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Exploring undergraduate nursing students’ perceptions on being change agents in a community-based transformative learning programme at a nursing education institution in KwaZulu-Natal.

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Background The World Health Organization advocates for the strengthening of the healthcare system to improve the quality and efficiency of health service delivery. Transformative learning is associated with producing graduates who are change agents and in possession of leadership abilities to influence change in the healthcare system. The undergraduate nursing education programme of interest in this study adopts a community-based and problem-based curriculum, which uses a competency-oriented approach since 1994.Developing students as change agent’s is one of the competencies in the undergraduate nursing education. Purpose of the Study The purpose of this study is to explore undergraduate nursing students’ perceptions of being change agent in a community-based transformative learning programme at a nursing education institution in KwaZulu-Natal. Methods An exploratory qualitative approach is adopted in this study. The research setting is a nursing department in a selected university in KwaZulu-Natal. The sample includes 2nd, 3rd and 4th year nursing students registered in a Bachelor of Nursing programme. The participants were purposively selected because of their exposure to competency-oriented, community and problem learning. A total of 15 participated in focus group interviews. Ethical clearance was obtained from the University of KwaZulu-Natal Ethics Board: Protocol number is HSS/1910/016M, and ethical principles are observed throughout the study. Issues of quality are addressed through observing the four elements of trustworthiness; credibility, dependability, transferability and conformability. Results/Findings from the Study The findings of the study reveal that students understand the concept ‘change agents’ as people who possess the following characteristics: problem solvers, action-oriented researchers, health advocates, as well as advocacy and an empowering role. This is shown as a result of exposing them to a community-based learning setting for experiential learning while providing service to under-resourced communities. The findings further reveal that the development of students as change agents follows a process comprising of a progressive curriculum, shifting from traditional to an innovative curriculum. The educational environment in schools embraces democracy with social accountability values abetted in the development of students as change agents. The conditions that prepare students to be developed as change agents are related to students, facilitators, institutions and community. The consequence of developing students as change agent’s results in producing empowered students, raises awareness on student’s health issues, develops self-reliant communities and further reveals widening access to disadvantaged communities as well as having benefits to the faculty. Recommendations It is recommended that students should be made aware early in the programme on competencies as they are expected to be change agents at the end of the programme and how the learning experiences in the programme are used to shape these competencies. There should be a structured way of monitoring the development of the required competencies as early as from first year so as to provide the necessary support timeously. The use of innovative teaching strategies will assist students to develop critical thinking skills, communication and creative skills, thus becoming change agents. Educators should introduce learners to the theory of transformative learning and should provide necessary tools for students to be able to develop critical analytical reflection in the changing world so as to become better change agents. The use of transformative learning Programmes including community based education could be used to shape the nursing education Policies that will enhance the development of students as change agents. Further research can enlightened policy makers to use transformative learning in order to prepare students as change agents thus improving the quality on patients outcomes. Further research is recommended with diverse participants comprise academics, community members and other stakeholders involved in developing students as change agents, with as this study presents only the views of the students as it was for a mini thesis Key words: Agents of change, Change Agents, Transformative learning, Community-based education


Master of Nursing in Education. University of KwaZulu-Natal. Durban, 2017.