The effects of a deliberate practice program on nursing students' perception of clinical competence

Abstract

Background: New nursing graduates' readiness for practice often does not meet the requirements needed in the real situation of clinical sites. Therefore, nurse education has placed more emphasis on developing students' technical skills to cultivate proficiencies needed for clinical sites.

Objectives: To develop a program including deliberate skill practices and technical skill testing, each conducted before students' clinical practicum, and to examine the program's effects on nursing students' clinical competence.

Design: The study was a repeated measure correlational design.

Settings: One nursing university.

Participants: Two-hundred-fifty-six and 266 nursing students in a RN-to-BSN night school program in Taiwan completed pretest and posttest surveys, respectively in 2009 and 2010. Their mean age was 22.61 years and had worked 12.75 months as a nurse.

Methods: Students were asked to participate in the deliberate nursing practice program, which includes skill practice and tests, before their last clinical practicum. The Clinical Competence Questionnaire was used to measure the outcome of deliberate practice.

Results: Findings indicated that participants who had nursing work experience, a higher grade point average, practiced their skills by watching videos, and higher pretest competence scores exhibited significantly higher posttest competence scores. Participants who worked in the operating room/outpatient department, scored higher on self-confidence in clinical performance, and had a higher level of future job stress exhibited significantly lower posttest competence scores.

Conclusions: Although work experience increased clinical competence, working in the operating room/outpatient department where many nursing skills were not performed did not have the effects. In contrast, skill reviews and better performance before practice promoted competence. Attaining motor skill competency is a slow process requiring practices. Thus, providing deliberate skill-practice program is suggested to help students increase their competence.