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Charette M, McKenna L, McGillion A, Burke S. Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study. J Clin Nurs 2023; 32:1354-1369. [PMID: 35451137 DOI: 10.1111/jocn.16317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/27/2022]
Abstract
AIM To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support. BACKGROUND Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs. DESIGN Longitudinal mixed-methods study. METHODS The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines. RESULTS Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn. CONCLUSION This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it. RELEVANCE There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.
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Affiliation(s)
- Martin Charette
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Anthony McGillion
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.,Nursing and Midwifery (Inspiring Innovation), Western Health, St Albans, Victoria, Australia
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Lee SJ, Seo H, Kim KH, Kim J, Kim H, Park J. Transcultural adaptation and validity of the nurse professional competence scale Korean version for graduating nursing students: An explanatory factor analysis. Nurs Open 2023; 10:579-590. [PMID: 36631728 PMCID: PMC9834538 DOI: 10.1002/nop2.1324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 03/21/2022] [Accepted: 07/29/2022] [Indexed: 01/19/2023] Open
Abstract
AIM The study aimed to assess the validity and reliability of the short-form Nurse Professional Competence Scale-Korean version (NPC-K) among Korean nursing students at the point of graduation. DESIGN This was a cross-sectional survey. METHODS The Nurse Professional Competence scale was translated into Korean using the World Health Organization (WHO) translation method. A total of 195 graduating nursing students participated. Exploratory factor analysis for validity and Cronbach's alpha coefficients for reliability were examined. RESULTS Factor analysis showed that five NPC-K factors accounted for 68.38% of the total variance. Cronbach's alpha for the total scale was 0.97. The NPC-K has high internal reliability and acceptable construct validity. The content of the scale reflected nursing students' confidence in formal competence requirements based on Korean cultural and educational backgrounds. An accurate assessment of nurse professional competence using the NPC-K may help nursing academics enhance the quality of education and training.
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Affiliation(s)
- Su Jung Lee
- College of NursingInje UniversitySouth Korea
| | - Hyun‐Ju Seo
- College of NursingChungnam National UniversityDaejeonSouth Korea
| | - Kye Ha Kim
- Department of NursingCollege of Medicine, Chosun UniversityGwangjuSouth Korea
| | - Jinhee Kim
- Department of NursingCollege of Medicine, Chosun UniversityGwangjuSouth Korea
| | - Hyunlye Kim
- Department of NursingCollege of Medicine, Chosun UniversityGwangjuSouth Korea
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New graduate registered nurses' professional competence and the impact of preceptors' education intervention: a quasi-experimental longitudinal intervention study. BMC Nurs 2022; 21:360. [PMID: 36526985 PMCID: PMC9757917 DOI: 10.1186/s12912-022-01133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
AIMS AND OBJECTIVES The aim of this quasi-experimental longitudinal intervention study was to investigate new graduate nurses' professional competence development after preceptors' participation in an education intervention. BACKGROUND New graduate registered nurses are expected to be competent in many areas of nursing. Expectations that are sometimes unrealistic may cause a sense of inadequacy and stress, and this may in turn prevent them from fully deploying their competencies. Competence development is related to practice environment, occupational commitment, empowerment, and work experience. Orientation or transition programs have been designed to ensure new graduate nurses' competence, and preceptors and preceptorship could also have significant influence on their competence development. DESIGN A quasi-experimental longitudinal intervention study. METHODS The data was collected from October 2015 to November 2017. Participating wards were randomized into intervention and control groups. The intervention group preceptors had an eight-hour education intervention that focused on new employees' orientation, particularly from new graduates' point of view. Wards in the control group continued to precept as before. The Nurse Competence Scale was used for new graduates' self-assessment at baseline and at three-month and nine-month follow-up. This study is reported in accordance with the TREND Statement Checklist. RESULTS The education intervention aimed at preceptors did not have impact on the intervention group NGRNs' competence development. There were no statistically significant differences between the groups and effect size remained small. CONCLUSIONS The preceptors' education intervention was not effective enough to develop new graduates' professional competence so that it would have differed from that of the graduates receiving conventional orientation at the university hospital. This study confirmed that competence development is a complex and multidimensional phenomenon and organizations should invest in new graduate registered nurses' competence development during their early career. Preceptors' education and development of preceptorship and transition programs are an important part of overall competence development in complex health care environments. TRIAL REGISTRATION Retrospectively registered.
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Hawkins N, Jeong SY, Smith T, Sim J, Clapham M. Creating respectful workplaces for nurses in regional acute care settings: A quasi-experimental design. Nurs Open 2022; 10:78-89. [PMID: 35739627 PMCID: PMC9748064 DOI: 10.1002/nop2.1280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/11/2022] [Accepted: 06/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM To examine self-reported exposure and experiences of negative workplace behaviour and ways of coping of nursing staff before and after educational workshops. DESIGN A Quasi-experimental design. METHOD/SETTING/PARTICIPANTS Data were collected pre- /postworkshops using a structured questionnaire. Nurses (N = 230) from 12 units in four regional acute care hospitals were invited to complete a pre-intervention survey. Educational workshops were then implemented by the organization at two of the hospitals, after which, follow-up surveys were undertaken. RESULTS There were 74 responses in the pre-intervention and 56 responses in the postintervention time period. There were 111 participants who attended the educational intervention, 20% (n = 22) completed the follow-up survey. Participants were more likely exposed to work-related bullying acts and they used problem-focused coping strategies and sought social support as a way of coping when exposed to the negative behaviours. Overall, there was a decrease in both bullying and incivility experienced by participants; however, our findings were unable to establish that a statistically significant difference was made due to the implementation of the intervention. STUDY REGISTRATION Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).
