An outcome-based evaluation of nursing competency of baccalaureate senior nursing students in Taiwan

Students' core competence performance during fundamental nursing practicum: A cross-sectional survey with importance-performance analysis

AIM

Limited available studies compare the core competence performance of students undertaking their practicum at different level-of-care practicum sites. This study aimed to (1) compare the gaps between the perception of importance for competence and the perceived performance of nursing students at practicum sites involving different level-of-care and (2) identify low competencies that must be prioritized for improvement at different sites during the fundamental nursing practicum.

DESIGN

Cross-sectional design.

METHODS

A total of 659 students who had passed their fundamental nursing practicum within 1 month from six nursing colleges in Taiwan were recruited. The students completed the 25-item Core Competence in Fundamental Nursing Practicum Scale, wherein both the importance and performance level of each item are indicated. One-way analysis of variance along with the Scheffe post hoc test and importance-performance analysis were used to explore the gaps between the perception of importance for competence and the perceived performance and to identify weak competencies that must be prioritized for improvement, respectively.

RESULTS

Compared with nursing students practicing in district hospitals (predominantly caring for chronically ill patients), nursing students practicing in medical centres (predominantly caring for patients with severe and critical conditions) had larger gaps in total scores and the application of nursing processes. Students in medical centres also had larger gaps in professional attitude than their counterparts in long-term care facilities. Importance-performance analysis identified a common shortfall in communication skills among nursing students for all level-of-care practicum sites. Students at long-term facilities had the highest number of weak competencies that required improvement. The results of this study can guide instructors in designing curricular activities focused on the weaker core competencies of the students at a practicum site for each level of care.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contributions.

2022 Shandong Province university medical technical skills competition nursing track: An effective project to improve core competencies of nursing students

Background

The core competencies of nursing students have gradually become the focus of attention of nursing educators. Nursing skills competitions are an important form of educational and teaching activity in universities and the nursing track at the Shandong Provincial University Students' Medical Technical Skills Competition gives nursing students an opportunity to demonstrate their clinical skills and knowledge. This study aims to describe the organisation and procedures of the nursing track, analyse the competition results and explore the impact the competition has on the core competencies of the nursing students. This will provide new ideas for future nursing professional education.

Methods

Statistical analysis of the competition results was performed as a means of understanding the current status of theoretical knowledge and clinical skills of nursing students in Shandong Province. The impact of the competition on the core competencies of participating students was analysed by distributing questionnaires to universities in Shandong Province that participated in the competition.

Results

14 universities with nursing programmes participated in the competition, including eight public universities and six private universities. 220 questionnaires were distributed to nursing students at the participating universities and 218 were ultimately included, demonstrating an efficiency rate of 99.09%.

Conclusions

The 2022 nursing track included the addition of a comprehensive written examination as a means of judging the competencies of nursing students in Shandong Province from a variety of aspects. Skills competitions are effective for improving the core competencies of nursing students and they will become an important means for nursing educators to reform education and improve the core competencies of nursing students in the future.

Effectiveness of breastfeeding educational interventions to improve breastfeeding knowledge, attitudes, and skills among nursing, midwifery, and medical students: A systematic review and meta-analysis

BACKGROUND

Breastfeeding education programs are necessary to prepare healthcare students to address the breastfeeding needs of families. Various breastfeeding educational modules have been used in academic settings; however, the effectiveness of breastfeeding educational interventions remains unclear.

OBJECTIVES

To examine the effectiveness of educational interventions to improve the breastfeeding knowledge, attitudes, and skills of nursing, midwifery, and medical students.

METHODS

A systematic review was conducted searching academic databases from inception to December 22, 2022. Searches were carried out by two authors independently in PubMed, MEDLINE, Web of Science, Scopus, CINAHL Plus, Embase, Cochrane Library, and ERIC. Joanna Briggs Institute critical appraisal checklist was used. The data were extracted for a random-effects meta-analysis to estimate the standardized mean differences (SMDs) with 95 % confidence interval (CI). Subgroup analyses were performed to identify potential moderators.

