Developing Core Competency-Based Learning Objectives for Postgraduate Curricula for Postanesthesia Nurses—A Delphi Study

PurposePostanesthesia care unit (PACU) nurse competencies involve the ability to care for patients receiving complex treatment. Well-educated PACU nurses are required to provide safe patient care, and accordingly, they require investment in their education. However, core competencies for PACU nurses that are based on systematic methods for curriculum development and consensus have not been established. The purpose of this study was to develop a nationwide consensus on core competency–based learning objectives for a postgraduate PACU nursing curriculum.DesignNationwide Delphi Study using Kern's six steps of curriculum development as a framework.MethodsForty-one anesthesiologists and 38 PACU nurses from 37 Danish departments of anesthesiology were invited to participate. In Delphi round 1, the participants listed core competencies for PACU nurses within 12 predefined categories. We analyzed the responses using an inductive and manifest approach to content analysis and developed learning objectives in accordance with the Structure of Observed Learning Outcomes and Simpson taxonomies. In Delphi round 2 and 3, the participants rated and rerated the learning objectives on a 7-point Likert scale, measuring statements of agreement. Consensus was predefined as a median score of 6 and or greater. The main outcome was a prioritized list of competency-based learning objectives for a postgraduate PACU nurse curriculum.FindingsTwenty-six nurses and 14 anesthesiologists (51%) completed all Delphi rounds, representing 22 (60%) departments of anesthesiology. Consensus was reached on 180 learning objectives. The learning objectives described competencies ranging from basic to complex nursing tasks and emphasized the knowledge and skills needed to identify and initiate treatment of postoperative complications.ConclusionsNationwide consensus on core competencies for postgraduate curricula for PACU nurses was achieved through the Delphi method. Our study exemplifies the range of complex knowledge and skills needed to work as a PACU nurse. The learning objectives are applicable in postgraduate curricula designed for PACU nurses.     

基于中医特色护理硕士专业学位研究生培养方案的构建

目的 探讨基于中医特色护理硕士专业学位研究生培养方案的构建。方法 运用德尔菲法对相关专家进行函询,初步构建中医特色护理硕士专业学位研究生培养方案。结果 2轮函询问卷的有效回收率分别为96%和100%,专家权威系数为0.853和0.873;2轮函询的协调系数经卡方检验均有统计学意义（P<0.05）,最终形成的培养方案包括培养目标、培养方式、理论课程安排、培养时限及内容安排、实践考核方式。结论 本研究构建的培养方案具有必要性和科学性,可为学校和医院培养中医特色护理硕士专业学位研究生提供依据。     

精神科护士规范化培训核心能力及培训内容的构建

目的 明确精神科护士规范化培训的核心能力,设计规范化培训内容,为进一步规范、改进和完善精神科护士规范化培训提供参考。方法 基于文献回顾和访谈结果,设计精神科护士规范化培训的核心能力与规范化培训内容咨询问卷,选取来自全国8个省市,从事精神科临床护理、护理管理和护理教育的28名专家进行2轮德尔菲专家咨询,确定精神科护士规范化培训的核心能力,并依此构建培训内容。结果 2轮专家咨询问卷有效回收率分别为93.3%和100%,专家的权威系数分别为0.864和0.870。2轮专家咨询的肯德尔和谐系数分别为0.359和0.326（P＜0.01）。构建的精神科护士规范化培训核心能力共7项,规范化培训内容共37项。结论 精神科护士规范化培训内容突出了精神科的护理特色,满足精神科护士规范化培训的要求,且培训方式和考核方法多样。     

