Adoption of new practice standards in nursing: Revalidation of a tool to measure performance using the Australian registered nurse standards for practice

Diagnostic radiography workforce expectations of learners against the 2023 HCPC standards of proficiency: Results of a UK Delphi study

INTRODUCTION

The UK Health and Care Professions Council revised the Standards of Proficiency for diagnostic radiographers in 2023 to reflect modern practices and service needs. This will impact on the training and assessment of learners throughout their programmes in order to support them to meet the threshold standards.

METHODS

A Delphi survey was distributed to UK diagnostic radiographers to ascertain the stage of training in which they expect each standard of proficiency to be demonstrated by the learner.

RESULTS

Ninety-four diagnostic radiographers responded to the survey and 58.5% (n = 55) completed the second round of the survey. Participants agreed on the stage of pre-registration training that 74.9% of standards should be met. However, for 19.6% of standards there was no consensus. In 5.5% of standards participants expected these to be met one year post qualification.

CONCLUSION

Agreement of when three quarters of the new Standards would be expected to be met during pre-registration training could support practice placement learning and assessment. However, there is some uncertainty around the Standards and the ability to provide appropriate resources, support, and expertise to enable learners to meet them.

IMPLICATIONS FOR PRACTICE

The consensus of expectations could inform stage appropriate learning opportunities aligned to the 2023 HCPC Standards within practice placements, and a standardised assessment, should the appetite be established. However, the UK diagnostic radiography profession still has some work to do in aligning expectations with the statutory regulatory body requirements and preparing all staff to support learners to meet all threshold standards at point of qualification.

Learning in the workplace: Development of a simple language statement assessment tool that supports second-level nurse practice

AIM

To focus learning through clarity of the enrolled nurse (EN) role (a second tier nurse position) through development of a user-friendly workplace performance assessment tool commensurate with EN standards for practice.

BACKGROUND

Internationally, the nursing workforce comprises regulated and unregulated staff. In Australia, similar to other western countries, there are two tiers of regulated workforce, namely Registered Nurses (RNs) and Enrolled Nurses (ENs). Differences in RN and EN standards based on the education preparation are not always clearly differentiated in workplace practice. Roles are often seen as interchangeable: Improved clarity of both regulated and unregulated roles, when numbers of healthcare workers are burgeoning, assists performance assessment that guides further learning and safe practice.

DESIGN

Two phase sequential, non-experimental design.

METHODS

Phase one used focus groups (n=48), expert reference panel (n=8) and end-users (n=16) to develop simple language statements. Phase two involved field testing of the statements.

FINDINGS

A 30-item, criterion-based workplace performance tool was developed. Principal component analysis of completed tools indicated work could be organised around three key areas of practice, namely, higher order thinking and problem solving, routine daily activities of care and personal and social attributes.

DISCUSSION

Participants reported the statement items assisted in determining suitable activities and accompanying cues in discussing learning needs. Analysis assisted with discriminating broader elements of EN workplace performance.

CONCLUSIONS

Workplace learning is important for nurses to continue to build their capacity to deliver optimum care. Assessment tools that describe professional capability in plain language statements and provide examples of supportive behavioural cues help guide on-going learning through improving the validity and thereby consistency of assessment processes. Furthermore, comprehensible and meaningful statements and cues can readily be adopted by students and educators to target learning and feedback thereby enhancing clarity of the EN role, to distinguish from other nursing roles.

Appraising differential capabilities of new graduate nurses: Development across the first nine months of employment

BACKGROUND

Effective transition to practice for new graduate nurses (NGNs) is of national and international concern. Development of NGNs expands well beyond higher education studies and relies heavily on support during their first year of employment. Little is known of the differential development of NGNs, namely the trajectory of developing capability.

AIM

This study differentiates NGN development during their first year of employment through appraisal of universal domains of nursing practice relevant to the international community.

METHODS

Using a quantitative evaluation design NGN performance was appraised at 1-, 3-, and 9-months from February 2020 to November 2021, using a 23-item appraisal tool and accompanying behavioural cues organised around four universal domains of practice: professional values and behaviours; comprehensive nursing practice; organisational capabilities; personal growth and development; and a fifth domain specific to Australia, that is, legislative requirements. Workplace performance was appraised by clinical supervisors and numerically rated according to intensity of coaching required to meet requisite standards of practice.

