Self-assessed level of competence of graduating nursing students and factors related to it

The mediating role of pediatric nursing competence in the relationship between pediatric drug administration self-efficacy and medical error tendency in nursing students

AIM

This study was conducted to determine the mediating role of pediatric nursing competence in the relationship between self-efficacy in pediatric drug administration and medical error tendency in nursing students.

BACKGROUND

The self-efficacy of nursing students towards drug administration knowledge and practices is one of the determinants of achieving the goals of nursing education programs related to drug administration.

DESIGN

The sample of the descriptive and correlational study consisted of a total of 303 3rd and 4th-year students taking the Pediatric Health and Diseases Nursing course at the Department of Nursing. Data were collected using the Pediatric Nursing Competency Scale (PNCS), the Medication Administration Self-Efficacy Scale in Children for Nursing Students (MASSC) and the Medical Errors Tendency Scale (METS). Pearson correlation analysis, linear regression analysis, independent groups t-test, one-way analysis of variance (ANOVA) and post hoc (Tukey, LSD) test were used to analyze the data. In addition, hierarchical regression analyses regarding the mediation effect were performed using PROCESS Model 4 developed by Hayes (2013) for SPSS.

RESULTS

When the correlation levels between the total scores of MASSC, PNSC and METS were analyzed, a positive moderate correlation was found between PNSC and MASSC total scores, a positive weak correlation was found between METS and MASSC total scores and a positive weak correlation was found between METS and PNSC total scores (p<0.05). As a result of the analysis, the model was found to be significant and the total change in METS was explained by 17.3 % of the total change in METS (F=63.289;p=0.000). It was found that PNSC was a partial mediator variable between MASSC and METS.

CONCLUSION

As a result of the study, it was determined that pediatric nursing competence had a partial mediating role in the relationship between pediatric drug administration self-efficacy and medical error tendency in nursing students.

The effect of case-based teaching method on professional competence and clinical decision-making levels of public health nursing students: A sequential explanatory mixed-methods study

OBJECTIVES

To evaluate the effect of case-based teaching method applied to fourth year nursing students on their professional competence and clinical decision-making levels.

DESIGN

A quasi-experimental design study with a sequential-exploratory mixed-method approach.

SAMPLE

64 nursing students enrolled in the Public Health Nursing course.

METHODS

A case-based teaching program was applied to the students that cover the topics of the Public Health Nursing course. Quantitative phase data were collected with the Clinical Decision Making in Nursing Scale and Nursing Students' Competence Scale. For the qualitative part, focus group interviews were conducted with a Structured Interview Form.

RESULTS

It was determined that the total and subscale posttest scores of the students increased significantly compared to their pretest scores (p < .001). A moderate positive correlation was found between the total scores received from the scale and a significant positive correlation was found between researching information and adopting new information impartially and all sub-dimensions except care (p < .05). Three main themes emerged from the focus group interviews conducted after the case-based teaching method experience: usefulness, limitations, and improvement.

CONCLUSIONS

Case-based teaching method is effective on students' professional competence and clinical decision-making scores. Students' professional competence levels positively affect their clinical decision-making levels.

Psychometric Validation of the Nursing Professional Competence Scale Among Italian Nurses and Albanian Nursing Students

Background and Purpose: The main aim of this study has been the psychometric validation of an Italian translation of the Nurse Professional Competence Scale-Short Form (I-NPCS-SF), testing its validity and reliability. Methods: A multiphase design was used for the I-NPCS-SF translation and psychometric validation: (a) cultural and linguistic validation, (b) content and face validity, and (c) construct validity. Results: The I-NPCS-SF showed adequate linguistic translation, cultural adaptation, and content validity. Confirmatory factor analysis supported a four-factor structure of the I-NPCS-SF, in explaining data obtained from nurses and nursing students. Conclusions: The I-NPCS-SF demonstrated evidence of validity and reliability in measuring four professional competencies. Having an appropriate tool to be applied in the Italian context for professional competence self-assessment constitutes an essential step in measuring professional competencies.

Self-Perceived Clinical Competence of Nurses in Different Working Experiences: A Cross-Sectional Study

BACKGROUND

Competence is an essential concept for measuring nurses' performance in terms of effectiveness and quality. To this end, our analysis highlighted the process of acquiring competencies, their self-evaluation into clinical practice, and how their proficiency levels change throughout the nursing career. In detail, this research explored nurses' perceived level of competence and the factors that influence it in different contexts.

METHODS

A cross-sectional survey using a structured questionnaire to assess the nursing participants' perception of their competencies in different clinical settings was accomplished.

RESULTS

A descriptive and bivariate analysis was performed on 431 nurses. Most respondents assessed their level of competence to be higher than their roles required. The Kruskal-Wallis test confirmed that nursing experience was a relevant factor influencing nursing competencies.

CONCLUSIONS

We suggest improving the competence of practicing nurses, using experience as a measurable effect of their development.

Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak

BACKGROUND

Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic.

METHODS

We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered.

RESULTS

The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic.

CONCLUSION

The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Self-assessed competence of final-year nursing students

AIM

To examine the overall level of self-assessed competence of final-year nursing 'bachelors' degree students in the Czech Republic. In addition, the study aimed at the factors associated with the students' level of competence.

DESIGN

A cross-sectional observational study.

METHODS

Data were collected with the Czech version of the Nurse Competence Scale from 274 final-year nursing students of the bachelor's nursing program. Data were analysed using descriptive statistics and multiple regression analyses.

RESULTS

Majority of the students (80.3%) assessed their level of competence as good or very good. The highest level of competence was assessed in the category of 'managing situations' (VAS mean 67.8) and 'work role' (VAS mean 67.2). Previous work experience in healthcare and successful supervisory experience had a positive association with self-assessed competence. Students who completed clinical placement during the COVID-19 pandemic assessed their level of competence as lower than students before the pandemic. No Patient or Public Contribution.

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.

New graduate registered nurses' professional competence and the impact of preceptors' education intervention: a quasi-experimental longitudinal intervention study

AIMS AND OBJECTIVES

The aim of this quasi-experimental longitudinal intervention study was to investigate new graduate nurses' professional competence development after preceptors' participation in an education intervention.

