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Nursing students taken to boot camp in innovative educational strategy

19 October 2021 | Story André Damons | Photo Charl Devenish

Dr Annali Fichardt and Dr Champion Nyoni — Dr Champion Nyoni and Dr Annali Fichardt, together with Prof Yvonne Botma (not on the picture), from the School of Nursing at the University of the Free State (UFS) came in second for their research paper on this innovative educational strategy at the recent Faculty of Health Sciences’ Faculty Research Forum.

When South Africa went into hard lockdown due to the outbreak of the COVID-19 pandemic, the School of Nursing at the University of the Free State (UFS) adopted the conventional boot camp as an innovative way to continue learning and teaching clinical skills for its students.

School of Nursing leadership adopting an innovative educational strategy

The COVID-19 pandemic, specifically the hard lockdown of 2020, challenged the leadership of the School of Nursing to adopt innovative educational strategies to continue learning and teaching, especially for undergraduate nursing students. Adapting theory classes to the online space appeared easier due to the various enabling modalities in the university such as Blackboard, but the same could not be said about learning clinical skills. It is near impossible to learn clinical skills at home. The School of Nursing had to devise ways to facilitate learning of clinical skills in campus during the pandemic. Underpinned by the theory of deliberate practice, they used the boot camp as an innovative educational strategy to continue the learning and teaching of clinical skills.

Dr Champion Nyoni, Dr Annali Fichardt and Prof Yvonne Botma, who did research on this innovative educational strategy, came in second place at the recent Faculty of Health Sciences’ Faculty Research Forum. They also won the Kerneels Nel medal for best educational research paper in 2020.

Manuscript already accepted

The manuscript about their research has already been accepted by The African Journal of Health Professions Education and will be published next year.

“Deliberate practice is understood as a type of purposeful and systematic learning of skills requiring focused attention and is conducted to improve performance. Boot camps are synonymous with conventional training camps, such as used in the military, where specific skills are learnt, and the School of Nursing adopted the practice for this particular situation,” wrote the researchers in the manuscript.

According to them, the boot camps had the dual aim of developing foundational clinical skills for undergraduate nursing students, including sessions missed during the higher levels of lockdown, and preparing them for the ‘new’ workplace environment.

Educational institutions were compelled to adapt their education strategies during the pandemic and the innovation of the use of boot camps as a strategy for learning and teaching clinical skills is an example of what the School of Nursing applied immediately after the hard lockdown.

How the boot camps worked

Each student year group was allocated a week at the simulation laboratory. Each year group was then split into smaller groups to attend their boot camp on specific days of the week. The module outcomes determined the nature and number of clinical skills to be taught per camp.

All the students received a video recording of the clinical skills and associated learning material prior to the boot camp to prepare for the session. On the day of the camp, the group was further split into smaller manageable groups, which were stationed in smaller venues of the simulation laboratory with a preceptor.

Equipment and materials related to the clinical skills for the day were made available in all the venues. A central venue hosted the leading session facilitator, who provided foundational information about the clinical skill before a demonstration while being live-streamed to the other smaller venues. Students in smaller venues watched the leading facilitator via live streaming after which they had opportunities for clarification from their preceptor. All the students in the small groups then demonstrated the taught skills to the preceptor who immediately provided feedback.

This intervention commenced after the hard lockdown and continued for the whole of the year 2020.

Outcomes of the strategy

The boot camps appeared to have influenced the learning and teaching of clinical skills positively, but the strategy is an emergency solution only in response to COVID-19 and is not regarded as suitable for long-term educational purposes. Students’ clinical outcomes appear to have improved compared to previous years and they appreciated the efforts taken by their educators in facilitating the learning of clinical skills and re-integrating them into the clinical environment.

“We always encourage our students to be innovative in their own practice, – the boot camps were an exceptional demonstration of practising what we preach,” says Dr Nyoni.

The infrastructure, the educators, and the leadership of the School of Nursing appeared to be enablers for the effective influence of this strategy. The boot camps were located at the state-of-the-art simulation facilities at the school that have multiple venues and facilities for live streaming. Teamwork among the educators in each year group drove the process through reflecting on their own practice.

