Development and validation of an instrument to measure nurse educator perceived confidence in clinical teaching

Teaching nursing in clinical environments is considered complex and multi‐faceted. Little is known about the role of the clinical nurse educator, specifically the challenges related to transition from clinician, or in some cases, from newly‐graduated nurse to that of clinical nurse educator, as occurs in developing countries. Confidence in the clinical educator role has been associated with successful transition and the development of role competence. There is currently no valid and reliable instrument to measure clinical nurse educator confidence. This study was conducted to develop and psychometrically test an instrument to measure perceived confidence among clinical nurse educators. A multi‐phase, multi‐setting survey design was used. A total of 468 surveys were distributed, and 363 were returned. Data were analyzed using exploratory and confirmatory factor analyses. The instrument was successfully tested and modified in phase 1, and factorial validity was subsequently confirmed in phase 2. There was strong evidence of internal consistency, reliability, content, and convergent validity of the Clinical Nurse Educator Skill Acquisition Assessment instrument. The resulting instrument is applicable in similar contexts due to its rigorous development and validation process.     

PDCA循环在临床教学质量控制中的运用及效果

目的探讨临床教学活动的质量控制方法。方法按照PDCA循环步骤,确定阶段性教学目标,根据教学计划,对不同层次的学生采取不同的教学方法,将护理部-护士长-带教老师三级质控链对教学效果评价的结果作为下一轮循环的标准。结果教师和学生的综合能力得到提升。结论运用PDCA循环控制教学质量,可使教学相长。     

Nurse competence between three generational nurse cohorts: A cross‐sectional study

Research indicates significant differences between nurse cohorts in many work‐related factors. This study compared nurse competence between three generational cohorts comprising the current nursing workforce. The Nurse Competence Scale was used to collect data for this cross‐sectional study from 2052 nurses in a university hospital in Finland. Data were analysed statistically. Significant differences were found between nurse cohorts in their competence. The length of work experience had a significant impact on the development of competence. The oldest cohort, with the longest work experience, had the highest competence scores (70.1 on a visual analogue scale), and the youngest had the lowest (59.0). All cohorts were most competent in patient‐related nursing tasks, in maintenance of professional competence and in ethical care. Nurses were weakest in the development of nursing practice and the use of evidence‐based knowledge. Targeted interventions in teaching–coaching for different nurse generations are needed to ensure the maintenance of nurse competence and high‐quality patient care.     

The association between the practice environment and selected nurse educator outcomes in public nursing education institutions: A cross-sectional study

AimThe purpose of this study is to describe the association between the practice environment and nurse educator outcomes (burnout, engagement, incivility, job satisfaction and intention to leave) in public nursing education institutions in the Gauteng province of South Africa.BackgroundThe practice environment holds the most promise for recruiting and retaining a qualified and engaged nurse workforce; however, the association between the practice environment and nurse educator outcomes has been relatively unexplored.DesignCross-sectional design.MethodsThe Gauteng province was purposively selected, as it has the highest number of public nursing education institutions in South Africa. All-inclusive sampling was applied to public nursing educations institutions in Gauteng province (N = 6) and then to Heads of Department (N = 30; n = 17) and nurse educators (senior lecturers [N = 162; n = 45] and lecturers [N = 257; n = 80]). Data were collected during March to November 2018. The data were collected using the Practice Environment Scale of the Nursing Work Index; Maslach Burnout Inventory - Educators Survey; Utrecht Work Engagement Scale (UWES); Incivility in Nursing Education-Revised (INE-R); job satisfaction and Propensity to Leave Scale.ResultsThe results show that nurse educators are an aging population, with limited numbers having master’s and doctoral qualifications. The most job dissatisfaction is regarding wages (M=2.0; SD 1.07); appreciation, recognition and rewards for good work (M=2.1; SD 1.01); and opportunities for advancement (M=2.2; SD 1.01). The nurse educators do not experience their public nursing education institutions as having a positive practice environment. Nurse educators experienced high levels of work engagement, moderate levels of burnout and low levels of incivility, that were highly correlated with the subscale of foundations of quality outcomes. They experienced moderate levels of job satisfaction but did not intend to leave their places of employment, which was highly correlated with the subscale of manager’s ability, leadership and support.ConclusionsA positive practice environment improves nurse educator outcomes. The subscale of foundations of quality outcomes and manager’s ability, leadership and support had the most impact on nurse educator outcomes, thus quality teaching practices should be cultivated and recognised; and managers must have the necessary skill and knowledge to lead effectively, while also including nurse educators in decisions that impact them and involving them in the affairs of the nursing education institution. There is a shortage of qualified nurse educators globally and in South Africa and urgent attention must be given to factors that influence the recruitment and retention of nurse educators.Twitter abstractThe practice environment holds the most promise for recruiting and retaining a qualified and engaged nurse educator workforce, especially regarding foundations of quality outcomes and manager’s ability, leadership and support.     

