Competency-based education in transitioning nurse practitioner students from education into practice

Pediatric and Congenital Cardiac Services: An Innovative and Empowering Approach to Global Training and Equitable Care

Congenital heart disease is a leading cause of preventable death in children, with a disproportionate impact on low- and middle-income countries. Despite progress in treating congenital heart disease globally, significant challenges remain in accessing specialized cardiovascular care, particularly cardiac surgery, in low- and middle-income countries. This review examines current models of assistance and proposes a novel global training program to address these inequities. Key challenges identified include building program infrastructure, training health care providers, ensuring financial sustainability, and promoting local engagement. The proposed program, structured under a new international organization, will leverage emerging technologies to deliver accessible and rigorously assessed training in pediatric and congenital cardiac care. By collaborating with local experts and global partners, the program will promote access to education for various health care personnel involved in congenital heart disease care, establish credentialing standards, and foster global collaboration. This unified, scalable approach aims to bridge the health equity gap and accelerate progress toward comprehensive and sustainable cardiac care programs worldwide.

Exploring the impact on faculty of the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education

BACKGROUND

Current nursing instructional methods inadequately prepare students for complex healthcare settings, exacerbating challenges in new graduate competency and transition to practice. The introduction of standardized competencies marks a substantial shift in nursing education, posing a considerable challenge for faculty implementing these changes.

PURPOSE

This study examined the experiences of faculty implementing a competency-based education program utilizing The Essentials: Core Competencies for Professional Nursing Education (2021) in undergraduate Bachelor of Science in Nursing (BSN) education programs.

METHODS

A qualitative research design using phenomenology was chosen to explore the experiences of eight faculty and gain insight into perceived challenges experienced during the implementation of The Essentials recommendations through semi-structured interviews. Data was analyzed using a manual content analysis with a constant comparative technique.

RESULTS

The data analysis revealed three primary themes focused on the faculty's initial uncertainty, the challenges associated with change processes and faculty engagement, and the strategies employed to develop and implement a competency-based program.

CONCLUSION

The findings provide insight into the faculty experience during The Essentials implementation, proposing strategies for curriculum alignment and overcoming resistance to change. Faculty continue to seek validation for their work while also facing the challenge of balancing implementation demands and broader institutional responsibilities. Continued discussions on faculty role development and resource identification are essential for future competency-based education program advancements.

SimZones Approach to a Competency-Based Objective Structured Clinical Examination

BACKGROUND

Competency-based education (CBE) can be achieved through purposeful structuring of experiential learning. Yet, there is scant guidance for nurse educators to operationalize this transition.

PURPOSE

To describe a semester-long CBE simulation curriculum for third-year nursing students, using the SimZone (Zone 0-3) framework.

METHODS

Zone 0 ensured foundational knowledge. Objective Structured Clinical Examination (OSCE) Prep Lab 1 (Zone 1) and Prep Lab 2 (Zone 2) provided deliberate skill practice and small group simulation practice, respectively. Zone 3 was the summative OSCE.

RESULTS

Students' (n = 107) performance was assessed on patient safety, clinical judgment, assessment, and communication. Initially, 64% of students were deemed competent, increasing to 92% after additional practice and to 100% with further iteration. Students also reviewed their OSCE recordings and completed reflective writing.

CONCLUSION

This approach may serve as a model for other nursing programs to implement competency-based curricula through leveled simulations and iterative learning.

The year-long journey: Transforming the BSN-DNP curriculum

BACKGROUND

Revising a doctor of nursing practice (DNP) curriculum for family nurse practitioner and psychiatric mental health nurse practitioner education with an eye on future changes in competencies required planning and consensus among taskforce members. Major priorities included: the need to embed competency- based education (CBE), the National Taskforce Criteria for Nurse Practitioner (6th ed.) education, and the Essentials: Core competencies for professional nursing education (American Association of Colleges of Nursing (AACN) Essentials, 2021).

FINDINGS

Challenges began with faculty knowledge of CBE, NP faculty skills in curriculum building, buying in to the revised degree, and reviewing all current literature on the DNP NP knowledge, skills and attitudes needed for current practice. The year long journey yielded a comprehensive curriculum model to share as well as several lessons learned and recommendations for this journey.

CONCLUSION

The process resulted in a curriculum revision that thus far, is better suited to development of the "work-ready" graduate while still supporting individualized student needs in attending a doctoral-level program. Ongoing work is focused on specific "pillars" of program support including clinical preceptor placement and partnerships, preceptor resources, student retention resources, and exploration of competency-based tracking data management. Considering the impact on faculty workload, program leadership should actively assess levels of curricular expertise of faculty involved to determine additional development or training needs for individual professional growth.

Talent identification and succession planning strategies for the appointment of nursing unit managers: A systematic review

Talent acquisition and succession planning are critical to the appointment of nursing managers to ensure high-quality leadership and improved outcomes in healthcare organizations. This review was carried out with the aim of systematically reviewing the literature on talent identification and succession methods for the appointment of nursing unit managers in the Islamic Republic of Iran (IRI). In this study, a comprehensive literature search was conducted using electronic databases, including PubMed, Cochrane Library, PsycINFO, Scopus, Web of Science, and Google Scholar, to identify relevant studies published between 2010 and 2023. The quality assessment of the selected studies was performed using the Critical Appraisal Skills Program (CASP) tool. Moreover, data extraction and synthesis were conducted to summarize the results of included studies. A total of 11 studies were included in this systematic review. The studies selected for this review were interventional (n = 7) and review studies (n = 4). The findings of this review demonstrated that the most important of talent acquisition and succession planning strategies included competency assessment, leadership development programs, coaching programs, and performance evaluation. The strategies are effective in identifying and developing managers of nursing units with high potential. Health policy and health promotion benchmarks emphasize the importance of ensuring a skilled workforce in healthcare settings to provide high-quality care to patients. By implementing talent acquisition and succession planning strategies, healthcare organizations can develop the next generation of nursing unit managers, which will ultimately lead to increased patient satisfaction and improved health outcomes.

Academic training of nurses developing advanced practice roles

The nursing profession, without losing its essence, is in continuous evolution in order to face and respond to the ever-changing health challenges of the population. Advanced Practice Nursing is a clear example of this development. The performance of advanced practice roles entails greater responsibility, expansion and depth of nursing practice, which is only possible with additional education beyond the bachelor's degree - a master's or doctoral degree in nursing - and greater expertise in clinical practice in a particular area of specialization. Advanced practice nursing is intrinsically linked to the level of education since, further academic development of nursing promotes the advancement of autonomous practice. This article addresses the education of Advanced Practice Nurses, and focuses on its core aspects; providing detailed information on competencies, curricular structure, curriculum and key components of training programs. Finally, special mention is made of advanced role training in the critical care setting.

