Perception of Senior Nursing Students Regarding Preparedness for Professional Practice

Monday, 30 October 2017

Debra Kerr Sr., PhD
School of Nursing and Midwifery, Deakin University, Geelong, Australia
Clive Miller, PhD
Nursing and Midwifery, Victoria University, St Albans, Australia

In Australia, nursing students spend a minimum of 800 hours on professional practice clinical placements; this is mandated by the accrediting body. This takes place over the three years of the course and occurs in a variety of clinical venues. During professional practice placement, students apply and contextualise the knowledge and skills they have been taught in the university setting.

Prior to conduct of the study, informal feedback from clinical partners suggested that students were not well prepared for either their final year professional practice clinical placements (as part of their undergraduate training) or for initial practice once qualified (graduate nurse program). At that time, the Bachelor of Nursing course was in its final year (HBBN) and a new curriculum (HBNB) was in progress. Within the new course, greater use was made of Objective Structured Clinical Examinations (OSCE) in the earlier years of the course. In addition, a specific strategy was introduced to enhance student preparedness for professional practice: the Self Directed Learning (SDL) lab.

The SDL Lab was furnished with equipment and provided access to clinical education staff, seconded from a major industry partner. This ‘real-life’ innovation aimed to assist the student to be ‘work safe’ and ‘work ready’ for professional practice in the clinical setting. Students were invited to self-nominate and practice skills in the SDL Lab, previously taught in structured formal classes including lectures, and theoretical and laboratory classes. The following objectives guided implementation of the SDL Lab: 1) Build clinical skills to improve student performance in the clinical setting; 2) Assist to ensure that students are work safe and work ready for clinical placements and beyond; 3) Maintain a strong emphasis on understanding the rationale behind each skill practiced; 4) Challenge the students to identify their own knowledge deficits and work with the student to understand the required information to overcome these deficits.

These changes have been made to increase student preparedness for professional practice during undergraduate workplace training (professional practice units) and after graduation as "students need to be adequately prepared for working in the real life ward environment" (Houghton, Casey, Shaw, & Murphy, 2013). It is clear from the literature that students who are more prepared for professional practice, demonstrate greater confidence and competence during workplace training (Marshburn, Engelke, & Swanson, 2009). In supporting this, one Australian study reported the outcome as showing that "students perceive placements and clinical skills practice as keys for enhancing readiness for practice and to facilitate a successful transition into professional nursing practice" (Woods, Usher, Mills, West, & Park, 2013).

The primary aim of the study was to compare students’ perspective of their preparedness for nursing practice in the final year of the Bachelor of Nursing course. The Casey-Fink Readiness for Practice Survey © 2008, with some adaption of demographic information to match local terms, was used to survey third year nursing students in their final semester of study in two periods: Semester 2, 2015 (HBBN) and Semester 2, 2016 (HBNB). The first section of the survey contains demographic data. The second section relates to students’ self-report of confidence for skills performance. The third and final section asks students to rate their level of confidence in performing nursing skills using a Likert-type scale ranging from strongly disagree to strongly agree. In this section there is one final open ended question asking students to report ways in which they could improve preparedness for practice after graduation. Comparisons were made between the two cohorts (HBBN and HBNB) for demographic details, utilisation of strategies to enhance preparedness including attendance to the SDL Lab and response to survey items. It was our hypothesis that students enrolled in the new course (HBNB) would report greater preparedness for practice than students enrolled in the old course (HBBN). Descriptive statistics and univariate analysis will be presented.

The findings of this study will be used for development and evaluation of strategies that aim to enhance nursing practice and preparadeness for practice in future curriculum. The results of this study will be used to inform the researchers about how this cohort of students prepare themselves for their final clinical placement along with what they see as their strengths and weaknesses. This information will then be used in a variety of ways. Firstly, evaluation of student perception of preparedness for professional practice, and ways in which students have prepared for professional practice, will be measured. Secondly, comparison of preparedness for professional practice will be made between two cohorts of students (HBBN and HBNB), to measure whether there has been an increase in reported preparedness, which may have occurred due to the introduction of various changes to curriculum and strategies (e.g., SDL Lab).