Construction of a competency framework of dental hygienists: A Delphi study

AimTo explore the basic and core competencies of dental hygienists, construct a systematic and scientific competency framework for dental hygienists taking into account China’s national conditions and provide a theoretical basis for the future training in China and other countries that have not yet established the competencies of dental hygienists.BackgroundThe establishment of dental hygienists role is essential for the public to improve the dental health level. Currently, more than 50 countries around the world have established the role of dental hygienists and defined the core competencies needed by dental hygienists. However, studies on developing a standardized and unified consensus of competencies of dental hygienists are lacking in China.MethodsBased on the literature review and theoretical research, this study explored the theoretical basis and fundamental principle of constructing the competency framework for dental hygienists. Moreover, a correspondence questionnaire on dental hygienists’ competency framework was initially constructed to clarify the specific content of each competency. Finally, the Delphi method was adopted to establish the indicators of the dental hygienists’ competency framework according to the principle of expert selection and inclusion criteria.ResultsThe three rounds of Delphi consultation experts were from nursing, stomatology and management and other fields. Three rounds of Delphi results showed that the expert authority, enthusiasm and coordination coefficients were high. Thereafter, a competency framework of dental hygienists with 4 primary indicators, 15 secondary indicators and 50 tertiary indicators was constructed, which included theoretical knowledge, professional skills, professional abilities and occupational qualities.ConclusionLiterature and theoretical research methods along with Delphi expert consultation were used to construct the competency framework of dental hygienists based on the onion model. The competency framework of dental hygienists was scientific, reasonable and practical, which is consistent with the current health situation in China and has distinct Chinese characteristics. Some of our findings, offer ideas for other developing countries that have not yet set up the role of dental hygienists or are in an initial stage.     

The process of learning and professional development according to nursing students’ experience during Covid-19: A constructivist grounded theory study

AimThis study explored the experiences of nursing students with respect to learning processes and professional development during internships with COVID-19 patients to build a novel theoretical model.BackgroundThe COVID-19 outbreak had a profound impact on the worldwide learning system and it interrupted the internship experiences of nursing students. After the second wave of COVID-19, to balance academic activities with COVID-19 containment, some Italian universities allowed nursing students’ internships in COVID-19 units. This new experience may have influenced nursing students’ learning processes and professional development, but this is yet to be investigated.DesignA qualitative study using a constructivist grounded theory (CGT) approach.MethodsNursing students were recruited from two hospitals in northern Italy between January and April 2021. Data are gathered from interviews and a simultaneous comparative analysis were conducted to identify categories and codes, according to Charmaz’s (2006) theory.ResultsThe sample consisted of 28 students. The results suggested the core category, that is the ‘Students’ sense of belonging to the nursing profession’ and four main categories: (1) From knowledge to know-how, (2) A new relationship modality, (3) Sharing and socialisation and (4) Responsibilization. Finally, a premise and a corollary, respectively (5) Motivation and the (6) Circularity of the process, were identified.ConclusionOur study proposed a new theory of nursing students’ learning processes in clinical contexts during internships with COVID-19 patients. Despite significant difficulties, the nursing students developed a unique learning process characterised by motivation. Therefore, our study provided insight into the learning process during a pandemic and investigated the support needed for nursing students to continue their internships.     

Determining the outcomes for clinicians completing a postgraduate diploma in transfusion medicine

BackgroundMuch is known about outcomes and content of training programs in blood banking, but only a limited amount of formal research has been done on the outcomes required for a postgraduate training program aimed at medical doctors working in clinical practice.Study design and methodsA formal qualitative and semi-quantitative research approach was followed to determine and test the factors considered important in determining the outcomes for clinicians completing a postgraduate diploma in transfusion medicine, and consisted of a literature survey, followed by semi-structured interviews and a Delphi survey.ResultsAfter a series of semi-structured interviews, based on an extensive literature survey, 42 factors were identified. These factors were categorized into eight groups and tested in a Delphi survey to determine which of these would be essential outcomes of a postgraduate training program in transfusion medicine. After three rounds of the Delphi survey, consensus was reached on 27 factors and stability on 14 factors. On one factor, neither consensus nor stability could be reached. Twenty-six factors were identified as essential outcomes.ConclusionThis research provides support for the essential outcomes to be considered in any postgraduate training program in transfusion medicine aimed at clinicians.     

