ASSESSING FACTORS ASSOCIATED WITH NURSING STUDENTS SATISFACTIONS

WITH THEIR CLINICAL LEARNING PLACEMENT IN THE HOSPITAL SETTING,

KAVANGO EAST REGION

A RESEARCH PROPOSAL SUBMITTED IN PARTIAL FULFILMENT OF THE

REQUIREMENT FOR THE

BACHELOR OF NURSING SCIENCE (CLINICAL) (HONOURS) DEGREE

OF THE UNIVERSITY OF NAMIBIA

NAME: TJIMBALI INESH

STUDENT NUMBER: 221098747

DATE: MARCH 2024

SUPERVISOR: MRS. H.K. HAIKERA

Table of Contents

1.1 Introduction.......................................................................................................................

1.2 Background.......................................................................................................................

1.3 Problem statement.............................................................................................................

1.4 Aim/Purpose of the study.......................................................................................................

1.5 Objectives/Research questions...............................................................................................

1.6 Significance of the study........................................................................................................

1.7 Limitations.............................................................................................................................

1.9 Operational definition............................................................................................................

2. LITERATURE REVIEW............................................................................................................

2.1 Introduction............................................................................................................................

3. RESEARCH METHODOLOGY..............................................................................................

3.1 Research design....................................................................................................................

3.2 Population of the Study........................................................................................................

3.3 Sampling method.................................................................................................................

3.3.1 Inclusion criteria...........................................................................................................

3.3.2 Exclusion criteria..........................................................................................................

3.3.1 Sampling size....................................................................................................................

3.4 Study settings.......................................................................................................................

3.5 Research instrument.............................................................................................................

 3.6 Data collections....................................................................................................................

3.7 Data quality..........................................................................................................................

3.8 Data analysis........................................................................................................................

3.9 Ethical considerations..........................................................................................................

REFERENCES..............................................................................................................................

APPENDICES...............................................................................................................................

6.1 Appendix A: Research information to participants..............................................................

6.2 Appendix B: Consent form..................................................................................................

6.3 Appendix C: Seeking approval to conduct a study..............................................................

6.4 Appendix D: The research instrument.................................................................................

6.5 Appendix E: University of Namibia approval letter...........................................................

1. INTRODUCTION AND BACKGROUND

1.1 Introduction

Clinical placement means the period spent by undergraduate nursing students in clinical and

other experiential learning sites to ensure the purpose of the auxiliary nurse education and

training program is achieved (Eksted, 2019). It is an environment that provides health care or

related services to patients or the public (Hooper et al., 2020). The clinical placement

environment is dyadic in nature; it includes the ward atmosphere, culture, and the

complexities of care and the supervisory relationships between students clinical. It provides

an opportunity to gain valuable experience in professional healthcare settings, which could be

beneficial for future career prospects (Froberg et al., 2018).

A student nurse refers to a person registered as such in terms of section 59 of the Nursing Act

2004 (Act no. 8 of 2004). It is a requirement that a person registered as a student nurse should

be attached to a healthcare setting for clinical attachment. Various factors, however, may

affect the satisfaction of student nurses with their clinical attachment. In this case, student

satisfaction is defined as the attitude resulting from an assessment of the student’s

educational experience, services, and facilities provided by the institution, the hospital

settings in this case student’s satisfaction with the clinical placement experience and the

overall stimulated learning environment is a good indicator of the quality of nursing

education (Robertson, 2016). Therefore, understanding students’ level of satisfaction with

their clinical placement is crucial to ensuring the required teaching process; it is crucial for

meaningful and engaged learning because it encourages active purposeful engagement in

clinical learning experience. Student’s satisfaction with clinical placement experience and the

overall of stimulated learning environment is a good indicator of the quality of nursing

education (Robertson, 2016). Therefore, understanding students’ level of satisfaction with

their clinical placement is crucial to ensuring the required teaching process; it is crucial for

meaningful and engaged learning because it encourages active purposeful engagement in

clinical learning experience (Druetz, 2014). Hence, this proposed study is aimed to explore

the satisfaction of student nurses with their clinical learning placement in the hospital setting.

1.2 Background

Globally, clinical placement plays a crucial role in nursing education worldwide (Chan et al.,

2019). Nursing students’ satisfactions with their clinical placements have been seen as an

important aspect in their learning experiences (Williams et al., 2017). Clinical placement

allows nursing students to gain hand on experience, which essential for developing the

competencies required for professional experience (Papastavrou et al., 2016). Various studies

conducted in different countries investigated the factors influencing students’ satisfaction

with their clinical placement in the hospital settings (Gaberson et al., 2012). However there

is still a need to explore this topic further to gain in-depth understanding of the factors at play

in different context. In Africa, nursing education faces unique challenges due to resources

constraints, diverse healthcare system and sociocultural factors (Mkandawire & Doering,

2012). Nursing education in Africa presents unique challenges due to resource constraints,

diverse healthcare systems, and sociocultural factors (Mkandawire & Doering, 2012).

