Experiences of Early and Enhanced Clinical Exposure for Postgraduate Neonatal Nursing Students at the University of Zambia, School of Nursing Sciences: Lessons and Implications for the Future.

Background and Objectives: Early and Enhanced Clinical Exposure immediately places postgraduate students in a clinical setting and incorporates continual hands-on instruction throughout their studies. It aims to motivate students by strengthening their academics, improving clinical and communication skills, and increasing their confidence. The underlying principles are to provide a clinical context and to ensure that the patient remains the centre of learning. The School of Nursing Sciences implemented this model in 2021 to produce hands-on Masters-level neonatal practitioners who can work in multidisciplinary clinical contexts. Therefore, this study explored the experiences of postgraduate nursing students on the Early and Enhanced Clinical Exposure model and draw implications for the future. Methods: A phenomenological study design was utilized at the University of Zambia, School of Nursing Sciences and comprised of eight Master of Science Neonatal Nursing students in their second year. Convenience sampling was used to select the study site and participants. Data was collected between 15th January 2023 and 31st January 2023 using an in-depth interview guide. Audio recording and notes were transcribed immediately after data collection. Data analysis was conducted using thematic analysis and codes and themes were constructed from the coded data. Ethical clearance and permission were sought before conducting the study. Results: Four major themes emerged from the study: identity and role confusion, challenging and hectic experiences, positive educational experiences, and personal and professional growth. These themes contributed to the promotion of evidence-based practice by helping students to assess, diagnose, and treat various conditions, as well as gain interest, experience, knowledge, and exposure. Conclusion: The model has a significant impact on motivation to learn, as evidenced by reported increased skill level with potential for use in clinical practice. It is recommended that it be implemented in all postgraduate programs for full-time students.

Application of Interprofessional Education Model to University Pre-Licensure Health Students in the Management of Chronic Care Conditions in Zambia.

Background: There is evidence that multidisciplinary healthcare teams can provide better quality of care and treatment outcomes compared to that delivered by individuals from a single health discipline. The project on which this article is based applied the interprofessional education model to university pre-licensure health students in the management of chronic care conditions in Zambia. Methods: Four distinct but interrelated approaches, namely desk review; module development workshops; review and validation of modules by experts; piloting and review of the training modules were employed. Results: Several models of interprofessional education currently in existence and used successfully by higher education institutions in other settings were identified. While several models of Interprofessional Education were identified, our project adapted the "didactic program, community-based experience, and interprofessional-simulation experience" models. To apply the models, modules of seven chronic care conditions were developed and piloted. The extent to which the module activities promoted interprofessional education were rated between 74 - 87% (agree or strongly agree) by the students. Conclusion: Three models of Interprofessional Education were identified and adapted in the project, and seven modules were developed and administered to the students. The process was effective for putting forth an interprofessional training program at the undergraduate level, with the potential to improve quality of care for patients.

Initiatives to enhance medical subspecialist training in Zambia: A cross-sectional analysis.

Introduction: There is a significant shortage of medical subspecialists in Zambia. The government of Zambia, through programmes at the Ministry of Health, spends considerable resources to send patients outside the country for subspecialist medical treatment. The objective of this analysis was to evaluate the current situation pertaining to medical subspecialty training at the University of Zambia School of Medicine (UNZASOM) and to illustrate the new programmes that are to be introduced. Methods: We collected data from formal desk reviews on the state of medical specialisation in Zambia, the UNZASOM graduation archives and patient referral records at the Ministry of Health (MoH). In addition, information on planned subspecialist programmes is presented. Results: From the first graduates in 1986up to 2019,UNZASOM produced 351medical specialists, 63 (18%) in Internal Medicine, 77 (22%) in Obstetrics &Gynaecology, 82 (23%) in Paediatrics&Child Health, 68 (19%) in General Surgery, 17 (5%) in Anaesthesia & Critical Care, 20 (6%) in Orthopaedics &Trauma and 8 (2%) in Urology. The remaining graduates were in Ophthalmology, Psychiatry, Infectious Diseases, Paediatric Surgery and Pathology contributing 1% each. To enhance medical subspecialist training at UNZASOM, new curricula for Breast Surgery, Urology, Glaucoma, Vitreo-retinalSurgery, Adult Gastroenterology, Forensic Pathology, Dermatology & Venereology, Ophthalmology, Gynaecological Oncology and Paediatric anaesthesia, Infectious Diseases, and Gastroenterology were developed. Since 2013, only 44% of patients requiring subspecialist treatment out of Zambia got assisted with the remainder still on the waiting list or having had bad outcomes. Conclusions: These programmes will provide an opportunity for accessible and affordable medical subspecialization training for Zambia and its neighbouring countries. With enhanced infrastructural support, the subspecialists will contribute toward enhanced healthcare provision and improvement in patient outcomes. They will also form a cohort of trainers to expand the space for quality training and skills building of specialists and subspecialists in the region and beyond.

