Work readiness of graduate health professionals

Exploring work readiness: A qualitative descriptive study of self-perceptions among new graduate nurses

Background

Reduced work readiness is associated with elevated turnover rates, necessitating efforts to enhance the positive work readiness of newly graduated nurses to alleviate the shortage in the nursing workforce. Research into the work readiness of recent nursing graduates in China is still in its infancy. Most studies employ quantitative research methods, and further exploration of the self-perception of work readiness among new nurses in China is required.

Objectives

This study aimed to investigate genuine experiences and self-perceptions of work readiness among new graduate nurses.

Design

A qualitative descriptive study.

Methods

Sixteen new nurses from a provincial tertiary hospital in China were included in this study, which adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist for reporting. The data collection process involved conducting semi-structured interviews from September to October 2021. Inductive content analysis was employed to analyze the interview data.

Results

The study identified four themes encompassing new nurses' real-life experiences and self-perceptions of work readiness: psychological stress, emotional conflict, empathy fatigue, and ethical dilemmas. Psychological stress comprised three subthemes: knowledge and skill deficits, communication barriers, and fear. Empathy fatigue was primarily characterized by psychological and physical symptoms. Ethical dilemmas involved conflicts over differences in values and between clinical reality and standardized nursing practice.

Conclusion

Drawing from the self-perceptions of work readiness among new nurses found in this study, nursing administrators and educators must enhance the existing transition support program for new nurses. Additionally, the establishment of individualized training programs is recommended to further improve the work readiness of new nurses.

The Turkish version of nursing practice readiness scale: Cross-cultural adaptation and psychometric evaluation

AIM

This study aims to adapt the "Nursing Practice Readiness Scale" to Turkish culture, and evaluate its psychometric properties.

BACKGROUND

New graduates' nursing practice readiness can impact their work adaptation and performance.

DESIGN

The research employed a methodological design.

METHODS

Data were collected between May and July 2022. The sample consisted of 436 newly graduated nurses. Content validity, construct validity and criterion validity were evaluated. Reliability was examined with adjusted item-total correlation, Cronbach's a coefficient, composite-reliability and split-half reliability.

RESULTS

The Turkish version of Nursing Practice Readiness Scale was found to have good content and criterion validity. As a result of confirmatory factor analysis, the original five-factor structure of the scale was also confirmed for the Turkish version. The scale's overall Cronbach's α coefficient was determined to be 0.96, with subscale coefficients ranging from 0.73 to 0.94. The composite reliability values of the subscales were found between 0.75 and 0.94. In split-half reliability, the correlation coefficient between half was 0.952, with a Spearman-Brown Coefficient (Unequal Length) of 0.976.

CONCLUSIONS

The Turkish version of Nursing Practice Readiness Scale is a valid and reliable measurement tool for evaluating the nursing practice readiness of newly graduated nurses.

Effects of the First Wave of the COVID-19 Pandemic on the Work Readiness of Undergraduate Nursing Students in China: A Mixed-Methods Study

Background

Newly graduated nurses with strong work readiness are more likely to smoothly transition from school to clinical settings. However, even before the pandemic, this transition from nursing graduate to clinical nurse was often challenging. Therefore, this study aims to investigate the impact of the initial wave of COVID-19 on the work readiness of nursing students.

Methods

A convergent mixed-method design was employed. For the quantitative study, an online cross-sectional survey was conducted among 500 graduating nursing students from four Chinese public higher education institutions. The questionnaire comprises three parts: socio-demographic information, the Chinese version of the Work Readiness Scale for Graduate Nurse, and a questionnaire on the socio-behavioral impact of COVID-19 on the general population. In the qualitative study, a semi-structured interview was carried out with 8 students who took part in the survey. The results from both parts were integrated using the "Pillar Integration Process".

Results

The study identified six key pillars: "Graduating nursing students possess fundamental knowledge, skills, and a preparedness in terms of attitude and psychology"; "Specialist knowledge and skills and soft skills for transition from nursing students to clinical nurses need to be strengthened"; "The most obvious impact of COVID-19 on nursing students are the adoption of preventive measures and the limitations in study and daily life due to household confinement"; "Growth in both personal and professional awareness"; "Negative effects of fear and anxiety"; and "Negative effects of household confinement".

Conclusion

Graduating nursing students require additional preparation in specialized nursing knowledge, skills, and soft skills to make a successful transition from students to clinical nurses. It is important to acknowledge that the impact of COVID-19 on students' work readiness has both positive and negative aspects. Therefore, whether during the pandemic or post-graduation, these students will benefit from increased support from universities and hospitals.

Physical activity promotion in the community pharmacy: An opportunity for an expanded role?

BACKGROUND

Physical inactivity is a major risk factor for the development of chronic diseases, and it is increasingly prevalent in the Portuguese population. Pharmacists' role in promoting physical activity (PA) is still not well established, although health promotion is foreseen by law in Portugal. Competing tasks and location where the pharmacy is embedded can hinder this promotion in their daily practice.

