Work readiness of nursing graduates: current perspectives of graduate nurse program coordinators

Stakeholder perspectives on graduates' acquisition of competencies in nursing bachelor's degree programs: A qualitative study

BACKGROUND

In nursing education, greater emphasis should be placed on stakeholder perspectives, and these perspectives should be integrated into the educational process. Stakeholder perspectives are of great importance in determining the extent to which graduates achieve program competencies, and if necessary, in revising these competencies based on the relevant feedback.

OBJECTIVE

This study aimed to determine stakeholder perspectives on the acquisition of nursing program competencies by graduates of undergraduate nursing programs.

DESIGN

Exploratory qualitative research design.

PARTICIPANTS AND SETTING

The study was conducted in June 2024 through focus group interviews with a total of 20 internal and external stakeholders.

METHODS

The data were collected using Semi-Structured Focus Group Interview Forms. The data were organized according to common/similar categories by content analysis.

RESULTS

The data obtained based on the views of the participants on the acquisition of nursing program competencies by graduates of nursing education programs were divided into three categories: Competencies Acquired from Nursing Education (professional knowledge and skills, lifelong learning), Competencies That Need Improvement (critical thinking/problem-solving skills, communication skills, foreign language proficiency, professional values, and managerial skills), and Suggestions to Improve Competencies Acquired from Nursing Education (suggestions related to education, the profession, and institutional/administrative matters). Additionally, 10 subcategories associated with these categories were identified.

CONCLUSION

Competencies expected in members of the profession of nursing are a global topic of discussion, and the findings of study provide important insights for future studies. In line with these results, it is recommended to enhance collaboration with stakeholders and conduct regular meetings involving all stakeholders. The outcomes of these meetings should guide the structuring of educational programs to ensure the acquisition of competencies, and relevant activities should be planned and implemented accordingly.

Readiness for professional practice among health professions education graduates: a systematic review

Readiness to practice is the state of being prepared and capable of engaging in professional activities in a specific field. Graduates of healthcare professions require a diverse set of skills, knowledge and attitudes to meet the demands of complex healthcare settings. This systematic review provides a comprehensive analysis of readiness for professional practice among graduates of health professions education. It encompasses a wide range of articles published between 2013 and 2024, incorporating various health professions and utilizing a combination of quantitative, qualitative, and mixed methods designs. The review identified 93 studies from 32 diverse countries. The review revealed that factors influencing readiness to practice, include individual capabilities, the workplace context, and educational provision. It also explored strategies to enhance readiness to practice. The findings underscore the significance of addressing challenges such as lack of confidence, stress, communication, time management, job satisfaction, clinical experience, academic workload, teaching quality, mentorship and curriculum design. This comprehensive analysis serves as a valuable resource for healthcare educators, policymakers, and practitioners seeking to optimize the preparedness of graduates for the complexities of contemporary healthcare environments. Future studies should explore the interactions between readiness to practice stakeholders' perception of the educational curriculum, and the quality of support in the professional practice environment.

Developmental trajectories of professional preparedness among senior nursing students during clinical placement: A longitudinal study

BACKGROUND

Newly graduated nurses' lack of professional competence is associated with inadequate preparation during their clinical placement as nursing students. Clinical placement is a critical stage in the development of nursing students' professional preparedness. However, research on the trajectory of nursing students' professional preparedness during clinical placement has not yielded findings with the same specificity.

OBJECTIVES

The aim of this study is to estimate differences in professional preparedness levels at different clinical placement stages, to identify distinct patterns of professional preparedness trajectories during clinical placement, and to evaluate predictors of these trajectory group memberships.

DESIGN

A quantitative longitudinal study.

SETTINGS

Participants were recruited on a voluntary basis using convenience sampling at a tertiary hospital in Nanning, China.

PARTICIPANTS

224 senior nursing students were initially invited to participate in the study. A total of 178 nursing students successfully completed the follow-up assessments at baseline, as well as at 1 month, 4 months, and 8 months into their clinical placement.

METHODS

Participants completed four online surveys, during which their professional preparedness level was measured using the Perceived Professional Preparedness questionnaire for senior nursing students. Professional preparedness scores at different time points were compared using one-way repeated measures ANOVA and latent growth model. Group-based trajectory model was applied to identify professional preparedness trajectories. Multiple logistic regression was adopted to determine the predictors of trajectory group memberships.

RESULTS

The entire sample of Senior nursing students experienced a significant increase in professional preparedness during clinical placement. The best-fitting group-based trajectory model delineated three distinct trajectories: low-slowly increase trajectory (27.53 % of sample), moderate-rapidly increase trajectory (47.19 % of sample) and a high-stably increase trajectory (25.28 % of sample). Male, good and excellent academic performance, and very high degree of professional interest are the predictors of the moderate-rapidly increase trajectory. While male, good and excellent academic performance, high and very high degree of professional interest and participating in medical-related part-time employment are the predictors of the high-stable increase trajectory.

CONCLUSIONS

Senior nursing students exhibit different levels of professional preparedness throughout their clinical placement. Simultaneously, three different trajectories were identified among the sample of nursing students. Therefore, in future research, greater attention should be directed towards the professional preparedness levels of nursing students with different trajectories, and early identification and targeted interventions should be prioritized.

Newly qualified general nurses' experiences of pre-registration internship: A Republic of Ireland cross-sectional study

Aim

The aim of this study was to examine Newly Qualified General Nurses' (NQGNs') experiences of and the value of the internship period.

Background

Internship was introduced as the final part of the undergraduate nursing degree in Ireland in 2002. The aim was to provide students with clinical experience, whereby they work more independently and in doing so, seamlessly progress their transition to the role of registered nurse.

Design

A cross-sectional, quantitative, descriptive study.

