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CHAPTER3 THEORETICAL FRAMEWORK
INTRODUCTION
The previous chapter presented rev1ew of literature in order to identify factors suggested as facilitative or impeding to clinical learning. Common concepts were then used as framework of this study.
This chapter presents the theoretical framework for the current study. The purpose of-the framework according to LoBiondo-Wood and Harber (1994: 144) is to « provicje a,frame of reference that is a base for observations, definitions of concepts,researchn designs, interpretations and generalizations. » In other words, the theoretical framework serves as the guide to systematic identification of logical and precise relationships among variables.
THEORETICAL FRAMEWORK
Theoretical framework as defined by Po lit and Bungler (1993: 109) refer to « a well-formulated deductive system of abstract formal statements ». It may also be viewed as « a set of interrelated constructs, definitions and propositions that presents a systematic view of the phenomenon, by specifYing relationships among variables, with the purpose of explaining and predicting the phenomenon », LoBiondo-Wood and Harber (1994: 143).
Furthermore, theoretical framework is described as a map that gives direction with regards to methods for the conduct of the study, and guides the interpretation, evaluation and integration ofthe study findings, (LoBiondo-Wood and Harber 1994).
The researcher chose the humanistic theories as the basis for this study with the belief that these theories provide insights into factors, which influence human growth and fulfilment in the context of student learning in the clinical environment.The humanistic theory of learning is concerned with feelings and experiences, which lead to the personal growth and individual fulfilment.
The humanistic framework, according Maslow (1971), Rogers (1983) and Kno_wles (1990) in Quinn (1995) combines the views of three theorists. The three concur that their approach « involves the study of man as a human being, with thoughts, feelings and experiences »,Quinn (1995: 99). Their viewpoint is summarized as « The psychological stance that focuses not so much on a person’s biological drives, but on their goals; not so much on stimuli impinging on them, but on their desires to be or to do something; not so much on their past experiences but on their current circumstances; not so much on life conditions perse, but on subjective qualities of human experiences, the personal meaning of an experience to persons, rather than on their objective observable responses », Quinn (1995: 100).
This theory has relevance to the current study, which seeks to explore factors in the clinical learning environment, which provide experiences that foster student growth and individual fulfilment.
According to the humanistic theorists, the goal of education is to assist an individual to become the best he is able to be, or facilitate for the student to become a fully functioning person. For the achievement of this goal, the theorists propose several factors to be considered. However, for the purpose of this study, only those thought to be relevant are discussed. These included; the establishment of a climate conducive to learning. This applies to the physical, human and the interpersonal environment, which can either be classroom or clinical. For the purpose ofthis study, the focus is on the clinical learning environment.
Determinants of an Effective Clinical Learning Environment
The following factors were identified, (Quinn, 1995: 101) as important determinants of effective clinical learning environments in the clinical setting. These are summarized below:
A Humanistic Approach to Students
Qualified staff role Treat students with kindness Are approachable and helpful to students Provide support for students to learn Are aware ofstudents as learners rather than just pairs ofextra hands; Foster students’ self-esteem Qualified nursing staff act as student supervisors, assessors or counsellors They provide opportunities for students to ask questions, attend medical rounds, observe new procedures, and have access to clients’ records Non-nursing professionals constitute members of the team, and contribute to the learning environment.
Team Approach
Qualified staff Work as a team Make students feel part of the team Create a learning atmosphere by their relationships within the team Considerate of each other Respectful ofeach other
The Nurse Unit Manager
Nurse Unit Manager Controls the management ofthe area Role models for nursing practice Assumes the role ofthe team leader Is efficient and flexible to produce quality care Ensures that teaching is an integral part ofthe organization Ensures that nursing practice is compatible with what students are taught at the college Facilitates for students to be given responsibility and encouraged to use initiative, and provides resources necessary for client care.
Lecturer/ Clinical Teachers’ Role
Lecturer/ clinical teacher Facilitates for student to take responsibility for own learning by actively seeking opportunities to learn, asking questions without feeling guilty, and applying new concepts and principles in client’s care. Works with the student to minimize risk of danger to the client, and examine reasons for failures or mistakes to assist students to learn from them, Assists other students at different levels to provide support, for one another through working together, discussing approaches, decisions and rationale for their nursing actions.
Teacher-student relationship is that of mutual respect, ji-iendliness and support where teachers facilitate for students to be aware of own learning needs, and be self-directing in developing competence to be where they want to be.
