Affects of Clinical Competencies in Nursing Education

Afza.Malik GDA

 How Clinical Competencies Effect Nursing Educators

Affects of Clinical Competencies in Nursing Education

What Is Clinical Competency in the view of banner,Clinical Competencies for Nurses Educators,Advantages and Disadvantages of Clinical Competencies in Nursing Education,Impact of Clinical Competencies Nursing Education.

What Is Clinical Competency in the View of Banner

    Benner (1982) defined nursing competence as the ability to perform a task with desirable outcomes under the varied circumstances of the real world. Benner (1984) famously placed competence in the middle of a continuum, ranging from novice to advanced beginner, to competent, to proficient, to expert. Competent practitioners are under stood to be able to consciously plan their activities, but can lack flexibility and speed (Benner, 1984) Chapman (1999) defined competence as being more concerned with what people can do rather than with what they know. 

    Similarly, competence-based training and education are believed to have concentrated on what people can do as opposed to what they know and not on the learning process itself, with emphasis on observable and measurable outcomes, requiring a consistent standard of practice (Winskill, 2000 )

Clinical Competencies for Nurses Educators

    Competence is much more than an array of skills attained by the clinician. The interface of professional skills with knowledge, attitudes, and values works in tandem with the cognitive and emotional intellect in nursing practice. Other critical qualities involved in competent practice include motivation, personal insight, explanatory capacity, maturity, and self-assessment ability (Axley, 2008).

    The importance of clinical competence must not be underestimated. One study explored competence levels of nurse's working in accident and emergency departments in Ireland. Findings demonstrated a positive correlation between level of perceived competence and frequency of practice, and a positive relationship between competence and frequency of activities, as well as competence and years of experience (McCarthy, Cornally, O'Mahoney, White, & Weathers, 2013)

Advantages and Disadvantages of Clinical Competencies in Nursing Education

    There is a wealth of literature on clinical competence, particularly on the advantages and disadvantages as a measure of practice ability: Nurse managers and educators have been increasingly required to demonstrate that a process is in place to assess, validate, audit, and maintain or improve the competence of staff on an annual basis. Recommended competencies have included the following: provision of patient centered care; collaboration as a member of an interdisciplinary team; understanding of how to access, interpret and synthesize information, and use of evidence to guide nursing practice and clinical decision making (Billings, 2008).

    Lejonqvist, Eriksson, and Meretoja (2012) conducted a study by exploring the views of clinical staff, students, and nurse educators. They found clinical competence was evident in practice as encountering, knowing performing, maturing. and improving. These authors discuss the core of nursing as the ethical foundation of clinical competence. The ethical foundation includes nurse patient relationships, the aim of doing good, and maintaining the dignity of the patient. 

    Clinical competence becomes evident in thought, words, and actions, thus constituting the culture of nursing Competence is believed to be the essence of nursing expertise and is grounded in meaning that it is transferable between contexts (Lejonqvist et al., 2012). Another view on competence considers the relationship with accountability to self. There is evidence that competence is related to continuous learning, professional career advancement, actively adopting self-care strategies, and taking control of work and life (Meretoja & Koponen, 2012)

    While some discuss the complexities of competence development, others argue competence-based nursing is reductionist. There is consensus that the perception of nurse competence as a task-based activity is redundant, and a holistic framework is more appropriate (Cowan, Norman, & Coopamah, 2005) One study found that an individual nurse's education level and years of experience influence level of expertise, thus enhancing the probability of becoming a competent expert (McHugh & Lake, 2010).

    The importance of competence should not be underestimated. It is most evident in terms of quality of care and patient safety. Ensuring patient safety is considered a major principle of clinical competence together with problem-solving competence, critical thinking ability, and the capacity to anticipate factors, which may impact on patient care outcomes (Axley, 2008). The absence of competence may lead to clinical errors resulting in serious consequences or harm for patients (Axley, 2008). 

    Nurses are fundamental in the systematic identification, assessment, and implementation of good care for patients, as well as recognizing potential adverse events. It is, therefore, essential that the acquisition and maintenance of competence for nurses is mandatory, particularly given the fast-evolving health care settings (Ponte, Kruger, DeMarco, Hanley, & Conlin, 2004) Educators and clinical managers should therefore safely guard patients by leading nurses in a culture of lifelong learning, which is critical in the maintenance of competence and safe practice.

Impact of Clinical Competencies Nursing Education

    Nursing requires a combination of knowledge, performance, skills, and attitudes; Hence, a holistic definition of competence is a requisite. This holistic approach could then underpin the development of competence standards and associated tools required for assessment (Cowan et al., 2005).

    Nurse educators and managers must be challenged to promote learning that builds competence, capability, and resilience. The ever-changing health care environment requires competent frontline clinical staff; Thus, nurse educators need to prepare nurses to manage practice improvement and change. Collaboration between educators and clinicians is key to positively influencing current competent, safe practice. Competence planning and monitoring of programs needs to consider a broad view of nursing, encompassing factors such as ethos, ethics, peer review, self-assessment, and the cultural context.

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