Do educational outcomes correspond with the requirements of nursing practice: educators' and managers' assessments of novice nurses' professional competence

A comparative study of nurses' competencies in integrating religion/spirituality into patient care

BACKGROUND

There is a need of research to evaluate and compare the competencies of nurses in integrating patients' religion and spirituality into nursing practice in various settings, including general and psychiatric hospitals. By understanding the competencies of nurses working in different environments, tailored spiritual care training programs can be developed to meet their specific needs. This study aimed to evaluate and compare the competencies of nurses in integrating patients' religion/spirituality into nursing practice in both a general and a psychiatric hospital.

METHODS

This cross-sectional descriptive-analytical study was conducted in two hospitals affiliated with Kerman University of Medical Sciences in southeastern Iran. Quota sampling was used to select 200 nurses (100 nurses from each hospital) in 2023. The Religious/Spiritually Integrated Practice Assessment Scale (RSIPAS) was used to evaluate and compare nurses' competencies in integrating the religion/spirituality of patients into their nursing practice.

RESULTS

The study revealed that nurses' competencies in integrating patients' religion/spirituality into nursing practice were moderate in both general (122.39 ± 19.40) and psychiatric hospitals (110.82 ± 25.63). Nurses in the general hospital had significantly higher competency scores compared to those in the psychiatric hospital (t = 3.59, p = 0.001). The type of hospital, work experience, and the involvement of professionals in providing religion/spirituality care were significant predictors of nurses' competencies in integrating patients' religion/spirituality into clinical practice.

CONCLUSIONS

The moderate levels of competencies among nurses highlight the need for further education and training to effectively integrate patients' religion/spirituality into nursing across various healthcare settings. The type of hospital also influenced their competencies. Therefore, it is crucial for nurses, particularly those working in psychiatric hospitals, to receive training that is tailored to the specific needs, culture, and context of their respective healthcare environments. It is essential to conduct a baseline assessment of nurses' readiness and competencies before implementing appropriate training programs.

The professional competence of newly graduated nurses in the transition phase as assessed by nurse managers: a descriptive cross-sectional multi-national study

Background

Nurse managers' (NMs) assessment of nurses' competences is needed to analyse how well the educational preparation corresponds with the requirements of nursing practice in Europe.

Aim

To assess newly graduated nurses' professional competence in the transition phase as perceived by NMs and to identify possible background factors related to their assessments.

Methods

A descriptive cross-sectional multinational study. Data were collected in 2019 from NMs (n = 425) in Finland, Germany, Iceland, Lithuania and Spain using the structured Nurse Competence Scale and statistically analysed.

Results

NMs assessed the level of newly graduated nurses' competence as 'good'. However, the overall competence varied between different countries. In all countries, the subcategory 'Managing situations' scored the highest and 'Therapeutic interventions' the lowest. NMs' background factors were related to their assessment.

Conclusions

Newly graduated nurses were assessed to have a good level of professional competence to meet the demands of their work in the transition phase, although there is room for improvement. The results can be used for cooperation between working life and nursing education to identify areas where the professional competence of newly qualified nurses can be improved and to promote their transition and continuous professional development in Europe.

Wound Care Education in Undergraduate and Graduate Nursing Settings

Chronic wounds are a significant global health issue, yet they are not adequately addressed in nursing education. This lack of focus results in nursing students graduating with insufficient knowledge in chronic wound care, leading to inadequate clinical practice. Consequently, nurses often struggle to manage wounds effectively, which negatively impacts patient care quality. To address this, it is crucial to enhance the nursing curriculum by incorporating more comprehensive content on chronic wound management. This will help ensure that nurses are better equipped with the necessary clinical competencies, ultimately improving patient outcomes.

Stakeholder perspectives on graduates' acquisition of competencies in nursing bachelor's degree programs: A qualitative study

BACKGROUND

In nursing education, greater emphasis should be placed on stakeholder perspectives, and these perspectives should be integrated into the educational process. Stakeholder perspectives are of great importance in determining the extent to which graduates achieve program competencies, and if necessary, in revising these competencies based on the relevant feedback.

OBJECTIVE

This study aimed to determine stakeholder perspectives on the acquisition of nursing program competencies by graduates of undergraduate nursing programs.

DESIGN

Exploratory qualitative research design.

PARTICIPANTS AND SETTING

The study was conducted in June 2024 through focus group interviews with a total of 20 internal and external stakeholders.

METHODS

The data were collected using Semi-Structured Focus Group Interview Forms. The data were organized according to common/similar categories by content analysis.