护理大专毕业生应具备的临床能力指标体系的研究

目的 探讨护理大专毕业生应具备的临床能力,为护理大专生培养目标的制定、临床能力的评价提供依据.方法 应用德尔菲法就护理大专毕业生应具备的临床能力进行2轮函询.结果 护理大专毕业生应具备的临床能力包括临床护理能力、护理管理与科研能力、护理职业素质3个一级指标及29个二级指标.结论 专家积极性、权威程度及专家意见的集中程度...     

Adaptation and validation of a nursing competencies framework for clinical practice on a continuum of care from childhood to adulthood: A Delphi study

BackgroundToo few of nursing competencies framework exceed applicability to a given environment, are validated by a research process or used to guide continuing development of nursing competencies.ObjectivesThe study objectives were: 1) to adapt and validate a nursing competencies framework from the continuum of care from childhood to adulthood and 2) to explore implementation strategies.DesignA collaborative approach including nurses from different practice perspectives. A modified Delphi method supported the adaptation and the validation of a nursing competencies framework.SettingThis study was conducted in a pediatric and an adult care university hospitals in Montreal.ParticipantsForty-two nurses were recruited from both university hospitals.MethodsA modified Delphi study was conducted. An online questionnaire, containing dichotomous and open-ended questions, was used to collect data on the nursing competencies framework and the suggested implementation strategies for its use. Consensus percentage was calculated, and thematic analysis was used to analyze nurses' comments and implementation strategies suggested.ResultsThe nursing competencies framework (NCF), adapted and validated in this study, includes seven competencies and four development stages, from advanced beginner to clinical expert nurses. After three rounds, the nursing competencies framework describes the professional role from the continuum of care from childhood to adulthood, and proposes a self-assessment tool that promotes professional development and continuing education of nurses. Moreover, four strategies for implementing the framework in the clinical setting obtained a consensus of 70% or more.ConclusionsA nursing competencies framework was validated by a rigorous research process and adapted to diverse contexts of care. The results revealed a common vision of the nursing practice for patients and their families on the life course from childhood to adulthood. This innovative framework carries the potential to be a relevant and unique reference tool. The nursing competencies framework can provide guidance for the development of nurses' competencies in clinical setting. Additionally, it is a relevant reference that should be use for knowing the scope and the standards of the professional practice in nursing education.     

参与胰岛素泵调节的糖尿病专科护士核心能力指标体系的构建

目的构建参与胰岛素泵调节的糖尿病专科护士核心能力的指标体系。方法基于文献研究法、理论分析法等构建参与胰岛素调节的糖尿病专科护士核心能力指标体系初稿,按纳入标准选择26名专家进入德尔菲专家咨询。结果共进行3轮咨询,第3轮咨询专家的权威系数为0.91,判断系数为0.92,熟悉程度为0.90,专家意见肯德尔和谐系数为0.299(P<0.001)。参与胰岛素泵调节的糖尿病专科护士核心能力Ⅰ级指标4个,包括临床专科护理实践能力、专业发展能力、评判性思维能力、专业人文素养实践,Ⅱ级指标18个,Ⅲ级指标64个。结论参与胰岛素泵调节的糖尿病专科护士核心能力指标体系具有较高的权威性和科学性,为相关医院或学会制订胰岛素泵管理规范提供参考依据。     

安宁疗护高级实践护士核心能力指标体系的构建

目的:构建安宁疗护专业高级实践护士的核心能力指标体系.方法:通过文献回顾,根据专家协调小组意见,自行设计专家咨询问卷,对全国7个省份15所医院从事临终护理实践、护理管理、姑息医疗以及从事院校安宁疗护教育4个领域的23名资深专家进行两轮德尔菲专家咨询.结果:构建的安宁疗护高级实践护士的核心能力指标体系包括沟通及合作能力、...     

