School of Medicine

Implementation of diploma nurse-training curriculum in selected nurse training institutions in South- Rift Region, Kenya

Thu, 01 Jan 2026 00:00:00 GMT

Implementation of diploma nurse-training curriculum in selected nurse training institutions in South- Rift Region, Kenya Towett, Philip Background: Graduates of the Kenya Registered Community Health Nursing (KRCHN) diploma program are vital to the frontline healthcare workforce, delivering important services in various clinical settings. Successful implementation of the KRCHN diploma curriculum requires adequate resources, trained educators, supportive clinical placements, and technology integration to develop skilled nurses. However, concerns exist about the gap between theory and practice, questioning the readiness of newly qualified nurses to provide quality care. There is also limited research on the implementation of the diploma nurse training curriculum in Kenya. Objectives: The study aimed to evaluate the implementation of the diploma nurse training curriculum in selected nurse-training institutions. Specific objectives were to assess the adequacy of teaching resources, nurse educators’ level of preparedness, the capacity of clinical placement sites for developing students' clinical skills, and the integration of emerging healthcare trends and technologies into the curriculum. Methods: This study was based on John Dewey’s experiential learning theory, highlighting the value of hands-on experiences. A mixed-methods approach employed a descriptive cross-sectional design in selected nurse training institutions in the South-Rift region. The study included 159 senior nursing students selected through random sampling, along with purposively selected nurse educators, principals, and nurse managers. Data collection utilized questionnaires, Key Informant Interviews, and Focus Group Discussions. Quantitative data was analyzed with descriptive and inferential statistics, while qualitative data was thematically analyzed. Findings were presented in tables and narrative form. Results: Educators and students rated classroom resources as most inadequate (M=3.77, SD =1.06) and (M=3.95, SD = 0.43), but differed on the lowest adequacy, with library resources and simulation equipment, respectively. Students’ concern was the adequacy of simulation equipment (M=3.50, with the highest SD=1.43). Students rated educators’ preparedness highest for effective teaching methodologies (M = 4.18, SD = 1.06), use of practical examples (M = 4.00, SD = 1.09), and timely feedback (M = 3.97, SD = 1.25). Mentorship and guidance received lower ratings (M = 3.55, SD = 1.13). Educators rated integrating practical case studies into their teaching (M = 4.56, SD = 0.50), evidence-based methodologies (M = 4.27, SD = 0.65), and continuous professional development (M = 4.25, SD = 0.57) highly. Concerns were noted regarding institutional support for development (M = 3.88, SD = 0.86). Nurse managers noted knowledge gaps among some educators, especially when guiding students in areas outside their specialty. Students rated the adequacy of exposure to real patient care low (M = 3.71, SD = 1.13821) and supervision effectiveness (M = 3.79, SD = 1.37502). Educators also reported insufficient clinical exposure (M = 3.79, SD = 0.63). Nurse managers highlighted challenges with high student-to-instructor and student-to-patient ratios that affected clinical learning. Students rated use of technology-enhanced learning tools like simulators (M=3.8, SD = 0.94), while educators rated (3.59, SD= 0.62), suggesting moderate and low utilization of digital learning methods, respectively. Nurse managers noted that students lacked adequate exposure to emerging healthcare technologies. Conclusion: The successful implementation of the diploma nurse-training curriculum relies on adequate teaching resources, nurse educators’ preparedness, a supportive clinical environment, and adaptability to emerging technologies. However, resource shortages, inadequately prepared educators, and the deficiency in the capacity of clinical sites hinder optimal curriculum implementation. Recommendations: The Nursing Council of Kenya should ensure training institutions and clinical sites uphold standards for training safe, competent nurses. Institutions must invest in teaching resources, support educator development, utilize digital learning tools, and adhere to guidelines for student-to-instructor ratios. Further research on the relationship between students’ self-efficacy and curriculum implementation is also recommended.