RESULTS

The data obtained based on the views of the participants on the acquisition of nursing program competencies by graduates of nursing education programs were divided into three categories: Competencies Acquired from Nursing Education (professional knowledge and skills, lifelong learning), Competencies That Need Improvement (critical thinking/problem-solving skills, communication skills, foreign language proficiency, professional values, and managerial skills), and Suggestions to Improve Competencies Acquired from Nursing Education (suggestions related to education, the profession, and institutional/administrative matters). Additionally, 10 subcategories associated with these categories were identified.

CONCLUSION

Competencies expected in members of the profession of nursing are a global topic of discussion, and the findings of study provide important insights for future studies. In line with these results, it is recommended to enhance collaboration with stakeholders and conduct regular meetings involving all stakeholders. The outcomes of these meetings should guide the structuring of educational programs to ensure the acquisition of competencies, and relevant activities should be planned and implemented accordingly.

The experiences and perceptions of nurse educators of culturally and linguistically diverse nursing students' competence development - Qualitative study

BACKGROUND

Many countries are becoming increasingly culturally and linguistically diverse due to globalisation and migration. The global shortage of nurses and the consequent migration of nursing professionals is leading to increasing cultural and linguistic diversity in health care and nursing education. Nurse educators play a significant role in supporting nursing students' competence and working life readiness.

RESEARCH AIM

To describe nurse educators' experiences and perceptions regarding competence and competence development of CALD nursing students.

METHODS

The study was conducted using a descriptive qualitative approach utilising individual thematic interviews for data collection. A purposive sample consisting of 20 volunteer nurse educators from five higher education institutions was used for the purpose. Data was collected in semi-structured interviews based on a literature review of previous studies. The data were analysed using inductive content analysis. The COnsolidated criteria for REporting Qualitative research (COREQ) criteria were used in the reporting of this study.

RESULTS

According to the content analysis, three main categories describing aspects related to the competence and competence development of CALD nursing students were identified: 1) educator's competence to support student's learning process and competence development, 2) development of supportive structures and safe learning environments, and 3) student-specific competence and competence development. The educators emphasised that setting clear goals, providing encouragement, having an open discussion, and student-centered approach to support their learning process and create a safe learning environment.

CONCLUSIONS

Supporting the learning process of CALD nursing students and developing safe learning environments were considered essential for the development of competence. These areas must be supported by developing educators' pedagogical and cultural competence and providing sufficient resources for both students and educators. In addition, the curriculum must be designed to support these aspects.

Clinical judgment in new nurse graduates: identifying the gaps

OBJECTIVES

Clinical judgment has been identified as a key component of clinical practice. We sought to measure the elements of clinical judgment in new nurse graduates to identify future educational interventions.

METHODS

Lasater's clinical judgment rubric was adapted and distributed to nurse preceptors at two significant health care systems in central Illinois.

RESULTS

One hundred and six surveys were returned and one hundred and five of those were included in the study. New nurse graduates were found to be the lowest ranking in ability to identify significant data and calm, confident responses.

CONCLUSIONS

The findings can guide nurse educators to create innovative, targeted educational interventions to improve students' ability to identify important pieces of data and respond to challenging situations in a self-assured manner.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Identifying and addressing the gaps to improve students' clinical judgment may facilitate NCLEX success and entry to practice.

Clinical nursing competency assessment: a scoping review

Objective

To ensure that only competent graduates are licensed to practice nursing, councils conduct licensing examinations, which may include among others clinical competency assessment. This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based, context-specific framework for clinical competency assessment in a sub-Saharan African (SSA) country.

Methods

A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted.

Results

Findings from 28 out of 1151 studies identified from Scopus, PubMed, CINAHL, Wiley Online Library, and ProQuest were included and synthesized. Results show that a good assessment system must be valid, reliable, transparent, feasible, fair, objective, and must provide feedback and continually improve to have an educational impact. Clinical competency assessment systems must be developed on sound empirical evidence, pilot tested, and involve thorough training and evaluation of the examiners. Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system. Only one of the included studies was conducted in Africa.

Conclusions

The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context. Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.

Simulated Wound Care as a Competence Assessment Method for Student and Registered Nurses

OBJECTIVE

To describe the development and use of a wound care simulation assessing RNs' and graduating student nurses' practical wound care competence and to describe observations of participants' wound care competence.

METHODS

A descriptive, qualitative design was used. Data were collected in 2019 from 50 healthcare professionals and students using a simulated wound care situation and an imaginary patient case. The simulation was based on a previously developed and tested wound care competence assessment instrument, which included a 14-item checklist that assesses practical wound care competence of chronic wounds. The data were analyzed and described based on the 14 competence areas or as other competencies.