OBJECTIVE

The aim of this study was to identify the main barriers and facilitators of physical activity promotion (PAP) in Portuguese community pharmacies and explore possible pathways for future implementation of physical activity promotion.

METHODS

In-depth, semi-structured interviews were conducted with purposively enrolled community pharmacists. Participant recruitment was aligned with data saturation. Data analysis comprised a mixed model of a deductive theme mapping strategy using the Theoretical Domains Framework (TDF) for the behaviour of promoting physical activity and an inductive approach for any other relevant themes and which might influence PA promotion.

RESULTS

Data saturation was reached at eleven interviews. Barriers and facilitators for the behaviour of promoting PA were identified from 11 out of the 14 TDF domains. Following an inductive approach, other emerging codes were clustered in additional seven major themes. Highlighted barriers focused on domains #1 - Knowledge, #10 - Memory, Attention and Decision Processes and #13 - Environmental Context and Resources. Community mapping, establishment of remuneration models and the use of digital technologies were suggested as additional potential contributors to scale up PAP.

CONCLUSION

Community pharmacists are well placed inside their communities to serve as a focal point for signposting, engagement with other healthcare professionals and community resources and activities organized by the pharmacy itself. Pharmacists should be supported in being knowledgeable, aware, and available when promoting PA in their daily counseling.

Work readiness of pharmacy graduates: An exploratory study

Introduction

The recent global pandemic of Covid-19 caused various disruptions. Among them were face-to-face teaching and learning activities being switched to virtual sessions in accordance with health authorities recommendations. The impact of these changes on work readiness of pharmacy graduates is unknown.

Aim

This study aims to determine the impact of pharmacy graduate's work readiness, particularly those that had their studies disrupted from the pandemic.

Methods

Practicing pharmacists with supervisory experience were interviewed on their opinions on work readiness of early career and intern pharmacists. Specifically, they were asked to comment on work readiness of pharmacy graduates who had their later stage of pharmacy education impacted by the pandemic. Data was transcribed verbatim and thematically analysed. This was also supplemented with quantitative data from graduating students in 2020 and 2021 using the Work Readiness Scale.

Results

Qualitative feedback showed four themes related to workforce readiness: work competence, social intelligence, personal characteristics, and organizational acumen. Preceptors interviewed noted differences in communication abilities when interacting with patients. However, this improved with time. Quantitative data collected from graduates via the validated Work-Readiness Scale also showed a more positive agreement towards perceived work readiness. These graduates were comfortable with using technology as they had used these extensively in their learning during the pandemic and thus was comfortable in adopting digital health tools in their practice.

Conclusion

Although graduates reported to be work ready, there were gaps in communication skills and confidence levels when interacting with patients, as reported by supervising preceptors. Graduates also described this sense of 'missing out' from not having the opportunity to attend face-to-face activities like their originally planned hospital placements and how it impacted their choice of career. As pharmacists continue to play vital roles as members of the broader healthcare workforce, both in clinical and nonclinical settings, learnings from this study should be considered in designing educational activities to train and develop the workforce of the future.

Nursing practice readiness improvement program tailored for newly graduated registered nurses: A quasi-experimental study

BACKGROUND

Helping newly graduated registered nurses successfully adapt to clinical practice, evaluating work capabilities, identifying deficiencies, and continuously providing educational support to improve deficiencies are reported to be of paramount importance.

OBJECTIVES

To develop a tailored nursing practice preparation improvement program for newly graduated registered nurses and assess its impact on the successful adaptation of nurses.

DESIGN

A quasi-experimental study.

SETTINGS

The study was performed at a tertiary general hospital in South Korea.

PARTICIPANT

A total of 53 newly graduated registered nurses (experimental group = 28; comparison group = 25) participated.

METHODS

The newly graduated registered nurses were recruited using purposive sampling to one of two groups. The study was conducted between February and May 2022. The experimental group underwent a 4-week education program that integrated various methods, whereas the control group underwent preceptor training in their department. Data were collected through a questionnaire survey and analyzed using the chi-square test, independent t-test, and analysis of covariance with the SPSS 26.0 program.

RESULTS

The nursing practice readiness improvement program tailored for newly graduated registered nurses was effective in reducing the transition shock (F = 9.18, p = 0.004) of newly graduated registered nurses and improving nursing practice readiness (F = 19.90, p < 0.001), job satisfaction (F = 4.09, p = 0.049), and retention intention (F = 6.20, p = 0.016).

CONCLUSIONS

This study presented an evidence based approach on the use of a nursing practice readiness improvement program for the successful adaptation of newly graduated registered nurses and the establishment of a nurse education system.

Nurse manager support of graduate nurse development of work readiness: An integrative review

AIM

To systematically review relevant literature to identify how Nurse Managers support graduate nurse work readiness.