Setting and Participants

Newly Qualified General Nurses who completed their undergraduate degree in general nursing and graduated from Higher Education Institutions (HEIs) in the Republic of Ireland between 2018 and 2020 were eligible for inclusion in the study.

Methods

Participants were recruited using snowball sampling. Data were collected anonymously using the electronic Experience of Internship Questionnaire. Analysis was undertaken using the Statistical Package for Social Sciences (SPSS 27).

Results

Pre-internship preparation experiences differed across hospitals. The NQGNs would have preferred more support with their caseloads and help with understanding the rationale for care delivery. However, internship provided good opportunities to link theory to practice and was considered valuable by most in preparing them for practicing as a registered nurse.

Conclusion

Internship assists intern nursing students to link theory to practice. Further, support in internship is crucial when managing a caseload and to enhance understanding of the care provided. The value of internship was identified with suggestions on ways to strengthen the experience of internship.

Introduction of a Registered Undergraduate Student of Nursing workforce: A qualitative study of student and registered nurses

AIM

To explore the benefits and challenges of a recently introduced Registered Undergraduate Student of Nursing workforce from the perspective of Nurses and Registered Undergraduate Students of Nursing, in a major metropolitan hospital in Australia in 2020.

DESIGN

A qualitative descriptive study was undertaken using individual interviews and focus groups.

METHODS

Purposively selected employed Registered Undergraduate Students of Nursing and nurses who worked with them were interviewed, using a semi-structured format. Recordings were transcribed and coded using NVivo software. Reflexive thematic analysis using an inductive approach was undertaken.

RESULTS

Four major themes were revealed: (i) Navigating the programme, (ii) Belonging and integration; (iii) Patient care; and (iv) Continuing Development. Initial challenges were common, often related to clarifying the scope of practice for the new role. Ongoing issues were associated with gaps in understanding the role and lack of integration into the team. Mostly, nurses and Registered Undergraduate Students of Nursing built positive, professional relationships. Nurses valued the Registered Undergraduate Student of Nursing knowledge and skill level, reporting improved workload and work experiences when the Registered Undergraduate Student of Nursing was on shift. Nurses believed that the Registered Undergraduate Students of Nursing enhanced patient care. Registered Undergraduate Students of Nursing described positive, therapeutic relationships with patients. Registered Undergraduate Student of Nursing employment provided opportunities for new learning, leading to increased efficiency and confidence on clinical placement.

CONCLUSIONS

This employment model benefited the Registered Undergraduate Students of Nursing and nurses who worked with them. In the absence of adequate training and support, challenges remained unresolved and negatively impacted the experience for nurses. In addition to university-level education and clinical placement, the employment model can create a third space for student learning via on-the-job training. The study supports the ongoing employment of student nurses through the Registered Undergraduate Student of Nursing model.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Impact This study contributes to the very small body of literature investigating Registered Undergraduate Student of Nursing workforces in Australian hospitals. It is the first to explore the experiences of both nurses and students working together in a major metropolitan setting and also the first in the context of the COVID-19 pandemic. This study reflected a mostly positive experience for Registered Undergraduate Student of Nursing and the nurses who worked with them and highlighted the importance of adequate oversight and support in the implementation and maintenance of a Registered Undergraduate Student of Nursing workforce. Employed Registered Undergraduate Students of Nursing reported improved confidence, skills, and felt like they started clinical placement at an advantage, ready to step up and learn the Registered Nurse scope of practice. In addition to university-level education and clinical placement, this employment model creates a third space for learning via on-the-job training.

REPORTING METHOD

COREQ guidelines were followed in the reporting of this study.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

New graduate nurses' readiness for practice, transition and integration into the workplace: A longitudinal study with mixed methods research

AIM

To examine the readiness of new graduate nurses for practice and evaluate factors influencing their transition into the workplace.

BACKGROUND

This is new research in Bahrain. Understanding readiness for practice is important during a time when there is a national initiative to promote nursing as a career among the indigenous Bahraini population. The worldwide nursing shortages and aging workforce require new and innovative recruitment and retention measures. There is change, increased demand and complexity, in nursing and healthcare needs with accompanying healthcare specialization. In such a health care environment, the transitioning and readiness of newly qualified nurses is an increasing challenge.

DESIGN

A longitudinal design, with a triangulated, mixed methods, research approach was used.

METHODS

The study population consisted of 50 newly graduated nurses. Data were collected over one year through self-administered questionnaires, reflective diaries and focus groups. Quantitative data were analysed using SPSS and qualitative data using thematic analysis with adherence to GRAMMS reporting guidelines.

RESULTS

In Bahrain, there are actions to recruit young Arabic students to nursing including schools and community presentations by trained nurse ambassadors, social media activities and career exhibitions, however there is a lack of objective information on the perspective of cohorts of nurses who have successfully completed graduate nursing registration programmes and transitioned into practice. International literature suggests that the transition of newly graduated nurses can be stressful and challenging. On entry to practice, the respondents positively perceived their characteristics and attributes; however, their confidence was affected by challenges in the workplace. The transitioning of the new graduate nurses was affected by the availability of support and leadership, induction programmes and the new complex work environment.

CONCLUSION

Understanding work readiness and the emotional needs of new graduate nurses, accompanied by improved support, will enhance the transition of newly qualified nurses into the workplace and reduce attrition.

STUDY REGISTRATION

KHUH/Research/No.279/2019.

Effects of the First Wave of the COVID-19 Pandemic on the Work Readiness of Undergraduate Nursing Students in China: A Mixed-Methods Study

Background

Newly graduated nurses with strong work readiness are more likely to smoothly transition from school to clinical settings. However, even before the pandemic, this transition from nursing graduate to clinical nurse was often challenging. Therefore, this study aims to investigate the impact of the initial wave of COVID-19 on the work readiness of nursing students.

