Community Orientation Programme: An Innovative and Integrative Teaching Learning Strategy for Nursing Students

 

Lalthanzami¹, L. Lidziisa Mao²

¹Associate Professor, Community Health Nursing, College of Nursing, Christian Institute of Health Sciences and Research, Dimapur, Nagaland

²Assistant Professor, Community Health Nursing, College of Nursing, Christian Institute of Health Sciences and Research, Dimapur, Nagaland

 

ABSTRACT:

Introduction: The nursing care provided by the nurses may be influenced by their knowledge of the people whom they are serving. Community Orientation Programme (COP) for nurses in the beginning of their nursing profession will sensitize the nursing students to provide culturally sensitive care to patients who come to hospital. A survey was conducted after the community orientation programme to identify the feedback of the students regarding COP. Among 70 -students 50 % of the students expressed that the knowledge acquired regarding activities of COP was Excellent and 28 % of them said it was very good. The skill learnt was Excellent 25.9%, Very good 38.9 %. Majority of the students 42% and 37% reported that they had an “Excellent” and “Very Good” Experience on community exposure respectively. Community Orientation Programme is a phenomenal teaching strategy which enabled the students to be aware of the actual community living of people and to understand the patients while planning the care in the hospital and community.

 

 

 

INTRODUCTION:

Health is everyone’s right, and all the nurses are expected to be able to deliver the best possible client centered nursing care, no matter the location and setting and irrespective of caste, creed or religion, at any given point of time (ICN Code of Ethics for Nurses). The nursing care provided may be influenced by the nurse’s knowledge of the people, their culture, their socio economic status, beliefs and other practice.

 

 

 

 

 

Many of the cultural inhibitors experienced by nurses like Stereotyping, Prejudice and Racism, Ethnocentrism, Cultural imposition, Cultural conflict and Cultural shock may be prevented by exposing the nurses early, preferably in the beginning of their nursing profession. The students may also have multiple dimensional learning experiences with one experience.

 

Medical College of Christian Medical College, Vellore had been organizing Community Living Programme for the first year MBBS students from 2002-2010, nine batches of students comprising 900 have completed the programme and all of them (100%) recommended the same programme for the future. The objectives of the Programme including developing medical students as a community and help them to become aware of community around them and learn basic of community medicine in an integrated manner; to help learn first steps of clinical care in an experiential way in the context of the community; to help understand basic concepts of epidemiology and management experientially were all achieved¹

 

SRM Institute of Science and Technology, Chennai also organized a similar one, “Community Orientation Programme” every year for the first year MBBS students where the students are oriented towards the Environmental, social, economic and psychosocial problems of the family and community and try to find out feasible solution for the problems.²

 

Our community orientation programme:

Community Orientation Programme is a Seven Days long Programme organized by College of Nursing, Christian Institute of Health Sciences and Research for the newly admitted first year students of General Nurses and Midwifery and Bachelor of Science (Nursing) where all the students are exposed to a selected village and carried out the planned activities for a given objectives. It is a programme designed to sensitize the students on the actual community living; have a multiple experiences to help them grow personally and professionally in order to prepare them to deliver a quality, culturally competent, people centered nursing care in all settings.

 

OBJECTIVE OF THE PROGRAMME:

The Community Orientation Programme was organize for the 1^st Year Nursing students in the beginning of their course to understands the community and the people and apply them in the care of people in the Hospital and in the Community.

The Programme had the following objectives:

1.     To observe the rural community in its natural setting

2.     To assess the community through survey and Participatory Rural Appraisal like Focus Group Discussion and Social mapping

3.     To identify community health problems and how they deal with them through different facilities and health care providers

4.     To provide need base care at home, school and though Health camp

5.     To educate the community as per their needs with appropriate methods and AV Aids

6.     To instill professionalism in the students through communication, team work, maintenance of record and report and leadership role.

 

Different aspects of community orientation programme:

“Go to the people. Live with them. Learn from them.” Lao Tzu

The Community Orientation Programme was organized for the 1^st Year Nursing students in the beginning of their course to understands the community and the people and apply them in the care of people in the Hospital and in the Community. The Programme had the following aspects

 

Community Assessment:

The Programme aimed at helping the students to learn about the community through different methods like Observation, Survey, Participatory Rural appraisal like Community Mapping and Focus Group Discussion. The Programme was designed in such a way that the students learn about the socio cultural, economic and educational aspects of the village, health and health issues, resources in terms of Man power, Money, Material and Organization.

 

Family Assessment:

The students were asked to stay with one family to learn the dynamic of each family. They had

Observed the family’s daily activities and interviewed family members to obtain information about the family and their practices pertaining to health

 

Physical Assessment:

Nurses play an important role in screening every individual in the community irrespective of Well/Sick; Young/Old, Sex, etc. The students were helped to develop their skills in certain Assessment like checking Vital signs, Body Mass Index, Degree of Malnutrition, Visual Acuity etc.