BACKGROUND

New graduate registered nurses are expected to be competent in many areas of nursing. Expectations that are sometimes unrealistic may cause a sense of inadequacy and stress, and this may in turn prevent them from fully deploying their competencies. Competence development is related to practice environment, occupational commitment, empowerment, and work experience. Orientation or transition programs have been designed to ensure new graduate nurses' competence, and preceptors and preceptorship could also have significant influence on their competence development.

DESIGN

A quasi-experimental longitudinal intervention study.

METHODS

The data was collected from October 2015 to November 2017. Participating wards were randomized into intervention and control groups. The intervention group preceptors had an eight-hour education intervention that focused on new employees' orientation, particularly from new graduates' point of view. Wards in the control group continued to precept as before. The Nurse Competence Scale was used for new graduates' self-assessment at baseline and at three-month and nine-month follow-up. This study is reported in accordance with the TREND Statement Checklist.

RESULTS

The education intervention aimed at preceptors did not have impact on the intervention group NGRNs' competence development. There were no statistically significant differences between the groups and effect size remained small.

CONCLUSIONS

The preceptors' education intervention was not effective enough to develop new graduates' professional competence so that it would have differed from that of the graduates receiving conventional orientation at the university hospital. This study confirmed that competence development is a complex and multidimensional phenomenon and organizations should invest in new graduate registered nurses' competence development during their early career. Preceptors' education and development of preceptorship and transition programs are an important part of overall competence development in complex health care environments.

TRIAL REGISTRATION

Retrospectively registered.

Experiences of socialization in clinical education among Indonesian nursing students: A phenomenology study

BACKGROUND

Professional socialization is an essential process of the nursing profession to internalize the values into behavior, resulting in professional identity. However, research into students' experience of professional socialization in clinical nursing education remains limited.

AIM

To explore Bachelor nursing students' (NS) experience of professional socialization in clinical education in Indonesia.

DESIGN

This study used a descriptive phenomenology qualitative approach. Four sessions of focus group discussions (FGD) were conducted with ten final-year NS from five teaching hospitals using the purposive sampling technique. Data were analyzed using Colaizzi methods and NVivo 12 Plus.

RESULTS

The analysis identified two themes and four-subthemes in this study. The first theme is the facilitators of the socialization experience, consisting of "being a professional nurse" and "Islamic culture". The second theme hinders the socialization experience, including "inadequacy of socialization" and "nurses' unprofessional behavior."

CONCLUSION

Bachelor NS experience is challenging in Indonesia in both a positive and negative way, which facilitates or hinders professional socialization. Thus, the role of a nurse educator in establishing a comprehensive professional socialization program for new NS to assist their transition from the academic setting into clinical education needs to be reassessed.

Advanced nursing practice and interprofessional dementia care (InDePendent): study protocol for a multi-center, cluster-randomized, controlled, interventional trial

Background

A redistribution of tasks between specialized nurses and primary care physicians, i.e., models of advanced nursing practice, has the potential to improve the treatment and care of the growing number of people with dementia (PwD). Especially in rural areas with limited access to primary care physicians and specialists, these models might improve PwD’s quality of life and well-being. However, such care models are not available in Germany in regular healthcare. This study examines the acceptance, safety, efficacy, and health economic efficiency of an advanced nursing practice model for PwD in the primary care setting in Germany.

Methods

InDePendent is a two-arm, multi-center, cluster-randomized controlled intervention study. Inclusion criteria are age ≥70 years, cognitively impaired (DemTect ≤8) or formally diagnosed with dementia, and living in the own home. Patients will be recruited by general practitioners or specialists. Randomization is carried out at the physicians’ level in a ratio of 1:2 (intervention vs. waiting-control group). After study inclusion, all participants will receive a baseline assessment and a follow-up assessment after 6 months. Patients of the intervention group will receive advanced dementia care management for 6 months, carried out by specialized nurses, who will conduct certain tasks, usually carried out by primary care physicians. This includes a standardized assessment of the patients’ unmet needs, the generation and implementation of an individualized care plan to address the patients’ needs in close coordination with the GP. PwD in the waiting-control group will receive routine care for 6 months and subsequently become part of the intervention group. The primary outcome is the number of unmet needs after 6 months measured by the Camberwell Assessment of Need for the Elderly (CANE). The primary analysis after 6 months is carried out using multilevel models and will be based on the intention-to-treat principle. Secondary outcomes are quality of life, caregiver burden, acceptance, and cost-effectiveness. In total, n=465 participants are needed to assess significant differences in the number of unmet needs between the intervention and control groups.

Discussion

The study will provide evidence about the acceptance, efficacy, and cost-effectiveness of an innovative interprofessional concept based on advanced nursing care. Results will contribute to the implementation of such models in the German healthcare system. The goal is to improve the current treatment and care situation for PwD and their caregivers and to expand nursing roles.

Trial registration

ClinicalTrials.gov NCT04741932. Registered on 2 February 2021.

Graduating nurse students' interest in older people nursing-A cross-sectional survey in six European countries

BACKGROUND

Countries vary in the number of qualified nurses employed in older adult services. Moreover, students' views of older people nursing as a career differ internationally. Studying future nurses and their career intentions for the field is warranted to meet the increased nurse workforce expectations in terms of quantity and competence.

AIM

To analyse graduating nurse students' interest in older people nursing and the factors associated with it.

METHODS

A cross-sectional multicountry survey design was applied. Data were collected between May 2018 and March 2019 from several educational institutions in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Non-probability convenience sampling was used to recruit graduating nurse students (n = 1796). The data were collected with a structured questionnaire comprising background factors and the Willingness sub-scale (six items) of the Students' Interest in Nursing Older People Scale. Data were analysed using a linear mixed model including relevant background variables.

