Experiences of Nurse Educators on the Implementation of the Competency-Based Curriculum for Nursing and Midwifery Programmes in Tanzania: A mixed methods study

In Tanzania, the competency-based curriculum for nursing and midwifery was introduced in 2008. Despite the government’s efforts to ensure its effective implementation, there has been a public concern on graduate nurses’ and midwives’ competencies in providing quality nursing care in the country. This concern has influenced people to question the process of the implementation of the same. This study describes experiences of nurse educators in implementing the Competency-Based Education and Training curriculum (CBET) for nursing and midwifery programmes in Tanzania. A descriptive cross-sectional study design using a convergent parallel mixed methods approach was used to describe the experiences of nurse educators in implementing CBET curriculum for nursing and midwifery programme. Of the 264 nurse educators who participated in this study, 240 answered a questionnaire and 24 were interviewed.  Chi-square test was used to assess the association between independent and dependent categorical variables. Statistical significance was set at a P value of less than 0.05 and the level of confidence interval was set at 95%. A thematic framework was used to analyse the qualitative data. The implementation fidelity of the CBET curriculum for nursing and midwifery programme was significantly associated with education level (p<0.001) and understanding the concept of CBET approach (p< 0.001). The 97% of the participants used lecture discussion and 53% used simulation in implementing CBET curriculum. Participatory methods of teaching and learning were uncommonly used due to shortage of teaching equipment (30%), time (25%) and lack of skills of some methods (13%). Participants had little understanding and interpretation of the CBET curriculum for effective implementation. For the effective implementation of Nursing and Midwifery programme, there is a need to strengthen nurse educators understanding and interpretation of the CBET curriculum. This can be achieved through mentorship programmes, constant supportive supervision and ensure that teaching and learning resources are adequate.