AACN competency-based essentials revisit: Evidence-based validation of entrustable professional activities in Asia

AIM

This study intended to validate the competency-based approach through an entrustable professional activity in the nursing undergraduate education arena in Taiwan.

BACKGROUND

Entrustable professional activity is a recommended strategy to enhance nursing competencies and skills. It has been widely applied to nursing education in Western countries, especially graduate programs. However, its effects in eastern countries and undergraduate programs remain unclear.

DESIGN

A quasi-experimental comparison design was used.

METHOD

The study is conducted at the Department of Nursing at a university in southern Taiwan. A total of 72 Two-Year Nursing Program students participated in the study. After implementing the designated entrustable professional activity in the Wound Care Nursing course, outcomes were measured using the Competency Inventory of Nursing Students, Learning Satisfaction and Objective Structured Clinical Examinations. These outcomes were then compared with post-test results at the end of the semester. About 90 % of students completed the study with the test group (n=31) receiving extra activity and the comparison group (n=34) receiving usual teaching. Data were analyzed through chi-square, paired t and Student's t-test.

RESULTS

The test group demonstrated significantly higher scores in perceived competency and clinical examinations than the comparison group. However, both groups experienced an increase in learning satisfaction without reaching a significant difference.

CONCLUSION

Results of the study indicate that competency-based pedagogy, e.g., using entrustable professional activities, should be integrated into nursing curricula to meet the new American Association of Colleges of Nursing standards with compelling evidence.

Effects of game-based learning integrated with the self-regulated learning strategy on nursing students' entrustable professional activities: A quasi-experimental study

BACKGROUND

In the field of nursing education, the expertise and knowledge required to perform Leopold's Maneuvers are critical, forming an integral part of Entrustable Professional Activities for nursing students. As a result, mastering Leopold's Maneuvers has become a core component of nursing education. Despite this, the prevailing didactic methods in many nursing courses tend to limit interactive and contextual learning experiences, which can hinder students' ability to engage deeply with the subject matter. This lack of engagement may subsequently affect both the effectiveness of students' learning and students' clinical judgment capacity, essential elements in the competencies of Entrustable Professional Activities.

METHODS

A quasi-experimental design was employed in this study, involving a total of 55 nursing university students, with 28 participants in the experimental group and 27 in the control group. The research incorporated game-based learning integrated with the self-regulated learning strategy, and employed a pretest, posttest, and questionnaires to assess students' learning performance, self-efficacy, and learning motivation. The experimental group participated in game-based learning with the self-regulated learning strategy, whereas the control group experienced game-based learning without the integration of self-regulated learning. Learning performance was analyzed using an independent samples t-test, while Analysis of Covariance was employed to compare the self-efficacy and learning motivation of the two groups.

RESULTS

The findings showed that the integration of game-based learning with the self-regulated learning strategy can significantly improve students' learning performance, self-efficacy, and learning motivation.

CONCLUSION

As an integral part of Entrustable Professional Activities, Leopold's Maneuvers were integrated into an interactive game-based learning environment, coupled with the self-regulated learning strategy in nursing education. This approach aimed at cultivating core competencies among nursing students. This study has demonstrated its efficacy in engaging students effectively, serving as a dynamic resource for immersive learning in Leopold's Maneuvers, aligning well with the design considerations for promoting Entrustable Professional Activities in nursing education.

Evaluating the Strengths and Barriers of Competency-Based Education in the Health Professions

OBJECTIVE

This study aimed to define competency-based education (CBE) for pharmacy education and describe how strengths and barriers of CBE can support or hinder implementation.

FINDINGS

Sixty-five studies were included from a variety of health professions in order to define competency based pharmacy education (CBPE) and identify barriers and benefits from the learner, faculty, institution, and society perspectives. From the 7 identified thematic categories, a CBPE definition was developed: "Competency-based pharmacy education is an outcomes-based curricular model of an organized framework of competencies (knowledge, skills, attitudes) for pharmacists to meet health care and societal needs. This learner-centered curricular model aligns authentic teaching and learning strategies and assessment (emphasizing workplace assessment and quality feedback) while deemphasizing time."

SUMMARY

This article provides a definition of CBE for its application within pharmacy education. The strengths and barriers for CBE were elucidated from other health professions' education literature. Identified implementation strengths and barriers aid in the discussions on what will support or hinder the implementation of CBE in pharmacy education.

OWIED System to Facilitate the Entrustment Decision in EPA Implementation

BACKGROUND

Entrustable professional activities (EPAs) are gaining attention as an approach for adequate implementation of a competency-based evaluation framework in nursing education. This study sought to develop an Online Web-assessment Interface for Entrustment Decision (OWIED) to facilitate the entrustment decision in EPA implementation.

METHOD

A participatory qualitative action research design consisting of two phases was used for this study. The exploration phase was conducted in close collaboration with stakeholders. Following the exploration phase, the primary researcher and a team of subject-matter experts in academic and information technology developed the OWIED system according to the exploration phase results.

RESULTS

The necessary features that met the expectations of the stakeholders were identified and assisted in developing the OWIED system.

CONCLUSION

OWIED may provide a valid tool to track and validate nursing student acquisition of core competencies and assist in making entrustment decisions as students fulfill their training requirements in their academic program. [J Nurs Educ. 2024;63(6):356-365.].

Evaluation of the implementation of the objective structured clinical examination in health sciences education from a low-income context in Tunisia: A cross-sectional study

Background

Objective structured clinical examination (OSCE) is well-established and designed to evaluate students' clinical competence and practical skills in a standardized and objective manner. While OSCEs are widespread in higher-income countries, their implementation in low-resource settings presents unique challenges that warrant further investigation.

Aim

This study aims to evaluate the perception of the health sciences students and their educators regarding deploying OSCEs within the School of Health Sciences and Techniques of Sousse (SHSTS) in Tunisia and their efficacity in healthcare education compared to traditional practical examination methods.

