Objective:To assess the clinical competency of nursing interns and the perception of clinical nurse mentors toward student nurses'clinical competency.Methods:A study was carried out among 104 nursing interns and 2...Objective:To assess the clinical competency of nursing interns and the perception of clinical nurse mentors toward student nurses'clinical competency.Methods:A study was carried out among 104 nursing interns and 26 clinical nurse mentors using the purposive sampling technique.A self-repor ted perception scale was used to collect the data.Results:In general,most nursing interns perceived themselves as clinically competent during the internship.The clinical nurse mentors too repor ted that the current internship is helping the nursing interns in becoming competent.Conclusions:Frequent clinical evaluation,buddy system,provision of stipends,good leadership,and coordination between the academic institute and hospital are repor ted as the critical motivating factors for improving the clinical competency of student interns.展开更多
The purpose of this study is to coordinate the alignment between the nursing curriculum and hospital clinical competencies,identify the reasons for the gaps,evaluate the impact of these gaps on the nursing profession,...The purpose of this study is to coordinate the alignment between the nursing curriculum and hospital clinical competencies,identify the reasons for the gaps,evaluate the impact of these gaps on the nursing profession,and propose strategies to bridge these gaps.This study will help strengthen nursing education,improve nursing students’skills,and help students adapt to complex clinical environments.展开更多
Through this study,we aim to construct a teaching model for basic medical courses that enhances“clinical competency.”We explore the optimal methods and pathways for the organic integration of exam-oriented teaching ...Through this study,we aim to construct a teaching model for basic medical courses that enhances“clinical competency.”We explore the optimal methods and pathways for the organic integration of exam-oriented teaching and professional teaching,optimize teaching efficiency,improve teaching quality and educational effectiveness,and provide theoretical support for the cultivation of clinical medical talents in China.The goal is to establish a talent cultivation objective oriented towards“clinical competency,”promote the teaching reform of basic medical courses in comprehensive universities,facilitate the transition of basic medical course teaching from“teacher knowledge presentation”to“student knowledge construction,”and cultivate high-quality medical talents with clinical competency.展开更多
Objective:To ensure that only competent graduates are licensed to practice nursing,councils conduct licensing examinations,which may include among others clinical competency assessment.This review explored current pra...Objective:To ensure that only competent graduates are licensed to practice nursing,councils conduct licensing examinations,which may include among others clinical competency assessment.This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based,context-specific framework for clinical competency assessment in a sub-Saharan African(SSA)country.Methods:A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR)was conducted.Results:Findings from 28 out of 1151 studies identified from Scopus,PubMed,CINAHL,Wiley Online Library,and ProQuest were included and synthesized.Results show that a good assessment system must be valid,reliable,transparent,feasible,fair,objective,and must provide feedback and continually improve to have an educational impact.Clinical competency assessment systems must be developed on sound empirical evidence,pilot tested,and involve thorough training and evaluation of the examiners.Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system.Only one of the included studies was conducted in Africa.Conclusions:The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context.Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.展开更多
Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The...Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.展开更多
The development of competency-based thinking is transforming medical education by preparing professionals for the new challenges of the 21st century. Its strategies are key to the development of clinical competence an...The development of competency-based thinking is transforming medical education by preparing professionals for the new challenges of the 21st century. Its strategies are key to the development of clinical competence and to improving critical thinking. Objective: This paper aims to evaluate the level of clinical competence of family medicine residents treating patients attending prenatal care in a medical unit in southern Mexico. Materials and Methods: In 2023, a cross-sectional, retrospective, and analytical study with an educational focus was conducted in two phases. The creation and validation of a clinical competence instrument based on five real real-world problem-based clinical cases of prenatal care patients, with indicators related to clinical aptitude. Three rounds of experts were used to validate the instrument following the Delphi method, with a concordance threshold of 80% or higher (Kappa index > 0.80). The Kuder-Richardson formula was used to calculate internal consistency, yielding a value of 0.87. The evaluation instrument was administered to 40 newly admitted medical residents in the second phase in Villahermosa, Tabasco. A descriptive analysis was performed, and the levels of competence were compared using the Chi-square test. Results: Internal consistency was 0.87. Among the residents, 32.5% demonstrated low knowledge levels (know-what), 37.5% showed intermediate skills levels (know-how), and 67.5% exhibited adequate performance in attitudes (know-be). Conclusions: Inclusive strategies are necessary to improve clinical competence levels in prenatal care.展开更多
