Clusters of competence : Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students

Aims To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme, and students' general self-efficacy (GSE). Design A cross-sectional study combining survey data and results from a national examination. Methods Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the GSE scale, and results from the National Clinical Final Examination. A two-step cluster analysis was used to identify competence profiles, followed by comparative analyses between clusters. Results Three clusters were identified illustrating students' different competence profiles. Students in Clusters 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value, respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher. Conclusion The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety. Impact The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their GSE lower than other students. The findings illuminate the need for student-centred strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence

Arts based approaches for sustainability

The arts encompass a broad and diverse landscape of interrelated creative practices and professions, including performance arts (including music, dance, drama, and theatre), literary arts (including literature, story, and poetry), and the visual arts (including painting, design, film) (see UNESCO, 2006). They have been explicitly linked to sustainable development in higher education at a global level through UNESCO’s Road Map for Arts Education (UNESCO, 2006) and The Seoul Agenda: Goals for the Development of Arts Education (UNESCO, 2010). Specifically, the arts have been deployed to promote human rights, enhancing education, promoting cultural diversity, enhancing well-being and, most broadly, “to resolving the social and cultural challenges facing today’s world” (UNESCO, 2010: 8)..

Drama and theatre for health and well-being

The rock art of indigenous communities from 20,000 years ago have been interpreted as early indications of how humans have connected performance, in a broad sense, with the health and well-being of their communities (Fleischer and Grehan, 2016). Now, at a global level, there is increasing recognition that drama and theatre can facilitate a variety of health and wellbeing outcomes for an extensive range of groups, not pre-determined by affluence or socioeconomic status (APPG, 2017). In a broad sense, drama and theatre are a constellation of arts based practices, processes, and spaces, which intentionally work with more or less fictive characters, roles, relationships, and plots, in order to generate a wide range of experiences or outcomes (Wall, Österlind and Fries, 2018, forthcoming). Indeed, theatre and drama have been described as “the most integrative of all the arts: they include singing, dancing, painting, sculpture, storytelling, music, puppetry, poetry and the art of acting” (British Medical Association, 2011, p 10), which can help people to understand and then change how they relate to and then live out their own world