Clinical Work Experience Research Articles

Work-Related Musculoskeletal Disorders: Prevalence Among Clinical Radiographers in Teaching Hospitals in North-Western Nigeria


 
 
 
 
 Background: The components and activities within the scope of radiography practice pose high risks of work-related musculoskeletal disorders (WRMSDs) to radiographers in the course of performing diagnostic and therapeutic procedures.
 Objectives: To determine the prevalence of WMSDs and identify the possible causes among radiographers within the study locality.
 Methods: A validated self-administered questionnaire was distributed to all registered and licensed radiographers working in teaching hospitals within the region. The questionnaire contained 21 questions, divided into 3 sections; “A” captured demographic data; “B” captured educational qualifications and work experience; and “C” captured the prevalence, possible causes and responses to WRMSDs.
 Results: The respondents were basically within the age range of 21 – 30 years (66.6%), with most of them being male. Most radiographers had clinical working experience between 1 to 10 years, and worked between 6-8 hours and above daily, with a case load of 30 patients and above. The reported case of WRMSD was 93.3%. The major identified causes of WRMSDs were maintaining of prolonged static position (20%), and frequent bending and twisting (16.7%). This study showed no statistically significant correlation between gender and WRMSDs.
 Conclusion: There was remarkable evidence of WRMSDs among the practicing clinical radiographers within the North-Western Nigeria.
 
 
 
 
 

Work-Related Musculoskeletal Disorders: Prevalence Among Clinical Radiographers in Teaching Hospitals in North-Western Nigeria


 
 
 
 
 Background: The components and activities within the scope of radiography practice pose high risks of work-related musculoskeletal disorders (WRMSDs) to radiographers in the course of performing diagnostic and therapeutic procedures.
 Objectives: To determine the prevalence of WMSDs and identify the possible causes among radiographers within the study locality.
 Methods: A validated self-administered questionnaire was distributed to all registered and licensed radiographers working in teaching hospitals within the region. The questionnaire contained 21 questions, divided into 3 sections; “A” captured demographic data; “B” captured educational qualifications and work experience; and “C” captured the prevalence, possible causes and responses to WRMSDs.
 Results: The respondents were basically within the age range of 21 – 30 years (66.6%), with most of them being male. Most radiographers had clinical working experience between 1 to 10 years, and worked between 6-8 hours and above daily, with a case load of 30 patients and above. The reported case of WRMSD was 93.3%. The major identified causes of WRMSDs were maintaining of prolonged static position (20%), and frequent bending and twisting (16.7%). This study showed no statistically significant correlation between gender and WRMSDs.
 Conclusion: There was remarkable evidence of WRMSDs among the practicing clinical radiographers within the North-Western Nigeria.
 
 
 
 
 

A Lung Cancer Auxiliary Diagnostic Method: Deep Learning Based Mediastinal Lymphatic Partitions Segmentation for Cancer Staging

Accurate assessment of lymph node involvement plays an essential role in lung cancer treatment. The lymph node zonation map is widely used to depict the location of lymph node metastases, which could effectively reflect the degree of tumor invasion. According to the IASLC partitioning criteria and clinical work experience, a total of 15 partitions should be closely monitored. To facilitate doctors in their diagnostic work and improve their efficiency, we developed an automatic mediastinal lymph partitions segmentation algorithm in this study to provide direct visual guidance of the mediastinal area. However, the complex anatomical structure, ambiguous borders, similarity between targets, and variation between cases make the segmentation task more difficult.In this study, we propose a novel two-stage deep learning model for the automatic segmentation of all 15 mediastinal lymph partitions. U-Net is used as the backbone to extract spatial features to establish the mapping from original CT images to the segmentation mask in the first stage. Residual and dense connections are combined in the networks to construct to enhance the propagation of features and characterization effect of the models. An attention mechanism is designed which uses convolutional LSTM layers to control the attention in the feature transmission process to enable the model to focus more on the target area. To tackle the hard samples, which could not be segmented correctly only based on spatial features, we designed a convolutional recurrent network with LSTM structure to fuse features of different scales in the second stage to exploit temporal features to produce more granular segmentation results.A total of 80 CT data cases with different standards in some aspects are collected in this study and annotated by two experts based on the IASLC criteria. For the quantitative evaluation of our proposed method, an average Dice coefficient of 0.78 is achieved of fifteen partitions on the independent test set, which has exceeded the performance of widely used segmentation approaches and reached an advanced level. To further evaluate our method's approbation degree, a user study is conducted, which demonstrates the effectiveness of the designed method with a score of 4 out of 5.This study is the first to design and implement the automatic segmentation algorithm for mediastinal lymphatic partitions, facilitating doctors' work in diagnosis and treatment planning compared with manual identification. Qualitative and quantitative evaluations indicate the effectiveness and advancements of the algorithm.