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Affiliation(s)
- Natasha Hawkins
- The School of Nursing & MidwiferyThe University of NewcastleTareeNew South WalesAustralia
| | - Sarah Yeun‐Sim Jeong
- The School of Nursing & Midwifery, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Tony Smith
- Department of Rural HealthThe University of NewcastleTareeNew South WalesAustralia
| | - Jenny Sim
- The School of Nursing & MidwiferyThe University of NewcastleOurimbahNew South WalesAustralia,School of Nursing University of WollongongNSW Australia Associate Professor Australian Health Services Research Institute (AHSRI) University of WollongongNew South WalesAustralia
| | - Matthew Clapham
- Hunter Medical Research InstituteLot 1 Kookaburra CCtNew Lambton HeightsNew South WalesAustralia
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Development and Psychometric Testing of a Self-Rated Scale Based on National Nursing Core Competency Standards. J Nurs Meas 2021; 30:75-93. [PMID: 34518416 DOI: 10.1891/jnm-d-20-00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The objectives of this study were to develop a National Nursing Core Competency Standards (NNCCS)-based instrument and determine its construct validity and internal consistency reliability. METHODS A methodologic research design was used to validate the 59-item scale based on the responses of 600 nurses. The scale items were culled from the client care, leadership and management, and research competencies identified in the NNCCS. RESULTS The results of the analyses confirmed 53 items and gave rise to a five-factor solution. The five dimensions are leadership, management, research, ethico-legal, and strategic competencies. CONCLUSIONS The seminal psychometric testing provided an evidence of acceptable validity and reliability of the proposed instrument. Further testing was recommended to accrue the psychometric soundness of the instrument.
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Kajander‐Unkuri S, Koskinen S, Brugnolli A, Cerezuela Torre M, Elonen I, Kiele V, Lehwaldt D, Löyttyniemi E, Nemcová J, de Oliveira CS, Palese A, Rua M, Salminen L, Šateková L, Stubner J, Sveinsdóttir H, Visiers‐Jiménez L, Leino‐Kilpi H. The level of competence of graduating nursing students in 10 European countries-Comparison between countries. Nurs Open 2021; 8:1048-1062. [PMID: 34482660 PMCID: PMC8046055 DOI: 10.1002/nop2.712] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/01/2020] [Accepted: 11/03/2020] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- Satu Kajander‐Unkuri
- Department of Nursing scienceUniversity of TurkuTurkuFinland
- Diaconia University of Applied SciencesHelsinkiFinland
| | - Sanna Koskinen
- Department of Nursing scienceUniversity of TurkuTurkuFinland
| | - Anna Brugnolli
- Department of Public HealthAzienda Provinciale per i Servizi SanitariTrentoItaly
| | | | - Imane Elonen
- Department of Nursing scienceUniversity of TurkuTurkuFinland
| | - Viktorija Kiele
- Department of Nursing scienceUniversity of TurkuTurkuFinland
- Faculty of MedicineInstitute of Health SciencesVilnus UniversityVilnusLithuania
| | - Daniela Lehwaldt
- School of Nursing, Psychotherapy and community HealthDublin City UniversityDublinIreland
| | | | - Jana Nemcová
- Department of nursingJessenius Faculty of Medicine in MartinComenius University in BratislavaBratislavaSlovakia
| | | | - Alvisa Palese
- Department of Medical SciencesUniversity of UdineUdineItaly
| | - Marília Rua
- School of Health SciencesUniversity of AveiroAveiroPortugal
| | - Leena Salminen
- Department of Nursing scienceUniversity of TurkuTurkuFinland
| | - Lenka Šateková
- Department of NursingPalacký UniversityOlomoucCzech Republic
| | - Juliane Stubner
- Institute for Health and Nursing ScienceMartin Luther University Halle‐WittenbergHalleGermany
| | | | - Laura Visiers‐Jiménez
- Fundación San Juan de DiosCentro de CC de la Salud San RafaelUniversidad Antonio de NebrijaMadridSpain
| | - Helena Leino‐Kilpi
- Department of Nursing scienceUniversity of TurkuTurkuFinland
- Turku University HospitalTurkuFinland
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van de Mortel TF, Nilsson J, Lepp M. Validating the Nurse Professional Competence Scale with Australian baccalaureate nursing students. Collegian 2021. [DOI: 10.1016/j.colegn.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Charette M, McKenna LG, Deschênes MF, Ha L, Merisier S, Lavoie P. New graduate nurses' clinical competence: A mixed methods systematic review. J Adv Nurs 2020; 76:2810-2829. [PMID: 32869369 DOI: 10.1111/jan.14487] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/19/2020] [Accepted: 07/07/2020] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Martin Charette
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Lisa G McKenna
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Marie-France Deschênes
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Laurence Ha
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Sophia Merisier
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
| | - Patrick Lavoie
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
- Montreal Heart Institute, Montréal, Québec, Canada
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Willman A, Bjuresäter K, Nilsson J. Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses. J Clin Nurs 2020; 30:83-92. [PMID: 32889729 PMCID: PMC7891354 DOI: 10.1111/jocn.15483] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022]
Abstract
Aims and objectives To explore newly graduated registered nurses' experiences and how they manage complex patient situations. Background Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages. Design Qualitative study design. Methods Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used. Results The analysis resulted in the overarching theme “Not being sufficiently prepared and supported to meet responsibilities and demands.” The theme included three categories: “Responsibility is not in proportion to competence,” “Lack of medical competence and experience complicates patient safety” and “Strives for control to manage and organise nursing care.” Conclusion The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised. Relevance to practice Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.