Academic achievement in biomedical sciences and its correlates among students of bachelor of nursing science program in Uganda

Thu, 01 Jan 2026 00:00:00 GMT

Academic achievement in biomedical sciences and its correlates among students of bachelor of nursing science program in Uganda Clement, Munguiko Background: Biomedical science courses such as anatomy, physiology, and biochemistry are critical components of nursing education, providing the foundational knowledge necessary for effective clinical practice. Despite their importance, academic achievement in these courses among nursing students remains low globally, with failure rates ranging from 20% to 50%. However, in Uganda, the extent of this problem and the factors associated with it remain poorly understood. Objectives: This study aimed to examine the level of academic achievement and sociodemographic, student educational and institutional factors influencing it among students in Bachelor of Nursing Science (BNS) program in Uganda. Methods: This mixed-methods study, guided by Critical Realism philosophy and Constructivist learning theory, was conducted at four purposively selected Ugandan public universities between March and July 2024. It employed cross-sectional and descriptive qualitative design for the quantitative and qualitative study aspects respectively. The qualitative study included 12 purposively sampled teaching staff, while the quantitative study used a census approach to enroll 208 students. Data were collected through key informant interviews and a self-administered questionnaire. Quantitative analysis involved Welch’s analysis of variance, Pearson correlation, and a linear mixed-effects model, while qualitative data were analyzed thematically. Results: The study found that academic achievement in biomedical sciences among nursing students had improved over time but remained context-dependent, with an overall failure rate of 8.41%. Physiology had the highest mean GPA (2.86 ± 0.768), while anatomy had the lowest (2.62 ± 0.825), leading to an overall GPA of 2.80 ± 0.788. Most students scored C (37%) and D (33.7%) letter grades. Similarly, one teaching staff stated: “There is a little bit of improvement in performance now”. Older age (e.g., 35+, β = -0.70, 95% CI: -1.25--0.16) and coming from a region outside central Uganda (e.g., Northern region, β = -0.43, 95% CI: -0.74--0.12) were sociodemographic factors associated with lower GPAs. Selecting nursing as a lower-choice career option (e.g., fourth choice, β = 0.62, 95% CI: 0.30-0.93) and using uncollaborative learning methods (e.g., rarely participating in group discussion, β = -0.61, 95% CI: -1.21- -0.12) were student educational factors associated with higher and lower GPAs respectively. Previous secondary education performance did not significantly influence academic achievement in biomedical sciences, despite its role in admission decisions (r = 0.1163). Not receiving feedback (e.g., lecturers not giving feedback on progressive test, β = -0.54, 95% CI: -0.93 --0.14) and using problem-based teaching method (β = 0.48, 95% CI: -0.05 --1.91) were some of the institutional factors associated with GPA. Conclusion: Academic achievement in biomedical sciences among BNS students in Uganda is reported to have improved but remains suboptimal, with overall failure rate of 8.41%. Key factors that influence academic achievement include socio-demographics (age, region of origin), student educational choices and learning approaches (career preference, collaborative learning), and institutional practices (feedback to students, competence-based teaching methods). Notably, prior academic performance at high school did not significantly predict success in biomedical science courses at university, despite its use as a criterion for university admission. Recommendations: To improve academic achievement, universities should provide targeted academic support to older students and those from regions outside central Uganda, strengthen career guidance at secondary level to align students’ interests with nursing education, encourage group discussions and peer-led learning strategies to enhance student engagement and comprehension, ensure regular and timely feedback on assessments to support learning progress, and promote the contextually appropriate use of problem based learning. Universities and government could also consider reviewing the current admission criteria of students into the BNS program.

Basic nursing training and leadership preparedness of nurse managers in South Rift and South Nyanza, Kenya