Factors affecting missed nursing care in hospitalized frail older adults in the medical wards: a qualitative study

BackgroundFrail older adults who are hospitalized, are more likely to experience missed nursing care (MNC) due to high care needs, communication problems, and complexity of nursing care. We conducted a qualitative study to examine the factors affecting MNC among hospitalized frail older adults in the medical units.MethodsThis qualitative study was carried using the conventional content analysis approach in three teaching hospitals. Semi-structured interviews were conducted with 17 nurses through purposive and snowball sampling. The inclusion criteria for the nurses were: at least two years of clinical work experience on a medical ward, caring for frail older people in hospital and willingness to participate. Data were analyzed in accordance with the process described by Graneheim and Lundman. In addition, trustworthiness of the study was assessed using the criteria proposed by Lincoln and Guba.ResultsIn general, 20 interviews were conducted with nurses. A total of 1320 primary codes were extracted, which were classified into two main categories: MNC aggravating and moderating factors. Factors such as “age-unfriendly structure,” “inefficient care,” and “frailty of older adults” could increase the risk of MNC. In addition, factors such as “support capabilities” and “ethical and legal requirements” will moderate MNC.ConclusionsHospitalized frail older adults are more at risk of MNC due to high care needs, communication problems, and nursing care complexity. Nursing managers can take practical steps to improve the quality of care by addressing the aggravating and moderating factors of MNC. In addition, nurses with a humanistic perspective who understand the multidimensional problems of frail older adults and pay attention to their weakness in expressing needs, can create a better experience for them in the hospital and improve patient safety.

Exploring the Concept of Spiritual Sensitivity from the Perspectives of Healthcare Providers in Iran.

Spiritual sensitivity (SS) is defined as attention to the available spiritual values in a conflicting situation and awareness of one's roles and responsibilities in that situation. It helps differentiate between the right and the wrong and leads to sound practice. This study explored the concept of SS from the perspectives of healthcare providers in Iran. This qualitative study was carried out in 2017-2019 using conventional content analysis. Twenty-two physicians, faculty members with clinical work experience, and healthcare providers were purposefully recruited. Data were collected using unstructured interviews and were analyzed using conventional content analysis. Participants' experiences of the concept of SS were grouped into three main themes, namely sense of value, spiritual growth and morale boosting, and SS as a motivator for purposeful service delivery. The findings of the present study will help healthcare managers develop programs for improving healthcare providers' spiritual sensitivity and also will help healthcare providers develop spirituality-based holistic care plans.

Development of clinical competence \u2013 a longitudinal survey of nurse practitioner students

BackgroundIn order to achieve a sustainable standard of advanced clinical competence for nurse practitioners leading to a credible role, it is important to investigate the development of clinical competence among nurse practitioner students.AimThe aim of the present study is to analyse the development of nurse practitioner students’ self-assessed clinical competence from the beginning of their education to after completion of their clinical studies.DesignThe study involved the application of a longitudinal survey design adhering to STROBE guidelines.MethodsThe participants consisted of 36 registered nurses from a nurse practitioner programme at a Norwegian university. The Professional Nurse Self-Assessment Scale II was used for data collection during the period August 2015 to May 2020.ResultsThe students developed their clinical competence the most for direct clinical practice. Our findings are inconclusive in terms of whether the students developed clinical competence regarding consultation, coaching and guidance, and collaboration. However, they do indicate a lack of development in some aspects of clinical leadership. The students with the lowest level of clinical competence developed their clinical competence regarding direct clinical practice significantly more than the students with the highest level of clinical competence. The differences between students with high and low levels of clinical competence were levelled out during their education. Thus, the students as a whole became a more homogenous group after completion of their clinical studies. Previous work experience in primary healthcare was a statistically significant, yet minor, predictor of the development of clinical competence.ConclusionOur findings indicate that the students developed their clinical competence for direct clinical practice in accordance with the intended learning outcomes of the university’s Master’s programme and international standards for nurse practitioners. It is imperative that the clinical field supports nurse practitioners by facilitating extended work-task fits that are appropriate to their newly developed clinical competence. We refrain from concluding with a recommendation that prior clinical work experience should be an entry requirement for nurse practitioner programmes. However, we recommend an evaluation of the nurse practitioner education programme with the aim of investigating whether the curriculum meets the academic standards of clinical leadership expected in advanced level of nursing.

