The competency of clinical nurse educators

Competency domains for registered nurse preceptor professional development: Evidence from a modified e-Delphi study

AIM

To develop an evidence-based framework of nurse preceptor competency domains and competency descriptors for use in nurse preceptor professional development.

BACKGROUND

Nurse preceptors are registered nurses who coach, support and assess nursing students while simultaneously caring for patients. Working as both clinician and educator requires preceptors to develop additional skills. However, preceptor preparation is often overlooked and may not be evidence based.

DESIGN

A modified e-Delphi study.

METHODS

A three-phase e-Delphi method informed the study that was conducted between March and September 2023. In the first preparatory phase an expert group distilled the results of a previous literature review identifying seven preceptor competency domains and more than 200 competency descriptors. Two e-Delphi rounds followed. A 70% rater agreement response threshold was chosen as appropriate in this study. The CREDES reporting framework was followed.

RESULTS

In the preparatory phase, the expert group (n=6) reached consensus on six preceptor domains and 57 preceptor descriptors. In Round 1, nurse preceptors (n= 89) rated the domains and descriptors using a four-point Likert scale; from not important to very important. Six domains and 34 competency descriptors were ranked as very important'. Round 2 participants (n=30) who opted in from Round 1 indicated their 100% agreement with the Round 1 results. The results reveal that preceptors resonate intuitively with the six domains Role model, Facilitator, Leader, Evaluator, Teacher and Coach and the related descriptors.

CONCLUSION

The preceptor evidence-based competency framework offers registered nurse preceptors and their employers the opportunity to focus efforts in developing a nurse preceptor workforce. The framework can be used to design preceptor professional development and offers registered nurses a self-assessment tool to identify their preceptorship skills strengths and areas for development. If implemented in these ways the framework may benefit healthcare organisations to provide quality nurse preceptorship, thus enhancing the clinical learning experiences of nursing preceptees.

Psychometric Testing of a Tool to Assess Nurse Anesthesia Clinical Educator Skill Acquisition

ABSTRACT

Nurse anesthesia clinical educators bridge didactic content and clinical practice. A sample of 99 nurse anesthesia clinical educators completed the Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT) to assess their skill acquisition and ACNESAT psychometric properties. Participants reported extreme confidence ( M = 170.07, SD = 22.31) overall; highest confidence with Ensures Safe Care is Delivered by Learners in the Clinical Setting ( M = 4.55, SD = 0.627) and lowest with Applies Theory to Clinical Practice ( M = 4.01, SD = 0.942). Academic leaders can utilize the ACNESAT to support role development and excellence among clinical educators.

Core competencies for Registered Nurse preceptors: A mapping review of quantitative studies

AIMS

To review the contemporary international literature on nurse preceptor competencies and map the components and their descriptors.

REVIEW METHODS

A mapping review.

DATA SOURCES

Articles reporting evidence-based and validated Registered Nurse (RN) preceptor competencies published between 2013 and 2022 were identified. Open access databases such as PubMed and Google Scholar and the library healthcare databases Scopus and CINAHL were searched. The authors collaborated at each review stage that included screening, article selection, tabulation, mapping and preparation of findings.

RESULTS

Seven quantitative studies were included. Three were based on existing nurse preceptor competency data sets and four were purposely developed using collaborative research methods. Each study validated findings through a survey of nurse stakeholders. Three key competencies shared across all studies were 'facilitating teaching', 'being a role model' and 'evaluating student's performance'. The number of competency categories ranged from three to 10 and the accompanying item descriptors from 9 to 83. Although terminology describing data sets was inconsistent, similarity was seen across competency domains.

CONCLUSION

The contemporary nursing preceptor role is considered an emerging specialist education role. The results offer a set of validated preceptor competency descriptors, applicable to practice, that provide insight into ways employers may recruit, support and retain nurse preceptors.

IMPLICATIONS FOR THE PROFESSION

The mapped results provide a concise summary of nurse preceptor competency research internationally that can inform further development of RN preceptors.

