Comparing New BSN RN Self Skills Assessment to Actual Skills Demonstration

A Study of Surgical Residents' Self-Assessment of Open Surgery Skills Using Gap Analysis

BACKGROUND

Surgical residents need structured and objective feedback to develop their skills and become capable of performing surgical procedures autonomously. A shortage of experienced surgical staff has prompted residents to seek feedback from self-assessment and peer assessments.

OBJECTIVES

We investigated whether surgical residents can reliably rate their own and their peers' basic surgical skills using the Global Rating Scale (GRS) from the Objective Structured Assessment of Technical Skills.

METHODS

The study was a prospective and descriptive study conducted using gap analysis at the Copenhagen Academy for Medical Education and Simulation (Copenhagen, Denmark) from 2016 to 2017. Surgical residents were recruited during a course in basic open surgical skills. Among 102 course participants, 53 met the inclusion criteria and 22 participated in the study.

RESULTS

We recruited surgical residents based in the Capital Region and Zealand Region of Demark, and 42% of eligible residents participated in the study. Surgical residents underestimated their own surgical performance (median, 17 [range, 15-18] vs. 20 [range, 19.75-22]; P < 0.001). They also rated their peers lower than an experienced rater did (median 10 [range, 8.75-14] vs. 15 and median 20.5 [range, 19-22] vs. 23; both P < 0.001). Gap analysis revealed residents had unrecognized strengths (ie, self-underappraisal) in most GRS domains.

CONCLUSIONS

Ratings are unreliable when surgical residents assess their own and their peers' performances using GRS. A gap analysis revealed unrecognized strengths in time and motion, instrument handling, knowledge of instruments and sutures, and knowledge of specific procedure as well as unrecognized weaknesses in flow of operation and forward planning.

Undergraduate nursing students' perceptions of the current content and pedagogical approaches used in PIVC education. A qualitative, descriptive study

BACKGROUND

The peripheral intravenous catheter (PIVC) is the most frequently used invasive medical device. PIVCs fail for a variety of reasons and failure often results in serious adverse events leading to patient discomfort, delays in treatment, increased health care costs and even death. Undergraduate nurses assess and manage PIVCs as part of their clinical learning. To date, no study has explored undergraduate nurses' perceptions of the education they receive about PIVCs.

AIM

We sought to critically explore the current state of education regarding PIVCs from the perspectives of undergraduate nurses.

METHODS

This qualitative study involved semi-structured interviews with third-year undergraduate nurses. Data were collected across two sites in Queensland, Australia. Fourteen face-to-face interviews were conducted and a modified 5-step qualitative content analysis was used to analyze the data.

FINDINGS

We identified three key domains relating to participants' experiences of PIVC education: 1) Universities provide foundational knowledge about PIVC assessment, management and removal; 2) Clinical practice consolidates and drives undergraduate nurses' knowledge, skills and confidence about PIVCs; and 3) inconsistencies in clinical practice and between individual clinicians impedes learning and knowledge translation about PIVCs.

CONCLUSION

Nursing students benefit from theoretical content delivered in the university setting. Practical application of theory and skill development whilst on clinical placement is variable. The current undergraduate curriculum, related to management of patients with a PIVC, is disjointed and inconsistent and this inconsistency may negatively impact patient safety.

Longitudinal Analysis of Postlicensure Student Competency Perceptions

BACKGROUND

A longitudinal evaluation of the final year of the Oregon Consortium of Nursing Education (OCNE) curriculum was undertaken to explore students' perception of competency and benchmark proficiency.

METHOD

A retrospective, longitudinal mixed-methods study of postlicensure students was tracked from the initial Transition course to the final Capstone course to evaluate levels of attainment. Researchers used previously developed language categories of attainment for each benchmark to determine perceived competence.

RESULTS

Researcher analysis tested the narrative language of attainment levels using prior developed themes. Researchers coded student attainment levels in the Capstone course compared with the initial Transition course, with higher confidence for Competencies for Relationship-Centered Care and Clinical Judgment and lower confidence for Leadership and Population Care Competencies.