Older immigrant Latino gay men and childhood sexual abuse: Findings from the Palabras Fuertes project.

Childhood Sexual Abuse (CSA) and maltreatment have long-term negative impacts on survivors, including older adults. Yet, limited qualitative examinations of how these experiences impact the lives of older adults exists and even fewer among older Latino gay men. We drew data from life-history narratives the first author conducted with five Spanish speaking older Latino gay men in New York City. Our analyses were guided by an Ecological Model, a Suffering lens, and our clinical social work experience with older adults, sexual minorities and people of color. All participants reported sexual experiences prior to the age of 15 and possible emotional and physical maltreatment. Yet, not all participants perceived these experiences as abuse. Our findings indicate how cultural, linguistic and contextual factors may affect disclosure and coping. Despite the fact that CSA and maltreatment occurred decades ago, these early experiences affected long-term psychosocial functioning. Our findings support a need for future research and clinical practice that considers the subjective perceptions of childhood sexual experiences and maltreatment and how these relate to psychosocial functioning in Latino gay men during older adulthood.

Clinical Work and Life of Mid-Career Male Nurses: A Qualitative Study.

In Korea, about 3000 qualified male nurses enter the clinical nursing field annually; however, they face challenges in long-term job retention in general hospitals. Therefore, this study characterized the work and life experiences of mid-career male nurses engaged in clinical nursing care. Participants were nine registered nurses with a minimum of five years’ work experience in a general hospital in Korea. Data were collected through face-to-face, in-depth, semi-structured interviews. A phenomenological qualitative design was used with Colaizzi’s data analysis method. Three categories, eight theme clusters, and seventeen themes were revealed. The three categories were “limitations and adaptation to work performance”, “interpersonal difficulties and coping”, and “facing reality and preparing for the future”. Findings suggested that mid-career male nurses were considering transitioning to other job roles. These findings help clarify the clinical work experience of mid-career male nurses and their difficulties with job retention. The results provide basic data that may inform the design of policies to practically support male nurses in preserving their careers.

Coping and growing in dilemma: Clinical work experience of front-line nurses in Wuhan during the early stage of COVID-19 epidemic.

AimTo deeply explore the experience of front‐line nurses who participated in rescuing Wuhan during the early stage of coronavirus disease 2019 (COVID‐19) epidemic.MethodsUsing a descriptive qualitative design, individual semi‐structured interviews were conducted between February 25 and March 5, 2020. A conventional content analysis method was used in data analysis to extract themes and sub‐themes.ResultsSix themes emerged after data analysis: (a) worries and stress during rescue; (b) difficulties encountered during rescue; (c) experience of team work; (d) experience of interaction with COVID‐19 patients; (e) experience of logistic support and widespread concern; and (f) value and significance of the experience.ConclusionsNurses took on difficult missions in the rescue and played an irreplaceable role. They experienced remarkable psychological changes over the intensive work. It was necessary to understand the feelings and problems of the nurses so as to establish a healthcare system that can protect medical staff effectively in future disasters.

Internet-Specific Epistemic Beliefs in Medicine and Intention to Use Evidence-Based Online Medical Databases Among Health Care Professionals: Cross-sectional Survey.