IMPACT

This review addresses the lack of consensus around nursing preceptor competencies for clinical supervision of undergraduate nursing students. Seven competency domains were identified describing key preceptor role capabilities. The domains Facilitator', 'Role model' and 'Evaluator' featured across the included studies: 'More than 300 competency descriptors were reported'. Our review results could better prepare RN preceptors for their important role. Employers of RN preceptors could use the results to design performance competencies that may enhance nursing preceptorship.

REPORTING METHOD

This review adheres to the PRISMA-ScR EQUATOR guidelines as the recommended reporting method for mapping reviews.

Development and validation of a core competence instrument for clinical nursing teachers: A mixed-methods study

BACKGROUND

Competence-based education (CBE) highlights the important position of clinical nursing teachers and stipulates additional requirements for them. However, research on the core competence of clinical nursing teachers remains lacking, which has hindered their development and the cultivation of nursing students.

OBJECTIVES

Developing and verifying a core competence instrument to evaluate clinical nursing teachers' competence in clinical settings and provide empirical guidance for their development.

DESIGN

A mixed-methods study including qualitative and quantitative methods.

SETTINGS

Primarily, 9 universities and hospitals throughout China.

PARTICIPANTS

Fourteen nursing experts and 2 students participated in the qualitative study, and 626 nursing professionals ultimately participated in the quantitative study.

METHODS

The instrument was developed based on behavioral event interviews and expert consultation as well as exploratory factor analysis using a cross-sectional survey, following which the instrument was verified by confirmatory factor analysis.

RESULTS

A 4-factor core competence instrument for clinical nursing teachers was developed and verified; the four factors included education and teaching competence, clinical nursing competence, management competence and professional awareness and attitude, and the instrument included 25 items in total. The instrument has an explanatory degree of 90.58 %, and it exhibits good reliability and validity as well as a good fit to the data.

CONCLUSIONS

This instrument can provide theoretical guidance for the development of clinical nursing teachers and can be widely used as an effective tool in practice. Nursing administrators and educators should implement policies and programs to help clinical nursing teachers improve their competencies with regard to these four aspects, which can play an important role in the development of nurse education.

Psychometric Testing of a Tool to Assess Midwifery Clinical Educator Skill Acquisition

BACKGROUND

Midwifery clinical educators balance expertise in clinical practice and academia.

PURPOSE

The purpose of this cross-sectional study was to assess midwifery clinical educator skill acquisition and psychometric properties of the Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT) with midwifery clinical educators.

METHODS

A convenience sample of 143 educators completed the 40-item ACNESAT aligned with the National League for Nursing academic clinical nurse educator competencies.

RESULTS

Participants reported extreme confidence overall with ACNESAT items ( M = 168.99, SD = 23.61), highest confidence with Ensures Safe Care is Delivered by Learners in the Clinical Setting ( M = 4.51, SD = 0.659), and lowest with Applies Theory to Clinical Practice During Clinical Nursing Education Experiences ( M = 4.01, SD = 0.934).

CONCLUSIONS

Academic leaders are empowered to utilize the ACNESAT to personalize clinical educator orientation programs with targeted professional development activities.

Strategies for transitioning from a clinical position to a faculty role

The nation faces a continued shortage of nurses that is projected to worsen in the next decade. The nursing shortage is fueled by a lack of faculty to educate nurses for entry into practice and advanced nursing practice positions. Many faculty enter academia after achieving expertise in a specialty area of clinical practice. These expert clinicians transition to novice faculty, a move that can be challenging and overwhelming. New faculty require guidance in understanding the various academic regulatory organizations; university structure, policies, and regulations; faculty responsibilities related to the university missions of teaching, service, practice, and scholarship; and face challenges with the need for new skills such as classroom management, curriculum development, and an understanding of the different culture and language of academia. The authors provide evidence from the literature and strategies and tips based on their experience for an expert clinician's successful transition from a clinical role to an academic position.

Pre-assessment judgement framework for judging nursing students' performance in clinical placements: A qualitative case study

AIM

This study aims to better understand and articulate the pre-assessment judgement processes commonly used by experienced clinical facilitators when assessing nursing students undertaking clinical placement.

