Nursing student and professor perceptions and assessments of the achievement of practicum competencies: A mixed method approach

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.

Nursing students' self-assessed level of nursing skills at the time of graduation in a Japanese University: A retrospective observational study

Objective

This study aimed to clarify nursing students' self-assessed levels of nursing skills at a nursing university at graduation and discuss how education and clinical experiences for students and post-licensure nurses should be improved, especially focusing on oncology nursing.

Methods

The study population comprised fourth-year students from 2017 to 2019 at the Faculty of Health Science and Nursing, Juntendo University, who had completed all stipulated clinical placements. The Japanese government determined 141 nursing skills and their target levels. Students subjectively evaluated their achieved levels for the 141 nursing skills after the final clinical placement.

Results

Of the 141 nursing skills, 81 (57%) were rated as "skills with easy-to-achieve targets" and five were rated as "skills with difficult-to-achieve targets." All nursing skills in the two subcategories of environmental adjustment skills and comfort management skills were rated as "skills with easy-to-achieve targets." Nursing skills with low target achievement rates were for patients with oral intake difficulties, unstable respiratory status, and those requiring glycemic control. These skills are also important in oncology nursing.

Conclusions

It cannot be concluded that the nursing university students fully achieved the target levels of nursing skills, as determined by the Japanese government. These findings may facilitate discussions on teaching nursing skills and their target levels at the time of graduation from nursing universities or post-employment.

Improving Active Collaborative Clinical Learning Through a Mobile Application for Undergraduate Nursing Students

Innovative teaching and learning strategies in pediatric clinical education are needed to ensure that learning outcomes are achieved efficiently and to improve students' satisfaction with the learning process. We developed a mobile application to enhance the clinical learning of nursing students during pediatric clinical practice and explored the participants' perceptions of the learning method. A mixed-method design and an online survey were used to assess participants' perceived achievement of learning objectives and satisfaction with the clinical practicum. Focus groups explored the participants' experience of using the application. The overall achievement of learning outcomes was 4.1 out of 5, and participants reported high satisfaction with the clinical practicum using the mobile application. Qualitative analysis of the transcripts revealed four major themes: (1) facilitation of collaborative learning through real-time interactions and communication; (2) engagement in active learning through an application; (3) a useful tool for enhancing critical thinking; and (4) the "curate's egg" nature of the application. The mobile application can be incorporated into the clinical education of nursing students to promote self-regulated learning and collaboration with faculty. Clear guidance on how to use the application in a clinical environment should be provided to students and preceptors to achieve better learning outcomes.

Assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement. An integrative review

AIM

To provide an overview of assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement and to identify recommendations for future assessment methods.

BACKGROUND

The purpose of postgraduate critical care nursing education is to educate professional, competent and caring critical care nurses and high-quality assessment strategies in clinical placement are of most importance.

DESIGN

An integrative review following Whittemore and Knafl's framework and Prisma 2020 guidelines for systematic reviews.

METHODS

Systematic searches were performed in June 2020 with an update in April 2021 using the following: Academic Search Premier, British Nursing Index, CINAHL, MEDLINE, SveMed+, Web of Science and the Joanna Briggs Institute databases. The systematic literature search and hand search yielded 380 studies. After screening and checking for eligibility, fifteen studies published between 2005 and 2020 were included in this review. The included studies were critically appraised using the Mixed Methods Appraisal Tool for empirical studies and the Joanna Briggs Institute Critical Appraisal tool for literature reviews.

RESULTS

Four qualitative, six quantitative, three mixed-methods and two literature review studies were included in this review. We identified that competence in postgraduate critical care nursing is a multidimensional concept and it is recommended to use a combination of assessment methods like self-assessment, observation and mentor evaluation. It is necessary to have discussions and reflections between the student, preceptor and lecturer, as well as written self- and mentor evaluation to provide formative and summative feedback to the students. The need to provide consistency and objectivity resulted in the development of competency assessment tools and they were mostly developed and validated as a collaboration between clinical sites and educational institutions. Most of the assessment tools consisted of domains reflecting holistic nursing, including both technical and non-technical skills. Domains reflecting evidence-based nursing practice were less common.

CONCLUSIONS

We need valid and reliable instruments to assess postgraduate critical care nursing student's competence in placement. Innovation and further research regarding effective and accessible assessment methods, such as digital assessment tools, are needed to meet future needs. This may also stimulate collaboration to improve the international inconsistency in critical care nursing educations. We should be working towards common, international educational competence descriptions and assessment tools that are in line with the ever-changing critical care environment, including holistic nursing and continuous learning.

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.

360-Degree evaluation: Towards a comprehensive, integrated assessment of performance on clinical placement in nursing degrees: A descriptive observational study

BACKGROUND

The assessment of the acquisition of clinical competencies is a critical issue for nursing students. 360-degree evaluations are a widespread practice in professional competency assessment and can be applied to the learning/teaching process of future nurses.

OBJECTIVES

To determine the effectiveness of the implementation of a 360-degree evaluation proposal for assessing the competencies acquired by third-year nursing students during their clinical placements.

DESIGN

A mixed-methods design was used with a primary component (a cross-sectional descriptive observational design) and a parallel qualitative component.