CONCLUSION

This analysis provided a deeper understanding of RN-to-baccalaureate student confidence toward attaining 10 OCNE competencies, supporting the continued development of a curriculum to address areas of low perceived competence. Tracking these competencies may strengthen accreditation processes. [J Nurs Educ. 2019;58(9):510-518.].

Student Competency Perceptions From Associate Degree to Bachelor Degree Completion

BACKGROUND

A curriculum evaluation gap was addressed by exploring the final year of the Oregon Consortium of Nursing Education (OCNE) curriculum through student perception of competency and benchmark proficiency.

METHOD

Researchers used a mixed-methods design to explore RN to baccalaureate (RNBS) student self-assessment data on perceived benchmark proficiency. Students' written statements were coded into four attainment categories, ranging from not attained to strong.

RESULTS

Researchers categorized strong attainment in the competencies of intentional learning, relationship-centered care, and clinical judgment, with moderate attainment in ethics, communication, health care team collaboration, and reflection on self-care. Competencies related to leadership, practicing within a broader health care system, and application of evidence in practice had limited attainment.

CONCLUSION

The results support using attainment categories in the measurement of student self-reported competency. The findings could be used to support course and curriculum evaluation, student advising, and coaching, as well as to improve professional development opportunities for students moving through the curriculum. [J Nurs Educ. 2017;56(10):581-590.].

Qualified nurses' perceptions of nursing graduates' abilities vary according to specific demographic and clinical characteristics. A descriptive quantitative study

BACKGROUND

Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings.

AIMS AND OBJECTIVES

The aim of this study was to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations.

DESIGN

A descriptive quantitative design was used.

METHODS

An online survey tool was used to assess how qualified nurses (n=201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests.

RESULTS

Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p≤0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area in which they worked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting.

CONCLUSION

This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.

What level of competency do experienced nurses expect from a newly graduated registered nurse? Results of an Australian modified Delphi study

Background

Individuals who have recently completed accredited courses and are eligible to register as a nurse in Australia are often referred to as not being ‘work-ready’ by clinically based colleagues. This project identified the level of competence that can be reasonably expected of a newly registered nurse (RN) graduating in Australia. The research was undertaken using the necessary skills identified by Crookes and Brown in 2010.

Methods

A consensus methodology using a modified Delphi technique invited experienced nurses to identify the level of competency expected by the new RN in each of the skills areas.

Results

More than half of respondents did not believe that new graduates could practice independently in 18 of the 30 skills areas. There were only four skills areas where more than two thirds of the respondents believed the new graduate could operate independently.

Conclusions

There is a lack of clarity about the level of competency of the newly graduating registered nurse in Australia. The profession and employers need clarity regarding the areas and level of competence that can reasonably be expected of a newly graduated RN. Utilising the findings of this research will enable the skills and competencies to be integrated into eligibility to practice programmes. Further research needs to be undertaken to review the foci of nursing preparation programmes to meet the needs of novice practitioners and the health care consumer population.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-016-0166-2) contains supplementary material, which is available to authorized users.

Registered nurses' perceptions of new nursing graduates' clinical competence: A systematic integrative review

Over the past decade, many questions have been raised about graduates' clinical competence and fitness for practice upon completion of their undergraduate education. Despite the significance of this issue, the perspectives of registered nurses have rarely been examined. This systematic review explores the perceptions of experienced registered nurses regarding the clinical competence of new nursing graduates. Original research studies published between 2004-2014 were identified using electronic databases, reference lists, and by searching "grey literature." Papers were critically reviewed and relevant data extracted and synthesized using an approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis. From 153 studies initially identified, 15 original research papers were included. Four main research themes were identified: clinical/technical skills, critical thinking, interaction/communication, and overall readiness for practice. Areas of concern in relation to the clinical competence of new nursing graduates specifically related to two themes: critical thinking and clinical/technical skills. Further research is required on strategies identified within the literature with the ultimate aim of ensuring new nursing graduates are safe and competent practitioners.