Methods

A convergent mixed-method design was employed. For the quantitative study, an online cross-sectional survey was conducted among 500 graduating nursing students from four Chinese public higher education institutions. The questionnaire comprises three parts: socio-demographic information, the Chinese version of the Work Readiness Scale for Graduate Nurse, and a questionnaire on the socio-behavioral impact of COVID-19 on the general population. In the qualitative study, a semi-structured interview was carried out with 8 students who took part in the survey. The results from both parts were integrated using the "Pillar Integration Process".

Results

The study identified six key pillars: "Graduating nursing students possess fundamental knowledge, skills, and a preparedness in terms of attitude and psychology"; "Specialist knowledge and skills and soft skills for transition from nursing students to clinical nurses need to be strengthened"; "The most obvious impact of COVID-19 on nursing students are the adoption of preventive measures and the limitations in study and daily life due to household confinement"; "Growth in both personal and professional awareness"; "Negative effects of fear and anxiety"; and "Negative effects of household confinement".

Conclusion

Graduating nursing students require additional preparation in specialized nursing knowledge, skills, and soft skills to make a successful transition from students to clinical nurses. It is important to acknowledge that the impact of COVID-19 on students' work readiness has both positive and negative aspects. Therefore, whether during the pandemic or post-graduation, these students will benefit from increased support from universities and hospitals.

Transition to professional practice: Perspectives of new nursing graduates of Nepal

BACKGROUND

Internationally, the transition from student nurse to practicing nurse is recognized as being the most stressful period. Yet very little is known about how new nursing graduates perceive this transition in Nepal. The study aimed to explore new nursing graduates' perceptions of the transition to professional practice.

METHODS

A qualitative descriptive methodology was used. In-depth semi-structured interviews were conducted with 10 purposively recruited participants from two private hospitals in Nepal. Data were analyzed using inductive thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to report the findings of this study.

RESULTS

New nursing graduates perceived the transition to professional practice as an intense experience. Inductive thematic analysis yielded four intrinsically linked themes that encompassed new nursing graduates' transition experiences: 'getting hit by reality', 'losing confidence', 'feeling unsupported', and 'gathering strengths.' The theme 'getting hit by reality' included three sub-themes: 'gap between theory and practice,' 'no protective shield,' and 'plethora of responsibilities', which explains nurses' initial encounter with real-world practice. The theme 'losing confidence' contained three sub-themes: 'being fearful,' 'being ignored,' and 'being accused,' which describes how nurses started losing confidence as they confronted the real side of the profession. The theme 'feeling unsupported' included two sub-themes: 'left without guidance,' and 'limited support from seniors,' which explains how nurses perceived their work environment. The theme 'gathering strength' contained two sub-themes: 'reflecting' and 'asking for help,' which describes how nurses coped with the challenges related to the transition.

CONCLUSION

To facilitate the transition to practice, educational institutions must impart to students a realistic understanding of the transition process, address the theory-practice gap, and collaborate with hospitals. Similarly, hospitals should have realistic expectations from new nurses, assign work according to their capabilities, and allow them sufficient time for role integration. Likewise, well-conceived detailed orientation, mentorship or preceptorship programs, and regular professional development programs are vital to easing the transition. Furthermore, establishing and maintaining a supportive work culture, which promotes equity, respect, and safety among employees, is crucial for positive transition experiences.

Senior nurses' expectations and support of new graduate nurses' adjustment in hospitals: A qualitative descriptive study

Aim

This study aimed to identify senior nurses' expectations and support of new graduate nurses' adjustment to their work environment.

Background

New graduate nurses have difficulties in adjusting to their work environment because they are not well prepared for clinical nursing practice upon graduation. Hospitals support their adjustment to their work environment through residency/transition programs. Although such support exists, new graduate nurses are expected to learn the expected behavior and attitude themselves. Thus, identifying senior nurses' expectations and support of new graduate nurses' adjustment may facilitate smooth adjustment to the work environment.

Design

This was a qualitative descriptive study.

Methods

Fourteen nurses who teach new graduate nurses in Japanese hospitals were interviewed face-to-face individually. The data were analyzed using qualitative inductive content analysis, which was coded and sorted to identify categories.

Results

Regarding senior nurses' expectations of new graduate nurses' adjustment, six categories emerged: trying to fit in with people in their ward, behaving by following the unspoken rules of their ward, having attitudes compatible with learning, addressing their situations using their initiative, showing a willingness to learn, and obtaining necessary information by themselves. Senior nurses' support of new graduate nurses' adjustment consisted of four categories: watching over and speaking to them, trying to create a good working environment, encouraging them to have attitudes compatible with learning, and teaching them how to learn.

Conclusions

Senior nurses need to understand and express what they expect from new graduate nurses at the stage of hospital adjustment. If senior nurses understand their expectations for adjustment, they can help new graduate nurses effectively. Furthermore, understanding the expectations of senior nurses may facilitate new graduate nurses' adjustment. These findings may contribute to good working relationships between senior and new graduate nurses.

The assessment of undergraduate bachelor of nursing students in the collaborative clusters education model: A qualitative descriptive design

BACKGROUND

Worldwide, undergraduate Bachelor of Nursing students are required to complete experiential learning placements in health care settings as part of the curriculum. There are a variety of facilitation models that support student learning and assessment on clinical placement. As workforce pressures increase globally, innovative approaches to clinical facilitation are required. In the Collaborative Clusters Education Model of clinical facilitation, hospital-employed clinical facilitators work collaboratively within peer groups (clusters) to collectively participate in a process of facilitating student learning and conducting assessment and moderation of student performance. The assessment process in this collaborative clinical facilitation model is not well described.

