TABLE OF CONTENTS
Title Page … … … … … … … … i
Approval Page … … … … … … ii
Certification … … … … … … … … iii
Dedication … … … … … … … … iv
Acknowledgement … … … … … … … … v
Table of Contents … … … … … … … … vi
List of Tables … … … … … … … … ix
List of Figures … … … … … … … … xi
Abstract … … … … … … … … xii
CHAPTER ONE: INTRODUCTION
Background of the Study … … … … … … … … 1
Statement of the Problem … … … … … … … … 4
The Purpose of the Study … … … … … … … … 5
The Objectives of the Study … … … … … … … … 5
Research Questions … … … … … … … … 6
The Significance of the Study … … … … … … … 6
Scope of Study … … … … … … … 7
Operational Definition of Terms … … … … … … … 7
CHAPTER TWO: LITERATURE REVIEW
Brief History and Trends of Nursing Education … … … … … 9
Factors Affecting Nursing Education … … … … … 12
The Concept of Curriculum and Curriculum Implementation … … … 15
Factors Affecting Implementation of Curriculum … … … … … 17
Classroom Management in Curriculum Implementation … … … … 17
Educators in Curriculum Implementation … … … … … … 18
Classroom Environment in Curriculum Implementation … … … … 20
Students in Curriculum Implementation … … … … … … 21
Resource Materials in Curriculum Implementation … … … … … 21
Resource Centre in Curriculum Implementation … … … … … 24
Theoretical Framework … … … … … … … … 26
Cognitive Theory … … … … … … … … 28
Empirical Review of Related Literature … … … … … … 34
Curriculum for Generic Nursing Education in Nigeria … … … … 35
Curriculum Objectives of Generic Nursing Education … … … … 36
Summary of Reviewed Literature … … … … … … … 38
CHAPTER THREE: RESEARCH METHODOLOGY
Research Design … … … … … … … … 39
Are of Study … … … … … … … … 39
Population of the Study … … … … … … … … 40
Sample … … … … … … … 40
Sampling Procedure … … … … … … … … 41
Instrument for Data Collection … … … … … … … 42
Validity of Instrument … … … … … … … … 42
Reliability of Instrument … … … … … … … … 43
Ethical Consideration … … … … … … … … 43
Procedure for Data Collection … … … … … … … … 44
Method of Data Analysis … … … … … … … … 45
CHAPTER FOUR: DATA ANALYSIS AND RESULTS
Demographics of Respondents … … … … … … … … 46
Summary of Findings … … … … … … 80
CHAPTER FIVE: DISCUSSION OF MAJOR FINDINGS
Discussion … … … … … … … … 86
Limitation of Study … … … … … … … … 92
Suggestion for Further Studies … … … … … … … … 92
Recommendations … … … … … … … … 92
Summary … … … … … … … … 93
Conclusion … … … … … … … … 94
ABSTRACT
This study focused on assessment of implementation of generic nursing curriculum in selected Nigerian universities. It particularly focused on identifying the difficulties associated with implementation of the generic nursing curriculum by nurse educators and students and exploring the opinions of Heads of Department on the implementation of the generic nursing curriculum.
Purposive sampling was used to select the universities. Stratified sampling was used to select proportionate size of students from 300, 400, and 500 levels. Simple random sampling was used to select the students. All the available nurse educators were used for the study. The data for this study was collected using two sets of structured questionnaire, one for nurse educators and the other for students, and in depth interview for the heads of the department, developed and validated by the researcher. The questionnaires were administered on the spot in the class setting to both lecturers and students as well as individually to lecturers in their offices. The interview questions were mailed to the heads of department with areas of emphasis highlighted to serve as guide and prevent wandering away from the research topic. The responses to the questionnaires were presented as frequencies and their percentages on tables, while the responses from the interview questions were categorised, coded and presented on tables. The data from the quantitative and qualitative study were triangulated to bring out the facts. The result of the findings showed that there is acute shortage of academic staff in the implementation of the generic nursing curriculum in all the universities used for the study. The major manpower/personnel problems identified are inadequate number of lecturers (100%) and (80.9%) for nurse educators and students respectively, inadequate number of clinical instructors in the clinical areas and inadequate number of practical demonstrators in the school. The findings also showed that there are difficulties with material resources in the implementation of the generic nursing curriculum. The major difficulties are inadequate number of computers, inadequate classrooms (92.9%) and (94.8%) for nurse educators and students, and inadequate equipment in nursing/midwifery laboratory. Nurse educators encounter difficulties with teaching in the implementation of the generic nursing curriculum. Major problems identified are too many courses in the curriculum, inadequate number of teaching aids, and excessive work load (91.7%) each. Students encounter difficulties with learning in the implementation of the generic nursing curriculum. Major problems identified are lecture overload (80.5%), and lack of audio-visuals. Major difficulties in clinical posting are insufficient clinical experience (75.6%), lack of cooperation from nurses working in the clinical area (71.4%), absence of clinical instructors/preceptors, and difficulty in transportation of students to the clinical areas (74.2%). The major administrative problems encountered in the implementation of generic nursing curriculum are inadequate funding (100%), inadequate staff training and development (81.8%) and inadequate incentive for staff (72.7%). Based on the findings of this study, it is recommended among others that departments of nursing should endeavour to ensure that the necessary manpower and personnel are in place for the effective and successful implementation of the curriculum. Material resources should be made available and the university authority should ensure that teachers and students alike have easy access to these materials; emphasis should be laid on ensuring that the library is properly equipped, provision of ICT materials which include computers and audio-visual learning aids, as well as provision of equipment in the nursing laboratory, midwifery laboratory, and the provision of instructional materials in the resource centre of the institution. Lecture time should be properly planned.