The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessm...The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally;however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.展开更多
Objectives: Although effective performance in clinical settings requires the integration between theory and practice,there is a gap between theoretical knowledge as taught in the classroom and what the students experi...Objectives: Although effective performance in clinical settings requires the integration between theory and practice,there is a gap between theoretical knowledge as taught in the classroom and what the students experience in clinical settings.This study aimed to elicit and explore the barriers of utilizing theoretical knowledge in clinical settings.Methods: A qualitative study was adopted with a conventional content analysis approach.Fifteen nursing and paramedic's students,faculty members and experienced nursing staff participated in the study.Data were collected by semi-structured individual interviews until data saturation and concurrently analyzed via MAXQDA 10.Results: Five main categories emerged as barriers of utilizing theoretical knowledge in the clinical settings i.e.non-standard practices in clinical settings;lack of trust in clinical competence;lack of perceived professional support;insufficiencies in teaching and learning process;and differences between doing things in simulated and real clinical situations.Conclusion: Transferring theory into practice in a structured manner requires professional support in the workplace,trust and the opportunity for direct experience,using valid and up-to-date knowledge by clinical staff and bridging the simulated situations with real life scenarios.展开更多
Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses...Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses were selected by stratified random sampling.The data collection tools included a personal information form and the"Nurse Competence Scale".Data were analyzed using descriptive and analytical statistics.Results:The mean score of nurses'clinical competence was equal to 76.14±1.59 out of 100,which was at a"very good level".The mean score of using clinical competence in practice was equal to 70.38±15.25 out of 100,which was at a"good level".Among the subscales of clinical competence,the highest mean score was related to"managing situation".The mean score of"using clinical competence in practice"was related to the subscale of"therapeutic interventions".There was no statistically significant difference among the score of clinical competence of nurses varying with different gender,age,academic degree,and work experience.Conclusions:The clinical competence of critical care nurses in Kermanshah was at a"very good"level,and the use of clinical competence in practice was at a"good level."Given the importance of clinical competencies in practice,nurses'clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.展开更多
Objective： To assess the outcome of the application of active learning during practicum among nursing students using clinical assessment and evaluation scores as a measurement. Methods： Nursing students were instruc...Objective： To assess the outcome of the application of active learning during practicum among nursing students using clinical assessment and evaluation scores as a measurement. Methods： Nursing students were instructed on the basics of active learning prior to the initiation of their clinical experience. The participants were divided into 5groups of nursing students （ n = 56） across three levels （years 2-4） in a public academic institute of a bachelor degree program in Macao. Final clinical evaluation was averaged and compared between groups with and without intervention. Results： These nursing students were given higher appraisals in verbal and written comments than previous students without interventian. The groups with the invention achieved higher clinical assessment and evaluation scores on average than comparable groups without the active learning intervention. One group of sophomore nursing students （year 2） did not receive as high of evaluations as the other groups, receiving an average score of above 80. Conclusions＂ Nursing students must engage in active learning to demonstrate that they are willing to gain knowledge of theory, nursing skills and communication skills during the clinical practicum.展开更多
Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and...Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and practices of students, interns, and residents about LP, and to assess their feelings about how this procedure is taught. Materials and Methods: We conducted a cross-sectional study of 160 participants, using an anonymous questionnaire, to evaluate the attitudes and practices of students, interns and residents in the pediatrics department concerning lumbar puncture. Results: Half of the participants had never performed LP, usually because of the risk involved or lack of confidence, while 20% had performed it more than 4 times. None of the participants had learned to perform the procedure through simulation sessions, while (42%) had learned it under the supervision of a senior physician and had not been able to perform it successfully the first time. Most participants inform the patient about the procedure before performing it. Only 44% of participants acknowledged that LP can be performed under local anesthetic. The sitting position (60%) was by far the most commonly used. Most LPs were performed for diagnostic purposes. Most participants stated that the pediatric ward and the pediatric emergency department are among the departments that perform LP most frequently, and that they would be interested in taking part in simulated lumbar puncture sessions in children in the future. Conclusion: The results of our study show that LP is perceived by students as a risky procedure that is difficult to perform. Teachers should reconsider how this technical procedure is taught, by integrating simulation on mannequins into student training.展开更多
Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valu...Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valuable endoscopy time. This is a review of the evidence surrounding virtual reality simulation and its efficacy in teaching endoscopic techniques. There have been 21 randomized controlled trials(RCTs) that have investigated virtual reality simulation as a teaching tool in endoscopy. 10 RCTs studied virtual reality in colonoscopy, 3 in flexible sigmoidoscopy, 5 in esophagogastroduodenoscopy, and 3 in endoscopic retrograde cholangiopancreatography. RCTs reported many outcomes including distance advanced in colonoscopy, comprehensive assessment of technical and non-technical skills, and patient comfort. Generally, these RCTs reveal that trainees with virtual reality simulation based learning improve in all of these areas in the beginning of the learning process. Virtual reality simulation was not effective as a replacement of conventional teaching methods. Additionally, feedback was shown to be an essential part of the learning process. Overall, virtual reality endoscopic simulation is emerging as a necessary augment to conventional learning given the ever increasing importance of patient safety and increasingly valuable endoscopy time; although work is still needed to study the nuances surrounding its integration into curriculum.展开更多
Objective: This study aimed to describe construction and content validation of the Brazilian Questionnaire of Competencies of Oncology Nurses.Methods: The methodological research was constructed based on the literatur...Objective: This study aimed to describe construction and content validation of the Brazilian Questionnaire of Competencies of Oncology Nurses.Methods: The methodological research was constructed based on the literature and observation in Brazilian hospitals searching to identify local evidence in the nursing practice.After,the construction of the 30 items distributed in eight sub-dimensions of competencies,the instrument was tested the content validation by 7 experts and 61 oncology nurses.Item responses were analyzed through content validity index and Cronbach's α were used in this test pilot.Results: The content validity index of the scale was 0.90,and the content validity index of each item was 0.80-1.00.The mean of items varied between 4.98 (standard deviation =0.13) and 4.70 (standard deviation =0.53).The Cronbach's α of the instrument was 0.77.The Cronbach's α if each item was excluded ranged from 0.78 to 0.74,indicating consistency between items.Conclusion: The instrument is concise and clear,resulting in a valid content on test pilot in conducting a self-assessment the oncology nurses.It can be used to facilitate decision-making by identifying subdimensions that require attention in nursing education to improve patient care.展开更多
Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of S...Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of Science,ProQuest,and Taylor&Francis Online using the descriptors barrier,physical assessment,nursing student et al.Only English-language and peer-reviewed journal articles were included,and there were no year restrictions.Results:Twelve articles were selected for review.Two aspects were extracted:the barriers included personal challenges,challenges related to nursing education,challenges related to clinical practice;establishing competency-based education learning as a method to reduce physical assessment barriers.Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments.Conclusions:The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice.A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments.Also,more constructive and competency-based teaching methods should be integrated into academic and clinical settings.展开更多
