College of Nursing, University of Santo Tomas, Manila, Philippines.
Faculty of Management and Development Studies, University of the Philippines - Open University, Los Baños, Philippines.
J Clin Nurs. 2019 May;28(9-10):1760-1770. doi: 10.1111/jocn.14775. Epub 2019 Feb 8.
To evaluate and determine the characteristics of a critical care clinical placement programme affecting the critical care nursing competency of baccalaureate nursing students.
The increase in global demand for competent critical care services and human resources translates to an educational focus in preparing students for their eventual role as critical care health professionals. Albeit clinical placement in critical care units can promote competency, evidence supporting such claim remains inadequate.
Cross-sectional, descriptive correlational design.
Employing structural equation modelling, 236 randomly selected baccalaureate nursing students from a clinically intensive university in the Philippines were recruited from January-March 2016. A three-part online survey, composed of the robotfoto, Critical Care Nursing Rotation Evaluation Questionnaire, and Intensive and Critical Care Nursing Competence Scale, was completed. The STROBE checklist was followed in reporting this study.
Five characteristics of clinical placement were extracted as follows: sufficient clinical exposure, adequate area orientation, supportive clinical instructor, diversified medical cases and supplemental learning resources. Four characteristics affected critical care nursing competency and built a good model (χ /df = 1.52; comparative fit index = 0.94; parsimonious normal fit index = 0.77; root mean square error of approximation = 0.047). Adequate area orientation had the most diverse influence on all competency domains, while supportive clinical instructor had the strongest positive influence on critical care nursing skill (β = 0.30, p = 0.005).
The model highlights the characteristics of a critical care clinical placement programme which influences critical care nursing competency among nursing students. It emphasised the importance of a supportive clinical instructor and adequate area orientation in promoting critical care nursing skills and values and attitude.
The proposed model highlights the role of clinical instructors and appropriate orientation which provides impetus in improving the clinical placement design to maximise competency development.
评估和确定影响护理学士学生重症护理能力的重症监护临床实习计划的特点。
全球对熟练重症护理服务和人力资源的需求不断增加，这意味着教育重点是培养学生最终成为重症护理卫生专业人员的角色。尽管在重症监护病房进行临床实习可以提高能力，但支持这一说法的证据仍然不足。
横断面描述性相关设计。
采用结构方程模型，2016 年 1 月至 3 月期间，从菲律宾一所临床密集型大学中随机抽取 236 名护理学士学生参加研究。使用在线三部分问卷调查，包括机器人照片、重症护理轮转评估问卷和强化与重症护理能力量表。本研究遵循 STROBE 清单进行报告。
从临床实习中提取出五个特征：充足的临床暴露、充分的区域定向、支持性的临床导师、多样化的医疗案例和补充学习资源。四个特征影响重症护理护理能力并构建了一个良好的模型（χ/df=1.52；比较拟合指数=0.94；简约正态拟合指数=0.77；均方根误差近似值=0.047）。充分的区域定向对所有能力领域的影响最为多样化，而支持性的临床导师对重症护理技能有最强的积极影响（β=0.30，p=0.005）。
该模型突出了重症监护临床实习计划的特点，这些特点影响着护理学生的重症护理能力。它强调了支持性临床导师和充分区域定向在促进重症护理技能以及价值观和态度方面的重要性。
所提出的模型强调了临床导师和适当定向的作用，这为改进临床实习设计以最大限度地提高能力发展提供了动力。