However, limited research has focused on factors associated with nursing students'
satisfaction with clinical placements in African countries (Oduyemi et al., 2019). Studies

conducted in some African countries have revealed mixed experiences, with students

reporting both satisfaction and dissatisfaction during their clinical placements (Halse et al.,

2016). Particularly, in environments where clinical resources are scarce, nursing students may

perceive their clinical placements as less conducive to learning and may even lose

compassion for nursing (Council, 2015). Understanding the factors contributing to

satisfaction in such contexts is crucial for enhancing the quality of nursing education

(Pitkanen et al., 2018). In Namibia, nursing student satisfaction with their clinical placement

is a critical aspect that needs attention to enhance the quality of education in Namibia,

practically at Rundu intermediate hospital. The Ministry of Health and Social Services

recognizes the importance of quality nursing education in improving healthcare outcomes

(Ministry of Health and Social Services [MoHSS], 2018). Namibian nursing education

programs have been working to align with international standards, yet they grapple with

challenges similar to those faced elsewhere in Africa (MoHSS, 2018). Nursing students in

Namibia have expressed concerns regarding the availability of clinical learning resources, the

quality of clinical supervision, and the need for a supportive learning environment (Haoses-

Gorases et al., 2020In Namibia, nursing student satisfaction with clinical placements is a

critical area that requires attention to improve the quality of education, particularly at

institutions such as Rundu Intermediate Hospital. The Ministry of Health and Social Services

acknowledges the importance of quality nursing education in improving healthcare outcomes

(MoHSS, 2018). Despite efforts to align nursing education programs with international

standards, Namibia faces challenges similar to other African countries, including resource

limitations and concerns about clinical learning environments (MoHSS, 2018; Haoses-

Gorases et al., 2020).Programs at nursing education institutions in Namibia are regulated by

the Health Professional Council (Nursing Act No 8 of 2004) with applicable regulations. This
act determines that a student nurse must throughout the course of study receive both

theoretical and clinical instructions while being placed in different clinical departments at

approved health training facilities. This placement is coupled by a certain number of hours.

The major part of clinical education in clinical learning settings in Namibia stretches from

semester one and continues until the end of fourth year which amounts to a minimum of 2800

hours. At least 940 hours for each module Act No 8 of 2004).

1.3 Problem statement

Nursing students’ satisfaction with their clinical placement in the hospital setting holds

profound significance in shaping their educational journey and eventual success within the

healthcare domain (Robertson, 2016). This satisfaction serves as a pivotal determinant,

intertwined with better learning outcomes, heightened retention rates, and the seamless

transition from student to competent practitioner (Levett & Lathlean, 2019). However,

despite its undeniable importance, there exists a noticeable gap in comprehensive research

dissecting the multifaceted factors that underpin nursing students' satisfaction during their

clinical placements in hospital settings (Courtney-Prall et al., 2012).

The pressing need to unravel these intricate elements becomes apparent when considering the

far-reaching implications for both healthcare institutions and nursing education programs. A

deeper understanding of these factors is imperative to not only enrich the learning experience

but also to proactively address potential barriers that may impede students' satisfaction and

hinder their growth (Druetz, 2014). The absence of such insights exacerbates the challenge,

leaving stakeholders grappling with how to cultivate environments that nurture and support

students effectively (Flott & Lenden, 2016). Indeed, the repercussions of nursing students

experiencing dissatisfaction during their clinical placements extend beyond mere

dissatisfaction. It permeates into the realm of motivation, stunting skill development and

compromising the overall educational trajectory (Flott & Lenden, 2016). This creates a ripple

effect, affecting the quality of care delivered in healthcare settings and perpetuating a cycle of

suboptimal learning experiences. Without a comprehensive grasp of the nuanced factors

contributing to nursing student satisfaction, institutions struggle to tailor clinical

environments conducive to growth and teach (Hjemas et al., 2019). Consequently, the need to

delve deeper into these variables is paramount, serving as a cornerstone for elevating the

standard of clinical education and fortifying the learning journey for aspiring nurses. By

unravelling these complexities, institutions can forge pathways towards not just academic

excellence, but also holistic development, ensuring that nursing students emerge as competent

and compassionate caregivers equipped to navigate the challenges of modern healthcare.

1.4 Aim/Purpose of the study

The aim of the study is to assess and understand the factors associated the nursing students’

satisfaction with clinical placement in the hospital settings.

1.5 Specific objectives

The proposed study will be guided by the following objectives:

 To identify and analyse the key factors influencing nursing students' satisfaction

during their clinical placements in hospital settings in Kavango East region.

  To assess the impact of nursing students' satisfaction with their clinical placements on

learning outcomes, retention rates, skill development, and overall educational

outcomes, thereby providing insights into the effectiveness of current clinical

education practices and opportunities for improvement.

1.6 Research question

1. What are the key factors that influence the nursing students’ satisfaction during their

clinical placements at the hospital settings in Kavango East Region.

1.7 Significance of the study

The significance of assessing factors associated with nursing students' satisfaction with their

clinical learning placement in the hospital setting, specifically in the Kavango East Region, is

multifaceted and crucial for several reasons. First and foremost, understanding the factors that

contribute to nursing students' satisfaction in their clinical placements is essential for

ensuring the quality of nursing education. Clinical placements play a pivotal role in nursing

education, providing students with hands-on experience and exposure to real-life healthcare

scenarios. When students are satisfied with their clinical placements, they are more likely to

be engaged, motivated, and invested in their learning process. This, in turn, can lead to better

academic performance and the development of competent and confident nursing

professionals.

