Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes

Using learning objects to provide context in simulation

Incorporating simulation in curricula is a strategy that provides innovative opportunities to address the challenges of preparing learners for the complexities of clinical practice (Jefferies, 2007). However, where students have had limited exposure to clinical practice their understanding of the context of this may impact on the quality of the learning experience. This is especially so when students are expected to engage in simulation activities that include role play. Using learning objects as a teaching tool and embedding these within the structure of simulation can enhance the quality of the learning experience through facilitating an understanding of the practice context, including how patients present (Windle, McCormick, Dandrea & Wharrad 2011). This presentation outlines the development and use of a DVD that depicted a series of scenarios related to the assessment and care of a patient with delirium, and how this was incorporated within the structure of simulation in the Challenges of Ageing subject in the Bachelor of Nursing at The University of Wollongong. The results of an initial evaluation of the usefulness of using the DVD as a learning object in simulation, including student and staff perspectives will be presented. Incorporating learning objects in simulation has transferability to other health professions and will be of interest to academics and practitioners interested in teaching methods that prepare students for simulation and enhance the quality of the learning experience

A COVID-19 Rapid Response: Evaluating an interRAI telehealth placement for final year nursing students

This research study evaluates a novel ‘telehealth’ clinical placement undertaken by final-year Wintec Bachelor of Nursing students in 2020. These students, after training from the appropriate organisations, contacted and undertook health and wellbeing assessments for ‘at-risk’ older people across the Waikato Region during the national COVID-19 lockdown. This represented the first example of telehealth approved by the Nursing Council of New Zealand as a student clinical experience. Results reveal several key themes highlighting the importance and lessons from this initiative, including tackling COVID-19; implementation requirements; nursing competencies; provider relationships, and community insights. More broadly, they demonstrate the viability and importance of telehealth placements in nursing programmes and provide learnings for those seeking to replicate such placements, especially in the context of constrained health systems growing health challenges

Stimulating an interest in mental health nursing

A team of researchers at the University of Wollongong are currently examining the experiences of Bachelor of Nursing (BN) students as they engage in a stimulating learning experience in mental health

Tools for faculty assessment of interdisciplinary competencies of healthcare students: an integrative review

Increasingly, interprofessional teamwork is required for the effective delivery of public health services in primary healthcare settings. Interprofessional competencies should therefore be incorporated within all health and social service education programs. Educational innovation in the development of student-led clinics (SLC) provides a unique opportunity to assess and develop such competencies. However, a suitable assessment tool is needed to appropriately assess student progression and the successful acquisition of competencies. This study adopts an integrative review methodology to locate and review existing tools utilized by teaching faculty in the assessment of interprofessional competencies in pre-licensure healthcare students. A limited number of suitable assessment tools have been reported in the literature, as highlighted by the small number of studies included. Findings identify use of existing scales such as the Interprofessional Socialization and Valuing Scale (ISVS) and the McMaster Ottawa Scale with Team Observed Structured Clinical Encounter (TOSCE) tools plus a range of other approaches, including qualitative interviews and escape rooms. Further research and consensus are needed for the development of teaching and assessment tools appropriate for healthcare students. This is particularly important in the context of interprofessional, community-partnered public health and primary healthcare SLC learning but will be of relevance to health students in a broad range of clinical learning contexts

HWA Expanded Scopes of Practice program evaluation: Extending the Role of Paramedics sub-project: final report

The Extending the Role of Paramedics (ERP) sub-project built on a model developed by the South Australian Ambulance Service (SAAS) which aims to provide a service that is complementary to primary health care, thus reducing emergency department presentations. The core of the model is training Extended Care Paramedics (ECPs) to treat patients in their usual place of residence, with referral to other health professionals if appropriate. ECPs manage patients with a diverse, and often ill-defined, range of signs and symptoms. Although these patients are deemed \u27low acuity\u27, these cases can be complex and require the ECP to apply advanced clinical reasoning. In many cases, the patient may have multiple chronic conditions and present as generally unwell. The published evidence to date generally supports an expansion of the role of paramedics to include the assessment and management of patients with minor illnesses and injuries to avoid transport to hospital. However, the evidence is primarily from overseas, particularly the United Kingdom, and more research is required to establish the effectiveness and safety of the model

HWA Expanded Scopes of Practice program evaluation: Advanced Practice in Endoscopy Nursing sub-project: final report