BACKGROUND

Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment.

DESIGN

A five-step, systematic integrative review reported in accordance with the PRISMA 2020 Checklist.

METHODS

The steps of the review method included (1) problem identification, (2) literature search, (3) data evaluation and quality appraisal, (4) data extraction and analysis and (5) presentation. Analysis used the Framework method and was guided by theory of graduate nurse work readiness and the Theoretical Domains Framework.

DATA SOURCES

MEDLINE COMPLETE, Cumulative Index to Nursing and Allied Health (CINAHL) Complete, ERIC and PSYCINFO searched in December 2020.

RESULTS

Studies eligible for inclusion (N = 40) represented research from 15 countries; most (67.5%, n = 27) used a qualitative design, 22.5% (n = 9) were quantitative and 10% (n = 4) used mixed methods. Three themes related to the social constructs and local area work environments influenced by nurse managers emerged: supporting people, supportive environment and supporting learning.

CONCLUSION

The review identified a lack of robust evidence about the effectiveness of specific nurse manager-led strategies to support development of graduate work readiness. However, the findings provide a framework to guide nurse managers in supporting graduate nurses and provide a foundation for further research about nurse manager roles in developing graduate work readiness.

IMPLICATIONS FOR THE PROFESSION OR PATIENT CARE

Previous research has described poor transition of graduate nurses as responsible for increased workplace errors, decreased job satisfaction and high rates of attrition. Exploring the role of nurse managers in graduate nurse transition is essential to ensure quality patient care and a sustainable workforce.

IMPACT

What Problem Did the Study Address? Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. What Were the Main Findings? High rates of attrition are attributed to poor support during the initial transition phase of graduate nurses. Nurse managers can impact transition by providing a supportive environment, support learning and by providing a team of supportive people. Where and on whom will the research have an impact? The research will have an impact on graduate nurses and nurse managers.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution (integrative review exploring existing literature). This integrative review was registered with PROSPERO (CRD42021213142).

Australian graduate radiographers' perspectives and experiences of work readiness

INTRODUCTION

Graduate radiographers entering their qualified positions need to orientate and familiarise themselves with a rapidly changing work environment to deliver a high standard of diagnostic imaging services. During this transitional phase, these newcomers also strive to meet self-expectations and workplace expectations. This study was performed to understand the work readiness perspectives and initial experiences of graduate radiographers on beginning their newly qualified roles.

METHODS

The study used a qualitative phenomenological approach to collect data through individual semi-structured in-depth telephone interviews with 14 purposively sampled undergraduate and postgraduate radiographers. The rich data were transcribed verbatim and then thematically analysed.

RESULTS

Four major themes emerged: (1) preparing to be 'work-ready', (2) initial encounters as qualified radiographers, (3) personal and professional challenges and (4) support strategies and advice for new graduates.

CONCLUSIONS

New graduate radiographers face many personal and professional challenges but agree that they thrive in supportive collegial environments. Most participants had a high perspective of their work readiness strongly related to their clinical placements as students, workplace familiarity, support networks and coping strategies. Further review into individual workplace orientations by organisation leaders may benefit the immersion and enhancement of graduate radiographers' initial experiences in their new role.

Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis

PURPOSE

It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment.

METHODS

We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model.

RESULTS

The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice.

CONCLUSION

Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

Evaluation of interprofessional student teams in the emergency department: opportunities and challenges

BACKGROUND

Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning.

METHODS

An interprofessional clinical placement program was implemented with the aim to enhance students' capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students' perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences.

RESULTS

The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging.

CONCLUSIONS

Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students' clinical supervision are proposed for the placement model.

Work readiness of newly graduated nurses transitioning to practice in Saudi Arabia: A cross-sectional study

AIMS

To explore work readiness among newly graduated nurses transitioning to practice in Saudi Arabia.

BACKGROUND

Many challenges encounter newly graduated nurses when transitioning to practice. Higher work readiness has been associated with smooth transitioning to practice. However, little is known about work readiness among newly graduated nurses in Saudi Arabia.

METHODS

Cross-sectional convenience sample of 174 participants.

RESULTS

The mean score in work readiness was 338.8 (SD = 69.6). Weekly working hours correlated with organizational acumen (r = 0.208, p ≤ 0.01), social intelligence (r = 0. 217, p ≤ 0.01), work competence (r = 0.173, p ≤ 0.05) and the number of weeks since the start of internship training (r = 0.180, p ≤ 0.05). There were significant mean differences in a) personal work characteristics based on the country (t = 5.582, p < 0.001) and university from which they graduated (f = 15.618, p < 0.001); b) organizational acumen based on having a second job (t = -2.18, p = 0.03), university from which they graduated (f = 1.837, p = 0.002) and whether the hospital was the first-choice preference (t = - 2.837, p = 0.005) and nursing was the first choice of study (t = -2.879, p = 0.005); and c) work competence based on the university from which they graduated (f = 5.267, p = 0.006).

