Competency gap among graduating nursing students: what they have achieved and what is expected of them.

BACKGROUND: Nurses' professional competencies play a significant role in providing safe care to patients. Identifying the acquired and expected competencies in nursing education and the gaps between them can be a good guide for nursing education institutions to improve their educational practices. METHODS: In a descriptive-comparative study, students' perception of acquired competencies and expected competencies from the perspective of the Iranian nursing faculties were collected with two equivalent questionnaires consisting of 85 items covering 17 competencies across 5 domains. A cluster sampling technique was employed on 721 final-year nursing students and 365 Iranian nursing faculties. The data were analyzed using descriptive statistics and independent t-tests. RESULTS: The results of the study showed that the highest scores for students' acquired competencies and nursing faculties' expected competencies were work readiness and professional development, with mean of 3.54 (SD = 0.39) and 4.30 (SD = 0.45), respectively. Also, the lowest score for both groups was evidence-based nursing care with mean of 2.74 (SD = 0.55) and 3.74 (SD = 0.57), respectively. The comparison of competencies, as viewed by both groups of the students and the faculties, showed that the difference between the two groups' mean scores was significant in all 5 core-competencies and 17 sub-core competencies (P < .001). Evidence-based nursing care was the highest mean difference (mean diff = 1) and the professional nursing process with the lowest mean difference (mean diff = 0.70). CONCLUSION: The results of the study highlight concerns about the gap between expected and achieved competencies in Iran. Further research is recommended to identify the reasons for the gap between the two and to plan how to reduce it. This will require greater collaboration between healthcare institutions and nursing schools.

Competencies expected of undergraduate nursing students: A scoping review.

AIM: Nursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the generalization and application of findings. The purpose of this review is to identify the core competencies necessary for undergraduate nursing students to enter nursing work. DATA SOURCES: We conducted a structured search using Scopus, MEDLINE (PubMed), Science Direct, CINAHL, Web of Science, and Google Scholar. REVIEW METHODS: We conducted a scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework, and guided by the PRISMA-ScR Checklist. Inclusion criteria included full-text articles in English, quantitative and qualitative research related to competencies for undergraduate students or newly graduated nurses, competency assessment, and tool development from 1970 to 2022. We excluded articles related to specific nursing roles, specific contexts, Master's and Ph.D. curricula, hospital work environment competencies, and editorial. RESULTS: Out of 15,875 articles, we selected 43 studies, and data analysis with summative content analysis identified five themes named individualized care, professional nursing process, nursing administration, readiness, and professional development. CONCLUSION: Considering the dynamics of competencies and their change with time, experience, and setting, it is necessary to update, localize, and levelling of the proposed competencies based on the culture of each country. IMPACT: These competencies provide a guide for undergraduate nursing curriculum development and offer a framework for both clinical instruction and the evaluation of nursing students.

Senior nursing student's confidence in learnt competencies and perceptions of patient safety competency: a multisite cross-sectional study.

OBJECTIVE: Nursing students' attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students' confidence of their PS competencies, and associated predictive factors. DESIGN: Cross-sectional study. SETTING: Four faculties from the nursing faculties of East Azerbaijan province. PARTICIPANTS: 253 senior nursing students in Iran. PRIMARY AND SECONDARY OUTCOME MEASURES: Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient's safety competencies were identified by linear regression statistics. RESULTS: Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of 'understanding human and environmental factors' in the classroom and the clinical setting. Nursing students displayed the least confidence in learning 'work in teams with other health professionals' in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students' perceived competency scores in the classroom (R2=0.53, p<0.001). Also, perceived competence in the clinical settings was predicted by the variables of reporting errors to personnel and peers and the type of university (R2=0.65, p<0.001). CONCLUSION: Study findings emphasise the role of learning environments and educational experiences of nursing students especially the clinical environment, clinical instructors and the hidden curriculum in improving safety competence. Nursing educators can use this information to revise and develop the undergraduate nursing curriculum, paying close attention to lesson plans and content in relation to teaching safety issues.

Identifying self-presentation components among nursing students with unsafe clinical practice: a qualitative study.

