Clinical teaching methods used during practical placements at Kericho County Referral Hospital, Kenya: A cross-sectional evaluation of methods in diploma health professions training

Abstract

In health professional education, clinical teaching plays a very crucial role in the gap between theoretical and competent skills in learning. The literature outlines various approaches as being useful in supporting clinical learning, such as bedside teaching, demonstrations, simulation, case presentation, and structured models of teaching. Nevertheless, little information is available regarding the particular practices applied in diploma-level clinical practicums in low-resource institutions like Kenyan referral hospitals. The objective of the study was to establish the clinical teaching strategies that were used when diploma health professions students were on clinical practicals at Kericho County Referral Hospital (KCRH), Kenya. This study was grounded in Albert Bandura’s social learning theory. Between January 2025 and June 2025, the descriptive cross-sectional design was used. An administered questionnaire was a pilot-tested, structured questionnaire that included 322 diploma students on practical placement, which included timing and location of first clinical exposure, frequency and timing of assessment, and use and rating of ten methods of clinical teaching. The use of descriptive statistics, Kendall W that measures rank concordance, and chi-square tests as well as multinomial logistic regression were done. The majority of students stated that the initial clinical teaching was in the second year and mostly in skills laboratories. The most appropriate strategies were considered case presentations, bedside instruction, and assessment during the ward round, whereas demonstration, lectures, and question-answer strategies were considered very helpful. Sixty-seven percent of the respondents liked simulation, but not as much as direct patient-centered approaches. Concordance in overall ranking was not high but showed a stronger result in agreement in individual programs. These results suggest that the diploma students at KCRH are exposed to numerous types of clinical teaching, most of which are interactive and patient-centered in nature. At Kericho County Referral Hospital, clinical education uses a variety of methods, but its efficacy is constrained by irregularity and inadequate feedback. The most effective strategies for students' learning and skill development were bedside instruction and mentoring. It is proposed to maximize standardized clinical teaching in the same setting by enhancing bedside and ward-based learning, increasing exposure to early skills in a laboratory, and offering various forms of faculty development that prioritize frequent bedside instruction, organized case discussions, and prompt feedback. These are advised in order to maximize clinical education. Programs for faculty development should be created to improve the teaching abilities of clinical instructors. Additionally, in order to establish a setting that supports reliable and excellent clinical training, sufficient teaching resources and management support must be provided.