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Affiliation(s)
- Anna Willman
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Kaisa Bjuresäter
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
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Sichone JM, Chigunta M, Kalungia A, Nankonde P, Kaonga P, Chongwe G, Banda S. Self-perceived Versus Supervisor-rated Technical Competence in Plain Film X-ray Evaluation by Newly Graduated radiographers: Implications for Curriculum Development and Practice in Zambia. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Allvin R, Bisholt B, Blomberg K, Bååth C, Wangensteen S. Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey. BMC Nurs 2020; 19:74. [PMID: 32774153 PMCID: PMC7397675 DOI: 10.1186/s12912-020-00466-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (≤ 0,5 year, > 0,5-5 years, and ≥ 6 years). METHODS A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. RESULTS Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. CONCLUSIONS Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.
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Affiliation(s)
- Renée Allvin
- Clinical Skills Center, Örebro University Hospital, S-701 85 Örebro, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-702 81 Örebro, Sweden
| | - Birgitta Bisholt
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, S-651 88 Karlstad, Sweden
- Department of Health care Sciences, Ersta Sköndal Bräcke University College, S-100 61 Stockholm, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-702 81 Örebro, Sweden
| | - Carina Bååth
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, S-651 88 Karlstad, Sweden
- Faculty of Health and Welfare, Östfold University College Fredrikstad, N-1757 Halden, Norway
| | - Sigrid Wangensteen
- Department of Health Sciences in Gjøvik, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Charette M, McKenna LG, Maheu-Cadotte MA, Deschênes MF, Ha L, Merisier S. Measurement properties of scales assessing new graduate nurses' clinical competence: A systematic review of psychometric properties. Int J Nurs Stud 2020; 110:103734. [PMID: 32810719 DOI: 10.1016/j.ijnurstu.2020.103734] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Martin Charette
- School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora (Melbourne), Victoria, Australia, 3086; Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4.
| | - Lisa G McKenna
- School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora (Melbourne), Victoria, Australia, 3086.
| | - Marc-André Maheu-Cadotte
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4; Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4.
| | - Marie-France Deschênes
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4; Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4.
| | - Laurence Ha
- Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4.
| | - Sophia Merisier
- Center for Innovation in Nursing Education (CIFI), Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4; Faculty of Nursing, University of Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, Canada, H3T 1J4.
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Kirca N, Ozgonul ML, Bademli K. The relationship between the competence of nurses and their attitudes in medical errors: a cross‐sectional survey. J Nurs Manag 2020; 28:1144-1152. [DOI: 10.1111/jonm.13013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/13/2020] [Accepted: 03/14/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing Faculty of Nursing Akdeniz University Antalya Turkey
| | - Mustafa Levent Ozgonul
- Department of History of Medicine and Ethics Faculty of Medicine Akdeniz University Antalya Turkey
| | - Kerime Bademli
- Department of Psychiatric Nursing Faculty of Nursing Akdeniz University Antalya Turkey
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Willman A, Bjuresäter K, Nilsson J. Newly graduated registered nurses' self-assessed clinical competence and their need for further training. Nurs Open 2020; 7:720-730. [PMID: 32257259 PMCID: PMC7113520 DOI: 10.1002/nop2.443] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 12/15/2019] [Indexed: 01/05/2023] Open
Abstract
Aim To explore and describe changes in self-assessed clinical competence and the need for further training among newly graduated Registered Nurses during their first 15 months of professional work in acute care hospital settings. Design Quantitative longitudinal design. Methods The 50-item Professional Nurse Self-Assessment Scale of clinical core competencies II was used. A total of 45 newly graduated Registered Nurses answered the questionnaire at four different occasions. Data were collected after 2, 5, 9 and 15 months of working experience. Result The components "ethical decision-making," "cooperation and consultation" and "clinical leadership" were rated highest in clinical competence and lowest in need for further training. The components "professional development" and "critical thinking" were rated lowest in clinical competence and "direct clinical practice" rated highest in need for further training. The clinical competence increased significant between 9-15 months, with the exception of "critical thinking" and need for further training decreased significantly between 9-15 months, with the exception of "critical thinking."