AIM

To describe how the assessment of undergraduate nursing students is achieved in the Collaborative Clusters Education Model.

DESIGN

A qualitative descriptive approach was employed.

METHODS

In March 2021 individual and group interviews were conducted with seven clinical facilitators working in the Collaborative Clusters Education Model in one health service in southeast Queensland, Australia. Content analysis of transcribed interviews was performed.

RESULTS

Assessment was achieved through two processes, situational scoring and moderation. In the process of situational scoring, clinical facilitators balanced the students' perception of their role in assessment, accounted for the type of experiences available, considered multiple sources of evidence and used the Australian Nursing Standards Assessment Tool. In the process of moderation, clinical facilitators communicated with their cluster colleagues to determine a shared understanding of student history, considered data from multiple evidence sources and collaboratively evaluated the trustworthiness of student performance evaluation decisions.

CONCLUSIONS

In the Collaborative Clusters Education Model, the input of multiple assessors, working in a small team, ensured transparency in assessment processes. Furthermore, this transparency in assessment practices normalised on-going moderation, an in-built quality-check and, as such, an innovative component of assessment in the Collaborative Clusters Education Model. As nursing directors and managers seek to ameliorate the impact of nursing workforce pressures, this innovative model of collaborative assessment may serve as a valuable addition to nursing clinical assessment toolkits.

TWEETABLE ABSTRACT

The Collaborative Clusters Education Model of Clinical Facilitation enables transparency in assessment processes and normalises moderation.

Graduate nurses' capability upon entering the workforce: An integrative review

OBJECTIVES

To clarify capability for work readiness in newly graduated registered nurses as viewed from the perspective of clinicians in practice, educators in tertiary institutions, and graduates.

DESIGN

Integrative review.

DATA SOURCES

Databases searched for peer-reviewed studies included PubMed, MEDLINE, ERIC, Campbell collaboration, Google Scholar, and Cochrane databases.

REVIEW METHODS

Pragmatism informed this integrative review. The five-stage method described by Whittemore and Knafl was used to enable rigorous examination of the expected capability of graduate nurses. A comprehensive database search was conducted using PRISMA guidelines. Eighteen articles were appraised and analysed for this review. The capability concept was used as a framework for analysis.

RESULTS

Eighteen articles met the inclusion criteria. Findings revealed that although there is no definition for graduate nurses' work readiness, there is a common theme. Graduate nurses are expected to have broad theoretical knowledge (knowing) along with practical knowledge (doing). They are also expected to demonstrate integrity, honesty, respect, compassion, and a moral compass. A list of personal attributes and organisational acumen was also reflective of graduate readiness upon entering the workforce and identified as necessary capabilities for graduates.

CONCLUSIONS

A picture of the perfect employee is illustrated in the definition of work readiness by the participants of the original studies. Yet there is a lack of stakeholder consensus on the capabilities expected from a graduate nurse.

Development and psychometric testing of Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS)

BACKGROUND

For nurses to carry out their responsibilities related to preoperative care in the best possible way, it is very important for them to receive competency-based training and for their competences to be measured with reliable and valid tools in the training process.

OBJECTIVE

To develop a measurement tool that evaluates nursing students' perceived competence for preoperative nursing care.

DESIGN

A cross-sectional, methodological study.

SETTING

Two universities in the Eastern Black Sea Region of Turkey.

PARTICIPANTS

A total of 661 second, third and fourth grade nursing students participated in the study.

METHODS

Items were created in line with the nursing competencies published by the International Council of Nurses, the competencies in the perioperative period nursing practices published by the European Operating Room Nurses Association, and a review of the literature. Then, to test the content validity, the items were submitted for expert opinion and a pilot implementation was made with 50 nursing students. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 350). Test-retest stability was also investigated for the PPreCC-NS (n = 58), in the study.

RESULTS

According to the results of the exploratory factor analysis, the Kaiser-Meyer-Olkin value was 0.948, and the Bartlett test χ2 was 7765.23; p < 0.001. Three items with a factor loading value below 0.50 were removed from the scale, and the obtained factor structure explained 62.25 % of the variance. The fit indices of the scale model tested in the confirmatory factor analysis were determined as χ²/df = 2.74, RMSEA = 0.07, CFI = 0.92, GFI = 0.88, AGFI = 0.85, IFI = 0.92. The structure of the draft scale was confirmed with 5 factors and 22 items. The Cronbach alpha values were found to be 0.79-0.96 for the sub-dimensions of the scale and 0.94 for the total scale. Data also showed a good test-retest stability (ICC = 0.72).

CONCLUSIONS

This scale is a reliable and valid measurement tool for nursing students to determine their level of perceived competence for preoperative nursing care. It is recommended that the psychometric structure of the scale be evaluated with further studies on larger and more diverse samples.

Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review

Introduction

Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia.

Methods

This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937-present), Emcare on Ovid (1995-present), Scopus (1969-present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946-present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings.

Results

From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles.

Conclusion

The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories.

Impact of pre-registration extended immersive ward-based simulation on student learning in preparation for clinical placement

BACKGROUND

Graduate nurses commonly experience significant challenges in transitioning to professional practice. The practice readiness of graduate nurses continues to be a concern for nurse educators and industry partners. Introduction of pre-registration extended immersive ward-based simulation can provide opportunities for students to practice the role of registered nurse before graduation. It is not clear if participation in simulation-based learning transfers to increased preparedness for dealing with real-life situations following entry into the workforce.

OBJECTIVE

To report on student views on how ward-based immersive simulation assisted in preparing for clinical placement and graduate practice.

DESIGN

A qualitative, descriptive design was used to conduct a series of face-to-face focus groups.

SETTING

School of Nursing and Midwifery metropolitan Western Australian university.

