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Communication motivationnelle et amélioration du stage-coaching clinique: effets sur l’engagement, l’autonomie et la performance des apprenants en formation initiale en santé mentale
No full textCette recherche examine l’efficacité de la communication motivationnelle intégrée au stage-coaching clinique dans la formation initiale en santé mentale. Face aux insuffisances observées dans les modèles traditionnels de supervision clinique, l’étude vise à évaluer les effets de cette approche sur l’engagement, l’autonomie et la performance clinique des apprenants. Un devis quasi-expérimental à groupe unique avec mesures prétest et posttest a été retenu, associé à une méthodologie mixte. L’échantillon comprenait des étudiants de troisième année en santé mentale et leurs encadrants cliniques, sélectionnés par tirage aléatoire simple. Les données ont été recueillies à l’aide d’une échelle auto-administrée, d’une grille d’observation structurée et d’entretiens semi-directifs. Les analyses quantitatives non paramétriques (test de Wilcoxon, corrélation de Spearman et taille d’effet) ont été complétées par une analyse thématique des données qualitatives. Les résultats montrent une amélioration statistiquement significative des compétences cliniques et des pratiques d’encadrement après l’intervention (p < 0,001), accompagnée d’une homogénéisation des pratiques professionnelles. Les données qualitatives révèlent une transformation de la dynamique de supervision, caractérisée par une communication centrée sur l’écoute, la valorisation des progrès et la responsabilisation progressive des apprenants. Par voie de conséquence, l’intégration de la communication motivationnelle dans le stage-coaching clinique apparaît comme une stratégie pédagogique pertinente pour renforcer la qualité de l’encadrement et le développement des compétences cliniques en formation initiale en santé mentale
Barriers and Bridges: Women and Leadership in the Sierra Leone Public Health Sector
No full textPurpose: The study examined gender and leadership in the public health sector to understand equality practices and the extent to which women are being considered for top leadership roles in the MoH.
Methodology: A mixed-method cross-sectional study design was used, including document reviews. A total of 402 respondents (grade 9-14 civil servants) completed the online survey, and 18 purposively selected individuals were interviewed. SPSS version 25 and Braun and Clarke’s (2006) step-by-step framework for performing thematic analysis were used for the quantitative and qualitative analyses, respectively.
Findings: There is a perception among the participants that women are inadequately considered for senior and top management positions in the MoH. There is a significant relationship between gender and perceptions about women being considered for leadership positions, X2 (3, N = 402) = 8.88, p < .05. However, the relationship between gender and the other variables (professional roles and service grade) shows no statistically significant difference (p > 0.05). Participants shared practices they perceived as barriers to women’s advancement to leadership positions. The findings from documents review in relation to gender representation across the various functional roles in the MoH, however, revealed significant effort by the leadership to close the gender gap in compliance with the mandated 30% women’s representation by 2023 GEWE Act. Overall, women account for 34% and 22% in the senior management level and the top management level, respectively. The political leadership has a 33% female representation, while the professional and administrative leadership remains male-centric, with no female representation. The proportion of females that are currently serving as directors and program managers are 29% and 47% respectively. The least represented roles by women are the District Medical Officer and Medical Superintendents, with only 12% and 14% female representation, respectively. Despite the perceived barriers to women’s career and leadership advancement in the MoH, the 2023 GEWE Act is considered an opportunity towards bridging the gender gap in the public health sector. It is imperative that gender equality and women’s empowerment initiatives go beyond token measures and result in meaningful and measurable changes in advancing women to top leadership positions not only in the public health sector, but also in all government ministries, department, and agencies.
Unique Contribution to Theory, Practice, and Policy: Utilizing Acker’s Gendered Organizational Theory, this study examined the barriers and opportunities for women’s career advancement to senior leadership positions in the public health sector. This is the first study in post-war Sierra Leone to examine the gender landscape in the MoH. This study is significant to policy and practice for providing insights on the barriers and facilitators for women’s career advancement in the MoH. The study findings demonstrate the importance of multi-level strategies that address the entrenched gender norms and systemic barriers that undermine women’s career advancement to senior leadership positions in the public health sector
Assessing Comprehension beyond Recognition: A Many-Facet Rasch Measurement Approach
No full textPurpose: Comprehension is commonly assessed through single-task tests, particularly multiple-choice questions (MCQs). Although MCQs offer many advantages, a growing number of researchers have raised concerns that such measures may overestimate degree of understanding because they are based on recognition. A less-frequently used method are summaries, which are assumed to reflect a higher level of comprehension because they require learners to select and integrate information in order to create a mental representation of the input. This study proposes a combined comprehension measure that integrates summaries (assessing global comprehension) and MCQs (targeting detail-level comprehension) into a single measurement system. The purpose of the study is to collect validity evidence for the use of the combined measure through many-facet Rasch measurement (MFRM).