Furthermore, identifying the factors that influence nursing students' satisfaction can inform

the development of strategies and interventions to enhance the quality of clinical learning

experiences. By addressing specific areas of concern or dissatisfaction, nursing educators and

healthcare institutions can tailor clinical placement experiences to better meet the needs and
expectations of students. This might involve improvements in the supervision and support

provided to students, the variety and complexity of clinical cases encountered, the availability

of resources and facilities, or the overall organizational culture within healthcare settings.

Moreover, enhancing nursing students' satisfaction with their clinical placements can have

broader implications for the nursing workforce and healthcare delivery. Satisfied students are

more likely to choose careers in nursing and remain in the profession long-term. They are

also more likely to advocate for improvements in healthcare systems and contribute

positively to patient care outcomes. By nurturing a positive learning environment during

clinical placements, we can cultivate a future generation of nurses who are passionate,

competent, and committed to delivering high-quality care to patients. Finally, focusing

specifically on the Kavango East Region is important for addressing context-specific factors

that may influence nursing students' satisfaction. Factors such as geographic location, cultural

norms, resource availability, and healthcare infrastructure can all impact the clinical learning

experiences of students in this region. By conducting research in this context, we can

generate insights that are relevant and applicable to improving nursing education and

healthcare delivery in the Kavango East Region, ultimately contributing to the overall

advancement of nursing practice and patient care in the area.

1.8 Limitations

Limitations are regarded as the influences, short comings or conditions that the research can

control but which can place restrictions to the study (Polit & Beck, 2017). Some of the factors

that might pose as a limitation of the study are financial challenge. The first limitation of the

study is related to the setting. This study will be conducted at one university in the Kavango

East region, Rundu Campus on assessing factors associated with nursing students’

satisfaction with their clinical placement in the hospital setting, Kavango east region. Due to
the study setting the results of this study cannot be generalized, in order to generalize the

findings, a bigger study needs to be conducted; hence, this could be a limitation to the study.

In a quantitative approach using questionnaires for data collection, limitations may arise from

factors such as response bias and limited generalizability. Response bias can occur if

participants provide inaccurate or socially desirable responses, affecting the validity of the

data. Additionally, the sample size and representativeness of the participants may limit the

generalizability of the findings to broader populations. To mitigate these limitations, a

researcher can employ strategies such as random sampling techniques to enhance

representativeness and ensure anonymity in questionnaire responses to reduce response bias.

Moreover, employing standardized measures and validation procedures can enhance the

reliability and validity of the questionnaire instrument, thereby improving the quality of the

data collected

1.9 Delimitations

Delimitations mean the boundaries that the researcher sets in a research study, what to

include and what to exclude (Schlick-Steiner et al., 2010). The study will be conducted at the

university of Namibia Rundu campus, on nursing students regarding factors associated with

nursing students’ satisfaction with their clinical placement in the hospital setting, Kavango

east region.

1.10 Operational definition

Factor is a circumstance, fact or influence that contributes to a result (Klopper, 2019). In this

study it is referred as the events that influence student nurses satisfaction.

Nursing student refers to a person registered as such in terms of section 59 of the Nursing

act 2004 (Nursing Act No 8 of 2004). In this study student nurse refers to nursing students

who is registered for the Bachelor of Science for four year programme at the University of

Namibia, regulated by Nursing Act 2004 (Nursing Act No 8 of 2004).

Clinical placement means the period spend by the undergraduate nursing students in the

clinical and others experiential learning sites to ensure the purpose of the auxiliary nurse

education and training programme is achieved (Eksted., 2019). In this study clinical

placement refers to the practical component of nursing education where nursing students

spend time in healthcare settings, such as hospitals, clinics, or community health centres, to

gain hands-on experience in caring for patients under the supervision of qualified nursing

staff.

Hospital setting is the place or social context in which people engage in daily activities in

which environmental, organizational and personal factors to affect health and wellbeing

(Gumhay et al., 2019). In this study it is referred as the health facilities which include wards

and clinic, where student nurses learn clinical practices.

2. LITERATURE REVIEW

2.1. Introduction:

A literature review is a comprehensive and critical analysis of existing scholarly works,

studies, and theories relevant to the proposed research topic. It involves identifying,
evaluating, and synthesizing a range of academic sources such as books, journal articles, and

other publications to provide a thorough understanding of the current state of knowledge in

the field. The literature review serves several purposes, including establishing the

significance of the proposed research, identifying gaps or unresolved issues in the literature,

and providing a theoretical framework or foundation for the study's hypotheses or research

questions. Additionally, it demonstrates the researcher's familiarity with existing scholarship

and sets the context for the proposed research by highlighting its contribution to advancing

knowledge in the field.

Clinical learning placements in hospital settings are pivotal components of nursing education,

offering students invaluable hands-on experience in real healthcare environments. The

satisfaction of nursing students with these placements significantly influences their learning

outcomes, professional development, and overall career trajectory. As such, understanding

the multifaceted factors that contribute to nursing students' satisfaction with their clinical

learning placements is crucial for educators, administrators, and policymakers in healthcare

and academia. This comprehensive literature review aims to delve into various dimensions of

this topic, exploring the complexities and interrelationships inherent in nursing students'

satisfaction within hospital-based clinical learning environments.