PARTICIPANTS

Sixty-seven third-year nursing students from a public university in Madrid, Spain, who were undertaking their clinical placements during seven weeks in medical/surgical units in hospital settings.

METHODS

This study was conducted between September 2017 and May 2018. Quantitative data were obtained using assessment tools specifically developed for this 360-degree evaluation proposal. Qualitative information was collected from two focus groups, one with students and one with teaching staff. A descriptive analysis of the quantitative data was conducted. Qualitative data were studied using a thematic analysis.

RESULTS

The mean scores for each of the items in the 360-degree evaluation were high, with the highest grades being observed in the evaluations made by peers and patients (a mean of 9.1 out of 10.0). On average, the 360-degree evaluation method yielded grades 0.067 percentage points higher than did the previous evaluation method (p ≤ 0.001). Students and teaching staff encountered difficulties in the evaluations made by users/families and other members of the healthcare team (nursing assistants and physicians), although they rated the overall proposal as being very powerful in terms of educational value.

CONCLUSIONS

The 360-degree evaluation method is an innovative, motivating, and integrating approach to the acquisition of competencies with a focus on excellence.

Quality Assurance in Nursing Education: A Qualitative Study Involving Students and Newly Graduated Nurses

Background: Assuring quality training for future nursing professionals is essential to preserving population health and socio-economic development. Quality assurance in the European Higher Education Area places students in a leading role to transform and improve higher education programs. Therefore, an innovative way of reviewing strengths and weaknesses of the nursing education program of a Spanish university has been developed. Objectives: The aim of this paper was to explore the perceptions and opinions of nursing students and newly-qualified nurses regarding the contents of the nursing curriculum in order to improve its quality. Methods: Descriptive and exploratory qualitative research was carried out involving 12 newly-qualified nurses and 12 student nurses. Semi-structured interviews and focus groups were performed. Results: Based on the thematic analysis, two themes emerged: improving clinical practices and reviewing the theoretical curriculum. Conclusions: Among the improvements suggested by the participants, the most relevant ones were establishing a clear structure of learning contents in the practicum, and redistributing the European Credit Transfer and Accumulation System ECTS credits in various courses of the study program. However, additional evidence is needed prior to proceeding with any changes.

Newly Qualified Nurses' Perception of Their Competency Achievement on Leaving University: A Qualitative Study

Background: After implementing the Tuning Educational Structures in Europe Project, numerous efforts have been made to define, establish, and evaluate nursing competences. The European Federation of Nurses Association played a key role in enacting the nursing competences included in Directive 2013/55/EU. Nevertheless, assessing competences remains elusive, and there is little research into nurses’ perceptions of the competency training provided by their universities. The purpose of the study was to explore the perceptions and experiences of newly qualified nurses about the competences they acquired during their university education. Methods: A qualitative research study was developed in a Spanish university. Twelve semi-structured interviews with newly qualified nurses were conducted, and two focus groups made up of twelve students were carried out in order to triangulate the results. Participants were recruited through email contact. Interviews focused on clinical training, theoretical content, and the reality of healthcare. Data was analyzed thematically. Results: Two main themes emerged: (1) improving theoretical content and (2) rethinking practical lessons and clinical training. A lack of knowledge about mental health, pharmacology, or critical care has been found; in addition, it was highlighted, among others, the need to improve communication skills in difficult and conflictive situations. Conclusions: Considering the participants’ perception of deficiency in some aspects of most of the competences established by the European Federation of Nurses Association, further research has been suggested to include other stakeholders’ views.

Percepciones de los estudiantes sobre sus vivencias en las prácticas clínicas

Introducción: Los estudiantes de enfermería deben adquirir conocimientos, habilidades, actitudes y valores, para proporcionar cuidados de calidad. Las prácticas clínicas son el contexto ideal para lograr algunas de las competencias requeridas. Objetivo: Explorar las percepciones de los estudiantes sobre sus vivencias durante sus prácticas clínicas. Método: Abordaje metodológico descriptivo de tipo cualitativo y con un encuadre sociocrítico. Se analizaron los 45 portafolios de estudiantes de 4º curso de la Escuela Universitaria de Enfermería (EUE) Cruz Roja, donde explican sus vivencias en prácticas. Se optó por un portafolio semiestructurado en función de la competencia a demostrar definiendo previamente las tareas o evidencias Se realizó un análisis de contenido que comprendía las siguientes fases: reducción de los datos; categorización-codificación, presentación de datos y conclusiones/verificación de los datos. Se alcanzó saturación en la información sobre las categorías presentadas. Resultados: Del análisis de los datos emergen distintas unidades de significado que se engloban en tres categorías: aprendizaje en prácticas, dificultades del entorno, crecimiento personal y profesional. Conclusiones: El estudio evidencia la importancia de las prácticas clínicas para los estudiantes dentro del plan de estudios, ya que es donde aplican lo que han aprendido en el aula y son conscientes de la realidad a la que se enfrentan. El entorno clínico y la relación que se establezca entre este y el estudiante determina en muchas ocasiones el aprendizaje. Queda patente que los estudiantes durante sus prácticas clínicas toman conciencia de aquellos conocimientos del saber, saber hacer y saber estar.