Evaluation of the implementation of a PhD capacity-building program for nurses in South Africa.

BACKGROUND: Nursing is experiencing a significant deficit in research capacity needed to meet future global healthcare demands-there is a call to double the number of nurses and healthcare professionals with a doctorate. AIM: The aim of this research was to evaluate the implementation of a national PhD capacity-building program for academic and practice-based nurses and other healthcare professionals in South Africa. METHODS: An implementation science framework was used. Implementation of the program across two national, longitudinal cohorts of participants was studied. Evidence of enablers and barriers to implementation was obtained from multiple data sources, including the curriculum for the program, regular evaluation reports from program participants and program facilitators after each stage of the PhD curriculum delivery, and meeting notes. Supplementary sources included rates of PhD candidate recruitment, retention, and successful completion. RESULTS: Evidence for the presence of enablers for successful implementation was found, including stakeholder consultation and buy-in, leadership, resources, staff capacity, and implementation teams. No evidence of an implementation plan, a supportive organizational culture, or effective ongoing communication at Stage 4 of the implementation process was found. Barriers to implementation included external environmental factors, resistance to change, and vested interests. DISCUSSION: Within the context of a recognized worldwide shortage of nursing scientists, the application of an implementation science framework to evaluate the initial stages of a national PhD development program rollout provided information on how effective implementation can be strengthened and how barriers to success can be overcome.

Scaling up nurse education: An evaluation of a national PhD capacity development programme in South Africa, in the context of the global shortage of nursing graduates.

BACKGROUND: The global shortage of nursing professionals educated at baccalaureate level and beyond has been highlighted. Within America, services are preparing to treat an additional 32 million individuals under the Health Reform Bill. Within South Africa nursing education outputs do not meet demands. Countries are addressing these shortages by developing advanced nurse roles which require research degrees. OBJECTIVE: To evaluate a national PhD programme within the context of a nurse education strategy and a national health insurance plan. DESIGN: A comparative effectiveness research design was employed. SETTING: The setting was in South Africa between 2011 and 2013, a county with 51.7 million inhabitants. PARTICIPANTS: Participants included PhD candidates, programme facilitators, supervisors and key stakeholders. METHODS: Data from a one day workshop was analysed using an inductive thematic analysis. Three years of evaluation reports were analysed. A mapping of the alignment of the PhD topics with healthcare priorities, and a comparison of the development of nurse education, of the national and international funder were conducted. RESULTS: The evaluation reports rated the programme highly. Three themes were identified from the workshop. These were, "support" with the sub-themes of burden, leveraging and a physical supportive place; "planning" with the sub-themes of the national context and practice, and "quality" with the sub-themes of processes and monitoring and evaluation. The mapping of PhD topics revealed that research was in line with development priorities. However, further investment and infrastructural changes were necessary to sustain the programme and its impact. CONCLUSIONS: To address sustainability and capacity in nations scaling up nurse education and healthcare insurance, it was recommended that top-up degrees for diploma educated nurses be developed along with, the implementation of a national nursing strategy for PhD and post-doctoral training encompassing clinical practice implementation and collaboration.