Design and Development Process of a Youth Depression Screening m-Health Application for Primary Health Care Workers in South Africa and Zambia: An Overview of the MEGA Project.

Literature indicates a high prevalence and burden of mental illness in youths world-wide, which may be even higher in low- and middle-income countries (LMIC), such as South Africa and Zambia. Additionally, there is a lack of knowledge regarding youth depression amongst many primary health care (PHC) practitioners. The principal goal of the MEGA project is to provide youth with better access to mental health services and appropriate care, by developing a mental health screening mobile application tool to be used in PHC settings in South Africa and Zambia. In this study, we will use a mixed methods multi-center study design. In phase one, we will investigate the mental health literacy of PHC practitioners to identify areas in need of development. Based on the needs identified, we will develop and test a mobile health application to screen for common youth mental health problems in phase two. In phase three, we will implement and evaluate a tiered education and training program in the use of the m-health application. In the final phase, we will evaluate the acceptability and feasibility of the m-health application in PHC centres across South Africa and Zambia. Evidence suggests that PHC practitioners should routinely consider mental illness when assessing youth. However, common psychiatric disorders remain largely undetected and untreated in PHC settings. By identifying limitations in PHC workers knowledge with regard to youth mental health, we aspire to improve the depression care provided to youth in Southern Africa and Zambia by developing and implementing a locally relevant m-health application.

Use of instant messaging to enhance leadership and management training for rural nurse managers.

This article describes a study that explored the use of instant messaging in continuing education for nurses and midwives using a leadership and management programme designed for rural nurse managers in Zambia. Twenty trainees who were enrolled in a leadership and management course, five supervisors and six course facilitators participated in the discussions over a period of nine months. Each week, a supervisor posted a question to participants regarding content in the curriculum and how the participants were applying this to their daily work. Participants were required to answer the question within a week. Information was free-flowing and participants were encouraged to engage actively, ask questions and share their experiences. Conversations were extracted from mobile devices and data were analysed using thematic analysis. Themes from the messages were identified as social interaction, professional networking and educational interactions. The findings demonstrate that instant messaging can be a useful platform for learners and their facilitators in a blended type of learning and can enhance communication, promote social interaction and professional networking, and support the application of knowledge to practice.

Developing a pain assessment tool for patients after major abdominal surgery.

The purpose of this study was to develop a pain assessment tool for use among postoperative patients in Zambia (Postoperative Pain Assessment tool for Zambia, or POPAZ). Phase 1 of this project was an epidemiological quantitative analytical study conducted at the University Teaching Hospitals, Lusaka in Zambia. The sample comprised of 30 nurses and surgeons who were actively involved in providing direct patient care to post-surgical patients. An adapted Clinical Decision Making Survey tool was used to collect the data. The study revealed five relevant measures of postoperative pain: patient mobility/activity, level of tolerance to activity, facial expressions, vital signs and overall patient behaviour. The findings of this phase have thus provided a framework for the development of a postoperative pain assessment tool that can be used with postsurgical patients following major abdominal surgery.