Performance competence of pregraduate nursing students and hospital nurses: A comparison study

AIMS AND OBJECTIVES: To compare and contrast the competence in clinical performance between pregraduate nursing students and hospital nurses. The study also explored the most difficult technical skills for the participants to perform. BACKGROUND: Assessment, communication and critical thinking are competencies that help in providing safe and appropriate care for patients. Yet, self-perceived competence was mostly measured while performance competence that reflected nurses' performance in real cases has seldom been explored in literature. DESIGN: A cross-sectional design was applied. The study adhered to the STROBE guidelines to improve reporting quality. METHOD: Fifty-two nurses and 50 nursing students completed the Computerized Model of Performance-Based Measurement system, which measures performance competence including the steps of critical thinking, conflict resolutions and common clinical technical problems. Six case scenarios containing 107 test questions were completed. RESULTS: Only 53.85% of nurses and 20.0% of students achieved a satisfactory level of performance competence. They showed low scores on the steps of critical thinking: "collecting data from on-site physical assessment," "processing information," "recognising/prioritising problems" and "arranging a course of action for patient care," as well as solving common technical problems and conflicts. The three most difficult skills to perform were CPR, reading EKGs and venipuncture/starting intravenous lines. CONCLUSIONS: The study captured the participants' weaknesses in the critical thinking process and the nursing skills that were difficult to perform. These skills are imperative to nursing care and need to be strengthened in school and in-service education. The academic curriculum and course design for students as well as training programmes for nurses need to be reviewed to address the challenges to be faced in a clinical setting. RELEVANCE TO CLINICAL PRACTICE: Teaching-learning strategies that focus on enhancing critical thinking and performing difficult skills need to be designed and implemented both in practice and in school.