Critical Analysis

Aim of assessment

The aim of this assessment provides students with an opportunity to critically analyse and discuss the relationship between the theoretical construct of ’being a professional nurse or midwife’ and the transition to graduate practice.

Details

Write an essay based on the case study provided exploring the different elements that inform your preparation for transition to professional practice. Based on current theoretical perspectives, analyse the case study and explain the importance of managing clinical and non-clinical skills essential for new graduate nurses or new graduate midwives to address in readiness for meeting professional responsibilities as capable practitioners in nursing and midwifery. You must also reflect on your own preparedness for practice as a new graduate nurse or new graduate midwife, taking into consideration your own values and personal goals as you enter the health workforce.

The Professional Nurse Competence Evaluation Tool

Critical Analysis

In order to meet the growing demands for professional nurse, it is clearly visible that professional nurse need to develop their competence and skills (Danhausen, Joshi, Quirk, Miller, Fowler & Schorn, 2015). The MCAT competency items have been developed on the basis of didactic courses. Moreover, such competency items are based upon ACNM’s Core Competencies as well as ICM’s Essential Competencies. The self-assessment tool has been developed from Brenner’s Novice-to-Expert theory. The tool focuses on nurses analyse and focus on their skills and capabilities. Then they can progress towards a specific competency goal, strengths and future learning goals. An entire form is provided to students, which they can fill out. Though the assessment is aimed at complete evaluation of a student in order that their complete professional competencies can be understood. The form is available for various stages of Clinical competence to mark progress of nurses, such as Novice, Advanced Beginner, Competent, Proficient and Expert. This form is exhaustive in nature and allows understanding related to each and every student, such that their gaps in skills can be overcome (Munoz & Collins, 2015). This evaluative practice helps nurses as well as healthcare centers. Individual students are able to understand their skill and knowledge gap areas, and then they can devise strategies in order to overcome the same. For healthcare centers this tool can be used for assessing competence levels of nurses.               

Though this competence evaluation is conducted for nurses there remains some challenge with the tool. One major challenge with this tool is that the feedback for the assessment is based upon assessment conducted by students themselves. Often students are unable to conduct self-assessment in an appropriate form, incomplete forms poses another challenge. In case a student is unable to undertake appropriate self-assessment, then the entire process of feedback will be inappropriate. The form’s length possesses another integral challenge in the process competence evaluation. The form’s length can be a concern against evaluation of professional competence. The accuracy of student’s self-assessment and overestimation of abilities is often confused with confidence. Determination of realistic and adequate expectations regarding student’s performance is essential to be understood. In clinical settings, competencies are primarily based upon evaluation of core and essential factors have to be determined.    

Discussion

The competency evaluation is based upon allowing nurses to transit from novice to becoming professional nurses (Gobet & Chassy, 2008). Brenner’s five stage theory focuses on educating nurses to develop their skills and practice towards understanding of patient care. Brenner made use of Dreyfus Model of Skill acquisition for providing basis for her theory. The five stages of clinical competence she described was described as Stage 1 Novice, Stage 2 Advanced Beginner, Stage 3 Competent, Stage 4 Proficient and Stage 5 Expert. The first stage is detailed as a first year student, who is in first year of clinical education. At the first stage of clinical education, behaviour professional nursess are expected to have limited knowledge and skills, they are assumed to undergo a process of mental transition. At this stage nurses possess limited knowledge in patient diagnosis. In the second stage, nurses emerge as fresh graduates who are in their first jobs. At this stage nurses can connect and reflect to more practical experiences. They can make meaningful analysis related to particular situations from their in-depth experience and knowledge.

Challenges of the Competence Evaluation Tool

During the third stage, competence is assumed for nurses. However, nurses lack flexibility and speed of proficient nurses (Grochow, 2008). Nurses at this level need to adhere to rules and planning and can recognize patterns. At this stage they have more quickness and accuracy compared to advanced beginners. At the fourth level of proficiency, nurses can diagnose whole situations. However, nurses at these stages rely mostly on advanced planning and can modify plans for responding to varied events. At the last stage of becoming an expert, nurses can easily recognize resources and demands for particular situations for arriving at goals. At this stage nurses no more rely on nursing leaders or any guide. They make use of analytical tools while dealing with an event where they have no experience. The whole focus of this theory is to allow nurses develop competencies and progress to Expert levels from being Novice. The competency tool allows diagnosing at which stage nurses are present such that skill gap analysis can be conducted and then they can progress to the next stage.                