PARTICIPANTS

Final year baccalaureate nursing students who had participated in six four-hour simulation workshops between February and April 2021 were selected through purposive sampling.

METHODS

Focus group and interview data was transcribed from audio recordings. A six-phase approach was used to analyse data into themes and sub-themes. The study adhered to the consolidated criteria for reporting of qualitative research.

RESULTS

Three focus groups and one interview were conducted. Eight themes emerged. Student learning was identified as occurring in a variety of ways, such as how to work as a team and was influenced by a number of factors, such as the capacity for students to self-reflect.

CONCLUSIONS

Learning opportunities for students to practice how to think and work independently as a registered nurse is something that can be supported by pre-registration extended immersive ward-based simulation. Understanding of what will be expected of them once qualified can make students more prepared for professional practice enabling them to apply knowledge gained from simulated experiences to a similar situation as a graduate nurse.

Strength of cross-sector collaborations in co-designing an extended rural and remote nursing placement innovation: Focusing on student learning in preference to student churning

AIM

To describe the strength of a cross-sector and multi-university collaboration in co-designing an extended nursing placement innovation in rural and remote Australia.

CONTEXT

Registered nurses are Australia's largest health workforce. Short-duration placements can limit nursing student exposure to rural and remote practice, impacting student capacity to tailor and contextualise their practice, navigate complex inequities, establish a sense of belonging and consider rural practice post-registration. Extended nursing placements have been recommended to address these challenges, but there are no guidelines governing their development and limited resources to support implementation.

APPROACH

Methods adopted in program development included the following: (1) collaboration establishment; (2) co-defining challenges confronting nurse education in these contexts; (3) co-developing guiding principles; (4) co-designing a new approach to nurse education, the Extended Nursing Placement Program (ENPP); and (5) the co-contribution of stakeholders to program design, implementation and evaluation. Regional stakeholders include a NSW and Victorian Local Health District/Service, three Aboriginal health services and the Royal Flying Doctor Service of Australia. University participants include two metropolitan universities, a University Department of Rural Health and final-year Bachelor of Nursing students. Program implementation in Semester 1 of 2022 with seven final-year nursing students.

CONCLUSION

The authors propose that the adoption of collaborative approaches can contribute to re-framing student nurse education and the development of a rural-ready nursing workforce. These approaches can provide regions and universities with the opportunity to avoid student churn whilst promoting the attainment of skills required to work, live and thrive in these locations.

Work Readiness of Newly Licensed RNs

OBJECTIVE

The aim of this study was to examine the work readiness of newly licensed RNs (NLRNs) based on demographics, education, and work experiences.

BACKGROUND

Work readiness is the extent to which new graduates possess qualities and competencies associated with workplace success. Work readiness of NLRNs complements their clinical knowledge and skills and has been shown to predict job satisfaction and work engagement.

METHODS

Two hundred ninety-seven NLRNs participating in the nurse residency program of a health system in the southeast region of the United States were surveyed using the Work Readiness Scale-Graduate Nurse.

RESULTS

Scores on all readiness dimensions were high. Analysis revealed unexpected differences in readiness dimensions based on race, nursing degree, and completion of a nurse externship program.

CONCLUSIONS

Work readiness adds to our understanding of factors that can affect the transition of NLRNs into the work setting. Further research is needed to understand how work readiness develops over time, factors that predict work readiness, and its relationship to NLRN retention and other outcomes.

Undergraduate Nursing Students' Readiness to Practice: Views of the Senior Students in the United Arab Emirates

BACKGROUND

Nursing literature identifies difficulties facing new graduates in managing their responsibilities as registered nurses. The ability of new graduates to be practice-ready upon entry to the workplace remains a challenging concern for nurse educators.

PURPOSE

This study investigated the perceptions of senior students toward their readiness to practice safely and independently and perform registered nurses' job-specific requirements upon graduation.

METHODS

A descriptive design using quantitative and qualitative methods was used to conduct the study. Data were collected from a sample of 117 senior nursing students in the United Arab Emirates using the Casey-Fink Readiness to Practice Survey.

RESULTS

Senior students felt confident to manage the care of 2 to 3 patients, communicate with patients and interdisciplinary teams, solve clinical problems, prioritize patients' care, and recognize significant changes in patient conditions. Areas of concern were their ability to care for more than 3 patients, among others, such as caring for dying patients and performing catheter insertion/irrigation.

CONCLUSION

Students need better learning opportunities and closer guidance, support, and on-time feedback in clinical settings.

Self-Reported Clinical Practice Skill Readiness of Final Year Nursing Students Studying in Bengaluru, Karnataka: An Institutional-Based Cross-Sectional Study

Introduction In recent few years, the production of nurses in both the public and private sectors has been growing rapidly to fill up the gap of health care staff. As there is a lack of data available on clinical practice readiness among final year nursing students in India, the question remains of how nursing students see themselves and what qualities and areas interest them are of great importance.

Objectives This study was conducted to determine the clinical practice skill readiness among final year nursing students and also to explore the factors that show the significant difference with clinical practice skill readiness level.

Methodology A nonexperimental institutional-based cross-sectional online survey was conducted from October 15 to November 15, 2020 using a simple random sampling technique. A total of 200 final year nursing students have participated in the study through the self-structured and prevalidated comprehensive nursing competencies questionnaire (CNCQ). Data was collected through Google Form and exported to SPSS version 20.0 for further analysis. To compare the nursing competencies score with selected demographic characteristics, a one-way analysis of variance and an unpaired t-test were applied at a 95% confidence interval (CI). The post hoc test was used to check for multiple comparisons.

