The International Council of Nurses (2009) acknowledges that the perception : New Graduates are not prepared for the realities of practice nor do they have the competencies needed by current health care services..

Aubeeluck, Aimee

Christensen, Martin

Craft, Judy

Fergusson, Diana

Knight, Jessica

Stupple, Ed

Wirihana, Lisa A.

Name not available

A comparison of final year undergraduate nursing students’ readiness for registration

Queensland University of Technology ePrints Archive

CRICOS No. 00213J a university for the world real R A Comparison of Final Year Undergraduate Nursing Students’ Readiness for Registration Martin Christensen*, Aimee Aubeeluck#, Diana Fergusson℘, Judy Craft*, Jessica Knight ℘, Lisa Wirihana*, Ed Stupple# *= Queensland University of Technology, # = University of Nottingham, ℘ = Western Institute of Technology, Taranaki CRICOS No. 00213J a university for the world real R The International Council of Nurses (2009) acknowledges that the perception of employers generally is that today’s Registered Nurses’ are not ‘prepared for the realities of practice nor do they have the competencies needed by current health care services’.   Moreover, the ICN (2009) considers education institutions and healthcare organisations as significant stakeholders and warns that the persistent lack of appropriate clinical role models,  overcrowded clinical placement areas and ineffective clinical teaching models continue to  impact on the Registered Nurse practice readiness.  New Graduates ar  not prepared for the realities of practice nor do they h ve the competencies needed by current he lth care services. International Council of Nursing (2009). Reducing the gap and improving the interface between education and service: a framework for analysis and solution generation. International Council of Nurses, Geneva. Graduate Registered Nurse Practice Readiness CRICOS No. 00213J a university for the world real R Graduate Registered Nurse Practice Readiness BN programmes were “never intended to produce nurses who could hit the ground running”. Greenwood, J., (2000). ‘Critique of the graduate nurse: an international perspective’. Nurse Education Today. 20(1);17-23. With the award of registration, the Graduate is declared to be practice ready as a safe and competent practitioner, but the proviso is at a novice level. CRICOS No. 00213J a university for the world real R Re-registration Nurse Education The Old vs The New Apprenticeship Style Hospital-Based Training & Education to meet the needs of the patient Has the theory-practice gap now been replaced  by practice-readiness gap? University Style  Training & Education to meet the needs of the patient through critical-analytical thinking and the contribution to  evidenced-based practice CRICOS No. 00213J a university for the world real R The aim of this study is to examine the extent at which imposter phenomenon is evident in four final year nursing student cohorts in Australia New Zealand and the UK. Its key objectives were to address the following questions:    To what extent is imposter syndrome prevalent in final year nursing students’?  To what extent does clinical practice preparation impact on the manifestation of Imposter Phenomena?  Is there a difference between different student cohorts in terms of their experiences of Imposter Phenomena?  The Study Aims & Objectives Nursing Students’ Readiness for Registration CRICOS No. 00213J a university for the world real R Transition Shock  Feelings of self doubt;  Feelings of insecurity & inadequacy;  Increased expectations;  Feeling demeaned;  Feeling abandoned;  Assumption of knowing everything. KNOWLEDGEABLE IDIOTS ↑ Stress ↑ Depression ↑ Anxiety ↓ Self-esteem CRICOS No. 00213J a university for the world real R Imposter Phenomena  Feelings of self-doubt;   Fear that their true abilities will be found out;   Other people have an over-inflated perception of an individual’s abilities;  A strong belief that they have ‘fooled’ people into believing they are more intelligent and capable than they really are. CRICOS No. 00213J a university for the world real R Imposterism vs Preparedness for Registration (the ideal vs the reality of registration) The unexpected reality of what it means to be a Registered Nurse  Presumptions by those already registered as to the capabilities of the new graduate;  Exposure to unprofessional workplace behaviour;  Horizontal violence;   The realities of shift work in particular night shift;   Personal stressors such as confidence in their ability to perform;   Guilt at having to ask questions;  Coping with death and dying. CRICOS No. 00213J a university for the world real R Imposter Phenomena in the  Health Professions Medicine, Dental, Pharmacy & Nursing Students Mean IP 55.6 (normal <40) Pharmacy   = 59.4 Nursing       = 56.4 Medicine    = 54.7 Dental         = 52.0 Nurse Practitioners 46.6 Henning, K., Ey, S., Shaw, D., (1998). Perfectionism, the imposter phenomenon and psychological adjustments in medical, dental, nursing and pharmacy students. Medical Education. 