Abstract

The aging population in Kenya is growing rapidly, necessitating a healthcare workforce, especially nurses, equipped to manage the complex needs of older adults. This study evaluates the extent to which geriatric nursing content and practicum are integrated into the Bachelor of Science in Nursing (BScN) curriculum at selected universities in Kenya. Using a descriptive cross-sectional design, the study targeted nursing lecturers and students to assess their perspectives on the adequacy of geriatric education and practical training. Findings indicate significant gaps, with only 35% of lecturers reporting sufficient integration of geriatric content and a notable lack of dedicated practicum experiences. The paper discusses the implications of these findings and offers recommendations for curriculum enhancement to better prepare nursing students for geriatric care.

1. Introduction

The global increase in the elderly population presents a significant challenge to healthcare systems, particularly in low- and middle-income countries like Kenya. The World Health Organization (WHO) projects that the population of older adults in the world will reach 2.1 billion by 2050 ¹

Based on estimates and projections from the Census Bureau’s International Database, Africa had the fewest older people of any world region: 74 million in 2020. But, by 2050, the older African population is projected to total 235 million, surpassing that of Latin America and Northern America and approximating that of Europe ².

Kenya is experiencing a similar demographic shift, the Kenya National Bureau of Statistics ³ reported that the number of people aged 60 and above has grown from 1.9 million in 2009 to over 2.9 million in 2019, with projections estimating a population of 3.7 million by 2030. This rapid increase poses significant challenges for the healthcare system, particularly in geriatric care, as the elderly are more susceptible to chronic diseases, dementia, and other age-related conditions. As a result, there is an urgent need for healthcare professionals, especially nurses, to be well-trained in geriatric care to meet the complex needs of this population ⁴.

Geriatric nursing involves managing chronic conditions, frailty, and the unique psychosocial needs of older adults, requiring specialized education and training ⁵. Despite the clear need, geriatric content in nursing education remains inadequate. In Asia, half of the universities in, specifically Taiwan offered both Geriatric nursing and Long-term care courses in Bachelor of science in Nursing program as optional and minority had provided consistent clinical course ⁶.

Analysis of nursing curriculum consistency stipulate many instances in which geriatric content in nursing education does not consider the necessity to prepare student nurses to encounter the compounded health care requisite of geriatric ^{7, 8}. A research done in Saudi Arabia addressed that in-sequence to empower geriatric curriculum in nursing, the faculty participation and enthusiasm must be forefront fascinating nurses in geriatric nursing care ⁹.

A review of the BScN curricula in various Kenyan universities reveals that geriatric nursing is often embedded within broader medical-surgical courses rather than as standalone subjects. This integration limits the depth and focus of geriatric training, leaving nursing graduates potentially underprepared for the realities of caring for the elderly population ¹⁰. The American Association of Colleges of Nursing ⁵ also emphasizes the importance of integrating essential gerontological nursing competencies in baccalaureate education to adequately prepare nurses for an aging population ⁵.

2. Methodology

A descriptive cross-sectional study was conducted at two universities in Kenya—Moi University and Kabarak University. Participants included 17 nursing lecturers and 72 nursing students selected through purposive sampling. Data were collected using structured questionnaires designed to evaluate the presence and extent of geriatric content in the BScN curriculum, as well as the level of practical exposure students received during clinical placements.

The questionnaires covered various aspects of geriatric education, including the integration of geriatric content into the curriculum, the number of dedicated units on geriatrics, the type and duration of clinical placements, and the perceived preparedness of students to handle geriatric patients independently. Descriptive statistics, including frequencies and percentages, were used to summarize the data, while inferential statistics such as chi-square tests were employed to explore associations between variables.

3. Results

Only 35% of nursing lecturers indicated that the BScN curriculum adequately integrates geriatric content. The majority of geriatric topics are incorporated within general nursing courses, such as adult health or medical-surgical nursing, rather than being offered as distinct units. As a result, the specific skills and knowledge required for geriatric care may not be fully addressed, limiting students' understanding of the unique health issues faced by older adults. Figure 1

According to the results in Table 1, there were 76.9% who agreed and 23.1% were neutral that Bachelor of Science curriculum needed to be reviewed. A mean of 3.77 and standard deviation of 0.44 indicated that there was a need for universities to review the bachelor of science curriculum.