CONCLUSIONS

The findings showed the work readiness of newly graduated nurses in Saudi Arabia's context.

IMPLICATIONS FOR NURSING MANAGEMENT

Findings have important implications for nurse managers to better design and implement a transition to practice programs for newly graduated nurses to improve their preparedness in their nursing careers.

Work Readiness of Newly Licensed RNs

OBJECTIVE

The aim of this study was to examine the work readiness of newly licensed RNs (NLRNs) based on demographics, education, and work experiences.

BACKGROUND

Work readiness is the extent to which new graduates possess qualities and competencies associated with workplace success. Work readiness of NLRNs complements their clinical knowledge and skills and has been shown to predict job satisfaction and work engagement.

METHODS

Two hundred ninety-seven NLRNs participating in the nurse residency program of a health system in the southeast region of the United States were surveyed using the Work Readiness Scale-Graduate Nurse.

RESULTS

Scores on all readiness dimensions were high. Analysis revealed unexpected differences in readiness dimensions based on race, nursing degree, and completion of a nurse externship program.

CONCLUSIONS

Work readiness adds to our understanding of factors that can affect the transition of NLRNs into the work setting. Further research is needed to understand how work readiness develops over time, factors that predict work readiness, and its relationship to NLRN retention and other outcomes.

Not too little, not too much: supervisor perceptions of work-readiness of speech-language pathology graduates

The work-readiness skills and attributes that facilitate healthcare graduates to succeed in their new workplaces are not well defined. In particular, the perspectives of supervisors of graduates in the diverse hospital and community settings of healthcare practice are not well represented in research about work-readiness. Interview data from a case study of twenty-nine supervisors of speech-language pathology graduates was thematically analysed, using Boundary Critique Theory to interpret how the supervisors' understanding of graduate work-readiness was bounded within their understanding of their own system, needs and work environment. The four themes captured the skills that the supervisors perceived as critical for graduate work-readiness: Independence; Attitude; Teamwork; and Learning. A tension was identified within these themes, as supervisors' understanding of work-readiness was bounded by an expectation that graduates are able to moderate how they transfer and apply their graduate skills in their workplace according to the complexity of client needs and the workplace setting. This study increases the visibility of the supervisors' boundaries around what are and are not considered to be work-ready skills, attributes and expectations of a work ready speech-language pathology graduate. This knowledge can be used to facilitate speech-language pathology graduates to successfully transfer, apply and expand these skills as they transition to work, and may be useful for other health professions to explore.

Readiness to enter the workforce: perceptions of health professions students at a regional Australian university

BACKGROUND

Perceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university.

METHODS

The study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants' self-perceived readiness for clinical practice.

RESULTS

From the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness.

CONCLUSIONS

The findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.

Work readiness in rehabilitation medicine: a qualitative exploration and framework

Background/aims

The skills and attributes that facilitate the transition from student to professional (also known as work readiness) have not been fully explored in rehabilitation medicine. The aim of this study was to develop a model of work readiness for new rehabilitation medicine professionals that allows for a successful transition to the workplace.

Methods

A qualitative approach was used to explore the perspectives of 26 clinicians, regulators and employers about work readiness in rehabilitation disciplines. Transcripts were coded and analysed using content analysis methods.

Results

At the core of work readiness for rehabilitation medicine professionals were three complex endeavours that were framed as professional challenges. Each endeavour integrated one or more foundational skills and could improve context-bound applied skills.

Conclusions

Work readiness in rehabilitation requires active and ongoing commitment from students, post-secondary programmes and employers.

Developing work readiness in graduate nurses undertaking transition to practice programs: An integrative review

OBJECTIVE

Investigate the strategies used to support graduate transition-to-practice, and how they align with the four domains of work readiness: work competence; personal work characteristics; organisational acumen; and social intelligence.

DESIGN

Integrative review with narrative synthesis.

DATA SOURCES

Databases searched in 2019 included Medline, CINAHL, PsychINFO, Embase via EBSCO, ERIC and MIDIRS. Grey literature was obtained through Proquest Dissertations and Thesis Global, and Trove.

REVIEW METHODS

The 5-step method included: 1) Independent title and abstract review; 2) discussion of conflicting findings after title and abstract review; 3) independent full text review; 4) discussion of conflicting findings after full text review; and 5) quality evaluation using the Mixed Methods Appraisal Tool. Twenty eligible studies were analyzed and synthesized using the framework method informed by four domains of Graduate Work Readiness.

RESULTS

Of the 24 strategies identified, most (n = 20) supported graduate development across two or more work readiness domains. Structured education (n = 14) and preceptorship (n = 13) were most often used, and findings related to development of graduate work competence (n = 17) were most often measured. All four domains of work readiness were seldom addressed, with social intelligence a common gap.