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Affiliation(s)
- Anna Willman
- Department of Health SciencesFaculty of Health, Science, and TechnologyKarlstad UniversityKarlstadSweden
| | - Kaisa Bjuresäter
- Department of Health SciencesFaculty of Health, Science, and TechnologyKarlstad UniversityKarlstadSweden
| | - Jan Nilsson
- Department of Health SciencesFaculty of Health, Science, and TechnologyKarlstad UniversityKarlstadSweden
- Department of Health Promotion SciencesSophiahemmet UniversityStockholmSweden
- Japanese Red Cross Institute for humanitarian StudiesTokyoJapan
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15
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New graduate nurses’ self-assessed competencies: An integrative review. Nurse Educ Pract 2020; 45:102801. [DOI: 10.1016/j.nepr.2020.102801] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 11/19/2022]
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16
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Liou SR, Liu HC, Tsai SL, Chu TP, Cheng CY. Performance competence of pregraduate nursing students and hospital nurses: A comparison study. J Clin Nurs 2020; 29:2652-2662. [PMID: 32279370 DOI: 10.1111/jocn.15287] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/24/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To compare and contrast the competence in clinical performance between pregraduate nursing students and hospital nurses. The study also explored the most difficult technical skills for the participants to perform. BACKGROUND Assessment, communication and critical thinking are competencies that help in providing safe and appropriate care for patients. Yet, self-perceived competence was mostly measured while performance competence that reflected nurses' performance in real cases has seldom been explored in literature. DESIGN A cross-sectional design was applied. The study adhered to the STROBE guidelines to improve reporting quality. METHOD Fifty-two nurses and 50 nursing students completed the Computerized Model of Performance-Based Measurement system, which measures performance competence including the steps of critical thinking, conflict resolutions and common clinical technical problems. Six case scenarios containing 107 test questions were completed. RESULTS Only 53.85% of nurses and 20.0% of students achieved a satisfactory level of performance competence. They showed low scores on the steps of critical thinking: "collecting data from on-site physical assessment," "processing information," "recognising/prioritising problems" and "arranging a course of action for patient care," as well as solving common technical problems and conflicts. The three most difficult skills to perform were CPR, reading EKGs and venipuncture/starting intravenous lines. CONCLUSIONS The study captured the participants' weaknesses in the critical thinking process and the nursing skills that were difficult to perform. These skills are imperative to nursing care and need to be strengthened in school and in-service education. The academic curriculum and course design for students as well as training programmes for nurses need to be reviewed to address the challenges to be faced in a clinical setting. RELEVANCE TO CLINICAL PRACTICE Teaching-learning strategies that focus on enhancing critical thinking and performing difficult skills need to be designed and implemented both in practice and in school.
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Affiliation(s)
- Shwu-Ru Liou
- Chang Gung University of Science and Technology, Puzi, ROC Taiwan.,Chang Gung Memorial Hospital at Chiayi, Puzi, ROC Taiwan
| | - Hsiu-Chen Liu
- Chang Gung University of Science and Technology, Puzi, ROC Taiwan
| | - Shu-Ling Tsai
- Chang Gung University of Science and Technology, Puzi, ROC Taiwan
| | - Tsui-Ping Chu
- Chang Gung Memorial Hospital at Chiayi, Puzi, ROC Taiwan
| | - Ching-Yu Cheng
- Chang Gung University of Science and Technology, Puzi, ROC Taiwan.,Chang Gung Memorial Hospital at Chiayi, Puzi, ROC Taiwan
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Willman A, Bjuresäter K, Nilsson J. Newly graduated nurses' clinical competencies and need for further training in acute care hospitals. J Clin Nurs 2020; 29:2209-2220. [PMID: 32043711 DOI: 10.1111/jocn.15207] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/09/2020] [Accepted: 02/03/2020] [Indexed: 12/13/2022]
Abstract
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.
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Affiliation(s)
- Anna Willman
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Kaisa Bjuresäter
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.,Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
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18
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Students’ Self-assessed Competence Levels during Nursing Education Continuum – A Cross-sectional Survey. Int J Nurs Educ Scholarsh 2020; 17:/j/ijnes.2020.17.issue-1/ijnes-2019-0050/ijnes-2019-0050.xml. [DOI: 10.1515/ijnes-2019-0050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 11/12/2019] [Indexed: 11/15/2022]
Abstract
AbstractDuring nursing education, nursing students are required to develop their competence to be able to fulfill their duties safely as Registered Nurses. The aims of this study were to explore 1) nursing students’ self-assessed competence levels during education 2) the relationship with competence and frequency at which competencies are utilized in clinical practice, and 3) factors related to competence levels. 841 (response rate 67.6 %) nursing students responded to the Nurse Competence Scale in a cross-sectional study. The self-assessed overall competence levels were improving during the education continuum (VAS-means 1st 56.6; 2nd 58.3; 3rd 59.8 and 3.5th -year students 68.4). Every group revealed a significant positive correlation with competence and frequency at which competencies are utilized in clinical practice in clinical placement. Risk factors for low competence were also identified. Systematic multimethod competence evaluations with longitudinal designs are needed to monitor outcomes of nursing education.
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Martínez-Momblán MA, Colina-Torralva J, la Cueva-Ariza LD, Guix-Comellas EM, Romero-García M, Delgado-Hito P. Analysis of the evolution of competences in the clinical practice of the nursing degree. Rev Lat Am Enfermagem 2020; 28:e3231. [PMID: 32022151 PMCID: PMC7000187 DOI: 10.1590/1518-8345.2927.3231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 09/16/2019] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE to analyze the student's progression in the acquisition of specific and transversal competences in relation to the competence dimensions.Method: the cross-sectional descriptive study was carried out in the clinical practice subjects included in the Nursing Degree. We included 323 students and we contemplated the development of competences through an ad-hoc questionnaire with 4 dimensions: delivery and care management, therapeutic communication, professional development and care management. RESULTS the academic results between the practice of the second and third year showed an improvement in care provision and therapeutic communication skills (Clinical Placements I: 12%-29%; Clinical Placements II: 32%-47%) and worsened in professional development and care management (Clinical Placements I: 44%-38%; Clinical Placements II: 44%-26%). CONCLUSION the correlations between these two years were high in all the dimensions analyzed. The evaluation of competence progression in the context of clinical practice in nursing university studies allows us to optimize these practices to the maximum and establish professional profiles with a greater degree of adaptation to the professional future.