BackgroundEvidence-based medicine has been regarded as a prerequisite for ensuring health care quality. The increase in health care professionals’ adoption of web-based medical information and the lack of awareness of alternative access to evidence-based online resources suggest the need for an investigation of their information-searching behaviors of using evidence-based online medical databases.ObjectiveThe main purposes of this study were to (1) modify and validate the internet-specific epistemic beliefs in medicine (ISEBM) questionnaire and (2) explore the associations between health care professionals’ demographics, ISEBM, and intention to use evidence-based online medical databases for clinical practice.MethodsHealth care professionals in a university-affiliated teaching hospital were surveyed using the ISEBM questionnaire. The partial least squares-structural equation modeling was conducted to analyze the reliability and validity of ISEBM. Furthermore, the structural model was analyzed to examine the possible linkages between health professionals’ demographics, ISEBM, and intention to utilize the evidence-based online medical databases for clinical practice.ResultsA total of 273 health care professionals with clinical working experience were surveyed. The results of the measurement model analysis indicated that all items had significant loadings ranging from 0.71 to 0.92 with satisfactory composite reliability values ranging from 0.87 to 0.94 and average variance explained values ranging from 0.70 to 0.84. The results of the structural relationship analysis revealed that the source of internet-based medical knowledge (path coefficient –0.26, P=.01) and justification of internet-based knowing in medicine (path coefficient 0.21, P=.001) were correlated with the intention to use evidence-based online medical databases. However, certainty and simplicity of internet-based medical knowledge were not. In addition, gender (path coefficient 0.12, P=.04) and academic degree (path coefficient 0.15, P=.004) were associated with intention to use evidence-based online medical databases for clinical practice.ConclusionsAdvancing health care professionals’ ISEBM regarding source and justification may encourage them to retrieve valid medical information through evidence-based medical databases. Moreover, providing support for specific health care professionals (ie, females, without a master’s degree) may promote their intention to use certain databases for clinical practice.

Attitudes and beliefs towards implementation of nurse prescribing among general nurses and nurse specialists in China: A cross-sectional survey study.

AimsTo investigate the attitudes and beliefs towards the implementation of nurse prescribing among general nurses and nurse specialists.DesignA cross‐sectional survey among general nurses and nurse specialists was conducted in seven provinces and one autonomous region in mainland China using convenience sampling method.MethodsThe attitudes and beliefs towards nurse prescribing were assessed using the Nurse Attitudes and Beliefs towards Nurse prescribing scale, of which Cronbach's coefficient was 0.902, retest reliability was 0.808. Respondents from eight hospitals across the country were employed to complete an online questionnaire.ResultsNurse specialists (n = 399) had statistically significantly more favourable intentions towards nurse prescribing than general nurses (n = 415; 105.64 ± 12.83 vs. 96.39 ± 13.16; p < .001). The years of clinical work experience, professional title, education degree were positively correlated with general nurses' and nurse specialists' attitudes and beliefs towards nurse prescribing (p < .05). Among nurse specialists, the variety of specialties and whether they work in nurse‐led clinics on an outpatient basis have positively influence on their intentions towards nurse prescribing (p < .05).

SIMBA as an alternative and/or an adjunct to pre-medical work experience during the COVID-19 pandemic

Work experience is considered as a vital part of an application to medical school and other healthcare-related educational programmes. Gaining clinical work experience via various previously available opportunities from healthcare centres has currently become more challenging and less accessible due to the COVID-19 pandemic-related limitations and resource shortages. In order to provide experience in the healthcare field, we conducted a case study by inviting two secondary school students to participate in Simulation via Instant Messaging -Birmingham Advance (SIMBA) as moderators. Despite no previous clinical knowledge, they found it accessible and to be an excellent alternative to the more traditional types of work experience, which had become unavailable to them. We, therefore, propose SIMBA can act as an alternative and/or an adjunct to work experience for healthcare-related courses.

Nurses' Clinical Work Experience during Pregnancy.

The working environment of nurses contains numerous hazards that can be particularly harmful to pregnant women. In addition, pregnancy-induced changes can themselves cause discomfort. Therefore, it is necessary to analyze pregnant nurses’ experiences of clinical work. This qualitative study analyzed data collected through in-depth interviews. From January to June in 2020, 12 shift-work nurses who had experienced pregnancy within three years were interviewed. The main question was “Could you describe your clinical work experience during pregnancy?” Qualitative data from field notes and transcriptions of the interviews were analyzed using Colaizzi’s method. Six categories were extracted that described the nurses’ clinical work experience during pregnancy, as follows: “enduring alone,” “organizational characteristics of nursing,” “risky work environment,” “strengths that sustain work during pregnancy,” “growth as a nurse,” and “methods to protect pregnant nurses.” Pregnant nurses experienced various difficulties due to physical and mental changes during pregnancy, and the clinical working environment did not provide them with adequate support. The findings of this study will be helpful for developing and implementing practical maternity protection policies and work guidelines.

