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

Level of clinical competency and associated factors of nursing students in Ethiopia: systematic review and meta-analysis

BACKGROUND

Assessing the clinical level of competency in nursing students is crucial as it represents the ultimate goal of nursing education. Poor competency result in low performance and can be affected by various factors. Thus, the aim of this study was to identify level of clinical competency and associated factors of nursing students in Ethiopia.

METHODS

systematic review and meta-analysis was employed. Searching strategy was conducted from January up to march 2024 from Web of Science, PubMed and Google Scholar. The quality of studies was assessed using PRISMA checklist. A meta-analysis was performed using R Studio with the meta package Version 1.4.1106.

RESULTS

in total, 145 studies were identified through database search, and only 7 studies were included in the meta-analysis representing 1937 nursing students. The pooled effect size of clinical competency of nursing students was 28%. Three factors were found to be associated with clinical competency: a positive clinical learning environment, student confidence in performing procedures, and effective staff-student interaction. The effect sizes of these factors were 6.30, 2.23, and 7.76, respectively.

CONCLUSION AND RECOMMENDATION

The clinical competency of nursing students was 28%, and it was associated with clinical learning environment, student confidence in performing procedures, and staff-student interaction. Nursing education programs should focus on enhancing students' competency levels by addressing specific factors. (PROSPERO) INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS: CRD42022367057.

Psychometric Testing of the Newly Developed Competence Scale for Clinical Nurses

BACKGROUND

Nursing competence is an essential element in ensuring high-quality nursing care and positive patient outcomes. Valid and reliable assessment tools for assessing nurse competence are needed to help nurse supervisors measure whether nurses are performing their job well and to provide a baseline for improving the competences of nurses.

PURPOSE

This study was designed to develop and psychometrically validate the Competence Scale for Clinical Nurses (CSCN).

METHODS

The CSCN was developed in three steps: (a) generalize assessment items from nursing competence-related scales and a review of the relevant literature, (b) determine the content validity of the developed scale, and (c) psychometrically test the developed scale. Five hundred nurses were recruited from a medical center in southern Taiwan. Exploratory and confirmatory factor analyses were executed to analyze construct validity and internal consistency reliability.

RESULTS

The scale-content validity index was .87, as determined by five experts. Two thirds (63.29%) of the variance was explained by three factors: basic care skills (nine items), being dedicated to work (five items), and patient-centered and ethical considerations (four items). A second-order confirmatory factor analysis indicated that the data fit the model well. The Cronbach's alpha coefficients for each of the three factors and the total scale were .84-.91.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The 18-item CSCN is a feasible and time-efficient tool for assessing competence in clinical nurses. Nursing supervisors may use this tool to explore nurses' competency and routinely track the effect of continuing education on competence. Continuous evaluation of nurses' clinical-based competence using the CSCN is recommended.

Effectiveness of pediatric learning modules in enhancing competencies among nurses in a specialized unit

The global shortage of highly competent nurses has forced healthcare organizations to adapt to various strategies, including rotating nurses to different units, impacting their competency levels. To equip nurses with the needed competencies, the researchers developed the pediatric learning modules and conducted this study to analyze their effectiveness. Researchers employed purposive and random sampling to identify study participants, and utilized a mixed-method design, including Solomon Four Group Design and a narrative approach. A researcher-made evaluation questionnaire, competency checklists, and guide questions for a written narrative were used to collect data. Descriptive statistics and factorial analysis of covariance were utilized for data analysis. The outcomes revealed that demographic variables have no effect on knowledge and competence (p > 0.05). It was also discovered that exposure to learning modules enhanced the competence levels of nurses who were inexperienced in the pediatric setting (F = 41.183, df = 1, p = 0.000). Furthermore, results revealed that enhancing knowledge and competencies is not wholly dependent on well-structured educational sessions and training modules, but is also influenced by other factors, including time allocation for module delivery, protected time to practice, and the opportunity to apply new skills in the clinical area.

