of the researcher, clarification of the underlying assumptions of the study, thick description of the process, and validation by means of peer- and expert review. Recommendations were made regarding dissemination of the model, practice, education and further research.