The Relationship between Clinical belongingness and Professional Behavior in Nursing Students

Introduction: Professional belongingness is one of the most important aspects of students' clinical work experience. An understanding of the relation between students’ belongingness on clinical setting and their professional behavior can significantly aid in promoting their professional behavior. This study determined the correlation between nursing students’ dependence on the clinical setting and their professional behavior. Methods: This research is a descriptive analytical study in which 110 third and fourth year nursing students ‌ at Islamic Azad University, Yazd Branch, were included in the study as a sample. Sampling was done by census method. Data were collected using questionnaires of demographic with 9 items, Levett-Jones clinical belongingness with 34 items and Goze professional behavior with 27 items. These questionnaires have been used in several studies and their validity has been assessed using content validity and reliability using Cronbach's alpha coefficient. After completion, the data were analyzed by descriptive and inferential statistics (Pearson, t-test) by SPSS software version 16. Result: The total score of professional behavior and clinical belongingness on clinical setting were 111.06 ± 16.38 and 118.69 ± 16.38, respectively. The subscales of efficiency (71.98 ±13.19), self-esteem (61/99 ± 11.56), and connectivity (42.62 ± 17.00) had the highest weight in the scores of clinical belongingness, respectively. Besides, there was a direct significant correlation between “belongingness on clinical setting and its dimensions” and “professional behavior”, based on Pearson correlation test (r = 548 and P = 0.000). Conclusion: The results showed that there is a positive and significant relationship between belonging and professional behavior. This means that with increasing belonging, professional behavior improves. Thus, educational decision-makers and instructors/educators can enhance nursing students’ professional behavior through using appropriate educational strategies and creating a supportive environment to increase feelings of belongingness clinical setting.

Comparative analysis of preclinical dental students' working postures using dental loupes and dental operating microscope.

Dentists are susceptible to musculoskeletal disorders due to prolonged static postures during dental treatments. Using a magnification tool like dental operating microscope (DOM) or the dental loupes may correct the operator's posture. Up until now, few studies have focused on preclinical dental students' posture when working with the DOM, while most of them have focused on the loupes. The aim of this study was to comparatively analyse the working posture of preclinical students during a dental restoration procedure, working with two different magnification methods. This study used a randomised cross-over design in which seventeen third year students were randomly divided into three groups. The exclusion criteria were previous contact with magnification systems and previous clinical working experience. Each student prepared 3 Black class 1 cavities on artificial lower molars: first with no magnification, following dental loupes and DOM. They were video-recorded throughout the preparation. Trunk, neck and upper-arm position were evaluated using the Posture Assessment Instrument. Students completed a questionnaire on their subjective perception of the two magnification systems. The statistical analysis showed significant improvement of the working posture using magnification systems compared to direct vision. The biggest improvement was obtained through the use of DOM, followed by the dental loupes. Students perceived dental loupes as being the most comfortable and easy to adapt to. They reported being more focused when using DOM. Both magnification systems had a positive impact on the working posture, DOM having the best results. Loupes showed better adaptability while DOM showed better concentration.

Factors Affecting Dental Hygienists’ Recognition of Elderly Implant Insurance

Objectives: The purpose of this study is to assess dental hygienists’ recognition of elderly implant insurance and examine the factors affecting it. Methods: This study was conducted on 215 dental hygienists working in dental clinics with more than four years of clinical work experience, based on the time when the elderly implant insurance benefit was implemented. Data collection was conducted through a self-contained survey through direct visits and mail. The questionnaire consisted of 16 questions that covered demographic characteristics, general awareness of dental health insurance, and detailed perception of elderly implant insurance. Multiple regression analysis was performed to identify the factors affecting dental hygienists’ awareness of the coverage of elderly implant insurance. Results: The dental hygienists had a low average perception of dental health insurance. The dental hygienists’ awareness of the elderly implant insurance coverage increased when they were more interested in national health insurance (p=.002), when they highly thought that the current dental health insurance is not being implemented for national oral health (p=.000), and when they highly thought that the current dental health insurance system aims to stabilize one’s family life (p=.004). Conclusions: Through this study, dental hygienists were able to identify implant health insurance benefits and awareness. It is expected that it will contribute to the improvement of awareness and awareness of dental health insurance benefits by dental hygienists according to the changing dental health insurance benefits in the future.