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Affiliation(s)
| | - Javier Colina-Torralva
- University of Barcelona, School of Nursing, L’Hospitalet de
Llobregat, Barcelona, Espanha
| | | | | | - Marta Romero-García
- University of Barcelona, School of Nursing, L’Hospitalet de
Llobregat, Barcelona, Espanha
| | - Pilar Delgado-Hito
- University of Barcelona, School of Nursing, L’Hospitalet de
Llobregat, Barcelona, Espanha
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20
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Newly Qualified Nurses' Perception of Their Competency Achievement on Leaving University: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214284. [PMID: 31690034 PMCID: PMC6862868 DOI: 10.3390/ijerph16214284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/01/2019] [Accepted: 11/03/2019] [Indexed: 01/06/2023]
Abstract
Background: After implementing the Tuning Educational Structures in Europe Project, numerous efforts have been made to define, establish, and evaluate nursing competences. The European Federation of Nurses Association played a key role in enacting the nursing competences included in Directive 2013/55/EU. Nevertheless, assessing competences remains elusive, and there is little research into nurses’ perceptions of the competency training provided by their universities. The purpose of the study was to explore the perceptions and experiences of newly qualified nurses about the competences they acquired during their university education. Methods: A qualitative research study was developed in a Spanish university. Twelve semi-structured interviews with newly qualified nurses were conducted, and two focus groups made up of twelve students were carried out in order to triangulate the results. Participants were recruited through email contact. Interviews focused on clinical training, theoretical content, and the reality of healthcare. Data was analyzed thematically. Results: Two main themes emerged: (1) improving theoretical content and (2) rethinking practical lessons and clinical training. A lack of knowledge about mental health, pharmacology, or critical care has been found; in addition, it was highlighted, among others, the need to improve communication skills in difficult and conflictive situations. Conclusions: Considering the participants’ perception of deficiency in some aspects of most of the competences established by the European Federation of Nurses Association, further research has been suggested to include other stakeholders’ views.
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21
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Charette M, Goudreau J, Bourbonnais A. How do new graduated nurses from a competency-based program demonstrate their competencies? A focused ethnography of acute care settings. NURSE EDUCATION TODAY 2019; 79:161-167. [PMID: 31132728 DOI: 10.1016/j.nedt.2019.05.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/21/2019] [Accepted: 05/19/2019] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Martin Charette
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Centre for Innovation in Nursing Education, Montréal, Canada.
| | - Johanne Goudreau
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Centre for Innovation in Nursing Education, Montréal, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Research Centre of the Institut Universitaire de Gériatrie de Montréal, Canada
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22
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Charette M, Goudreau J, Bourbonnais A. Factors influencing the practice of new graduate nurses: A focused ethnography of acute care settings. J Clin Nurs 2019; 28:3618-3631. [PMID: 31190368 DOI: 10.1111/jocn.14959] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/16/2019] [Accepted: 05/26/2019] [Indexed: 11/28/2022]
Abstract
AIM To explore the influence of an acute care setting on competency deployment of new graduate nurses (NGNs) from a competency-based undergraduate programme. BACKGROUND In the last 15 years, nursing education has shifted to competency-based education (CBE). Few studies have focused on how NGNs from these reformed programmes use the competencies they have developed. To be paradigmatically coherent with the nature of a competence, studies should also examine how context influences nursing practice and competency deployment. DESIGN A focused ethnography of three acute care units from one academic hospital in Canada. METHODS Purposive and snowball sampling strategies were used to recruit 19 participants: NGNs (n = 4), nurse preceptors (n = 2), clinical nurse specialists (n = 9) and nurse managers (n = 4). Data were collected through individual interviews, focus groups, observation and documentation. Data were analysed according to Roper and Shapira (Ethnography in nursing research. Thousand Oaks, CA: Sage Publications, 2000) ethnographic nursing analysis framework. RESULTS Organisational and individual factors were identified as influencing NGNs' competency deployment. Organisational factors are orientation, stability, workload and the scientific culture of the unit. Personal factors have been linked to groups of professionals: for NGNs, personality and clinical placements during their initial education; for nurses working with NGNs, to be role models, to promote integration and to denounce bullying; and for other health professionals, to recognise nursing expertise. CONCLUSION One way to smooth the transition from academic to clinical settings for NGNs is by offering transition or orientation programmes that will provide them with stability and a reduced workload, allowing them to progressively deploy their competencies. RELEVANCE TO CLINICAL PRACTICE Organisational and individual factors influence how new graduate nurses deploy their competencies. Clinical educators and nurse managers can help new nurses by acting on these factors. This study conforms to the COREQ Research Reporting Guidelines for qualitative studies.
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Affiliation(s)
- Martin Charette
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Centre for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Johanne Goudreau
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Centre for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Centre for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada.,Research Centre of the Institut Universitaire de gériatrie de Montréal, Montréal, Canada
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23
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Kiekkas P, Michalopoulos E, Igoumenidis M, Michalopoulos A, Stefanopoulos N. Factors associated with self-reported competence of graduating nursing students. Collegian 2019. [DOI: 10.1016/j.colegn.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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24
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Hawkins N, Jeong S, Smith T. Coming ready or not! An integrative review examining new graduate nurses' transition in acute care. Int J Nurs Pract 2018; 25:e12714. [PMID: 30537440 DOI: 10.1111/ijn.12714] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 09/30/2018] [Accepted: 11/01/2018] [Indexed: 12/18/2022]
Abstract
AIMS To synthesize the scientific evidence about new graduate nurses' transition to practice in the acute care setting and consider implications for nurses and nursing practice. BACKGROUND Despite the vast amount of literature on new graduate nurses' transition to practice, the transition of new graduate nurses is a global issue and remains at the forefront of discussions within the nursing community. DESIGN An integrative review. REVIEW METHODS A search of evidence-based research from seven electronic databases (CINAHL, MEDLINE, ProQuest, Cochrane, JBI, Wiley, and Scopus) was conducted for the period of 2006-2016. Eligible articles were critically reviewed and scored using the Mixed Methods Appraisal Tool (MMAT). RESULTS Twenty-six articles were reviewed, which included 19 qualitative, five quantitative, and two mixed methods studies. "The Experiences" are described in three themes: Dominated by fear but feeling a sense of accomplishment and satisfaction; Reality vs Idealism; and Adjusting to nursing life. "The Factors" are described under three themes: Personal, Professional, and Organizational. CONCLUSION The transition experience of new graduate nurses is complex and multidimensional and highlights that "it takes a village" to grow and support new graduate nurses.