Methods

This cross-sectional study was conducted in June 2022, focusing on final-year Health Sciences students at the SHSTS in Tunisia. The study participants were students and their educators involved in the OSCEs from June 6th to June 11th, 2022. Anonymous paper-based 5-point Likert scale satisfaction surveys were distributed to the students and their educators, with a separate set of questions for each. Spearman, Mann-Whitney U and Krusakll-Wallis tests were utilized to test the differences in satisfaction with the OSCEs among the students and educators. The Wilcoxon Rank test was utilized to examine the differences in students' assessment scores in the OSCEs and the traditional practical examination methods.

Results

The satisfaction scores were high among health sciences educators and above average for students, with means of 3.82 ± 1.29 and 3.15 ± 0.56, respectively. The bivariate and multivariate analyzes indicated a significant difference in the satisfaction between the students' specialities. Further, a significant difference in their assessment scores distribution in the practical examinations and OSCEs was also demonstrated, with better performance in the OSCEs.

Conclusion

Our study provides evidence of the relatively high level of satisfaction with the OSCEs and better performance compared to the traditional practical examinations. These findings advocate for the efficacy of OSCEs in low-income countries and the need to sustain them.

Curriculum and Competency Guidelines for the Advanced Care Practitioner in Infectious Disease

Background

Changes in the health care delivery system have altered the way internal medicine (IM) is practiced, with inclusion of subspecialty advanced care practitioners (ACPs) as vital members of the health care team.

Methods

ACPs are provided the clinical settings and educational resources within an academic center to become competent in recognizing and managing common and complicated infectious diseases (ID). The ID ACP will be given progressive responsibility with expectations for achievement of milestones as they develop into competent practitioners. We seek to ensure quality, cost-effective, and comprehensive patient-centered care on the ID service in the inpatient and ambulatory settings in compliance with national standards and scope of practice recommendations and regulations.

Results

In recognition of the expanding role of ACPs, we developed a curriculum and guidelines in the subspecialty of ID.

Conclusions

Our proposal greatly adds to the available literature for ACPs to provide the full spectrum of ID practice.

Higher Vocational Nursing Students' Clinical Core Competence in China: A Cross-Sectional Study

Introduction

Understanding the clinical core competence of nursing students in higher vocational colleges is crucial for adjusting the nursing core curriculum and training of nursing professionals. However, little is known about the level of clinical core competence of higher vocational nursing students in China.

Objective

To investigate nursing students' clinical core competence in the school of nursing and health at a vocational and technical college in Guangdong, China.

Methods

The Core Competency Scale for Registered Nurses in China was used to evaluate the clinical core competence of higher vocational nursing students from February to March 2022. Data were analyzed by descriptive statistics, Mann-Whitney U test and Kruskal-Wallis test.

Results

A total of 1,120 nursing students were investigated, 1,069 were valid questionnaires, and the response rate was 95.4%. The total score of core competence score of higher vocational nursing students was 176.55 ± 43.95, only 43.3% of students obtained an overall score more than 178, and 47.7% of students scored between 116 and 178 scores. The lowest score was on critical thinking and scientific research (2.72 ± 0.77) following by clinical nursing (2.85 ± 0.80), which had differences in gender, category of students, and years of study. There were differences in the total average score of core competence in terms of gender and category of students. Leadership and interpersonal relationships differ significantly by gender, while professional development, teaching, and coaching differ significantly by category of student.

Conclusions

The findings revealed the core competence of higher vocational nursing students is at a medium level. Moreover, critical thinking and scientific research, and clinical nursing ability are significantly insufficient.

Competency-based curriculum in nurse practitioner education

ABSTRACT

Professional nursing standards and guidelines form the foundation for nurse practitioner curriculum. Nurse educators should understand the role these professional standards and guidelines have in the development of curriculum. Recently, nursing education has moved to a competency-based education with the release of the new American Association of Colleges of Nursing Essentials and the National Organization of Nurse Practitioner Faculties Nurse Practitioner Role Core Competencies. Competency-based curriculum allows for a common understanding of the knowledge, skills, and experiences nurse practitioner graduates require for entry to practice. Competency-based education also provides consistent and uniform expectations for novice nurse practitioners on entry to practice. With the change to a competency-based curriculum, nurse educators can review and revise curriculum through refinement of courses, student learning objectives, assignments, and evaluations. Nurse educators have a responsibility to critically analyze student assignments and evaluations to ensure competencies are met multiple times through a variety of methods. In addition, nurse educators have the opportunity to use assignments that meet multiple competencies to modernize student learning. Refinement and revision lead to enhanced student critical thinking and provide opportunities for real-world training to improve student outcomes.

Implementation of Competency-Based Education for Quality Midwifery Programs in Africa: Protocol for a Scoping Review

BACKGROUND

Competency-based education (CBE) for midwifery programs is a system of academic instruction and evaluation that aims to achieve proficiency in midwifery student learning outcomes, which is based on students' ability to demonstrate the knowledge, attitudes, self-perceptions, and skills of a predetermined set of educational activities in theory and practice. CBE focuses on ensuring that midwifery students can develop critical thinking abilities, values, and the clinical decision-making abilities needed for the delivery of safe care in future practice.

OBJECTIVE

The objective of this scoping review is to map and synthesize existing literature on the implementation of CBE for midwifery programs and its sustainability in Africa.

METHODS

We will use the Arksey and O'Malley approach for scoping reviews for the research methodology. The 3-stage search process, proposed by the Joanna Briggs Institute, will be used to determine the eligibility of published and unpublished studies. PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, and Scopus will be searched to screen published articles. ProQuest Dissertations and Theses and Google Scholar will be used to search for unpublished studies. Findings will only apply to studies conducted in Africa from 2010 to the present year in English. The 2 reviewers will work independently to carefully screen and compare the full text of the selected citations to the inclusion criteria. In the event of any disagreements between the 2 reviewers at any stage of the selection process regarding the inclusion of an article, this will be settled by discussion or consultation with a third reviewer. The extracted data will be presented using a PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review) flow diagram with an attached narrative summary. The review will summarize and disseminate findings on the implementation of the CBE for midwifery programs and its sustainability in Africa.

RESULTS

It is intended that this scoping review will be completed within 6 months following the publication of this protocol.

CONCLUSIONS

The conclusions from this scoping review will inform midwifery educators, institutions, policy makers, and other stakeholders on the strategies to implement and sustain CBE for midwifery programs in Africa.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/47603.

