Ntombifikile Fikile Mtshali

• Doctor of Philosophy (Nursing)- Professor
• Professor (Associate) at University of KwaZulu-Natal

Background Competency-based education (CBE) is adopted to reform health professionals’ education. The goal is to produce graduates who are not only competent in their fields but also equipped with the necessary social accountability skills for safe practice. Aim The study aimed to explore nursing education stakeholders’ perspectives on competency-...

Chronic kidney disease (CKD) is one non-communicable disease mainly caused by comorbid of diabetes and hypertension, thus compromising quality of life for the patients. Few rigorous Quality of Life frameworks on chronic kidney disease (CKD) have been reported in low-middle income countries including South Africa. Therefore, the study aimed at devel...

Background Although the barriers and facilitators of translating health research into policy are generally well documented, not much has been reported for universities in low-and middle-income countries. We identified and analyzed barriers and facilitators of translating doctoral research findings into policy in a selected health sciences school in...

Translation of health research findings into policy contributes to improvement of health systems. Generally, in sub-Saharan Africa policymakers rarely use research evidence and hence policies are often not informed by research evidence. Unless published or in the case of commissioned research, doctoral health research is often not used for health p...

Background: Nurses in Eswatini are best positioned to assist adolescents living with HIV to disclose their status to others. Nonetheless, it is evident that many nurses are not actively involved in the disclosure process. Aim: The aim of this study was to explore the process of nurses in preparing adolescents for self-disclosure and describe the ro...

The shortage of nurses is a global crisis, particularly in remote and rural communities. Contributory factors are retirements, resignations, recent increased deaths due to the COVID-19 pandemic, and the reduced production of nurses because of high attrition rates. This article’s purpose was to investigate the provision of student support in the nur...

Background and aim: Primary Health Care is a foundational element within the realm of healthcare reforms, serving as a linchpin for achieving Universal Health Coverage and Sustainable Development Goals. Globally, there is a growing emphasis on building a robust primary health care nursing workforce to meet the challenges arising from chronic and co...

Access to antiretroviral therapy (ART) has promoted a significant decrease in mortality of vertically HIV-infected children. As a result, there has been an increasing growth of this population that reaches adolescence. These adolescents face problems such as self-disclosure and the stigma of the disease. This study aimed to determine the process fo...

Background A few frameworks have been developed to guide the translation of research findings into policy in low-resourced countries. However, none of the frameworks are specific for PhD work and this often results in the work not being fully utilized for policy development. Objective This paper aimed to develop a framework tailored to facilitate...

Background Translation of health research findings into policy remains a challenge in sub-Saharan Africa. Factors influencing health research utilization are poorly described in literature. Therefore, identifying factors that influence the utilization of research findings for policy formulation is essential to facilitate implementation of evidence-...

Introduction There has been a growing interest in preconception care (PCC) as a primary means of tackling the high maternal and child mortality rates, as evidence has shown that the state of maternal health before conception can have a direct impact on the health of the mother and baby. Primary care nurses have been recognized as the highest provid...

Purpose: This study aimed to measure learning gains during an ICT training intervention in first-year students completing a four-year undergraduate nursing degree. Methodology: This study adopted a quasi-experimental, one group pre-test and post-test design. The intervention effectiveness was measured using individual single-student normalised gai...

The recent migration of public nursing colleges from the Department of Health to the higher education sector in South Africa has compelled nursing institutions to ensure that their programs meet the Council of Higher Education requirements. One of these requirements is comprehensive student support services in line with the prerogative to widen acc...

Background: The significance of ensuring high quality of care has become apparent in nursing and midwifery education worldwide, especially in low- and middle-income countries. This has led to upgrades of the nursing curriculum to include several aspects of care that have been overlooked with recent evidence-based care. Objectives: To explore the...

The adoption of a competency-based curriculum has necessitated the shift of simulation-based education to the centre stage rather than being an add-on in the nursing education programme. Since the adoption of a competency-based nursing curriculum in Lesotho in 2014, simulation-based learning has been one of the policy areas and is implemented in al...

This article aimed to investigate the availability and utilization of support services by undergraduate (UG) students in a nursing education institution in South Africa. The article employed a quantitative non-experimental descriptive design, using a self-administered questionnaire, to collect data from 118 participants selected through a non-proba...