Methodology: Listening data were longitudinally collected from 290 EFL Japanese high school students over three separate waves, with each involving three measurement points (i.e., Pretest, Posttest 1, and Posttest 2). Comprehension was assessed twice at each measurement point through the combined measure consisting of a summary and a set of five MCQs, which were administered in paper-and-pencil format. The summaries were rated by two expert raters using a five-point rating scale in tandem with a list of main ideas and details that had been previously extracted from the target texts. The MCQs were dichotomously scored. All three waves of data were linked through a Rasch stacking design and were analyzed using MFRM with the analysis involving three facets: persons, items, and raters. Under the theoretical assumption that summaries are more difficult and entail a higher level of comprehension than MCQs, the summaries were given double weight when estimating learner ability.
Findings: The Wright map confirmed a hierarchy of item difficulty consistent with the theoretical expectation that the summaries were more difficult than the MCQs, providing support for the weighting scheme. The persons showed acceptable fit to the Rasch model with most participants being within parameters. Similarly, all summaries and multiple-choice items fit the Rasch model’s expectations with the exception of only two multiple-choice items, which were slightly above the recommended criteria. The analysis revealed fair person reliability and excellent item reliability, suggesting that the replicability of the person ability and the item difficulty hierarchies were fair and high, respectively. In addition, rater severity did not negatively impact the measurement and the response thresholds suggested that the rating scale functioned as intended. These findings indicate that the combined measure is a valid instrument for comprehension assessment.
Unique Contribution to Theory, Practice and Policy: Practically, this study contributes to the literature by providing a combined measure that mitigates the weaknesses of summaries and MCQs when used separately. In addition, it demonstrates how MFRM can model productive and receptive tasks, which may be differently weighted tasks, within a single measurement system. Regarding policy, this study advocates for tests that move beyond single tasks to provide a more precise picture of learners’ levels of comprehension across different educational settings.  
The Game Dominated Physical Education Curriculum for Primary Schools in Uganda
No full textPurpose: The purpose of the study was to examine the nature of the learning activities of the Physical Education (P.E) Curriculum and its influence on the Pedagogy of P.E in Primary Schools in Central Uganda.
Methodology: The study employed the qualitative methodology and design. Maximum variation sampling was used where five Primary Schools were selected based on geographical locations and school categories in Uganda. In each school, two classes were chosen, primary three and six. The data collection methods included participatory observation, field notes, focus group discussions, Interviews and document analysis. The overall data generated was qualitative in nature and analysis was thematic.
Findings: It was clear that not all that was prescribed by the curriculum was always taught, but what sometimes the teachers found interesting or easy to teach or where equipment /facility was available. Most schools lacked equipment or facilities and others concentrated on the nationally examined subjects.. From the study findings, it was clear that most schools teach for exams, other than skills, competencies, etc. Thus, a need for the ministry of education /government of Uganda to come out clearly and implement the P.E pedagogy in all schools throughout the country. Besides, the P.E curriculum is masculine, dominated by games that traditionally were for boys, which put girls at a disadvantage, with boys and teachers dominating, segregating and discriminating them. Moreover, in a situation where teachers and the learners are tied up by socio-cultural stereotypes that make teachers assign most of the exciting games to boys.
Unique Contribution to Theory, Practice and Policy: There is need for strong gender policies to guide the process of curriculum reform, development and implementation; and all pedagogical processes in schools for equal access of boys and girls including those with special needs. In view of this, I developed a gender responsive pedagogy model-framework for primary schools in Uganda for the pedagogy of P.E and other subjects. Thereby embracing policies of equal opportunity and access for all learners in Ugandan schools. Lastly, this study was undertaken within ethical and moral boundaries
Digital Transformation Practices and Government Service Delivery in Developing Countries
No full textPurpose: The purpose of this study is to examine the effect of digital transformation practices on government service delivery in developing countries. Specifically, the study seeks to analyse how technological infrastructure, digital competencies, and process automation influence key service delivery outcomes, including accessibility, timeliness, and user satisfaction, within the context of public sector institutions.
Methodology: The study adopted a critical desktop review research design. Data were drawn from peer-reviewed journal articles, policy reports, and empirical studies published between 2018 and 2024. Sources were retrieved from Scopus, Web of Science, Google Scholar, and selected institutional repositories using keywords related to digital transformation, government service delivery, technological infrastructure, digital competencies, automation, and developing countries. Study selection was guided by relevance, methodological rigor, and alignment with the study variables. A thematic analysis approach was employed to compare findings across global, developing-country, and African contexts and to identify empirical, conceptual, and contextual gaps.