BACKGROUND: Maintaining patient safety is a practical standard that is a priority in nursing education. One of the main roles of clinical instructors is to evaluate students and identify if students exhibit unsafe clinical practice early to support their remediation. This study was conducted to identify self-presentation components among nursing students with unsafe clinical practice. METHODS: This qualitative study was conducted with 18 faculty members, nursing students, and supervisors of medical centers. Data collection was done through purposive sampling and semi-structured interviews. Data analysis was done using conventional qualitative content analysis using MAXQDA10 software. RESULTS: One main category labelled self-presentation emerged from the data along with three subcategories of defensive/protective behaviors, assertive behaviors, and aggressive behaviors. CONCLUSION: In various clinical situations, students use defensive, assertive, and aggressive tactics to maintain their professional identity and present a positive image of themselves when they make a mistake or predict that they will be evaluated on their performance. Therefore, it seems that the first vital step to preventing unsafe behaviors and reporting medical errors is to create appropriate structures for identification, learning, guidance, and evaluation based on progress and fostering a growth mindset among students and clinical educators.

Comparison of the Iranian and Scandinavian bachelor of nursing curriculum (Sweden): A scoping review.

BACKGROUND: The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care. MATERIALS AND METHODS: The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases. RESULTS: The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation. CONCLUSION: It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.

The Relation of Work Ability and Return to Work Among Iranian Cancer Survivors.

OBJECTIVE: Cancerous diseases are known to disrupt a person's ability and inflict physical, psychological, financial, and social complications on the person, thereby challenging an individual's returning to work. The aim of this study was to investigate the ability of cancer patients to work after returning to work. METHODS: This descriptive-correlational study examined a total of 227 surviving cancer patients, having picked the participants through convenience sampling. Data were collected by the return to work and work ability index (WAI) questionnaires and analyzed by descriptive statistics and inferential statistics using SPSS software. RESULTS: A total of 166 (73.2%) of the participants had returned to work after completing the basic treatment. The mean (standard deviation) of the work ability score was 29.52 (9.43), ranging from 9 to 43 while the average daily work hours dropped from 12.30 to 5.50. The chi-square test showed a significant relationship between the work ability score and the type of return to work. Moreover, the rank logistic regression analysis revealed that work ability was the most important predictor of return to work. CONCLUSION: Survivors of cancer face reduced working hours and limited ability to work after returning to work, and it is possible to facilitate the return to work in these patients by identifying their job needs in relation to their abilities and barriers of returning to work through the appropriate interventions.

Content analysis of identity challenges in patients with haemophilia: A qualitative study.

AIMS: Inherited bleeding diseases greatly affect education, working, job, social activities and quality of life. We aimed to discover the sources of identity challenges among patients with Haemophilia. DESIGN: The present study has been designed and performed as a qualitative content analysis research. METHODS: Participants were purposively selected from haemophilia patients referred to our clinic during one year, from March 2018 to April 2019. Data collection was done through semi-structured, in-depth interviews using purposeful sampling. Data were analysed based on Granheme and Landman method. The main categories were fear of rejection, losing social roles, discrimination and stigma and marriage breakdown. RESULTS: Patients with haemophilia encounter several challenges due to physical and social constraints caused by the disease. Such challenges result in disturbances in the self-identity of the patients. CONCLUSION: According to the results of this study, the nurses should plan to have attention to the patients with haemophilia, based on more protection and better supports.

Improving the safety and quality of the intra-hospital transport of critically ill patients.

BACKGROUND: Adverse events during patient transport are common and may threaten critically ill patients' lives. AIM: This study aimed to determine the incidence of adverse events during intra-hospital transport and to obtain suggestions from critical care nurses for improving the transportation process. DESIGN: This was a cross-sectional study. METHODS: This study was carried out with 160 critical care nurses between September 2018 and January 2019. Data were collected through a semi-structured interview using a 53-item questionnaire developed by Brunsveld-Reinders et al. It assesses nurses' experiences of adverse events during the three phases of intra-hospital transport related to equipment, patient physiology, monitoring, medications, and fluid management. The data were analysed using descriptive statistics in SPSS software, and the responses of open-ended questions were analysed using a conventional qualitative content analysis. RESULTS: On scales from 0 to 10, the mean (and SD) values of fear, confidence, and skill to carry out a safe intra-hospital transport were 2.66 (2.73), 6.45 (3.16), and 7.75 (1.55), respectively. The most important causes of feeling afraid or unconfident about the transport among the nurses were unstable patient condition, cardiac arrest, extubation, and oxygen desaturation. In all three phases, oxygen desaturation, haemodynamic instability, and agitation were reported as the most frequent events. The most important suggestions by nurses for improving the transport process were related to paying attention to the patient's clinical condition and connections before, during, and after the transfer. CONCLUSIONS: Along with the acquisition and improvement of technical and tactical skills, adequate human resources and appropriate equipment can improve the quality of intra-hospital transport. RELEVANCE TO CLINICAL PRACTICE: Nurses are key members of the transport team and lead the team. They are responsible for keeping patients safe during transport. By identifying adverse events and trying to modify risk factors, nurses can improve patients' safety.