CONCLUSIONS

This review provides two important considerations for graduate nurse programs. First, a combination of strategies is required to address all four domains of work readiness. Second, there is a need to tailor strategies, and their implementation, to the context of the organisation and clinical workplace.

Validation of a 'Work Readiness Scale' for health professional (HP) graduates

BACKGROUND

There is a continuing concern about how graduate work readiness (WR) reflects on the success of universities meeting the requirements of employment. This study is to establish a valid and reliable instrument measuring WR in health professions (HP) graduates of medicine, pharmacy and dentistry.

METHODS

The study from March 2016 to April 2017 was conducted to validate the 'Work Readiness Scale' (WRS; Deakin University) using Principal Component Analysis and Cronbach - α for internal consistency. It was modified to a four-item even-point scale and distributed as an online survey to 335 final year students of the three programs.

RESULTS

A reduction from 64 to 53 items provided good internal consistency in all factors: WC 0.85, OA 0.88, SI 0.88 and PC 0.71. The PC domain had the greatest item reduction from 22 to 6, whilst the SI domain increased in items from 8 to 19. These changes may be associated with difference in understanding or interpretation of the items in the SI domain.

CONCLUSION

The modified WRS can be used to evaluate job readiness in HP graduates. However, it needs further refinement and validation in specific educational and employment contexts.

Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates

CONTEXT

Work readiness is often described in terms of the clinical competence medical graduates bring to day 1 of internship. Despite being increasingly viewed as a key graduate outcome, work readiness has remained poorly defined.

OBJECTIVE

This narrative review draws on the international literature to explore how different research methods provide differing insight into what constitutes work readiness of medical graduates. From this, we explored contributory factors and developed a conceptual framework to better understand work readiness.

METHODS

Databases were searched using the terms including "ready," "readiness," "preparedness," "medical graduates," "intern," and "junior doctor." Information was summarized using a textual description template that included information on study setting, participants, methodologies, limitations, and key result areas (including measures/themes and study conclusions). Consensus discussions between authors led to the naming and understanding of the key themes.

RESULTS

Seventy studies were included in the review. Study participants included final-year medical students (n = 20), junior doctors early in internship (n = 24), and junior doctors late in internship or postgraduate year 2 and above (n = 23). Most studies explored work readiness through the retrospective self-report of the students and/or junior doctor participants. Quantitative research methods elaborated on key skills-based competencies, whereas qualitative research methods provided insight into key contextual and individual characteristics that contributed to preparedness.

CONCLUSIONS

Different research methods provided insight into competencies, as well as individual and contextual aspects, associated with preparedness for practice. The transition from university to clinical practice is significant and requires personal capability and confidence, as well as a supportive training context. Enabling students to engage authentically in clinical environments enhanced preparedness by promoting understanding of role and responsibility. Individual resilience is important, but contextual factors, including provision of adequate support and feedback, can enhance or subtract from feeling prepared. We propose a novel conceptual framework for better understanding work readiness.

Psychology Education and Work Readiness Integration: A Call for Research in Australia

Supporting students to develop transferable skills and gain employment is a vital function of Universities in the era of the Fourth Industrial Revolution. A key area is work readiness, which has steadily grown in importance over the last 2 decades as tertiary institutions increasingly aim to produce graduates who perceive and are perceived as work ready. However, a large majority of graduates report a lack of skills and confidence needed for the effective transition from study to work. This may be particularly problematic for disciplines that impart both discipline-specific and transferrable skills, such as psychology. The aim of this paper is to addresses the concept of work readiness within Australian psychological training and explores the need to shed light on and integrate work readiness within the pedagogy of psychology within Australia. Specifically, this paper calls for a review of work readiness skills developed in psychological courses to ensure industry needs are met. Beyond such a review, it is suggested that tertiary centres need to facilitate students in capturing and reflecting upon the transferable skills that they develop; and build assessments that allow students to demonstrate transferable skills in a meaningful way. Further, this paper proposes that work readiness skills be routinely mapped onto graduate attributes and course learning outcomes to be readily available by students so as to increase students’ potential to articulate their learnt work readiness skills once in the workplace.

The relationship between the undergraduate clinical learning environment and work readiness in new graduate nurses: A pre-post survey study

BACKGROUND

Due to projected nurse shortages, it is necessary that undergraduate programs optimise work readiness outcomes in new graduate nurses. Research that quantitatively evaluates characteristics of clinical nursing programs that predict increased work readiness is required.

OBJECTIVES

To explore the relationship between the undergraduate clinical learning environment and nurse perceptions of work readiness prior to and following, commencement as a new graduate nurse.

DESIGN

A pre-post follow-up study. Undergraduates were surveyed at the end of their Bachelor's degree (baseline) and at 8-10 weeks after commencement as a graduate nurse (Time 1).

SETTING

A multi-site, metropolitan private hospital in Victoria, Australia.