RESULTS

Overall, students' interest in older people nursing was low (score 20.5, on a 0-100 scale). Among the studied countries, Spanish students scored the highest (38.8) and German students the lowest (3.6). Students' interest in older people nursing was associated with country (p < .001), the length of work experience (p = .006), plans for further study (p = .007), competence (p < .001) and the extent that nursing is valued by society (p < .001). The students who were most interested in older people nursing had higher self-reported competence level (p < .001).

CONCLUSION

In the studied sample of future nurse professionals, interest in older people nursing is low at a time when the field suffers from workforce shortage. As for quality workforce, it was promising that the students who considered working in the field also evaluated themselves as competent.

IMPLICATIONS FOR PRACTICE

Multidimensional actions are required to promote interest in the field, including continued development of competence in both undergraduate education and workplaces, and investing in various career pathways to envisage potential opportunities.

Final clinical practicum shapes the transition experience and occupational commitment of newly graduated nurses in Europe-A longitudinal study

Aims

The aim of the study was to examine the association between the characteristics of a nursing student’s final clinical practicum and the success of transition of newly graduated nurses (NGNs) in six European countries.

Design

A longitudinal design with two data collections points (pre‐ and post‐graduate).

Methods

The data were collected with an online survey between May 2018 and April 2020 from graduating nursing students (n = 1796) in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Altogether, 642 NGNs responded to the second questionnaire 1 year after graduation. Logistic and linear regression analyses were used to examine the associations between five clinical practicum characteristics and three indicators for the success of transition (ease of transition, turnover intentions and occupational commitment). Models were adjusted for demographic and background/workplace factors and professional competence.

Results

Several associations were observed between the different clinical practicum characteristics and the indicators for a successful transition. Good pedagogical atmosphere and good supervisory relationship were associated with higher likelihood of an easy transition. Good leadership style of the ward manager, good premises of nursing care on the ward and a good supervisory relationship were associated with higher occupational commitment. No consistent association with turnover intention was found.

Conclusion

Having a good final clinical practicum before graduation can contribute to an easier transition experience for newly NGNs and strengthen their commitment to the nursing profession.

Impact

This study adds to the limited existing knowledge about the importance of final clinical practicums in shaping the transition process and occupational commitment of NGNs. Investing in creating a good final practicum experience could help healthcare organizations engage new nursing professionals and thus alleviate the existing shortage of nurses.

Nurse educators' perceptions of factors related to the competence of graduating nursing students

BACKGROUND

Clinical practice, clinical nursing teaching, curricula, working experience and previous healthcare degrees are factors related to the competence of graduating nursing students from the points of view of nursing students and clinical mentors. However, nurse educators' perceptions of these factors are lacking in previous studies, despite assessing student performance and competence is a core competence and one of the main duties of nurse educators.

OBJECTIVES

The aim of this study was to describe nurse educators' perceptions of factors related to graduating nursing students' competence.

DESIGN

The study was conducted using a descriptive qualitative approach utilising focus group interviews in data collection.

PARTICIPANTS

A purposive sample consisting of 23 volunteer nurse educators from five Finnish universities of applied sciences took part in seven group interviews.

METHODS

Data was collected in guided, semi-structured interviews, based on a literature review of previous studies. The data was analysed using a deductive-inductive content analysis.

RESULTS

According to nurse educators, six main categories describing factors related to graduating nursing students' competence were found: (1) commitment to the nursing profession, (2) experiences in healthcare, (3) learning abilities, (4) learning environments, (5) student characteristics and (6) the nurse educator's role.

CONCLUSIONS

To ensure the adequate competence of the graduating nursing students, students' commitment to the nursing profession and their learning abilities and should be supported, and the quality of the learning environments, especially those of study groups and successful clinical practices, should be ensured during the education.

The level of competence of graduating nursing students in 10 European countries-Comparison between countries

AIM

To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career.

DESIGN

An international cross-sectional evaluative design.

METHODS

Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically.

RESULTS

In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.

Clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students

Evaluation and cultivation of clinical competence in undergraduate nursing students are essential in nursing education. Self-efficacy and good clinical learning environments are expected to have a positive influence on the clinical competence of undergraduate nursing students, but few studies have focused on the relationships among clinical competence, self-efficacy, and clinical learning environments. This study aimed to examine clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students. A cross-sectional questionnaire survey was conducted with 1518 undergraduate nursing students being recruited from five medical colleges in China. The nursing students' clinical competence, self-efficacy, and clinical learning environments were assessed using a set of self-reported questionnaires, including Chinese versions of the Holistic Clinical Assessment Tool; General Self-Efficacy Scale; and Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale. Factors significantly associated with the clinical competence of undergraduate nursing students were professional interest, self-efficacy, and clinical learning environments, accounting for 36.1% of the total variance. Self-efficacy played a mediating role between clinical learning environments and clinical competence. The results of this study can be applied as reference for the enhancement of a nursing education program to improve the clinical competence of Chinese undergraduate nursing students.

Psychometric properties of the clinical learning environment, Supervision and Nurse Teacher scale (CLES+T) for undergraduate nursing students in Hong Kong

The Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale is useful for understanding students' perceptions towards clinical placement and for measuring the quality of clinical education. Validated versions of the scale are only available for Western countries. Therefore, this study aimed to establish the validity and reliability of the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale for undergraduate nursing students in Hong Kong. Six experts including clinical mentors, clinical teachers, advanced practice nurse and nursing students participated in phase 1. Fifteen nursing students participated in phase 2 and 178 nursing students participated in phase 3 of this study during January 2017 to June 2017. The Scale-Content Validity Index was 0.93 and the Item-Content Validity indexes ranged from 0.83 to 1. Exploratory factor analysis indicated a 6-factor solution (i.e. "supervisory relationship", "role of nurse teacher", "leadership style of ward manager", "premises of nursing on the ward appreciated", "interaction with staff" and "learning atmosphere"). The internal consistency was good (Cronbach's alpha = 0.94) and test-retest reliability over a 2-week interval was satisfactory (Pearson's coefficient = 0.85). The Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale showed acceptable psychometric properties for use as an evaluation scale in Hong Kong.