News Archive

Higher than expected prevalence of dementia in South African urban black population

2010-09-22

Prof. Malan Heyns and Mr Rikus van der Poel

Pilot research done by University of the Free State (UFS) indicates that the prevalence of dementia, of which Alzheimer’s disease is only one of the causes, is considerably higher than initially estimated. Clinical tests are now underway to confirm these preliminary findings.

To date it has been incorrectly assumed that dementia is less prevalent among urban black communities. This assumption is strongly disputed by the findings of the current study, which indicates a preliminary prevalence rate of approximately 6% for adults aged 65 years and older in this population group. Previous estimates for Southern Africa have been set at around 2,1%.

The research by the Unit for Professional Training and Services in the Behavioural Sciences (UNIBS) at the UFS and Alzheimer’s South Africa is part of the International 10/66 Dementia Research Group’s (10/66 DRG) initiative to establish the prevalence of dementia worldwide.

Mr Rikus van der Poel, coordinator of the local study, and Prof. Malan Heyns, Principal Investigator, say worldwide 66% of people with dementia live in low and middle income countries. It is expected that it will rise to more than 70% by 2040, and the socio-economic impact of dementia will increase accordingly within this period. 21 September marks World Alzheimer’s Day, and this year the focus is on the global economic impact of dementia. Currently, the world wide cost of dementia exceeds 1% of the total global GDP. If the global cost associated with dementia care was a company, it would be larger than Exxon-Mobil or Wal-Mart.

The researchers also say that of great concern is the fact that South Africa’s public healthcare system is essentially geared toward addressing primary healthcare needs, such as HIV/Aids and tuberculosis. The adult prevalence rate of HIV was 18,1% in 2007. According to UNAIDS figures more than 5,7 million people in South Africa are living with HIV/Aids, with an estimated annual mortality of 300 000. In many instances the deceased are young parents, with the result that the burden of childcare falls back on the elderly, and in many cases elderly grandparents suffering from dementia are left without children to take care of them. “These are but a few reasons that highlight the need for advocacy and awareness regarding dementia and care giving in a growing and increasingly urbanized population,” they say.

Low and middle income countries often lack epidemiological data to provide representative estimates of the regional prevalence of dementia. In general, epidemiological studies are challenging and expensive, especially in multi-cultural environments where the application of research protocols relies heavily on accurate language translations and successfully negotiated community access. Despite these challenges, the local researchers are keen to support advocacy and have joined the international effort to establish the prevalence of dementia through the 10/66 DRG.

The 10/66 DRG is a collective of researchers carrying out population-based research into dementia, non-communicable diseases and ageing in low and middle income countries. 10/66 refers to the two-thirds (66%) of people with dementia living in low and middle income countries, and the 10% or less of population-based research that has been carried out in those regions.

Since its inception in 1998, the 10/66 DRG has conducted population based surveys in 14 catchment areas in ten low and middle income countries, with a specific focus on the prevalence and impact of dementia. South Africa is one of seven LAMICs (low and medium income countries) where new studies have been conducted recently, the others being Puerto Rico, Peru, Mexico, Argentina, China and India.

Mr Van der Poel says participating researchers endeavour to conduct cross-sectional, comprehensive, one-phase surveys of all residents aged 65 and older within a geographically defined area. All centres share the same core minimum dataset with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non-communicable risk factor questionnaires, disability/functioning, health service utilization and caregiver strain).

The local pilot study, funded by Alzheimer’s South Africa, was rolled out through an existing community partnership, the Mangaung University of the Free State Community Partnership Programme (MUCPP).

According to Mr Van der Poel and Prof. Heyns, valuable insights have been gained into the myriad factors at play in establishing an epidemiological research project. The local community has responded positively and the pilot phase in and of itself has managed to promote awareness of the condition. The study has also managed to identify traditional and culture-specific views of dementia and dementia care. In addition, existing community-based networks are being strengthened, since part of the protocol will include the training and development of family caregivers within the local community in Mangaung.

“Like most developing economies, the South African population will experience continued urbanization during the next two decades, along with increased life expectancy. Community-based and residential care facilities for dementia are few and far between and government spending will in all probability continue to address the high demands associated with primary healthcare needs. These are only some of the reasons why epidemiological and related research is an important tool for assisting lobbyists, advocates and policymakers in promoting better care for those affected by dementia.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za
21 September 2010

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