PARTICIPANTS

Nursing graduates who completed a university fellowship program (n = 26), or were undertaking their graduate year and had completed placement blocks within (n = 18) or outside (n = 31) the healthcare organisation.

METHODS

Participants self-completed the Clinical Learning Environment Inventory (CLEI) and Work Readiness Scale for Graduate Nurses (WRS-GN) at baseline and Time 1. Multiple regression analyses were performed.

RESULTS

CLEI scores significantly predicted work readiness outcomes (all p-values<.05), accounting for 16-36% and 17-28% of the variance of WRS-GN scores at baseline and Time 1, respectively. After adjusting for clustering due to clinical placement groups, CLEI Individualisation (p = .023) and Valuing Nurses Work (p = .01) predicted improved Time 1 WRS-GN Organisational Acumen. CLEI Innovative and Adaptive Culture scores predicted poorer Time 1 Organisational Acumen (p = .001).

CONCLUSIONS

Learning environments that offered high levels of individualised attention and valued nurses' work appeared to facilitate post-graduation engagement and identification with nursing practice. However, highly innovative and adaptive education may detract from optimal work readiness. Findings revealed that while important, the clinical learning environment only accounted for a small-to-moderate degree of nursing graduates' work readiness. To facilitate robust evidence-based improvement of clinical nursing education, future research should attempt to empirically establish the value of additional facilitators of work readiness.

Perceptions of preparedness: How hospital-based orientation can enhance the transition from academic to clinical learning

BACKGROUND

Clinical placements are essential for applied learning experiences in health professions education. Unfortunately, there is little consensus on how best to prepare learners for the transition between academic and clinical learning. We explored learners' perceptions of hospital-based orientation and resulting preparedness for clinical placement.

METHODS

Sixty-three learners participated in a total of 18 semi-structured focus groups, during their clinical placements. Data were analyzed thematically.

RESULTS

We organized learners' perceptions of hospital-based orientation that support their preparedness for placement into three themes: (1) adequate site orientation for learner acquisition of organization acumen and (2) clinical preceptor training to support unit/service and (3) individual components.

CONCLUSION

Thoughtful attention to hospital-based orientation can support learners in transitioning from academic to clinical learning. Hospital organizations should attend to all three components during orientation to better support learners' preparedness for clinical learning.

Psychometric properties assessment of Chinese version of work readiness scale for graduate nurses (WRS-GN) and associated factors of work readiness: Two cross-sectional studies

BACKGROUND

Lower work readiness is tied to anxiety, high turnover and nurse transition failure. An assessment of work readiness is necessary. To date, no relative scale exists in China. Thus, a work readiness related scale is urgently needed.

OBJECTIVES

To assess the psychometric properties of the scale, and look into the status of Chinese graduate nurse work readiness and factors associated with work readiness.

DESIGN, SETTINGS, AND PARTICIPANTS

Both psychometric assessment and associated factors are designed with cross-sectional studies. 832 and 435 graduate nurses were recruited in the above two studies, respectively.

METHODS

Brislin's transition model was utilized for the transition process, and a six-expert panel and preliminary survey were conducted for face validity and testing the transition version respectively. Exploratory factor analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability were applied for reliability and validity testing. Additionally, a linear regression method was carried out for analyzing influencing factors of work readiness of graduate nurses across China.

RESULTS

A 37-item Chinese version scale was proven to have great psychometric qualities. Five factors were extracted by exploratory factor analysis, which can explain 68.637% of the total variance. Furthermore, the confirmatory factor analysis demonstrates the fit indices of a five factors mode: X²/df = 1.769, RMSEA = 0.067, NFI = 0.859, RFI = 0.839, IFI = 0.934, CFI = 0.933, TLI = 0.923. Intra-class correlation coefficient, Cronbach's α and Guttman Split-half were 0.805, 0.960 and 0.903, respectively. Interpersonal relationships, leadership experience, scholarship, work experience and willingness to be nurses were associated with the potential to achieve higher work readiness.

CONCLUSION

The Chinese version of WRS-GN with good validity and reliability can be utilized for assessment of work readiness. Besides, improving work readiness of graduate nurses based on above five associated factors, educators and hospital managers could help graduate nurses having a smooth transition for a stable nursing workforce.

What makes a great clinical team? Stakeholder perspectives on the attributes of effective veterinary health care teams in Australia

Extensive research in the business and organisational literature links teamwork to enhanced productivity and employee job satisfaction. Good teamwork capability is also a highly regarded graduate attribute linked to employability. This study explored desirable teamwork attributes for veterinary technology graduates in Australia, by surveying veterinarians, veterinary technology graduates, veterinary nurses, clients and academics. Respondents highlighted the importance of seven attributes sourced from the cross-disciplinary teamwork literature-'flexibility' (in approach to work), 'agreeableness', being 'cooperative', 'socially sensitive and perceptive', 'conscientiousness', being 'accepting of others' and 'sharing professional values'. The majority in each stakeholder group viewed all attributes important for teamwork concurring with findings in other fields. Few differences were found between and within groups with veterinarians and academics rating 'conscientiousness' higher than others and female clients placing more importance on relational attributes compared to male clients. Thematic analysis of an open-ended item asking the veterinary health care groups, and veterinary academics, to define teamwork generated nine themes centred on: collaboration, goals and outcomes, sharing values, relationships, diversity, communication, task-orientation, personal attributes, and workplace culture. This study illuminates an interprofessional perspective on veterinary teamwork. Results will be useful for veterinary technology, veterinary nursing and veterinary educators when developing a curriculum for interprofessional teamwork to enhance team performance, employability and, ultimately, the quality of veterinary services.

