Biosciences for antibiotic resistance : a mixed methods study assessing the level of knowledge and learning experiences among preregistration nursing students in Uganda

Nantamu, M 2021, Biosciences for antibiotic resistance : a mixed methods study assessing the level of knowledge and learning experiences among preregistration nursing students in Uganda , PhD thesis, University of Salford.

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Abstract

Biosciences form the basis on which our understanding of human biology and body functions is established. They guide nurses to detect risks to health and improve and sustain health through informed decisions. Task-shifting has expanded the scope of practice for nurses in Uganda and increased the need for improved understanding and application of bioscience knowledge in clinical practice. In Uganda, there is limited evidence of the success of current science teaching in supporting the retention and application of biosciences in clinical practice. Antibiotic resistance, a bioscience concept on the preregistration curriculum and applicable to clinical practice, was used in this study as an indicator of the level of bioscience knowledge among nursing students. The aim of this study was to understand nursing students’ current level of bioscience knowledge, the associated factors, and their experiences of learning and applying biosciences in Uganda. This study utilized a two-phase sequential explanatory design. Phase one used two sources of data. Initially, secondary data originally collected from 203 students in one university was used to assess performance between bioscience and non-bioscience courses. Then, a quantitative cross-sectional descriptive survey was used to understand the level of explicit knowledge of antibiotic resistance and the factors associated with acquisition of that knowledge. Data were collected from 207 students in the 3rd and 4th year, across four universities. Phase two utilized a hermeneutic phenomenological design to explore students’ experiences of learning and applying biosciences in clinical practice. Qualitative data was collected using three focus groups (n = 19) from one university, to explain and expand on the quantitative results. Failure rates in biosciences and non-biosciences were 15% and 0.5% (n = 203) respectively. The bioscience and non-bioscience scores were statistically significant for each student (Z= -11.203, p = 0.000) and by group (p = 0.000). Higher failures rates of 21.3% (n = 207) were recorded from the survey data. Sixty percent and 70% (n = 207) of the students failed core bioscience knowledge and clinical application questions on antibiotic resistance, respectively. Only 30% reported good antibiotic use and 48% passed questions on antibiotic resistance. Overall bioscience success was statistically associated with age group (p = 0.033), route of entry on the nursing program (t = 13.438, p = .001), employment status (p = 0.001), and university (p = 0.025). Core bioscience knowledge was significantly associated with the university of study (p = .000). Clinical application of bioscience knowledge was significantly associated with age group (p = 0.049), route of entry (z = -3.307, p = 0.001), and employment status (z = -3.277, p = 0.001). Four themes emerged from the qualitative phase: the bioscience curriculum; teaching methods; clinical supervision; and assessment and feedback. There was consensus that the bioscience portion of the nursing curriculum was crowded. Students perceived lectures to be ineffective in conveying complex bioscience concepts. Medical doctors on the wards were perceived to be the most important resource of bioscience knowledge, although integration to clinical nursing practice was limited. Bioscience teaching in practice settings was sidelined in favour of clinical nursing skills. There was a general lack of clinical supervision. The model of clinical supervision was perceived to be ineffective in supporting the integration and application of biosciences. Participants expressed dissatisfaction with their assessments and feedback due to poor alignment with teaching, assessor absenteeism, and reduced time allocated to assessments. This limited their ability to identify learning gaps and improve on bioscience knowledge and application to clinical practice. Nursing students in Uganda struggle to retain and apply biosciences. Several challenges within their universities and clinical placement sites contribute to the bioscience problem. This study calls for reforms in bioscience curricula, teaching, clinical supervision, and assessments to support registered nurses to competently tackle healthcare challenges such as antibiotic resistance upon graduation.

Item Type: Thesis (PhD)
Contributors: Wilding, MA (Supervisor), Ackers, HL (Supervisor) and Probyn, JE (Supervisor)
Schools: Schools > School of Health and Society > Centre for Applied Research in Health, Welfare and Policy
Funders: Commonwealth Scholarship Commission (UK)
Depositing User: Miriam Nantamu
Date Deposited: 17 Feb 2022 14:39
Last Modified: 17 Mar 2022 02:30
URI: http://usir.salford.ac.uk/id/eprint/62501

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