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