Evaluation of student learning in the midwifery nursing science: A performance assessment approach

Previous research on student learning and performance aimed at developing staff research skills highlighted the discrepancies which contribute to an increasing failure rate by student nurses. The study was, however, limited as a result of the sampling method used. The students experienced the courses as problematic.

The paper reports on student learning and performance, specifically in the Midwifery discipline. The study is comprised of a literature review and a questionnaire survey for first-year Midwifery students. A questionnaire dealing with the following basic areas was developed:

• The students' personal background.
• The students' study environment.
• The students' study habits.
• The medium of instruction.
• Orientation.
• Teaching strategies.
• Social and cultural matters.
• Personality characteristics of the lecturers.
• The teaching and learning environment.
• Student accompaniment in the practical areas.
• Learning academic values.

The paper attempts to identify the strong and the weak points of both the students and the lecturers in Midwifery Nursing Science, so that corrective steps may be taken timeously to resolve educational problems.

1. Introduction

This project provided funds to the institutions to embark on programs aimed at developing and improving teaching and learning in higher education. Amongst other things, funds were provided for the workshops aimed at developing personnel at the Nursing College of the Free State (Welkom campus) and for conducting research.

The study was conducted so as to identify the factors that may impact both negatively and positively on students' learning. It was worth conducting the study as it revealed a great deal of information where improvements can be made so as to ensure quality teaching.

2. The research problem

3. Literature review

According to the philosophy and policy of the South African Nursing Council (SANC) (1992:3), an awareness of socio-cultural factors which influence nursing in the community is fundamental. Accompaniment is indispensable in all teaching situations. In the clinical practice area all registered nurses or midwives are indispensable in the accompaniment of students (SANC, 1992:5).

4. Method

A questionnaire was distributed to the respondents. It included both open- and closed-ended questions. Factors addressed were in the categories: students' personal background; study environment; study habits; medium of instruction; orientation; teaching strategies; social and cultural matters; personality characteristics of lecturers; teaching and learning environment; student accompaniment in the practical areas; and, lastly, learning academic values.

As this questionnaire is a replicated version of the previous one it was not pretested. The previous questionnaire was pretested and was found to be valid and reliable.

The design followed is both descriptive and exploratory. It is descriptive as it gives a detailed picture of student learning in the Midwifery Nursing Science discipline. It also describes the views, beliefs and attitudes of first year Midwifery students towards effective teaching and learning. It is exploratory because it gives new insights into the performance of both students and lecturers in Midwifery Nursing Science.

5. Results

5.1 Personal background

5.2 Study environment

5.3 Study habits

5.4 Medium of instruction

5.5. Orientation

5.6 Teaching strategies

• Group discussion
  Respondents indicated that this method was never used in Midwifery.

• Lecture method
  Respondents indicated that this method is the best.

• Study guides
  100% of the respondents indicated the need to consult textbooks even when one has the study guide. Textbooks give more insight into the course.

• Video
  54% were not in favour of the use of video as a medium of instruction as the one in question was full of mistakes that could not be rectified easily.

• Supplemental instruction
  64% of the respondents indicated that they participated in supplemental instruction in their first year in Anatomy. It was very useful as it improved their marks.

• Demonstration method
  All the respondents were in favour of the demonstration method as it reinforced information. 54% of the respondents indicated that the use of videos to demonstrate procedures to the students is not useful because the lecturer is not there to elaborate on some issues.

• Case study method
  82% indicated that the case study method is useful in both classroom and clinical situations because it helps students to think critically and analytically.

• Peer group teaching
  73% of the respondents were not in favour of peer group teaching because students lack 'teaching' skills and undermine each other.

5.7 Social and cultural matters

5.8 Personality characteristics of midwifery lecturers

5.9 Teaching-learning environment

5.10 Student accompaniment

5.11 Learning/academic value

6. Discussion

• Regarding age, all respondents are above 20 years. This could be regarded as an indication that students should be able to engage in self-directed learning.

