Clinical education
Self-perception of readiness for clinical practice: A survey of accelerated Masters program graduate registered nurses

https://doi.org/10.1016/j.nepr.2017.03.005Get rights and content

Highlights

  • Graduates felt prepared as beginner practitioners on completion of an accelerated Masters program.

  • Areas of readiness for practice included nursing practice standards and implementing evidence-based nursing practice.

  • Graduates felt less prepared when responding to emergencies.

  • Recognition of abnormal laboratory results and meeting spiritual needs of patients was another concern noted by graduates.

Abstract

Accelerated nursing programs are gaining momentum as a means of career transition into the nursing profession for mature age learners in an attempt to meet future healthcare workforce demands in Australia. With a gap in the literature on readiness for practice of graduates from accelerated nursing programs at the Masters level the purpose of this study was to evaluate the effectiveness of the program based on graduates' preparedness for practice and graduate outcomes. Using a descriptive, exploratory design an online survey was used to explore the perception of graduate nurses' readiness for clinical practice. Forty-nine graduates from a nursing Masters program at an Australian university completed the survey defining readiness for practice as knowledge of self-limitations and seeking help, autonomy in basic clinical procedures, exhibiting confidence, possessing theoretical knowledge and practicing safe care. Graduates perceived themselves as adequately prepared to work as a beginner practitioner with their perception of readiness for clinical practice largely positive. The majority of participants agreed that the program had prepared them for work as a beginner practitioner with respondents stating that they felt adequately prepared in most areas relating to clinical practice. This would suggest that educational preparation was adequate and effective in achieving program objectives.

Introduction

Escalating demands on healthcare systems worldwide have increased the need for qualified registered nurses (RN). In Australia an estimated gap of 61,000 registered nurse positions was identified for 2012 according to workforce projections (Twigg et al., 2010) with a significant shortfall identified by 2025 (Health Workforce Australia, 2012). To address the nurse shortage and facilitate rapid entry of graduates seeking a second career into the profession (McKenna et al., 2015, Neill, 2011), nine Australian universities currently offer accelerated graduate-entry programs that span 18 months to two years at the undergraduate and postgraduate levels. A previous undergraduate degree from any field is a prerequisite for admission to accelerated nursing programs. The accelerated option performs on par with traditional undergraduate program outcomes by way of academic accomplishment, program completion, attrition and employment with an added benefit of producing mature critical thinkers who can draw from previous life experience (Cangelosi and Whitt, 2005, Duke, 2001, Moe et al., 2009;; Raines, 2007). In light of these mature age career shifters' qualities, for example experience gained while developing a career related to their first degree, it would be likely that their perceived readiness for clinical practice would be more realistic.

Although the United States introduced accelerated degrees in the early 1970s (Rico et al., 2010, Yastik and Anthony, 2009) Australian graduate-entry nursing degrees were only introduced in the mid-1990s following the establishment of nursing education in the university sector (Neill, 2011, Neill, 2012). Research into Australian based graduate-entry nursing degrees is lacking (Neill, 2011, Haddad et al., 2013) with minimal insight into the student's experience and efficacy of accelerated courses available (Neill, 2011).

Graduates of Masters level entry-to-practice nursing programs in Australia have yet to be surveyed regarding their perceptions and definitions of readiness for clinical practice in the literature. What is known about transition of the graduate RN's to practice is problematic with tension between healthcare industry and education providers expectation of the graduates' readiness for practice reported in the literature (Haddad et al., 2013). Therefore, measurement of the students perception can be useful for education providers as strengths and areas for improvement in the program can be identified (Raines, 2009).

This study explored these issues in Master of Nursing Science (MNSc) graduates from an Australian University. Referring to existing meanings of readiness for clinical nursing practice identified from other studies, this study aimed to add to the literature on conceptualising readiness as well as investigate graduates' self-perceptions of clinical practice readiness. Accordingly, the study secondarily assessed the effectiveness of the program in certain competency areas based on the perceived level of preparedness reported by graduates.

What this study adds: With previous life and work experience, accelerated nursing graduates perceived themselves as being ready for practice, rating highly the areas they defined as essential to indicate readiness, such as independence in basic clinical skills and theoretical knowledge. This study therefore identified that an Australian graduate entry Masters program assisted students in preparation for practice as a graduate nurse.