Findings: The findings indicate that technological infrastructure is a foundational enabler of effective government service delivery, as system reliability, interoperability, and connectivity directly influence service accessibility and processing speed. Digital competencies among public servants were found to be a critical operational driver, shaping system utilization, institutional responsiveness, and service quality. Process automation emerged as a key efficiency mechanism that enhances service timeliness, accuracy, and transparency, although its adoption remains limited in many developing countries. The study further reveals strong interdependencies among the three dimensions, suggesting that isolated digital interventions are insufficient to achieve sustainable service delivery improvements.
Unique Contribution to Theory, Practice and Policy: The study is informed by the Diffusion of Innovations theory and the Technology–Organization–Environment framework, which jointly explain technology adoption and institutional readiness in public sector contexts. The findings validate the applicability of these frameworks in developing-country settings. For practice, the study recommends integrated digital transformation strategies that simultaneously strengthen infrastructure, build digital skills, and expand automation. From a policy perspective, the study underscores the need for coherent legislative frameworks that promote interoperability, data protection, accountability, and sustained investment in digital public services
Role of Transformational Leadership in the Relationship between Top Management Support and Performance of Public Organizations: A Look at State Corporations in Kenya
No full textPurpose: The aim of the study was to examine the role of transformational leadership in the relationship between top management support and performance of public organizations looking at state corporations in Kenya.
Methodology: The study adopted descriptive research design. The study targeted 221 state corporations in Kenya. 143 corporations were sampled. Respondents were Chief Executive Officers and Senior Managers, who are responsible for strategy and planning. The study utilized the use of self-administered structured questionnaires to collect primary data. Statistical Package for Social Sciences (SPSS) version 25 was used in data analysis.
Findings: Pearson Correlation results indicate that top management support was positively and significantly related to performance of state corporations (.315, p<0.000). Results further exposed that top management support was found to affect performance (β=.065, p<.05). This suggests that, while top management support is important, its direct influence on performance is modest and may be affected by other variables. Introducing transformational leadership as a moderating variable reduced the F-statistic, indicating that transformational leadership affects the strength of these relationships. However, despite the reductions, the relationships remain statistically significant (p < .05) in all cases. Based on the study, transformational leadership moderates the relationship between top management support and firm performance. Despite reduced F-statistic, this relationships remain significant.
Unique Contribution to Theory, Practice and Policy: The study recommends development of transformational leadership through Investment in leadership skill development to maximize strategy implementation effectiveness, integration of transformational leadership in strategy by embedding transformational leadership in strategy formulation and implementation for enhanced outcomes, aligning strategy with transformational leadership by customizing processes to fit transformational leadership. Next is to implement a training program that focuses on transformational leadership and strategy integration and establish a metrics and monitoring system that regularly assess the impact of leadership on strategy. These steps will improve firm performance through effective strategy implementation
A Qualitative Study on Strategies to Enhance Student Nurses’ Engagement in Community Mental Health Nursing, Central Uganda
No full textPurpose: Mental illness remains a significant global burden, affecting nearly 970 million people as of 2019. Community Mental Health Nursing (CMHN) is pivotal in promoting recovery and reducing stigma, yet limited student engagement poses a challenge, particularly at Butabika School of Psychiatric Nursing (BSPN), Uganda. Records indicate only 34% of student nurses attended CMHN placements, despite institutional efforts. This study aimed to assess strategies to enhance student nurses\u27 engagement in Community Mental Health Nursing at BSPN.
Methodology: A qualitative descriptive cross-sectional design was used. Twenty diploma student nurses who had participated in CMHN placements were purposively selected. Data were collected through face-to-face in-depth interviews and analyzed thematically using NVivo software.
Findings: Four major themes emerged: Individual Strategies –hands-on learning, patient interaction, community outreach, and mentorship improved engagement. Institutional Strategies –structured mentorship, hands-on supervision, feedback sessions, and case-based learning were emphasized. Community Strategies –students highlighted the need for community support, mental health education, and involvement in decision-making. General Improvements –suggestions included early pre-placement training, stronger collaboration with local health workers, and culturally informed orientations.
Unique Contribution to Theory, Practice and Policy: Enhance mentorship and resilience training, foster peer support, and integrate self-directed learning. Institutions should invest in supervision, workshops, and logistics. Community sensitization and government support are critical to reduce stigma and improve practical training environments. A multifaceted approach involving individual commitment, institutional investment, and community collaboration is essential to improve student nurse engagement in CMHN and ensure competent future psychiatric nursing professionals
Effects of Training on Service Delivery in Selected Medical Laboratories in Kenya
No full textPurpose: Medical laboratories play an essential role in disease diagnosis and treatment, yet their efficiency is often compromised by gaps in staff competencies. This study examined the effects of technical, soft skills, digital, and cognitive skills training on service delivery in selected medical laboratories in Kenya.