2.2 Factors Influencing Nursing Students' Satisfaction

2.2.1 Quality of Clinical Supervision

Clinical supervision provided by experienced nurses and preceptors significantly impacts

students' satisfaction with their clinical placements (Bogo et al., 2014). Effective supervision

involves overseeing students' clinical activities, providing mentorship, guidance, and

constructive feedback. When students receive high-quality supervision characterized by clear

communication, support, and mentorship, they are more likely to feel engaged, competent,

and satisfied with their learning experiences.

2.2.2 Learning Resources and Facilities

The availability and adequacy of learning resources and facilities within clinical settings play

a crucial role in shaping nursing students' satisfaction (Kramer et al., 2019). Access to state-

of-the-art simulation labs, medical equipment, and patient care technology enhance students'

learning experiences and confidence in delivering quality care. Furthermore, well-equipped

clinical environments contribute to students' sense of preparedness and competence,

positively impacting their satisfaction levels.

2.2.3 Interprofessional Collaboration

Collaboration among healthcare professionals enriches nursing students' learning experiences

and satisfaction levels (Cunningham et al., 2018). Interprofessional collaboration fosters a

holistic approach to patient care, allowing students to witness the value of teamwork,

communication, and mutual respect in clinical practice. Positive interactions with colleagues

from different disciplines enhance students' understanding of their role within the healthcare

team and contribute to their overall satisfaction with their clinical placements.

2.2.4 Patient Diversity and Case Mix

Exposure to diverse patient populations and a variety of clinical cases is essential for nursing

students' professional development and satisfaction with their clinical placements (Pellatt et

al., 2019). Interacting with patients from different backgrounds, cultures, and socioeconomic

statuses enables students to develop cultural competence, empathy, and critical thinking

skills. Additionally, exposure to complex cases challenges students to apply theoretical

knowledge to real-life scenarios, enhancing their clinical competence and confidence.

2.2.5 Supportive Clinical Environment:

A supportive clinical environment characterized by teamwork, respect, and inclusivity is

conducive to nursing students' satisfaction and learning outcomes (Levett-Jones et al., 2019).

When students feel valued, supported, and respected by clinical staff, preceptors, and peers,

they are more likely to actively engage in learning activities and seek opportunities for

professional growth. A positive clinical environment nurtures students' confidence, resilience,

and sense of belonging, contributing to their overall satisfaction with their clinical

placements.

Conclusion:

Nursing students' satisfaction with their clinical learning placements in hospital settings is

influenced by a myriad of factors, including the quality of clinical supervision, availability of

learning resources, interprofessional collaboration, patient diversity, and the supportive

clinical environment. These interconnected factors contribute to students' overall learning

experiences, professional development, and readiness for clinical practice. By prioritizing

these factors and creating optimal learning environments, educators, administrators, and

healthcare institutions can enhance nursing students' satisfaction, engagement, and success in

their academic and professional endeavours. Moving forward, further research and ongoing

evaluation of clinical learning environments are essential to continually improve the quality

of nursing education and ensure the preparation of competent, compassionate, and resilient

nurses for the evolving healthcare landscape.

3. RESEARCH METHODOLOGY

3.1 Introduction

. The previous chapter provided an overview and background of the study. The problem

statement, purpose, objectives and the significant of the study were outlined and the literature

review. This chapter will include design and methodology which include research design,

population, sample, and sampling method. Data collection procedures, data collection

instruments, data analysis and ethical consideration. Methodology makes provision of the

strategies and grounding of the study (Pilot & Beck, 2016). Research methodology is a

process or plan for collecting the specific steps of the study (Burns & Grove, 2017). In

addition, Polit and Beck (2016) describes research methodology as the steps, strategies and

procedures used for gathering and analysing in research. Research methods includes: research

designs, study population, sample, sampling techniques, settings, and research instruments

etc.

3.2 Research Approach and Design

Maree, (2016) defines designs as overall strategy that are needed in order to integrate the

different components of the study in a more logical way. The research design is therefore

used to effectively address the research problems and it shows the exact collection,

measurement and analysis of the data. In quantitative research, one of the important tasks of

the researcher is to describe what they obtain during the field work (Holloway & Galvin,

2016). A cross-sectional study will be employed in this study. This design involves collecting

data at a single point in time to examine the relationship between variables, in this case, on

assessing factors associated with nursing students’ satisfaction with their clinical placement in

the hospital setting, Kavango east region (Creswell & Creswell, 2017). Thus, the researcher
chose this design for the study as it facilitates the precise actions the researcher aims to

achieve such as identifying any issues with current practice or justifying current practice.

3.3 Population of the Study

A population is a particular type of individuals or elements that of interest to the researcher

and which meets the criteria of the study (Gray & Grove, 2016). A population is the entire

group of persons or objects that is of interest to the researcher and which meet criteria they

are interested in studying (Brink et al. 2018). The population that the researcher has access to

is referred to as the study population. This study will consist of nursing students from second

year to fourth year will be eligible to participate in research as these groups of students had

been rotated or placed in all the departments. There about 255 student from second year to

fourth -year; therefore, the sample size was calculated according to Sekaran and Bougle

(2013). Whereas second year contains 64 students, 105 students in third year and 86 students

in fourth year.

