Nursing competence: not just a skills list
Whilst undertaking a funded (A$230K) project aimed at developing a clinical assessment tool for pre-registration nursing programmes across Australia, our initial work involved an analysis of the curriculum documents of all but one Australian University Nursing programme. This enabled us to identify skills taught and assessed in most or all programmes. A concern consistently raised, was that we were in danger of reducing nursing to a list of skills. Having identified competencies that would be assessed in clinical practice via our tool, the project was extended to capture those competencies/areas of skill which newly graduating nurses need to possess but which one cannot guarantee will be able to be assessed in clinical areas; in other words, those competencies/skills which would need to be covered in Simulated Learning Environments (SLEs). Via a modified aggregation of skills lists from the 36 Universities. In this way, 1300 skills were reduced to 270+, categorised within initially 30 skills areas. This was undertaken in part, via a consideration of the work of Anderson 87 and Meretoja 04 who considered the roles of nurses (educator, manager, communicator, etc) as well as the Essentials of Care project (NSW Health 2007). This work is now being considered by the (Australian) National Health Workforce Taskforce (NHWT) as the basis for their plans to identify (nursing) curriculum content for the SLEs they intend to set up across the country, aimed at improving skills and easing the problems associated with a shortage of clinical placements, for a variety of health professions, including nursing. This paper will briefly outline the parent project and then focus on the process we followed to generate a conceptually based schema for the identification of nursing competencies, which could usefully be developed and assessed in Simulation and clinical practice settings.
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