Background: The changing landscape of nursing education to competency-based education has strengthened the importance of simulation learning in the process of developing the required graduate competencies. Aim: This study aimed to develop a model that guides the implementation of simulation- based education (SBE) in under-resourced nursing educat...

Background. Simulation has taken centre stage in health sciences education in the context of the increasing adoption of a competency-based curriculum. Simulation replicates facets of the real world in an interactive manner that allows students to learn clinical skills and develop clinical reasoning skills in a safe learning environment. Facilitat...

Background Preconception care (PCC) is necessary to identify and deal with all the risk factors before conception. Some aspects of PCC, like folic acid supplementation, would be relevant to people desiring a pregnancy. Alternatively, PCC could provide contraceptive support to those with no pregnancy intention. In South Africa, primary healthcare nu...

Background: The digital world is rapidly changing, and so do the required digital skills. As physical devices and software are adapted to meet new possibilities and demands, individuals’ skills must adapt to technological advancement. Digital literacy is increasingly used in the public discourse, becoming a core requirement of students, academics,...

Background. Learning management systems (LMS) are indispensable teaching and learning tools in nursing education, and in recent years, LMS have become a cornerstone to support online learning, particularly during the COVID-19 pandemic. The South African (SA) e-education policy requires every teacher and learner in the education and training sector...

Background: Preconception care (PCC), a policy directive from the World Health Organisation (WHO), comprises all the health interventions offered to women and couples before conception and is intended to improve their overall health status and the pregnancy outcomes. Although PCC should be an essential part of maternal and child health services in...

Background: In order to ensure an effective health system, there is a need to recruit, train and deploy a competent nursing workforce. A competent workforce can be made possible by integrating simulation into the curriculum. Implementation of simulation-based education in Lesotho is facing a number of challenges as the country has limited resources...

Background: Preconception care (PCC) utilisation is essential to extend and complete the health continuum. However, these services are not yet incorporated into many low-income countries’ existing maternal health services. Aim: This study aims to review the current literature on the knowledge, utilisation and provision of PCC. Setting: This inclu...

The coronavirus disease 2019 (COVID-19) pandemic exposed an absence of blueprints to avert an education disaster. In South Africa, in line with Alert Level-5, adhering to lockdown restrictions, higher education institutions (HEIs) closed, necessitating the transition to online teaching and learning. The HEIs, inclusive of the nursing discipline, ne...

Despite efforts made by sub-Saharan Africa (SSA) countries to promote evidence-informed health policymaking, translating research evidence into policy remains a very challenging task fraught with many barriers. However, to achieve the goal of making more evidence-informed decisions to improve health, it is critical to overcome the barriers to the t...

Introduction: The World Health Organization introduced the workload indicators of staffing needs (WISN) in 1998 to improve country-level health workforce planning. This study presents the primary care health workforce planning experiences of India, South Africa and Peru. Methods: A case study approach was used to explore the lessons learnt in th...

Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and...

Background: Reduced quality of life (QOL) is associated with shorter survival, and is more marked in patients with end-stage renal disease (ESRD). Predictors of health, which include policymaking, social factors, health services, individual behaviour, biology and genetics, have an impact on the QOL of patients with ESRD. Patients with ESRD in South...

Background Reform to Competency-based curricula, a standard for training health professionals of the 21st century, requires rigorous planning for successful implementation. However, although the reform defines the direction of the schools and quality of their products, it lacks in planning and prominence which could lead to the failure and waste of...

The use of simulation learning in competency-based nursing education programmes is gaining momentum in an effort to ensure competency among graduates. Nursing education institutions are using various simulation methods, such as low, medium, and high fidelity. Simulation laboratories need to be manned by qualified personnel and the management of the...

Background: The rapid development of technology has compelled tertiary institutions to devise innovative teaching strategies to meet the students’ needs and market’s demands. Recently, the Covid-19 pandemic has forced educational institutions to shift from in-person to online learning. E-learning is one of the areas advancing rapidly and which prov...

