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1. 2011 Annual Nursing Education Conference Adelaide Tambo School of Nursing Science Developmental Process to Facilitate Teaching and Learning through a Nursing Community of Practice (NCoP) Dr C van Belkum (Tshwane University of Technology) & Prof Lize Maree (University of the Witwatersrand) Live your life. Create your destiny.

2. Background: R16 m grant awarded through UNEDSA • University-based Nursing Education (UNEDSA): • Launched: December 2008 • Through: A grant of R70-million (7 million UD$) by The Atlantic Philanthropies • Aim: Transform nursing scholarship in South Africa with the focus on nurse • academics and higher education • Competitive grant: Awarded at an award ceremony to 4 universities– R16 m over 4 years • UWC, UFS, TUT & University of Fort Hare Prof T Khanyile (University of Western Cape); Prof A van der Merwe (University of the Free State); Prof Lize Maree (TUT); Dr EM Yako (University of Fort Hare).

3. Background: Developmental process to facilitate teaching and learning • 2008 City of Tshwane Annual Report: • Critical shortage of nurses • Ratio: 1 nurse: 2689 members of the Tshwane population • South African Nursing Council (SANC): • Restrict number of nursing students according to number of accredited learning opportunities in clinical settings • Generous grant: • Enabled ATSON to develop a NCoP as strategy to: •  facilitate teaching and learning for nursing students •  increase the number of clinical learning opportunities

4. Background: Planning of NCoP – based on Wenger’s CoP Model • Community of Practice (CoP): • = model of situational learning • Cornerstones of the model: collaboration among peers and shared learning • Defined by knowledge rather than task - individuals come together and work to obtain a common purpose (Andrew, Tolson, & Ferguson, 2008; Wenger, 1998) • Literature emphasized: More patient care takes place in settings outside of hospitals in the community, than in hospitals. • CoPshave advantages for: • teaching, learning and scholarship, • nursing research and • development of the leadership and nursing as profession (Budgen and Gamroth 2008 in Maree and Ferns 2008) • Therefore the CoP approach was selected to guide the greater Nursing Community of Practice (NCoP) as basis for the initiation of 5 individual nurse-led clinics.

5. Background: Planning according to the greater NCoP’s Objectives • To develop 5 nurse-led Nursing Communities of Practice (NCoPs) to form a greater NCoP • Mother and well baby, • Childhood development, • Lifestyle diseases, • Cancer screening, and • Palliative Care • To comply with the accreditation criteria for Community Health Centers(CHCs) of Gauteng DoH • To create appropriate community based learning opportunities for undergraduate students • To create appropriate community based learning opportunities for post graduate students • To facilitate nursing research and scholarship • To build capacity for the future needs of The School • To benchmark the greater NCoP as a nursing education model that can be utilized by other nursing education institutions, nationally and internationally

6. Background: Establishing of the NCoP - 4 phases • Phase 1: Planning • 1. Grant application • 2. Planning • 3. Formulation of • objectives Additional Services Additional LO’s & Skills Development Additional Research Opportunities • Phase 3: • Growth • Development • Research • & • Refine • Phase 2: Implementation • Roll-out of greater NCoP to the community Phase 4: Evaluation (continuous process)

7. Background: Development of greater NCoP – 5 Nurse-led NCoPs Mother & Well Baby (M&B) NCoP (clinic) Childhood Development (CD) NCoP (clinic) Greater Nursing CoP (NCoP) Lifestyle Diseases (LSD) NCoP (clinic) Palliative Care (Pall) NCoP (clinic)

8. Background: Planning of NCoP – Nurse-led clinics • Nurse-led clinic: • = an umbrella term for an outpatient clinic that is managed by a Professional Nurse Practitioner (Registered Nurse) (Daly, Clark, & al, 2008) • Main objective: enable nurses to – • presume their own patient caseloads in specified time slot, • educate patients to promote health, • provide psychological support, • monitor the patients’ condition, and • to perform nursing interventions (Hatchett, 2008).

9. Background: Patient database

10. Aim: Developmental process to facilitate teaching and learning • 2. Aim: • To determine the number and nature of additional learning opportunities (LOs) created by means of establishing a NCoP The community we serve

11. Research methodology: Developmental process to facilitate teaching and learning • 3. Method: • Research design: • Document audit • Unit of analysis: • Statistics of services delivered by each NCoP • Curricula of the various learning programmes • Data gathering: • January 2010 till March 2011 • Structured observation • Data gathering instrument: Checklist

12. Findings: Developmental process to facilitate teaching and learning • 4. Findings: • Findings will be presented in terms of: • the total number of new learning opportunities • the different learning opportunities in relation to the statistics of the various NCoPs • micro curriculum requirements vs. LOs available at the NCoPs

13. Findings: Developmental process to facilitate teaching and learning (cont) 4.1 New learning opportunities developed through the establishment of the NCoP: Undergraduate learning opportunities: 50 LOs

14. Findings: Developmental process to facilitate teaching and learning (cont) 4.1 New learning opportunities developed through the establishment of the NCoP: Postgraduate learning opportunities: 14 LOs

15. Findings: Developmental process to facilitate teaching and learning (cont) • New postgraduate learning opportunities: • Masters & Doctoral degree students - 14 LOs

16. Findings: Developmental process to facilitate teaching and learning (cont) 4.1 New learning opportunities developed through the establishment of the NCoP: • New post basic learning opportunities : • = post registration qualification • Oncology and Palliative students = 4 LOs

17. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : 120 • Mother and Well Baby NCoP: Adults • Number of different learning opportunities= 16 • Mainly family planning: Nur Isterate injection, Petagon injection and oral pill cycle

18. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : • Mother and Well Baby NCoP: Babies and young children • Number of different learning opportunities= 15 • Mainly preventative: Supplementation, immunization and deworming

19. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : • Childhood Development NCoP: Early childhood intervention (ECI) • Number of different learning opportunities= 13 • Mainly: physical growth monitoring, neuro development and visual screening

20. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : • Childhood Development NCoP: School health (SH) • Number of different learning opportunities= 6 • Mainly: physical assessment, visual screening and hearing assessment

21. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : • Lifestyle Diseases NCoP: • Number of different learning opportunities= 20 • Mainly: BP screening for hypertension, HAST screening and TB

22. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : • Cancer Screening NCoP: • Number of different learning opportunities= 13 • Mainly: cervical screening, oral screening and breast examination

23. Findings: Developmental process to facilitate teaching and learning (cont) 4.2 The different LOs in relation to the statistics of the various NCoPs : • Palliative Care NCoP: • Number of different learning opportunities = 50 • Mainly symptom management: Pain, fatigue and cough

24. Findings: Developmental process to facilitate teaching and learning (cont) 4.3 The micro curriculum requirements vs. LOs available at the NCoPs : • Under graduate learning opportunities: • Curriculum focus: Community based • B1 and B 2 students = 50 new LOs

25. Findings: Developmental process to facilitate teaching and learning (cont) 4.3 The micro curriculum requirements vs. LOs available at the NCoPs :

26. Discussion: Developmental process to facilitate teaching and learning • Discussion: • NCoPs (clinical setting) serve as an effective tool for nursing schools to: • create its own clinical learning opportunities • not be affected by the shortage of clinical placements • teach and learn while serving the community

27. Conclusion: Developmental process to facilitate teaching and learning • Conclusion: • Various additional LOs for all categories of students were created by means of the establishment of a NCoP

28. A Greater NCoP - The Dawn of a New Era

29. Developmental process to facilitate teaching and learning • What a journey... • Thank you