Exploring stakeholder perspectives regarding the implementation of competency-based medical education: a qualitative descriptive study

Introduction

Competency-based medical education (CBME) offers perceived advantages and benefits for postgraduate medical education (PGME) and the training of competent physicians. The purpose of our study was to gain insights from those involved in implementing CBME in two residency programs to inform ongoing implementation practices.

Methods

We conducted a qualitative descriptive study to explore the perspectives of multiple stakeholders involved in the implementation of CBME in two residency programs (the first cohort) to launch the Royal College's Competence by Design model at one Canadian university. Semi-structured interviews were conducted with 17 participants across six stakeholder groups including residents, department chairs, program directors, faculty, medical educators, and program administrators. Data collection and analysis were iterative and reflexive to enhance the authenticity of the results.

Results

The participants' perspectives organized around three key themes including: a) contextualizing curriculum and assessment practices with educational goals of CBME, b) coordinating new administrative requirements to support implementation, and c) adaptability toward a competency-based program structure, each with sub-themes.

Conclusion

By eliciting the perspectives of different stakeholder groups who experienced the implementation processes, we developed a common understanding regarding facilitators and challenges for program directors, program administrators and educational leaders across PGME. Results from our study contribute to the scholarly conversation regarding the key aspects related to CBME implementation and serve to inform its ongoing development and application in various educational contexts.

Diagnostic Reasoning Competency and Accuracy by Nurse Practitioner Students Following the Use of Structured Reflection in Simulation: A Mixed-Methods Experiment

AIM

The aim of this study was to examine the effect of structured reflection used during a simulated patient's diagnostic workup on diagnostic reasoning competency and accuracy and explore participants' cognitive bias experience and perceived utility of structured reflection.

BACKGROUND

Reasoning flaws may lead to diagnostic errors. Medical learners who used structured reflection demonstrated improved diagnosis accuracy.

METHOD

Embedded mixed-methods experiment examined diagnostic reasoning competency and accuracy of nurse practitioner students who did and did not use structured reflection. Cognitive bias experience and perceptions of structured reflection's utility were explored.

RESULTS

Diagnostic Reasoning Assessment mean competency scores and categories were not changed. Accuracy trended toward improvement with structured reflection. The theme, diagnostic verification, prompted diagnosis change by both structured reflection users and control participants.

CONCLUSION

Despite no changes in quantitative outcomes, explicit users of structured reflection believed that this strategy is helpful to their reasoning, and control participants used the strategy's components with the same noted benefits.

Supporting Emergency Care Delivery Through Updated Emergency Nurse Practitioner Competencies

As multidisciplinary emergency care becomes increasingly complex, all team members must be aware of their respective roles and responsibilities. In the emergency department, nurse practitioners are integral members of the team. They possess a wide range of clinical and leadership competencies that allow them to perform specific and differentiated tasks within the emergency department. A well-defined competency not only contributes to the promotion of a positive work culture but also clarifies performance expectations, identifies skill gaps, and supports team development. Furthermore, it allows the nurse practitioner to adapt to changing conditions while maintaining patient safety. The competencies of emergency nurse practitioners have evolved over the past 2 decades. The authors discuss the importance of establishing clear expectations for emergency nurse practitioner practice in this article and the alignment of competencies with organizational culture and objectives.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies

BACKGROUND

The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts.

OBJECTIVE

The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course.

DESIGN/METHODS

Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting.

CONCLUSION

Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

Addressing the elephant in the room: Differentiating the AACN Essentials levels of competency within advanced practice

While the 2021 AACN Essentials, "The Essentials: Core Competencies for Professional Nursing Education", provide a framework for educational preparation, academia is challenged to navigate through the muddy waters of competency attainment at the advanced level (L2). The aim of the new Essentials is to serve as a curriculum guide and provide a clear vision of the profession to community and stakeholders, while those within the profession struggle to thread this vision through redesign, specifically differentiating competency in L2 for master's and doctoral level preparation. This perspective article challenges educators to expand the definition of competency attainment to one of innovation based on the history and evolution of Doctor of Nursing Practice (DNP) education, competency-based education (CBE), and the achievement of milestones as advanced practice moves to entry level as DNP.

Effects of the mini-clinical evaluation exercise teaching mode based on nurse-faculty cooperation in Fundamentals of Nursing course: A quasi-experimental study

Objectives

This study aimed to explore the effects of the mini-clinical evaluation exercise (mini-CEX) teaching model based on nurse-faculty collaboration in Fundamentals of Nursing course.

Methods

A quasi-experimental design was conducted. A total of 111 nursing students of two parallel classes were recruited from a nursing college in Guilin, China from February to December 2022, and allocated to the intervention group (n = 56) and control group (n = 55). The intervention group received a mini-CEX teaching model based on nurse-faculty collaboration, the teaching-learning process included scenario creation (10 min), inquiry-based learning (30 min), case report (30 min), scenario simulation exercise (40 min), and effectiveness evaluation (10 min). While the control group received conventional teaching method. All students were invited to complete the College Classroom Climate Assessment Scale (CCCA) and the Chinese version of the Competency Inventory for Nursing Students (CINS-CV) before and after the intervention. Course achievement of students was evaluated. After the intervention, the intervention group was asked an open-ended question to explore the difficulties or challenges they had encountered.

Results

After intervention, the CCCA score (208.36 ± 23.25 vs. 190.60 ± 28.83), CINS-CV score(106.95 ± 14.48 vs. 99.55 ± 14.60), the oretical exam score (83.01 ± 4.27 vs. 79.75 ± 5.45), and scenario simulation exam score (89.23 ± 3.17 vs. 81.42 ± 7.19) of intervention group were higher than those of the control group (P＜0.01). The open-ended questionnaire survey revealed that the difficulties or challenges faced by the intervention group were mainly related to case analysis, group cooperation, learning material acquisition, and teacher guidance.

Conclusion

Applying the mini-CEX teaching model based on nurse-faculty collaboration could cultivate nursing students' competency, build a positive classroom climate, and improve the course achievement of students.

Emotional intelligence as a mediator between spiritual care-giving competency and core competencies in Chinese nursing interns: a cross-sectional study

BACKGROUND

The development of nursing interns' fundamental competencies should be a top focus because they represent an essential reserve for nursing professionals. The objective of this study is to investigate the relationship between spiritual care-giving competency (SCG) and nursing core competencies (NCC) among Chinese nursing interns, adopting a competency-based education (CBE) perspective, additionally, the study aims to examine how emotional intelligence (EI) serves as a mediator in this relationship.

