Presentation on theme: "ASSESSMENT AND EVALUATION OF ADVANCED CLINICAL COMPETENCE NURSE CLINICAL COMPETENCE SCALE (NCCS) NURSE COMPETENCE SCALE (NCS) Presented by: Anna-Lena Nieminen,"— Presentation transcript:
ASSESSMENT AND EVALUATION OF ADVANCED CLINICAL COMPETENCE NURSE CLINICAL COMPETENCE SCALE (NCCS) NURSE COMPETENCE SCALE (NCS) Presented by: Anna-Lena Nieminen, RN, PHN, MSc, Doctoral student Svenska Yrkeshögskolan / Health Care and Social Welfare. Department of Caring Science Faculty of Social and Caring Sciences, Åbo Akademi University, Vasa Finland. Supervisor: Lisbeth Fagerström, RN, PhD, Dean Svenska Yrkeshögskolan / Health Care and Social Welfare, Vasa Finland.
CONTENT 1.Educational Programme for Nurse Practitioners in Finland 2.Assessment and Evaluation of Advanced Clinical Competence / Instruments A.Nurse Competence Scale B.Nurse Clinical Competence Scale 3. Investigation group 4.Data collection 5. Data analysis 6. Preliminary Results 7.Summary
Proficient Chronic and acute diseases (60 cr) Advance clinical skills Evidence based practice and critical thinking Pharmacology Probing and identifying caring needs Advance Chronic and acute diseases (90 cr) => master level Advance clinical skills and physical assessment Evidence based practice and critical thinking Health promotion (theoretical models ) Probing and identifying caring needs Nursing research methods Educational Programme for Nurse Practitioners in Finland
AIM The purpose of this study is to measure advanced clinical competences, by describing professional skills while comparing three groups with different educational and working background. Instruments for assessment and evaluation of advanced clinical competence A.Nurse Clinical Competence Scale (Nieminen & Fagerström 2005) B.Nurse Competence Scale (Meretoja 2004)
Nurse Competence Scale, Meretoja 2004 Nurses self-assessment of competence 73-item instrument (of clinical indicators) VAS-scale mm(visual analogue scale) 4-point scale (0= not applicable in my work, 1= used very sheldom, 2=used occasionally and 3= used very often Derived from Benner´s theory: from novice to expert Categories: Helping role(7 items), Teaching-coaching (16items), Diagnostic functions (7 items), Managing situations (8 items), Therapeutic interventions (10 items) and Work (professional) role (19 items)
Nurse Clinical Competence Scale, Nieminen & Fagerström 2005 (unpubliched material) Nurses self-assessment of clinical competence 65-item instrument (of clinical indicators) VAS-scale mm(visual analogue scale) 4-point scale (0= not applicable in my work, 1= used very sheldom, 2=used occasionally and 3= used very often Interdisciplinary framework: caring- and nursing science, natural sciences, psychology etc.
Nurse Clinical Competence Scale Based on ICN:s definition of Nurse Practitoners i.e: the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice Exampel of items to be assessed: -I take responsibibility for my own actions -I work independently -I am systematic in my way of working -I am self critical about my way of working -I conduct physical assessment of the patient -I have independent responsibility for the examination, care and treatment of patients with complicated- and uncomplicated illness -I provide individual advice on health promotion and illness prevention to the patient, taking national recommendations into consideration -I take active responsibility for my own professional development The Background
Investigation group R.N students in Nurse Practitioners program, n= 19 R.N working with proficient tasks within primary health care, n= 37 R.N working with proficient tasks within health care at the hospital, n= 28
Data Instruments - NCS and NCCS Theme-related additional questions - How do you describe your clinical competence? - How do you develope and maintain your clinical competence - What is the meaning of responsibility for you in your own work setting?
AGE AgeNrangeSDmean a) Students, AP ,3239,8 b) Nurses in primary health care ,0446,9 c) Nurses in hospital settings ,0845,01 P=.009
Work experience in years Work experience NrangeSDmean a)Students, NP ,8812,8 b)Nurses in primary health care ,1822,3 c)Nurses in hospital settings ,5119,4 P=.033
Background Information Specialization
Background Information Academic studies
Data analysis Statistics - Descriptive -Anova test Content analysis
NCCS F=3,258 (d.f.=2;80);p=.044 The statement: I am acting independently
NCCS p<.05 Acting independently F=3,25 (d.f.=2;80); p=.044 Mean a) 8,5 b) 9,2 c) 9,1 Making own decisons F=3,790 (d.f.=2;80); p=.027 Mean a) 8,4 b) 9,3 c) 8,7 Preventing medical problems F= 5,79 (d.f.=2;80); p=.004 Mean a) 5,9 b) 8,1 c) 8,2 Providing individual advice on health promotion and illness prevention F=4,08 (d.f.=2;80); p=.004 Mean a) 6,1 b) 8,4 c) 8,4 a) Students b) Nurses in primary health care c) Nurses in hospital settings
NCS p<.05 Mapping out patients education needs carefully F=2,91(d.f.=2;81);p=.060 Mean a) 7,0 b) 6,9 c) 8,2 Recognizing family members´ needs for guidande F=3,74 (d.f.=2;81);p=.028 Mean a) 7,7 b) 5,9 c) 6,7 Arranging expert help for patient when needed F=5,94(d.f.=2;81);p=.004 Mean a) 6,3 b) 8,2 c) 8,0 Utilising nursing research findings in relationship with patients F=2,91(d.f.=2;81);p=.060 Mean a) 5,7 b) 4,9 c) 6,3 a) Students b) Nurses in primary health care c) Nurses in hospital settings
NCCS The statement: I am coherent in compiling information concerning the state of the patients illness and health resourses. F=1,122 (d.f.=2;80); p=.331
NCCS F=1,091 (d.f.=2;78); p=.341 The statement:I create and utlize clinical strategies based on evidense based practice
NCCS F=2,023 (d.f.=2;80); p=.139 The statement: I reflect on my actions
Preliminay results from the theme related questions 1.Organizational 2.Educational 3.Role and professionalism 4.Caring for the patient as the source to work Responsibility is:
Caring in responsibility LimitateFreedom Lonely Independence ScaringTempting and Challenging BurdensomePleasant
Summary 1.Useful instruments for assessing clinical competence 2.Describes the competence level of the investigation groups 3.Longitudinal studies 4.Prefering one of the tools (NCCS or NCS) 5.The main aspect of caring where related to the inner dimension of responsibility