RESULTS

The shift in rating scores of intensity of coaching required, over three time periods across four key universal domains, were statistically significant (p < .001). These findings which indicate the intensity of required coaching for maintenance of standards reduced over the time period suggest advancing NGN capability. The domain representing professional values consistently rated the highest. The domain denoting legislative requirements largely flattened after three months.

CONCLUSION

These findings corroborate the significant development of NGN capability during the first nine months of employment, especially during the initial three months. Furthermore, they provide empirical evidence that NGNs are most adept at demonstrating professional values; a recognised capability developed through employment during pre-registration studies. Discriminant data is of value to inform both targeted development of individual NGNs and when collated, the education needs of cohorts.

Measuring changes in nursing students' workplace performance following feedback encounters: A quasi-experimental study

BACKGROUND

Work-integrated learning and performance is intimately linked with assessment and feedback; however, empirical evidence concerning the impact of feedback on student performance in workplace settings is limited. A novel practice-based feedback intervention-the REMARK (nuRse fEedback iMplementAtion frameworRK) program-was developed and implemented. Sustainable feedback processes that involve both learners and learning partners can ultimately maximise learning outcomes, optimise self-regulation, and impact performance.

OBJECTIVES

To determine the impact of implementing an educational intervention based on best practice principles of feedback on undergraduate nursing student performance during clinical placements in acute healthcare settings.

METHODS

A non-equivalent, quasi-experimental design was used. A pre- and post-assessment strategy for both control and intervention groups was employed. The REMARK program was based on known attributes of effective feedback critiqued in the literature that foster interactions between a learner and learning partner and, hence, support dialogic feedback.

RESULTS

Clinical assessment data of 214 final-year nursing students collected at three time points were analysed. Using multivariate modelling, the results indicated that students participating in the REMARK programme (intervention group) had statistically higher performance scores than students in the control group when time and placement setting were controlled.

CONCLUSIONS

This research provides evidence that engagement with an intervention based on attributes of effective feedback improves nursing students' workplace performance during clinical placement. To achieve the greatest advantage, incorporating strategies that encourage students to adopt an active role in feedback conversations that relate to the student's learning goals are recommended.

Design and Validation of a Questionnaire to Measure the Perception of Nursing Degree Students about the Learning Process in Primary Care

The aim of this study was to develop a tool for the evaluation of the learning process of the clinical practicum in primary care. The study was carried out in two phases: (1) identification of the categories that determine the perception of the nursing degree students about the learning process in the clinical practicum in primary care and the items for each category; and (2) cross-sectional study in a sample of 475 nursing degree students. The psychometric properties in terms of reliability (internal consistency) and construct validity were analyzed through a confirmatory factor analysis. Cronbach’s alpha coefficient of internal consistency for the entire questionnaire was 0.93, and that for each of the categories was above 0.70 in all cases. The chi-squared test was statistically significant (2.84; p < 0.001). The confirmatory factor analysis produced a model of 6 dimensions and 41 items. The parameters were estimated through the least squares method. All saturations were statistically significant (p < 0.05). In view of the results of this study, it can be asserted that the questionnaire to measure the perception of the nursing degree students about the learning process in the community clinical practicum (QPCLP) presents good properties in terms of internal consistency and validity.

Impact of a work-based feedback intervention on student performance during clinical placements in acute-care healthcare settings: a quasi-experimental protocol for the REMARK programme

INTRODUCTION

Current perspectives present feedback as a dynamic, dialogic process. It is widely accepted that feedback can have an impact on workplace performance, however, how dialogic feedback is enacted with the learner in authentic healthcare settings is less apparent. This paper seeks to describe the design and development of an implementation study to promote the learner voice in the feedback process and improve feedback encounters between learners and learning partners in healthcare settings.

METHODS AND ANALYSIS

A quasi-experimental study design will be used to evaluate whether implementation of a work-based intervention to improve feedback impacts student performance during clinical placements in healthcare settings. Student performance will be measured at three time points: baseline (pre), mid-placement (post-test 1) and end-placement (post-test 2) in keeping with standard assessment processes of the participating university. The intervention is underpinned by Normalisation Process Theory and involves a layered design that targets learners and learning partners using best-practice education strategies. Data regarding participants' engagement with feedback during clinical placements and participants' level of adoption of the intervention will be collected at the completion of the clinical placement period.

ETHICS AND DISSEMINATION

This study has ethics approval from both Griffith University and Metro South Health Human Research and Ethics committees. Dissemination of results will be local, national and international through forums, seminars, conferences and publications.