METHODS

A nationwide online survey was completed by 1811 Chinese nursing interns at vocational colleges between June and July 2022 as part of a multi-site, cross-sectional, web-based study. Participants completed a demographic questionnaire and competencies inventory for the registered nurse questionnaire (CIRN), the Chinese version of the spiritual care-giving scale questionnaire (C-SCGS), and the Chinese version of the Wong and Law EI scale questionnaire (WLEIS-C). Means, standard deviations, t-tests, one-way ANOVA analysis, and Pearson's production correlation coefficients were calculated using IBM SPSS25.0 software. Mediated effect tests and studies utilizing the process plug-in SPSS developed by Hayes.

RESULTS

The NCCs of college nursing interns were related to whether working as student leaders, whether have a better self-learning evaluation level, whether a college nursing intern with good interpersonal relationship, and whether they intend to engage in the nursing profession in the future. The scores of NCC, EI, and SCG were (156.43±23.14), (61.55±9.10), and (167.64±20.52) respectively. There were positive correlations among SCG (r = 0.402), EI (r = 0.506), and NCC. The partial mediating effect of EI between SCG and NCC was 0.127, accounting for 36.29% of the total results.

CONCLUSION

The average levels of Chinese college nursing interns' NCC and SCG were at a moderate level. EI is mediating between SCG and NCC in Chinese nursing interns. This new perspective shows that developing and improving SCG and EI may improve NCC. We suggest modifying the nurse curriculum and instruction to strengthen NCC and integrating SCG and EI management into the nursing curriculum.

In-hospital education of parents of newborns may benefit from competency-based education: A qualitative focus group and interview study among health professionals

AIMS/OBJECTIVES

The aim of this study was to appraise health professionals' self-reported practices in educating parents of hospitalised newborns from the perspective of competency-based education and to identify areas for improvement of parental learning.

BACKGROUND

Patient education is essential to achieve autonomy in parents of hospitalised newborns. The literature provides descriptions of the use of various components of competency-based education in patient education. This suggests that competency-based education is a valuable concept for patient education.

DESIGN

A case-based qualitative study.

METHODS

Three focus group discussions were conducted and 28 semi-structured interviews with 45 health professionals who practice in a hospital setting that is designed to empower parents. The data were analysed with a framework analysis approach, using a framework of competency-based education themes for a combined inductive and deductive content data analysis. The recommendations of the Standards for Reporting Qualitative Research checklist were followed.

FINDINGS

Two themes of competency-based education emerged as evidently operationalised: (1) 'Learning climate' and (2) 'Role modeling'. Five themes emerged as incompletely operationalised: (1) 'Parent curriculum based on inter-professional consensus'; (2) 'Transparency about the competencies needed'; (3) 'Access to teaching'; (4) 'Assessing and reporting results'; and (5) 'Proficiency statements based on autonomy expectations'. Two themes did not emerge: (1) 'Empowering parents to be active learners' and (2) 'Evaluation and improvement of the education program'.

CONCLUSIONS

Parent education is at risk of being merely on a master-apprentice model and may be more effective if it is designed on competency-based education principles. Identified areas for improvement are empowering parents to be 'active learners' and by involving them in the evaluation and improvement of the educational program. Parent education in neonatal health care may benefit from an appraisal based on competency-based education themes.

RELEVANCE TO CLINICAL PRACTICE

Appraising parent education based on competency-based education principles is feasible for improving the learning process towards parent autonomy.

An example of evaluation of tuning nursing competences in the licensure exam: An observational study

Introduction The licensure exam in nursing has always focused on the curricula used in universities. 'Tuning' was the first project that sought to harmonize training purposes regarding competences and learning outcomes in Europe. The Tuning educational structures have been offered in various disciplines, including nursing with the development of the Tuning Nursing Project. The study describes which of 47 Tuning Nursing Competences were evaluated during the licensure exam in nursing degree courses, and what types of trials were used for their assessment. Methods A multicentric observational study was conducted in 4 universities in Italy. Data were collected in academic years 2017-2019, using two grids: one for cognitive and one for psychomotor tests. Results The Tuning competences were requested 7522 times. The most frequently demanded were those associated with domain number two, "Nursing practice and clinical decision making". The level of performance most required in cognitive tests was the autonomy of judgement, and both tests concerned the fields of non-communicable diseases and the hospitalized adult patient. Conclusions The competences most often assessed coincided with those deemed core for the first cycle of studies at the European level. Unfortunately, it has been detected a high degree of discrepancy in the types of tests used in different schools.

Development and psychometric testing of Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS)

BACKGROUND

For nurses to carry out their responsibilities related to preoperative care in the best possible way, it is very important for them to receive competency-based training and for their competences to be measured with reliable and valid tools in the training process.

OBJECTIVE

To develop a measurement tool that evaluates nursing students' perceived competence for preoperative nursing care.

DESIGN

A cross-sectional, methodological study.

SETTING

Two universities in the Eastern Black Sea Region of Turkey.

PARTICIPANTS

A total of 661 second, third and fourth grade nursing students participated in the study.

METHODS

Items were created in line with the nursing competencies published by the International Council of Nurses, the competencies in the perioperative period nursing practices published by the European Operating Room Nurses Association, and a review of the literature. Then, to test the content validity, the items were submitted for expert opinion and a pilot implementation was made with 50 nursing students. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 350). Test-retest stability was also investigated for the PPreCC-NS (n = 58), in the study.

RESULTS

According to the results of the exploratory factor analysis, the Kaiser-Meyer-Olkin value was 0.948, and the Bartlett test χ2 was 7765.23; p < 0.001. Three items with a factor loading value below 0.50 were removed from the scale, and the obtained factor structure explained 62.25 % of the variance. The fit indices of the scale model tested in the confirmatory factor analysis were determined as χ²/df = 2.74, RMSEA = 0.07, CFI = 0.92, GFI = 0.88, AGFI = 0.85, IFI = 0.92. The structure of the draft scale was confirmed with 5 factors and 22 items. The Cronbach alpha values were found to be 0.79-0.96 for the sub-dimensions of the scale and 0.94 for the total scale. Data also showed a good test-retest stability (ICC = 0.72).

CONCLUSIONS

This scale is a reliable and valid measurement tool for nursing students to determine their level of perceived competence for preoperative nursing care. It is recommended that the psychometric structure of the scale be evaluated with further studies on larger and more diverse samples.

