Clinical competency and associated factors among undergraduate nursing students studying in universities of Southern regional state of Ethiopia, 2021

Background

Clinical practice is the means by which nursing students learn to apply the theory, facilitating integration of theoretical knowledge and practical skill in the clinical setting which becomes arts and science of profession. This correlation of theory and practice, and the building of meaningful experience, take place during clinical practice in the health care service. Even though, nursing students need to have clinical competency during practical setting, there were little available evidences regarding to their competency status in Ethiopia. Therefore, this study was aimed to assess magnitude of clinical competency and its predictors among undergraduate nursing students studying in universities of Southern regional state of Ethiopia in 2021 G C.

Methods

Multi-centered institutional based cross-sectional study was conducted among 414 undergraduate nursing students studying in eight universities of Southern regional state of Ethiopia in 2021 academic year. Systematic random sampling technique after proportional allocation to each selected university was used to select the study participants. Data were collected using pretested structured questionnaire by face to face interview after written informed consent was obtained from each participant. Data were cleaned, coded and entered into Epidata version 3.01 and analyzed using statistical package for social science (SPSS) software version 26. Descriptive statistic for all variables and bi-variable and multi-variables logistic regression analysis to identify factors associated with clinical competency was computed and expressed in odds ratio. The result was presented in the form of text, tables and figures and those variables with P-value of <0.05 in multivariable analysis were declared as statistically significant.

Result

From 423 total calculated sample sizes, 414 of them were participated in this study giving a response rate of 97.8%. From those participants, 248 (59.9%) of them has clinical competency [95% CI: (55.18%, 64.62%)]. In multivariable analysis, studying in post basic program [AOR: 5.58], conducive clinical learning environment [AOR: 4.10], good staff-student interaction [AOR: 7.44], satisfaction [AOR: 20.66] and positive attitude towards clinical practice [AOR: 2.49] were factors significantly associated with clinical competency.

Conclusion

In this study, the overall magnitude of clinical competency was found to be unsatisfactory (59.9%). Studying in private program, non-conducive clinical learning environment, poor staff-student interaction, low satisfaction and negative attitude towards clinical practice were identified as factors associated with clinical incompetency. Policy makers, universities and teaching health facilities need to work collaboratively to create nurses with clinical competency by focusing on proper screening to select candidates for studying in private program, creating conducive clinical learning environment, integrating students with clinical staffs to facilitate learning and positive attitude change of students towards their profession to increase level of satisfaction.

Effectiveness of a critical reflection competency program for clinical nurse educators: a pilot study

BACKGROUND

Critical reflection is an effective learning strategy that enhances clinical nurses' reflective practice and professionalism. Therefore, training programs for nurse educators should be implemented so that critical reflection can be applied to nursing education. This study aimed to investigate the effects of a critical reflection competency program for clinical nurse educators on improving critical thinking disposition, nursing reflection competency, and teaching efficacy.

METHODS

A pilot study was conducted using a pre- and post-test control-group design. Participants were clinical nurse educators recruited using a convenience sampling method. The program was conducted once a week for 90 min, with a total of four sessions. The effectiveness of the developed program was verified by analyzing pre- and post-test results of 26 participants in the intervention group and 27 participants in the control group, respectively. The chi-square test, independent t-test, Mann-Whitney U test, and analysis of covariance with age as a covariate were conducted.

RESULTS

The critical thinking disposition and teaching efficacy of the intervention group improved after the program, and the differences between the control and intervention groups were statistically significant (F = 14.751, p < 0.001; F = 11.047, p < 0.001). There was no significant difference in the change in nursing reflection competency between the two groups (F = 2.674, p = 0.108).

CONCLUSION

The critical reflection competency program was effective in improving the critical thinking disposition and teaching efficacy of nurse educators. Therefore, it is necessary to implement the developed program for nurse educators to effectively utilize critical reflection in nursing education.

Development of a protocol for guidance in the pediatric nursing practicum in South Korea: a methodology study

Purpose

Practical training in pediatric nursing gives students the opportunity to apply nursing knowledge to children in a realistic clinical context. Clinical practice faculty (CPF) and clinical nursing instructor (CNI) have played important roles in the pediatric nursing practicum. This study was conducted to develop a protocol to guide clinical practicum in pediatric nursing.