Clinical learning environment and graduating nursing students' competence: A multi-country cross-sectional study

The purpose of this study was to explore nursing students' perceptions of their final clinical learning environment and its association with their self-assessed competence, satisfaction with nursing education, and turnover intentions at graduation in six European countries. A multi-country comparative cross-sectional study was conducted with nursing students (n = 1746) from the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain using the Nurse Competence Scale and the Clinical Learning Environment and Supervision scale. Nursing students' overall perceptions of their final clinical learning environment and supervision were positive in all the countries studied. The correlation between the students' perceptions of their final clinical learning environment and competence was statistically significant and positive. Satisfaction with the nursing program and clinical practicum and no consideration of career change were related to positive perceptions of the final clinical learning environment. Highlighting the importance of the supervisory relationship and pedagogical atmosphere, nursing students' positive perceptions of the final clinical learning environment and supervision contribute to a better level of self-assessed competence and satisfaction with the nursing program and clinical practicum, leading to lower turnover intentions.

The development and testing of the C/WoundComp instrument for assessing chronic wound-care competence in student nurses and podiatrists

The purpose of this study was to describe the level of chronic wound-care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.

Clinical competence in nursing: A hybrid concept analysis

BACKGROUND

Clinical competence (CC) is central issue in nursing. There are some controversies about this concept that needs further investigation. The present study was conducted to analyze the concept of clinical competence in nursing.

METHODS

This concept analysis was conducted using the three-phase hybrid model. In the theoretical phase, the Science Direct, PubMed, CINAHL, ProQuest, Scopus, Web of Science, SID, Iranmedex, and Magiran databases were searched to retrieve articles published from 2000 to 2020. Forty two eligible articles were included and analyzed. In the fieldwork phase, semi-structured interviews were held with eighteen university lecturers, clinical instructors, students, and hospital nurses and the data were analyzed through conventional content analysis. In the final analytic phase, the findings of the first and the second phases were combined.

RESULTS

The majority of literature defined CC in nursing as a combination of knowledge, and skills, and attitudes that is consistent with those of the fieldwork phase. Most participants in fieldwork stated that gaining CC is a process that is achieved over time through practice and repetition and increasing experience. A nurse needs to acquire personal, social and professional competencies during the study and work period. The CC has antecedents of efficient education, and organizational support. It also has consequences for patients and nurses such as satisfaction, and quality care.

CONCLUSION

CC is a continuous process of obtaining knowledge, values, and attitudes, and skills such as critical thinking skills that brings creativity and innovation in nursing practice.

Nursing Students' Satisfaction: A Comparison between Medium- and High-Fidelity Simulation Training

Training based on clinical simulation is an effective method of teaching in nursing. Nevertheless, there is no clear evidence about if it is better to use high- or medium-fidelity simulation. The aim is to analyse if students are more satisfied when their clinical simulation practices are based on high-fidelity simulation (HFS) or medium-fidelity simulation (MFS). Students´ satisfaction was assessed using the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation. The sample is composed of 393 students from two Spanish Universities. Satisfaction with simulation in nursing students is significantly greater in MFS than HFS. Simulation is beneficial for learning in all its forms, but for the acquisition of basic skills, and at a lower cost, MFS proves to be effective. However, high-fidelity is not always better than medium-fidelity as this depends on the student’s level of knowledge and clinical experience.

Dual use of instruments for assessing nursing students professional- and clinical competence

BACKGROUND

Changes in demographics and the development of health systems have a direct impact on patients' nursing needs and nurses' ability to meet them. Modern and forward-looking nursing education programmes that will help nursing students to develop their professional competence require useful tools for assessment and self-reflection that can be combined in theoretical and clinical education.

OBJECTIVES

To investigate the associations between the Nurse Professional Competence Scale - Short Form (NPC-SF), and the tool Assessment of Clinical Education (AssCE) tool, and to assess the graduating students´ professional competence based on their self-assessment.

DESIGN

A cross-sectional descriptive study design was used.

PARTICIPANTS AND SETTINGS

A total of 151 nursing students at a Swedish university college completed the NPC-SF and the AssCE (response rate 77%).

METHODS

In their final weeks of the nursing programme, students were invited to respond to two questionnaires: the NPC Scale - Short Form (35 items) and the AssCE tool (21 items).

RESULT

There are significant correlations between the nursing students' responses to the NPC-SF competence areas and the AssCE areas (r = 0.19-0.57). Students score in the NPC-SF were highest in Value-based Nursing Care and lowest in Development, Leadership and Organization of Nursing Care, and in the AssCE areas student scores were highest in Examination and treatment and Professional Approach and lowest in Management and Cooperation.

CONCLUSION

The NPC-SF and AssCE are valid and reliable instruments, showing a high level of correlation. Results imply that dual use could strengthen student-centred theoretical and clinical learning as well as professional competence development. Additional research is needed to assess student's competence development during the nursing program.

Hemşirelik Son Sınıf Öğrencilerinin Mesleğe Hazir Bulunuşluklari Ve Etkileyen Faktörler: Doğu Karadeniz Bölgesi Örneği

Objectives: This study aims to examine the readiness of final year nursing students for their profession and the affecting factors.Method: The population of this descriptive study consisted of 440 final year nursing students at five different universities in Turkey's Eastern Black Sea Region. The sample consisted of 313 students. The data were gathered between January and February, 2015. The researchers prepared and used a questionnaire form in line with the literature to collect the data. The data were evaluated with SPSS 20.0 statistical software using descriptive statistics, the chi-square test and binary logistic regression.Results: Of the students, 56.2% said that they were ready for the profession. There were statistically significant correlations between students' readiness for the profession and their having selected the profession willingly, being happy to have selected the profession, feeling safe in the profession, self-efficacy for the profession, feeling anxiety concerning working life and thoughts about nursing (p&lt;0.05). There is statistically significant correlation between students' readiness for nursing and their finding practical training adequate in undergraduate study (p&lt;0.05).Conclusion: This study found that half of the students were ready for the profession. Their having selected the profession willingly, being happy to have selected the profession, self-efficacy for the profession and feeling anxiety concerning working life were predictor variables for readiness.