Development, Validity and Reliability of Objective Structured Clinical Examination in Nursing Students

Introduction

The adoption of measurement instruments such as the Objective Structured Clinical Examination (OSCE) is essential to assess clinical competencies in nursing students.

Objective

The purpose of this study is to develop an OSCE, analyze its validity and reliability in the nursing curriculum and measure self-assessment, stress and satisfaction.

Methods

The observational validation study of a measurement instrument was carried out in two phases: the design and development of the OSCE and validity and reliability analysis.

Results

A total of 118 students participated in the study. Ten scenarios were designed that incorporated six competency components extracted from the curriculum. Good results were obtained in face validity, content validity (CVI .82-.95), criterion validity (r = .71, p < .001), and reliability (α Cronbach .84). Satisfaction and stress scores were high, and self-assessment scores were lower than the scores obtained.

Conclusion

A rigorously designed OSCE provides a reliable and valid method for assessing the clinical competence of nursing students.

Developing and Implementing Entrustable Professional Activities to Prepare Global Nurses

INTRODUCTION

Nurses work in global settings and must be prepared to enter practice and provide culturally appropriate care to diverse populations. As faculty we want to ensure the achievement of programmatic, national, and global competencies for our student's successful future practice.

METHODS

Aligning current programs with American Association of Colleges of Nursing's (AACN) New Essentials provides an opportunity to consider new approaches and address challenges. By merging the New Essentials with the Consortium of Universities for Global Health (CUGH) competencies, we facilitate the achievement of programmatic outcomes, mission, and values in nursing education.

RESULTS

Using an entrustable professional activities framework provides a clear measure of achieving priority competencies. We created an approach other faculty might find helpful.

DISCUSSION

Entrustable professional activities, well established in medical education, are emerging as a valuable tool to measure the achievement of competencies in the preparation of nurses.

Integration of a Simulation Curriculum Across Semesters in an Acute Care Pediatric Nurse Practitioner Program

INTRODUCTION

Simulation is a common strategy for health care education. Research regarding simulation for nurse practitioner education is sparse. This paper describes the integration of a nine simulation session curriculum into a nurse practitioner program, including motivating factors, process description, and lessons learned.

RESULTS

Students report high satisfaction and improved perception of confidence and competence of knowledge, skills, and performance.

DISCUSSION

Integrated learning experiences and outcomes that span an educational program are needed in thetransition to competency-based education. This description serves as a guide for other programs seeking to incorporate simulation-based education.

Public health in undergraduate nursing education and workforce readiness

Student engagement with the community is a cornerstone of undergraduate nursing education in Canada. Working with community from perspectives of social justice, health equity, advocacy, and political action are essential for workforce readiness. We suggest that the erosion of public health theory and clinical courses in baccalaureate nursing programs undermines the potential capability of nurses to address the intersectionality of the social determinants of health. The impact of the COVID-19 pandemic on populations further demonstrates inequities, particularly among marginalized populations. Public health nursing education supports students' understanding about the health impacts of social injustice, how systemic racism is embedded in colonial and Eurocentric structures, and practices of superiority and privileges.We, as a national group of public health nursing educators, set out to investigate how existing guidelines and competencies support public health in undergraduate education across Canada. Results from a national questionnaire of educators, and of PHN leaders on new graduate practice readiness are presented. Questionnaire responses confirm an erosion of PHN theory and practice in baccalaureate nursing education (BNE) curricula. The results of the questionnaires combined with evidence of PHN since the global pandemic provide educators and practitioners more insight to inform future directions to respond to workforce readiness.

Diagnostic Reasoning Outcomes in Nurse Practitioner Education: A Scoping Review

BACKGROUND

Diagnostic reasoning is the process of collecting, considering, and analyzing information to determine a diagnosis. Educational strategies that structure diagnostic reasoning exposure, experience, and evaluation are hypothesized to improve diagnostic safety. However, few studies measure diagnostic reasoning outcomes in nurse practitioner education. This review sought to identify the educational interventions intended to improve diagnostic reasoning competency, determine which components of reasoning are evaluated, and examine how they are measured.

METHOD

Four databases were searched, and 12 studies were identified that met the inclusion criteria.

RESULTS

Simulation was the most common intervention. The most frequently measured diagnostic reasoning components were information gathering, differential diagnosis, and leading diagnosis. Checklists and patient management problems were the most used assessment method.

CONCLUSION

More studies are needed to assess the reasoning processes of hypothesis generation, problem representation, and diagnostic justification. Within simulation, methods capable of capturing these components include think-aloud, global assessments, checklists, and note evaluation. [J Nurs Educ. 2022;61(10):579-586.].

Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students

STUDY OBJECTIVES

Primary care nurse practitioners (NPs) receive little sleep education in graduate programs but are often first-line providers for patients presenting with sleep-related symptoms. A pre-/postevaluation study was conducted using asynchronous, case-based sleep education modules in a cohort of primary care NP students enrolled in a single academic institution's nursing master's degree program.

METHODS

Six virtual, case-based modules addressed adult sleep health and disorders, prioritized based on prevalence and primary care presentation. Kirkpatrick Training Evaluation Model guided outcome selection. Descriptive and paired comparative analyses were conducted.

RESULTS

Participants were first-year NP students (n = 149; 88% female; 82% ≤ 35 years of age) in an adult primary care program that included psychiatric/mental health track. Participants reacted positively to course delivery methods and content. Insomnia was endorsed by 87% as most relevant to practice with healthy sleep (88%) and obstructive sleep apnea (50%) also frequently endorsed as practice relevant. Posttest knowledge scores significantly improved for all modules (P < .001). Self-rated confidence for future practice application was high.

CONCLUSIONS

This novel asynchronous, virtual curriculum met Kirkpatrick levels 1 and 2 (positive reaction and knowledge transfer) in NP students who predicted an impact on their practice (Kirkpatrick level 3). Studies are needed to assess the benefits of increasing primary care NP knowledge in sleep medicine on quality of care and access to care (Kirkpatrick level 4). Future use of this novel sleep curriculum in other professional curricula, new-to-sleep clinical researchers, and practicing primary care providers may further potentiate care quality and sleep care access.

CITATION

Sawyer AM, Saconi B, Lyons MM, et al. Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students. J Clin Sleep Med. 2022;18(10):2367-2376.

Construction on teaching quality evaluation indicator system of multi-disciplinary team (MDT) clinical nursing practice in China: A Delphi study

AIM

To construct an evaluation indicator system for nursing multi-disciplinary team (MDT) clinical practice in China and to provide quantifiable indicators for MDT clinical teaching courses.