3.4 Sampling method

Brink et al., (2018), defined sample as a subject of population that is selected to present the

population. Sampling is the process of selecting adequate sample size from a population of

interest so that by studying the sample we may fairly generalize our results back to the

population of interest (Brink, Van der Walt, and Van Rensburg, 2013). In accordance with

quantitative design, convenient sample will be used as respondent will be selected by

availability and willingness to participate. Convenience sampling is chosen due to its

practicality and feasibility within the clinical setting, allowing for efficient data collection

from student nurses allocated at clinical areas. The researchers will collaborate with

healthcare providers at each clinic to identify and approach eligible participants. Brink et al
(2018), defines convenience sampling as a sampling that involves the choice of readily

available participants or objects for the study. Furthermore, elements are included in the

sample because they happen to be in the right place and at the right time. Grove et al (2017),

entails that this method of sampling is about making judgement about the population to be

studied, the sampling will enable the researcher to acquire critical information that will make

it easy in assessing factors associated with nursing students' satisfaction with their clinical

learning placement in the hospital setting, specifically in the Kavango East Region.

There about 255 student from second year to fourth -year; therefore, the sample size was

calculated according to Sekaran and Bougle (2013). Whereas second year contains 64

students, 105 students in third year and 86 students in fourth year.

3.5 Sample size calculation

The size of the sample (N) has been calculated using a formula according to Sekaran and

Bougie (2013) as follows.

N =total population whilst n= the sample size and α = the confidence limit 5% 0R 0.05

N
n= 2
1+ N × α

255
n= 2
1+255 × 0.05

255
n=
1+255 × 0.0025

255
n=
1+0.6375

n=156
3.6 Inclusion criteria

Inclusion criteria outline the characteristics where by the subjects will be included in the

study (Pilot & Beck, 2017). Nursing students who are in their second year, third year and

fourth academic year at university of Namibia Rundu campus doing their practical’s at Rundu

intermediate hospital are eligible to be included and those who are to participate in the

research. The selected students are presumed to have adjusted to the hospital settings, as they

have completed their first year and therefore would be able to give feedback on the factor

associated with their satisfaction with their clinical placement.

3.7 Exclusion criteria

Exclusion criteria is not the opposite of inclusion rather refers to the attributes that prevent a

person from being included in the study (Gray et al., 2016). First year students, students who

just transferred from other campuses and students who will not be willing to sign the consent

would be excluded.

3.8 Study settings

A research setting refers to the physical, social, or virtual environment where a research study

takes place. It includes the location or locations where data collection occurs, such as specific

institutions, communities, laboratories, or online platforms. The research setting is integral to

the design and implementation of a study, as it determines the context in which data are

gathered and influences the interpretation of results. The research setting for the study

assessing factors associated with nursing students' satisfaction with their clinical learning

placement in the hospital setting, specifically Rundu Intermediate Hospital.

3.9 Research instrument

A research instrument is presumably anything which give information on whatever is being

researched to intensify the knowledge of your subject. In a quantitative study a researcher

goes into the field for collecting data by questioning the participants` (Lobiondo-wood &

Haber, 2017). The research instruments, structured questionnaire, self-administered

questions, and observational checklist. Question format and sections from previous studies on

factors associated with nursing student satisfaction with their clinical placement at the

hospital settings will be adopted and modified only. A questionnaire is a series of instrument

consisting of series of questions and prompts for the aim of gathering information from

participant (Brink et al. 2018). The questions will take about 10-15 minutes to finish. This

study questionnaires, there are short instruction addressed to the respondents, informing them

on how to answer the questions. The questionnaire is partitioned into three sections with

section A that will capture demographic information on the status of the respondents, and

section B will contain factors associated with nursing student satisfaction with their clinical

placement. The questionnaire designed to gather specifically views of the students. It will

also use research objectives in developing questions; these objectives will guides the

researcher on developing questionnaire.

3.10 Data collections

It refers to the precise, systematic gathering of information relevant to the research objectives

(Brink, Walt, Rensburg, 2012). The researcher will seek for ethical approval from the

research committee at the University of Namibia, Rundu campus. After the approval will be
granted, the researcher will approach respondents basically face-to-face explain to then the

aim and inclusion criteria of the study and determine the respondents. And give them an

overview of the study purpose, significance, consent seeking for their permission to

participate in the study. Each respondent who will agree to participate will sign a consent

form and no punishment will be given if they will withdraw or refuse to participate. The

setting will take place at Rundu state hospital and university of Namibia Rundu campus, will

maintain confidentiality and anonymity of the respondents' and collected data will only be

accessible to the supervisor and researcher only. The survey will take about 10-15 minutes

and the questionnaire will only be available to the researcher and supervisor

3.11 Data quality

3.11.1. Validity

Instrument validity seeks to ascertain whether an instrument accurately measures what is

supposed to measure, given the context in which it’s applied (Brink et al., 2018). In this

study, validity will be ensured by thoroughly going through the information that will

be collected in relation to the questions and objectives of the study, to ensure accuracy and

completeness of the data collection. The research supervisor and the ethical review

committee will examine the questionnaire and the appropriate changes suggested will be

made prior to data collection. In addition, data collection instrument will be pretested before

main data collection period to ensure validity.