Methodology: Guided by the Theory of Reasoned Action (TRA), Technology Acceptance Model (TAM), and Social Learning Theory, the study adopted a descriptive cross-sectional design targeting 4,053 practitioners across 18 accredited laboratories in Nairobi County. Data were collected through semi-structured questionnaires and analyzed using descriptive statistics, correlation, and multiple regression.
Findings: Results revealed that technical, soft, digital, and cognitive skills training significantly influenced service delivery, with technical training contributing the highest effect (B=0.364), followed by digital skills (B=0.310), soft skills (B=0.247), and cognitive skills (B=0.145), all at p=0.000. The study concludes that holistic training programs are essential for strengthening diagnostic accuracy, efficiency, and patient satisfaction in Kenyan medical laboratories.
Unique Contribution to Theory, Practice and Policy: Recommendations include establishing structured, continuous training frameworks prioritizing technical and digital competencies while reinforcing soft and cognitive skills
Compliance on Triaging Traumatic Patients Attending Emergency and Outpatient Surgery Department at University Teaching Hospital of Butare (CHUB), Rwanda: A Quasi-Experimental Study
No full textPurpose: The World Health Organization (WHO) defined triage as the action of sorting and prioritizing patients based on the estimation of the urgency for intervention. This approach is used as the basis for identification of those patients who require immediate medical intervention and those who can safely wait. Locally triage is the process including the initial assessment followed by the prioritization of patients needing emergency care and assigns them according to their actual need or likely benefit from immediate medical treatment. To assess the compliance with triage protocols among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare.
Methodology: The total sample size were 109 but the participants enrolled in the study were 101because 8 participants voluntary did not want to participate to the study (they refused to sign consent form) a prospective cross-sectional study was conducted among health workers in the surgical department (CHUB staff 70), and the emergency department (CHUB staff 31), making a total of 101 participants across both departments. The participants ’knowledge of triage tool was assessed and their level of compliance with triaging. The training on the triage tool was provided among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare, and after one moth of intervention the reassessment was also done about the level of compliance with triage tool following training received.
Findings: A total of 101 participants were included, the majority being nurses (63.4%). Most respondents reported that the current triage protocols effectively addressed the needs of trauma patients (86.1%) and that adherence to these protocols significantly or somewhat improved patient outcomes (95%). Compliance monitoring was limited, with over one-third (36.6%) stating that outcomes were never reviewed. However, urgent cases were largely well prioritized (89.1%). About one-fifth (20.8%) acknowledged adverse outcomes due to non-compliance with triage protocols. Nearly half (49.5%) of participants reported challenges to implementation, mainly related to lack of training, monitoring, and updated tools. Training interventions were associated with improvements in outcome review practices, prioritization of urgent cases, and reduction of adverse outcomes related to non-compliance.
Unique Contribution to Theory, Practice and Policy: In both department participants emphasized the need for ongoing training and to increase staffing as key strategies for further enhance level of compliance and strengthen the triage process in both the emergency and outpatient surgery departments
Digital Communication Strategy for Government Public Relations in Indonesia and Thailand
No full textPurpose: Government Public Relations (GPR) increasingly depends on Digital Public Relations platforms to communicate policies and maintain the government’s public image. This study aims to identify the implementation, obstacles, and improvement efforts of Government Digital Public Relations in Indonesia and Thailand.
Methodology: Using a descriptive qualitative method, data were collected through interviews, observations, and documentation from seven purposively selected informants consisting of government PR officers and citizens from both countries.
Findings: The findings reveal that both governments emphasize transparent and factual communication through various digital platforms. Indonesia predominantly uses Instagram, Facebook, TikTok, Twitter, and official websites, while Thailand utilizes Instagram, Line, Facebook, television, bloggers, and vloggers. Indonesia also demonstrates clear information segmentation and corrective strategies such as press releases when discrepancies occur. Positive outcomes include increased public support and enhanced government image, although user-generated reinterpretations may influence social perceptions. Key obstacles involve limited human resources, inadequate infrastructure, the need for frequent updates, and delays in information processing, which may hinder public service quality and policy implementation.
Unique Contribution to Theory, Practice and Policy: Efforts to strengthen Digital PR include establishing supportive regulations, enhancing coordination, providing HR training, delivering timely information, and improving real-time engagement with communities and stakeholder