Arthur Labatt Family School of Nursing, Faculty of Health Sciences, London, Canada.
School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
BMC Med Educ. 2023 Dec 20;23(1):984. doi: 10.1186/s12909-023-04941-7.
Promoting family planning (FP) is a key strategy for health, economic and population growth, and achieving sustainable development goals (SDGs) especially SDG 3, which promotes health and well-being for all. The quality of FP services depends on the training of competent nursing and midwifery graduates before entering the workforce. In order to ensure graduates are well-trained and capable of meeting the needs of the population, their teachers need to demonstrate high self-efficacy and willingness to teach FP. However, there is a lack of research on the capacity and willingness of nursing and midwifery faculty to teach FP at higher learning institutions (HLIs) in Rwanda. The objective is to investigate and articulate the perceived self-efficacy and willingness of the nursing and midwifery faculty to instruct HLIs students on FP.
RESEARCH DESIGN/METHODOLOGY: We conducted a mixed methods study using a sequential explanatory design among almost all the HLIs (n = 6, 1 institution declined) that train nurses and midwives in Rwanda. One hundred thirty-six nursing and midwifery faculty who were actively teaching FP either in class, simulation lab, or clinical practice were invited to participate in a self-administered questionnaire and four qualitative focused group discussions. Participants answered questions ranking their self-efficacy in four domains from 0 - not confident to 3 - completely confident. Scores were calculated for each domain. A semi-structured interview guide was developed based on quantitative survey findings to gain a deep understanding of the ability and willingness to teach FP. Data were analyzed using thematic analysis. Ethical approval was obtained from the University of Rwanda, College of Medicine and Health Sciences Institutional Review Board.
A total number of 89 nursing and midwifery faculty participated in the study and only 85 completed the questionnaires fully, yielding a response rate of 95.5%. The mean age was 40.39 and there were more females (62.4%) compared to their male counterparts (37.6%). Respondents scored highest for perceived self-efficacy in course preparation (mean = 2.37), evaluation and examination (mean = 2.12) and instructor behavior and delivery (mean = 2.35). However, the score was low for clinical practices (mean = 1.79). There was a significant correlation among the four items of self-efficacy (p < 0.05). Being a female, a midwife, and having more years of experience in nursing education were each significantly associated with perceived self-efficacy to teach FP (p < 0.05). In the qualitative phase, 32 study participants participated in four focus group discussions. Four themes were identified: (a) educational background as a determinant of confidence to teach FP; (b) willingness to teach FP; (c) enabling factors of teaching FP; and (d) structural challenges.
Nursing and midwifery faculty reported inadequate self-confidence in teaching FP in clinical practice. Addressing personal and structural challenges in teaching FP should be a top priority. This requires a collective effort between nursing and midwifery faculty and HLIs to dismantle individual and systemic barriers that hinder self-efficacy and willingness to teach FP. There is a need for HLIs and different stakeholders to invest in training the nursing and midwifery faculty on FP practical skills to have a nursing and midwifery workforce providing up-to-date clinical FP services that will help Rwanda reach the SDGs.
推广计划生育（FP）是促进健康、经济和人口增长以及实现可持续发展目标（SDG）的关键战略，特别是促进所有人健康和福祉的 SDG3。FP 服务的质量取决于护理和助产专业毕业生在进入劳动力市场之前的能力培训。为了确保毕业生接受过良好的培训，能够满足人口的需求，他们的教师需要表现出高度的自我效能感和教授 FP 的意愿。然而，卢旺达高等学府（HLIs）护理和助产教师教授 FP 的能力和意愿方面的研究还很缺乏。本研究旨在调查和阐述护理和助产教师教授 HLIs 学生 FP 的感知自我效能感和意愿。
研究设计/方法：我们采用顺序解释设计，对卢旺达培训护士和助产士的几乎所有 HLIs（n=6，1 所机构拒绝参与）进行了一项混合方法研究。邀请了 136 名积极教授 FP 的护理和助产教师参加自我管理问卷和四个焦点小组讨论。参与者回答了四个领域的自我效能感从 0-完全没有信心到 3-完全有信心的问题。为每个领域计算了分数。根据定量调查结果制定了半结构化访谈指南，以深入了解教授 FP 的能力和意愿。使用主题分析进行数据分析。卢旺达大学医学与健康科学学院机构审查委员会批准了伦理。
共有 89 名护理和助产教师参加了研究，只有 85 名教师完整地完成了问卷，应答率为 95.5%。平均年龄为 40.39 岁，女性（62.4%）多于男性（37.6%）。受访者在课程准备（均值=2.37）、评估和考试（均值=2.12）以及讲师行为和教学（均值=2.35）方面的自我效能感评分最高。然而，临床实践的评分较低（均值=1.79）。四个自我效能感项目之间存在显著相关性（p<0.05）。女性、助产士和护理教育方面的更多年经验与教授 FP 的自我效能感显著相关（p<0.05）。在定性阶段，32 名研究参与者参加了四个焦点小组讨论。确定了四个主题：（a）教育背景是对教授 FP 有信心的决定因素；（b）教授 FP 的意愿；（c）教授 FP 的有利因素；和（d）结构挑战。
护理和助产教师报告在临床实践中教授 FP 的自我信心不足。解决教授 FP 方面的个人和结构挑战应是当务之急。这需要护理和助产教师以及 HLIs 之间的共同努力，以消除阻碍自我效能感和教授 FP 意愿的个人和系统障碍。HLIs 和不同利益相关者需要投资于护理和助产教师 FP 实践技能的培训，以便拥有提供最新临床 FP 服务的护理和助产人员，帮助卢旺达实现可持续发展目标。