Attitudes towards advanced nursing roles in primary dementia care - Results of an observational study in Germany

AIMS

To demonstrate the attitudes of general practitioners (GPs), nurses, persons with dementia, and caregiver towards suitable tasks and qualification needs for and the acceptance and impact of advanced nursing roles in German dementia primary care.

DESIGN

Observational study using a questionnaire survey with 225 GPs, 232 nurses, 211 persons with dementia, and 197 caregivers, conducted between December 2017-August 2018.

METHODS

A questionnaire was generated that includes specific assessment, prescription, and monitoring tasks of advanced nursing roles in dementia primary care as well as qualification requirements for and the acceptance and the impact of advanced nursing roles. Data were analysed using descriptive statistics. Group differences were assessed using the Fisher's exact test.

RESULTS

Advanced nursing roles were highly appreciated across all groups. Assessment and monitoring tasks were rated as highly suitable, and prescription authorities as moderately suitable. Nurses felt less confident in assessment and monitoring, but more confident in prescribing as practitioners expected. Patients and caregivers would appreciate a takeover of tasks by nurses; nurses and practitioners preferred a delegation. A dementia-specific qualification was rated as best suitable for advanced nursing roles, followed by 'no specific qualification' if medical tasks that only can be carried out by practitioners were delegated and an academic degree if tasks were substituted. Advanced nursing roles were rated as beneficial, strengthening the confidence in nursing care and improving the cooperation between professionals and the treatment. Practitioners assumed that advanced nursing roles would improve job satisfaction of nurses, which was not confirmed by nurses.

CONCLUSION

There is an extended consensus towards the enlargement of advanced nursing roles, represented by high endorsement, acceptance, and willingness to reorganize tasks.

IMPACT

Results debunk the common notion that German practitioners would be reluctant towards advanced nursing roles and a takeover of current practitioner tasks, supporting the implementation of advanced nursing roles in Germany.

Nursing student-patient relationship - a 10-year comparison study in Finland

Objective This study aimed to describe and compare the group-level findings from 2005-2006 and 2015-2016 regarding students' and patients' views of the nursing student-patient relationship and associated factors. Methods The data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically. Results In both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship. Conclusion In order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.

Knowledge of patient observation among critical care nurses

BACKGROUND

The clinical observations made by critical care nurses are vital for maintaining patient safety and making appropriate decisions in the care of patients who are critically ill. Evaluating the reliability of observations and applying analytical thinking are essential elements of patient observation. Previous studies of critical care nurses' knowledge have focused either on specific aspects of patient observation or on critical care nursing in general; therefore, the findings are not comprehensive.

AIM

The aim of this study was to evaluate critical care nurses' level of knowledge in patient observation and to explore the factors that are associated with it.

STUDY DESIGN

A cross-sectional knowledge test survey with critical care nurses in Finland was used.

METHODS

Data were collected in seven adult intensive care units in all five university hospitals in Finland between September 2017 and January 2018 by using a knowledge test (20 items) developed for this study. All critical care nurses were eligible to participate. The data were analysed using descriptive and inferential statistics.

RESULTS

Altogether, 372 nurses responded (response rate 49%). Their average scores in the knowledge test were 77% (mean 15.29/20, SD 2.41) for correct answers, 75% (mean 8.2/11, SD 1.54) in the sum-variable "Evaluating the reliability of observation" and 79% (mean 7.08, SD 1.45) for "Analytical thinking." A higher knowledge level was associated with education in special tasks in an intensive care unit.

CONCLUSION

The critical care nurses' knowledge level was considered to be suboptimal. There is a need for improving knowledge of patient observation among Finnish critical care nurses to ensure safe and good quality care.

RELEVANCE TO CLINICAL PRACTICE

Finnish critical care nurses' knowledge of patient observation could be improved by providing specific continuing education for new nurses entering intensive care units and for experienced critical care nurses throughout their career.

Anaesthesia nursing competence: Self-assessment of nursing students

BACKGROUND

The importance of competence assessment in anaesthesia nursing education has increased since nurse educators and anaesthesia care employers have identified the gap between nursing education and nursing practice. In order to ensure nursing students' preparedness for entry into anaesthesia nursing practice, it is necessary to measure whether nursing students have achieved the required competence to practice as anaesthesia care providers.

OBJECTIVES

To assess the anaesthesia nursing competence of nursing students and to describe factors related to their anaesthesia nursing competence. This study will provide new knowledge to support the curricula of nursing education and new nurses' practice in anaesthesia care.

DESIGN

Cross-sectional survey design.

METHODS

Data from a sample of Finnish nursing students (n = 205) were collected by using an on-line/paper and pencil survey (the Anaesthesia Nursing Competence Scale, 7 categories) in 2017. The assessment was based on self-assessment and used a Visual Analogue Scale (0-100). Descriptive statistics, a Pearson correlation coefficient, independent sample t-tests and a multivariable regression were used to analyse the data.

RESULTS

The self-assessed overall competence of graduating nursing students was 59 (range 43-73). Approximately half of the students reached an acceptable level (60≤) and half did not. The highest self-assessed category was collaboration within patient care, and the lowest was knowledge of anaesthesia patient care. The number of credits, anaesthesia courses, and experience of clinical practice in anaesthesia nursing were significantly related to anaesthesia nursing competence.

CONCLUSIONS

Competence development in the knowledge of anaesthesia patient care should be considered in general nursing education. Student nurses' competence could be developed by providing more opportunities for theoretical studies and clinical practice in anaesthesia nursing. A specialised post-registration education in anaesthesia nursing might be one solution to overcome the limitations in the competence that general nursing education is not fully able to cover for anaesthesia nursing.

Analysis of graduating nursing students' moral courage in six European countries

Background:

Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career.

Aim:

To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries.

Research design:

A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0–100), the questionnaire also covered several background variables.

Participants and research context:

The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires.

Ethical considerations:

Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent.

Results:

The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves.

Discussion and conclusions:

In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.