32(5); 456-464. Vance, S.K., (2002). Incidence of the Imposter Phenomenon among Nurse Practitioner Students. Unpublished Master’s Thesis; Gonzaga University, Spokane, Washington State, USA. CRICOS No. 00213J a university for the world real R Study Design  A survey design was incorporated using the:  Clance Imposter Phenomena Scale (n=20; alpha – 0.84) Preparedness for Hospital Placement Questionnaire for Nursing (n=22; alpha, 0.84-0.96)   223 students from Australia, New Zealand, the United Kingdom n=106 n=53 n=65 CRICOS No. 00213J a university for the world real R  I feel able to cope with practice;  I feel able to carry out nursing procedures like those that will be expected of me as a registered nurse;  I feel able to discuss health issues with patients;  I feel that I could handle an emergency nursing situation;  I feel able to recognize my own clinical limitations;  I feel able to assess the health needs of a new patient;  I feel able to plan the nursing care required for assigned patient/group of patients;  I feel able to understand the application of basic sciences to clinical conditions;  I feel able to understand and observe for the actions, interactions and adverse effects of prescribed drugs;  I feel able to remain calm in difficult situations;  I feel able to assist and counsel a distraught patient and/or other family members. Readiness for Practice CRICOS No. 00213J a university for the world real R  I can give the impression that I’m more competent than I really am;  I avoid evaluations if possible and have a dread of others evaluating me;  When people praise me for something I’ve accomplished, I’m afraid I won’t be able to live up to their expectations of me in the future;  I sometimes think I obtained my present position or gained my present success as a 3rd year nursing student because I happened to be in the right place at the right time or knew the right people;  I’m afraid people important to me may find out that I’m not capable as they think I am;  Sometimes I feel or believe that my success in my life or in my job has been the result of some kind of error;  It’s hard for me to accept compliments or praise about my intelligence or accomplishments;  At times, I feel my success has been due to some kind of luck;  Sometimes I’m afraid others will discover how much knowledge or ability I really lack. Imposter Phenomena CRICOS No. 00213J a university for the world real R The Results Imposter Phenomena 57  Readiness for Practice 41 Normal <40 Mild      40-60 Moderate   60 - 80 CRICOS No. 00213J a university for the world real R New Zealand 53  United Kingdom 62  Australia  64 Imposter Phenomena Readiness for Practice New Zealand 35  United Kingdom 40  Australia  47 45.1%  = Moderate Imposters  33.4%  = Frequently having imposter feelings  8.3%    = Intense imposter experiences  CRICOS No. 00213J a university for the world real R Stranger in a Strange Land Clinically Based Hours while a student  (total in 3yrs) Australia – 800  New Zealand – 1300  UK - 2300 CRICOS No. 00213J a university for the world real R The Nursing Curricula Nursing  Curricula Australia – Modularised  New Zealand – Apprentice  UK – Semi-apprentice CRICOS No. 00213J a university for the world real R Clinical Practice Clinically Based Hours while a student  (total in 3yrs) Australia – 800  New Zealand – 1300  UK - 2300 The escalating difficulties in accessing appropriate clinical placements for their nursing students.   The limited availability of appropriate clinical placements in response to the substantial increase in nursing student enrolments. CRICOS No. 00213J a university for the world real R The Limitations Pre-existing mental health issues Student demographics CRICOS No. 00213J a university for the world real R  Does self-reported preparedness mediate experiences of IP?  Does grade point average contribute to the internalised feelings of IP?  Do feelings of anxiety predispose final year nursing students to experiencing IP?  Do social demographics contribute to experiences of IP?  In what way does clinical practice contribute to the experiences/feelings of IP?  Implications for further Research & Nursing Education CRICOS No. 00213J a university for the world real R  This study suggests that the delivery of the nursing curricula could be an important consideration along with clinical placement hours as to the development of imposterism.   The degree of imposterism may be a contributing factor in individuals experiencing work/career dissatisfaction, in addition to burnout.   Feelings of Imposterism could also potentiate existing mental health issues especially in susceptible individuals which has implications for patient care and organisational productivity. Conclusion 

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A comparison of final year undergraduate nursing students’ readiness for registration

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