Original Research

Factors influencing implementation of simulation in nursing and midwifery training in Malawi

Gertrude Mwalabu, Annie Msosa, Ingrid Tjoflåt, Christina F. Risa, Patrick Mapulanga, Bodil Bø, Kristin H. Urstad, Masauko Msiska
Health SA Gesondheid | Vol 29 | a2422 | DOI: https://doi.org/10.4102/hsag.v29i0.2422 | © 2024 Gertrude Mwalabu, Annie Msosa, Ingrid Tjoflåt, Christina F. Risa, Patrick Mapulanga, Bodil Bø, Kristin H. Urstad, Masauko Msiska | This work is licensed under CC Attribution 4.0
Submitted: 26 April 2023 | Published: 15 May 2024

About the author(s)

Gertrude Mwalabu, Department of Adult Health Nursing, School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
Annie Msosa, Department of Adult Health Nursing, School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
Ingrid Tjoflåt, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
Christina F. Risa, Department of Caring and Ethic, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
Patrick Mapulanga, Library Department, Kamuzu University of Health Sciences, Lilongwe, Malawi
Bodil Bø, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger,, Norway
Kristin H. Urstad, Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; and Institute of Nursing, Faculty of Health Studies, VID Specialized University, Oslo, Norway
Masauko Msiska, Department of Biomedical Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Lilongwe, Malawi

Abstract

Background: The study explored factors influencing implementation of simulation-based education (SBE) in nursing and midwifery education in Malawi.

Aim: This study aimed to identify factors influencing nursing and midwifery educators in selected training institutions and clinical sites.

Setting: The study covered one district and four central hospitals, five professional training institutions, Ministry of Health and Nurses and Midwives Council of Malawi officials.

Methods: Using mixed-methods approach, quantitative data were gathered from 293 participants, including 149 final-year nursing and midwifery students, and 144 clinical instructors. Qualitative data were obtained from 24 faculty members, 11 clinical instructors and two key informants. Researchers conducted 37 in-depth interviews, 10 focus group discussions and eight desk reviews. Descriptive statistics were used to analyse the quantitative data, while content analysis was used for qualitative findings.

Results: Five themes emerged from qualitative data: absence of simulation in regulatory body syllabi, insufficient formal training, demand for knowledgeable clinical instructors, inadequate human and material resources, and resistance to change. Survey results indicated that 83% of the participants had theoretical SBE knowledge but lacked practical skills, with only 13% considering SBE as a current teaching method. Educators emphasised lack of infrastructure, skills laboratories, teaching hospitals, equipment, and a deficit in formal training as critical barriers to SBE implementation.

Conclusion: The study concluded that skilled educators, appropriate infrastructure and resources could facilitate SBE implementation in Malawi.

Contribution: Recommendations included regulatory body support, formal training for educators, utilisation of low-fidelity simulators, and establishment of SBE centres and corners in health facilities.


Keywords

simulation; nursing; midwifery; education; educators; clinical teaching; Malawi

Sustainable Development Goal

Goal 4: Quality education

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