'Bumping along': a qualitative metasynthesis of challenges to interprofessional placements

CONTEXT

Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed.

OBJECTIVES

This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation.

METHODS

A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage-process-product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research).

RESULTS

We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach.

CONCLUSIONS

In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice-ready workforce. This in turn will enhance service user outcomes and safety.

Examining the Indirect Effects of Self-Concept on Work Readiness Through Resilience and Career Calling

The current study examined the relations among self-concept, career calling, resilience, and work readiness in a Malaysian sample of vocational college students ( N = 674). As hypothesized, self-concept was positively associated with work readiness. To explain this relation further, we examined the indirect effect of self-concept through calling and resilience on work readiness. Using structural equation modeling, both career calling and resilience were found to be significant avenues through which self-concept influences work readiness. Results of the indirect effects also indicated that resilience was a stronger pathway compared to career calling. These results suggest that for vocational college students, a more crystallized self-concept may link to greater work readiness skills due, in part, to a heightened sense of resilience and clarity in one’s career calling.

A conceptual framework for simulation in healthcare education - The need

This study used a social constructivist approach to explore the literature in relation to the acknowledgment and application of models and frameworks in simulation based learning and teaching activities in health care education. This paper addresses the data collection phases in the research design in developing a Conceptual Framework for Simulation in Healthcare Education.

BACKGROUND

Two literature review activities occurred in the study. The first literature review explored the challenges in the literature for further research in relation to the educational factors that have an impact upon simulation as a learning and teaching modality. This part of the research process was to identify the publications that address simulation as a learning and teaching modality and uncover evidence to justify the study. The literature revealed that there were limited publications in relation to simulation as a learning and teaching modality that was underpinned by a conceptual framework.

DESIGN

The study research design employed Evaluation Research to conduct a further intensive review of the literature as part of phase one of data collection. The second part of phase one of data collection was the surveying of randomly selected simulation education centres around the world to ascertain their employment of a conceptual framework in the application of simulation as a learning and teaching modality. Phase two was the genesis of the conceptual framework and Phase three was the evaluation of the draft framework using a modified Delphi Technique by randomly selected simulation experts.

RESULTS

The intensive literature review highlighted that authors acknowledged education-based theories but this did not extend to the application of a conceptual framework to simulation as a learning and teaching modality. The survey provided the evidence to support the development of a Conceptual Framework for Simulation in Healthcare Education for the conceptualisation, design, development and delivery of simulation teaching and learning activities in health care education. The simulation experts provided valuable data and commentary in the final formation of the conceptual framework.

CONCLUSION

Based on the outcomes of the literature review, questionnaire and modified Delphi Technique the need for the development, and subsequent structure and utility of the Conceptual Framework for Simulation in Healthcare Education was verified.

'Doing it for real now' - The transition from healthcare assistant to newly qualified nurse: A qualitative study

BACKGROUND

There has been increasing international research and policy interest concerning the transition from student to newly qualified nurse (NQN). However, the influence of previous employment as a healthcare assistant (HCA) on students' experiences of this transition is comparatively under-researched.

AIMS AND OBJECTIVES

To explore the experiences of NQNs also employed as HCAs during their pre-registration education programme and how this prior and ongoing HCA experience influenced their transition experiences.

DESIGN

Qualitative research design using a descriptive method.

SETTING AND PARTICIPANTS

Former students (n = 14) of a unique four year, part-time, employer-sponsored pre-registration nursing programme, specifically designed for HCAs and delivered by supported open learning, located in different regions and nations of the United Kingdom who had qualified within the last two years.

METHODS

Telephone interviews, digitally recorded, transcribed verbatim and analysed using NVivo8.

RESULTS

Four themes described participants' experiences of transition: In at the deep end, Changing identities, Coming together and Scaffolding. Findings confirm existing literature that all NQNs appear to experience a similar overarching experience of transition, including those with prior HCA experience. However, familiarity with people, place and routines afforded by this previous experience appeared to ease transition, particularly if the NQNs stayed in their previous HCA work location. However, managing the dual roles of being both HCA and student and adapting to their changing identities were frequently cited as particular challenges.