The Advanced Practice in Endoscopy Nursing (APEN) sub-project was undertaken in response to a national trend of increasing demand for endoscopy services, in part due to the implementation of the National Bowel Cancer Screening Program. The aim was to train nurses to perform endoscopic procedures previously only undertaken in Australia by doctors. Although new to Australia, nurse endoscopists are well established in the United Kingdom. Recently published evidence based on a systematic review of the literature indicates that nurses can achieve similar results for efficacy and safety to those achieved by doctors

Educating a culturally competent health workforce for Pasifika communities: A Wintec/K'aute Pasifika clinical partnership project

Introduction The connection between Wintec and K’aute Pasifika is long standing through health and education and the time is right for collaboration that lifts both organisations is the strongest possible partnership. Significant opportunity exists for Wintec’s CHASP/CSSHP and K’aute Pasifika to work together in developing innovative strategies to enhance opportunities for student engagement in the delivery of services offered through K’aute Pasifika and to evaluate these. Literature review Pacific Islanders typically have lower health status and life expectancy than other New Zealanders. Implementation of Māori initiatives are not always appropriate for Pasifika peoples and there is a need to develop Pacific-specific initiatives. Evidence suggests tailored teaching and learning interventions may be required to promote participation and academic success of underrepresented minority groups in New Zealand, such as Pasifika. However, the focus needs to be on more than just Pasifika students and also on increasing non-Pasifika student capacity to work with the Pasifika community in a culturally acceptable and competent manner. There is a consistent shortage of Pacific primary health care workers in New Zealand and Pasifika are underrepresented across all health occupations. The literature identifies a complex range of factors that may contribute to this including high levels of mobilization in the skilled professional workforce and blurring of boundaries. Student-led placements with Indigenous populations have been identified as a feasible and meaningful way of developing a workforce ready to serve Indigenous and minority populations. Method A mixed method study design incorporating Talanoa was implemented to address the following key objectives: 1. Map current Wintec student placement provision within K’aute Pasifika against regional population health needs 2. Identify educational opportunities available at K’aute Pasifika through consultation with K’aute Pasifika staff 3. In collaboration between Wintec and K’aute Pasifika, develop a 5-year strategic plan for enhancement of cultural competence of Wintec staff and students in working with Pasifika people Findings Our Talanoa identified three major themes through which current and potential student placements could be better understood: the student experience, vā/relationships, and transformation. The first theme, student experience, was divided into subthemes, which expressed how students are valued, quality experiences for students are important to K’aute Pasifika staff, cultural practices are significant in placements at K’aute Pasifika, authentic experiences and interprofessional practices are essential and readily occur at K’aute Pasifika. The second theme, vā/relationships, was conceptualised as a network, with K’aute Pasifika at the centre, surrounded by the relevant partnerships. Equally as important as who those partners were, was the connections and space - or vā - between them. The third theme, transformation, was divided into three sub-themes: growth, capacity for more, and workforce development. These themes were understood in the context of the health data to create a clearer picture of the health needs for the Pasifika community in Kirikiriroa/Hamilton. Recommendations A clear action plan for 2021 is outlined which was co-constructed and agreed between K’aute Pasifika and Wintec and derived from the Strategic Plan

Bachelor of nursing: student experience of undertaking nursing assessment in clinical settings

The aim of this research was to:- •Describe student nurses experiences undertaking nursing assessments on clients in clinical practice. •Identify factors influencing the students’ ability to perform assessments. •Determine the types of nursing assessments undertaken by students and the frequency of these. •Identify student involvement in completing assessment documentation on nursing assessments

The impact of professionalism on the assessment of clinical competence

Critical Comparative Nursing Assessment (CCNA) is a Grounded Theory explaining how decisions about practice competence are formulated. This theory emerged as an outcome of research undertaken to discover how practice competence was determined for completing Bachelor of Nursing students. The study revealed that comparative assessment was central to determining competence. This involves a process of gathering, benchmarking, using comparative decision making to weigh assessment outcomes, and validation of professional judgement. While presenting a summary of the theory, this presentation will focus on the impact of professionalism on the assessment of clinical competence. This will highlight the influence of subjective information and the impact this may have on competency assessment outcomes. The presentation will explore how professional judgement and processes surrounding the assessment of competence may be managed to avoid compromising the assessment process. While this study was initially designed to investigate how student nurse competence was assessed, results have relevance to the assessment of students in other health professions. This presentation will be of interest to people involved in the assessment of clinical skills and competence in practice, and professional decision making