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Affiliation(s)
- Natasha Hawkins
- School of Nursing and Midwifery, University of Newcastle, Taree, Australia
| | - Sarah Jeong
- School of Nursing and Midwifery, University of Newcastle, Ourimbah, Australia
| | - Tony Smith
- Department of Rural Health, University of Newcastle, Taree, Australia
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25
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Wangensteen S, Finnbakk E, Adolfsson A, Kristjansdottir G, Roodbol P, Ward H, Fagerström L. Postgraduate nurses' self-assessment of clinical competence and need for further training. A European cross-sectional survey. NURSE EDUCATION TODAY 2018; 62:101-106. [PMID: 29306748 DOI: 10.1016/j.nedt.2017.12.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 11/15/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Nursing practice requires application of knowledge, skills and values in various combinations and has undergone substantial changes the last decades. An increased focus on inter-professional collaboration and possible new and more independent roles for nurses are described. A variety of programs have been developed in order to educate registered nurses (RN) to meet the changes and demands in health and nursing care throughout the world. AIM The aims were to 1) describe nurses' self-assessment of clinical competence and need for further training, and 2) explore possible differences between nurses in specialist vs master's programs. METHODS A cross-sectional survey design was applied. 97 nurses in postgraduate programs from five countries responded (response rate 45%). A revised version of the Professional Nurse Self-Assessment Scale of clinical core competencies (PROFFNurseSASII) was used for data collection. Independent student t-test and regression analyses were carried out. RESULTS The respondents rated their competence highest in taking full responsibility, cooperation with other health professionals and in acting ethically. Items where they considered themselves needing further training most were competence on medications, interaction and side effects and differential diagnoses. For all items, nurses in master's programs rated their competence higher than nurses in the specialist programs. Nurses in specialist programs rated their need for more training for all items higher than nurses in master's degree programs, and for 47 out of the 50 items these differences were statistically significant. CONCLUSION Even though the nurses rated their competence high for important competence aspects such as taking responsibility and cooperation with other health professionals, it is worrying that their need for further training was highest for effects and interaction of various types of medications. Further studies are needed to conclude if and how master's education improves patient outcome.
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Affiliation(s)
- Sigrid Wangensteen
- NTNU, Norwegian University of Science and Technology, Department of Health Sciences in Gjøvik, Norway.
| | - Elisabeth Finnbakk
- Lovisenberg Diaconal University College, Norway, School of Health and Medicine, Örebro University, Sweden.
| | - Annsofie Adolfsson
- School of Health and Medicine, Örebro University, Sweden; Center for Women's Family and Child Health, Faculty of Health Science, University College of Southeast Norway, Norway.
| | | | | | - Helen Ward
- London South Bank University, United Kingdom.
| | - Lisbeth Fagerström
- University College of Southeast Norway, Norway; Åbo Academy University, Finland.
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Burgess A, Murphy Buc H, Brennan JM. Using a Complex Patient Management Scenario to Help Bridge the Education-Practice Gap. Nurs Educ Perspect 2018; 39:116-118. [PMID: 29053532 DOI: 10.1097/01.nep.0000000000000224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Adriane Burgess
- About the Authors Adriane Burgess, PhD, RNC-OB, CCE, CNE, is an assistant professor of nursing, Towson University, Towson, Maryland. Hannah Murphy Buc, MSN, RN, is an assistant professor, Notre Dame of Maryland University School of Nursing, Baltimore, Maryland. Janice M. Brennan, MS, RN-BC, CNE, is Director of the Center for Caring with Technology and assistant professor, Notre Dame of Maryland University. For more information, contact Adriane Burgess at
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Shahsavari H, Ghiyasvandian S, Houser ML, Zakerimoghadam M, Kermanshahi SSN, Torabi S. Effect of a clinical skills refresher course on the clinical performance, anxiety and self-efficacy of the final year undergraduate nursing students. Nurse Educ Pract 2017; 27:151-156. [PMID: 28910662 DOI: 10.1016/j.nepr.2017.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/12/2017] [Accepted: 08/06/2017] [Indexed: 12/21/2022]
Abstract
Although the final year of nursing undergraduate programs that focus on clinical education are planned to prepare nursing students to better transition to the real world of health care service; evidence has shown that this program is not sufficient to reach this end goal. This controlled trial study was to investigate the effectiveness of a basic clinical skills refresher course for nursing students before entering the internship program. The sample consisted of 160 undergraduate nursing students assigned into two groups. The intervention was a three-day refresher course directed by nurse instructors for intervention group focused on 10 basic nursing procedures in the clinical skill lab. The control group did not receive any intervention. The students' anxiety, clinical self- efficacy and clinical skills practice were measured before and after intervention in both groups. The results indicated that the students who took part in the refresher course experienced lower anxiety levels, higher levels of clinical self-efficacy, and have better clinical skills during their internships. The undergraduate nursing curriculum can be strengthened by the basic clinical skills refresher course. This refresher course can bridge the theory - practice gap and provide a better transition from the student to nurse role.