RESULTS

Participants showed competence in identification of wound infection, debridement, dressing selection, tissue type identification, and consultation. Participants' shortcomings were related to pain assessment and management, asepsis, offloading, and documentation. Simulation was shown to be a promising tool to assess healthcare professionals' and students' practical wound care competence in a safe and standardized situation.

CONCLUSIONS

This study provided new information about simulation as a method to assess student nurses' and RNs' wound care competence. The results could be used in wound care education planning and development in both undergraduate nursing education and continuing education for nursing professionals.

An integrative review of simulation, senior practicum and readiness for practice

Readiness for practice (RFP) is essential as new nurses will practice in a nursing shortage climate, with high acuity patients and complex technology. Nurse educators are challenged to foster readiness for practice.

AIM

The aim of this integrative review was to explore the impact of simulation and senior practicum on graduating senior nursing students' readiness for practice.

BACKGROUND

Readiness for practice has been a point of concern for healthcare for quite some time. This has led to a need for better understanding for what RFP means including their perceptions of various stakeholders. Further, it is important to address what teaching and learning strategies can be implemented to assist in ensuring the graduating senior nursing student is ready for practice on graduation and for their first professional practice. Readiness for practice is defined as the ability to safely and competently care for patients by synthesizing theory, skills, attitudes and values in applying clinical reasoning in practice settings.

METHOD

An integrative review identified 48 published papers on simulation and senior practicum that met the inclusion criteria.

RESULTS

Themes identified from the senior practicum/preceptor literature included clinical reasoning, skills, barriers to the senior practicum and transition. Themes identified regarding simulation as a strategy included preparation, competence development, clinical reasoning and the number of human patient simulators used.

CONCLUSION

Although the evidence is not conclusive, simulation and senior practicums have the promise of preparing graduating nursing students for their first professional practice. However, nurse educators must ensure simulations are well-organized with clear objectives and that preceptors are supported in teaching and assessing students.

The level of competence of graduating nursing students in 10 European countries-Comparison between countries

AIM

To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career.

DESIGN

An international cross-sectional evaluative design.

METHODS

Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically.

RESULTS

In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.

The development and testing of the C/WoundComp instrument for assessing chronic wound-care competence in student nurses and podiatrists

The purpose of this study was to describe the level of chronic wound-care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.

Developing a self-checklist of staff development behavior for associate nurse unit managers using the Delphi method

The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self-checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6-99.2% for 40 of 53 items. Consequently, we created 40-item self-checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing.

New graduate nurses' clinical competence: A mixed methods systematic review

AIM

To appraise and synthesize evidence of empirical studies reporting assessment of new graduate nurses' clinical competence in clinical settings.

DESIGN

Mixed methods systematic review.

DATA SOURCES

The search strategy included keywords relevant to: new graduate nurse; clinical competence; and competence assessment. The searched literature databases included CINAHL, MEDLINE, Embase, PsycINFO and Web of Science. The search was limited to full-text papers in English or French, published between 2010 -September 2019.

REVIEW METHODS

Inclusion criteria were: 1) empirical studies; 2) detailed method and complete results sections; 3) competence assessment in clinical settings; and 4) new graduate nurses (≤24 months). Two independent reviewers screened eligible papers, extracted data and used the Mixed Methods Appraisal Tool framework for quality appraisal. Divergences were solved through discussion.

RESULTS

About 42 papers were included in this review: quantitative (N = 31), qualitative (N = 7) and mixed methods (N = 4). Findings suggest that new graduate nurses exhibit a good or adequate level of competence. Longitudinal studies show a significant increase in competence from 0-6 months, but findings are inconsistent from 6-12 months.

CONCLUSION

There are a multitude of quantitative tools available to measure clinical competence. This suggests a need for a review of their rigor.

IMPACT

No recent reviews comprehensively synthesized the findings from new graduate nurses' clinical competence. This review has found that new graduate nurses' competence has been mostly assessed as good, despite the expectation that they should be more competent. Longitudinal studies did not always show a significant increase in competence. These findings can help nurse educators in providing more support to new graduate nurses throughout the transition period or design improved transition programme. This review also identified quantitative tools and qualitative methods that can be used for competence assessment.

Measurement properties of scales assessing new graduate nurses' clinical competence: A systematic review of psychometric properties

BACKGROUND

New graduate nurses' competence is a concern for all healthcare organizations. Previous reports show heterogeneous levels of competency amongst them. As a positive association between competency and quality of care in clinical settings has been suggested, it is essential for researchers and clinicians to select valid, reliable, and responsive scales to assess new nurses' competence. However, a systematic evaluation of the measurement properties of scales measuring new nurses' competence had yet to be published.

