The assessment of clinical competence remains almost universally accepted in the nurse education literature as a laudable pursuit yet there are aspects of it that remain at odds with the higher education of nurses.

Stress, burnout and attrition may not be directly linked. Personality factors at course entry contributed significantly to the prediction of burnout and programme completion, but the relationships were not strong enough to be practically useful.

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Background: Stress in nursing students may be related to attrition from nursing

was subsequently identified in the Key points section. This notice is included in the online and print versions to indicate that both have been corrected [26 January 2010].Objectives: To construct a training protocol for spaced retrieval (SR) and to investigate the effectiveness of SR and Montessori-based activities in decreasing eating difficulty in older residents with dementia. Methods: A single evaluator, blind, and randomized control trial was used. Eighty-five residents with dementia were chosen from three special care units for residents with dementia in long-term care facilities in Taiwan. To avoid any confounding of subjects, the three institutions were randomized into three groups: spaced retrieval, Montessori-based activities, and a control group. The invention consisted of three 30-40 min sessions per week, for 8 weeks.Results: After receiving the intervention, the Edinburgh Feeding Evaluation in Dementia (EdFED) scores and assisted feeding scores for the SR and Montessori-based activity groups were significantly lower than that of the control group. However, the frequencies of physical assistance and verbal assistance for the Montessori-based activity group after intervention were significantly higher than that of the control group, which suggests that residents who received Montessori-based activity need more physical and verbal assistance during mealtimes. In terms of the effects of nutritional status after intervention, MiniNutritional Assessment (MNA) in the SR group was significantly higher than that of the control group. Conclusion: This study confirms the efficacy of SR and Montessori-based activities for eating difficulty and eating ability. A longitudinal study to follow the long-term effects of SR and Montessori-based activities on eating ability and nutritional status is recommended.

Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.

Aim To expand knowledge about the predictive factors of nurses' intention to leave their job and consequently to turnover. Background Nurse turnover is costly and negatively influences quality of care. Understanding the association between intention to leave and modifiable features of hospital organisation may inform strategies to reduce turnover. Methods A cross‐sectional survey of 3,667 medical and surgical nurses was conducted in Italy. Measures included intention to leave; work environment; burnout; job satisfaction; and missed care using the RN4CAST instruments. Descriptive, logistic regression analysis was used. Results Due to job dissatisfaction, 35.5% of the nurses intended to leave their current job, and of these, 33.1%, the nursing profession. Push factors included the following: understaffing, emotional exhaustion, poor patient safety, performing non‐nursing care and being male. Pull factors included the following: positive perception of quality and safety of care, and performing core nursing activities. Conclusion The present study expands knowledge about the predictive factors of nurses' intention to leave their job and consequently to turnover, which is one of today's major issues contributing to the shortage of nurses. Implications for Nursing Management Nurses' intention to leave their job is the consequence of a poor work environment, characterized by factors such as understaffing and performance of non‐nursing activities.

Aims. To explore and explain the different concepts of reliability and validity as they are related to measurement instruments in social science and health care. Background. There are different concepts contained in the terms reliability and validity and these are often explained poorly and there is often confusion between them. Design. To develop some clarity about reliability and validity a conceptual framework was built based on the existing literature.Results. The concepts of reliability, validity and utility are explored and explained. Conclusions. Reliability contains the concepts of internal consistency and stability and equivalence. Validity contains the concepts of content, face, criterion, concurrent, predictive, construct, convergent (and divergent), factorial and discriminant. In addition, for clinical practice and research, it is essential to establish the utility of a measurement instrument. Relevance to clinical practice. To use measurement instruments appropriately in clinical practice, the extent to which they are reliable, valid and usable must be established.