Clinical Evaluation of Competence in Nursing Education: What Do We Know?

AIM: The purpose of this article was to examine the research literature to identify objective, replicable measurement of clinical competence in undergraduate nursing education. BACKGROUND: Although a standardized licensure examination is used to determine minimal competence to practice, no consensus on the definition or components of competence exists in the research literature. METHOD: A comprehensive search was conducted to locate studies that evaluated nursing students' general competence in the clinical setting. Twelve reports published from 2010 to 2021 were examined. RESULTS: Measures to evaluate competence were varied and contained multiple concepts including attributes of knowledge, attitudes and behaviors, ethics and values, personal attributes, and cognitive or psychomotor skills. Most studies used researcher-created instruments. CONCLUSION: Although essential to nursing education, competence in the clinical setting is not commonly defined or evaluated. The lack of standardized instruments has contributed to the use of varied methods and measures for evaluating competence in nursing education and research.

Forging Unique Paths: The Lived Experience of Hispanic/Latino Baccalaureate Nursing Students.

BACKGROUND: The purpose of this study was to describe the lived experience of Hispanic/Latino nursing students, as shared by new graduates of baccalaureate nursing programs in the southeastern United States. METHOD: This research used descriptive phenomenology with in-depth, private, semistructured interviews. Data were analyzed using inductive analysis methods consistent with Braun and Clarke. RESULTS: Data analysis resulted in four main themes: Being an Edge Runner, Connections Matter, Looking Within, and We Are Not All the Same. CONCLUSION: Analysis revealed that the lived experience of Hispanic/Latino baccalaureate nursing students is complex and multifaceted. Fostering these students' connections within nursing, understanding their unique paths, and recognizing the individuality that each brings to the learning environment are key factors in promoting their success. [J Nurs Educ. 2021;60(1):13-19.].

The Validity and Reliability of Professional Self-Concept in Nursing in Accelerated Bachelor's and Master's Nursing Students.

BACKGROUND AND PURPOSE: Accelerated bachelor's and master's nursing students supported through the New Careers in Nursing program were surveyed (n = 3,506) using subscales from Arthur's Professional Self-Concept in Nursing Instrument (PSCNI). Reliability and validity of the instrument was assessed. METHODS: Factor analysis using a random split-half design were conducted and differences investigated based on characteristics. RESULTS: Four factors were revealed: leadership (α = .85), skill (α = .89), career positivity (α = .72), and career negativity (α = .72), with acceptable confirmatory fit. Gender and race/ethnicity differences were found in self-perceived leadership and skill and in career positivity by race/ethnicity. Accelerated bachelor's and master's students were different on skill and career positivity. CONCLUSIONS: Self-perceived leadership, skill, career positivity, and career negativity are distinct PSCNI concepts.

Acculturating Into Nursing for Hispanic/Latinx Baccalaureate Nursing Students: A Secondary Data Analysis.

BACKGROUND: This is a secondary data analysis of an original study describing the lived experiences of Hispanic/Latinx nursing students as they acculturate into the profession of nursing. METHOD: The original study described the experiences of 11 Hispanic/Latinx new graduates from three baccalaureate nursing programs in the southeastern United States. A secondary data analysis using a theoretical thematic analytical approach with data gathered in the original study was done to determine the utility of the theory of cultural marginality in understanding these student experiences. RESULTS: Findings support aspects of the theory, including marginal living, cross-cultural conflict recognition, and adjustment responses of poise and integration. Personal and contextual influences also impact the acculturation process for these nursing students. CONCLUSION: The theory of cultural marginality is valuable and provides important context for understanding the process that Hispanic/Latinx nursing students experience as they acculturate into nursing.

Differences in Gender-related Profile Characteristics, Perceptions, and Outcomes of Accelerated Second Degree Nursing Students.

BACKGROUND: The New Careers in Nursing (NCIN) program provided scholarships and other supports to accelerated degree students at 130 nursing schools and collected data from the scholars at three time-points. PURPOSE: The NCIN database was analyzed to identify gender-based differences in scholars' profile characteristics, program experiences, and post-graduation outcomes. METHOD: An adaptation of Jeffreys's Nursing Universal Retention and Success Model guided the analysis. Gender differences were assessed after multiplicity adjustments for false positive rates. RESULTS: Differences based on gender were found for profile characteristics, student affective factors, academic factors, professional integration factors, environmental factors, as well as academic, psychological and NCIN program outcomes. Results suggest that males were influenced by economic factors more than females when choosing nursing as a career. They had fewer concerns about financial aspects associated with being a student again yet secured employment sooner after graduation than female scholars. They did not view support services as important as did female students. They expressed confidence in their leadership competence more than their female counterparts. CONCLUSION: Efforts are needed to better understand and address the nuanced gender-based perceptions and needs of nursing students who are male.

Acculturation Into Nursing for Hispanic/Latino Prelicensure Nursing Students and New Graduates: Integrative Review of Literature.