The Relation of Readiness for Return to Work and Return to Work Among Iranian Cancer Survivors.

Return to work after completion of cancer treatments has many benefits for patients, families, and society. Readiness for return to work (RRTW) seems to be an effective factor for return to work in cancer survivors. Therefore, the present study was to investigate return to work and its relation to RRTW among Iranian survivors of cancer. This descriptive-correlational study examined a total of 227 survived cancer patients with completed primary treatments and without active cancer symptoms. Data were collected by the return to work and RRTW questionnaires and analyzed with descriptive statistics and inferential statistics using SPSS software. Upon completion of initial treatment, 166 (73.2%) of survivor participants returned to work, of which 78 (34.4%) and 88 (38.4%) participants returned to full-time and part-time works, respectively. ANOVA test showed a significant difference between RRTW and the type of return to work. In addition, results of regression analysis revealed that there was a positive significant relationship between RRTW and the rate of return to work before and after the adjustment of variables (p ≤ 0.05). Considering the findings of the study, there is a necessary need planning for rehabilitation programs by nursing managers concerning these patients to facilitate their return to work.

The Relationship between Health Literacy and Stages of Change in Smoking Behavior among Employees of Educational Health Centers of Tabriz University of Medical Sciences (2016).

BACKGROUND: Health literacy has been considered as a predictor of starting, maintaining, and stop smoking. However, such relations have not been well documented in previous texts. Therefore, the purpose of this study was to investigate the relation between health literacy and changes in the behavior of smoking in Tabriz University of Medical Sciences. METHODS: In this correlational descriptive study, a total of 297 employees of Tabriz health centers were examined. To collect data, a demographic-social questionnaire, Iranian Health Literacy Questionnaire, and DiClemente's behavior change questionnaire were used. Besides, SPSS 13 software (significance level = 0.05) was employed to analyze the data. RESULTS: The average health literacy rate of participants was 70, and most respondents had adequate health literacy. Nearly 41.1% were in the precontemplation phase which is one of the stages of behavior change. There was a positive and significant statistical relation between behavior change variable with all health literacy areas (except the scope of understanding) and total health literacy score (P = 0.011 and r = 0.147). The results of ordinal regression analysis demonstrated that there is a significant positive relationship between the score of health literacy and behavioral change (b = 0.019, 95% confidence interval = (0.010-0.029), P < 0.001). CONCLUSIONS: Improving the level of health literacy can lead to change people's behavior in relation to tobacco consumption. However, due to the lack of relevant texts, there is a need for further studies in this field.

Return to work and its relation to financial distress among Iranian cancer survivors.

BACKGROUND: Return to work after treatment completion is important for both cancer survivors and society. Financial distress is one of the factors that may influence the return to work in cancer survivors. However, this relationship has not been well investigated. This study aimed to determine the rate of return to work and its relation to financial distress among Iranian cancer survivors. MATERIALS AND METHODS: This descriptive-correlational study was undertaken among 165 cancer survivors who completed their initial treatments and had no signs of active cancer. The Return to Work questionnaire and Financial Distress/Financial Well-Being Scale were used for data collection. Data were analyzed using SPSS statistical software. RESULTS: After initial treatments, 120 cancer survivors (72%) had returned to work, of which 50 patients (42%) had returned to full-time work and 70 (58%) reduced their work hours and returned to part-time work. Cancer survivors also reported high levels of financial distress. In addition, the financial distress was lower among patients who had returned completely to work, in comparison to patients who had quit working for cancer-related reasons (p=0.001) or returned to work as part-time workers (p=0.001). CONCLUSIONS: The findings showed that a high percent of Iranian cancer survivors had not returned to their jobs or considerably reduced working hours after treatment completion. Accordingly, due to high levels of financial distress experienced by participants and its relation to return to work, designing rehabilitation programs to facilitate cancer survivor return to work should be considered.