Chang Gung University of Science and Technology, Puzi, ROC Taiwan.
Chang Gung Memorial Hospital at Chiayi, Puzi, ROC Taiwan.
J Clin Nurs. 2020 Jul;29(13-14):2652-2662. doi: 10.1111/jocn.15287. Epub 2020 Apr 27.
To compare and contrast the competence in clinical performance between pregraduate nursing students and hospital nurses. The study also explored the most difficult technical skills for the participants to perform.
Assessment, communication and critical thinking are competencies that help in providing safe and appropriate care for patients. Yet, self-perceived competence was mostly measured while performance competence that reflected nurses' performance in real cases has seldom been explored in literature.
A cross-sectional design was applied. The study adhered to the STROBE guidelines to improve reporting quality.
Fifty-two nurses and 50 nursing students completed the Computerized Model of Performance-Based Measurement system, which measures performance competence including the steps of critical thinking, conflict resolutions and common clinical technical problems. Six case scenarios containing 107 test questions were completed.
Only 53.85% of nurses and 20.0% of students achieved a satisfactory level of performance competence. They showed low scores on the steps of critical thinking: "collecting data from on-site physical assessment," "processing information," "recognising/prioritising problems" and "arranging a course of action for patient care," as well as solving common technical problems and conflicts. The three most difficult skills to perform were CPR, reading EKGs and venipuncture/starting intravenous lines.
The study captured the participants' weaknesses in the critical thinking process and the nursing skills that were difficult to perform. These skills are imperative to nursing care and need to be strengthened in school and in-service education. The academic curriculum and course design for students as well as training programmes for nurses need to be reviewed to address the challenges to be faced in a clinical setting.
Teaching-learning strategies that focus on enhancing critical thinking and performing difficult skills need to be designed and implemented both in practice and in school.
比较和对比本科护生和医院护士在临床绩效方面的能力。该研究还探讨了参与者最难执行的技术技能。
评估、沟通和批判性思维是帮助为患者提供安全和适当护理的能力。然而，自我感知的能力主要是在测量时进行的，而反映护士在实际情况下表现的绩效能力在文献中很少被探索。
采用横断面设计。该研究遵循 STROBE 指南，以提高报告质量。
52 名护士和 50 名护理学生完成了基于计算机模型的绩效测量系统，该系统测量绩效能力，包括批判性思维、冲突解决和常见临床技术问题的步骤。完成了包含 107 个测试问题的 6 个案例场景。
只有 53.85%的护士和 20.0%的学生达到了令人满意的绩效能力水平。他们在批判性思维的步骤上得分较低：“从现场身体评估中收集数据”、“处理信息”、“识别/优先处理问题”和“为患者护理安排行动方案”，以及解决常见技术问题和冲突。最难执行的三项技能是心肺复苏术、阅读心电图和静脉穿刺/开始静脉输液。
该研究揭示了参与者在批判性思维过程和难以执行的护理技能方面的弱点。这些技能对护理至关重要，需要在学校和在职教育中加强。需要审查学生的学术课程和课程设计以及护士的培训计划，以应对临床环境中面临的挑战。
需要设计和实施注重增强批判性思维和执行困难技能的教与学策略，无论是在实践中还是在学校中。
