Although the nature and characteristics of expert practice have been described in the literature, the description is incomplete. How expertise is gained is not fully understood, and definitions of expert competencies have yet to be developed. Essential issues for education arise from the demand for knowledge for expert practice. Because expertise is gained in the context of practice, expertise cannot be achieved out of context or taught as an academic exercise. A clear picture of the practice of expert nurses is necessary so that those in the profession can know and articulate expert practice and direct it to the community.
Introduction: Peripheral venous cannulas are predominantly inserted by nurses and medical practitioners. Placement and related care of such devices are one of the most frequently performed tasks by these staff members. Clinicians in training should be given ample opportunity to practice these skills before patient encounters begin.
Aims: To identify the best available evidence on the training of undergraduate clinicians in peripheral venous access.
Methods: We used an integrative literature review method that considered both experimental- and nonexperimental-design studies that addressed the issue of clinician peripheral venous access training of undergraduates. The electronic databases Medline, Embase, Ovid Nursing Database, British Nursing Index, Pre Medline, Mosby's Index, and CINAHL were searched using a predetermined search strategy. The Cochrane and Joanna Briggs databases were also searched along with the reference lists of published materials.
Results: A total of 56 articles were retrieved using the defined search strategy. There were 11 experimental-design studies and 1 nonexperimental-design study selected for final review after independent assessment for methodologic quality. Retrieved articles found disparity between actual skill and student self-evaluation. Teaching methods varied with the use of traditional task trainers and high-fidelity simulation. No method was found to be superior.
Conclusion: Skill acquisition in vascular access is an international issue and one that has been addressed in varying degrees. We identified heterogeneity in training methods that were tailored to institutional requirements and resources. Training in this skill is imperative to ensure competency before patient encounters.
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