Endosonography （EUS） has an estimated long learning curve including the acquisition of both technical and cognitive skills. Trainees in EUS must learn to master intraprocedural steps such as echoendoscope handling a...Endosonography （EUS） has an estimated long learning curve including the acquisition of both technical and cognitive skills. Trainees in EUS must learn to master intraprocedural steps such as echoendoscope handling and ultrasonographic imaging with the interpretation of normal anatomy and any pathology. In addition, there is a need to understand the periprocedural parts of the EUS-examination such as the indications and contraindications for EUS and potential adverse events that could occur post-EUS. However, the learning process and progress vary widely among endosono-graphers in training. Consequently, the performance of a certain number of supervised procedures duringtraining does not automatically guarantee adequate competence in EUS. Instead, the assessment of EUS-competence should preferably be performed by the use of an assessment tool developed specifically for the evaluation of endosonographers in training. Such a tool, covering all the different steps of the EUS-procedure, would better depict the individual learning curve and better refect the true competence of each trainee. This mini-review will address the issue of clinical education in EUS with respect to the evaluation of endosonographers in training. The aim of the article is to provide an informative overview of the topic. The relevant literature of the field will be reviewed and discussed. The current knowledge on how to assess the skills and competence of endosonographers in training is presented in detail.展开更多
Objectives:The aim of this study was to explore factors that motivate students to engage in skills practice in a laboratory setting,and to identify their motivation types and the regulatory styles.Methods:Semi-structu...Objectives:The aim of this study was to explore factors that motivate students to engage in skills practice in a laboratory setting,and to identify their motivation types and the regulatory styles.Methods:Semi-structured interviews were conducted with 23 nursing students from three universities between November 2017 and January 2018.A thematic analysis was used to identify factors associated with students’motivation to engage in skills practice in a laboratory.The types and the regulatory styles of student motivation were identified based on the self-determination theory.Results:Seven motivating factors were identified.These factors included the students’desire“to acquire the skills necessary to work as a nurse”,the“desire to improve skills in preparation for clinical practicum”,and their felt“obligations to patients as a nurse”.Moreover,“the impetus to study arising from the objective evaluation of oneself and others”and“wanting to pass the skills examination”motivated the students to engage in skills practice.A“learning environment that facilitates students’learning”and the“supportive involvement of educators”facilitated their learning.Based on the self-determination theory,the students were found to embrace extrinsic motivation with four regulatory styles of motivation,namely integrated,identified,introjected,and external regulation.Conclusions:Nurse educators should understand the motivating factors of students,and help students embrace a more internally controlled motivation by helping them envision their future careers as nurses,and by fostering their ethical duty to care for patients.展开更多
文摘Objective:To assess the clinical competency of nursing interns and the perception of clinical nurse mentors toward student nurses'clinical competency.Methods:A study was carried out among 104 nursing interns and 26 clinical nurse mentors using the purposive sampling technique.A self-repor ted perception scale was used to collect the data.Results:In general,most nursing interns perceived themselves as clinically competent during the internship.The clinical nurse mentors too repor ted that the current internship is helping the nursing interns in becoming competent.Conclusions:Frequent clinical evaluation,buddy system,provision of stipends,good leadership,and coordination between the academic institute and hospital are repor ted as the critical motivating factors for improving the clinical competency of student interns.
文摘The purpose of this study is to coordinate the alignment between the nursing curriculum and hospital clinical competencies,identify the reasons for the gaps,evaluate the impact of these gaps on the nursing profession,and propose strategies to bridge these gaps.This study will help strengthen nursing education,improve nursing students’skills,and help students adapt to complex clinical environments.
基金Key Project of the“14th Five-Year”Plan for Heilongjiang Provincial Education Science in 2021(GJB1421168)Key Project of the“14th Five-Year”Plan for Heilongjiang Provincial Education Science in 2022(GJB1422698)+4 种基金Key Project of the“14th Five-Year”Plan for Heilongjiang Provincial Education Science in 2023(GJB1423165)Research Topic on Higher Education of Heilongjiang Provincial Association of Higher Education(23GJYBC057)Special Project for New Medical Education in Jiamusi University(2023XYK-20)“Dongji”Academic Team of Jiamusi University(DJXSTD202405)Heilongjiang Province Postgraduate Quality Course High-Quality Construction Project(HLJYJSZLTSGC-YJSJPKC-2022-082)。
文摘Through this study,we aim to construct a teaching model for basic medical courses that enhances“clinical competency.”We explore the optimal methods and pathways for the organic integration of exam-oriented teaching and professional teaching,optimize teaching efficiency,improve teaching quality and educational effectiveness,and provide theoretical support for the cultivation of clinical medical talents in China.The goal is to establish a talent cultivation objective oriented towards“clinical competency,”promote the teaching reform of basic medical courses in comprehensive universities,facilitate the transition of basic medical course teaching from“teacher knowledge presentation”to“student knowledge construction,”and cultivate high-quality medical talents with clinical competency.