An online 5-week professional identity program for nursing student in clinical rotation practice during the first wave of COVID-19 pandemic: A two-arm randomized trial

AimDevelopment and evaluation of the effectiveness of an online 5-week professional identity program among nursing students in clinical internship practice during the COVID-19 restrictions.BackgroundNurse professional identity is a strong predictor of career commitment. Clinical internship practice is a key stage when nursing students build and rebuild their professional identity. Meanwhile, the COVID-19 restrictions has strongly influenced the professional identity of nursing students as well as nursing education. A well-designed online professional identity program may contribute to nursing students who are in clinical internship practice developing positive professional identity during the COVID-19 restrictions.DesignThe study was a two-armed, randomised, controlled trial conducted and reported based on Consolidated Standards of Reporting Trials (CONSORT) 2010 guidelines.MethodsA total of 111 nursing students undergoing clinical internship were randomised into an intervention group and a control group. The five-weekly session intervention was developed based on social identity theory and career self-efficacy theory. The primary outcomes were professional identity and professional self-efficacy and the second outcome was stress. Qualitative feedback was analysed by thematic analysis. Outcomes were assessed before and after the intervention and analysed using an intention-to-treat principle.ResultsThe generalised linear model showed that group-by-time effects were significant for the total score of professional identity and three factors of professional self-image, social comparison and self-reflection and independence of career choice, with small effect sizes (Cohen’s d from 0.38 to 0.48). Only one factor of the capacity of information collection and planning in professional self-efficacy was significant (Wald χ² =0.4.82, P < 0.01) with a medium effect size (Cohen d=0.73). The group effect, time effect and group-by-time effect of stress were not significant. Three themes were: ‘Gaining in professional identity, self-recognition and peer belonging’; ‘Content, self-motivation and intervenor as participation facilitators’; and ‘Combining offline and courses, setting group rules and building mutual trust as recommendations’.ConclusionsThe online 5-week professional identity program effectively promoted the development of professional identity and the capacity for information collection and career planning but did not significantly relieve pressure during the internship.     

校院联合培养护士核心能力的探索

为了探讨“校院联合,定向培养,提升护士核心能力”的护理人才培养模式,厦门医学高等专科学校与厦门长庚医院建立校院联合办学的模式,以技术应用能力为支撑制订新型人才培养方案,采取课程精简、融合、重组等多种形式,优化课程结构,从而建立具有鲜明护理专业特色、提升护士核心能力的新课程体系。采取灵活多样的护理教学方法．实行实验训练、见习、实习带教厦门长庚医院“一贯制”。     

高职助产护生核心能力指标体系的构建

目的 构建高等职业教育助产护生核心能力指标体系,为高职助产学生的培养提供参考依据。方法 通过文献分析、半结构访谈、德尔菲法及优序图法,构建高等职业教育助产护生核心能力的指标体系及统计各指标的权重。结果 对从事助产护理的23名专家进行2轮函询,2轮专家函询的回收率均为100%,第1轮、第2轮问卷函询专家的熟悉程度系数为0.828、0.836,判断系数为0.903、0.926,权威系数为0.866、0.881;第1轮、第2轮函询的肯达尔和谐系数分别为0.109和0.112（P<0.05）;共构建一级指标6项,二级指标56项,其中一级指标包括职业素养、一般保健护理、孕期护理、分娩期护理、产后护理、新生儿护理6个方面。结论 构建的高等职业教育助产护生核心能力指标体系内容较全面,具有一定的科学性,可为国内高职护生的培养提供参考依据。     

护理硕士专业学位研究生临床带教老师遴选标准的构建

目的 构建护理硕士专业学位研究生临床带教老师遴选标准。方法 基于国内外文献研究和专家访谈形成函询指标,通过德尔菲法对来自15个省、市的35名护理专家进行2轮函询。结果 2轮函询结束时专家意见趋向一致,专家权威系数为分别为0.821和0.853,肯德尔和谐系数分别为0.225和0.296（P<0.01）。最终形成的护理硕士专业学位研究临床实践带教老师遴选标准包括10项带教资质标准、5项核心能力以及35项核心能力相关评估条目。结论 护理硕士专业学位研究生临床带教老师遴选标准比较全面和富有代表性,可以为合理选择护理硕士专业学位研究生临床带教老师提供参考。     