Results Results of the study revealed that the overall CNCQ mean score of basic nursing skills were reasonably high (39.08 ± 13.27) compared with advanced nursing care skills (13.03 ± 5.28). A significant difference (p < 0.05) was observed in overall clinical posting duration in both basic (p < 0.004) and advanced (p < 0.001) nursing skills with selected demographic variables. There is also a significant difference found in the overall level of qualification (p < 0.004) in basic nursing skills. It was observed that in basic nursing care skills half of the year clinical posting (minimum 6 months) duration had a significant difference with the improved performance skills (p < 0.005) (0.57; 95% CI 0.14–1.00). Whereas the results also show that, the advanced nursing skills will be greatly improved if the nursing students get an opportunity to practice in different specialty areas for at least 2 months (p < 0.013) (0.62; 95% CI 0.11–1.14) or half of the year (p < 0.001) (0.95; 95% CI 0.34–1.56). This result shows a clear indication of how important clinical posting for nursing students is.

Conclusion Our data suggested that the final year nursing students are losing ground in clinical practice readiness and competency. The result also shows that the clinical competency score will greatly improve in both basic and advanced nursing skills if the students are exposed to the clinical areas at least for a few months. Our findings will support the stakeholders, authorities of nursing colleges, and policymakers to make a significant decision to enhance the clinical practice among final year nursing students.

The contribution of paid employment for students during their pre-registration nursing studies: An integrative review

OBJECTIVE

This integrative review of the literature explores potential associations between paid employment during students' pre-registration study period and development of workplace capabilities. The capacity to demonstrate attainment of standards of practice upon registration as a nurse is essential for the delivery of safe, quality care. The increasing shift, internationally, to higher education, concerns have been raised about limited time in practice settings and consequently nurses' capability upon employment. Extensive research has been conducted into student clinical placement models and graduates transition programs, but employment during students' pre-registration study has received little consideration.

DESIGN

An integrative approach of peer reviewed articles.

DATA SOURCES

A systematic search of the literature published between 1996 and 2021 across five electronic data bases; including Cumulative Index to Nursing and Allied Health Literature, Scopus, Medline, American Psychological Association and Education Resource Information Centre was conducted.

REVIEW METHODS

Data was analysed according to the Whittemore and Knafl (2005) framework to maintain a methodical and meticulous approach.

RESULTS

Fourteen studies differentiated graduates employed during their studies. Employment contributed to developing capabilities across four domains, namely, personal growth and development, comprehensive nursing practice, organisational capability and professional values and behaviours upon employment.

CONCLUSION

Employment during pre-registration studies is associated with developing workplace capabilities. Opportunities to develop the capability of graduates should focus on the possibility of 'learning' during employment rather than merely a recruitment strategy.

Readiness to enter the workforce: perceptions of health professions students at a regional Australian university

BACKGROUND

Perceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university.

METHODS

The study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants' self-perceived readiness for clinical practice.

RESULTS

From the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness.

CONCLUSIONS

The findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.

Developing work readiness in graduate nurses undertaking transition to practice programs: An integrative review

OBJECTIVE

Investigate the strategies used to support graduate transition-to-practice, and how they align with the four domains of work readiness: work competence; personal work characteristics; organisational acumen; and social intelligence.

DESIGN

Integrative review with narrative synthesis.

DATA SOURCES

Databases searched in 2019 included Medline, CINAHL, PsychINFO, Embase via EBSCO, ERIC and MIDIRS. Grey literature was obtained through Proquest Dissertations and Thesis Global, and Trove.

REVIEW METHODS

The 5-step method included: 1) Independent title and abstract review; 2) discussion of conflicting findings after title and abstract review; 3) independent full text review; 4) discussion of conflicting findings after full text review; and 5) quality evaluation using the Mixed Methods Appraisal Tool. Twenty eligible studies were analyzed and synthesized using the framework method informed by four domains of Graduate Work Readiness.

RESULTS

Of the 24 strategies identified, most (n = 20) supported graduate development across two or more work readiness domains. Structured education (n = 14) and preceptorship (n = 13) were most often used, and findings related to development of graduate work competence (n = 17) were most often measured. All four domains of work readiness were seldom addressed, with social intelligence a common gap.

CONCLUSIONS

This review provides two important considerations for graduate nurse programs. First, a combination of strategies is required to address all four domains of work readiness. Second, there is a need to tailor strategies, and their implementation, to the context of the organisation and clinical workplace.

Investigating Relationships Between Preparedness for Practice, Grade Point Average, and Demographic Correlates Among Prelicensure Nursing Students

ABSTRACT

Understanding the factors contributing to the clinical preparedness of nursing students provides essential information for their successful transition into the workforce. The aims of this study were to examine preparedness for practice with demographic factors, grade point average, and taking care of multiple patient caseloads. This study used a correlational design with 185 prelicensure nursing students in the midwestern United States. The results showed that self-reported clinical preparedness was associated with program type and externship experience. The findings contribute to nursing education by bringing new information that contributes to the understanding of students' preparedness for practice.

A medical play experience: Preparing undergraduate nursing students for clinical practice

BACKGROUND

Undergraduate nursing programs are required to prepare nursing students to care for people across the lifespan, however due to limited paediatric nursing content in undergraduate nursing curricula and limited paediatric clinical placements, nursing graduates may lack competence and experience in caring for children.

OBJECTIVES

The aim of this study was to enhance undergraduate nursing students' work readiness and confidence to care for children by immersing them in a mock paediatric ward experience where students could practice using medical play to communicate and engage with children.

PARTICIPANTS

Participants (n = 22) were undergraduate nursing students recruited across all years from a Bachelor of Nursing program.

DESIGN

Participants were involved in a mock paediatric hospital experience providing them the opportunity to engage with children from 2 to 8 years.