Methods

A service design methodology was employed between August 2020 and May 2021 at four universities and four hospitals in South Korea. The participants were five CPFs, five CNIs, five nursing college graduates, and 60 nursing students. The service design process had four phases: discovery, definition, development, and delivery. Data were collected through self-report questionnaires, in-depth interviews, and observations. The data were analyzed using content analysis and descriptive statistics.

Results

The participants reported needs for providing concrete guidance and explanation, nursing practice experience, and a link between school and the clinical field. A protocol was developed to fulfill the participants' needs. The protocol comprised detailed information, teaching methodology, and partnership to guide students in the pediatric nursing practicum.

Conclusion

The protocol developed in this study can be used to provide guidance for students' clinical practice in the field of pediatric nursing.

Development and Validation of a Self-Efficacy Scale for Nursing Educators' Role in Sri Lanka

This study develops a scale that assesses the self-efficacy of Sri Lankan nursing educators in assuming the roles of nursing educators and validates its psychometric properties. This methodological research followed the DeVellis Scale Development Model, which involves six steps of instrument development and evaluation. Preliminary items were determined through a literature review and focus group interviews with nine Sri Lankan nursing experts. The experts, comprising five South Korean and two Sri Lankan nursing professors, tested the scale's content validity. Moreover, 15 nursing educators participated in a pilot study, and 126 educators took part in the main survey. To evaluate the scale's validity and reliability, the data from a preliminary questionnaire were analyzed using SPSS/IBM and AMOS 24.0. Further, construct validity was tested using exploratory and confirmatory factor analyses, and reliability was tested by calculating Cronbach's alpha and performing split-half testing. Finally, 39 items under four themes, "clinical mentorship" (18 items), "research" (10), "teaching" (6), and "advising" (5), explained 63.5% of the total variance. Confirmatory factor analysis results revealed an acceptable model fit for the final scale. The developed scale achieved a Cronbach's alpha value of 0.97. Thus, the psychometrical properties of the scale measuring Sri Lankan nursing educators' self-efficacy were comprehensively evaluated and found acceptable. The developed scale will be useful in guideline development or studies regarding the self-efficacy of nursing educators' roles in developing countries with similar context to Sri Lanka.

Factors associated with teaching efficacy among nurse educators in hospital settings

AIMS AND OBJECTIVES

The objective of this study was to examine differences in personal characteristics, core practice competency and role stress according to levels of teaching efficacy among clinical nurse educators working in general hospitals.

BACKGROUND

In the clinical setting, successful adaptation to instruction among practicing clinical nurse educators is challenging.

DESIGN

Secondary analysis of data through a cross-sectional study design was adopted.

METHODS

Originally, 565 nurses were recruited from general hospitals; 364 were included in this study. Participants were nurses with more than 1 year of experience in various settings from 16 general hospitals wherein nursing students trained for clinical practicum in five cities in South Korea. Self-reported data were collected via the Teaching Efficacy, Core Practice Competency and Perceived Stress Scales assessing clinical education-related teaching efficacy, core practice competency and role stress. In the analyses, comparison between nurses with high and low teaching efficacy was conducted. We have followed through the EQUATOR (e.g. STROBE) research checklist for the preparation of this manuscript.

RESULTS

According to univariate analysis, levels of teaching efficacy were shown to be higher with age, longer clinical careers, in those undergoing a doctoral course or with a doctorate, previous experience in providing clinical education and enrolment in continuing education for clinical education. In the multivariate analysis, enrolment in continuing education for clinical education, assessment and intervention skills, critical thinking skills, teaching skills and role ambiguity were associated with level of teaching efficacy among nurse educators.

CONCLUSION

Based on the results of this study, we recommend that nursing administrators should foster the recognition of personal characteristics in potential clinical nurse educators or preceptors with high teaching efficacy.

RELEVANCE TO CLINICAL PRACTICE

Nurses should be supported by providing them with opportunities for professional development to enhance teaching efficacy.