OBJECTIVE

To analyse, evaluate and synthesize the measurement properties of scales used to assess new nurses' clinical competence.

DESIGN

A systematic psychometric review based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methods.

DATA SOURCES

The search strategy included a combination of keywords and thesaurus terms related to new graduate nurses, clinical competence, and competence assessment. Five databases were searched: Embase, CINAHL, MEDLINE, PsycINFO and Web of Science. The search was limited to full-text papers published in English or French, from 2010 to 2019.

REVIEW METHODS

Two independent reviewers screened eligible papers, extracted data related to validity, reliability, and responsiveness of each scale, and evaluated the quality of their measurement properties as well as risk of bias in their psychometric evaluation. Divergences were solved through discussion.

RESULTS

Ten scales were included: eight original scales, one culturally adapted and one modified. Of these scales, eight were developed or adapted in the 2010s decade and the other two scales were developed earlier. Most scales are divided into 6 to 8 subscales and use an adjectival scale with either 4, 5 or 7 points. The content validity study of all scales in this review was deemed to be doubtful or inadequate quality. Reliability was almost exclusively assessed by calculating the internal consistency with Cronbach's alpha coefficient which gives no information on equivalence or stability of the measure. Responsiveness was never properly assessed in the reviewed studies.

CONCLUSIONS

There is little evidence on the measurement properties for each scale regarding their validity and reliability; responsiveness was not assessed for any scale. Every scale evaluated in this review had different characteristics (length, subscales, response options). Therefore, selection of the most appropriate scale depends on the context and purpose of the assessment. Prospero registration number: CRD42018109711 Tweetable Abstract: Systematic review of scales measuring new nurses' competence: we must do better and conduct more validity/reliability testing of existing scales.

Intentional learning: a student-centered pedagogy

Objective The objective was to test the assumption that characteristics of intentional learning are not fixed and if an interview assignment enhanced intentional learning. Methods In order to meet the needs of practice, nursing educators have trialed student-centered pedagogies, often with resistance from students. Intentional learning appears to mirror the characteristics, such as autonomy, responsibility of one's own learning, self-regulation, and motivation, needed by students to be successful in student-centered pedagogies. Intentional learning had not been studied in nursing. A quasi-experimental pre/post-test design was used to test intentional learning in nursing students (N=92). Results While the interview assignment did not enhance intentional learning scores, intentional learning scores did significantly increase over the semester (p=0.039). Conclusion Intentional learning scores did increase, showing that students move along the intentional learning continuum depending on their learning experiences. Future research should include testing teaching strategies that foster intentional learning.

[Nurses and Nursing Students' Recognition of Good Instruction]

PURPOSE

The purpose of this study was to identify and assess from nursing students and nurses in the clinical field what constitute good instruction, through the review of nursing students' opinions and clinical field demands.

METHODS

The study design was used Creswell's exploratory sequential design by collecting and analyzing qualitative data obtained from interviews and then analysis of quantitative data. The participations were 79 seniors in nursing schools and 85 nurses with less than three years of clinical experience. The data were collected through individual interviews and analyzed based on Elo and Kyngäs's content analysis method. The quantitative data were collected using the questionnaire developed based on qualitative results and analyzed by SPSS 23.0 program and Importance Performance Analysis (IPA).

RESULTS

The results showed that IPA extracted seven items with high importance but low satisfaction: "nursing fads and trends," "teacher-learner communication and reflection," "materials used in clinical settings such as monitoring results and test results," "special presentations by experienced practitioners," "instruction assures learners' comprehension," "accurate and detailed evaluation standards" and "feedback on homework and exam."

CONCLUSION

The factors comprising good instruction were verified, and the necessity for additional efforts to improve high importance and low performance factors was noted. Therefore, this study can serve as a guide for nursing education facilities and educators in developing of a thorough education system with excellent instruction designed to achieve an ideal nursing education.

Newly graduated nurses' clinical competencies and need for further training in acute care hospitals

AIM

To assess self-reported clinical competence and the need for further training among newly graduated registered nurses (NGRNs) working in Swedish acute care hospital settings.

BACKGROUND

NGRNs are expected to take full responsibility for patients' nursing care in an increasingly complex clinical context, and professional nurses' clinical competence is critical in providing high-quality and safe nursing care.

DESIGN

A cross-sectional design.

METHODS

Data were collected using the 50-item ProffNurse SAS II. A total of 85 NGRNs who had recently commenced working with direct patient care at three hospitals in central Sweden participated in the study. The response rate was 69%. The STROBE cross-sectional reporting guidelines were used.