Reflection

Self-reflection is critical in any learning related experience as it allows understanding related to knowledge and skills gained. Applying Rolfe’s model in nursing related reflection allows analysing skills and knowledge in a comprehensive manner (Rolfe, 2014). In the first stage of describing what happened and experience for analysis in undertaken for reflecting on self-learning. Consecutively the meaning from the experience gained in a particular situation has to be understood. Consultation with colleagues and literatures has been undertaken such that interpretation and insight into the matter can be gained. There has been immense transfer of knowledge that has happened from this course and in every module. I have gained knowledge and skills related to clinical reasoning, teamwork, problem solving, research and communication. In my clinical experience, I had to diagnose patient and provide them with adequate care. I was able to conduct patient case analysis to resolve problems and then provide adequate care. From my learning, I practiced simulation based decision making related to patient care. I saw during my clinical practice, tremendous pressure in which nurses operate but they handle all responsibilities well with teamwork and mutual respect. Teamwork is integral in any clinical practice and also respecting colleagues and nurse leaders. I learnt regarding teamwork in my clinical experience that teamwork and respect is integral for problem solving. Nurses and nursess experience tremendous pressure; hence it is crucial that nurses undertake research of the skills and expertise that are needed in their job role (Fullerton, Thompson & Johnson, 2013). While interacting with a patient, one professional nurses did not interact much; this led to dissatisfaction in the patient. As the patient felt that his voice and concerns was not being heard, he complained due to lack of communication from nurses.  I learnt from this experience that communicating is integral in clinical practice.       

The above reflective practice helped understand 2 of my strengths related NMBA professional standards. I was able to think critically and analyses nursing practice. Secondly, comprehensively conducts assessments.  As we were give education regarding decision making tools, we had developed competency related to decision making in various situations.  However, due to lack in practical skills, we often lagged in undertaking decision related to patient condition. Moreover, we had learned ways to conduct comprehensive assessment of patient condition. This is a highly important skill that is required for nurses. Developing of these skills will help in undertaking professional nursing service. Such skill development will help in my professional nursing practice.

Conclusion:

Growing worldwide demand in professional nurse has imposed tremendous challenges in terms of meeting competencies. The Professional nursesry Competency Assessment Tool (MCAT) integrates some of the best practices from the American College of Nurse-Professional nursess (ACNM). The toll allows developing competency of nurses in developing competencies from being novice to developing an expert level of competence. While such competence is integral to develop professional nursing skills, often it becomes burdensome for some nurses. Analysing skills and knowledge in my practice it can be said that there has been a lot of learning and practice oriented skill development. From the learning, my competence in professional nursing practices has grown immensely.  

Worldwide professional nurse education programs have been developed and implemented, which encompasses varied innovative strategies (Cohen, Thomas & Gerard, 2015). Such programs aim at fulfilling the global shortage in professional nurse and enhance levels of education and skills amongst them. While implementing such programs, there have been varied challenges and opportunities that were presented by students from multiple streams of enrolment. This presented the opportunity to develop competency based education. The current essay evaluates development of the Midwifery Competency Assessment Tool (MCAT) as described in her article by Kate Woeber, which allows developing and implementing of a competency based clinical evaluation tool for professional nursing education (Woeber, 2018). The essay argues in favor of and against development of such tools. The tools effectiveness is understood through Brenner’s Novice-to-Expert theory. Then a personal reflection of clinical reasoning, teamwork, problem solving, research and communication has been undertaken, in accordance to Rolfe’s model.      

Reference:

Cohen, S. R., Thomas, C. R., & Gerard, C. (2015). The clinical learning dyad model: an innovation in midwifery education. Journal of midwifery & women's health, 60(6), 691-698. doi: 10.1111/jmwh.12363

Danhausen, K., Joshi, D., Quirk, S., Miller, R., Fowler, M., & Schorn, M. N. (2015). Facilitating Access to Prenatal Care Through an Interprofessional Student?Run Free Clinic. Journal of midwifery & women's health, 60(3), 267-273. doi: 10.1111/jmwh.12304

Fullerton, J. T., Thompson, J. B., & Johnson, P. (2013). Competency-based education: The essential basis of pre-service education for the professional midwifery workforce. Midwifery, 29(10), 1129-1136. doi: 10.1016/j.midw.2013.07.006. doi: 10.1016/j.midw.2013.07.006.

Gobet, F., & Chassy, P. (2008). Towards an alternative to Benner's theory of expert intuition in nursing: a discussion paper. International journal of nursing studies, 45(1), 129-139. doi: 10.1016/j.ijnurstu

Grochow, D. (2008). From novice to expert: transitioning graduate nurses. Nursing Management, 39(3), 10-12. doi: 10.1097/01.NUMA.0000313089

Munoz, E. G., & Collins, M. (2015). Establishing a Volunteer Doula Program Within a Nurse?Midwifery Education Program: A Winning Situation for Both Clients and Students. Journal of midwifery & women's health, 60(3), 274-277. doi: 10.1111/jmwh

Rolfe, G. (2014). Rethinking reflective education: what would Dewey have done?. Nurse Education Today, 34(8), 1179-1183. doi: 10.1016/j.nedt

Woeber, K. (2018). Development and implementation of a competency-based clinical evaluation tool for midwifery education. Midwifery, 62, 92-95. doi: 10.1016/j.midw