 

Household survey:

Household Survey was done with a Family Survey Proforma which has different components like Family detail, details of Residence, Socio-economic details, Health history, and details pertaining to vulnerable family members.

 

Social Mapping and Focus Group Discussion:

Community assessment with Participatory Rural Appraisal was introduced to the students through Social Mapping. Focus Group Discussion was done on immunization, hypertension and disability. These processes not only made the students learn about the community assessment but also made them improve their communication and leadership skills.

 

Field Visit:

The students were taken to Angandwadi Centers and learn how the Centre contributes to the health of the beneficiaries and the community as a whole. There was no Pharmacist, no Health centre or Government Offices function in the village

 

School Health:

School health was conducted in the school available; Government Primary school in order to make the students realized the importance of targeting these groups of children and also makes them know the different aspects of school health services

Sanitation Drive:

Sanitation Drive was conducted by picking thrash from all corners of the village. A soakage Pit and Dumping Pit was also constructed in the Village Council Hall.

 

Health Camp:

Health Camp was conducted for the whole Villagers with the help of multi disciplinary team in the Hospitals. The students also learnt the concept of Referral service by referring sick people they came across throughout their Household survey. Villagers who need specialized care were referred to the Specialty Hospital for further investigations and treatment.

 

Community Meeting and Report Presentation:

On the last day of the Community Orientation Programme, Community meeting was organized. All the villagers were invited and the report of the Household survey and other findings during the weeks were presented to them. Certain health issues identified during the week were also addressed during the presentation

 

The learning outcome of the students:

A review was done and it was found that they have fulfilled all their objectives. The students also listed some knowledge and skills which they gained during the COP. Some of the Knowledge listed by the students include Community –lifestyle, culture, tradition and practice differentiate between urban and rural community; Environmental sanitation; Health status, diseases and health practice; Importance of Recording and reporting, functioning of Anganwadi centre and Anganwadi workers, and nurses role and responsibility in the community

 

The skill gained as listed by the students include Communication and Rapport Building skills; Leadership and Managerial skills; Team Work; Nursing care Skills; Health Education skills; Humanitarian skills- empathy, patience, confidence, helpfulness, being loving, hard work, humility, courtesy and creativity.

 

The following pictures depict what the students expressed on their knowledge and skills gained during the Community Orientation programme.

 

 

Figure 1: Over all Knowledge gained through COP as expressed by the students (N=78)

 

 

Figure 2: Over all Skill gained through COP as expressed by the students (N=77)

 

 

 

Students perception of the community orientation programme:

At the end of the Community Orientation Programme, feedback was taken from the students to know how they perceived their experiences during the community orientation programme. As high as 99 % of the students said that COP must be organized every year. The students were also asked to rate their experience of the different events, the following figure describe the rating of the students

 

 

 

 

 

 

 

Events during COP

Figure 3: Experience during selected events of Community Orientation Programme (N= 75)

 

 

Figure 4: Overall experience of the Community Orientation Programme (N=75)

 

SUMMARY:

The COP helped the students to grow personally and professionally. The students were able to identify the needs of the community and provide priority based care with the full participation of the community. They were more confident and developed certain skills like communication and rapport building, history collection, health assessment, survey, focus group discussion, social mapping, organizing health camp, leadership, public speaking, self evaluation, recording and reporting. The students learnt to make the community to be responsible of their own health and for the health of the entire community.

 

The Community Orientation programme conducted proved to be an innovative teaching learning strategy for nursing students. As expressed by one of the students, “Community Orientation Programme is the best experience a student can have,” we believe that the experiences that they had during COP will help them to be a better and more sensitive nurses in their professional journey.

 

REFERENCE:

1.      Joseph Rajan Marina; Adopted from Community Orientation Programme of CMC Vellore (Goggles PDF) May 2012 (Available from Jul.05.2017) http://www.researchgate.net>link>Experiment from Community Living Program (CLP)

2.      Community Development Programme; www.srmuniv.ac.in>past-events>com.

3.      Huber, M. L., Making Community Health Care culturally correct, American Nurse Today, May 2009, Volume 4, and No 5, https://www.americannursetoday.com/making-community-health-care-culturally-correct/

4.      https://www.goodreads.com/quotes/215411-go-to-the-people-live-with-them-learn-from-them

5.      The ICN Code of Ethics for Nurses, International Council of Nurses, 2012. http://www.icn.ch/images/stories/documents/about/icncode_english.pdf

 

 

 

Received on 28.08.2018         Modified on 06.09.2018

Accepted on 01.11.2018      ©AandV Publications All right reserved