CHAPTER ONE
INTRODUCTION
Background to the Study
Education is absolutely essential in the development of any country. It is an indispensable factor in the modern search for the solution of man’s problems. Curriculum is the crux of the whole educational process. Without curriculum no educational endeavour can be conceived (Neeraja, 2007). Curriculum according to Neeraja (2007) is a systematic and planned series of intended learning conceived to be imparted through selected, planned, organised and sequential learning experiences for a defined group of learners to attain the stated aims of a particular educational programme. It is a blue print or plan of the school that includes the experiences for the learners to encounter.
According to Offorma (1994), teachers set up learning opportunities aimed at enabling learners acquire the desired knowledge, skills, and values specified in the curriculum.
Curriculum implementation which is the focus of this study is the translation of curriculum plan into practice (Offorma, 1994). After the curriculum has been planned and developed, the next line of action is normally done in the classroom (which by extension includes laboratories, libraries, workshops, studios, playfields) by the joint efforts of the teachers and the learners in the execution of an educational programme (Akpochafo and Filho,2006).
In the United States, the American Association of Colleges of Nursing (AACN) has maintained the baccalaureate system of nursing education for transforming the health system and how health care professionals are educated (AACN, 2008). The global community has embraced BNSc (Bachelor of Nursing Science) as the entry point to the profession. The entry point into the nursing profession in Australia ,Belgium, Canada, Denmark, Ireland, Finland, Italy, Spain, Norway, Netherlands, New Zealand, Norway, and Philippines is the BNSc (Etowa,2012).
University education in Nigeria, as it is the case in other developing countries has a specific mission of producing graduates grounded in the key generic skills, who on the basis of the high-quality higher education they offer would provide the needed catalyst for the nations socio-political and economic development. According to Akpochafo and Filho (2006), Nigerian universities at present are not producing high quality graduates.
Many factors in the teaching-learning environment may make it difficult for a teacher to effectively implement the planned curriculum. These factors may be in the learners, classroom situation, teacher and physical environment. The National Universities Commission (NUC) observed that in both Federal and State owned universities enrolment far outstrips the capacity to cater for enrolees (Akpochafo and Filho, 2006). This has the capacity to mar the implementation of curriculum when there are insufficient facilities and manpower to cater for the students.
A study of the graduate labour market found that employers believe “university graduates are poorly trained and unproductive on the job and short comings are particularly severe in oral and written communication and in applied technical skills” (Dabalen, Oni, and Adekola, 2001).
Generic nursing education is a formally recognised programme of study in a university providing learners with the opportunity to acquire, integrate, apply, and synthesise knowledge in the delivery of nursing care and preparation for post basic education in nursing specialties or advanced nursing practice (Happell, 2009). Baccalaureate nursing education is therefore a systematic and planned programme of study in the university through which learners are exposed to various experiences of art and science basic to nursing to help them in delivering evidence-based care that is holistic in nature.
In recent years the education of nurses has been the subject of considerable interest within and outside the profession because of the increasing complexity of modern health services and demands made on the education of nurses. This has led to various reforms in nursing education worldwide. Passage of the Comprehensive Nurse Training Act in 1964 prompted the American Nurses Association (ANA) Committee on Education to study nursing education, practice and scope of responsibilities. At the time, the study recognised the increasing complexity of health care and changes in practice, raising concerns about hospital – based diploma education programmes. Subsequently, in 1965, the ANA Board of Directors adopted the Committee on Education’s statement which became the ANA’s “position paper” and contained the recommendation that the minimum preparation for beginning professional nursing practice should be baccalaureate degree education in nursing, (American Nurses Association, 2013). In 2004, the American Association of Colleges of Nursing (AACN) Board of Directors reaffirmed its position that baccalaureate education is the minimum level required for entry into professional nursing practice (American Association of Colleges of Nursing, 2008).In the United Kingdom, a fundamental shift in the approach to nursing education was initiated by the recommendation of the Project 2000 report. One of its recommendations was that nursing education should be part of university education (Akinsanya, 2001).
