Clinical teaching practices in maternal mental health in the selected christian health association of Malawi's nursing colleges

Abstract

Clinical teaching practices of nurse educators are very important in building students’ competencies and preparing them for practice. However, most nurse midwife technicians trained by the Christian Health Association of Malawi lack competencies in mental health services, as a result, clients are missed and undertreated, which negatively affects care. The study aimed to assess clinical teaching practices in maternal mental health in the selected Christian Health Association of Malawi’s nursing colleges. This explanatory sequential mixed methods study was conducted at St. Luke’s and Ekwendeni College of Health Sciences, where 183 participants were recruited using convenient and purposive sampling techniques. Data was collected through a survey, in-depth interviews, focus group discussions, and document reviews. Descriptive statistics, Fisher’s exact test, thematic analysis, and content analysis were used to analyze the data. The findings show that maternal mental health is a neglected area because nurse educators implement a few MMH competencies in the NMT education program, such as documentation (M=4.55±0.595), collaboration of care (M = 4.27±0.78), and referral (M = 4.08±0.910). Furthermore, nurse educators use a few teaching practices, like sharing clinical objectives (M = 4.17±0.964), encouraging students to develop individual objectives (M = 4.51±0.680), and orienting students to clinical objectives (M = 4.39±0.728). The Fishers exact test revealed an association between the gender of students and the utilization of clinical teaching strategies in MMH (two-tailed p-value = 0.011). Furthermore, the qualitative findings discovered six themes, which include: the assessment and management of maternal women with mental health problems; clinical teaching and student support; maternal mental health practice has been neglected; difficulty in translating theoretical knowledge into practice; and functional teaching and learning in maternal mental health care. The findings further show that nurse educators face.some challenges when implementing maternal mental health clinical competencies, such as inadequate competencies in the nurse midwife technician’s curriculum, a shortage of skilled nurse educators, limited time for student practice, and a lack of teaching and learning resources, which act as barriers to student’s achievement of MMH competencies. The study recommends nursing and midwifery curriculum review, continuous professional development, and the mobilization of resources to support student’s learning. Nursing colleges should review their curriculum periodically, to maximize student learning opportunities in maternal mental health practice. Effective collaboration between academia, students, and hospital staff is required to enhance student competence development.