Sedgwick Monique, Kellett Peter, Kalischuck Ruth Grant
Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
Nurse Educ Today. 2014 Mar;34(3):421-7. doi: 10.1016/j.nedt.2013.04.012. Epub 2013 May 1.
Nursing programs across Canada have begun to implement at an unprecedented rate second-degree nursing programs in response to consumer demands and a nursing shortage. While these types of programs are enjoying considerable popularity among prospective students and employers, it is imperative that nursing programs assess their graduates' ability to meet Registered Nursing entry-to-practice competencies (ETCs).
This study sought to determine if second-degree undergraduate nursing students achieved the entry-to-practice competencies established by the provincial regulatory body for registered nurses of Alberta, Canada.
The study took place in southern Alberta, Canada as the first cohort of second-degree undergraduate nursing students were completing the final practice course for the program.
In this exploratory study, quantitative and qualitative data generation approaches were used. Quantitative data were collected using the nursing program's standardized Clinical Evaluation Tool which is mapped to the 119 ETCs established by the regulatory body. Qualitative data were generated by conducting focus group interviews with students, faculty advisors, and preceptors.
A convenience sample consisting of both male and female students (n=14) submitted their mid-term and final clinical evaluations for inclusion in the dataset. Thirteen preceptors submitted mid-term and final clinical evaluations. Three students, three faculty advisors, and two preceptors participated in focus group interviews.
At mid-term, statistically significant differences were noted on 31% of the indicators within the clinical evaluation tool between students and preceptors with preceptors consistently ranking students higher than the students' ratings of their performance. Student and preceptor ratings of students' clinical performance were more consistent on the final evaluation. However, where there were differences, preceptors rated students higher than student ratings. Qualitative data analysis suggests that the concept of competence is complex and multifaceted and understood differently by students, preceptors, and advisors.
The findings of this study suggest that there is ambiguity among second-degree students, preceptors and faculty advisors surrounding the concept of competence. In order to develop an understanding of competence, nursing program administrators must encourage faculty advisors, preceptors and students to engage in a discussion at the outset of the preceptored practice experience in regard to what is meant by competence within various practice setting. Further, we suggest nursing programs in collaboration with their clinical partners and re-examine their practice evaluation tools to determine the degree to which they are sensitive to the clinical practice context.
加拿大各地的护理项目已开始以前所未有的速度实施第二学位护理项目，以回应消费者需求和护理人才短缺的问题。虽然这类项目在准学生和雇主中颇受欢迎，但护理项目必须评估其毕业生是否具备注册护士入职实践能力（ETCs）。
本研究旨在确定第二学位本科护理学生是否达到了加拿大艾伯塔省注册护士省级监管机构规定的入职实践能力要求。
该研究在加拿大艾伯塔省南部进行，当时首批第二学位本科护理学生正在完成该项目的最后实践课程。
在这项探索性研究中，采用了定量和定性数据收集方法。定量数据通过使用护理项目的标准化临床评估工具收集，该工具与监管机构确定的119项ETCs相对应。定性数据通过对学生、教师顾问和带教老师进行焦点小组访谈生成。
一个由男女生组成的便利样本（n = 14）提交了他们的期中及期末临床评估，以纳入数据集。13名带教老师提交了期中及期末临床评估。三名学生、三名教师顾问和两名带教老师参加了焦点小组访谈。
在期中时，临床评估工具中31%的指标在学生和带教老师之间存在统计学上的显著差异，带教老师对学生的评分一直高于学生对自己表现的评分。在期末评估中，学生和带教老师对学生临床绩效的评分更为一致。然而，在存在差异的地方，带教老师对学生的评分高于学生自评。定性数据分析表明，能力的概念复杂且多面，学生、带教老师和顾问对此的理解各不相同。
本研究结果表明，第二学位学生、带教老师和教师顾问对能力概念存在模糊认识。为了形成对能力的理解，护理项目管理人员必须鼓励教师顾问、带教老师和学生在带教实践经验开始时，就不同实践环境中能力的含义展开讨论。此外，我们建议护理项目与其临床合作伙伴合作，重新审视他们的实践评估工具，以确定这些工具对临床实践背景的敏感程度。
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