Preparedness In Nursing Education
What Is Preparedness
The concept of preparedness is used in many different contexts including of disaster (e. emergency, bioterrorism) preparedness and within the psychological literature to explain why certain associations are learned more readily than others. A concept analysis of bioterrorism preparedness (Rebmann, 2006, p. 623) revealed that the antecedents to preparedness are readiness and acceptance to change: the defining attributes comprise gaining knowledge, planning, practicing response behaviors, and evaluating knowledge level, and the consequences of preparedness include recognition of a bioterrorism event and enactment of suitable actions.
Health Professionals and Preparedness In Nursing Education
Preparedness of newly qualified health care professionals for the clinical environment has been the topic of debate (Walker et al., 2013). Preparedness can be extrapolated in a multitude of ways including knowing “what you are getting into” (Sedgwick & Yonge, 2007, p. 620) and having the requisite knowledge, skills, and competencies that can be converted into effective clinical practice (Edwards, Smith, Courtney, Finlayson, & Chapman, 2004).
Various aspects of how graduates can improve their prepared news for practice have been reviewed and explored (Newton & Cross, 2011; Romyn et al, 2009, Wolff, Regan, Pesut, & Black, 2010).These authors looked at different factors and influences that contribute to the preparedness of graduates for clinical practice, and ultimately their successful transition to a competent health care professional. Graduate-level factors include role preparation (Doody, Tuohy, & Deasy, 2012), role competence (Doody et al, 2012), and personal attributes such as self confidence in the ability to perform in a role and show interest in the role (Houghton, Casey, Shaw, & Murphy, 2012).
Environmental factors influencing graduate preparedness include role clarity, mentorship, and preceptorship programs (Whitehead & Holmes, 2011) and supportive working environments (Wolff et al, 2010).The role of the graduate nurse within the health care setting varies according to the geographical location, subspecialty, regulatory requirements, and the associated duration of clinical placements within the undergraduate program. Lack of role clarity and varying levels of expectations of graduates can be perceived as a stressors for many newly qualified nurses (Newton & Cross, 2011; Wolff et al., 2010).
Studies focused on assessing the level of competence of graduate nurses highlight the importance of having adequate undergraduate clinical experience (Newton & Cross 2011).Graduates with previous clinical experience have increased familiarity with ward routine, greater confidence, enhanced ability to communicate with patients and their families, and enhanced sense of belonging (Levett Jones, Lathlean, Higgins, & McMillan, 2006; Newton & Cross, 2011) .
Whitehead and Holmes (2011) argue that students were sheltered from the realities of nursing and did not partake in difficult situations, such as dealing with crisis situations and complex patient care needs. Thus, it was suggested from the perspective of stake holders and nurse leaders that on commencement of employment, graduate nurses lacked sufficient levels of competence in critical aspects of nursing care (Newton & Cross, 2011).
Preparedness as a Part of Educational Training
The concept of graduate preparedness within the context of clinical practice is one that is thoroughly debated and challenged. The essence of preparedness within a general context implies that the individual is ready, willing, and able to undertake the duties of a particular role. It also encapsulates the notion that the individual is and will be competent. This mentality toward preparedness for practice is universally acknowledged; However, no single homogeneous definition exists.
Furthermore, the educational structures and processes to enable the individual to embody this broader concept of preparedness for clinical practice is something that is constantly challenged, changed, and adjusted to ensure the best possible development and output of graduates, again, this can differ. from country to country, resulting in no single coherent model for preparedness for practice.
However, the consequences of inadequate preparedness of new graduates for clinical practice can include reality shock, a perception of not being able to adjust to a new role, and competence and skill deficits that have the potential to negatively impact on the quality and safety of health care provided.The expectations of clinical staff, nurse leaders, and other key stakeholders vary related to the preparedness of graduating nurses. These varying levels of expectations are a cause for concern as they result in unnecessary stress for graduating nurses.
Some researchers have measured the preparedness of graduates to meet the challenges of clinical practice, linking the perception of preparedness to preparedness in relation to terminal program outcomes and program content (Tallentire, Smith, Wylde, & Cameron, 2011). Other researchers have linked preparedness and the measurement of competence in certain domains (Safadi. Jaradeh, Bandak, & Froelicher, 2010). The socialization of nurses to the role of registered nurse is another dimension of preparedness, and requires careful thought and nurturing support systems to ensure that the graduate nurse feels included, valued, respected, and ultimately prepared for practice.
Preparedness as a Transitional Element In Nursing Education
Preparedness in the context of graduates making the transition from a nursing program to practicing as a newly registered nurse is a broad concept. It can be taken to mean that the individual is ready, willing, and able to undertake the duties of a role in clinical practice. However, to ensure a graduate is prepared for the role, adequate role preparation, role competence, self-confidence in the ability to perform in that role, and interest in the role are required. Research is needed to further define preparedness for practice and develop psychometrically tested measures of preparedness for practice.
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