Collaborates and liases with clinical stafffor teaching. Guides, supervises, teaches and evaluates students for attainment of clinical objectives.
The factors identified by humanistic theorists are applicable to the study under investigation. The purpose is to explore and describe factors, which characterize the clinical learning environment for student nurses in Botswana using this theory as a point of reference.
CONCEPTUAL FRAMEWORK
The following is a conceptual relationship of factors/concepts as perceived by the researcher, and applicable to the study. Accordingly, the concepts in the framework are all interrelated and influence each other in the creation of the conducive learning environment, and in the provision of quality care for the client, as presented in the Figure 3.1
List of concepts
- Nurse manager’s role.
- Humanistic staff role.
- Team approach.
- Clinical teachers’ I lecturers’ role.
- Client and family care.
- Student learning.
- Clinical setting organization and space adequacy.
- Patient care standards.
Description of the Model
The conceptual framework derives from humanistic theories, with the identified concepts, as described under 3.3 above The outer cycle represents the openness of the health care system to influences from other systems such as social, political, psychological and physical factors. These factors continuously impact on the health care environment, which may be hospitals, clinics or other community settings, used for clinical learning
The middle cycle is made up of key concepts, which constitutes clinical learning environment. These concepts include the nurse managers’ role, the humanistic staff role, the nurse teachers’ role and the team approach. These variables interact together, and influence each other in the creation of the conducive learning environment.
The innermost square is made up of client and family care and student learning which interacts with each other. This interaction may positively or negatively influence learning and care provided. Availability and utilization of practice standards guide the quality of care provided. The setting in which patient’s care and clinical learning takes place must be appropriately organized to facilitate learning. Space must be adequate for both students and patient care and provide adequate and variety of learning experiences. The function of this part of the framework is a direct result of the impact by the four concepts identified previously.
Quinn (1995: 193) has observed, that the right amount, and the balance between these factors result in optimum stimulation for the student to perform learning tasks, and make appropriate decisions in client and family care. Conversely, imbalance or inappropriate amounts will result in either over or understimulation, which may cause student a lot of anxiety. This anxiety may affect student’s performance of learning tasks, and also affect client/family care. The ultimate outcome will be a non-conducive clinical learning environment, which fails to facilitate for students to learn or for quality client and family care. The arrows indicate interaction between all variables, influencing each other positively or negatively.
CONCLUSION
This chapter has discussed the theoretical framework, which was used to guide the study. Factors conducive to effective clinical learning environment were identified as, staff who are humanistic in dealing with students; nurse manager who is committed to student learning, the concept of team approach, and nurseteachers role.
These factors were described as interacting together to create a conducive learning environment. However, they were also influenced by the external environment, which may be the whole hospital, or even the larger health care system.
A conceptual framework was described which showed how all the concepts interact and impact on each other. In the following chapter the methodology is discussed.
CHAPTER I
1.1 Introduction
1.2 Background Of The Problem
1.3 The Nature Of The Problem
1.4 Motivation Of The Study
1.5 Significance Of The Study
1.6 Statement Of Purpose
1. 7 Research Questions
1. 8 Definition of Terms
1. 9 Assumption
CHAPTER2 Literature Review
2.1 Introduction
2.2 Literature Reviewed
2. 3 Conclusion
CHAPTER3 Theoretical Framework
3.1 Introduction
3 .2 The Theoretical Framework
3.3 Pictoral View Of The Conceptual Framework
3.4 Description Of The Conceptual Framework
3. 5 Conclusion
CHAPTER4 Research Methodology
4.1 Introduction
4.2 Research Design
4. 3 Target Population
4.4 Sample Selection
4. 5 Research Instrument
4.6 Validity And Reliability
4. 7 Ethical Considerations
4. 8 Conclusion
CHAPTERS Study Findings
5.1 Introduction
5.2 SECTION 1: Demographic Data
5.3 SECTION 2: Findings On Main Study Variables
5.4 Cross Tabulations
5.5 Qualitative Findings
5.6 Conclusion
CHAPTER6 Discussion Of Findings, Conclusions, Limitations And Recommendations
6.1 Introduction
6.2 Purpose Of The Study
6.3 Study Limitations
6.4 Discussion Of Findings
6.5 Recommendations
6.6 Conclusions
6. 7 Bibliography
6. 8 List Of Appendice
GET THE COMPLETE PROJECT
AN EXPLORATION OF VARIOUS CLINICAL SETTINGS FOR THE EDUCATIONAL PREPARATION OF STUDENT NURSES