BACKGROUND

In the Australian context, clinical facilitators are registered nurses who primarily educate, monitor, support and assess groups of nursing students on clinical placements without carrying a patient load. The duties and scope of clinical facilitators may differ across international and institutional contexts. However, the core concepts of this paper will be relevant despite these differences as the importance of facilitators' confidence in making pre-assessment judgements of individual nursing student performance while on placement is universally acknowledged. Nursing students are often assessed on their provision of safe practice, patient task-orientated outcomes and professional behaviour. Clearly articulating performance judgements prior to formal assessment is vital to ensure progressive learning of students. Literature reports that many clinical facilitators lack confidence in the art of making performance judgements and call for targeted professional training and support in the clinical assessment of nursing students. To better understand and address this problem, clinical facilitators need a shared understanding of how individual nursing students' pre-assessment performance judgements are reached during placement experiences.

DESIGN

A qualitative case study was used, with data collected via semi-structured interviews. Fifteen Australian clinical facilitators participated, each with over six months of experience.

METHODS

Interview transcripts were analysed through an interpretive-constructivist paradigm. Thematic analysis revealed themes that were then deductively described through the application of the Cognitive Continuum Theory.

RESULTS

Six modes of pre-assessment judgement emerged from the data synthesis process: 1) Recognising patterns, 2) Acknowledging uncertainty, 3) Understanding key players, 4) Verifying or refuting the information, 5) Benchmarking performance and 6) Contextualising information. Each mode is validated through the deductive application of the Cognitive Continuum theory.

CONCLUSIONS

Understanding how experienced clinical facilitators make pre-assessment performance judgements has the potential to increase confidence in performance judgement decisions. In turn, confidence in judgements will increase clinical facilitator's capacity to give nursing students feedback that can be explained and justified. The pre-assessment judgement framework also provides a preliminary model for teaching the art of reaching accurate performance judgements to clinical educators in disciplines beyond nursing.

A Scoping Review of Nurse Educator Competencies: Mind the Gap

BACKGROUND

Unclear guidance continues faculty role preparation for promoting students' successful transition to practice.

OBJECTIVES

To examine nurse educator competencies and their role in students' transition to practice.

DESIGN

This study utilized Arksey and O'Malley's methodological framework for conducting a scoping review. The review is reported using the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR), including the PRISMA-ScR checklist.

METHODS

A comprehensive systematic search of MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL was performed for nurse educator competency. For the original search, no limitations were placed on dates. Two authors independently assessed eligibility via abstract review. The reference lists of the included studies were also examined.

RESULTS

Eleven articles were included in the review dating from 1992 to 2021. Three themes in the literature were identified by the authors: (1) the need for appropriate mentorship, (2) lack of preparation of educators who transition directly from clinical practice, and (3) lack of use and/or vague operationalization of the National League for Nursing nurse educator competencies.

CONCLUSION

Evidence regarding requisite competencies of nurse educators is limited. Further research on the competencies required for nurse educators to facilitate successful student transitions to practice is needed.

A Qualitative Study of Midlevel Nurse Managers' Perspectives of Scholarly Inquiry

OBJECTIVE

This study explored the key characteristics and needs of midlevel nurse managers (MLNMs) who support and engage clinical nurses (CNs) in scholarly inquiry.

BACKGROUND

Healthcare organizations expect CNs to participate in scholarly inquiry, incorporating evidence-based interventions to improve outcomes and safety. How the MLNM supports and engages CNs in scholarly inquiry remains unclear.

METHODS

Twelve semistructured interviews of MLNMs occurred at several facilities in the mid-Atlantic region utilizing the institutional review board-acknowledged protocol. Theme interpretation utilized inductive analysis.

RESULTS

Four recurrent themes emerged from the interviews related to the value of scholarly inquiry: 1) securing organizational resources to promote scholarly inquiry; 2) knowledge and experience in scholarly inquiry; 3) actions supporting scholarly inquiry; and 4) the value of scholarly inquiry within the organization.

CONCLUSIONS

Senior nursing leadership and healthcare organizations must recognize the value and provide the infrastructure to support scholarly inquiry. Infrastructure includes education, dedicated time, access to expertise, and resources.