Pregraduation clinical training program improves clinical competence of nurse students in Taiwan: An interventional study

Abstract

Background: Recruiting and retaining new graduate nurses are high priorities for hospitals confronting nurse vacancy issues. However, new graduate nurses may not meet the professional entry-level expectations in providing safe patientcare skills. The purposes of this study were to evaluate the effectiveness of a nurse pregraduation clinical training program by measuring students' clinical competency levels, from the students' and the preceptors' perspectives, and by analyzing students' decision to continue working at the same hospital where they received their clinical practicum. Methods:This study utilized a pretest-posttest design. In the developed training program, students practiced as a registered nurse under the supervision of a nurse preceptor for 208 hours. The Clinical Competence Questionnaire was used. The pregraduate participants (N=571) consisted of three cohorts of students who were completing their final semester of a RN-to-BSN program. The preceptors (N=203) responsible for the students also completed questionnaires. Data were analyzed using descriptive statistics, Kolmogrov-Smirnov test, the Wilcoxon signed-rank test, and one-way ANOVA.Results: Students significantly increased their clinical competence after completing the training program. The preceptors generally rated the students with a high clinical competence score; however, the preceptors' scores were lower than the students' self-rated scores. The students' satisfaction with their preceptors positively influenced their decision to remain working in the hospital or unit where they received the practicum. Conclusion:New graduate nurses' transition in employment demands continuing support from the hospital, especially from preceptors who mentor them. To maintain the retention rate of nurses, hospitals are encouraged to offer a formal education program to preceptors regarding proper methods of mentoring pregraduates.

Development of a nursing-specific Mini-CEX and evaluation of the core competencies of new nurses in postgraduate year training programs in Taiwan

“…Considering the need for healthcare professionals to have both academic knowledge and practical skills, it is especially important for their training to integrate both of these elements. This need for effective training applies to both pre-employment training as well as continuing education [36, 37]. As the attention being paid to quality of care and practitioner competency increases, the need for tools to evaluate these competencies is growing.…”

Explaining the inhibitory characteristics of clinical instructors in the process of developing clinical competence of nursing students: a qualitative study

“…The nursing literature continues to raise the concern regarding both the retention of the knowledge and skills acquired by nursing students, and the standard of competency in clinical skills among the newly graduated nurses. [101112] According to studies, clinical competency of new graduates has been identified as an area with statistically significant deficiency in nursing education. [1314] There are several factors involved in this issue, the most important of which is the inadequacy of some of the clinical educators.…”

What level of competency do experienced nurses expect from a newly graduated registered nurse? Results of an Australian modified Delphi study

“…In the first theme “feeling competent on graduation” a range of clinical skills or procedures were identified in which new graduates did not ‘feel’ competent to perform (Adair et al [ 3 ]; Dlamini et al [ 4 ]; Liou et al [ 5 ]; Liou and Cheng [ 6 ]); both new graduates and senior nursing clinicians supported this perception. This led to the exploration of ‘core’ and ‘advanced’ skills and competency highlighted by Liou et al [ 5 ] however this lacks clarity and requires further research.…”

“…In the first theme “feeling competent on graduation” a range of clinical skills or procedures were identified in which new graduates did not ‘feel’ competent to perform (Adair et al [ 3 ]; Dlamini et al [ 4 ]; Liou et al [ 5 ]; Liou and Cheng [ 6 ]); both new graduates and senior nursing clinicians supported this perception. This led to the exploration of ‘core’ and ‘advanced’ skills and competency highlighted by Liou et al [ 5 ] however this lacks clarity and requires further research. Students express the need for more practice within their programmes of study, even in the UK where the students spend 2300 h in a variety of settings – they still lack confidence (Bradshaw and Merriman [ 7 ], Farrand et al [ 8 ], Ross & Clifford [ 9 ], Dolan [ 10 ]).…”