3.11.2. Reliability

Reliability denotes the extent to which the methodology can be relied upon to produce the

same results should it be repeated (Brink et al., 2018). The Research instrument will be
checked by the research supervisor who is an expert in quantitative research (Burns et al.,

2016). Moreover, the tools will also be shared with other experts (supervisors) for

corrections, inputs, and deletion of destructive items. These will be addressed accordingly to

ensure clarity, adequacy, and comprehensiveness of the tools. The questionnaire will be pre-

tested using pilot study before the actual data collection, conducted and the participants will

be informed on the purpose of the study

3.12 Data analysis

According to Brink et al., (2018) data analysis is the methods of organizing raw data and

displaying them in a fashion that will provide answers to research questions. The aim of data

analysis is to organize structure and elicit meaning from the data which have been collected

(Polit & Beck 2017). Brink et al, (2018) defines data analysis as the phase in research that

requires careful planning, it involves categorizing, ordering, manipulating, and summarizing

data and describing them in a meaningful term. Data analysis allows a researcher in

quantitative research to organize the data in various ways, thus the researcher gets the ideas

of the pattern, outliers and missing data. In the proposed study the researcher aims to use

statistical analysis which is essential tool to reduce, summarize, organize, manipulate,

evaluate, interpret and communicate quantitative data. Microsoft excel 2016 will be used to

enter the data to present them in to different types of graphs and tables. Moreover the SPSS

(Statistical Package for Social Science) version 28.0 software will be performed for

descriptive statistics.

3.13 Ethical considerations

Research ethics are principles, rules, and regulations that researcher should follow and abide

by while conducting research. Permission to conduct the study will be obtained from the

Ministry of Health and Social Services and also the (MOHSS), the research proposal will be

submitted to the school of Nursing Research Committee of the faculty of health science at the

University of Namibia for ethical approval. The permission to conduct the study will be

granted after research proposal is approved.

3.13.1. Informed consent

Informed consent is a process by which participants voluntarily confirms his or her

willingness to participate in a particular trial, after having been informed of all the aspects of

the trials that are relevant to the participant’s decision to participate (Polit & beck, 2012). The

study will be held in such a way that all participants will be informed, verbal and written

consent will be obtained for the participants to understand fully what the study will be.

Individuals will be asked to volunteer to participate in the study and they are free to withdraw

from the study anytime they wish to do so.

3.13.2 Principle of beneficence

One of the most fundamental ethical principle in research is that it imposes a duty on

researcher to minimize harm and to maximize benefits. Human research should be intended

to produce benefits for participants themselves or a situation that is more common, for other

individuals or society as a whole. The researcher has an obligation to avoid, prevent, or

minimize harm (non-maleficence) in studies with humans. Participants must not be subjected

to unnecessary risk of harm or discomfort, and their participation in research must be

essential to achieving scientifically and societally important aims that could not otherwise be

called off. In this study the researcher will ensure that beneficence is practiced through

confidentiality as the participant’s responses will be encoded.

3.13.3 Principle of autonomy

The principle focuses on ensuring that people’s rights are respected at all times. Participants

were given an information letter to read through and understand so that they participate

without influence. All their questions and concerns will be answered. Participants also have

an informed consent form to sign. In this study the researcher therefore will ensure that the

nature of the study is fully disclosed to the participant in order for them to make an informed

decision to either participate or decline participation, and self-determination will be ensured

by giving the participants opportunities to ask questions.

3.13.4 Principle of justice

This principle entails participants’ right to fair treatment and their right to privacy. The

researcher will treat people who declined to participate in a study or who withdrew from it in

a non-judgemental manner, honour all agreement made with participants. The researcher will

be fair by informing all participants of their rights during the study and obtain their consent.

In this study, the researcher will ensure fair treatment through asking the same questions to all

participants regardless of their sex or age, those who happen to decline to participate in the

research will be treated fairly without any prejudice from the researcher.

3.13.5 Principle of autonomy

Autonomy is the respect for self-determination in decision-making (Cosac, 2017). In this

study the ethical principle of autonomy will be maintained through giving the participant the

right to choose to participate or withdraw from the study. There researcher therefore will

ensure that the nature of the study is fully disclosed to the participant in order for them to

make an informed decision to either participant or decline participation. Self-determination

was ensured by giving the participants opportunities to ask questions.

3.13.6 Principle of anonymity

The study will not share identifying information that can be specifically linked to the

individual participant. Participants names will not be mentioned in the interview recording or

transcript, as their names will be substituted with code letter, for example; participant A, B or

C etc.

References

Abouelfettoh, A., & Al Mumtin. S. (2015). Nursing education satisfaction with their clinical

placement. [Link] &aid=6801

Atakro, C. A., Armah, E., Menlah, A., Garti, I., Addo, S. B., Adatara, P., & Boni, G. S.