BACKGROUND: Increasing recruitment and retention of Hispanic/Latino nursing students is urgently needed to increase the diversity of the nursing profession and address persisting health disparities. PURPOSE: This integrative review describes current knowledge of Hispanic/Latino prelicensure nursing student and new graduate experiences. METHODS: A comprehensive literature review was performed using several online databases. RESULTS: The Theory of Cultural Marginality provides structure for organizing and synthesizing the literature. Several concepts from the theory are prominent in the literature, including marginal living and across-culture conflict, easing cultural tension and adjustment responses, and contextual, independent, and personal influences. CONCLUSIONS: The process that Hispanic/Latino prelicensure nursing students and new graduates experience as they acculturate into the profession of nursing is complex. Understanding this process is paramount for nurse educators and should be the foundation on which to design, measure, and evaluate educational strategies aimed at fostering student success.

The State of the Science on Clinical Evaluation in Nursing Education.

AIM: The purpose was to synthesize the published evidence to present the state of the science in clinical evaluation research in nursing education. BACKGROUND: Clinical evaluation is key to ensuring nursing students' clinical competence, application of knowledge, and critical thinking, all of which are important to patient safety and quality nursing care. METHOD: Cooper's research synthesis method was used. RESULTS: A comprehensive literature search resulted in 250 documents, of which 88 met study criteria. Topics were exhaustive but not mutually exclusive and included competence, instrumentation, congruence, teaching methods, objective structured clinical evaluation, faculty/preceptor issues with clinical evaluation, essential clinical behaviors, topic-based evaluation, decision-making about clinical grade, and clinical reasoning. CONCLUSION: Nursing education science is in its infancy in many areas. Two areas most in need of future research are the need to accurately define and efficiently measure competence in the clinical area and the need for reliable and valid instrumentation.

Preparing the nurse scientist for academia and industry.

The number of doctoral programs in nursing has been increasing. However, these programs tend to focus on preparing nurse scientists to conduct research, and many spend little time preparing doctoral students for the educator, clinical researcher, or administrator role. Leaders of doctoral programs have identified the need to prepare doctoral students in the functional roles they will assume upon graduation, in addition to the researcher role. This article describes a two-course (six-credit) sequence of courses within a research-focused PhD in Nursing program that provides didactic and experiential knowledge about the role of the nurse scientist in academia and industry settings. Students are highly satisfied with the courses, and report that the experiences have provided them with important knowledge and skills as they assume the scientist role.

Nursing students' perceived knowledge and attitude towards genetics.

The purpose of this study was to assess the knowledge base of nursing students regarding the topic of genetics and how this may change as a student progresses through the nursing program. A 70 item multiple-choice and dichotomous survey was given to freshman, sophomore, junior, and senior nursing students at a university school of nursing in the eastern part of the United States. Two hundred and seventy five pre-licensure nursing students, 255 females and 18 males, comprised the sample. A one-way analysis of variance (ANOVA) was performed and the results concluded that there was a significant difference among the freshmen, sophomores, juniors, and seniors in regards to having at least a 'minimal' knowledge or better of medical genetic terminology and conditions. Seniors reported a higher number of terms which they had at least a 'minimal' knowledge level or better than freshmen or sophomores. Also the juniors reported a higher number of terms which they had at least a 'minimal' knowledge level or better than sophomores.

Choosing a publication venue.

The choice of a venue for publication of a manuscript is rarely a clear-cut decision. Several factors should be considered in this decision, such as the audience for whom you are writing, the topic of the manuscript, the purposes for which you are writing, and the journal guidelines. These factors may vary in importance to the author. Examining each factor and plotting the importance visually on a checklist will assist the author in making the decision about where a manuscript should be submitted so that the article will have the desired impact.

Religious activities and health outcomes: the College Bound Sisters Program.

College Bound Sisters (CBS) is a program that helps younger sisters of teenage mothers change their life trajectory by accomplishing three objectives: avoidance of pregnancy, completion of high school, and enrollment in college. Data related to religious activities and accomplishment of the three objectives for 129 members were analyzed using chi square. CBS defines health as the accomplishment of the three program objectives using Norbeck's theoretical model of social support. The adolescents were divided into three groups: those who became pregnant, dropped out of school, or completed high school. The three groups were compared with regard to the frequency of participating in religious activities. The majority of the CBS adolescents reported participating in weekly religious activities. No significant difference was found among the three groups, with regard to religious activities. However, CBS program participants were more likely than nonparticipants to graduate high school and enroll in college. Implications for incorporating religious activities in teenage pregnancy prevention programs are discussed.

Modified breastfeeding attrition prediction tool: prenatal and postpartum tests.

In earlier studies, the Breastfeeding Attrition Prediction Tool (BAPT) demonstrated predictive validity in the postpartum period. The purpose of this study was to compare the effectiveness of a modified version of the BAPT when given in the last trimester (BAPT1) and following delivery (BAPT2) in predicting breastfeeding attrition among 117 women who planned to breastfeed for at least 8 weeks. Subjects completed the BAPT during a prenatal breastfeeding class and again at delivery, and they received a phone call at 8 weeks to determine breastfeeding status. In this study, neither of the two administrations of the BAPT was predictive of breastfeeding status at 8 weeks. Findings here may differ because subjects in the current study were all committed enough to attend breastfeeding class and, thus, varied less on commitment than women in earlier studies. Significant associations were found with level of education and having a close relative who breastfed. To assist the perinatal educator in identifying women most at risk for early cessation of breastfeeding, the use of three questions regarding level of education, family support, and breastfeeding preparation is suggested.