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Affiliation(s)
- Hooman Shahsavari
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Iran
| | - Shahrzad Ghiyasvandian
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Iran.
| | - Marian L Houser
- Department of Communication Studies, Texas State University, United States
| | - Masoumeh Zakerimoghadam
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Iran
| | | | - Sedigheh Torabi
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Iran
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28
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Numminen O, Leino-Kilpi H, Isoaho H, Meretoja R. Development of Nurses' Professional Competence Early in Their Career: A Longitudinal Study. J Contin Educ Nurs 2017; 48:29-39. [DOI: 10.3928/00220124-20170110-08] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/02/2016] [Indexed: 11/20/2022]
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29
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Flinkman M, Leino-Kilpi H, Numminen O, Jeon Y, Kuokkanen L, Meretoja R. Nurse Competence Scale: a systematic and psychometric review. J Adv Nurs 2016; 73:1035-1050. [PMID: 27731918 DOI: 10.1111/jan.13183] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Mervi Flinkman
- Corporate Headquarters, Helsinki University Hospital, Finland.,Department of Nursing Science, University of Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku University Hospital, Finland
| | - Olivia Numminen
- Corporate Headquarters, Helsinki University Hospital, Finland.,Department of Nursing Science, University of Turku, Finland
| | - Yunsuk Jeon
- Corporate Headquarters, Helsinki University Hospital, Finland.,Department of Nursing Science, University of Turku, Finland
| | - Liisa Kuokkanen
- Corporate Headquarters, Helsinki University Hospital, Finland.,Department of Nursing Science, University of Turku, Finland
| | - Riitta Meretoja
- Corporate Headquarters, Helsinki University Hospital, Finland.,Department of Nursing Science, University of Turku, Finland
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Kajander-Unkuri S, Leino-Kilpi H, Katajisto J, Meretoja R, Räisänen A, Saarikoski M, Salminen L, Suhonen R. Congruence between graduating nursing students’ self-assessments and mentors’ assessments of students’ nurse competence. Collegian 2016. [DOI: 10.1016/j.colegn.2015.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lima S, Newall F, Jordan HL, Hamilton B, Kinney S. Development of competence in the first year of graduate nursing practice: a longitudinal study. J Adv Nurs 2016; 72:878-88. [DOI: 10.1111/jan.12874] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Sally Lima
- The Royal Children's Hospital Melbourne; Parkville Victoria Australia
- The University of Melbourne; Parkville Victoria Australia
- Murdoch Children's Research Institute Melbourne; Parkville Victoria Australia
| | - Fiona Newall
- The Royal Children's Hospital Melbourne; Parkville Victoria Australia
- The University of Melbourne; Parkville Victoria Australia
- Murdoch Children's Research Institute Melbourne; Parkville Victoria Australia
| | | | | | - Sharon Kinney
- The Royal Children's Hospital Melbourne; Parkville Victoria Australia
- The University of Melbourne; Parkville Victoria Australia
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Liao RX, Liu YH. The impact of structural empowerment and psychological capital on competence among Chinese baccalaureate nursing students: A questionnaire survey. NURSE EDUCATION TODAY 2016; 36:31-6. [PMID: 26233678 DOI: 10.1016/j.nedt.2015.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 05/29/2015] [Accepted: 07/05/2015] [Indexed: 05/16/2023]
Abstract
BACKGROUND Competence in nursing has been increasingly addressed. However, studies from the international literature have demonstrated that graduate nurses are not ready and they are not competent to provide safe and effective nursing care. Therefore, it is important to assess nursing students' competence and to explore the relevant factors for improving nursing students' competence and the quality of nursing care. OBJECTIVES The purpose of this paper is to investigate the influence of structural empowerment (an environmental resource) and psychological capital (an intrapersonal resource) on baccalaureate nursing students' competence. DESIGN AND METHODS The study was designed as a cross-sectional survey. A total of 300 senior baccalaureate nursing students in China practicing in five major tertiary teaching hospitals were invited to participate in the current survey. A total of 286 students completed the survey and were evaluated statistically. Thus, the response rate was 95.3%. RESULTS The results of the study indicate that nursing students have medium-high levels of competence, and medium-high levels of structural empowerment and psychological capital. Students with perceived higher levels of structure empowerment and psychological capital were more likely to achieve higher levels of competence. CONCLUSIONS Structural empowerment and psychological capital were significantly and positively correlated with students' competence. The findings implicate that nursing managers and educators should not only promote interventions to enhance competence of baccalaureate nursing students but also focus on creating a supportive clinical learning environment and strengthen their positive intrapersonal resource.
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Affiliation(s)
- Rui-xue Liao
- School of Nursing, Tianjin University of Traditional Chinese Medicine, No. 312, Anshan West Road, Tianjin 300193, China.
| | - Yan-hui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, No. 312, Anshan West Road, Tianjin 300193, China.
