Browsing by Author "van Zyl, Ann Elizabeth"

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    Re-exploring the anaesthetic and recovery room component of the Diploma in Operating Department Assistance curriculum at a private higher education institution in South Africa
    (Stellenbosch : Stellenbosch University, 2019-04) van Zyl, Ann Elizabeth; Bitzer, Eli; Van der Merwe, Anita; Stellenbosch University. Faculty of Education. Dept. of Curriculum Studies.
    ENGLISH ABSTRACT : The provision of high quality education and training is paramount in healthcare contexts to ensure graduates are trained according to the needs of stakeholders and are competent to enter the 21st century workforce. Healthcare education and training predicates the provision of high quality surgical and medical training which enable healthcare professionals to respond effectively and flexibly to the demands in the healthcare environment − of which the operating department forms a major part. This technological high-impact, fastmoving perioperative environment is staffed by nurses and operating department assistants (ODAs) who deliver patient care with the anaesthetic assistance functions historically provided by nurses. However, due to a shortage of nurses and changes in the higher education landscape in South Africa, anaesthetic and recovery room assistance as an exit-level outcome was added to the training of ODAs. This was mainly done to enable ODAs to fulfil these roles and functions. Thus, the anaesthetic and recovery room assistance course was included in the three-year Diploma in Operating Department Assistance to develop competent ODAs to assist anaesthetists and recovery room registered nurses. Due to critique from different sources it was deemed necessary to revisit and re-explore the anaesthetic and recovery room curriculum. It became clear that the anaesthetic and recovery room module in use was not effective to equip ODAs with the appropriate cognitive, affective and psychomotor skills. These skills are critical to contribute to an effective and competent team approach to address the skills shortage in the operating department. The aim of this study was therefore to inquire how an existing undergraduate curriculum in anaesthetic and recovery room practices could be reconstructed to fit the needs of a private hospital group in South Africa. This aim was pursued against the background of wider theoretical and healthcare education issues which influence curricula in health training environments. The development of theoretical perspectives relevant to the study was based on exploring the following concepts and models: competency-based education, curriculum-mapping, Kerns’ six-step approach to curriculum development and Fishbein’s Integrated Behavior Model (IBM). These key concepts and models guided the investigation in the search for possible curriculum changes. A programmatic case study design using a mixed method of data collection was used to obtain qualitative data through individual, pair and focus group interviews. Quantitative data were gathered via a selfadministered paper-based questionnaire. Data were generated from samples of clinical environment managers, anaesthetists, ODAs, students and educators. An inductive approach through an interpretivist lens of knowledge production was employed to investigate the understanding and needs of the stakeholders. A total of 35 interviews were conducted which involved 71 participants. It included 24 nursing and operating department managers, seven anaesthetists, seven ODAs, 22 students and 11 educators. Sixty-two respondents completed the paper-based questionnaires and the results served to compile a questionnaire on the possible knowledge, technical skills, attitudes and non-technical skills to be included in the anaesthetic and recovery room course. These learning-identified outcomes were verified by means of an online modified Delphi exercise. To obtain consensus a panel of 17 experts (of whom each held either a Diploma in Operating Room Nursing Science or a Diploma in Operating Department Assistance) participated. The study findings indicated that a few of the essential cognitive, psychomotor, affective and non-technical skills ODAs require to assist anaesthetists and registered nurses were lacking. It emerged this was mainly due to the lack of ODAs’ psychomotor skills. The study further confirmed that a number of factors suggested by Fishbein’s Integrated Behavior Model (IBM) impacted on the teaching and learning of anaesthetic and recovery room assistance. Of these factors, mediocre clinical assessments and environmental constraints were found to contribute substantially. Some of the constraints related to the training environment were unclear work profiles and nursing staff shortages. From the factual and conceptual conclusions drawn, a framework for a redesigned undergraduate needs-based anaesthetic and recovery room curriculum within a private higher education institution was proposed. The proposed curriculum aims at contributing towards dealing with the criticisms levelled against the previous curriculum – which was largely the product of a nonparticipative and non-verified curriculum process – in several ways.