Evaluation of clinical competence and its related factors among ICU nurses in Kermanshah-Iran: A cross-sectional study

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.

Clinical competency:perceptions of nursing interns and clinical mentors

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.

Exploring the barriers of utilizing theoretical knowledge in clinical settings: A qualitative study

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.

Clinical nursing competency assessment:a scoping review

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.

Attitudes of Nursing Faculty Members and Graduates towards the Objective Structured Clinical Examination (OSCE)

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.

Brazilian questionnaire of competencies of oncology nurses:Construction and test of content validation

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.

The assessment of endosonographers in training

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 endosonographers in training. Consequently, the performance of a certain number of supervised procedures during training does not automatically guarantee adequate competence in EUS. Instead, the assessment of EUScompetence 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 EUSprocedure, would better depict the individual learning curve and better reflect 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.

Attitudes and Practices of Lumbar Puncture among Students, Interns, and Residents of the Pediatric Department of the Mohammed VI University Hospital Center of Oujda, Morocco

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.