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33
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Finnbakk E, Wangensteen S, Skovdahl K, Fagerström L. The Professional Nurse Self-Assessment Scale: Psychometric testing in Norwegian long term and home care contexts. BMC Nurs 2015; 14:59. [PMID: 26578847 PMCID: PMC4647290 DOI: 10.1186/s12912-015-0109-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 11/02/2015] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Nurses' clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses' clinical competence is of major concern. A validated instrument for the self-assessment of nurses' clinical competence at different educational levels across specialties and countries is lacking. The aim of this study was to test the reliability and construct validity of the new Professional Nurse Self-Assessment Scale (ProffNurse SAS) questionnaire in long term and home care contexts in Norway. The questionnaire is based on the Nordic Advanced Practice Nursing model, in which the nurse-patient relationship is central. METHODS The study has a cross-sectional survey design. A purposive sample of 357 registered nurses who worked in long term and home care contexts in two geographical regions encompassing eight municipalities and three counties was included. The respondents completed the 74-item ProffNurse SAS questionnaire and demographic background data was collected. Data collection was conducted in two phases: first region autumn 2011 and second region spring 2012. Exploratory factor analyses (EFA) were used to test the psychometric properties of the questionnaire and included the following steps: assessment of the factorality of the data, factor extraction by Principal Component Analysis (PCA), oblimin (oblique) factor rotation, and interpretation. Cronbach's alpha was used to estimate the internal consistency. RESULTS The PCA revealed a six-component structure, reducing the number of items in the questionnaire from 74 to 51. Based on the content of the highest-loading items, the six components were named: Direct Clinical Practice, Professional Development, Ethical Decision-Making, Clinical Leadership, Cooperation and Consultation, and Critical Thinking. The Cronbach's alpha values ranged from 0.940 (highest; Direct Clinical Practice) to 0.737 (lowest; Critical Thinking), leading to the estimation that the ProffNurse SAS is reliable. CONCLUSIONS The six components support the study's theoretical framework. The ProffNurse SAS showed acceptable reliability and construct validity and may therefore be a promising instrument for the assessment of practicing nurses' clinical competence. However, we recommend further psychometric testing in other countries and contexts and the inclusion of larger samples of nurses at various levels of education, particularly master's level APNs.
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Affiliation(s)
- Elisabeth Finnbakk
- />School of Health and Medical Sciences, Örebro University, Fakultetsgatan 1, Örebro, 702 81 Sweden
- />Lovisenberg Diaconal University College, Lovisenberggt. 15 b, Oslo, 0456 Norway
| | - Sigrid Wangensteen
- />Faculty of Health, Care and Nursing, Gjövik University College, Postbox 191, Gjövik, 2802 Norway
| | - Kirsti Skovdahl
- />Faculty of Health Sciences, Buskerud and Vestfold University College, Postbox 7053, Drammen, 3007 Norway
| | - Lisbeth Fagerström
- />School of Health and Medical Sciences, Örebro University, Fakultetsgatan 1, Örebro, 702 81 Sweden
- />Faculty of Health Sciences, Buskerud and Vestfold University College, Postbox 7053, Drammen, 3007 Norway
- />Åbo Akademi University, Vasa Campus, Postbox 311, Vasa, 65101 Finland
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Wangensteen S, Johansson IS, Nordström G. Nurse Competence Scale--psychometric testing in a Norwegian context. Nurse Educ Pract 2014; 15:22-9. [PMID: 25434831 DOI: 10.1016/j.nepr.2014.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 08/15/2014] [Accepted: 11/10/2014] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Sigrid Wangensteen
- Faculty of Health, Care and Nursing, Department of Nursing, Gjøvik University College, Norway.
| | - Inger S Johansson
- Faculty of Health, Care and Nursing, Department of Nursing, Gjøvik University College, Norway; Faculty of Health, Science and Technology, Department of Health Sciences, Karlstad University, Sweden
| | - Gun Nordström
- Faculty of Health, Science and Technology, Department of Health Sciences, Karlstad University, Sweden; Faculty of Public Health, Department of Nursing, Hedmark University College, Norway
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Burke L, Sayer J, Morris-Thompson T, Marks-Maran D. Recruiting competent newly qualified nurses in the London region: An exploratory study. NURSE EDUCATION TODAY 2014; 34:1283-1289. [PMID: 24565807 DOI: 10.1016/j.nedt.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/26/2014] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
AIM This paper reports a study commissioned to address concerns that not all newly qualified nurses (NQNs) were perceived to be competent at the point of appointment to their first post. It seeks to understand how competence is interpreted in the context of selection and recruitment, and explore the different expectations and experiences of employing Trusts across the London region. BACKGROUND Competence is a significant topic in nursing and there is much literature around the concept, what it means and how it relates to behaviours and values with no universally accepted definition. However, there appears to be little evidence about how competence is assessed in practice in the selection and recruitment of NQNs to their first post. METHODS The study took a three-phase, mixed method approach including a literature review, an electronic survey to map current assessment and selection procedures, and focus groups to identify the competencies perceived essential by senior nurses. FINDINGS Most Trusts reported assessing core competencies, and could report how they do this with respect to literacy and numeracy. Employers could describe what they required from NQNs, and how applicants both met and did not meet expectations. Several personal attributes were considered as important as key competences, but these are not described in the KSF or NMC frameworks, and it is not clear how these are assessed in selection processes. CONCLUSION There appeared to be a large variation in the number and types of competence assessments being used for recruitment, with little consistency in the detail of the assessments, although broadly similar assessment exercises are used. There appears to be little evidence as to the validity of the measures being used and whether in fact they are measuring the competences that are being sought or considered most important. It would appear that practical skills are more easily assessable, but there is a lack of clarity regarding the assessment of those competences that are considered equally important but appear to be more elusive to assessment such as communication and teamwork. It is also unclear how a number of 'personal qualities' described as essential for NQNs are being assessed at recruitment.
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Affiliation(s)
| | - Jane Sayer
- South London and Maudsley, NHS Foundation Trust, United Kingdom
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