Measuring nursing competence: development of a self-assessment tool for general nurses across Europe

In response to the global challenge of providing and delivering effective health care, the aim of the European Healthcare Training and Accreditation Network project is to work towards improving the transparency of European Union (EU) nurse workforce qualifications, competence, skills, experience and culture. Currently, there is no detailed or tangible method available for comparison, which is perceived as an obstacle to EU nurse workforce mobility. OBJECTIVES: Clearly, this is an important issue that needs to be addressed. Accordingly, this paper reports on the development and psychometric testing of a nurse competence self-assessment questionnaire tool, with the aim of contributing to and enhancing the transparency of nurse competence and ultimately facilitating greater nurse workforce mobility across the EU. SETTINGS: The project comprises a partnership led by a school of nursing in London, operating in collaboration with nursing and other academics from institutions in Belgium, Germany, Greece and Spain. METHODS: Subsequent to a review of literature on nurse competence, a 108 item, post-registration nurse competence self-assessment questionnaire was developed. It elicits information indicating nurse's self-assessment of their competence in the EU country where they trained and qualified and are currently still employed. Responses invite a self-reported frequency of nursing function, this being recommended as the most accurate and least threatening way of assessing competency. During the development process, the questionnaire, constructed from EU countries' competence frameworks, was deemed to be relevant to the measurement of nurse competence by a group of professors of nursing, senior nurse educators, senior nurse managers and other academics thus attesting to the questionnaire's content validity. PARTICIPANTS: A convenience sample of 588 post-registration, generalist nurses from medical or surgical inpatient wards/units were surveyed from acute hospitals in the partner countries (UK n=100, Belgium n=113, Greece n=95, Germany n=150, Spain n=130). RESULTS: Psychometric testing, as expressed by Cronbach's alpha values and by principal component factor analysis, suggests that the questionnaire has an acceptable degree of reliability, construct validity and further supports the content validity. CONCLUSION: In the future, it is envisaged that nurses will be able to utilise the questionnaire to make more informed judgement about the match between their competence and that required of a possible host country. Employers will be able to detect any differences in the required competence levels of potential employees, thus facilitating greater EU nurse workforce mobility.     

Medical students’ self-assessment of performance: Results from three meta-analyses

Objective

Self-assessment is an important component of medical education. Meta-analyses were conducted to better understand accuracy of self-assessment and direction of inaccuracy.

Methods

Three meta-analyses were conducted on results from 35 published articles on medical student self-assessment, one for each of the theoretically distinct ways of measuring accuracy of self-reported ability (correlational, paired comparison, and independent means comparison). Characteristics that potentially influence self-assessment accuracy, including gender, year in medical school, and type of self-assessment, were examined.

Results

Students are moderately able to self-assess performance and are more accurate later in medical school. Students as a whole do not significantly over- or underestimate, but are more likely to overestimate on communication-based, standardized patient encounters than objective, knowledge-based performance measures. Female students underestimate their performance more than male students, but gender analyses are often unreported.

Conclusion

A deeper understanding of the causes and consequences of over- and underestimation is impossible without measurement and reporting of the direction of inaccuracy.

Practice implications

To improve our understanding of self-assessment and increase its effectiveness as a teaching tool, research should report self-assessment as both a correlation and a paired comparison, and conduct analyses of important moderators that can influence self-assessment accuracy.     

中医药院校教育建立“中医药学习自我评估系统”的探索

中医药院校教育应当是完整的'双向反馈机制',不仅要建立针对教师和教学质量的评估机制,还要重视引导学生建立'中医药学习自我评估系统',包括学习系统自我评价体系、中医药学习伤病病例和中医药学习目标与方法管理档案。缺乏适宜的个人中医学习方法是导致中医院校学生中医理论学习困难、学用分离的重要原因。采取建立'学习病例'的方式,构...     

A commentary on Marja Jylhä's “What is self-rated health and why does it predict mortality? Towards a unified conceptual model”(69:3, 2009, 307–316)

This is a commentary on Marja Jylhä's paper “What is self-rated health and why does it predict mortality? Toward a unified conceptual model” (2009) published recently in this journal. In this commentary we address two issues that we believe the paper raises. Firstly, we react to the theory proposed by Jylhä about how individuals form an assessment of their own health. Secondly, we discuss what we believe amounts to an existing confusion about what self-rated health can and should be considered to measure. We conclude that the cognitive process that Jylhä introduces in her paper should be expanded to include external and internal states that influence the process illogically and irrationally, as well as a long-term ongoing component reflecting that people are continuously presented with health-relevant information during their lives and continuously evaluate and change their assessment of health according to this information. Further, we conclude that self-rated health should best be viewed as a measure of people's perception of their health rather than a measure of true health.     