Mobile devices are increasingly part of daily life, with the benefits of using the technology in nursing education widely recognized. This study explored the use of mobile devices among undergraduate nursing students for academic purposes in South Africa, using a quantitative survey. The majority of participants owned smartphones (87.6%), followed...

Purpose This article explores the drivers of transformation to competency-based nursing education in Rwanda. Method The Strauss and Corbin grounded theory approach was used. Ethics approval was obtained prior to data collection. Data were collected using in-depth interviews of academic staff and students, and documents being analyzed using constan...

Aim: The study aimed to establish the role played by technology in nursing education through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Methods: 150 student nurses participated, with data being collected using a structured questionnaire with 14 items on a 5-point Likert scale. Parallel Analysis (PA) and Exploratory F...

Technological innovations such as e-learning are rapidly transforming the ways that institutions of higher education teach and students learn. In nursing education, e-learning offers opportunities to reach a great number of students, irrespective of time and space. In the context of Rwanda, the implementation of e-learning in nursing education was...

The aim of this study was to investigate challenges associated with postgraduate research supervision in nursing education and possible implications for improvement efforts. Background: Postgraduate research-based programs in nursing education are particularly new compared to other professions. Anecdotal notes from nursing education stakeholders i...

Technological innovations are changing the face of nursing education, with teachers being expected to integrate best teaching practices in the classroom and to ensure that nursing students are motivated and engaged. Taking into consideration students’ needs is essential to provide successful integration of the technology in teaching and learning. T...

Background and objective: Nursing education throughout the world is striving for international competitiveness and accountability for effectiveness, quality, and trust to the students, patients, and the community, thus making the issue of institutional accreditation increasingly important. The aim of this paper was to explore the perceptions of hea...

Background and objective: Nursing education throughout the world is striving for international competitiveness and accountability for effectiveness, quality, and trust to the students, patients, and the community, thus making the issue of institutional accreditation increasingly important. The aim of this paper was to explore the perceptions of hea...

Background The healthcare system is increasingly becoming technology dependent; consequently, nurses in all regions of the world are expected to develop their information and communication technology (ICT) skills, and integrating ICT in the nursing curriculum is fundamental. Aim This study aims to explore the types of ICT applications used and the...

Background: Public nursing colleges (PNCs) are currently redeploying from provincial departments of health to higher education to become part of a unified higher education system in South Africa. As primary producers of nurses, this migration process needs to be managed carefully, with stakeholders having a common understanding of this process. Ob...

The National University of Lesotho Nursing Department, in implementing the first Master degree programme in Nursing, conducted a rapid needs assessment to understand the nursing education status in the country, establish the nature of the Master degree programme suitable to meet needs of the country and identify the core competencies expected from...

Background: Globally, there is consensus on the need for student support to address high student attrition and low throughputs, especially in nursing and midwifery programmes. Objectives: This study analysed the implementation of academic monitoring and support (AMS) in an undergraduate nursing programme to generate a context-informed academic mon...

Background: Clinical reasoning remains central in midwifery care in the light of uncontrollable high maternal mortality rates and errors in midwifery practice. However, there is no consensus, locally and internationally, on how clinical reasoning skills can be developed in undergraduate students particularly within midwifery context. Aim: This arti...

Background Malawi made great strides to increase the number of nurses through the Emergency Human Resource for Health Program. However, quantity of health workforce alone is not adequate to strengthen the health system. Malawi still reports skill mix imbalance and geographical mal-distribution of the nursing workforce. Health systems must continuou...

Background: The internet has become an indispensable tool for teaching and learning, research, and communication in today’s educational landscape. Nursing students, in particular, rely heavily on the internet to access scholarly resources, collaborate with peers, and engage in online learning activities. This article explores the general internet u...

Background: Despite a global consensus that nurses and midwives constitute the majority and are a backbone of any country’s health workforce system, productive capacity of training institutions remains low and still needs more guidance. This study aimed at developing a middle-range model to guide efforts in nursing education improvements. Objective...

Aim: The aim of this paper is to present the intervening conditions that influence the implementation of e-learning in resource-constrained nursing education institutions in Rwanda. Methods: Exploratory qualitative method was used. Forty participants were purposively selected from identified school’s campuses in Rwanda, and included nursing student...