Factors impacting on psychological wellbeing of international students in the health professions: A scoping review

BackgroundThere are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions.ObjectivesTo explore what is known about factors that influence the psychological wellbeing of international students in the health professions.DesignA scoping review.Data sourcesA range of databases were searched, including CINAHL, Medline, Scopus, Proquest and ERIC, as well as grey literature, reference lists and Google Scholar.Review methodsThe review included qualitative or quantitative primary peer reviewed research studies that focused on international undergraduate or postgraduate students in the health professions. The core concept underpinning the review was psychological issues, with the outcome being psychological and/or social wellbeing. Thematic analysis across studies was used to identify key themes emerging.ResultsA total of 13 studies were included in the review, from the disciplines of nursing, medicine and speech-language pathology. Four key factor groups emerged from the review: negotiating structures and systems, communication and learning, quality of life and self-care, and facing discrimination and social isolation.ConclusionsInternational health professional students face similar issues to other international students. The nature of their courses, however, also requires negotiating different health care systems, and managing a range of clinical practice issues including with communication, and isolation and discrimination from clinical staff and patients. Further research is needed to specifically explore factors impacting on student well-being and how international students can be appropriately prepared and supported for their encounters.     

Contrast-Enhanced Ultrasound: Development of Syllabus for Core Theoretical and Practical Competencies

Contrast-enhanced ultrasound (CEUS) is dependent on the observer's competencies, and thus, appropriate education and testing of individual competency is essential. The current international curriculum in CEUS is methodologically weak and lacks validated competency assessment tests. In this study, we aimed to develop a syllabus for core competencies in CEUS using the Delphi process and an international panel of experts. A core writing group constructed an initial draft of the syllabus based on the existing literature. Eight international experts in CEUS or medical education were recruited as Delphi panelists. The draft underwent iterative and anonymous Delphi rounds until a pre-defined level of consensus was reached. The final syllabus consisted of 16 items, which were indexed in two main domains and in procedural order. An expert-generated proposal for a syllabus of core CEUS competencies has been constructed via the Delphi process and may serve as framework for future development of a CEUS curriculum, including competency assessment tests.     

中医专科护士核心能力评价指标体系的构建

目的 构建中医专科护士核心能力评价指标体系,为中医专科护士的培养与管理提供参考依据.方法 通过文献研究法、理论分析法初步构建中医专科护士核心能力评价指标,采用Delphi法对17名专家进行2轮咨询.结果 整合专家反馈意见后,最终形成包括7项一级指标,22项二级指标,67项三级指标的中医专科护士核心能力评价指标体系;3轮...     

The clinical practice experience in psychiatric clinic of nursing students and career intention in China: A qualitative study

BackgroundNursing students face a lot of complicated situations and problems when they participate in psychiatric clinical practice for the first time. However, the nursing students' internship experience and career intention in psychiatry have not been well described in China.PurposeThis study aims to explore the experience and career intention of Chinese nursing undergraduates during their first psychiatric internship.MethodThis is a qualitative design using phenomenological approach. Data were collected through a case-study, semi-structured, two face-to-face in-depth interviews (N = 13) with third-year nursing students from a university in China on their first clinical internship in a psychiatric department. We followed the consolidated criteria for reporting qualitative research (COREQ) checklist.ResultsFour themes were identified: negative stereotype perceptions about mental illness, professional maturation, personal development, attitude towards psychiatric patients and career choice.ConclusionsThe experience of nursing students in psychiatric clinical practice was constantly changing. This study indicated that nursing students went through a continuous development process of psychiatric care professional maturation and personal development. However, psychiatric nursing was not an ideal career choice of nursing students. This study provides guidance for educators to optimize the internship experience and take comprehensive measures to improve the professional attractiveness and professional identity of psychiatric nursing.