RESULTS

Thirty-three quasi-experimental studies (12 two-group studies and 21 one-group studies), which included 1313 nursing students, 204 midwifery students, and 1066 medical students, were identified. The students who received educational interventions had significantly higher scores in breastfeeding knowledge (SMD: 0.67, 95 % CI: 0.46, 0.87 for two-group studies; SMD: 1.42, 95 % CI: 0.91, 1.94 for one-group studies), more positive attitudes toward breastfeeding (SMD: 0.43, 95 % CI: 0.22, 0.63 for two-group studies; SMD: 0.98, 95 % CI: 0.32, 1.63 for one-group studies), and higher scores for breastfeeding skills (SMD: 1.52, 95 % CI: 0.46, 2.58 for two-group studies; SMD: 1.33, 95 % CI: 0.43, 2.23 for one-group studies) than the control groups. As a teaching method, clinical practicums were a significant moderator of both breastfeeding knowledge (p = .035) and skills (p < .001). Few studies (n = 5) described the educational framework underpinning the program development.

CONCLUSIONS

Breastfeeding educational interventions effectively improve the breastfeeding knowledge, attitudes, and skills of undergraduate nursing, midwifery, and medical students. Incorporating clinical practicums in interventions is important. Future studies to examine useful teaching strategies for enhancing learning outcomes are warranted.

Critical thinking abilities among newly graduated nurses: A cross-sectional survey study in China

AIM

The aim of this study is to describe critical thinking dispositions among newly graduated nurses with different educational background in China and to explore related factors.

DESIGN

A cross-sectional questionnaire survey.

METHODS

The data were collected using the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV). Overall, 588 newly graduated nurses finally completed the survey. Spearman and Pearson's correlation coefficients were used to examine the correlation between the CDTI-CV and nurses' general characteristics.

RESULTS

In terms of open-mindedness, analysis and inquisitiveness subscales, significant differences were found among nurses based on three educational level. When dichotomizing total CTDI scores into high and low, nearly 80% of the respondents fell into low score group. Pressure from workplace was high for 68.4% of them. Significant correlation was found among the new graduated nurses' critical thinking ability and their age, education level, reading habit and attitude towards nursing profession.

Nursing students' extracurricular activity experiences of suicide prevention volunteering: A qualitative study

BACKGROUND

Extracurricular activities of college students have been perceived as a means of developing competencies related to professional success.

OBJECTIVES

This study aimed to explore the extracurricular activity experience of nursing students who participated in suicide prevention volunteering.

DESIGN

Qualitative research.

SETTING

This study was conducted at an undergraduate university in Gyeongsan-do, Korea.

PARTICIPANTS

Participants in the study were 36 nursing college students who participated in suicide prevention volunteer activities for more than 4 months.

METHODS

Data were collected by focus group interviewers, which were analyzed using content analysis.

RESULTS

The experiences of participants in the study were identified by four sub-themes 'Developing sensitivity to suicide issues', 'Improving confidence in suicide prevention', 'Getting interested in mental health nursing', and 'Learning basic skills of practical nursing' that derived the theme 'Prepared for a competent nurse in mental health nursing'.

CONCLUSION

A variety of activities and programs for extra-curriculum will serve as a foundation for nursing students to improve their basic competencies and qualities to become more competent in their future careers.

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

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

AIM

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

The State of the Science on Clinical Evaluation in Nursing Education

AIM

The purpose was to synthesize the published evidence to present the state of the science in clinical evaluation research in nursing education.

BACKGROUND

Clinical evaluation is key to ensuring nursing students' clinical competence, application of knowledge, and critical thinking, all of which are important to patient safety and quality nursing care.

METHOD

Cooper's research synthesis method was used.