Background: Competency Based Curriculum is acknowledged as the benchmark for transforming and up scaling the education and training of the health workforce for improved population and health outcomes. It was adopted in pre-service nursing education in Rwanda in 2007, when it switched from a content-driven curriculum to align education with the dema...

Background The Lancet Commission and the Global Health Workforce Alliance reported that professional education has generally not kept up the pace of health care challenges. Sub Saharan Africa needs an effective and efficient nursing education system to build an adequate, competent and relevant nursing workforce necessary for the achievement of Sust...

The dynamic nature of HIV care in the context of South Africa challenges nurses to continually keep abreast of changes in treatment and care policies. Communities of practice (CoPs) are considered an effective method of promoting lifelong learning, enhancing professional development and clinical reasoning through reflective practice. This paper rep...

Background: Several African countries, including South Africa, are using the Workload Indicators of Staffing Need (WISN) method, as the preferred health workforce planning and management approach. Ineffective implementation of this method can however mean that health outcomes are not improved.Objectives: This study explored the views of health work...

In an e-learning environment, teachers need to have the necessary knowledge and skills to deliver course content effectively. Information and communication technology is increasingly utilised in tertiary education due to its flexibility and diverse capabilities in catering to a large number of learners. In Rwanda, e-learning in nursing and midwifer...

Postgraduate programmes prepare nurses and midwives for advanced nurse practice. They value the nature of feedback they receive as it strengthens their capacity in functioning as advanced or specialist nurse level. The effective of their learning depends on the nature and quality of feedback provided. Feedback, especially formative feedback plays a...

The attrition and dropout rate of nursing and midwifery students affects the planned nursing workforce projections, especially in countries where health care systems are nurse-led. A range of student support interventions including academic monitoring and support (AMS) are implemented to ensure that all the nursing students complete their studies a...

Although in recent decades reforms to undergraduate nursing and midwifery education have increasingly been guided by the concept of competency-based curriculum in a drive to produce competent graduates in the African context, the topic remains poorly researched in-depth. The related issues and challenges need to be explored in the interest of evide...

Background. Scientific advancement, particularly in the area of information communication technology (ICT), challenges the mode of knowledge advancement at universities. Such challenges are especially evident in the area of postgraduate (PG) research supervision, particularly in the light of the changing students’ demography, whereby there is a rad...

Analysis on the perception of e-learning by nursing students was conducted in a selected school' campuses in Rwanda using the Demand-Driven Learning Model (DDLM)[1]. A quantitative survey was used based on the constructs from DDLM model (Content (PCUE); delivery (PDCE), Service (PSPE), Structure (PSOE), outcomes (POFE), and evaluation (PEDE), data...

Abstract: E-learning is a commonplace in nursing and healthcare professional education, and generally the importance of Information and Communication Technology (ICT) and the Internet in tertiary education is recognized. The entry visa for e-learning is a computer and an Internet connection [1]. The aim of this paper is to analyse the utilisation o...

Background: Higher education institutions have executed policies and practices intended to determine and promote good teaching. Students' evaluation of the teaching and learning process is seen as one measure of evaluating quality and effectiveness of instruction and courses. Policies and procedures guiding this process are discernible in universi...

Nursing education in Rwanda is undergoing rapid transformation. The literature reveals that the training of nurses and midwives in Rwanda started during the colonial era. Many of the nursing schools were opened by religious institutions such as Catholics, Protestants and Adventists, some being public and private. During 1980s there was a great tran...

Background Community-based education (CBE) serves as a primordial instrument in the implementation of Primary Health Care (PHC). Learning experiences in community-based settings provide the students with opportunities to learn by means of being actively engaged in primary health care associated activities to under-resourced communities (Mtshali, 20...

Background: The change to a democratically elected government in South Africa in 1994 brought with it an impetus for change in public health and education systems, which was signalled by a number of policy documents. Traditional content-driven education was to be replaced by a community-oriented approach to education. Community-based education was...

This paper is about community-based nursing education and promotion of primary health care philosophy

Emergency Centre (EC) overcrowding is a global concern. It limits timeous access to emergency care, prolongs patient suffering, compromises quality of clinical care, increases staff frustration and chances of exposing staff to patient violence and is linked to unnecessary preventable fatalities. The literature shows that a better understanding of t...