Thu, 01 Jan 2026 00:00:00 GMT

Basic nursing training and leadership preparedness of nurse managers in South Rift and South Nyanza, Kenya Chebet, Annah Towett Background: Effective leadership and management are vital for strengthening global health systems, yet they remain under-prioritized in low- and middle-income countries (LMICs). Despite the essential role of nurse leaders in maintaining service delivery amid evolving epidemiological demands, training deficiencies often leave them feeling underprepared for managerial responsibilities. In Kenya, Mid-Level Nurse Managers (MLNMs) are central to hospital unit operations; however, significant knowledge gaps exist regarding whether basic nursing training sufficiently prepares them for these leadership roles. Objectives: The objectives were to assess nurse managers' level of preparedness for MLNMs’ leadership role, determine the level at which basic nursing training prepares nurses for MLNMs’ leadership roles, assess the contribution of role-induction programs to MLNMs’ leadership role preparedness, and determine MLNMs’ training needs for leadership role preparation. Methods: The study was grounded on Henri Fayol’s management theory and Frederick Taylor’s principles of scientific management. A mixed-methods study design employing a descriptive, cross-sectional approach was conducted in 9 hospitals and 4 Diploma nursing training institutions selected in South Rift and Nyanza, using a multi-level sampling process. The study population involved 68 purposively selected MLNMs and 7 Nursing Directors (NDs). Data was collected using pretested instruments adapted from validated tools, including self-administered questionnaires, Focus Group Discussions (FGDs), Key Informant Interviews (KII), and a document review checklist. Quantitative data was analyzed using frequency tables, percentages, mean, and mode, while Qualitative data was analyzed thematically. Results: More than half (56.9%) of the MLNMs perceived their level of preparedness for leadership roles as above average, 24.6% excellent, 15.4% average, and 3.1% below average. About 57%, 41%, and 2% of respondents rated their satisfaction with nursing training for leadership roles as satisfied, somewhat satisfied, and dissatisfied, respectively. This is largely due to a focus on theory (65%) through lectures, a change in assessment focus, and a one-month clinical rotation in leadership. Role induction programs contributed to leadership role preparation as follows: formal leadership training (M=4.84, SD = .412, Skw -2.502), Mentorship (M=4.69, SD = .499, Skw -1.196), Supportive supervision (M=4.66, SD = .565, Skw -1.430), ‘On-the-job (M=4.60, SD = .552, Skw -.955), and Preceptorship (M=4.35, SD = .734, Skw -.899). Nurse managers stated that formal leadership training, on-the-job training, mentorship, and supportive supervision significantly contribute to preparedness for the leadership role. They noted being appointed to leadership directly or through progressive promotion without structured leadership role preparation. Managers felt least prepared for budgeting and expressed a need for formal training in resource management. Conclusion: Majority of the respondents rated their leadership preparedness as suboptimal. Basic nursing training was inadequate due to overemphasis on theory, a shift in assessment focus, and limited clinical experience. Formal leadership training, on-the-job training, mentorship, preceptorship, and supportive supervision play a significant role in improving leadership readiness. To effectively fulfill their leadership roles, MLNMs require formal leadership training, resource management training, particularly in budgeting, and training in emotional intelligence. Recommendation: Hospital management teams (HMTs) should develop strategies to enhance the leadership preparedness of MLNMs. Nursing training institutions should reassess the leadership and management aspects of basic nursing programs, focusing on budgeting content and the length of clinical rotations for leadership training. Moreover, HMTs should introduce formal leadership training, structured role-induction programs, and training in emotional intelligence to build the capacity of their MLNMs.

Early surgical outcomes of children with mechanical intestinal obstruction at Moi teaching and referral hospital, Kenya

Tue, 01 Oct 2024 00:00:00 GMT

Early surgical outcomes of children with mechanical intestinal obstruction at Moi teaching and referral hospital, Kenya Agade, Ivy W; Saula, Peter W.; Maiyo, Francis Background: Intestinal obstruction constitutes the largest proportion of abdominal surgical emergencies in the paediatric and adult patients in Sub-Saharan Africa, including Kenya. It is associated with high postoperative surgical complication and mortality rate in low resource healthcare systems. Methods: A prospective mixed methods study with consecutive sampling procedure was carried out from September 2021 to June 2023. Pediatric patients from birth to 14 years, with mechanical intestinal obstruction were included in the study. Categorical data was analyzed in frequencies and percentages and continuous data was analyzed using measures of central tendency and measures of dispersion. Bivariate and multivariate associations between the dependent and independent variables were assessed with a p value of less than 0.05 being statistically significant. Results: The final study population was 318 participants. Majority of participants were male with neonates comprising almost one third of participants. Classical symptoms were present in a majority of patients at initial presentation. Intussusception (34.6%) was the leading acquired aetiology of paediatric mechanical intestinal obstruction. Operative surgical management was in 94.6% of participants. Surgical complications were present in 61.1% of participants. The commonest surgical complication was surgical site infection in 16.9%. Overall mortality rate was 10.2% with 23.3% among neonates and 4.9% in older children. Referral status was statistically associated with mortality (p<0.001). Intestinal atresia had the highest case-specific mortality rate. Age, presence of comorbidity were factors associated to postoperative complications and mortality (p<0.05). Conclusions: The overall mortality rate was 10.2%. A higher mortality was seen among neonates compared to older children.