RESULTS

A comprehensive literature search resulted in 250 documents, of which 88 met study criteria. Topics were exhaustive but not mutually exclusive and included competence, instrumentation, congruence, teaching methods, objective structured clinical evaluation, faculty/preceptor issues with clinical evaluation, essential clinical behaviors, topic-based evaluation, decision-making about clinical grade, and clinical reasoning.

CONCLUSION

Nursing education science is in its infancy in many areas. Two areas most in need of future research are the need to accurately define and efficiently measure competence in the clinical area and the need for reliable and valid instrumentation.

Preliminary study of outcome-based clinical practicum for undergraduate nursing students

AIM

A growing trend in South Korean nursing education is toward outcome-based education. In response, there is now a greater emphasis on achieving the learning outcomes that are outlined in the curricula of outcome-based education. This study aimed to describe the effectiveness of outcome-based clinical practicum for nursing students.

METHODS

In this preliminary longitudinal study, 62 third-year nursing students were enrolled from a university in Seoul, Korea. Three parameters of proficiency were measured three times in the students for 1 year including: achievement of expected learning outcomes, nurses' core competence, and critical thinking. For the data analysis, a descriptive analysis and repeated-measures ANOVA were used with the IBM SPSS v. 23.0 software program.

RESULTS

Completing the outcome-based clinical practicum was associated with a significantly enhanced achievement of expected learning outcomes, nurses' core competency, and critical thinking. All of the six expected learning outcomes significantly improved across the pre-, mid-, and postpracticum time points.

CONCLUSIONS

The outcome-based clinical practicum improved the achievement of the expected learning outcomes, nurses' core competency, and critical thinking of the nursing students. Further study is recommended to investigate students' and educators' qualitative experiences of outcome-based clinical practicum.

The effectiveness of outcome based education on the competencies of nursing students: A systematic review

BACKGROUND

Outcome Based Education (OBE) is a student-centered approach of curriculum design and teaching that emphasize on what learners should know, understand, demonstrate and how to adapt to life beyond formal education. However, no systematic review has been seen to explore the effectiveness of OBE in improving the competencies of nursing students.

OBJECTIVE

To appraise and synthesize the best available evidence that examines the effectiveness of OBE approaches towards the competencies of nursing students.

DESIGN

A systematic review of interventional experimental studies.

DATA SOURCES

Eight online databases namely CINAHL, EBSCO, Science Direct, ProQuest, Web of Science, PubMed, EMBASE and SCOPUS were searched.

REVIEW METHODS

Relevant studies were identified using combined approaches of electronic database search without geographical or language filters but were limited to articles published from 2006 to 2016, handsearching journals and visually scanning references from retrieved studies. Two reviewers independently conducted the quality appraisal of selected studies and data were extracted.

RESULTS

Six interventional studies met the inclusion criteria. Two of the studies were rated as high methodological quality and four were rated as moderate. Studies were published between 2009 and 2016 and were mostly from Asian and Middle Eastern countries. Results showed that OBE approaches improves competency in knowledge acquisition in terms of higher final course grades and cognitive skills, improve clinical skills and nursing core competencies and higher behavioural skills score while performing clinical skills. Learners' satisfaction was also encouraging as reported in one of the studies. Only one study reported on the negative effect.

CONCLUSIONS

Although OBE approaches does show encouraging effects towards improving competencies of nursing students, more robust experimental study design with larger sample sizes, evaluating other outcome measures such as other areas of competencies, students' satisfaction, and patient outcomes are needed.

Strategies used for the promotion of critical thinking in nursing undergraduate education: A systematic review

OBJECTIVE

Identifying the strategies used to promote critical thinking (CT) during undergraduate education in nursing courses.

DESIGN

Systematic review.

SOURCE OF DATA

Five electronic databases were searched without language, publication time or geographic filters.

METHOD

A systematic review of the literature. Including experimental studies that considered at least one teaching strategy to promote critical thinking of undergraduate students in Nursing courses. The search for studies occurred in three phases: title and summary review, complete text and implementation of a clinical form of selection according to predetermined criteria. All included studies were assessed for quality through a classification tool for experimental studies.