• The fact that 82% of the respondents indicated that they use their own rooms at the nurses' residence for studying and not the college library could be contributed to the fact that the semester in which the study was conducted, was the time when students were in practica. When students are in practica, they use the library less often as compared to when they are in theory.

• Time devoted to studying for tests and examinations is reasonable, as there was a 97% pass rate in theory by the same group.

• The pregnancy part of the Midwifery course was experienced as being problematic by 91% of respondents. This could be contributed to the fact that a newly appointed lecturer was assigned to do this part of the course; and she still needed some in-depth knowledge of the subject. Steps were taken by the respondents to correct the situation. This is evident in the NCOFS OTE 4.6 form for acknowledgment of poor progress. The lecturer was subsequently made aware of the problem.

• Amongst the various teaching strategies used in the discipline, the lecture method is still popular. Lecturers need to review their teaching strategies so that they can engage fully in the paradigm shift where their roles will have to change from that of being lecturers to that of facilitators.

• A larger percentage of respondents (54%) were not in favour of the use of a video even though it can be a useful tool in teaching. These issues will have to receive urgent attention.

• Social and cultural matters did not seem to be a big problem to students practicing Midwifery. However, those isolated cases of negative attitudes by the registered nurses towards the students will have to be attended to.

• Personality characteristics of Midwifery lecturers were rated reasonably; however, there are some discrepancies with regard to identification of learning problems of individual students and the intervention thereof. Lecturers need to recognise their role in academic support so that learning is enhanced.

• All respondents are comfortable with the use of English as a medium of instruction; however, there are some isolated cases where videos used in teaching and learning are in Afrikaans. This matter will have to be followed up.

• 36% of the respondents indicated that accompaniment at the clinics was not adequate.

7. Recommendations

• Review of the orientation program to ensure its relevance and applicability.

• Development of student-, self- and peer-evaluation tools so that strong and weak points can be identified earlier and corrective steps taken.

• Utilisation of the Midwifery clinical meeting for discussion of problems experienced by students in clinical situations.

• Encouragement of senior registered nurses in the wards where students are placed for their practica to develop evaluation tools for their respective departments.

• Implementation of staff development programs for lecturers to utilise the latest methods of teaching as necessitated by the paradigm shift, for example, the implementation of Problem-based Learning in daily teaching.

• Encourage students to utilise the library even when allocated to clinical areas, as there is valuable information they can gather.

• Extensive staff orientation and induction for the newly appointed lecturers.

• Use of a video for demonstrations only after the lecturer has demonstrated the procedure once and live.

• Implement the strategy of reflecting on teaching practice.

• Make use of teaching portfolios as a way to document and evaluate quality teaching.

• Maximise student accompaniment at the clinics by motivating for better transport facilities since transport is one of the main problems.

8. Conclusion

One cannot agree more with what the 1997 Australian Teacher of the Year, Tom Stannage (UWA) said: "We should listen a lot more to what our students have to say" (Murphy, 1998: iv).

References

Grey, P. (1995). Teacher talk: A journey into feminist Pedagogy. Journal of Nursing Education, 34(2), 11-14.

Mellish, M. & Brink, H. (1990). Teaching the Practice of Nursing. 3rd Edition. Durban: Butterworths.

Murphy, E. (1998). Lecturing at University. 1st Edition. Curtin University of Technology, Bentley: Paradigm Books.

Murphy, E. (1985). You can write: A do it yourself Manual. South Melbourne: Addison Wesley Longman.

Quinn, F.M. (1991). The principles and practice of nurse education. 2nd Edition. London: Chapman and Hall.

Radloff, A. et. al. (1997). Success in Learning: Your guide to tertiary studies through open, distance and flexible learning. 1st Edition. Curtin University of Technology, Bentley: Paradigm Books.

South African Nursing Council (1992). Philosophy and Policy. Pretoria: SANC.

Walter, T.L. & Siebert, A. (1993). Student Success: How to succeed in College and still have time for your friends. Ohio: Harcout Brace Johavonicho College.