微观社会资本与农转非中老年人自评健康关系探究

目的 探讨微观社会资本与自评健康之间的关系,为促进失地农转非中老年人的健康水平提供参考.方法 采取多阶段分层随机抽样的方法,抽取符合条件的居民共2669人进行面对面问卷调查.自评健康采用主观评分的方式,微观社会资本从家庭和个人两个层面测量,通过单因素和Logistic二元回归模型分析微观社会资本对自评健康的影响.结果 ...     

Factors associated with self-reported halitosis in Kuwaiti patients

OBJECTIVES: Oral malodor is a common complaint of dental patients, yet limited data is available on the actual prevalence of this condition. The aim of this study was to assess the prevalence and factors associated with self-reported halitosis in Kuwaiti patients. METHODS: This was a cross-sectional study of Kuwaiti adults using a 19-point self-administered structured questionnaire on self-perception of halitosis. Significant associations between self-reported oral malodor and sociodemographic, medical history, and oral hygiene variables were examined with multiple logistic regression analysis. RESULTS: A total of 1551 subjects participated (response rate=86.2%). The prevalence of self-reported halitosis was 23.3%. Use of the toothbrush less than once daily was the factor most strongly associated with self-perceived halitosis (OR=2.68; 95% CI=1.83-3.92; p<0.001). Other factors significantly associated with self-perceived halitosis included current or past smoking (OR=2.51), female gender (OR=1.54), being 30 years of age or older (OR=1.35), having high school education or less (OR=1.41), history of chronic sinusitis (OR=1.58) or gastrointestinal disorders (OR=1.73), never using miswak (OR=1.56), and never using dental floss (OR=1.33). CONCLUSION: Inadequate oral hygiene practices were the factors most strongly associated with self-reported oral malodor in this sample of Kuwaiti patients. Other factors with significant associations included history of gastrointestinal tract disorders, chronic sinusitis, older age, female gender, and lower education levels.     

Self-assessment of performance among surgical trainees during simulated procedures in a simulated operating theater

BACKGROUND: The ability of surgeons to assess their own performance is essential for training and self-regulation. The latter is based on the premise that they recognize their weaknesses and seek remedial action accordingly. METHODS: Twenty-seven surgical trainees performed a simulated saphenofemoral high-tie on a synthetic model in a simulated operating theater. The performance assessment consisted of blinded rating of technical skills and a global rating of team skills by a human factors expert and a trained surgical research fellow. Subjects also were asked to assess their own performance using the same methods. Spearman's rho was used for data analysis. RESULTS: There was a strong correlation between the experts rating of technical skills and self-assessment (rho = .64). However, the correlation improved with increasing experience. It was .24 for junior trainees, .43 for those with intermediate experience, and .52 for senior trainees. There was a low correlation between the self-assessment and the expert scores for human factors skills (rho = .31). The correlation was higher for the 2 junior groups compared with the senior trainees. CONCLUSIONS: Unlike other studies on self-assessment, this study found that senior surgical trainees are accurate in their self-assessment of technical skills. However, this was not true in the case of human factors skills.     

Effects of age on the amplitude,frequency and perceived quality of voice

The manner and extent to which voice amplitude and frequency control mechanisms change with age is not well understood. The related question of whether the assessment of one’s own voice evolves with age, concomitant with the acoustical changes that the voice undergoes, also remains unanswered. In the present study, we characterized the aging of voice production mechanisms (amplitude, frequency), compared the aging voice in different experimental contexts (vowel utterance, connected speech) and examined the relationship between voice self-assessment and age-related voice acoustical changes. Eighty healthy adults (20 to 75 years old) participated in the study, which involved computation of several acoustical measures of voice (including measures of fundamental frequency, voice amplitude, and stability) as well as self-assessments of voice. Because depression is frequent in older adults, depression and anxiety scores were also measured. As was expected, analyses revealed age effects on most acoustical measures. However, there was no interaction between age and the ability to produce high/low voice amplitude/frequency, suggesting that voice amplitude and frequency control mechanisms are preserved in aging. Multiple mediation analyses demonstrated that the relationship between age and voice self-assessment was moderated by depression and anxiety scores. Taken together, these results reveal that while voice production undergoes important changes throughout aging, the ability to increase/decrease the amplitude and frequency of voice are preserved, at least within the age range studied, and that depression and anxiety scores have a stronger impact on perceived voice quality than acoustical changes themselves.     

Development of the Leadership Influence Self-Assessment (LISA©) instrument

Purpose

This study aims to describe the development and psychometric evaluation of the Leadership Influence Self-Assessment (LISA©) tool.