RESULTS

The NGRNs assessed their clinical competence as being highest in areas relating to team collaboration and ethics and lowest in areas relating to professional development and direct clinical practice. The need for further training was greatest in areas such as direct clinical practice and patient safety and lowest in areas such as team collaborating and ethics.

CONCLUSION

The use of instruments to identify NGRNs' self-assessed clinical competence is of value when designing and evaluating introductory programmes for NGRNs taking on positions in acute care hospital settings. The availability of experienced nurses from whom NGRNs can gain clinical competence and learn from is of importance, both from the perspective of the NGRNs themselves and patient safety.

RELEVANCE TO CLINICAL PRACTICE

An understanding of NGRNs' clinical competence and their need for further training may assist in both planning and organising nursing programmes and in making clinical policy decisions when designing introduction programmes in acute care settings.

Nurse managers' perceptions of the competence of newly graduated nurses: A scoping review

AIM

To summarize nurse managers' perceptions of newly graduated nurses' (NGNs) competence and connected factors.

BACKGROUND

Nurse managers recruiting staff are responsible for employing competent nurses to ensure quality care and professional standards. Knowledge of managers' perceptions about the competence of NGNs is needed to understand the expectations of the health care system towards future professionals.

EVALUATION

A scoping review was conducted. A total of 12 research publications met the inclusion criteria and were analysed using inductive content analysis.

KEY ISSUES

Managers' perceptions can be divided into three perspectives: NGNs' competence descriptions, assessment of competences and connected factors. The NGNs' level of competence was assessed to be at least satisfactory, and dependent on prior exposure to the work setting, change in the degree of responsibility and lack of confidence.

CONCLUSION

Existing knowledge about nurse managers' perceptions of NGNs' competence is limited and rather fragmented. There is a clear need for rigorous empirical studies with comprehensive views of managers, emphasizing the key role of managers in the evaluation of nurse competence.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can use the results of this review in recruitment, performance reviews and the development of job orientation programmes aimed at enhancing NGNs' transition to the nurse workforce.

How do new graduated nurses from a competency-based program demonstrate their competencies? A focused ethnography of acute care settings

BACKGROUND

Following major organizations' recommendations, healthcare professionals' education has been reformed in the last decade into competency-based education (CBE) to better prepare them with core competencies. This change was intended to prepare new graduates for the reality of health systems and future challenges. Few studies have focused on how new graduate nurses (NGNs) from these reformed programs use the competencies they have developed.

OBJECTIVE

To describe the competencies of NGNs from a Canadian competency-based baccalaureate program, as perceived by various actors in acute-care settings.

METHODS

A focused ethnography was conducted on three acute-care wards of an academic hospital. Participants (n = 19) from four subgroups (NGNs, preceptors, clinical nurse specialists, and nurse managers) participated in individual semi-structured interviews or focus groups. Data were also collected through observation and fieldnotes; an ethnographic analysis framework was used.

RESULTS

Three themes were identified to describe the deployment of NGNs' competencies: NGNs' appropriation of their new role, fragmentation of practice into tasks, and development of practice; NGNs' collaboration within the interprofessional team, management of the dyad with licensed practical nurses, and ability to integrate patients and families into the team; and NGNs' scientific practice, increased scientific curiosity, and use of credible sources. Analysis of these themes' elements in light of the competency framework of the program showed that NGNs deploy seven of the eight competencies developed during their training.

CONCLUSION

This study's results can be applied by nursing educators and hospital decision makers to ensure NGNs are able to use their competencies and to smoothen the transition period between the academic and clinical settings.

Oncology Nurse Managers' Perceptions of Palliative Care and End-of-Life Communication

The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided by group-as-a-whole theory and empirical phenomenology, was part of a larger, multisite study aimed at understanding pediatric oncology nurses' experiences of PC/EOL communication. Nurses were assigned to focus groups based on length or type of experience (i.e., nurses with <1, 2-5, or >5 years' work experience and NMs). Eleven NMs from three Midwestern pediatric hospitals with large oncology programs participated in one focus group. The participants' mean years of experience was 15.8 in nursing and 12 in pediatric oncology; 90% had a BSN or higher degree; all had supervisory responsibilities. The authors identified 2,912 meaning statements, which were then analyzed using Colaizzi's method. Findings include NMs' overall experience of "Fostering a Caring Climate," which includes three core themes: (1) Imprint of Initial Grief Experiences and Emotions; (2) Constant Vigilance: Assessing and Optimizing Family-Centered Care; and (3) Promoting a Competent, Thoughtful, and Caring Workforce. Findings indicate that pediatric oncology NMs draw on their own PC/EOL experiences and their nursing management knowledge to address the PC/EOL care learning needs of nursing staff and patient/family needs. NMs need additional resources to support nursing staff's PC/EOL communication training, including specific training in undergraduate and graduate nursing programs and national and hospital-based training programs.

