Simulation as a learning strategy: supporting undergraduate nursing students with disabilities.

AIMS AND OBJECTIVES: To promote simulation as a learning strategy to support undergraduate nursing students with disabilities. BACKGROUND: Supporting undergraduate nursing students with disabilities has gained further momentum because of amendments to the Disability Discrimination Act in 2009. Providers of higher education must now ensure proactive steps to prevent discrimination against students with a disability are implemented to assist in course progression. Simulation allows for the impact of a student's disability to be assessed and informs the determination of reasonable adjustments to be implemented. Further suitable adjustments can then be determined in a safe environment and evaluated prior to scheduled placement. Auditing in this manner, offers a risk management strategy for all while maintaining the academic integrity of the program. DESIGN: Discursive. METHODS: Low, medium and high fidelity simulation activities critically analysed and their application to support undergraduate nursing students with disabilities assessed. RESULTS: With advancing technology and new pedagogical approaches simulation as a learning strategy can play a significant role. In this role, simulation supports undergraduate nursing students with disabilities to meet course requirements, while offering higher education providers an important risk management strategy. CONCLUSION: The discussion recommends simulation is used to inform the determination of reasonable adjustments for undergraduate nursing students with disabilities as an effective, contemporary curriculum practice. Adoption of simulation, in this way, will meet three imperatives: comply with current legislative requirements, embrace advances in learning technologies and embed one of the six principles of inclusive curriculum. Achieving these imperatives is likely to increase accessibility for all students and offer students with a disability a supportive learning experience. RELEVANCE TO CLINICAL PRACTICE: Provides capacity to systematically assess, monitor, evaluate and support students with a disability. The students' reasonable adjustments can be determined prior to attending clinical practice to minimise risks and ensure the safety of all.

Competency measurements: testing convergent validity for two measures.

AIM: This paper is a report of a study to investigate whether the Australian National Competency Standards for Registered Nurses demonstrate correlations with the Finnish Nurse Competency Scale. BACKGROUND: Competency assessment has become popular as a key regulatory requirement and performance indicator. The term competency, however, does not have a globally accepted definition and this has the potential to create controversy, ambiguity and confusion. Variations in meaning and definitions adopted in workplaces and educational settings will affect the interpretation of research findings and have implications for the nursing profession. METHOD: A non-experimental cross-sectional survey design was used with a convenience sample of 116 new graduate nurses in 2005. The second version of the Australian National Competency Standards and the Nurse Competency Scale was used to elicit responses to self-assessed competency in the transitional year (first year as a Registered Nurse). FINDINGS: Correlational analysis of self-assessed levels of competence revealed a relationship between the Australian National Competency Standards (ANCI) and the Nurse Competency Scale (NCS). The correlational relation between ANCI domains and NCS factors suggests that these scales are indeed used to measure related dimensions. A statistically significant relationship (r = 0.75) was found between the two competency measures. CONCLUSION: Although the finding of convergent validity is insufficient to establish construct validity for competency as used in both measures in this study, it is an important step towards this goal. Future studies on relationships between competencies must take into account the validity and reliability of the tools.

Relating new graduate nurse competence to frequency of use.

The healthcare workplace can be a stress-laden environment for new graduates and job performance indicators are an important sign of developing confidence and expertise that will lead to improved patient outcomes. What is not evident from nursing studies is whether new graduate nurse competencies relate to the frequency of their use. This study sought to determine the relationship between perceived nursing competence and self-assessed frequency of use by new graduate nurses. Three cohorts (n = 116) of new graduate nurses undertaking year-long transition to graduate practice programs responded to a questionnaire that utilised the 2001 ANCI competencies and the Nurse Competency Scale and a Visual Analogue scale to self assess their perceived competence and the relative frequency of use for specific competence items. Results indicate that a relationship exists between perceived competence and frequency of use and that research competency scores are substantially lower than all other categories of competency. Implications for education and practice indicate that assessment of nurse competency for the new graduate nurse should focus on the development of generic nursing competencies rather than current expectation of advanced and workplace specific nurse competencies.

Psychometric properties of the Australian nurse competency 2000 standards.

BACKGROUND: The Australian Nursing Competency Incorporated (ANCI) 2000 standards provide a standardised framework of accepted professional standards for the registered nurse. AIM: The study aimed to examine the psychometric properties of the ANCI 2000 national competency standards for measuring nursing competence in new graduate nurses. RESEARCH DESIGN AND METHODS: One hundred and sixteen new graduated nurses from three metropolitan public hospitals were surveyed. The psychometric properties of the ANCI 2000 including internal consistency and construct validity were examined. RESULTS: The mean score was lowest for competency unit 6 (mean 5.96) and highest for competency unit 4 (mean 8.83). The internal reliability for the total ANCI 2000 was alpha=.93 and for the domain alpha=.81 (Domains 1 and 3), alpha=.79 (Domain 2), and alpha=.77 (Domain 4). Confirmatory factor analysis using the domains as factors confirmed the 4 factor structure although 3 factors had two items each with loadings in the .4-.5 range. CONCLUSIONS: There are inconsistencies in the psychometric properties of the ANCI 2000 which suggest that further investigation is warranted before it can be used as an instrument for the measurement of new graduate competencies.

New graduate nurse self-concept and retention: a longitudinal survey.

Graduate nurse attrition is an increasing phenomenon within a world of decreasing nursing numbers. The newly developed nursing self-concept of the graduate nurse may provide a key indicator for predicting graduate retention. This study explores the development of multiple dimensions of nursing self-concept and examines their relationship to graduate nurse retention plans. A descriptive survey design with repeated measures was utilised to assess nurse self-concept and retention plans. The key findings suggest that multiple dimensions of graduate nurse self-concepts rise significantly in the second half of their graduate year and that nurse general self-concept is a strong predictor of graduate nurse retention. The implications of this study are that monitoring of self-concept throughout the transitional period for new nurses can lead to early detection and appropriate intervention strategies thereby improving retention rates for new nurses.