In Nigeria, nursing profession took a tremendous leap with the establishment of the Department of Nursing at the University of Ibadan in 1965. The purpose of the programme was to produce teachers and administrators to meet the needs of the rapidly expanding health services in Nigeria and Africa as a whole. This programme has metamorphosed into generic nursing education in universities offering nursing education programme in Nigeria (Ajibade, 2012). This demands a curriculum in which a broad liberal arts education is balanced with the natural and behavioural sciences. The curriculum for the generic nursing education in Nigeria University programme is developed by individual universities, but with National Universities Commission (NUC) and Nursing and Midwifery Council of Nigeria (NMCN) benchmark as the basis for the development of the curriculum in respective universities. It is a five – year programme of study in nursing comprising courses for basic nursing, midwifery, and bachelor of nursing science
Many factors can be responsible for the ineffective implementation of the curriculum, which will no doubt affect the quality of the product as well as the overall health system. It is therefore pertinent to investigate the problems that militate against effective implementation of generic nursing curriculum in Nigerian Universities.
Statement of the Problem
Ade-Ajayi (2002) asserted that Nigerian universities today produce half-baked graduates with all the first class materials being asked to repeat their first degree in some universities abroad. According to Akpochafo and Filho (2006), the National Universities Commission (NUC) observed that both Federal and State owned universities exceed their carrying capacity in students intake which will have implications in curriculum implementation. The general pattern of academic deterioration in universities worldwide prompted the world conference on Higher Education convened by the United Nations Educational Scientific and Cultural Organization (UNESCO) in Paris in October, 1998. The conference undertook an exhaustive analysis of the challenges facing university education in contemporary society. It observed that the universities were failing in developing generic skills in the students due to faulty implementation of the curriculum (Akpochafo and Filho, 2006).
It is observed that generic nursing programme in Nigeria started since 1973. Many Nigerian universities are currently running the programme, but there is no documented evidence of the challenges encountered in the programme.
The researcher having had her post graduate education at the University of Nigeria, observed that most nurse educators and students of the nursing department in Department of Nursing, University of Nigeria, Enugu campus complain of one problem or the other that hamper effective implementation of generic nursing curriculum such as, inadequate skilled manpower, instructional materials, inadequate time for classroom and clinical teaching etc. These complaints have not been empirically generated and documented. Statistics also show that generic student nurses perform poorly in the Nursing Council Final Qualifying Examination for General Nursing and Midwifery. (Nursing and Midwifery Council of Nigeria, 2006, 2007, 2008, 2009, 2010 and 2011). See Appendix VI. The present study is therefore designed to assess the implementation of generic nursing curriculum in selected Nigeria Universities.
The Purpose of the Study
The purpose of the study is to assess the implementation of generic nursing curriculum in selected Nigerian universities.
The Objectives of the Study
- To identify the difficulties associated with implementation of the generic nursing curriculum by nurse educators.
- To identify the difficulties associated with implementation of the generic nursing curriculum by students.
- To explore the opinions of Heads of Department on the implementation of the generic nursing curriculum.
Research Questions
The following research questions guided the study:
- What are the difficulties associated with implementation of the generic nursing curriculum by nurse educators?
- What are the difficulties associated with implementation of the generic nursing curriculum by students?
- What are the opinions of the heads of department on the implementation of the generic nursing curriculum?
The Significance of the Study
The findings of this research will show the types of problems in implementing the generic nursing curriculum. They will provide the basis for finding solutions to such problems and also for modifying the curriculum where necessary.
It will provide the essential information that could be used at the institutional level.
The universities that are yet to commence a generic nursing programme will have prior knowledge and will therefore guard against such problems.
The nurse educators will be better informed and will thereby map out strategies that will help to make their teaching more effective. On the part of the students, the findings of the research will provide basis for finding solution to their problems as it will guide them to plan towards effective learning. The Heads of the Department of Nursing will also be better informed and will thereby map out strategies to effectively coordinate the programme.
The study assessed the implementation of the generic nursing curriculum in order to provide a literature so as to encourage further research in this field.
Scope of Study
The study was carried out in five universities offering generic nursing programme in Nigeria – University of Nigeria, Enugu campus, University of Calabar, Obafemi Awolowo University Ile Ife, University of Ibadan, and Ahmadu Bello University, Zaria. The study involved students of 300, 400, and 500 levels, lecturers and the heads of department. Problems of skilled manpower, material resources, teaching and learning of the courses and administration were identified by the students and lecturers. The opinions of the heads of department were explored on the implementation of the generic nursing curriculum.
Operational Definition of Terms
For the purpose of this study, the following terms are operationally defined:-
- Assessment of generic nursing curriculum: The opinions of the heads of department on the implementation of generic nursing curriculum and the difficulties encountered by nurse educators and students in the implementation of generic nursing curriculum.
- Difficulties Encountered by Nurse Educators: These are problems associated with manpower, material resources, teaching of the courses, and administration of the generic nursing programme that lecturers encounter while implementing the generic nursing curriculum.
- Difficulties Encountered by Students: These are problems associated with manpower, material resources, that students encounter while undergoing the generic nursing programme. These difficulties may affect learning.
- Nurse Educators: The nurses teaching in the nursing department of the selected universities with a minimum of Bachelor of Science degree.
- Generic Nursing Curriculum: The University approved five – year academic programme for training of nurses as designed by Department of Nursing based on National Universities Commission and Nursing and Midwifery Council benchmark.
- Curriculum Implementation: It is the administration, teaching and learning of the courses in the generic nursing curriculum.