A Competency Transcript to Assess and Personalize New Graduate Competency

Psychometric Evaluation of a Tool for Assessment of Clinical Development in Newly Licensed Registered Nurses

BACKGROUND AND PURPOSE

For effective evaluation of clinical development, established psychometric properties of reliability and validity are essential. The Clinical Development Assessment (CDA) tool was developed within a 12-month pediatric nurse residency program. Benner's novice-to-expert model framed the development of the CDA.

METHODS

Data from 129 nurse residents and their preceptors were used to evaluate internal consistency reliability and face, content, and construct validity. Nine elements were assigned a six-point Likert scale scored as (a) unsafe, (b) novice, (c) advanced beginner, (d) competent, (e) proficient, and (f) expert.

RESULTS

Moderately strong reliability was found. Using exploratory factor analysis, a single factor accounted for 68% of the variance in clinical development. Face and content validity were confirmed.

CONCLUSIONS

This study identified a brief, valid, and reliable tool to evaluate clinical development in newly licensed registered nurses.

Development of the Computerized Model of Performance-Based Measurement System to Measure Nurses' Clinical Competence

Critical thinking skills and clinical competence are for providing quality patient care. The purpose of this study is to develop the Computerized Model of Performance-Based Measurement system based on the Clinical Reasoning Model. The system can evaluate and identify learning needs for clinical competency and be used as a learning tool to increase clinical competency by using computers. The system includes 10 high-risk, high-volume clinical case scenarios coupled with questions testing clinical reasoning, interpersonal, and technical skills. Questions were sequenced to reflect patients' changing condition and arranged by following the process of collecting and managing information, diagnosing and differentiating urgency of problems, and solving problems. The content validity and known-groups validity was established. The Kuder-Richardson Formula 20 was 0.90 and test-retest reliability was supported (r = 0.78). Nursing educators can use the system to understand students' needs for achieving clinical competence, and therefore, educational plans can be made to better prepare students and facilitate their smooth transition to a future clinical environment. Clinical nurses can use the system to evaluate their performance-based abilities and weakness in clinical reasoning. Appropriate training programs can be designed and implemented to practically promote nurses' clinical competence and quality of patient care.

Perceived Clinical Competence among Undergraduate Nursing Students in the University of Gondar and Bahir Dar University, Northwest Ethiopia: A Cross-Sectional Institution Based Study

Introduction. To produce competent, confident, critical thinker with the ability to lead, to question, and to be questioned is needed in nursing education. This study aimed to assess perceived clinical competence among nursing students. Methods. This cross-sectional study was conducted in two nursing schools in Ethiopia. Data were collected using pretested, semistructured questionnaire. Clinical competence was measured by Short Nursing Competence Questionnaires. Binary logistic regression model was fitted to identify associated factors. An adjusted odds ratio with 95% confidence interval was computed. Results. Overall, 48.7 % of the participants perceived themselves as clinically competent. Social support [moderate (AOR = 5.87, CI: 1.346, 9.586), high (AOR = 6.27, CI: 1.741, 7.608)], type of institution [(AOR = 3.20, CI: 1.331, 7.694)], year of study [(AOR = 1.89 (4.760, 18.510)], attending theoretical classes [(AOR = 0.83 CI: 0.017, 0.412)], and clinical environment [poor (AOR = 5.65, CI: 1.837, 13.453), fair (AOR = 7.31, CI: 2.790, 15.356), good (AOR = 9.31, CI: 3.260, 19.967)] were associated with clinical competence. Conclusion. More than half of the study participants perceived themselves as incompetent. Social support, type of institution, year of study, attending theory classes, and clinical environment were associated with perceived clinical competence. Authors suggested that nursing students attend their theoretical class and utilize the available resource.

Faculty's Role in Assisting New Graduate Nurses' Adjustment to Practice

The purpose of this research was to identify nursing faculty behaviors that reduced the stress and anxiety experienced by new graduate nurses as they transcended from the role of student to professional registered nurse. New graduate nurses often go through a period of high anxiety and stress as they adapt to the role of professional nursing. Known as role transition, many new graduate nurses have difficulty remaining employed and leave the profession of nursing. Staff educators in the health-care industry have worked on developing orientation programs targeted at reducing the anxiety and stress experienced by new graduate nurses. Nursing faculty in academia have worked to provide student nurses with the education needed to practice in an ever-evolving complex health-care system. Despite efforts to provide the education needed, role transition remains a relevant barrier in the ability of many nurses to adjust from the role of student to professional registered nurse. Once specific behaviors were identified, a beginning theory was developed. The beginning theory was developed from the five categories derived from the coding process. They are caring, rigor, experience, knowledge, and professionalism. The purpose of the beginning theory is to provide guidance for nursing faculty as they prepare students for professional practice.

Competence areas of nursing students in Europe

The focus of this study is on European nursing education, where there have been several reforms over the last two decades attempting to harmonise curricula and degree structures. One of the most powerful reforms was started by the Bologna Declaration in 1999; since then, significant progress has been made towards achieving the European Higher Education Area (EHEA) and the implementation of the European Qualifications Framework (EQF) in education practice. The Directive of recognition of professional qualifications (2005/36/EC) regulates nursing education. All these strategies aim to harmonise nursing education, but specific competence areas in nursing are still missing within the European Union (EU). The purpose of this review was to seek competence areas for nursing students within the EU as identified in previous studies and other documents. Altogether, 67 competence areas were identified and classified into eight main categories: (1) professional and ethical values and practice, (2) nursing skills and intervention, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, and (8) research utilisation. In order to obtain a comprehensive concept of competence, more research is needed on nursing students' competence areas across the EU due to the fact that the EU is a common labour market and nurses are educated for the EU as a whole. Nursing is a global profession and nurse competence is central to patient care outcomes, so it is also internationally important that nurses have good competence.

Clinical judgment: the last frontier for evaluation

Nursing educators and preceptors often find it difficult to evaluate prelicensure students' clinical judgment development. Clinical judgment is critical to excellent patient care decisions and outcomes. The Lasater Clinical Judgment Rubric, a validated, evidence-based clinical judgment rubric, is described as a tool that offers a common language for students, nurse educators, and preceptors and a trajectory for students' clinical judgment development. The rubric has been used to provide feedback for reflective journals and a means for self-evaluation in addition to a guide for formulating higher level thought questions to shape students' thinking like a nurse.

Competency education and validation in the United States: what should nurses know?

This article provides an overview of the progress in the past decade toward effectively documenting the initial and continuing competence of registered nurses.