Clinical placements focused specifically on geriatric care were reported to be insufficient. Only 25% of students stated that they had adequate exposure to geriatric settings during their practicums. Most clinical experiences were concentrated on general adult and pediatric care, with minimal opportunities to engage with elderly patients. Furthermore, students reported that when they did encounter older patients, the care provided was not tailored to geriatric-specific needs, which affected their confidence in managing such cases independently Figure 1.

The findings in Table 1 revealed that 76.9% of the respondents agreed that the course should be taught by specialist in geriatric. There was need to incorporate specialist in geriatric in improving geriatric skills among the nurse student (mean of 3.92 and standard deviation of 0.49). There were 69.2% of the respondents who agreed that the university should identify geriatric home-care centers for clinical placements. The adoption of geriatric home-care centers for clinical placement was proposed by respondents in improving geriatric practices (mean of 3.69 and standard deviation of 0.48).

A significant proportion of students (70%) felt unprepared to manage geriatric patients autonomously, highlighting a critical gap in both education and hands-on training. Lecturers echoed these concerns, pointing to a lack of standardized guidelines for the inclusion of geriatric nursing in clinical practice, which further exacerbates the inconsistency in training quality. A majority of the students (70%) felt unprepared for geriatric nursing despite going through the BSN curriculum Figure 1.

Finally, the findings in Table 1 revealed that 53.8% agreed that there was need for benchmark with institution that offer geriatric nursing course. A mean of 3.85 and standard deviation of 0.69, further indicated that the instructors posited that benchmarking with other institution offering geriatric nursing course would be beneficial to nurse students.

4. Discussion

The findings of this study reveal substantial deficiencies in the integration of geriatric content and practicum within the BScN curriculum at the selected universities. The insufficient focus on geriatrics in the curriculum, coupled with limited clinical exposure, suggests that nursing students may not be receiving the necessary training to effectively care for the aging population. This gap is concerning given the complex nature of geriatric care, which often involves managing multiple comorbidities, addressing mobility and functional impairments, and providing holistic, patient-centered care ⁷.

The study underscores the need for dedicated geriatric courses within the BScN curriculum that cover essential topics such as chronic disease management, geriatric syndromes, and ethical considerations in elder care. In addition, structured clinical practicums focused on geriatrics are crucial for building students' competencies and confidence in this specialty area ¹¹. Without these enhancements, there is a risk that nursing graduates will be inadequately prepared to meet the healthcare needs of Kenya’s growing elderly population.

5. Conclusion and Recommendations

The study found that only 35% of lecturers reported adequate integration of geriatric content into the BScN curriculum, with limited practical exposure for students. A chi-square test comparing perceptions between lecturers and students indicated no significant difference (p-value = 0.47), suggesting a consensus on the curriculum’s inadequacies. This highlights a gap in the curriculum that fails to sufficiently prepare students for geriatric care, aligning with the first objective of the study.

To address the identified gaps, the following recommendations are made:

1. Curriculum Enhancement

Introduce dedicated courses on geriatric nursing within the BSN program. These courses should cover key areas such as aging physiology, chronic disease management, functional assessments, and palliative care. Integrating geriatric content as standalone units will ensure a comprehensive approach to elder care education.

2. Structured Practicum

Develop specific clinical rotations focused on geriatrics, allowing students to gain hands-on experience in settings such as nursing homes, geriatric clinics, and community-based care for older adults. This practical exposure is essential for building the skills and confidence needed to provide effective geriatric care.

3. Standardized Guidelines

Collaborate with Nursing Council of Kenya [NCK) to establish standardized guidelines for the integration of geriatric content into the nursing curriculum. These guidelines should ensure consistency in training across all nursing programs and set benchmarks for geriatric competency.

By implementing these recommendations, nursing programs in Kenya can better prepare their students to meet the needs of the elderly population, ultimately contributing to improved health outcomes for older adults.

References