Other Titles
“We were empowered”: Using the consolidated framework for implementation research to examine a pediatric nurse preceptor program in Malawi [Title Slide]
Abstract
Purpose: Examine barriers and facilitators to implementation of a novel pediatric critical care preceptor program in Malawi.
Background: Malawi is a low-middle income country in sub-Saharan Africa with significant gaps in the availability of pediatric critical care nurses. We conducted a needs assessment in 2022 and developed a novel preceptor program to address these shortages.1,2 The program was found to be effective;3 however, to understand barriers and facilitators to the implementation of this preceptor program in Malawi, we conducted followed-up interviews with participants.
Methods: Using the Consolidated Framework for Implementation Research (CFIR), interviews were conducted via Zoom (N=20).4 A predetermined codebook was used to code transcripts using the five CFIR domains of: innovation, outer setting, inner setting, characteristics of individual, and process. Barriers and facilitators were identified per domain and coded using the CFIR constructs and themes were developed using qualitative content analysis.5
Results: Participants reported the program was comprehensive, well designed, and delivered effectively. Partnerships – between the university, hospitals, and non-profit organizations are essential to the program’s initiation and likely important to the program’s sustainability. Participants voiced challenges with lack of physical and human resources, leading to prioritization of patient needs over program attendance at times. Participants were motivated by this program and appreciated the advantage of this program over previous programs offered for continuing professional development. In terms of process, participants felt they needed additional time to devote to this program and fully engage.
Conclusion: This preceptor program had significant strengths across all five CFIR domains, yet participants also discussed areas to improve upon in the future. Participants voiced their enthusiasm for it to expand within and beyond Malawi. Understanding barriers and facilitators to a program is critical to understand from multiple perspectives before scaling-up or scaling-out. Improving on the challenges and building upon the program’s facilitators will strengthen the program in future iterations. Providing nurses with knowledge and skills to precept students may decrease the shortage of quality pediatric critical care nurses through two avenues 1) empowering nurses with confidence and competence and 2) improving the pipeline of well-trained students.
Notes
References:
1. Renning, K., van de Water, B., Brandstetter, S., Kasitomu, C., Gowero, N., Simbota, M., & Majamanda, M. (2022). Training needs assessment for practicing pediatric critical care nurses in Malawi to inform the development of a specialized master's education pathway: a cohort study. BMC nursing, 21(1), 6. https://doi.org/10.1186/s12912-021-00772-3Top of Form
2. van de Water, B., Renning, K., Nyondo, A. et al. Development and initiation of a preceptor program to improve midwifery and nursing clinical education in sub-saharan Africa: protocol for a mixed methods study. BMC Nurs 23, 365 (2024). https://doi.org/10.1186/s12912-024-02036-2
3. Renning, K., Thompson, J. A., Hartman, A. M., Nyondo, A. N., Mann, J., Chepuka, L., Mula, C., Gowero, N., Wilson, G., Ramwell, C., & van de Water, B. (2024). Effectiveness of a pediatric critical care pilot preceptor program: Improved confidence and competency outcomes among a cohort of professional nurses in Blantyre, Malawi. Nurse education today, 142, 106351. https://doi.org/10.1016/j.nedt.2024.106351
4. Damschroder, L.J., Reardon, C.M., Widerquist, M.A.O. et al. The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Sci 17, 75 (2022). https://doi.org/10.1186/s13012-022-01245-0
5. O’Brien, Bridget C. PhD; Harris, Ilene B. PhD; Beckman, Thomas J. MD; Reed, Darcy A. MD, MPH; Cook, David A. MD, MHPE. Standards for Reporting Qualitative Research: A Synthesis of Recommendations. Academic Medicine 89(9):p 1245-1251, September 2014. | DOI: 10.1097/ACM.0000000000000388
Sigma Membership
Alpha Chi
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Teaching and Learning Strategies, Implementation Science, Precepting, Malawi
Recommended Citation
van de Water, Brittney; Renning, Kelsey; Yang, Olivia; Ali, Ijaabo; Chiluzi, Blessings; Mula, Chimwemwe; Mann, Julie; Gowero, Netsayi; Nyondo, Ando; and Chepuka, Lignet, "Barriers and Facilitators of Implementing a Novel Pediatric Nurse Preceptor Program in Malawi" (2025). International Nursing Research Congress (INRC). 86.
https://www.sigmarepository.org/inrc/2025/presentations_2025/86
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Barriers and Facilitators of Implementing a Novel Pediatric Nurse Preceptor Program in Malawi
Seattle, Washington, USA
Purpose: Examine barriers and facilitators to implementation of a novel pediatric critical care preceptor program in Malawi.
Background: Malawi is a low-middle income country in sub-Saharan Africa with significant gaps in the availability of pediatric critical care nurses. We conducted a needs assessment in 2022 and developed a novel preceptor program to address these shortages.1,2 The program was found to be effective;3 however, to understand barriers and facilitators to the implementation of this preceptor program in Malawi, we conducted followed-up interviews with participants.
Methods: Using the Consolidated Framework for Implementation Research (CFIR), interviews were conducted via Zoom (N=20).4 A predetermined codebook was used to code transcripts using the five CFIR domains of: innovation, outer setting, inner setting, characteristics of individual, and process. Barriers and facilitators were identified per domain and coded using the CFIR constructs and themes were developed using qualitative content analysis.5
Results: Participants reported the program was comprehensive, well designed, and delivered effectively. Partnerships – between the university, hospitals, and non-profit organizations are essential to the program’s initiation and likely important to the program’s sustainability. Participants voiced challenges with lack of physical and human resources, leading to prioritization of patient needs over program attendance at times. Participants were motivated by this program and appreciated the advantage of this program over previous programs offered for continuing professional development. In terms of process, participants felt they needed additional time to devote to this program and fully engage.
Conclusion: This preceptor program had significant strengths across all five CFIR domains, yet participants also discussed areas to improve upon in the future. Participants voiced their enthusiasm for it to expand within and beyond Malawi. Understanding barriers and facilitators to a program is critical to understand from multiple perspectives before scaling-up or scaling-out. Improving on the challenges and building upon the program’s facilitators will strengthen the program in future iterations. Providing nurses with knowledge and skills to precept students may decrease the shortage of quality pediatric critical care nurses through two avenues 1) empowering nurses with confidence and competence and 2) improving the pipeline of well-trained students.
Description
Participants report significant strengths across all five domains of the consolidated framework for implementation research and voiced enthusiasm for program expansion (N= 20 interviews).