(2019). Clinical placement experiences by undergraduate nursing students in selected

teaching hospitals in Ghana. BMC Nursing, 18(1), 1-10

Council, S. A. N. (2013). Code of ethics for nursing practitioners in South Africa. Pretoria:

South African Nursing Council, 3-5

Courtney-Pratt, H.,Fitzgerald, M., Ford, K., Marsden, K., & Marlow, A. (2012). Quality

clinical placements for undergraduate nursing students: a cross-sectional survey of

undergraduate and supervising nurses. Journal of Advanced Nursing, 68(6), 1380-1390.

[Link]
Du Plooy-Cilliers, F., & Cronje, J. (2014). Quantitiave data collection. In F. Du Plooy-

Cilliers, C. Davis, & R. Bezuidenhout (Eds.), Research matters147–172. Cape Town: Juta.

Edmonson, C., & Zelonka, C. (2019). Our own worst enemies: The nurse bull

Higazee, M. Z. A., Rayan, A., Ades, M. A., & Alrawashdeh, F. (2015). Nursing students’

satisfaction with their clinical experiences. International Journal of Nursing and Health

Science, 4(2), 16

Kaphagawani, N. C., & Useh, U. (2013). Analysis of nursing students learning experiences in

clinical practice: Literature review. Studies on Ethno-Medicine, 7(3), 181-185.

Kolb, D. Mwai, E. (2014). Nursing students’ experiences in clinical nursing environment.

Unpublished bachelor’s degree programme in nursing thesis, JAMK University of Applied

Sciences, Finland.

Papastavrou, E., Dimitriadou, M., Tsangari, H., & Andreou, C. (2016). Nursing students’

satisfaction of the clinical learning environment: a research study. BMC Nursing, 15(1), 1-10.
 Appendices

ANNEXURE 1: UNAM APPLICATION FOR APPPROVAL OF RESEARCH PROPOSAL

TO: Prof Louise Pretorius

Associate Dean: School of Nursing and Public Health

University of Namibia

Main Campus

THROUGH: Mr Daniel Opotamutale Ashipala

Coordinator: School of Nursing Public Health

 University of Namibia

Rundu Campus

FROM: Ms Tjimbali Inesh

221098747

University of Namibia

Rundu Campus

20 September 2024

Application for approval of research project: Assessing factors associated with nursing

students’ satisfaction with their clinical placement in the Rundu hospital setting, Kavango

east region:

Ms Inesh Tjimbali Mbaku an undergraduate Nursing Science student from the university of

Namibia, Rundu Campus, is planning to conduct a Research titled “assessing factors

associated with nursing students’ satisfaction with their clinical placement in the hospital

setting, Kavango east region:

The study aims to assessing factors associated with nursing students’ satisfaction with their

clinical placement in the Rundu hospital setting, Kavango east region, with the objective of to

identify and analyse the key factors influencing nursing students' satisfaction during their

clinical placements in hospital settings in Kavango East region. To assess the impact of

nursing students' satisfaction with their clinical placements on learning outcomes, retention

rates, skill development, and overall educational outcomes, thereby providing insights into

the effectiveness of current clinical education practices and opportunities for improvement.
By assessing factors associated with nursing students' satisfaction with their clinical learning

placement in the hospital setting, specifically in the Kavango East Region, is multifaceted

and crucial for several reasons. First and foremost, understanding the factors that contribute

to nursing students' satisfaction in their clinical placements is essential for ensuring the

quality of nursing education. Clinical placements play a pivotal role in nursing education,

providing students with hands-on experience and exposure to real-life healthcare scenarios.

When students are satisfied with their clinical placements, they are more likely to be engaged,

motivated, and invested in their learning process. This, in turn, can lead to better academic

performance and the development of competent and confident nursing professionals.

Furthermore, identifying the factors that influence nursing students' satisfaction can inform

the development of strategies and interventions to enhance the quality of clinical learning

experiences. By addressing specific areas of concern or dissatisfaction, nursing educators and

healthcare institutions can tailor clinical placement experiences to better meet the needs and

expectations of students. This might involve improvements in the supervision and support

provided to students, the variety and complexity of clinical cases encountered, the availability

of resources and facilities, or the overall organizational culture within healthcare settings.

Thank you very much

Yours sincerely

Inesh Tjimbali Mbaku

 ANNEXURE: 2: REGISTRATION OF RSEARCH PROJECT

REPUBLIC OF NAMIBIA

MINISTRY OF HEALTH AND SOCIAL SERVICES

REGISTRATION OF A RESEARCH PROJECT

 TITTLE: assessing factors associated with nursing students’ satisfaction with their

clinical placement in the Rundu hospital setting, Kavango east region Personal details

regarding researcher

(CV to be attached)

Name of the Principle investigator: Inesh Tjimbali

Address: Namibia, Rundu, Kehemu.

Institution: University of Namibia, Rundu campus.

Official title’s: Ms

Academic / Professional qualifications: Bachelor of Nursing Clinical (Honours) degree

2, Address for correspondence (if not as above): As above.