护理临床带教中存在的问题分析及对策

护生实习的过程是理论和实践相结合,由知识向能力转化的过程,护生能否顺利完成实习任务,完成的质量如何,不仅取决于护生本人,带教老师素质的高低将对护生心理素质及业务素质的形成产生潜移默化的作用,直接影响护生的实习效果,对护生以后走向工作岗位的能力起决定性作用。我们针对临床带教中存在的问题进行了分析并提出相应对策,收到较满意的效果。     

Clinical teaching practices of nurse educators at a public college of nursing in South Africa: A survey study

Standardisation of clinical teaching practices by nurse educators for undergraduate students is vital, especially within large nursing education institutions distributed over multiple campuses. This quantitative study investigated current clinical teaching practices of nurse educators at a Public College of Nursing in South Africa. A total of n = 68 nurse educators were selected from 5 campuses over a two-month period (April–May 2016), using convenience sampling. Data was collected with a structured questionnaire, the design of which was informed by the Dundee Three Circle Outcomes Model for Clinical Teaching. The results showed that 37% (n = 25) of the nurse educators had above 10 years of clinical teaching experience. Of the 66% (n = 45) who had formal education on clinical teaching practices, 49% (n = 33) received in-service education. Most nurse educators were willing to share amongst colleagues documents they used for clinical teaching, to promote standardisation of teaching practices. Further, they evidenced best clinical practices regarding planning for assessment and clinical placement of students. However, there were significant variations in the majority (seven) of the nine investigated clinical teaching practices among participants. In-service education was positively correlated to best clinical teaching practices (Chi square (d.f. = 2, n = 68) = 7.24; p = .027; V = 0.33 Medium).     

Nurse educator knowledge,attitude and skills towards using high-fidelity simulation: A study in the vocational education sector

High-fidelity simulation has become an essential educational approach in nurse education globally. Several studies have explored the experience of undergraduate nursing students and educators with high-fidelity simulation; however, none have explored the experience of students in the vocational educational sector. The aim of the study was to explore nurse educators’ knowledge, attitude and skills toward using high-fidelity simulation in the setting of vocational education. An anonymous on-line survey design was conducted at three campuses of a major Australian Technical and Further Education vocational education setting. Forty-eight nurse educators teaching into Diploma of Nursing program for at least six months were invited to participate, 29 participated in the study, a response rate of 60%. Participants expressed lack of knowledge in managing technological issues, simulation facilitation procedures and conducting scenarios. Most participants had positive attitude towards high-fidelity simulation and rated their skills as ‘novice’. An urgent need for nurse educator training was identified to enhance knowledge and skills in technical and scenario management of high-fidelity simulation. A program of supportive mentoring by nurse educator mentors experienced in high-fidelity simulation, engaging with existing simulation associations, will enhance and sustain nurse educator knowledge, attitude and skills in a protected environment further, so that they can optimise training they provide to students for safe quality care of patients in the future.     

在临床教学活动中强化护理软技能培养的探讨

目的探索临床护理教学活动中增加护理软技能培养实施效果。方法选择2006年进入我院临床实习的护生设为试验组,通过导学辅导、情景模拟、课外拓展等多种手段,强化护理软技能培养,与2005年度护生（对照组）进行比较。结果试验组在患者服务态度满意度和综合考核评价结果均优于对照组。结论护理软技能的培养应从临床实习开始。     

以能力为核心的临床护理教学模式的构建与实践

目的探讨以能力为核心的临床护理教学模式。方法编写《临床护理教学手册》,制订分阶段目标教学计划,将实习分为基础护理阶段、专科护理阶段和整体护理阶段．由带教老师对274名实习学生实施以能力为核心的临床护理教学模式的带教。结果学生临床护理能力得到提高,学生和带教老师对教学模式的满意度均较好（P〈0．01）。结论以能力为核心的临床护理教学模式能提高学生临床护理能力,有利于提高临床教学质量。     

“PBL”教学模式在呼吸科护理临床教学中的应用探讨

目的探讨以问题为基础(PBL)的教学模式应用于呼吸科临床护理实习带教的效果。方法将24名在我院呼吸科实习的护理本科生随机分为实验组和对照组各12名。实验组按"PBL"模式带教,对照组按传统方法带教。在出科前进行考核,比较两组护生的理论、实践成绩及综合成绩,同时对PBL组护生进行问卷调查。结果实验组护生的理论成绩、实践成绩及综合成绩均明显高于对照组护生,(86.67±2.27 vs 74.75±2.8)(、86.25±3.08 vs 82.75±2.01)、(86.46±1.54 vs 78.76±1.08),两组比较差异有显著意义(P0.05)。问卷调查显示PBL教学法能提高护生学习的积极主动性,培养临床思维,提高解决实际问题的能力。结论 PBL临床带教能促进教学相长,有效提高临床带教水平。     