Demands of experiential training for ICU nurses in Hunan of China

ObjectiveTo assess intensive care unit (ICU) nurses’ demands for specialized experiential training and to provide inputs for developing an experiential training program for ICU nurses. MethodsA questionnaire for assessing ICU nurses’ demands for experiential specialty training was distributed to 360 ICU nurses, selected through purposive sampling from two secondary hospitals and six tertiary hospitals in Hunan Province, China. ResultsOf the survey participants, 63.6% had undergone a specialty training program for ICU nurses. Of these individuals, 53.0% were satisfied with the training. Certification as a qualified nurse was considered an essential criterion for admission of trainees into the program by 81.8% of respondents, while 77.1% of respondents considered clinical working experience to be a critical requirement for selecting trainers. A total of 48.1% of the respondents preferred part-time training, and 36.1% considered a training cycle of 9–12 weeks to be reasonable. Moreover, they felt that the training methods should be tailored to different stages of the experiential learning cycle. Demands for experiential training among ICU nurses were quantified, with high demand reflected in an overall score of 4.41 ± 0.48. The “intensive care technology” experiential training module was ranked highest in terms of demand, with the top five sub-modules being specialty operating technology (4.67 ± 0.53), care of critically ill patients (4.66 ± 0.55), critical patient rescue procedures (4.65 ± 0.56), assessing monitoring indexes (4.63 ± 0.56), and the application of relevant instruments (4.61 ± 0.57). ConclusionNearly half of the respondents indicated that their experiences of specialty training programs were not satisfactory, and they had high demands for experiential training. Thus, to optimize training outcomes, continuous updating of training methods is essential. Moreover, a systematic, comprehensive, and multilevel experiential training program that targets the specific needs of ICU nurses is essential.

Experiences of clinical first-line nurses treating patients with COVID-19: A qualitative study.

AimTo explore the work experience of clinical first‐line nurses treating patients with coronavirus disease 2019 (COVID‐19).BackgroundCOVID‐19 has been listed as an international public health emergency. Clinical first‐line nurses are at a high risk of infection, and they face a lack of experience and inadequate preparation for COVID‐19, leading to physical and psychological disorders.MethodsA qualitative study was conducted from January to February 2020 at a COVID‐19‐designated hospital in Wuhan, China. Thirty nurses were selected for the study using a purposive sampling method. Data were collected by semi‐structured interviews and analysed using content analysis.ResultsTwo main categories were defined in the study from the perspective of nurses: negative experiences during clinical first‐line work and positive impacts of clinical first‐line work. Under the first category, two subcategories were included: psychological experiences of clinical first‐line work and difficulties faced during clinical first‐line work. The analysis further yielded two subcategories for the second category: the needs of clinical first‐line work and the impact of clinical first‐line work on professional attitudes.ConclusionsThe results demonstrate that success depends upon strengthening emergency training and knowledge of infectious diseases for nurses, providing adequate protective equipment and improving the emergency response plans of hospitals for public health emergencies.Implications for Nursing ManagementIt is believed that our findings will guide hospital managers to make improvements in personal, administrative and institutional areas and that they will provide a reference and inspiration for nurses with regard to public health emergencies in the future.

Analysis on the professional orientation of part-time nursing master degree graduates

Objective To explore the professional orientation of part-time nursing master, in order to provide reference for the cultivation and development of the education of part-time nursing master in China. Methods The information of colleges and universities with admission qualification in 2019 was searched, and the admission requirements and specialty orientation setting of 34 colleges and universities that enrolled part-time nursing master's degree students were investigated. Results The 24 colleges and universities set specific professional directions, mainly focusing on specialized nursing, accounting for 62.50% (15/24) of the total. Clinical work experience is not mandatory in all institutions; In central China and east China, 95.83% (23/24) and 91.67% (22/24) of the colleges and universities admitted students set their major directions respectively. Conclusion China′s part-time nursing postgraduate education is still in its initial stage, and the professional orientation of enrollment is varied but general, so it should be standardized to strengthen the direction of Traditional Chinese Medicine nursing. Educational development is not balanced among different regions, and academic exchanges and cooperation between colleges and universities should be strengthened. Key words: Nursing education; Professional degree postgraduate; Part-time graduate; Professional direction; Specialist care

The self-assessment of clinical competence and the need for further training: A cross-sectional survey of advanced practice nursing students.

(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.