3. Is the research to be carried out as part of an academic fulfilment?

Yes

4. Are you a MoHSS employee?

No

If yes which Directorate/Region: N/A

5. Personal details regarding official supervising the proposal:

Name: Mrs Haikera

Address: P O Box 5101, Kehemu, Rundu, Namibia. Rundu

Official title: Lecturer

University of Namibia
 Rundu Campus

6. Details regarding research proposal:

Research proposal and data collection tools attached

Yes

6.2 Estimated period for research: September 2023 to March 2024

Commencing date: 17.09.2023

6.4 Completion date: 08.08.2024

6.5 Facilities required (specify): Yes

6.6 MoHSS staff required (specify): No

6.7 Patient/Subjects required (Specify): No

6.8 Laboratory investigation required (specify): None

6.9 Specimen required (specify): None

6.10 Records required (Specify): None

7. Additional information for research concerning clinical tests with medications (trials):

7.1 Name and address of firm executing the test/evaluation:

None

Pharmaceutical products or equipment which will be used/tested:

7.2.1 Pharmaceutical products:

N/A

7.3 Is the pharmaceutical products registered with the Medicine Control Council?
 N/A

If YES give registration number

7.4 Proof of registration (letter attached):

N/A

8. Is publication envisaged (specify what form, when)

Yes, through peer review and ultimately for a merit publication in international accredited

journal.

I Inesh Tjimbali. agree to undertake the above Project in accordance with the requirements

mentioned in this registration.

I agree to carry out the project without incurring any expenses not budgeted for by the

Ministry, and to bear the full responsibility for the project as approved. Should it be necessary

to deviate from any procedure of the project as approved, I shall notify the Permanent

Secretary of the Ministry of Health and Social Services to obtain his/her consent.

I undertake to obtain full consent from subjects who are legally in a position to or to do so or

obtain consent from their legal guardians.

I agree to submit preliminary results of the project to the Permanent Secretary of the Ministry

of Health and Social Services, within a period of 3 months after completion of said project.

I agree to submit all results of the project to the Permanent Secretary of the Ministry of

Health and Social Services.

I understand that the Ministry, in granting permission for the execution of the project, places

itself under no obligation and will not necessarily grant permission for publication.
I agree to submit a copy of the work (paper, report) I intend to publish to the Ministry to

obtain the necessary permission before publication.

____________________________ ______________

SIGNATURE OF RESEARCHER DATE

WITNESSES:

1.__________________ _____________________________ ___________

SIGNATURE NAME AND ADDRESS DATE

2.__________________ _____________________________ ___________

SIGNATURE NAME AND ADDRESS DATE

FOR OFFICIAL USE ONLY

REFERENCE NUMBER: ---------------

1. RESEARCH MANAGEMENT COMMITTEE:

RECOMMENDED/NOT RECOMMENDED

COMMENTS .........................................................................................
 .........................................................................................

.........................................................................................

SIGNATURE:

................................................................................ ..............

CHAIRPERSON: RESEARCH MANAGEMENT COMMITTEE

DATE: …………………………………………………………………

2. OFFICE OF THE PERMANENT SECRETARY:

APPROVED/NOT APPROVED

COMMENTS.............................................................

.........................................................................................

SIGNATURE:

................................................................. ................................

PERMANENT SECRETARY DATE

Participant Information Sheet

Title of Study assessing factors associated with nursing students’ satisfaction with their

clinical placement in the Rundu hospital setting, Kavango east region

Researcher: INESH TJIMBALI MBAKU

Contact Information: Cell no: 0818529537 Email address: intjimbali@[Link]

Introduction:

You are invited to participate in a research study assessing factors associated with nursing

students’ satisfaction with their clinical placement in the Rundu hospital setting, Kavango

east region. Your participation in this study will contribute to understanding the factors

associated with nursing students’ satisfaction with their clinical placement in your faculty.

Purpose of the Study:

The purpose of this study is to assessing factors associated with nursing students’ satisfaction

with their clinical placement in the Rundu hospital setting, Kavango east region. By

participating, you will provide valuable insights that can inform healthcare practices and

University.

Procedures:

If you agree to participate in this study, you will be asked to complete a questionnaire. The

questionnaire will include questions about your satisfaction with their clinical placement in

the Rundu hospital setting, Kavango east region, as well as some demographic information.

The questionnaire will take approximately 10 to 20 minutes to complete. Your responses will

be anonymous and confidential.

Risks and Benefits:

There are no anticipated risks associated with participating in this study. By participating, you

will contribute to research aimed at improving satisfaction of the clinical placements, which

may benefit you and others in the community in the future.

Confidentiality:

Your responses will be kept confidential. No identifying information will be collected, and

your individual responses will not be shared with anyone outside of the research team. Data

will be stored securely and only accessed by the research team.

Voluntary Participation:

Participation in this study is voluntary. You have the right to withdraw at any time without

consequence. Your decision to participate or withdraw will not affect your current or future

healthcare services.

Questions and Contact Information:

If you have any questions or concerns about the study, you may contact the researcher,

Tjimbali Inesh, intjimbali@[Link], cell no: +264818529537 or my supervisor: Mrs

Haikera, hhaikera@[Link]. Faculty of Health Science and Veterinary Medicine, School of

nursing and public health, University of Namibia, Rundu Campus. If you have questions

about your rights as a participant, you may contact.

Consent:

By completing and returning the questionnaire, you indicate your voluntary consent to

participate in this study.

Thank you for considering participation in this study. Your contribution is greatly

appreciated.
Researcher's Signature: --------------------------- Date: ------------------------

Participant's Signature: ------------------------------ Date: -----------------------