Clinical Practice Competence of Mettu University Nursing Students: A Cross-Sectional Study

INTRODUCTION

Clinical practice competence is the ability to effectively integrate cognitive, affective and psychomotor skills during the delivery of health care. It is the concern and the center of attention for the managers, professional associations, government, and society as a whole. Therefore, identifying the level of clinical practice competence of students and taking appropriate action is crucial. The aim of the present study was to investigate clinical practice competence of nursing students in Mettu University.

METHODS

A cross-sectional study was employed on 105 nursing students at Mettu University from February to April, 2019. Systematic random sampling technique was used to select study participants. Data were entered into EpiData manager version 4.2.2 and exported to statistical package for the social science (SPSS) version 20.0 and analyzed using descriptive statistics, bivariate and multivariate logistic regressions. The statistical significance was set at p<0.05.

RESULTS

Out of the total participants involved, 102 participants returned the questionnaire making response rate of 97.1%. Majority 78 (76.5%) of participants were males with the mean age of 23.05 (SD = 1.11) years. The overall clinical practice competence of participants was 2.03 (SD = 0.54) which indicates clinical practice incompetence. Year of study [AOR 4.9; 95%, CI: 0.04, 16.53] and clinical practice placement [AOR: 2.7; 95% CI: 0.1, 14.86] were the identified associated factors of clinical practice competence at p<0.05.

CONCLUSION

Clinical practice competence of nursing students was inadequate to provide quality, safe and satisfying nursing care. This could not meet patients holistic needs and may even bringfear, stress, anxiety and unnecessary errors by students at clinical sites. Nursing schools and teaching hospitals should collaborate to enhance the nursing students clinical practice competence.

Nursing student-patient relationship and related factors-A self-assessment by nursing students

AIMS AND OBJECTIVES

To describe the nursing student-patient relationship in terms of three types of relationships-mechanistic, authoritative and facilitative-and analyse the factors related to the type of relationship.

BACKGROUND

As future professionals, nursing students have a central role in facilitating patient autonomy while working in partnership with patients. Supporting student-patient relationship throughout the nursing education may result in positive outcomes for both students and patients.

DESIGN

A cross-sectional study.

METHODS

The data were collected from a convenience sample of Finnish nursing students using a structured web survey. Statistical data analysis was performed using chi-square test, two-sample t test, one-way analysis of variance and multinomial logistic regression. The STROBE Statement - Checklist for cross-sectional studies was used (Appendix S1).

RESULTS

Students most often assessed their relationship with the patients as facilitative, followed by authoritative and mechanistic relationships. The results revealed three predictors for facilitative relationship: students' older age, long enough contact time with the patient and higher competence in ensuring quality. In authoritative and facilitative relationships, students had significantly more positive perceptions of the contextual factors and consequences of the relationship and higher ratings of self-assessed competence levels than students in a mechanistic relationship.

CONCLUSIONS

It seems that the facilitative student-patient relationship is connected to the professional competence of nursing students, especially in the area of ensuring the quality of patient care. Therefore, sustaining clinical learning environments and pedagogical approaches that value and support facilitative relationships in students' clinical learning should be enhanced.

RELEVANCE TO CLINICAL PRACTICE

Efforts aimed at contributing to facilitative student-patient relationships have a crucial role in shaping students' competency and in promoting high-quality patient care. Thus, supervision of students organised around establishing mutual student-patient relationships with the preceptors acting as facilitators will benefit both students and patients.

Developing and Evaluating the Psychometric Properties of the Pediatric Nursing Competency Scale for Nursing Students

Aim

This study aims to develop and evaluate the psychometric properties of the Pediatric Nursing Competency Scale for nursing students.

Methods

This study was conducted with 318 nursing students, including third-year students enrolled in a pediatric nursing course and fourth-year students completing a pediatric nursing internship. Factor analysis, Cronbach’s alpha, item-total score analysis, and known-groups comparison were used to assess the research data. In total, 16 items were eliminated from the scale on the basis of experts’ recommendations.

Results

The scale consisted of 39 items and 8 sub-scales. The 8 sub-scales exhibited 66.4% of the total variance. Both exploratory factor analysis and confirmatory factor analysis (CFA) revealed that all factor loads were greater than 0.40. The CFA also revealed that all of the fit indices were greater than 0.85, and the root mean square error of approximation was less than 0.08. Cronbach’s alpha was 0.96 for the entire scale, and greater than 0.80 for all sub-scales.

Conclusion

The Pediatric Nursing Competency Scale for nursing students was found to be valid and reliable.

Newly graduated registered nurses' self-assessed clinical competence and their need for further training

Aim

To explore and describe changes in self-assessed clinical competence and the need for further training among newly graduated Registered Nurses during their first 15 months of professional work in acute care hospital settings.

Design

Quantitative longitudinal design.

Methods

The 50-item Professional Nurse Self-Assessment Scale of clinical core competencies II was used. A total of 45 newly graduated Registered Nurses answered the questionnaire at four different occasions. Data were collected after 2, 5, 9 and 15 months of working experience.

Result

The components "ethical decision-making," "cooperation and consultation" and "clinical leadership" were rated highest in clinical competence and lowest in need for further training. The components "professional development" and "critical thinking" were rated lowest in clinical competence and "direct clinical practice" rated highest in need for further training. The clinical competence increased significant between 9-15 months, with the exception of "critical thinking" and need for further training decreased significantly between 9-15 months, with the exception of "critical thinking."

Performance competence of pregraduate nursing students and hospital nurses: A comparison study

AIMS AND OBJECTIVES

To compare and contrast the competence in clinical performance between pregraduate nursing students and hospital nurses. The study also explored the most difficult technical skills for the participants to perform.

BACKGROUND

Assessment, communication and critical thinking are competencies that help in providing safe and appropriate care for patients. Yet, self-perceived competence was mostly measured while performance competence that reflected nurses' performance in real cases has seldom been explored in literature.

DESIGN

A cross-sectional design was applied. The study adhered to the STROBE guidelines to improve reporting quality.

METHOD

Fifty-two nurses and 50 nursing students completed the Computerized Model of Performance-Based Measurement system, which measures performance competence including the steps of critical thinking, conflict resolutions and common clinical technical problems. Six case scenarios containing 107 test questions were completed.