RESULTS

Six studies were selected. The results were grouped into three key themes: an evaluation of the quality of the selected studies, characterization of the studies and the strategies used to promote critical thinking. All selected studies were in English, with significant conceptual similarity of Critical Thinking and dominance in choosing the approached theme during strategies in clinical nursing education with an emphasis on the nursing process.

CONCLUSIONS

The most widely used teaching intervention was Problem-Based Learning. Nursing education mediated by strategies that stimulate CT is considered a positive difference in undergraduate curriculums.

Development of a competency framework for evidence-based practice in nursing

BACKGROUND

The measurement of competence in evidence-based practice (EBP) remains challenging to many educators and academics due to the lack of explicit competency criteria. Much uncertainty exists about what specific EBP competencies nurses should meet and how these should be measured.

OBJECTIVES

The objectives of this study are to develop a competency framework for measuring evidence-based knowledge and skills in nursing and to elicit the views of health educators/researchers about elements within the framework.

DESIGN

A descriptive survey design with questionnaire.

PARTICIPANTS AND SETTINGS

Between August and December 2013, forty-two health academics/educators, clinicians; and researchers from the medical and nursing schools at the University of Sydney and the Nurse Teacher's Society in Australia were invited to comment on proposed elements for measuring evidence-based knowledge and skills.

METHODS

The EBP competency framework was designed to measure nurses' knowledge and skills for using evidence in practice. Participants were invited to rate their agreement on the structure and relevance of the framework and to state their opinion about the measurement criteria for evidence-based nursing practice.

RESULTS

Participant agreement on the structure and relevance of the framework was substantial, ICC: 0.80, 95% CI: 0.67-0.88, P<0.0001. Qualitative analysis of two open-ended survey questions revealed three common themes in participants' opinion of the competency elements: (1) a useful EBP framework; (2) varying expectations of EBP competence; and (3) challenges to EBP implementation.

CONCLUSIONS

The findings of this study suggested that the EBP competency framework is of credible value for facilitating evidence-based practice education and research in nursing. However, there remains some uncertainty and disagreement about the levels of EBP competence required for nurses. These challenges further implicate the need for setting a reasonable competency benchmark with a broader group of stakeholders in nursing.

Randomized comparison between objective-based lectures and outcome-based concept mapping for teaching neurological care to nursing students

BACKGROUND

Pre-registration programs have been found to insufficiently prepare nurses for working in the neurosciences specialism. Effective approaches to neurology education are important, not only to enhance motivation to learn, but also for learners to develop basic competence in handling patients with neurological problems.

OBJECTIVES

To demonstrate that outcome-based course design using concept mapping would bring about significant differences in the nursing students' competency, cognitive load, and learning satisfaction with the neurological care course.

METHODS

A two-group pretest and post-test experimental study was administered. Two of the four clusters of participants were randomly assigned to the experimental group for experiencing an outcome-based course design using concept mapping, and the rest were designated the control group to be given objective-based lectures only. The Competency Inventory of Nursing Students, Cognitive Load Scale of Neurological Nursing, and Learning Satisfaction Scale of Neurological Nursing were used in this study for the students to rate their own performance. In addition, The Concept Map Scoring Scale was used in the experimental group for examining students' concept mapping ability.

RESULTS

Significant increases of mean nursing competency scores in both groups from pre-test to post-test were found. There was no statistically significant difference in mean nursing competency score between the experimental group and the control groups at post-test. The mean cognitive load score of the experimental group was lower than the control group at post-test. The mean learning satisfaction scores of the experimental group were higher than the control group.

CONCLUSIONS

This article provides that outcome-based concept mapping as educational method could encourage a group of nursing students to take a bio-psycho-social approach to medicine, which might ultimately result in better nursing care quality.

The impact of structural empowerment and psychological capital on competence among Chinese baccalaureate nursing students: A questionnaire survey

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.