METHODS

Based on relevant literature retrieval and analysis, a evaluation indicator system of nursing MDT clinical teaching quality was preliminarily constructed using the Donabedian. Structure-Process-Outcome model as theoretical guidance. Then, a final indicators content was formed after two rounds of expert consultation and Analytic Hierarchy Process (AHP) was used to determine the weight of indicators at all levels.

RESULTS

The effective response rate of the questionnaires in two rounds were 95.23% (20/21) and 100% (20/20) respectively, the expert authority coefficient (Cr) were 0.838 and 0.853 respectively and the Kendall's coefficient of concordance (Kendall's W) of indicators at all levels were 0.137-0.612 (P < 0.05). The final evaluation index system consisted of three one-class indicators, 8 s-class indicators and 28 third-class indicators.

CONCLUSION

The study constructed a comprehensive set of evaluation indicator system of nursing MDT clinical practice, which was scientific and reliable and provides reference for the clinical teaching quality evaluation of MDT nursing.

Telehealth Competencies: Leveled for Continuous Advanced Practice Nurse Development

BACKGROUND

The COVID-19 pandemic spurred a rapid uptake of telehealth utilization, with advanced practice registered nurses (APRNs) at the forefront of telehealth care delivery. To advance training of nurse practitioners and support curricular development, essential APRN student competencies in telehealth were developed.

PROBLEM

Although telehealth competencies have been developed, little is understood about their evaluation across the curricula. Moving to competency-based nursing education involves leveling broad competencies into subcompetencies, including those for telehealth. Subcompetencies support frequent, multimodal evaluation of student progress across APRN curricula.

APPROACH

Adapting Benner's Novice to Expert Theory, faculty experts in telehealth and graduate nursing education used an iterative process to develop and level subcompetencies aligned with the Four Ps of Telehealth framework.

OUTCOMES

Telehealth subcompetencies were leveled for preclinical and clinical rotations and for readiness for practice.

CONCLUSIONS

The leveled subcompetencies, aligned with the Four Ps of Telehealth framework, will support APRN faculty in diverse programs as they implement competency-based education in telehealth.

Entrustable Professional Activities in Clinical Education: A Practical Approach for Advanced Nursing Education

BACKGROUND

Competency attainment is foremost in the ethos of this project that provides a practical guide to implementing entrustable professional activities (EPAs) as one approach to competency acquisition in the clinical education component of a health care program. EPAs are units of work that provide evidence of required competencies for the clinical education component of a program of study for educators, preceptors, and students.

PROBLEM

The American Association of Colleges of Nursing has raised the importance of competency-based education and need for a practical approach to assess clinical competency challenges (eg, EPAs) in nursing education.

APPROACH

The implementation of EPAs in the clinical component of advanced nursing education is detailed as an example in this article. Prioritizing a systematic approach, the Knowledge to Action framework, was chosen to guide the process.

CONCLUSION

Nursing must act now to put in place a robust competency acquisition and validation system.

Innovative Team Approach for Achieving DNP Program Competencies for Distance Learners During the COVID-19 Pandemic

ABSTRACT

Doctor of nursing practice (DNP)-prepared nurses must be competent in organizational and systems leadership, advanced clinical skills, and initiation of policy and programmatic changes. Students develop competencies in the DNP advanced practice and nurse administrator specialty tracks through online didactic and in-person practicum experiences within various settings. The COVID-19 pandemic created a barrier to in-person practicum experiences and an urgent need for flexible practicum opportunities. In response, faculty developed, implemented, and evaluated an innovative pedagogical strategy utilizing a team-based case study assignment to facilitate achievement of DNP program competencies for distance learners in these specialty tracks.

Systemic barriers and facilitators to the transition of registered nurse to nurse practitioner in Canada: A scoping review

BACKGROUND

The scope of practice of nurse practitioners (NPs) is expanding, and an increasing number of registered nurses (RNs) are advancing their careers to become NPs. Nurse practitioners are prepared to improve access to high-quality care and enhance care standards. The barriers and facilitators in the transition of RNs to NPs have been seldom studied in the Canadian context.

OBJECTIVE

To conduct a scoping review to identify systemic barriers and facilitators affecting Canadian RN experience in transitioning to independent practice as NPs.

DATA SOURCES

Four electronic databases were searched for primary studies, and several search engines were used to retrieve gray literature. Keywords included NP, transition, novice, Canada, barriers, obstacles, facilitators, and their variations. Eligible studies are those published from the inception of each respective database to 2021.

CONCLUSIONS

Four research studies and one report in the gray literature were located. Three themes were identified from the literature review, including inconsistencies in education and the need for mentors, need for legislation supportive of NP practice, and inconsistent remuneration structures for NPs.

IMPLICATIONS FOR PRACTICE

Addressing systemic barriers and employing systemic facilitators are likely to facilitate the transition of RNs to NPs. The lack of primary evidence to explore the factors that affect the transition process from an RN to an NP in Canada indicates that further research must be done. Findings from the future research are likely to furnish a better understanding of the transition process so that the integration of new NPs into the health care system can be achieved efficiently.

Psychometric evaluation of a nursing competence assessment tool among nursing students: a development and validation study

BACKGROUND

Nursing competence refers to the core abilities that are required for fulfilling one's role as a nurse. A specific instrument comprehensively measuring competence among nursing students has not yet been developed. The purpose of the study was to develop and validate a nursing competence instrument for nursing students in bachelor training.

METHODS

A descriptive and explorative study design was used. Data were collected from students at one medical college in Taiwan in 2020 and 2021. A total of 241 nursing students participated in this study. We developed the initial instrument through systematic review, expert evaluations, and pilot versions. Its validity was then tested using confirmatory factor analysis (CFA) and criterion-related validity, while its reliability was tested using Cronbach's alpha and test-retest analysis.

RESULTS

The final fit indexes of CFA were as follows: chi-square = 860.1 (p < 0.01), normed chi-square = 2.24, SRMR = 0.04, RMSEA = 0.07, CFI = 0.94, and TLI = 0.94. Cronbach's alpha values for the subscales observed ranged from 0.91 to 0.98. The test-retest reliability coefficient for the Nurse Competence Scale was 0.515 (n = 30, p < 0.01).

CONCLUSIONS

The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating nursing students' competence at bachelor training. Further assessments of its reliability, validity, and generality from mentors' and scholars' views in different contexts and cultures are recommended.

