Levels' of attainment in nursing practice: reality or illusion? (original) (raw)
Related papers
Journal of Clinical Nursing, 2005
Assessing competency in nursing: a comparison of nurses prepared through degree and diploma programmes Aims and objectives. The present study aimed to investigate the competencies of qualifiers from three-year degree and three-year diploma courses in England at one, two and three years after qualification. Background. The provision of three-year preregistration nursing degrees in the UK has increased in recent years and in many colleges degrees are offered alongside the existing three-year diploma courses. Yet little is known about the relationship between these different education programmes and the competence of qualifiers. Methods. A cross-sectional survey design was employed to make comparisons of both self-reported and line-manager-rated competencies of graduate and diplomate nurses who had qualified up to three years previously. Instruments. A revised version of the Nursing Competencies Questionnaire was used to measure both overall competence and also eight specific nursing competencies. A shortened version of this scale was also used to assess internal consistency across measures. Two additional competencies, research awareness and policy awareness, were also measured. Results. Structural equation modelling found very little difference in the overall competence and specific competencies of graduates and diplomates. Where differences were found in the self-report data, diplomates scored more highly than graduates in the constructs of planning and social participation; however, these differences became non-significant when background variables were controlled for. Limitations. The findings are interpreted with caution due to the size of differences, the size of some of the samples of respondents and the developmental stage of the instrument used. Conclusions. It does not appear that graduates and diplomates in England differ in their level of competence to any great extent as measured by the Nursing Competencies Questionnaire. Areas of further work are discussed in the light of the findings.
Nursing competence 10 years on: fit for practice and purpose yet?
Journal of Clinical Nursing, 2008
Nursing competence 10 years on: fit for practice and purpose yet? Aims and objectives. This paper examines how nurses are prepared to be clinically competent and safe at registration, so that they are fit for practice and purpose. It follows up two papers on competence published in 1997 and 1998 and investigates subsequent developments. Background. In 1979, major changes in nursing affected nurse education and preparation for competence. In the following two decades, it became clear that nurses lacked clinical skills. This paper examines subsequent changes and asks the question whether this crucial shortcoming has now been remedied. This paper considers the background and context of change in nursing and nurse education in the 1980s. It looks at the new ideology, to prepare the 'knowledgeable doer' and examines the consequences of the change on nursing competency from the 1990s to the present day. Methods. This is a position paper. Professional policy documents from the English National Board for Nursing, Midwifery and Health Visiting, United Kingdom Central Council for Nursing, Midwifery and Health Visiting and Nursing and Midwifery Council, government reports and legislation on nursing and relevant nursing literature are examined and critically analysed and conclusions drawn. Conclusions. From 1923-1977, mandatory nursing syllabuses set by the General Nursing Council of England and Wales required the registered nurse to have acquired certain specific clinical skills. These were rigorously tested to an explicit standard set by the General Nursing Council before a nurse was awarded state registration. Twenty-five years later, the loss of this system for ensuring this competence and the implications of this loss, have been widely recognised. As a result, many nurse training institutions have introduced clinical skills laboratories, simulation of practice and the Objective Structured Clinical Examination. However, to the authors' surprise and contrary to their initial expectations, the Nursing and Midwifery Council has not made these systems uniform or mandatory and so still has no way of ensuring all nurse training is producing safe nurses in the United Kingdom. The authors conclude that the untested educational ideology that brought root and branch change to nurse training in 1983 and which failed to produce nurses 'fit for practice and purpose' may still prevail.
Competence in nursing practice: A controversial concept-A focused review of literature
Nurse Education Today, 2005
The competency-based approach to education, training and assessment has surfaced as a key policy in industrialised nations. Following the transition of nurse preparation to the higher education sector the need to attenuate the tension of interests between employer and educator arose. While the competency-based approach has the potential to fulfil this, the application of competence to nursing is controversial and little consensus exists on definition. This paper synthesises a significant volume of literature relating to the acceptability and definition of the concept of competence with regard to nursing practice. Subsequent to a focused review of literature, problems inherent to the definition and utilisation of the concept of nursing competence are discussed. Because nursing requires complex combinations of knowledge, performance, skills and attitudes, a holistic definition of competence needs to be agreed upon and operationalised. This could facilitate greater acceptance of the concept and also underpin the development of competency standards and the tools required for the assessment of such.
