Clinical supervision of midwifery students at the University Teaching Hospital school of nursing and midwifery in Lusaka,Zambia

Abstract

Clinical supervision plays a significant role in the acquisition of psychomotor skills by student midwives during training leading to the provision of high quality midwifery care. However, the acquisition of the psychomotor skills required for successful practice and learning can only be acquired if student midwives are supported and guided by clinical supervisors in their learning environments.The main objective was to determine factors influencing clinical supervision of student midwives at UTH school of midwifery in Lusaka district. A sequential explanatory mixed method study design with both quantitative and qualitative methods was used. The study population comprised 124 nurses and midwives working in Lusaka urban district at University Teaching Hospital (UTH) Women and Newborn Hospital, Lusaka College of Nursing and Midwifery and five urban health facilities which included four (4) first level hospitals and one (1) health center. A total of 14 student midwives participated in focus group discussions (FGDs). Self-administered questionnaires were used to collect data from the nurses and midwives and a FGD guide was used to guide discussions with the student midwives at Lusaka College of Nursing and Midwifery. Three FGDs were conducted. Quantitative data was entered into the Statistical Package for the Social Sciences (SPSS) version 22 for windows. Chi-square test was used to test associations among variables. The confidence interval was set at 95% with a significance level of 0.05. Qualitative data was analysed using content analysis. Themes and categories were classified by looking for repeated ideas or patterns of thoughts. The findings showed that a high percentage of clinical supervisors (89.5%) had not been trained in clinical supervision, and most respondents had moderate knowledge on clinical supervision of students. More than half of the respondents (63%, n=78) exhibited inadequate supervision skills. The attitudes of all the supervisors towards supervision were positive. A large percentage of respondents (73%) were competent in clinical supervision. However, the learning environment was considered to be poor by most respondents (61%). The study revealed a significant association between clinical supervision and the respondents’ knowledge on clinical supervision (p-value of 0.00). The current study showed that clinical supervisors were untrained and had inadequate supervision skills and the learning environment was poor. There is need, therefore, to

train clinical supervisors and improve the students learning environment in order to enhance teaching and learning. The study offers a valuable insight into the factors influencing students’ midwives learning in clinical learning environment.