Section snippets

Background

A review of 2006–2016 research was conducted using MEDLINE, ProQuest, CINAHL, ERIC, CSA, PsycInfo, Psychological in Ebsco, Google Scholar, Informit and Australian online content resources.

A number of studies exploring the graduate entry to practice from accelerated programs were identified in the literature, with a scarcity of studies identified from an Australian context. Haddad et al. (2013) examined the ongoing discourse on graduate registered nurses' readiness for practice in Australia and

Methodology

In 2007 the Master of Nursing Science (MNSc), an accelerated 2 year program, was launched as an initiative of a Melbourne based University, introducing professional graduate programs into nursing with an undergraduate degree from any field the primary entry requirement. The purpose of this study was to establish registered nurses' perception of readiness for practice on completion of an accelerated Masters Nursing degree. Ratings of satisfaction with the theoretical and clinical preparation,

Results

The study population included three graduating classes of the Master of Nursing Science course since its inception in 2008, with total number of graduates from the classes of 2009 (N = 48), 2010 (N = 77) and 2001 (N = 58) equalling 183. Fifty two surveys were completed, a response rate of 28%, with three surveys not included in the final data analysis due to missing data. . The highest response rate was found in the 2011 cohort (65%) with lower response rates found in the 2010 and 2009 cohort

Discussion

Many definitions of readiness for clinical nursing practice reported by respondents in this study were consistent with the four broad themes identified in the literature. Safe care was the most frequently reflected theme amongst MNSc graduates in terms of recognising knowledge deficits. Practicing safely, knowing self-limitations and asking for help were categorised under the practicing safe care category. One respondent described readiness for practice as having a ‘realistic understanding of

Limitations

The limited size of the entire study population and accordingly low overall response rate prevented inferential statistical analyses, as well as generalisation of the results, beyond the sample. It is unknown how many members of the study population actually received the invitation to participate in the survey. The accuracy of the study population's contact details in the university's alumni database needs to be considered. Email notification to potential participants may have been too passive

Conclusion

Overall, MNSc graduates defined readiness for clinical nursing practice using similar themes expressed previously in the literature. Their high ratings of preparedness in the areas they defined as essential to readiness (e.g. knowledge of self-limitations and asking for help, independence in basic clinical skills and theoretical knowledge foundation) indicated that the MNSc program provided sound preparation in these areas. In contrast, supervision of care provided by others was an area in

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

References (44)

  • E.S. Scott et al.

    New graduate nurse transitioning necessary or nice?

    Appl. Nurs. Res.

    (2008)
  • C. Yanhua et al.

    A review of clinical competence assessment in nursing

    Nurse Educ. Today

    (2011)
  • N.M. Aktan et al.

    Comparison of outcomes in a traditional versus accelerated nursing curriculum

    Int. J. Nurs. Educ. Scholarsh.

    (2009)
  • Australian Institute of Health and Welfare (AIHW)

    Nursing and Midwifery Labour Force 2009

    (2011)
  • C. Boswell et al.

    Validating graduate student programmatic outcomes

    Nurs. Educ. Perspect.

    (2011)
  • L. Candella et al.

    Recent RN graduate perceptions of educational preparation

    Nurs. Educ. Perspect.

    (2008)
  • P.R. Cangelosi et al.

    Accelerated nursing programs

    Nurs. Educ. Perspect.

    (2005)
  • K. Casey et al.

    The graduate nurse experience

    J. Nurs. Adm.

    (2004)
  • J.B. Duchscher

    A process of becoming: the stages of new nursing graduate professional role transition

    J. Contin. Educ. Nurs.

    (2008)
  • J.B. Duchscher

    Transition shock: the initial stage of role adaptation for newly graduated registered nurses

    J. Adv. Nurs.

    (2009)
  • S.A. Etheridge

    Learning to think like a nurse: stories from new nurse graduates

    J. Contin. Educ. Nurs.

    (2007)
  • K. Goh et al.

    From “dependent on” to “depended on”: the experience of transition from student to registered nurse in a private hospital graduate program

    Aust. J. Adv. Nurs.

    (2003)
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