Assessing practice of student nurses: methods, preparation of assessors and student views
Journal of Advanced Nursing, 2002
2 0 0 2 ) ( 2 0 0 2 ) Journal of Advanced Nursing 38(5), 516-523 Assessing practice of student nurses: methods, preparation of assessors and student views Aims. To describe the methods of measuring progress in achieving competence of preregistration nursing and midwifery students used by institutions of higher and further education in Scotland and to describe the philosophy and approaches to competence assessment in each institution. Background. Institutions of higher and further education in Scotland operate a variety of schemes to assess the clinical practice of student nurses. These are based on different philosophies and practices and this raises the question of which are valid and reliable. Methods. All institutions in Scotland providing validated Diploma of Higher Education programmes for preregistration nursing and midwifery participated in this study. Data were collected by postal questionnaire, review of programme documentation and supplemented with interviews with key stakeholders. The directors of the 13 programmes (seven nursing and six midwifery programmes) were surveyed and also 12 group interviews with students (six nursing and six midwifery student groups) from seven institutions. Students from all four branches were represented and 72 students (36 nurses and 36 midwives) were interviewed. Results. Four key findings were identified and related to competence assessment methods, preparation of practice assessors, consequences of failure to meet expected level of outcome and students' views.
Analysis of the evolution of competences in the clinical practice of the nursing degree
Revista Latino-Americana de Enfermagem, 2020
Objective: to analyze the student’s progression in the acquisition of specific and transversal competences in relation to the competence dimensions. Method: the cross-sectional descriptive study was carried out in the clinical practice subjects included in the Nursing Degree. We included 323 students and we contemplated the development of competences through an ad-hoc questionnaire with 4 dimensions: delivery and care management, therapeutic communication, professional development and care management. Results: the academic results between the practice of the second and third year showed an improvement in care provision and therapeutic communication skills (Clinical Placements I: 12%-29%; Clinical Placements II: 32%-47%) and worsened in professional development and care management (Clinical Placements I: 44%-38%; Clinical Placements II: 44%-26%). Conclusion: the correlations between these two years were high in all the dimensions analyzed. The evaluation of competence progression in ...
Croatian Nursing Journal, 2017
aim. the aims of this research were to obtain students' opinions on the necessary knowledge for performing nursing practice listed in eU directives, student self-assessments on adopted competencies and students' opinions on internships. this research was undertaken to determine whether there are differences in student responses depending on their previous education. Methods. the final study included 61 third-year nursing students. students voluntarily and anonymously completed a questionnaire that included information such as demographic data, learning areas according to directive 2005/36/ec and competencies under directive 2013/55/eU, and questions related to the need and length of internships at the end of the nursing programme. results. At the end of the study, students considered nursing knowledge to be the most significant knowledge (M=4.74), followed by communication skills (M=4.49), and clinical and basic medical sciences. students rated research knowledge in nursing as the least significant. students who had not completed secondary nursing school gave statistically significant higher estimates related to the significance of required knowledge (p=0.035). students were cautious in their self-assessments of the acquired competencies of nursing practice. they rated their ability to empower individuals, families and groups towards healthy lifestyles and self-care the highest; and their ability to independently initiate
Evaluating the level of degree programmes in higher education: the case of nursing
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Nurse Education Today
Objectives: The purpose of this integrative review is to evaluate the empirical and theoretical literature on the challenges mentors face in interpreting and assessing levels of competence of student nurses in clinical practice. Design: An integrative review of the literature. Data sources: An extensive and systematic literature search was conducted covering the period 1986-September 2016 across twelve databases covering health and education related publications. Grey literature was searched from wide relevant sources. Review methods: Sources were eligible for review when they referred to mentor's interpretation or assessment of student nurses' level of competence in practice settings. Methodological rigor of the included studies was evaluated with the Mixed Methods Appraisal Tool. Results: After screening 1951records by titles, abstracts and full text, 8 were selected for review. The methodological quality of the studies was moderate. The studies reported: Difficulties in the language used to describe competencies. The challenge of distinguishing between different levels of competence. Lack of clear and constructive feedback to students. Accurate and fair assessment of students is impeded by a lack of transparent and explicit criteria. Conclusions: There is a need to establish a transparent and common language to distinguish between and facilitate interpretation of different levels of competence. Well-designed rubrics might offer the solution to the challenges faced in practice-based assessment and necessitates further research into their use.
Nurse Education Today, 2007
In Australia and Norway final examinations to determine eligibility for registration as a nurse were discontinued during the period when nurse education moved into the higher education sector. In response to recent calls for the reintroduction of final examinations we explore the range of knowledge needs for the practice of nursing. These various forms of knowledge demand different forms of mediation and acquisition as well as assessment. There are numerous problems identified in the literature about the shortcomings of examinations as the foundation of assessing clinically based professions. There is a need to develop systems of appropriate assessment to ensure that graduates of nursing demonstrate adequate knowledge and competence to enter their profession.