CONCLUSIONS

Van Gennep's Rites de Passage and Bridge's work on organisational change were combined to theoretically analyse participants' accounts of transition. This illustrated that transition is not always linear with clearly defined and bounded stages but can also be seen as a more undulating or organic process with curving, slanting and overlapping phases. NQNs can therefore simultaneously occupy more than once phase in their journey of transition. Implications for students, higher education and practice are highlighted.

The impact of undergraduate clinical teaching models on the perceptions of work-readiness among new graduate nurses: A cross sectional study

BACKGROUND

Clinical Placements are an essential component of bridging the gap between academic theory and nursing practice. There are multiple clinical models designed to ease the transition from student to professional, yet there has been little exploration of such models and their impact on graduates' perceptions of work-readiness.

OBJECTIVES

This cross sectional study examined perceptions of work-readiness of new graduate nurses who attended one of the following clinical teaching models: the University Fellowship Program (UFP), the Traditional Multi-facility Clinical Model (TMCPM), and the Mixed Program (MP).

METHODS

Three groups of first year graduate nurses (UFP, TMCPM, and MP) were compared using the Work-readiness Scale, a validated and reliable tool, which assessed nurses' perceptions of work-readiness in four domains: organizational acumen, personal work characteristics, social intelligence, and work competence. A multivariable Generalized Estimating Equations regression investigated socio-demographic and teaching-modelrelated factors associated with work-readiness.

RESULTS

Of 43 nurses approached, 28 completed the survey (65% response rate) of whom 6 were UFP attendants, 8 attended the TMCPM and 14 the MP. Those who had attended the UFP scored higher than the other two in all four domains; however, the crude between-group comparisons did not yield statistically significant results. Only after accounting for age, gender, teaching setting and prior work experience, the multivariable model showed that undertaking the UFP was likely to increase perceptions of work-readiness by 1.4 points (95% CI 0.11-2.69), P=0.03). The UFP was superior to the other two placement models.

CONCLUSION

The study suggests that the UFP may enhance graduate nurses' perceptions of work readiness.

The development and evaluation of online stories to enhance clinical learning experiences across health professions in rural Australia

Clinical placement learning experiences are integral to all health and medical curricula as a means of integrating theory into practice and preparing graduates to deliver safe, high-quality care to health consumers. A growing challenge for education providers is to access sufficient clinical placements with experienced supervisors who are skilled at maximising learning opportunities for students. This paper reports on the development and evaluation of an innovative online learning program aimed at enhancing student and clinical supervisors' preparedness for effective workplace-based learning. The evidence-based learning program used 'story-telling' as the learning framework. The stories, which were supported by a range of resources, aimed to engage the learners in understanding student and supervisor responsibilities, as well as the expectations and competencies needed to support effective learning in the clinical environment. Evaluation of this program by the learners and stakeholders clearly indicated that they felt authentically 'connected' with the characters in the stories and developed insights that suggested effective learning had occurred.

Novice nurses' experiences of unpreparedness at the beginning of the work

Introduction:

Unpreparedness of novice nurses during the process of transition to their professional role can has broad consequences for the nurse and health care system and leads to reduction of the quality of patient care. This study has been carried out with the aim of investigating the experiences of the unpreparedness of novice nurses.

Method:

This study was conducted qualitatively by using conventional content analysis. Participants were 21persons including 17 novice nurses, 2 supervisors, and 2 experienced nurses who were selected through purposeful sampling from four hospitals dependent on Tehran University of Medical Sciences.

Findings:

Participants' experiences were reflected in three main themes of "functional disability", "communicative problems", and "managerial challenges". Each of these dimensions consisted of several sub-categories. These areas had represented the inability to apply the learned knowledge in practice.

Discussion:

The sensitivity of health system, especially, educational mentors and nursing managers to create preparation in novice nurses by providing appropriate orientation programs at the beginning of work and the revision and amendment of nursing curriculum can solve this problem to some extent.

Work readiness of graduate nurses and the impact on job satisfaction, work engagement and intention to remain

BACKGROUND AND AIM

Graduate work readiness is a relatively new construct that can predict graduate potential. Its impact on graduate work outcomes however, is unknown. The current study aimed to explore the relationships between work readiness and a number of work outcomes (job satisfaction, work engagement, and intention to remain).

DESIGN AND PARTICIPANTS

A survey design was used. A sample of 96 graduate nurses from two regional hospitals in Victoria, Australia participated in this study.

METHOD

Data were collected using quantitative surveys

RESULTS

Three of the four work readiness dimensions (organisational acumen, clinical competence and social intelligence) were found to predict job satisfaction and work engagement. Moreover, both job satisfaction and work engagement were found to mediate the relationship between organisational acumen and intention to remain. The findings indicate that dimensions of work readiness uniquely predict work outcomes.

CONCLUSION

Findings support prior research, which suggests that graduate work readiness is a multidimensional construct comprising skills and attributes beyond discipline-specific competence.