METHODS

A mixed methods approach was used. Participants completed a confidence scale questionnaire pre and post the mock paediatric ward experience and a satisfaction scale post the experience. Inductive thematic analysis was used to analyse qualitative data. Quantitative data was analysed using the Wilcoxon Signed-Ranked Test.

RESULTS

Findings indicated a marked improvement in paediatric nursing skills and work readiness among the student nurses post intervention. Participants developed confidence in the use of medical play in the mock paediatric nursing setting. Improvements in paediatric nursing skills in relation to clinical learning, clinical reasoning and clinical confidence were reported.

CONCLUSIONS

The mock children's ward provided a real time paediatric experience for undergraduate nursing students to practice using medical play to communicate and engage with children. Nursing students had the opportunity to experience children's play, practice age related communication and provide explanations to children about hospital related procedures that children may encounter. With the lack of paediatric placements, it is necessary that nursing curricula examine strategies to enhance the learning for undergraduate students about paediatrics.

Psychology Education and Work Readiness Integration: A Call for Research in Australia

Supporting students to develop transferable skills and gain employment is a vital function of Universities in the era of the Fourth Industrial Revolution. A key area is work readiness, which has steadily grown in importance over the last 2 decades as tertiary institutions increasingly aim to produce graduates who perceive and are perceived as work ready. However, a large majority of graduates report a lack of skills and confidence needed for the effective transition from study to work. This may be particularly problematic for disciplines that impart both discipline-specific and transferrable skills, such as psychology. The aim of this paper is to addresses the concept of work readiness within Australian psychological training and explores the need to shed light on and integrate work readiness within the pedagogy of psychology within Australia. Specifically, this paper calls for a review of work readiness skills developed in psychological courses to ensure industry needs are met. Beyond such a review, it is suggested that tertiary centres need to facilitate students in capturing and reflecting upon the transferable skills that they develop; and build assessments that allow students to demonstrate transferable skills in a meaningful way. Further, this paper proposes that work readiness skills be routinely mapped onto graduate attributes and course learning outcomes to be readily available by students so as to increase students’ potential to articulate their learnt work readiness skills once in the workplace.

The defining characteristics of newly graduated nurses - A Delphi study

Despite processes designed to ensure that graduates of accredited nursing programs possess the necessary skills and knowledge to enter the workforce, a gap remains between graduate capabilities and industry expectations of work-readiness. This study aims to identify the defining characteristics of work-ready graduate nurses from the perspective of a purposive sample of new graduates, employers and academics utilising a three-round Delphi design and to compare the findings. In Round One participants provided free-text descriptors of graduate attributes, core knowledge and skills. In Rounds Two and Three participants prioritised categorised results from Round One and added free-text responses. Data from these rounds were not aggregated. In Round One, 14 academics, 20 clinicians and 12 graduates provided responses. In Round Two we received 10, 12 and 5 responses respectively and in Round Three 9, 8 and 4 responses respectively. The final round identified 19 characteristics and attributes, 10 knowledge areas and 11 skills for work-ready graduate nurses. This study identified that graduates should be safe practitioners, with professional behaviours, an understanding of anatomy and physiology, pathophysiology of disease, and medication safety, with good patient assessment and communication skills. Time management and prioritisation skills that graduates expect of themselves, develop with consolidation of practice.

TIDES: examining the influence of temporal individual differences on multitasking in educational simulation

BACKGROUND

The majority of tasks nurses complete in acute care settings are time-sensitive. Due to complex patient needs, nurses' multitasking behavior is of growing importance. Situations involving multitasking behavior typically require nurses to switch their attention among multiple tasks and patients in a rapid fashion. Research suggests temporal individual differences such as time urgency, polychronicity, and time perspective influence decision-making. The factors suggest that balanced time perspective may facilitate multitasking. Given novice nurses commit errors related to multitasking, we evaluated the relationship between temporal individual differences, cognitive workload, and multitasking behaviors in a simulation setting.

METHODS

A one-group repeated measures design was used to evaluate the relationship between multitasking, demographic factors, cognitive workload, and temporal individual differences. One hundred sixty fourth-year, prelicensure nursing students independently completed two 45-min multiple patients simulations involving care of three interactive patient simulators. Participants completed the Multitasking Preference Inventory, Time Perspective Inventory, Experiences of Time survey, and Time Urgency Scale before simulation. A summary Creighton Simulation Evaluation Instrument score was used to represent multitasking. Participants completed the Task Load Index to represent cognitive workload. We calculated deviation from balanced time perspective and measured its correlation with multitasking. Regression models calculated how much variance deviation from balanced time perspective, demographic factors, and cognitive workload contributed to multitasking.

RESULTS

Standardized test scores were more predictive of multitasking than deviation from balanced time perspective (β = 0.19, t = 2.48, p = 0.0142). As deviation from balanced time perspective increased, multitasking behaviors decreased (r = - 0.17), participants reported a higher sense of urgency (r = 0.39), and they had more frustration after simulation (r = 0.22). Deviation from balanced time perspective did not influence cognitive workload.

CONCLUSIONS

Nursing students who demonstrate multitasking behaviors tend to have a more balanced time perspective. Knowing students' deviation from balanced time perspective may help educators anticipate who will need more assistance with multitasking in simulation. Nursing students frequently wait until just before graduation to provide care for multiple patients; including mention of deviation from balanced time perspective in simulation preparation may help senior nursing students become more self-aware and ultimately improve behavioral performance.

New graduate nurses' clinical competence: A mixed methods systematic review

AIM

To appraise and synthesize evidence of empirical studies reporting assessment of new graduate nurses' clinical competence in clinical settings.

DESIGN

Mixed methods systematic review.

DATA SOURCES

The search strategy included keywords relevant to: new graduate nurse; clinical competence; and competence assessment. The searched literature databases included CINAHL, MEDLINE, Embase, PsycINFO and Web of Science. The search was limited to full-text papers in English or French, published between 2010 -September 2019.

