Comparison of Expected and Evidenced Baccalaureate Degree Competencies

Strengths and challenges of the first prelicensure baccalaureate of science in nursing program in Pakistan

With the increasing complexities of health care and the associated strong advocacy for baccalaureate of science in nursing (BScN) program as entry to practice in the developing countries, gradually, nurse leaders are moving in that direction. Although extensive information is available in the literature about the outcomes of prelicensure BScN programs in developed countries, little is known about the outcomes of such programs in developing countries. In this article, we report strengths and challenges of the first prelicensure BScN program in Pakistan. Using a focused ethnographic approach, data for this study were collected mainly through semistructured interviews of the graduates from the first five cohorts of the BScN program and their supervisors at Aga Khan University, Pakistan. Interviews were tape-recorded, transcribed verbatim, and content analyzed for explicit and implicit patterns of themes, meanings, and understanding about the program. Findings of this study affirmed the worth of BScN program for preparing competent nurses that can contribute to the development of nursing in Pakistan. However, various contextual issues and challenges in the nurses work environment have affected the utilization and retention of these graduates and hence the perceived outcome of the program.

A survey of physical assessment techniques performed by RNs: lessons for nursing education

There is ongoing concern about the adequacy of the educational preparation of nursing graduates; at the same time, there is concern regarding excessive content within nursing curricula. The purpose of this study was to identify physical examination skills performed by practicing nurses to better understand the competencies needed by graduates of nursing programs. A sample of 193 nurses completed a survey indicating the frequency they performed various physical assessment techniques. Thirty skills routinely performed by nurses were identified; the remaining skills were reportedly performed occasionally or were not performed. The fact that only 30 skills were reportedly performed regularly by the sample raises questions about the depth at which examinations should be conducted in the clinical setting and the depth at which physical examination skills should be taught in nursing programs. Nurse educators should assess the skills currently taught in nursing programs and consider what skills graduates actually need to enter nursing practice.

Rescuing Nursing Education from Content Saturation: The Case for a Concept-Based Curriculum

Nursing education has been plagued with a saturation of content for many years. The multiple contributing factors underscore the complexity of the problem and validate the need for educational reform. The purpose of this article is to discuss various factors contributing to content saturation and propose a conceptual approach for curriculum development and teaching in nursing education.

'Levels' of attainment in nursing practice: reality or illusion?

In earlier research based on an analysis of course documentation, it had been found that there was little consensus among nurse educators concerning the parameters which distinguish levels of practice skills, particularly those which differentiate diploma and degree qualifications in the United Kingdom. This result was confirmed and strengthened in the current study. Lecturers in nursing, when presented with a sorting task using 40 statements derived from course documentation selected from the earlier study, were unable to distinguish statements describing diploma level from those describing degree level practice. Possible reasons for the difficulty are discussed. It is concluded that the attempt to represent practice skill in a hierarchy of assessment for degree or diploma qualifications is premature since the parameters of practice remain unreliably specified.

Practical skill development in new nurses

This paper reports the results of an empirical study of new nurses' development of practical skill. Actual practice and clinical learning of new nurses has received minor attention in nursing research. This may build on the assumption that practical skill naturally improve as a result of working in the clinical setting. In the present study nurses were videotaped several times as they performed in the clinical setting, and interviewed after each filming. Analysis of skill development was rendered possible by comparing characteristics of performance over time. A model of practical skill performance was developed during the analysis. This model advances a broader understanding of practical skill by incorporating the following constructs: substance and sequence, accuracy, fluency, integration and caring comportment. The nurses' trajectories of practical skill development are presented on the basis of this model. Individual and common trends in practical skill development are discussed, and the idea of development of practical skill as a natural happening in the clinical setting is critiqued.

Using the Telephone Interview for Evaluation of Baccalaureate Nursing Programs

Efficient use of the telephone is certainly relevant in the 20th century telecommunication age. A 20- to 30-minute phone call allows for interactive communication between the nurse educators and those who hire their graduates. Important information can be quickly obtained for assessing the outcomes of curriculum related to the perceived quality of nurse graduates practicing in various health care settings. This interview method was found to be efficient, convenient, and facilitated dynamic interchange. Feedback from respondents varied in their familiarity with the graduates and programs.

Community nursing competencies: a comparison of educator, administrator, and student perspectives

Perceptions of functioning levels of baccalaureate students nearing graduation were assessed, comparing views of 15 educators, 15 health department administrators, and 185 students. A modified list of the 47 essential public health nursing competencies identified through the U. S. Department of Health and Human Services Division of Nursing served as the basis for data collection and analyses. Student competencies in individual skills were ranked higher than group and community competencies by all three groups surveyed. Students ranked competencies at higher levels than educators and educators at higher levels than administrators. Although administrators continue to advise new graduates to work in acute care before entering community health, support for continuation of this practice was not observed based on administrator ratings.

Conceptualization of differing levels of educational attainment: what are the characteristics of nurses and midwives who have undertaken diploma and degree educational programmes?

This paper looks at the differences in the characteristics of registered nurses and midwives who have achieved differing levels of educational attainment. A review of the pertinent literature demonstrates that there is little published material on this topic and therefore, proposals are put forward with regard to a conceptual model to frame outcome characteristics. The model is seen as being appropriate when trying to identify the different characteristics of nurses and midwives educated to diploma, degree, post-graduate diploma, masters and doctoral level. The model is subsequently applied to identifying core outcomes and composite statements of nurses and midwives who have undertaken diploma or degree programmes. Initial work examining the validity and reliability of the core outcomes and composite statements with regard to degree preparation is described. Areas for further research are also identified.

Competence versus performance: which is more important?

The extensive literature in the field of competence and performance is reviewed in this paper, which argues that there is much confusion between these different constructs. It concludes that since nurse pre-registration education is concerned with producing nurses who consistently provide care of a high quality, greater emphasis should be placed upon performance in the real-life clinical setting rather than upon competence.

Baccalaureate Nursing Students' Perspectives of Their Clinical Nursing Leadership Experience

This qualitative study using Colaizzi's (1978) method of protocol analysis describes baccalaureate nursing students' perspectives of a clinical nursing leadership experience. Students participated in pre- and postexperience focused interviews and completed logs during their experience. Findings revealed that although students felt pre-experience anxiety, they held positive expectations and anticipated acquiring skills for the clinical leadership role. During the process, students experienced emerging clarification of the leadership/management role and became aware of support systems. As a result of the clinical leadership activity, students experienced an emerging sense of confidence, developed a value system prizing professional nursing needed for managing care for a group of patients, and added desirable leadership qualities to their repertoire of skills. Gaining entrance into the nursing care delivery system and being actively involved in leadership activities were necessary for acquisition of skills.