The Internet is rapidly becoming an important learning tool in academic institutions and workplaces. In academic institutions it plays a pivotal role in meeting information and communication needs of students, academics and researchers. Despite internet becoming an important information gathering and dissemination tool, literature reflects under-ut...

The worldwide changes in the health systems, including the adoption of a primary health care approach, has contributed significantly to the paradigm shift from hospital-based education to community-based education. Community-based education is favoured because of its potential to stimulate interest amongst graduates to serve in rural and under-reso...

Background: Employers and educators of nurses expect that, upon graduation, they will have acquired a basic set of scientific knowledge, clinical skills and professional attitudes. In Swaziland, however, these expectations remain unmet. Methods: We explored the perceptions of stakeholders in nursing education of how new graduates cope and perform a...

Background: Employers and educators of nurses expect that, upon graduation, they will have acquired a basic set of scientific knowledge, clinical skills and professional attitudes. In Swaziland, however, these expectations remain unmet. Methods: We explored the perceptions of stakeholders in nursing education of how new graduates cope and perform a...

Community-based learning (CBL) is one of the fastest growing reforms in the education of health professionals. This article aims to present the contextual determinants of CBL and to describe the casual conditions that led nursing education institutions (NEIs) to incorporate CBL into their curricula. A grounded theory research design was adopted. Tw...

Community-based learning (CBL) is one of the fastest growing reforms in the education of health professionals. This article aims to present the contextual determinants of CBL and to describe the casual conditions that led nursing education institutions (NEIs) to incorporate CBL into their curricula. A grounded theory research design was adopted. Tw...

There have been calls to reform nursing education to respond to the priority health needs of the country. Literature reviewed did not reveal any research conducted in the Eastern Cape with regard to exploring the concept of responsive nursing education programme by stakeholders at any nursing college, especially in the context of responding to comm...

The impact of information technology on nursing has been a subject of discourse for the latter half of the 20th century and the early part of the 21st. Despite its obvious benefits, adapting information technology to healthcare has been relatively difficult, and rates of use have been limited especiallyin many developing countries. This quantitativ...

Abstract: Background : Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogi...

Background: Community involvement is one of the crucial principles in the implementation of successful community-based education programmes. However, a gap continues to exist between the rhetoric of this principle and the reality of involving or engaging communities in the education of health professionals. Objectives: This study investigated the...

Education in the twenty-first century and educational reforms are subjects of interest and discourse worldwide because of the link between education and development. What appears not to have been fully explored in the Nigerian context is the responsiveness of various professions, especially nursing, to the consistently changing educational system....

Abstract Education in the twenty-first century and educational reforms are subjects of interest and discourse worldwide because of the link between education and development. What appears not to have been fully explored in the Nigerian context is the responsiveness of various professions, especially nursing, to the consistently changing educational...

Background: Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogical strate...

The worldwide changes in the health systems, including the adoption of primary health care approach, has contributed significantly to the paradigm shift from hospital-based education to community-based education. Community-based education is favoured because of its potential to stimulate interest amongst graduates to serve in rural and under-resour...

Assessment of clinical learning is imperative in order to ensure that those who become registered nurses are safe and competent practitioners. Literature however reveals that the measurement of clinical skills performance continues to pose a challenge for nurse educators. There is an ongoing debate around the best assessment method in clinical lear...

Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community-based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementati...

Reviewed literature revealed that clinical supervision is a conceptually sound learning model, which, unfortunately, is flawed by problems of implementation. Some of the more glaring problems include limited emphasis upon problem-solving, lack of clear expectations for student performance, inadequate feedback to students, inappropriate role models...

The National Plan for Higher Education (2001) mooted funding as a lever to engender equitable student access, quality teaching and research, improved student retention and throughput and the production of graduates responsive to the country's social and economic needs. Maximizing income via the teaching input and output grants, the research output...

Background: The use of tobacco is the single most preventable cause of death and disease in our society and despite the information delivered through materials or messages to increase awareness of the harms of tobacco, many people continue to smoke. Smoking in Rwanda is prohibited in public areas although staff in a large hospital in Kigali continu...