文摘Objective:To ensure that only competent graduates are licensed to practice nursing,councils conduct licensing examinations,which may include among others clinical competency assessment.This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based,context-specific framework for clinical competency assessment in a sub-Saharan African(SSA)country.Methods:A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR)was conducted.Results:Findings from 28 out of 1151 studies identified from Scopus,PubMed,CINAHL,Wiley Online Library,and ProQuest were included and synthesized.Results show that a good assessment system must be valid,reliable,transparent,feasible,fair,objective,and must provide feedback and continually improve to have an educational impact.Clinical competency assessment systems must be developed on sound empirical evidence,pilot tested,and involve thorough training and evaluation of the examiners.Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system.Only one of the included studies was conducted in Africa.Conclusions:The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context.Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.
文摘Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.
文摘The development of competency-based thinking is transforming medical education by preparing professionals for the new challenges of the 21st century. Its strategies are key to the development of clinical competence and to improving critical thinking. Objective: This paper aims to evaluate the level of clinical competence of family medicine residents treating patients attending prenatal care in a medical unit in southern Mexico. Materials and Methods: In 2023, a cross-sectional, retrospective, and analytical study with an educational focus was conducted in two phases. The creation and validation of a clinical competence instrument based on five real real-world problem-based clinical cases of prenatal care patients, with indicators related to clinical aptitude. Three rounds of experts were used to validate the instrument following the Delphi method, with a concordance threshold of 80% or higher (Kappa index > 0.80). The Kuder-Richardson formula was used to calculate internal consistency, yielding a value of 0.87. The evaluation instrument was administered to 40 newly admitted medical residents in the second phase in Villahermosa, Tabasco. A descriptive analysis was performed, and the levels of competence were compared using the Chi-square test. Results: Internal consistency was 0.87. Among the residents, 32.5% demonstrated low knowledge levels (know-what), 37.5% showed intermediate skills levels (know-how), and 67.5% exhibited adequate performance in attitudes (know-be). Conclusions: Inclusive strategies are necessary to improve clinical competence levels in prenatal care.
文摘The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally;however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.
基金Maragheh University of Medical Sciences provided financial resources
文摘Objectives: Although effective performance in clinical settings requires the integration between theory and practice,there is a gap between theoretical knowledge as taught in the classroom and what the students experience in clinical settings.This study aimed to elicit and explore the barriers of utilizing theoretical knowledge in clinical settings.Methods: A qualitative study was adopted with a conventional content analysis approach.Fifteen nursing and paramedic's students,faculty members and experienced nursing staff participated in the study.Data were collected by semi-structured individual interviews until data saturation and concurrently analyzed via MAXQDA 10.Results: Five main categories emerged as barriers of utilizing theoretical knowledge in the clinical settings i.e.non-standard practices in clinical settings;lack of trust in clinical competence;lack of perceived professional support;insufficiencies in teaching and learning process;and differences between doing things in simulated and real clinical situations.Conclusion: Transferring theory into practice in a structured manner requires professional support in the workplace,trust and the opportunity for direct experience,using valid and up-to-date knowledge by clinical staff and bridging the simulated situations with real life scenarios.
基金This work was supported by the Kermanshah University of Medical Sciencesgrant numbers 96566
文摘Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses were selected by stratified random sampling.The data collection tools included a personal information form and the"Nurse Competence Scale".Data were analyzed using descriptive and analytical statistics.Results:The mean score of nurses'clinical competence was equal to 76.14±1.59 out of 100,which was at a"very good level".The mean score of using clinical competence in practice was equal to 70.38±15.25 out of 100,which was at a"good level".Among the subscales of clinical competence,the highest mean score was related to"managing situation".The mean score of"using clinical competence in practice"was related to the subscale of"therapeutic interventions".There was no statistically significant difference among the score of clinical competence of nurses varying with different gender,age,academic degree,and work experience.Conclusions:The clinical competence of critical care nurses in Kermanshah was at a"very good"level,and the use of clinical competence in practice was at a"good level."Given the importance of clinical competencies in practice,nurses'clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.