Exploring the environment of clinical baccalaureate nursing students' education in Iran; A qualitative descriptive study

INTRODUCTION

Today's students are the nurses of tomorrow. They need appropriate clinical learning opportunities in order to shape their professional identity, attitudes and values. Despite undeniable progresses of nursing education in Iran, the quality of the clinical education in Iran is not favorable. There is a need to explore the environment of clinical baccalaureate nursing students' education for developing, maintaining and enhancing the quality of clinical program.

METHOD

This is a qualitative study and was conducted based on content analysis multimethod design. Data were collected by individual interviews, focus groups and direct observations. 54 nursing students and 8 clinical educators from the four geographically diverse universities in the Iran composed the study sample. A purposive sampling was used.

RESULT

Five themes were emerged from data analysis including; ambiguity in the nursing care role, routine-based nursing care, uncritical and dependent thinking climate, incompetency of clinical educators and patient education as important component of nursing.

CONCLUSIONS

The findings of this study describe a clearer understanding of the real environment of the clinical education in Iran. All of themes that emerged from the study play an important role in student learning and nursing education. It is crucial to pay more attention to reconsider care concept as an operational component of nursing, maximize meaningful learning opportunities, reevaluate clinical instructor as role models and prepare effective operational plan to combine theoretical and evidence based knowledge with clinical practice.

The influence of critical thinking skills on performance and progression in a pre-registration nursing program

BACKGROUND

The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression.

AIM

The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression.

METHOD

This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined.

RESULTS

There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance.

CONCLUSION

Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success and as such can inform curriculum development and selection strategies.

A longitudınal study on the effect of tailored training and counseling on the professional attitude of nursing students

The development of professional attitudes in nursing students is influenced by their learning experiences (knowledge, skills, and attitudes) and instructors' professional behaviors. Instructors can enhance students' professional attitude by organizing the training environment, being a role model, and providing counseling. This study was conducted as a tailoring intervention study over 4 years (2010-2013) examining 73 nursing students (34 intervention, 39 control) to determine the effect of training and counseling on nursing students' professional attitudes. Data were collected utilizing the Introductory Characteristics Form and the Instrument of Professional Attitude for Student Nurses. Intervention group students were provided training and counseling complementing their current education to develop their professional attitudes. Controls proceeded with their current education. Instrument for Professional Attitude for Student Nurses posttest scores of the intervention group were significantly higher than those of control group students. Furthermore, intervention group scores on all subscales other than "competence and continuous education" significantly increased after training. Controls showed no growth in professional attitudes, other than in "contribution to scientific knowledge." The training and counseling program had a positive influence on the professional attitudes of nursing students. Thus, providing tailored training and counseling associated to professionalism throughout the educational process at schools providing nursing training is recommended.

A core competency model for Chinese baccalaureate nursing graduates: a descriptive correlational study in Beijing

BACKGROUND

A review of the literature showed that the core competencies needed by newly graduated Chinese nurses were not as of yet undocumented.

OBJECTIVE

To develop a psychometrically sound instrument for identifying and measuring the core competencies needed by Chinese nursing baccalaureate graduates.

DESIGN

Descriptive correlational and multicentre study.

SETTING

Seven major tertiary teaching hospitals and three major medical universities in Beijing.

PARTICIPANTS

790 subjects, including patients, nursing faculty members, doctors and nurses.

METHOD

A reliable and valid self-report instrument, consisting of 58 items, was developed using multiple methods. It was then distributed to 790 subjects to measure nursing competency in a broader Chinese context. The psychometric characteristics of reliability and validity were supported by descriptive and inferential analyses.

RESULTS

The final instrument consists of six dimensions with 47 items. The content validity index was 0.90. The overall scale reliability was 0.97 with dimensions range from 0.87 to 0.94. Six domains of core competencies were identified: professionalism; direct care; support and communication; application of professional knowledge; personal traits; and critical thinking and innovation.

CONCLUSION

The findings of this study provide valuable evidence for a psychometrically sound measurement tool, as well as for competency-based nursing curriculum reform.