Increasing nursing students' knowledge of evidence-based hand-hygiene: A quasi-experimental study

Aim of study was to evaluate the effects of a multi-component intervention on nursing students' knowledge of evidence-based hand-hygiene. A quasi-experimental design was used. Nursing students (N = 146) from two universities of applied sciences (experimental group n = 107, control group n = 39) completed an instrument based on international clinical guidelines related to hand hygiene that consisted of 17 Likert-scale items. Data were collected at three time points (baseline, after university-based training and after clinical training) between autumn 2014 and spring 2016. Group differences were examined using chi-squared or Fisher Exact tests, the Mann-Whitney and U test. Within-group differences were assessed with the McNemar test for paired nominal data. At the first and second time points the experimental group had better hand hygiene knowledge than the controls. There were no group differences in responses to items concerning the appropriate length of hand disinfection. The experimental group showed improvements in the practice of washing hands with soap and water, but not in the other statements concerning hand disinfection. Theoretical recap and training at school seemed to influence students' hand hygiene knowledge, but reinforcement during clinical training may be required to ensure that learning practical evidence-based skills, such as hand-hygiene, may be established.

The factors related to self-other agreement/disagreement in nursing competence assessment: Comparative and correlational study

BACKGROUND

While assessment made by nurses of themselves (self-assessment) and assessment made of them by others (other-assessment) provide unique and valuable information as to individual nurses' competence, the subjective nature of both assessments often causes a disagreement between them. This is problematic when educational interventions to foster nurses' competence are designed. However, the question of what factors contribute to the self-other disagreement in competence assessment has rarely been investigated in nursing.

OBJECTIVES

The aims of this study were to compare competence assessments made by nurses with that by others, and to investigate what types of demographic variables of nurses and others, and which personality traits of nurses were associated with the self-other agreement/disagreement in the competence assessment.

DESIGN

A cross-sectional survey design.

SETTINGS

Three hospitals in Japan.

PARTICIPANTS

A total of 1167 registered nurses, who were practising in these three hospitals, were invited to participate in the study. The inclusion criteria of the participants were as follows: 1) currently working in an inpatient department, and 2) directly involved in patient care.

METHODS

The survey package included two sets of questionnaires: one for self-assessment and the other for other-assessment, each of which was accompanied by an ID number for matching. Collected data were analysed using a Wilcoxon signed-rank test to compare the scores on competence assessed by nurses and others, and using multiple regression to examine the relationships between the demographics, personality traits, and the degree of self-other disagreement.

RESULTS

A total of 207 matched questionnaires were obtained. The results showed that the scores on the assessment made by others were statistically significantly higher than those made by nurses of themselves. Moreover, regression analysis suggested that the age of nurses (i.e., younger nurses) and that of others (i.e., older evaluators), and nurses' personality traits of conscientiousness and extraversion were statistically significantly related to the agreement in self-other competence assessment.

CONCLUSIONS

Nurse managers need to understand which factors contribute to self-other disagreement in competence assessment, and to identify a way to precipitate mutual agreement between them. By doing so, both nurses and managers can comprehend nurses' own strengths and weaknesses, and can determine educational needs and goals regarding nurses' competence development.

Using a Complex Patient Management Scenario to Help Bridge the Education-Practice Gap

Preparing nursing students for transition to practice is challenging in light of the increasing complexity of today's health care environment. A clinical simulation was developed to engage senior-level bachelor of science in nursing students in the management of a critically ill patient whose deterioration warranted timely transfer to an intensive care unit. In this fast-paced, highly charged simulation, students were challenged to implement priority setting, delegation, communication methods, and teamwork. This article examines the gaps in students' understanding of complex patient situations and points to the need for simulations that bridge the gap between education and practice.

The academic-practice gap: Strategies for an enduring problem

The academic-practice gap in nursing is well documented. Academe is criticized for producing nurses insufficiently prepared to fully participate in patient care. Practice settings are criticized for having unrealistic expectations of new graduates. This article is based on a review of the literature and an exploration of contemporary practices used to bridge academic and practice partnerships. Differences in outcome expectations for new graduates between academe and practice are outlined and consequences of the gap for new graduates, patients, and employers are discussed. Five specific strategies to address the gap are discussed, with the primary realm and responsibility for two falling to education, one to practice, and two to both. Strategies discussed include increased use of simulated learning in nursing education; disruptive innovations in education that promote learner-centered active learning; extended orientation/Transition to Practice Programs for new graduates; dedicated education units; and academic service partnerships. Current literature suggests the viewpoints of academic and practice leaders continue to appear divergent. Closing the gap will require a dedicated and coordinated response from both academe and clinical practice.