临床实习带教过程对男护生职业角色认同感的影响

目的：探讨临床实习带教过程对男护生职业角色认同感的影响。方法采用自制量表对58名男护生职业角色认同感进行调查,参与临床实习带教过程前后职业角色认同感的结果作自身对照进行比较。结果临床实习带教前,男护生的职业角色认同感较差,有41名（70．7％）男护生表示将来毕业后不会选择从事护理工作,主要影响因素是家人不支持、护士地位低、没有成就感、患者及家属对男护士的接受率低、人际关系交往时较为尴尬等。通过8个月的临床实习,男护生们对职业认同感的认识有所改变。37．9％的调查对象表示会从事护理工作,32．8％明确表示不会从事护理工作,低于临床实习前。临床实习后,男护生愿意从事护理工作的比例增加,与实习前比较差异有统计学意义（χ2＝16．76, P＜0．05）。81％的调查者对护理工作有了更全面的认识,意识到护理工作是一项技术性和专业性很强的行业。实习过程中自我成就感较高、某些特定科室男护生更受欢迎与实习所在科室的护理团队气氛融洽是增加男护生职业角色认同感的前3个主要因素。结论实习过程中,带教老师应积极引导和帮助男护生,且管理优秀、气氛融洽的护理团队能够提升男护生职业角色认同感。     

Predictors of occupational stress and well-being in First-Line Nurse Managers: A cross-sectional survey study

BackgroundFirst-line nurse managers have a pivotal role in the organization of health care but have to deal with significant job-related issues and problems in a changing and challenging health care environment. As their new roles are complex and often unclear, it might be expected that these professionals are at risk for occupational stress.ObjectivesThe objective of this study is to analyze and describe relationships between job characteristics, and also interdisciplinary conflicts with physicians as potential predictors of occupational well-being (job satisfaction, psychosomatic distress, turnover intention, work engagement and burnout).Designthis study had a cross-sectional design and used a web-based survey.MethodsThis study was conducted in 2015 in 11 Belgian (Flemish) hospitals. All First-line nurse managers were eligible (N = 481) and 318 respondents (66.1%) agreed to take part in the survey. A hierarchical regression analyses was applied to analyze relationships between predictors and outcomes.Resultsjob demand and job control measures were predictive of all outcomes. Collaboration with doctors only predicted job satisfaction and turnover intention. Social support from management was predictive of turnover intention. Social support from colleague- first-line nurse managers was not predictive. Social support from the staff members (team) was however a strong predictor of all stress outcomes.ConclusionsJob demands, job control and social support of the team and management were all important predictors of occupational well-being in first-line nurse managers. All of these variables can be influenced by hospital management to improve the work conditions of this professional group in order to retain their workforce.     

教学组合法应用于护生临床带教的研究

目的探讨教学组合法在护生临床带教中对于提高学生综合素质与能力的影响。方法对2004—2005年度进入我院实习的全日制护理专科生90名进行随机分组，对照组采用传统的临床师徒式教学方法，实验组采用教学组合的综合临床教学法。在学生实习3个月后和实习结束前（即实习第8个月后）分别对2组学生进行理论笔试、操作考核，以及使用自制问卷调查表调查患者对研究对象的认可程度方面综合评价学生的素质与能力，并采用重复测量方差分析法比较2组结果。结果对患者调查结果与对学生的综合考核结果显示实验组在服务意识、知识运用、动手能力、交流技巧、适应能力方面均优于对照组。结论对高等护生实施教学组合法的综合临床教学新模式，更有利于提高学生的综合素质与能力.     

Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study

BackgroundHealth care systems globally are facing challenges of meeting the growing demand for primary care services due to a shortage of primary care physicians. Policy makers and administrators are searching for solutions to increase the primary care capacity. The effective utilization of nurse practitioners (NPs) has been proposed as a solution. However, organizations utilize NPs in variable capacities. In some settings, NPs serve as primary care providers delivering ongoing continuous care to their patients, referred to as patient panels, whereas in other settings they deliver episodic care. Little is known about why organizations deploy NPs differently.ObjectivesInvestigate the NP role in care delivery—primary care providers with the own patient panels or delivering episodic care—within their organizations and understand how work environments affect their role.DesignA cross-sectional survey design was used to collect data from primary care NPs.SettingsThe study was conducted in one state in the United States (Massachusetts). Data from 163 primary care organizations was obtained, which employed between one to 12 NPs.Participants807 NPs recruited from the Massachusetts Provider Database received mail surveys; 314 completed and returned the survey, yielding a response rate of 40%.MethodsThe survey contained measures of NP role in care delivery and work environment. NP role was measured by an item asking NPs to report if they deliver ongoing continuous care to their patient panel or if they do not have patient panel. The work environment was measured with the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ). The multilevel Cox regression models investigated the influence of organization-level work environment on NP role in care delivery.ResultsAbout 45% of NPs served as primary care providers with their own patient panel. Organization-level Independent Practice and Support subscale, an NP-PCOCQ subscale, had a significant positive effect on NP role (risk ratio = 2.33; 95% CI: 1.06-5.13); with a one unit increase on this subscale, the incidence of the NPs serving as primary care providers with their own patient panel doubled.ConclusionsNPs can help meet the increasing demand for primary care by taking responsibilities as primary care providers, and organizations can assign NPs their own patient panels. Supporting NP independent practice within organizations promotes NP role as primary care providers. Policy and organizational change focused on promoting NP work environments so NPs can practice as primary care providers can be an effective strategy to increase the primary care capacity.