Using Simulation to Assess Nurse Practitioner Education

Resource restraints and the movement toward competency-based education encourage exploration of innovative simulation experiences in advanced practice registered nurse education. Building upon existing best practices in simulation development, this pilot project explores opportunities and challenges translating these practices to the advanced practice registered nurse context. Innovations focused on using a competency-based framework, developing a competency-based evaluation tool, and providing feedback from faculty and standardized patients. Lessons learned from this experience inform recommendations for how to design instructional experiences and provide formative methods of feedback for nurse practitioner student assessment.

Effects of high-fidelity simulation teaching on nursing students' knowledge, professional skills and clinical ability: A meta-analysis and systematic review

OBJECTIVE

This meta-analysis was designed to systematically determine the effect of high-fidelity simulation teaching on nursing students' knowledge level, professional skill level and clinical ability.

BACKGROUND

High-fidelity simulation is an increasingly popular pedagogical approach in nursing education. It provides students with opportunity to practice in a variety of simulations before entering clinical practice through a variety of real-life situational experiences and many institutions and educators have embraced this method for enhancing access to clinical skills. However, evidence for the effectiveness of the method in nursing teaching remains scarce.

DESIGN

A meta-analysis and systematic review.

METHODS

The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wangfang. The search encompassed the establishment of these databases up until November 2021. Two reviewers separately entered the data into Review Manager Software 5.3.

RESULTS

A total of 15 studies were included in this study. High-fidelity simulation significantly increased nursing students' knowledge acquisition (SMD = 1. 37, 94％CI:0. 73-2. 00，P ＜0. 0001), enhanced nursing students'professional skills (SMD = 0. 90, 95％CI:0. 36-1. 44，P = 0. 0001). In terms of clinical practice ability outcomes, high-fidelity simulation significantly improved the levels of critical thinking ability (SMD = 0. 58, 95％CI:0. 09-1. 07，P ＜0. 00001), Clinical judgement ability (SMD = 1. 34, 95％CI:0. 38-2. 31，P＝0. 006) and communication skills (SMD = 2. 62, 95％CI:1. 84-3. 40，P ＜0. 001) of nursing students.

CONCLUSIONS

We found that high-fidelity simulation have strong educational effects in nursing education, helping nursing students to increase knowledge acquisition, enhance professional skills and cultivate their clinical practice ability (critical thinking ability, communication skills and clinical judgement ability). These findings can provide guidance for nursing educators, indicating that the use of High-fidelity simulation teaching represents an effective solution for transitioning students from the learning environment to clinical practice.

Development, Implementation, and Assessment of a New Competency and Outcomes-Based Orientation in an Air Medical Transport Program

OBJECTIVE

The development and evaluation of new employees in air medical transport has historically lacked standardization and competency-based learning goals. Here we discuss the development, implementation, and assessment of a new competency-based education and evaluation method at Geisinger's Life Flight air medical transport service.

METHODS

Using Bloom's taxonomy of learning, 14 competencies for flight employees were identified. An electronic database was created to track progress across competencies and serve as an information repository for the identification of goals and the development of individualized learning plans. Ten months after implementation of the new method, 11 preceptors and education team members were surveyed to understand their views on the new program.

RESULTS

At the time of survey administration, 20 orientees had completed orientation under the new education and evaluation program in an average of 6.45 weeks, with a range of 3 to 10 weeks. Of the 11 surveyed instructors, 81.1% definitely agree that the new method adequately assesses performance compared with 45.5% with the previous unstandardized method; 81.8% of the instructors rated the overall change as very helpful.

CONCLUSION

The adoption of a competency-based learning model for air medical transport employee education and evaluation improves the assessment of performance and allows for the development of customized learning plans.

The effect of competency-based education on clinical performance of health care providers: A systematic review and meta-analysis

AIM

This study aimed to investigate the effects of competency-based education on the clinical performance of health care providers.

BACKGROUND

Having in mind the importance of developing an intervention to enhance the clinical performance of health care providers, the researchers carried out the present study to investigate the effect of competency-based education on the clinical performance of health care providers.

METHODS

This was a systematic review and meta-analysis carried out by searching six international electronic databases including PubMed, Ovid, Cochrane Library, Web of Science, ProQuest, Scopus and Google Scholar, as well as two national electronic databases including IranMedex and SID. The studies relevant to the research aims were included in the study. To assess the quality of the studies, the Cochrane Collaboration's Risk of Bias Tool was used.

RESULTS

Based on the random effects model, competency-based education could enhance the clinical performance of the health care providers in the intervention group compared with that of the control group (standardized mean difference [SMD] = -2.717, 95% CI: -3.722 to -1.712). However, more recent studies have shown that competency-based education has little effect on clinical performance (β = -.255, 95% CI: -0.319 to -0.192, P < .001).

CONCLUSION

Competency-based education can enhance the clinical performance of health care providers. However, there is increasing concern over the attenuation of the positive effect of competency-based education on the clinical performance of health care providers, which deserves further studies.

Senior BSN students' confidence, comfort, and perception of readiness for clinical practice: the impacts of COVID-19

OBJECTIVES

The Coronavirus Disease 2019 (COVID-19) has impacted overall nursing education program requirements, classroom delivery of theory hours, as well as clinical and laboratory learning opportunities for students. The aims of this study were to explore the impacts of COVID 19 on the students' perceptions of readiness for practice and their preparation for the NCLEX exam and initial clinical practice.

METHODS

A cross-sectional descriptive design was used to investigate the impact of COVID-19 on senior BSN students' preparation for NCLEX and future careers. The Casey-Fink Readiness for Practice Survey was used to investigate the perceptions of the BSN students' clinical confidence and readiness for practice.

RESULTS

Students reported substantial impacts of COVID-19 on their clinical experiences, their ability to practice skills and procedures, their preparations for NCLEX exam, and their nursing career. The most significant confidence concerns noted from this study seemed to center on handling multiple patient assignments, calling the physician, responding to a change in patient condition, and treating a dying patient.

CONCLUSIONS

Healthcare experts expect that the impact of COVID-19 may last until 2022. More research is needed to understand the impact of COVID-19 on nursing education and transition to nursing practice. While clinical confidence and readiness for practice are essential topics, more research is needed to investigate the psychological and physiological impacts of COVID-19 on nurses, nursing students, nursing preceptors, and faculty members.