Intentional learning: A concept analysis

AIM

To use a concept analysis to determine a clear definition of the term "intentional learning" for use in nursing.

BACKGROUND

The term intentional learning has been used for years in educational, business, and even nursing literature. It has been used to denote processes leading to higher order thinking and the ability to use knowledge in new situations; both of which are important skills to develop in nursing students. But the lack of a common, accepted definition of the term makes it difficult for nurse educators to base instruction and learning experiences on or to evaluate its overall effectiveness in educating students for diverse, fast-paced clinical practices.

DESIGN AND REVIEW METHODS

A concept analysis following the eight-step method developed by Walker and Avant (2011).

DATA SOURCES

Empirical and descriptive literature.

RESULTS

 Five defining attributes were identified: (1) self-efficacy for learning, (2) active, effortful, and engaged learning, (3) mastery of goals where learning is the goal, (4) self-directed learning, and (5) self-regulation of learning.

CONCLUSION

Through this concept analysis, nursing will have a clear definition of intentional learning. This will enable nurse educators to generate, evaluate, and test learning experiences that promote further development of intentional learning in nursing students. Nurses in practice will also be able to evaluate if the stated benefits are demonstrated and how this impacts patient care and outcomes.

The effects of nursing preceptorship on new nurses' competence, professional socialization, job satisfaction and retention: A systematic review

AIMS

The aim of this study was to determine the effects of nursing preceptorship on the competence, job satisfaction, professional socialization and retention of new nurses.

BACKGROUND

Although studies have focused on the effects of nursing preceptorship on new nurses' competence and retention, a systematic review of the overall effects is lacking.

DESIGN

A quantitative systematic review.

DATA SOURCES

Five English/Chinese databases were searched for original articles published before June 2015 and only six articles published between 2001-2014 were included in the final analysis.

REVIEW METHODS

Joanna Briggs Methodology was used to process one randomization control trial, one quasi-experimental study and four observational studies. Two appraisers independently reviewed each study using the standardized critical appraisal tools from the Joanna Briggs Institute.

RESULTS

The most adopted preceptorship was a fixed preceptor/preceptee model and one-on-one for 1-3-month duration. It showed that new nurses' overall competence increased significantly due to preceptorship. Only a few studies explored the effects of preceptorship on the job satisfaction and professional socialization of new nurses. Clear conclusions regarding the effect of preceptorship on nurses' retention rate could not be made because of inconsistent time points for calculation and a lack of control groups in the study design.

CONCLUSIONS

Preceptorship can improve new nurses' nursing competence; however, more studies are needed to ascertain its effects on new nurses' retention rates, job satisfaction and professional socialization to promote nursing care quality and resolve nursing shortages.

Nurse Competence Scale: a systematic and psychometric review

AIM

The aim of this study was to report a systematic and psychometric review.

BACKGROUND

The Nurse Competence Scale is currently the most widely used generic instrument to measure Registered Nurses' competence in different phases of their careers. Based on a decade of research, this review provides a summary of the existing evidence.

DESIGN

A systematic literature review of research evidence and psychometric properties.

DATA SOURCES

Nine databases from 2004 - October 2015.

REVIEW METHODS

We retrieved scientific publications in English and Finnish. Two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist.

RESULTS

A total of 30 studies reported in 43 publications were included. These consisted of over 11,000 competence assessments. Twenty studies were from Europe and 10 from outside Europe. In addition to experienced nurses, the Nurse Competence Scale has been used for the competence assessment of newly graduated nurses and nursing students, mainly in hospital settings. Length of work experience, age, higher education, permanent employment and participation in educational programmes correlated positively with competence. Variables including empowerment, commitment, practice environment, quality of care and critical thinking were also associated with higher competence. The Nurse Competence Scale has demonstrated good content validity and appropriate internal consistency.

CONCLUSION

The value of Nurse Competence Scale has been confirmed in determining relationships between background variables and competence. The instrument has been widely used with experienced and newly graduated nurses and their managers. Cross-cultural validation must be continued using rigorous methods.

Newly graduated nurses' empowerment regarding professional competence and other work-related factors

Background

Although both nurse empowerment and competence are fundamental concepts of describing newly graduated nurses’ professional development and job satisfaction, only few studies exist on the relationship between these concepts. Therefore, the purpose of this study was to determine how newly graduated nurses assess their empowerment and to clarify professional competence compared to other work-related factors.