Competences in the training of nurses to assist the airway of adult patients in urgency and emergency situations

Objective:

construction and validation in appearance and content of the competence frameworks and of the Entrustable Professional Activities to develop skills in the training of nurses to assist the airway of adult patients in urgency and emergency situations.

Method:

a descriptive and methodological study developed in four phases: in the first, a workshop was held, composed of experts, for the construction of the competence frameworks; in the second, the material was validated using the Snowball Technique and the Delphi Technique, in the third, content analysis and calculation of the Content Validation Index were conducted; and in the fourth phase, the Entrustable Professional Activities were built, validated in simulated workshops.

Results:

the competence frameworks were built and validated, with a resulting CVI≥0.85 in all the items. The Entrustable Professional Activities were validated by experts regarding their applicability; of these, 44% stated they were applicable in simulated environments, 100% that they were useful content and with appropriate language, 22% suggested the insertion of new items to assess competence, 11% reported the difficulty of assessing competence individually in the clinical settings, and 11% of the experts referred to the need for prior training of the teacher/facilitator to use it.

Conclusion:

the study resulted in the construction of competence frameworks and six Entrustable Professional Activities relating them to the domains of essential competences in the training of nurses to assist the airway of adult patients in urgency and emergency situations. The participation of experts in the construction and validation of this material was essential to guarantee the theoretical and practical relevance of the result.

A Transparent Tracking System for Competency-Based Orientation: One Children's Hospital Transport Unit Experience

When nurses are hired for positions that require lengthy, highly specialized in-house orientation, their failure to complete orientation on time can lead to staffing shortages. In this article, we report the use of a transparent tracking system to monitor nurses' progress through a competency-based orientation program. By monitoring progress and detecting lapses, immediate remediation can be offered to those who need it, and staffing shortages thereby are avoided.

Comparing Intravenous Insertion Instructional Methods with Haptic Simulators

Objective. The objective of this review was to compare traditional intravenous (IV) insertion instructional methods with the use of haptic IV simulators. Design. An integrative research design was used to analyze the current literature. Data Sources. A search was conducted using key words intravenous (IV) insertion or cannulation or venipuncture and simulation from 2000 to 2015 in the English language. The databases included Academic Search Complete, CINAHL Complete, Education Resource Information Center, and Medline. Review Methods. Whittemore and Knafl's (2005) strategies were used to critique the articles for themes and similarities. Results. Comparisons of outcomes between traditional IV instructional methods and the use of haptic IV simulators continue to show various results. Positive results indicate that the use of the haptic IV simulator decreases both band constriction and total procedure time. While students are satisfied with practicing on the haptic simulators, they still desire faculty involvement. Conclusion. Combining the haptic IV simulator with practical experience on the IV arm may be the best practice for learning IV insertion. Research employing active learning strategies while using a haptic IV simulator during the learning process may reduce cost and faculty time.

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.

Factors affecting the communication competence in Iranian nursing students: a qualitative study

Background:

Communication competence in nursing students is one of the nursing education requirements, especially during the internship period, the final stage of the bachelor nursing education in Iran. Several factors can influence this competence and identifying them could help provide safe care by nursing students in the future.

Objectives:

This study aimed to investigate factors that influence nursing students' communication competence.

Patients and Methods:

A purposeful sampling technique was used to select 18 nursing students who had completed their internship. Semi-structured interviews were conducted and data were analyzed by the conventional qualitative content analysis method.

Results:

After data analysis, three main categories were achieved: organizational factors, humanistic factors and socio-cultural factors. The main and latent theme that affected the students' communication competence was not being accepted as a caregiver in the clinical environment.

Conclusions:

With regards to students not being accepted in health care environments, it is recommended to plan special programs for empowering students to acquire better social state and acceptance by the health care team.

A systematic review of the literature to support an evidence-based precepting program

AIM

To provide a systematic review of the literature regarding development of an evidence-based Precepting Program for nurses transitioning to burn specialty practice.

