The nursing literature identifies an ongoing concern regarding undergraduate nursing students’ competency in clinical skills and implies that current methods do not sufficiently enable undergraduate nursing students to effectively transfer and develop clinical skills competency learned in the classroom to the practice setting. The research question for this study was, ‘does a practice based learning aid influence theory practice integration for clinical skills competence among undergraduate nursing students’? The educational approach incorporated a number of components including theoretical learning in the classroom, Simulated Learning (SL) in the Clinical Skills Laboratory (CSL), an Objective Structured Clinical Examination (OSCE) and finally, the use of a practice based learning aid, entitled the Reflective Checklist for Clinical Skills Competence (RCCSC). The practice based learning aid conceptually synthesises reflective theory with a self-grading approach, using a competency scale and a criterion-based clinical skills checklist. A mixed-methods approach incorporating an explanatory sequential design was used for the study. Data was collated at four stages over an eight-month period and included clinical skills competency level data generated from the OSCE, the practice based learning aid and from the researcher’s observations of students at the end of their clinical placement. Qualitative data was generated from the practice based learning aid in the form of written reflective comments. Further data was collated on completion of the clinical placement and included an evaluative questionnaire, the findings of which were further explored using qualitative data from a focus group. The findings included an improvement in clinical skills competency levels recorded at the end of clinical placement when compared to competency levels recorded at the beginning of clinical placement (p≤0.05). The educational approach used and specifically the integration of a practice based learning aid, was identified by students as a key factor in developing and improving their clinical skills competency levels during clinical placement. Three key themes emerged from the qualitative analysis and included factors identified as pre-requisites for learning, factors that were conducive to learning and factors that were unconducive. These themes provided a deeper understanding of the students’ learning experience and support the use of the educational approach employed in the study. Whilst the study is limited in context to one cohort of students the findings from both data sets increase our understanding of how students develop competency in clinical skills. The study concludes that the educational approach employed benefited theory-practice integration by enabling students to transfer learning from the simulated setting to clinical practice and improve their clinical skills competency. The study has particular relevance and implications for nurse educators and practitioners seeking teaching and learning methods to enhance clinical skills competency transfer and transition among undergraduate nursing students. This educational approach could also be adapted by other health care professionals to enhance theory practice integration and skills competency.

Thesis (M. Nurs.)--University of Hong Kong, 2005.

Thesis (Ph. D.)--University of Sydney, 2008. / Title from title screen (viewed 11 February 2009). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Nursing And Midwifery. Includes bibliographical references. Also available in print form.

Background: The nursing workforce needs to be adequately prepared to deliver care to an increasingly diverse patient population in the United Kingdom (UK). The Nursing and Midwifery Council (NMC) expects newly qualified nurses (NQNs) to deliver culturally sensitive and respectful care. Aim: The study aimed to explore NQNs’ perceptions of culturally competent practice during the first 9 months post qualification. Methods: A qualitative longitudinal study was conducted with a volunteer sample of 14 NQNs recruited from 3 Higher Education Institutions in the north of England. Data was collected using directed reflections (at 2-3 and 5-6 months) and semi-structured interviews (at 8-9 months) and analysed using a phenomenological approach informed by symbolic interactionism. Results: Perceptions of culturally competent nursing practice were associated with core concepts such as individualised patient care, compassionate and respectful care, respecting individual differences, professionalism and patient trust. Specific behaviours were associated with verbal and non-verbal communication, care planning and diversity-specific adjustments. Discussion: Self-perceived competence and confidence in caring for, and interacting with, patients from diverse backgrounds developed and changed throughout the transition period with experience and interaction opportunities. An ability to reflect upon and learn from novel experiences, plus an enabling ward culture and environment which responded positively to nurses seeking advice and support was important. Conclusion: Educational preparation may have enabled NQNs’ opportunities to develop some but not necessarily all of the skills and behaviours required to demonstrate culturally competent practice. During transition, supported development and professional socialisation can assist in enhancing competence and confidence.

Indiana University-Purdue University Indianapolis (IUPUI) / Factor H is a newly identified phenomenon which describes a constellation of attributes of the new graduate nurse reflecting personality traits, intellectual abilities, and clinical judgment. In a previous pilot study conducted by this researcher nurse managers and experienced Registered Nurse (RN) preceptors described characteristics demonstrated by new graduate nurses demonstrating Factor H and the new graduate nurse’s ability to transition quickly and successfully into the RN role in the acute care environment. There is currently no instrument available to measure this phenomenon. The specific aim of this research was to develop and psychometrically test a scale designed to identify the presence of attributes of Factor H in the new graduate nurse. The Sims Factor H Assessment Scale (SFHAS) was developed and piloted with a sample of one hundred one new graduate nurses within three months of completing the their nursing program at one of three nursing schools in central and south central Indiana. Evidence of content validity was demonstrated through the use of the Content Validity Index conducted with a panel of four experts. Evidence of face validity was demonstrated through interviews with a group of new graduate nurses, nurse managers, and experienced RN preceptors. Principle Axis Factoring with Varimax rotation was used to demonstrate evidence of construct validity and the scale was found to have a single component which was identified as nursing personality. Evidence of criterion-related validity was demonstrated utilizing analysis of the SFHAS and the criterion scale for personality traits (NEO-FFI). Evidence of internal consistency reliability was demonstrated through analysis of inter-item correlations, Cronbach’s coefficient correlations, and item-total correlations. Test re-test reliability using interclass correlation was also conducted to demonstrate stability of the scale. The SFHAS was found to be reflective of nursing personality and not general mental ability or clinical judgment. Use of the SFHAS will allow organizations to evaluate the nursing personality of the new graduate nurse for fit into the work environment. Further study is recommended to gain clarity around the attributes which support successful transition of the new graduate nurse into practice in the acute care environment, also known as Factor H.