Abstract
(a) To describe and analyse advanced practice nursing students' self-assessment of their clinical competence and need for further training and (b) to analyse the possible predictive variables in their self-assessment. The self-assessment of clinical competence in nursing education is important for identifying professional development and educational needs to improve patient care. A cross-sectional survey following STROBE guidelines was used. Ninety-nine students from three universities/university colleges in Norway participated in the study, and data were collected using a revised version of the Professional Nurse Self-Assessment Scale II. Descriptive, correlation and regression analyses were performed. The students gave the highest self-assessment ratings for their clinical competence in taking full responsibility and for their need for further training in medication effects and interactions. Although the students gave themselves low ratings for the use of electronic devices, they assessed their need for further training in this area as average. Clinical work experience as a registered nurse and previous higher education level were not significant predictors of clinical competence nor the need for further training. The findings indicate that self-assessment is appropriate for students in advanced practice nursing programmes. This study implies that programmes in advanced practice nursing need to familiarise students with the possibilities of information technology. It questions the entry requirement that stipulates that prospective students must have several years of clinical work experience as registered nurses before entering advanced practice nursing programmes. These programmes need to communicate that competencies other than direct clinical practice are also needed for students' future roles. The study contributes to the exploration of how students self-assess own clinical competence and need for further training in advanced practice nursing programmes. Further research should evaluate the development of clinical competence.
Highlights
The emergence of the role of advanced practice nurses (APNs) has been a reflection of the needs within population and health services for improved diagnostic and treatment services (Fealy et al, 2018)
We found that the higher the APN students assessed their clinical competence, the less need they saw for further training (r = −.34), indicating a relatively strong correlation (Pallant, 2016), which was found by Wangensteen et al (2018)
The findings of the present study show a strong connection between what the APN students assessed that they have the least clinical competence in and what they assessed to be their greatest need for further training, except for the two items of using telephone, e-mail or other electronic devices when “giving advice and recommendations to the patient” and “assessing the patient.”
Summary
The emergence of the role of advanced practice nurses (APNs) has been a reflection of the needs within population and health services for improved diagnostic and treatment services (Fealy et al, 2018). According to the definition by the International Council of Nurses (ICN, 2019), an APN has an expert knowledge base, complex decision-making skills and clinical competencies for expanded practice. The Nurse Competence Scale (NCS) is the most widely used generic instrument to measure the competence of RNs (Flinkman et al, 2017; Meretoja et al, 2004). Inspired by the NCS, the Nurse Clinical Competence Scale (NCCS) instrument, with its 67 items, was developed to assess advanced clinical competence, including additional variables such as history taking, physical assessment and clinical decision-making (Nieminen & Fagerström, 2006). Seven new items were added to the NCCS in preparation for a Norwegian study, and the instrument was subjected to an exploratory factor analysis, resulting in a 51-item questionnaire called the Professional Nurse
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