基金supported by the research fund of Macao Polytechnic Institute(RP/ESS-04/2012)
文摘Objective： To assess the outcome of the application of active learning during practicum among nursing students using clinical assessment and evaluation scores as a measurement. Methods： Nursing students were instructed on the basics of active learning prior to the initiation of their clinical experience. The participants were divided into 5groups of nursing students （ n = 56） across three levels （years 2-4） in a public academic institute of a bachelor degree program in Macao. Final clinical evaluation was averaged and compared between groups with and without intervention. Results： These nursing students were given higher appraisals in verbal and written comments than previous students without interventian. The groups with the invention achieved higher clinical assessment and evaluation scores on average than comparable groups without the active learning intervention. One group of sophomore nursing students （year 2） did not receive as high of evaluations as the other groups, receiving an average score of above 80. Conclusions＂ Nursing students must engage in active learning to demonstrate that they are willing to gain knowledge of theory, nursing skills and communication skills during the clinical practicum.
文摘Introduction: Even though lumbar puncture (LP) represents an important tool in the diagnosis of certain neurological diseases, this procedure is little practiced by our students. We aimed to evaluate the attitudes and practices of students, interns, and residents about LP, and to assess their feelings about how this procedure is taught. Materials and Methods: We conducted a cross-sectional study of 160 participants, using an anonymous questionnaire, to evaluate the attitudes and practices of students, interns and residents in the pediatrics department concerning lumbar puncture. Results: Half of the participants had never performed LP, usually because of the risk involved or lack of confidence, while 20% had performed it more than 4 times. None of the participants had learned to perform the procedure through simulation sessions, while (42%) had learned it under the supervision of a senior physician and had not been able to perform it successfully the first time. Most participants inform the patient about the procedure before performing it. Only 44% of participants acknowledged that LP can be performed under local anesthetic. The sitting position (60%) was by far the most commonly used. Most LPs were performed for diagnostic purposes. Most participants stated that the pediatric ward and the pediatric emergency department are among the departments that perform LP most frequently, and that they would be interested in taking part in simulated lumbar puncture sessions in children in the future. Conclusion: The results of our study show that LP is perceived by students as a risky procedure that is difficult to perform. Teachers should reconsider how this technical procedure is taught, by integrating simulation on mannequins into student training.
文摘Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valuable endoscopy time. This is a review of the evidence surrounding virtual reality simulation and its efficacy in teaching endoscopic techniques. There have been 21 randomized controlled trials(RCTs) that have investigated virtual reality simulation as a teaching tool in endoscopy. 10 RCTs studied virtual reality in colonoscopy, 3 in flexible sigmoidoscopy, 5 in esophagogastroduodenoscopy, and 3 in endoscopic retrograde cholangiopancreatography. RCTs reported many outcomes including distance advanced in colonoscopy, comprehensive assessment of technical and non-technical skills, and patient comfort. Generally, these RCTs reveal that trainees with virtual reality simulation based learning improve in all of these areas in the beginning of the learning process. Virtual reality simulation was not effective as a replacement of conventional teaching methods. Additionally, feedback was shown to be an essential part of the learning process. Overall, virtual reality endoscopic simulation is emerging as a necessary augment to conventional learning given the ever increasing importance of patient safety and increasingly valuable endoscopy time; although work is still needed to study the nuances surrounding its integration into curriculum.