REVIEW METHODS

Inclusion criteria were: 1) empirical studies; 2) detailed method and complete results sections; 3) competence assessment in clinical settings; and 4) new graduate nurses (≤24 months). Two independent reviewers screened eligible papers, extracted data and used the Mixed Methods Appraisal Tool framework for quality appraisal. Divergences were solved through discussion.

RESULTS

About 42 papers were included in this review: quantitative (N = 31), qualitative (N = 7) and mixed methods (N = 4). Findings suggest that new graduate nurses exhibit a good or adequate level of competence. Longitudinal studies show a significant increase in competence from 0-6 months, but findings are inconsistent from 6-12 months.

CONCLUSION

There are a multitude of quantitative tools available to measure clinical competence. This suggests a need for a review of their rigor.

IMPACT

No recent reviews comprehensively synthesized the findings from new graduate nurses' clinical competence. This review has found that new graduate nurses' competence has been mostly assessed as good, despite the expectation that they should be more competent. Longitudinal studies did not always show a significant increase in competence. These findings can help nurse educators in providing more support to new graduate nurses throughout the transition period or design improved transition programme. This review also identified quantitative tools and qualitative methods that can be used for competence assessment.

Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study

AIM

This study examined transition shock experiences in newly graduated nurses as well as its relative influence on job outcomes (job satisfaction, stress and burnout, and intent to leave their organisation) and select patient outcomes (missed care, adverse events and perceived quality of care).

BACKGROUND

Transition shock is a reality common among newly graduated nurses and has been considered an issue relevant to nursing administrators. To date, the mechanism by which transition shock perception is linked with nurse and patient outcomes remains unexplored.

METHODS

A descriptive, cross-sectional design was used. One hundred seventy-six newly graduated nurses (nurses with <1 year of work experience) were included in the study. Data were collected using seven standardized scales.

RESULTS

Hospital classification (e.g., being employed in a government-owned hospital) (β = 0.255; p = .001) predicted transition shock. Overall, newly graduated nurses reported greatest challenges with regard to their expectations of the actual work environment (mean = 2.60, standard deviation = 0.42) and in balancing their professional and personal lives (mean = 2.51, standard deviation = 0.35). Higher levels of reality shock were associated with adverse patient events (β = 0.821; p = .001).

CONCLUSION

New graduates experience great challenges in balancing their professional and personal lives. Ensuring work-life balance and work readiness in newly graduated nurses may potentially reduce the occurrence of missed nursing care and adverse events.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can adequately support newly graduated nurses' transition through the implementation of empirically based transition programmes. By providing flexible work arrangement, reasonable workload, adequate nurse staffing, limited mandatory overtime and self-scheduling, nurse managers can effectively assist newly graduated nurses in attaining work-life balance.

Emotional intelligence as a mechanism to build resilience and non-technical skills in undergraduate nurses undertaking clinical placement

The environments in which nursing work is undertaken can be highly stressful and complex with resultant harmful outcomes for the health of both nurses and patients reported. Undergraduate nursing students are particularly challenged when on clinical placement through having only partially developed work capabilities, with wide claims that these nurses remain underprepared for work even upon graduation. Over time undergraduate nursing education has arguably not prioritized developing resilience and other non-technical skills required to respond effectively to these challenges. This paper reports findings from a qualitative study of student nurses who received training and coaching in emotional intelligence, a well-established correlate of resilience, just prior to undertaking a mental health or medical/surgical clinical placement. Of that cohort, 12 agreed to qualitative semi-structured interviews that sought to better understand how these students used the knowledge and capabilities from the training within clinical placement contexts. Four themes emerged from the thematic analysis of the interviews: (1) greater experiences of resilience; (2) responding positively to mental health consumers; (3) experiences of greater empathy and compassion; and (4) experiences of improved non-technical work skills. Implications from these findings suggest that student and patient experiences of nursing placement, and mental health nursing placements in particular, would be enhanced by pre-placement emotional intelligence training and coaching. Such training will support nursing graduates to be work-ready upon entering the workforce.

The impact of undergraduate clinical teaching models on the perceptions of work-readiness among new graduate nurses: A cross sectional study

BACKGROUND

Clinical Placements are an essential component of bridging the gap between academic theory and nursing practice. There are multiple clinical models designed to ease the transition from student to professional, yet there has been little exploration of such models and their impact on graduates' perceptions of work-readiness.

OBJECTIVES

This cross sectional study examined perceptions of work-readiness of new graduate nurses who attended one of the following clinical teaching models: the University Fellowship Program (UFP), the Traditional Multi-facility Clinical Model (TMCPM), and the Mixed Program (MP).

METHODS

Three groups of first year graduate nurses (UFP, TMCPM, and MP) were compared using the Work-readiness Scale, a validated and reliable tool, which assessed nurses' perceptions of work-readiness in four domains: organizational acumen, personal work characteristics, social intelligence, and work competence. A multivariable Generalized Estimating Equations regression investigated socio-demographic and teaching-modelrelated factors associated with work-readiness.

RESULTS

Of 43 nurses approached, 28 completed the survey (65% response rate) of whom 6 were UFP attendants, 8 attended the TMCPM and 14 the MP. Those who had attended the UFP scored higher than the other two in all four domains; however, the crude between-group comparisons did not yield statistically significant results. Only after accounting for age, gender, teaching setting and prior work experience, the multivariable model showed that undertaking the UFP was likely to increase perceptions of work-readiness by 1.4 points (95% CI 0.11-2.69), P=0.03). The UFP was superior to the other two placement models.

CONCLUSION

The study suggests that the UFP may enhance graduate nurses' perceptions of work readiness.

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.