RESULTS

Only 53.85% of nurses and 20.0% of students achieved a satisfactory level of performance competence. They showed low scores on the steps of critical thinking: "collecting data from on-site physical assessment," "processing information," "recognising/prioritising problems" and "arranging a course of action for patient care," as well as solving common technical problems and conflicts. The three most difficult skills to perform were CPR, reading EKGs and venipuncture/starting intravenous lines.

CONCLUSIONS

The study captured the participants' weaknesses in the critical thinking process and the nursing skills that were difficult to perform. These skills are imperative to nursing care and need to be strengthened in school and in-service education. The academic curriculum and course design for students as well as training programmes for nurses need to be reviewed to address the challenges to be faced in a clinical setting.

RELEVANCE TO CLINICAL PRACTICE

Teaching-learning strategies that focus on enhancing critical thinking and performing difficult skills need to be designed and implemented both in practice and in school.

A Comparison of Patient Safety Competencies between Clinical and Classroom Settings among Nursing Students

Background: As nurses play an important role in the implementation of patient safety in hospitals, competencies of patient safety should be developed and enhanced among nursing students. Self-assessment is a method that can be used to assess patient safety and its dimensions to help the students prepare themselves before entering the work life.Purpose: This study aimed to investigate differences in patient safety competencies between classroom and clinical settings among nursing students using a self-assessment method.Methods: A descriptive study using the Health Professional Education in Patient Safety Survey (H-PEPSS) questionnaire was conducted among 181 nursing students in a public university in Indonesia. Paired t-test, ANOVA, and independent t-test were performed to determine the comparison in the values of patient safety dimensions across classroom, clinical learning, and year of nursing course.Results: Nursing students showed a higher mean value in the classroom setting than the clinical setting. Out of the seven dimensions of patient safety competencies, “clinical safety” (M=4.36) and “communicate effectively” (M=4.29) obtained the highest score in classroom setting, while “adverse events” showed the lowest (M=4.03). In the clinical setting, “clinical safety” (M=4.19) and “communicate effectively” (M=4.12) obtained the highest score, while “working in teams” (M=3.82) was the lowest. The third-year students showed a better score than the fourth year in most dimensions.Conclusion: In this study, the patient safety competencies among nursing students were higher in the classroom setting than in the clinical setting. It is recommended to investigate the factors that can increase the achievement of patient safety competence among nursing student in the clinical setting.

[Nurses and Nursing Students' Recognition of Good Instruction]

PURPOSE

The purpose of this study was to identify and assess from nursing students and nurses in the clinical field what constitute good instruction, through the review of nursing students' opinions and clinical field demands.

METHODS

The study design was used Creswell's exploratory sequential design by collecting and analyzing qualitative data obtained from interviews and then analysis of quantitative data. The participations were 79 seniors in nursing schools and 85 nurses with less than three years of clinical experience. The data were collected through individual interviews and analyzed based on Elo and Kyngäs's content analysis method. The quantitative data were collected using the questionnaire developed based on qualitative results and analyzed by SPSS 23.0 program and Importance Performance Analysis (IPA).

RESULTS

The results showed that IPA extracted seven items with high importance but low satisfaction: "nursing fads and trends," "teacher-learner communication and reflection," "materials used in clinical settings such as monitoring results and test results," "special presentations by experienced practitioners," "instruction assures learners' comprehension," "accurate and detailed evaluation standards" and "feedback on homework and exam."

CONCLUSION

The factors comprising good instruction were verified, and the necessity for additional efforts to improve high importance and low performance factors was noted. Therefore, this study can serve as a guide for nursing education facilities and educators in developing of a thorough education system with excellent instruction designed to achieve an ideal nursing education.

Newly graduated nurses' clinical competencies and need for further training in acute care hospitals

AIM

To assess self-reported clinical competence and the need for further training among newly graduated registered nurses (NGRNs) working in Swedish acute care hospital settings.

BACKGROUND

NGRNs are expected to take full responsibility for patients' nursing care in an increasingly complex clinical context, and professional nurses' clinical competence is critical in providing high-quality and safe nursing care.

DESIGN

A cross-sectional design.

METHODS

Data were collected using the 50-item ProffNurse SAS II. A total of 85 NGRNs who had recently commenced working with direct patient care at three hospitals in central Sweden participated in the study. The response rate was 69%. The STROBE cross-sectional reporting guidelines were used.

RESULTS

The NGRNs assessed their clinical competence as being highest in areas relating to team collaboration and ethics and lowest in areas relating to professional development and direct clinical practice. The need for further training was greatest in areas such as direct clinical practice and patient safety and lowest in areas such as team collaborating and ethics.

CONCLUSION

The use of instruments to identify NGRNs' self-assessed clinical competence is of value when designing and evaluating introductory programmes for NGRNs taking on positions in acute care hospital settings. The availability of experienced nurses from whom NGRNs can gain clinical competence and learn from is of importance, both from the perspective of the NGRNs themselves and patient safety.

RELEVANCE TO CLINICAL PRACTICE

An understanding of NGRNs' clinical competence and their need for further training may assist in both planning and organising nursing programmes and in making clinical policy decisions when designing introduction programmes in acute care settings.

Students’ Self-assessed Competence Levels during Nursing Education Continuum – A Cross-sectional Survey

During nursing education, nursing students are required to develop their competence to be able to fulfill their duties safely as Registered Nurses. The aims of this study were to explore 1) nursing students’ self-assessed competence levels during education 2) the relationship with competence and frequency at which competencies are utilized in clinical practice, and 3) factors related to competence levels. 841 (response rate 67.6 %) nursing students responded to the Nurse Competence Scale in a cross-sectional study. The self-assessed overall competence levels were improving during the education continuum (VAS-means 1st 56.6; 2nd 58.3; 3rd 59.8 and 3.5th -year students 68.4). Every group revealed a significant positive correlation with competence and frequency at which competencies are utilized in clinical practice in clinical placement. Risk factors for low competence were also identified. Systematic multimethod competence evaluations with longitudinal designs are needed to monitor outcomes of nursing education.