基金This study was financed by the Coordenacao de Aperfeicoamento de Pessoal de Nível Superior-Brazil(CAPES)-Finance Code 001
文摘Objective: This study aimed to describe construction and content validation of the Brazilian Questionnaire of Competencies of Oncology Nurses.Methods: The methodological research was constructed based on the literature and observation in Brazilian hospitals searching to identify local evidence in the nursing practice.After,the construction of the 30 items distributed in eight sub-dimensions of competencies,the instrument was tested the content validation by 7 experts and 61 oncology nurses.Item responses were analyzed through content validity index and Cronbach's α were used in this test pilot.Results: The content validity index of the scale was 0.90,and the content validity index of each item was 0.80-1.00.The mean of items varied between 4.98 (standard deviation =0.13) and 4.70 (standard deviation =0.53).The Cronbach's α of the instrument was 0.77.The Cronbach's α if each item was excluded ranged from 0.78 to 0.74,indicating consistency between items.Conclusion: The instrument is concise and clear,resulting in a valid content on test pilot in conducting a self-assessment the oncology nurses.It can be used to facilitate decision-making by identifying subdimensions that require attention in nursing education to improve patient care.
基金The authors would like to thank Deanship of Scientific Research at Majmaah University,Kingdom of Saudi Arabia(Project number 1440-08)for supporting this work.
文摘Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of Science,ProQuest,and Taylor&Francis Online using the descriptors barrier,physical assessment,nursing student et al.Only English-language and peer-reviewed journal articles were included,and there were no year restrictions.Results:Twelve articles were selected for review.Two aspects were extracted:the barriers included personal challenges,challenges related to nursing education,challenges related to clinical practice;establishing competency-based education learning as a method to reduce physical assessment barriers.Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments.Conclusions:The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice.A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments.Also,more constructive and competency-based teaching methods should be integrated into academic and clinical settings.
基金Supported by The Health and Medical Care Committee of the Regional Executive Board,Region Vastra Gotaland,Nos.VGFOUREG-564381 and VGFOUREG-144591Sahlgrenska University Hospital LUA-ALF,No.73830+1 种基金Magtarmfonden,No.A79211Assar Gabrielsson Foundation,No.FB 17-20
文摘Endosonography （EUS） has an estimated long learning curve including the acquisition of both technical and cognitive skills. Trainees in EUS must learn to master intraprocedural steps such as echoendoscope handling and ultrasonographic imaging with the interpretation of normal anatomy and any pathology. In addition, there is a need to understand the periprocedural parts of the EUS-examination such as the indications and contraindications for EUS and potential adverse events that could occur post-EUS. However, the learning process and progress vary widely among endosono-graphers in training. Consequently, the performance of a certain number of supervised procedures duringtraining does not automatically guarantee adequate competence in EUS. Instead, the assessment of EUS-competence should preferably be performed by the use of an assessment tool developed specifically for the evaluation of endosonographers in training. Such a tool, covering all the different steps of the EUS-procedure, would better depict the individual learning curve and better refect the true competence of each trainee. This mini-review will address the issue of clinical education in EUS with respect to the evaluation of endosonographers in training. The aim of the article is to provide an informative overview of the topic. The relevant literature of the field will be reviewed and discussed. The current knowledge on how to assess the skills and competence of endosonographers in training is presented in detail.
基金supported by JSPS KAKENHI(Grant Number 17K12147).
文摘Objectives:The aim of this study was to explore factors that motivate students to engage in skills practice in a laboratory setting,and to identify their motivation types and the regulatory styles.Methods:Semi-structured interviews were conducted with 23 nursing students from three universities between November 2017 and January 2018.A thematic analysis was used to identify factors associated with students’motivation to engage in skills practice in a laboratory.The types and the regulatory styles of student motivation were identified based on the self-determination theory.Results:Seven motivating factors were identified.These factors included the students’desire“to acquire the skills necessary to work as a nurse”,the“desire to improve skills in preparation for clinical practicum”,and their felt“obligations to patients as a nurse”.Moreover,“the impetus to study arising from the objective evaluation of oneself and others”and“wanting to pass the skills examination”motivated the students to engage in skills practice.A“learning environment that facilitates students’learning”and the“supportive involvement of educators”facilitated their learning.Based on the self-determination theory,the students were found to embrace extrinsic motivation with four regulatory styles of motivation,namely integrated,identified,introjected,and external regulation.Conclusions:Nurse educators should understand the motivating factors of students,and help students embrace a more internally controlled motivation by helping them envision their future careers as nurses,and by fostering their ethical duty to care for patients.