BACKGROUND

Burned patients are admitted to specialty Burn Centers where highly complex nursing care is provided. Successful orientation and integration into such a specialized work environment is a fundamental component of a nurse's ability to provide safe and holistic patient care.

DESIGN

A systematic review of the literature was performed for the period 1995-2011 using electronic databases within PUBMED and Ovid search engines.

DATA SOURCES

Databases included Medline, CINHAL, ProQuest for Dissertations and Thesis, and Cochran Collaboration using key search terms: preceptor, preceptee, preceptorship, precept*, nurs*, critical care, personality types, competency-based education, and learning styles.

REVIEW METHODS

Nurses graded the level and quality of evidence of the included articles using a modified 7-level rating system and the Johns Hopkins Nursing Quality of Evidence Appraisal during journal-club meetings.

RESULTS

A total of 43 articles related to competency (n=8), knowledge acquisition and personality characteristics (n=8), learning style (n=5), preceptor development (n=7), and Precepting Programs (n=14).

CONCLUSIONS

A significant clinical gap existed between the scientific evidence and actual precepting practice of experienced nurses at the Burn Center. Based on this extensive review of the literature, it was determined that a sufficient evidence base existed for development of an evidence-based Precepting Program.

Stabilizing and retaining a quality nursing work force through the use of the Married State Preceptorship Model

BACKGROUND

The nursing shortage requires new graduate registered nurses (RNs) to work at the bedside, often leading to a shortened orientation period and increased stress. In the Married State Preceptorship Model (MSPM), the preceptor and the preceptee work together as the new graduate RN transitions to the bedside while maintaining safety and quality. This study explored first-year turnover rates of new graduate RNs and new graduate RNs' and preceptors' perceptions of the MSPM in transitioning new graduate RNs to practice.

METHODS

Focus groups and surveys were used with 108 new graduate RNs and 100 preceptors.

RESULTS

Four themes emerged for new graduate RNs: partnership, critical thinking, learning, and transition. A statistically significant decrease in turnover rates was seen with MSPM versus traditional precepting. Survey data found that new graduate RNs and preceptors perceived the MSPM as promoting safety and reducing anxiety.

CONCLUSION

The MSPM allows organizations to retain a quality nursing work force focused on safety patient care by transitioning new graduate RNs into the practice setting.

The relationship between the levels of nurses' competence and the length of their clinical experience: a tentative model for nursing competence development

AIMS AND OBJECTIVES

To explore the relationship between the levels of nurses' competence and the length of their clinical experience, in order to provide a tentative model of the continuing competence of nurses.

BACKGROUND

The professional development of employees has attracted great interest. This interest has led to the development of various models that illustrate how employees develop their competence throughout their careers. However, little is known of how nurses maintain and develop their competence throughout their career pathways.

DESIGN

A cross-sectional design was used.

METHODS

Using a survey method, five dimensions of self-assessed nursing competence and the length of the nurses' clinical practice were measured (n = 325). Each dimension of competence was plotted against the length of their clinical experience using locally weighted scatterplot smoothing. Then, the shapes of the plots were analysed by fractional polynomial regression analysis.

RESULTS

Overall, the relationships between the levels of nursing competence and the length of clinical experience were illustrated by curves with a rapid increase in competence levels at the early stage of the nursing career and a slower increase later. These curves were modelled by either a logarithmic, square-root function or its reciprocal. The results supported the learning curve model.

CONCLUSIONS

The competence development of nurses may be characterised by two distinctive periods: a rapid growth period followed by stable periods. However, the modality of the growth may be different depending on which dimension of nursing competence is in focus.

RELEVANCE TO CLINICAL PRACTICE

The level of nursing competence directly affects the quality of care provided to patients. The findings of the study enable healthcare organisations to take proactive approaches to enhance nurses' competence by identifying when and how to assist nurses.