Abstract
The clinical ladder is an essential tool for nursing education, enabling nurses to ascend from novice to expert. The learning content for nurses can depend on their clinical situations. The aging of societies has changed the demand for nurses at community hospitals because of the multimorbidity of older patients. At the same time, the gap in nursing education between urban and rural hospitals is wide, as rural hospitals often lack the application of the clinical ladder. This study investigates the effectiveness of using the clinical ladder in a rural Japanese community hospital using the clinical ladder scale and interviews. Through its application, we found that both novice nurses and nursing educators came to recognize the effectiveness and importance of the ladder. However, unfamiliarity with assessments, working conditions, and Japanese culture inhibited the smooth application of the ladder. For the effective application of the clinical ladder, continual training on assessments and the ladder’s effectiveness in clinical situations, along with consideration of educational background, should be enhanced through the monitoring of the clinical ladder.
Highlights
The clinical ladder is an educational system that indicates the developmental stages of clinical nurses and promotes their growth through individual autonomous behavior and organizational support [1]
The gap in nursing education between urban and rural hospitals is wide, as rural hospitals often lack the application of the clinical ladder
We found that learners who may not have had self-assessment abilities appeared to overestimate their own abilities in some instances [21]
Summary
The clinical ladder is an educational system that indicates the developmental stages of clinical nurses and promotes their growth through individual autonomous behavior and organizational support [1]. The ladder was devised in the 1970s to assess nursing ability in the United States. In Japan, a nursing university hospital first developed it in. It is widely recognized as a system for evaluating individual clinical nurses’ abilities in the hospital nursing setting [2,3]. The clinical ladder evaluates multiple stages of nursing competencies and shows the nurse’s expected skills at each stage as well as the nurse’s ability according to the achievement level [4,5]. By utilizing the clinical ladder, nurses can aim for self-improvement while checking their ability stage. It has been used as a useful tool for human resource development [6]
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