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19 October 2021 | Story André Damons | Photo Charl Devenish
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

UFS cardiologists and surgeons give children a beating heart
2015-04-23

Photo: René-Jean van der Berg

A team from the University of the Free State School for Medicine work daily unremittingly to save the lives of young children who have been born with heart defects by carrying out highly specialised interventions and operations on them. These operations, which are nowadays performed more and more frequently by cardiologists from the UFS School of Medicine, place the UFS on a similar footing to world-class cardiology and cardio-thoracic units.

One of the children is seven-month-old Montsheng Ketso who recently underwent a major heart operation to keep the left ventricle of her heart going artificially.

Montsheng was born with a rare, serious defect of the coronary artery, preventing the left ventricle from receiving enough blood to pump to the rest of the body.

This means that the heart muscle can suffer damage because these children essentially experience a heart attack at a very young age.

In a healthy heart, the left ventricle receives oxygenated blood from the left atrium. Then the left ventricle pumps this oxygen-rich blood to the aorta whence it flows to the rest of the body. The heart muscle normally receives blood supply from the oxygenated aorta blood, which in this case cannot happen.

Photo: René-Jean van der Berg

“She was very ill. I thought my baby was going to die,” says Mrs Bonizele Ketso, Montsheng’s mother.

She says that Montsheng became sick early in February, and she thought initially it was a tight chest or a cold. After a doctor examined and treated her baby, Montsheng still remained constantly ill, so the doctor referred her to Prof Stephen Brown, paediatric cardiologist at the UFS and attached to Universitas Hospital.

Here, Prof Brown immediately got his skilled team together as quickly as possible to diagnose the condition in order to operate on Montsheng.

During the operation, the blood flow was restored, but since Montsheng’s heart muscle was seriously damaged, the heart was unable to contract at the end of the operation. Then she was coupled to a heart-lung machine to allow the heart to rest and give the heart muscle chance to recover. The entire team of technologists and the dedicated anaesthetist, Dr Edwin Turton, kept a vigil day and night for several days.

Prof Francis Smit, chief specialist at the UFS Department of Cardiothoracic Surgery, explains that without this operation Montsheng would not have been able to celebrate her first birthday.

“After the surgery, these children can reach adulthood without further operations. Within two to three months after the operation, she will have a normal active life, although for about six months she will still use medication. Thereafter, she will be tiptop and shortly learn to crawl and walk.”

Mrs Ketso is looking forward enormously to seeing her daughter stand up and take her first steps. A dream which she thought would never come true.    

“Write there that I really love these doctors.”

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