Portfolios and the assessment of competence in nursing: a literature review.

OBJECTIVES: The purpose of this paper is to explore the literature on the portfolio as a tool for the assessment of competence in nurse education. DESIGN: Literature reviews are a valuable source of information; by locating, appraising and synthesising evidence from primary studies they can provide reliable answers to focused questions. They can also help to plan new research by identifying both what is known and not known in a given area. Literature reviews adhere to a scientific methodology which seeks to minimise bias and errors generating inferences based on the synthesis of best available evidence. DATA SOURCES: The literature review was conducted utilising several databases, selected because of their relevance to the subject under review and including CINAHL and MEDLINE as well as a hand search of relevant journals and documents. The search terms included: nurses in education, portfolios and assessment and competence. Articles were included in the review if they focused on portfolios as a method of assessment in nurse education and if they were published after 1993 when portfolios first appeared in the nursing literature. REVIEW METHODS: The review divides the literature into content themes allowing synthesis of the subject looking at consistencies and differences, followed by a summary and key arguments relating to the next theme. RESULTS: Results highlight the importance of clear guidelines for portfolio construction and assessment, the importance of tri-partite support during portfolio development and guidelines for qualitative assessment. Where the portfolio process is well developed there are clear links to competence in practice. CONCLUSIONS: The evidence on portfolios as a means of assessment continues to expand. If educators take on board the lessons learned from previous research and apply it to their assessment process, the difficulties found at present, in defining and measuring competence may be reduced.

Student nurses' knowledge and attitudes toward CAM therapies.

Hessig et al (2004) highlight that nurses value complementary and alternative therapies (CAM) but lack the knowledge regarding their application. They suggest that education can affect knowledge and application of CAM in nursing practice. Complementary and alternative therapy input into the pre-registration nursing curriculum is sporadic and higher education institutions need to incorporate CAM therapies more fully into professional education (Department of Health, 2003). This study investigated the knowledge and attitudes student nurses have to CAM therapies and their use in cancer and palliative care. Ethical approval was sought from the ethics committee at the University of Hull. A quantitative evaluative study using a convenience sample of student nurses in their final semester of pre-registration nurse education was used. Data were collected via a questionnaire; the findings demonstrate the respondents' acknowledgement of their limited knowledge of CAM therapies and the study has highlighted the need to continue working towards integrated CAM education into the pre-registration nursing curriculum.

Breast self-examination and breast awareness: a literature review.

AIM: To explore the literature on breast self-examination and breast awareness. OBJECTIVES: To clarify the confusion surrounding breast awareness and breast self-examination. To critique the evidence for breast awareness as a health promotion tool. BACKGROUND: Over 41,000 women are diagnosed with breast cancer each year in the United Kingdom. Compared with other European countries, women in England have poor survival prospects, for breast cancer, due in part to advanced disease at first presentation. In the United Kingdom, women are encouraged to be breast aware from the age of 18. However, the evidence suggests that women do not engage in breast awareness and are frightened and confused about their role in breast health promotion. METHODOLOGY: Four databases were used: Medline, Ebsco including CINAHL and Sociological Abstracts and the Cochrane Database of Systematic Reviews. The search terms 'breast awareness' and 'breast self-examination' were used and combined with 'breast cancer', 'breast screening' and 'health promotion'. CONCLUSION: The evidence on breast self-examination is clear, there is no benefit to breast cancer mortality and results suggest that breast self-examination may do more harm than good. Breast awareness provides women with some acknowledgement of the part they can play in being empowered to fight breast disease, not in terms of statistics used for mortality but on the qualitative effects of reductions in morbidity. RELEVANCE TO CLINICAL PRACTICE: The Royal College of Nursing of The United Kingdom is actively encouraging all nurses to promote breast awareness along with clear guidelines for doing so. The United Kingdom National Health Service Cancer Plan: a plan for investment, a plan for reform, encourages preventive care, information giving, good communication as well as evidence-based practice. In breast care this can reduce confusion for women and encourage empowerment in breast health promotion.

Management of patients with breast cancer.

Breast cancer is the most common cancer in the UK, with over 39,500 women diagnosed every year (Cancer Research UK 2003). The author examines the biological, psychological and social aspects of managing patients with breast cancer. This article also highlights the importance of the nurse's role in supporting patients throughout their illness and in some cases at the end of life.

Perceptions of nursing: a study involving nurses, nursing students, patients and non-nursing students.

This paper describes a study of perceptions of nursing by nursing students, qualified nurses (United Kingdom and Spain), patients and non-nursing students. A survey method was used with a longitudinal panel element incorporating a 35-item version of the Nursing Dimensions Inventory translated into Spanish. Data were analysed using principal component analysis, congruence analysis, Mokken scaling, correlation, ANOVA, t-test and Cronbach's alpha. Patients may perceive nursing differently from nursing students, nurses (in the UK and Spain) and non-nurses. These findings are discussed in the context of nurse education and patient care.

Differences and similarities in the perception of caring between Spanish and UK nurses.

The aim of the present paper was to compare and contrast perceptions of caring in nursing between Spanish and UK nurses. There are no previous studies comparing directly the perceptions of caring across cultures in nursing. A survey method was used employing the 25-item Caring Dimensions Inventory. Data were Mokken scaled for comparison with data from a previous study and scores for common items on the 25-item Caring Dimension Inventory for Spanish and UK nurses were correlated. There were similarities and differences between Spanish and UK nurses' perceptions of caring: many similar items were incorporated into Mokken scales but the endorsement of items did not correlate. The present work demonstrates that it is possible to measure differences and similarities in perceptions of caring. The study design could be improved and such work could be valuable in cross-cultural work with nurses.