Graduating student nurses' and student podiatrists' wound care competence: a cross-sectional study

OBJECTIVE

To explore and describe graduating student nurses' (SNs) and student podiatrists' (SPs) theoretical wound care competence, as well as students' own perceptions of their wound care competence and their opinions about the received wound care education.

METHOD

A descriptive cross-sectional design was used. Data were collected from five Finnish universities using a graduating SNs and SPs wound care competence (WCC) questionnaire, which included a wound care knowledge test and a wound care competence self-evaluation. Data were analysed statistically and with qualitative content analysis.

RESULTS

A total of 213 students (response rate: 86%) participated in the study. Of these, 194 were SNs and 19 SPs. Students answered 48% of the knowledge test questions correctly (SNs 46%, total score 14/29; SPs 60%, total score 13/22). SPs' wound care competence was statistically significantly higher (p<0.0001) than that of SNs. Both groups self-evaluated their wound care competence to be deficient. Students who had more practical training in wound care during practical training periods scored statistically significantly better in the knowledge test. Students showed a positive attitude towards wound care by expressing an interest in it and acknowledging its importance.

CONCLUSION

Graduating SNs' and SPs' theoretical wound care competence is limited. The results showed that more wound care education, especially practical training, is needed in SNs' and SPs' education curriculums to adequately respond to the increasing needs in wound care.

The awareness of contextual factors, placebo and nocebo effects among nursing students: Findings from a cross-sectional study

Contextual Factors (CFs) have been documented to influence nursing interventions and patients' outcomes triggering placebo/nocebo effects. However, given that no studies to date have explored the beliefs and the use of CFs among nursing students, a cross-sectional study was undertaken. Two Italian nursing programmes were involved and a self-administered survey tool was used. A total of 510 students participated. The majority (266; 52.2%) defined CFs as an intervention without a specific effect on the condition being treated, but with a possible nonspecific effect. They reported a substantial level of confidence in CFs and in using them more than twice/week in addition to nursing interventions to optimise clinical outcomes. Physiological and psychological therapeutic effects were mostly reported by participants in treating insomnia (n = 351; 68.8%) and chronic pain (n = 310; 60.8%). The use of CF was considered ethically acceptable when it exerted beneficial psychological effects (n = 188; 36.8%). Participants communicated to patients that a CF is a treatment that can help and will not hurt (n = 128; 25.1%). Students are aware of the value of CFs. Increasing their emphasis in nursing programmes can promote nursing students' consideration with regards to their use, their underlying mechanisms, their potential effects, as well as their ethical and comunicative implications.

Psychometric evaluation of the Nurse Competence Scale: A cross-sectional study

Measuring nurses' competence for practice is critical for quality and safety improvement in nursing care and patient outcomes. While the Nurse Competence Scale is a widely used international measure of the generic nursing competence of nurses in various career stages, it has not been used in Thailand. This study involved the forward-backward translation of the scale into Thai and evaluation of its psychometric properties with 571 nurses at one public and one private hospital in Chiang Mai, Thailand. Participants also completed a demographic form. The content validity analysis revealed that the item-level content validity index (I-CVI) was .90, and the scale-level content validity index (S-CVI/Average) was .91. The principal component analysis with varimax rotation demonstrated that the six factor structure accounted for 58.45% of the total variance. The Mann-Whitney U-test showed a significant difference between low and high work experience groups for all six factors, providing further support for the scale's construct validity. The reliability analysis showed an acceptable level of Cronbach's alphas in six factors ranging from .82 to .88. In conclusion, the Thai version demonstrated promising psychometric properties, but requires further testing with nurses in different settings before use in practice.

Leveling the core competencies of public health nursing to evaluate senior baccalaureate nursing students

OBJECTIVES

This study assessed a revised instrument based on the tier one Core Competencies for Public Health Nurses. Following instrument revision, the self-reported competence of prelicensure baccalaureate nursing students was examined.

DESIGN AND SAMPLE

In this descriptive study, 102 senior, prelicensure baccalaureate nursing students completed a revised Core Competencies instrument prior to and immediately following completion of public health nursing courses. Parametric statistics were used to determine if there were significant differences in pre- and postcourse domain scores and the impact of selected demographic variables on postcourse domain scores.

RESULTS

Pilot testing confirmed the reliability and validity of the revised instrument. A paired t test determined postcourse domain scores were significantly higher than precourse domain scores. Overall, students rated themselves as competent in all domains, with the lowest ratings of competence in policy development/program planning. Likelihood of choosing a future career in public health was significantly higher for students in traditional public health clinical settings.

CONCLUSION

The revised tier one Core Competency instrument provided information related to students' self-reported competence in public health nursing competencies. These findings provide valuable insight for development and revision of public health nursing courses ensuring a nursing workforce competent in the provision of population health.

The Nurse Professional Competence (NPC) Scale: A tool that can be used in national and international assessments of nursing education programmes

The quality of basic nursing bachelor programmes nationally and internationally must regularly be assessed to ensure that they fulfil requirements and are appropriate in relation to developments and changes in societies and healthcare systems. There is a need for instruments in helping to assess this. The aim of this study was to investigate whether the Nurse Professional Competence (NPC) Scale could serve as a tool to measure and detect possible differences between universities/university colleges regarding nursing students’ self-reported competence. Totally, 543 nursing students who had just completed their academic three-year nursing bachelor programmes at 10 universities/university colleges in Sweden participated in the study (response rate 71%). The students answered the NPC Scale with its 88 items constituting eight competence areas (CAs) and two overarching themes. The results from using the NPC Scale by the students were then compared between the 10 universities/university colleges. Significant mean score differences were found between the universities/university colleges on all CAs and on both themes. The highest mean score differences were found for the CAs ‘Medical and technical care’ and ‘Documentation and information technology’. The lowest mean score differences were found for the CAs ‘Value-based nursing care’ and ‘Leadership in and development of nursing’. It is concluded that the NPC Scale can serve as a useful tool in national and international assessments of nursing bachelor programmes.