Methods

A descriptive, cross-sectional and correlational design was applied. The sample comprised newly graduated nurses (n = 318) in Finland. Empowerment was measured using the 19-item Qualities of an Empowered Nurse scale and the Nurse Competence Scale measured nurses’ self-assessed generic competence. In addition to demographic data, the background data included employment sector (public/private), job satisfaction, intent to change/leave job, work schedule (shifts/business hours) and assessments of the quality of care in the workplace. The data were analysed statistically by using Spearman’s correlation coefficient as well as the One-Way and Multivariate Analysis of Variance. Cronbach’s alpha coefficient was used to estimate the internal consistency.

Results

Newly graduated nurses perceived their level of empowerment and competence fairly high. The association between nurse empowerment and professional competence was statistically significant. Other variables correlating positively to empowerment included employment sector, age, job satisfaction, intent to change job, work schedule, and satisfaction with the quality of care in the work unit. The study indicates competence had the strongest effect on newly graduated nurses’ empowerment.

Conclusions

New graduates need support and career opportunities. In the future, nurses’ further education and nurse managers’ resources for supporting and empowering nurses should respond to the newly graduated nurses’ requisites for attractive and meaningful work.

How Likely Is It for a Nurse Student to Become a Competent Nurse? A Protocol for Scale Development and Validation Using a Mixed Methods Study

The aim of the paper was to develop and validate a scale for estimating the likelihood of a nurse student to become a competent nurse.

Admitting students to nursing schools without assessing their personal characteristics has led to serious consequences, including low quality of nursing care. Early detection of students who are at risk of attrition or becoming non-competent nurses can save the time, money, and energy devoted to educating and training the future nurses.

A mixed methods design will be employed. Using literature review and interviews with nurse students, clinical nurses, nurse experts, and nurse managers during the first qualitative phase, we will build a comprehensive item pool that has a focus on nurse students’ personal characteristics. To increase the trustworthiness of interview findings, we will distinguish competent versus incompetent nurses by measuring their competence levels. In the second quantitative phase, the Nurse Competence Predicting Scale will be developed and tested for psychometric properties.

We believe that Nurse Competence Predicting Scale may help in early identification of nurse students who are at risk of not acquiring expected nurse competencies on graduation or joining the workforce. In such cases, educational managers may take timely remedial interventions.

Reaching their potential: Perceived impact of a collaborative academic-clinical partnership programme for early career nurses in New Zealand

BACKGROUND

The dynamic nature of healthcare ensures that early career nurses enter an uncertain and complex world of practice and consequently require support to develop their practice, build confidence and reach their potential. The New Zealand Nurse Entry to Practice programme for registered nurses in their first year of practice has been operating since 2005 to enable safe and confident practice, improve the quality of care, and positively impact on recruitment and retention. This academic and clinical programme was offered as a partnership between a university and a clinical provider with postgraduate academic credits gained.

AIM

The aim of this study was to explore the perceived impact of postgraduate university education for early career nurses in one regional health area of New Zealand.

METHODS

Participants were registered nurses who had completed the early career nurse programme and their clinical preceptors. The research was conducted via an online survey of 248 nurses and three focus groups to explore how the programme was experienced and its impact on knowledge and practice.

RESULTS

Early career nurses and their preceptors found that the programme enables improved knowledge and skills of patient assessment, application of critical thinking to clinical practice, perceived improvement in patient care delivery and outcomes, enhanced interprofessional communication and knowledge sharing, and had a positive impact on professional awareness and career planning.

CONCLUSIONS

This clinical-academic partnership positively impacted on the clinical practice and transition experience of early career nurses and was closely aligned to an organization's strategic plan for nursing workforce development.

Nurse Competence Scale--psychometric testing in a Norwegian context

The aim was to test the construct validity of the Nurse Competence Scale. The Nurse Competence Scale has been used in hospital settings for various purposes in several countries. Despite this, confirmatory factor analyses are scarcely reported. The present study is based on re-analyses of data from 2007 (i.e. psychometric testing) and 593 newly graduated nurses working in various contexts were included. Confirmatory as well as exploratory factor analyses (Principal Component Analysis) were carried out. The original 7-factor model of the Nurse Competence Scale (73 items) was not confirmed. The exploratory factor analyses resulted in a Norwegian Nurse Competence Scale consisting of 46 items in the following competence categories: Planning and delivery of care, Teaching functions, Professional leadership, Research utilization and nursing values and Professional awareness. The results underline the needs for psychometric testing of an instrument after translation processes. The instrument is suitable for describing and comparing nurse competence for various reasons. It may also be helpful in creating competence development programs at an individual as well as at an organizational level. Further studies with a broader sample are recommended.