Irene Koren

Objective structured clinical evaluation of clinical competence: an integrative review

AIM This paper presents an integrative literature review conducted to describe the utility of the objective structured clinical evaluation (OSCE) as a strategy of measuring one form of clinical competence in nursing. BACKGROUND The emergence of the OSCE, one form of evaluation of clinical competence used in medicine, is gaining more scrutiny and consideration in nursing education. DATA SOURCES The review was conducted through an initial search of computerized databases CINAHL, Cochrane Database of Systematic Reviews, Academic Search Premier and MEDLINE for the period from 1960 to 2008. METHODS An integrative review was performed and 41 papers met the inclusion criteria. RESULTS The complexities of evaluating clinical competence can be addressed through use of an OSCE process. Concerns related to the conceptual limitations and the lack of psychometric properties of the tools available for measurement in nursing education have been identified. CONCLUSION Major gaps exist in the nursing literature regarding the examination of the psychometric properties of the OSCE, the suitability of the design of the OSCE structure and tools for nursing to measure clinical competency, and the associated costs in the application of this evaluative method. Research conducted on the psychometric properties of the OSCE tool used and correlations to other evaluative methods currently used to evaluate nursing clinical competence would inform educational practices.

The novice objective structured clinical evaluation tool: psychometric testing

AIM This paper is a report of a study of the psychometric properties of the Novice Objective Structured Clinical Evaluation Tool. BACKGROUND A collaborative undergraduate nursing programme is currently using an objective structured clinical evaluation at the conclusion of the first nursing clinical course to determine student competence as a component of quality and safety education. However, the reliability and validity of the assessment tool has not been established. METHODS Psychometric testing was conducted with a convenience sample of 565 nursing students. Data were collected during three consecutive years from 2002 to 2004. Exploratory factor analysis and reliability testing were conducted on this 25-item tool. RESULTS Principal axis factoring method identified two factors through the orthogonal, oblimin and promax rotations: Factor 1 Safety and Factor 2, Anticipation. Spearman-Browns result for Factor 1 was 0·93 and for Factor 2 was 0·77. Cronbachs alpha was.94 for Factor 1 and 0·71 for Factor 2. CONCLUSION The tool was found to have adequate construct validity and reliability. Its stability should be tested by conducting test-retest analysis. Equivalency dimensions of reliability should be evaluated by looking at interrater reliability. This tool shows merit for assessing elements of quality and safety education.

Nurses who work in rural and remote communities in Canada: a national survey

BackgroundIn Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions.MethodsA cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada.ResultsRural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses’ levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region.ConclusionsThe proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

An examination of retention factors among registered nurses in Northeastern Ontario, Canada: Nurses intent to stay in their current position.

BACKGROUND The purpose of the study was to examine factors related to the retention of registered nurses in northeastern Ontario, Canada. OBJECTIVE/METHOD A cross-sectional survey of registered nurses working in northeastern Ontario, Canada was conducted. Logistic regression analyses were used to consider intent to stay in current employment in relation to the following: 1) demographic factors, and 2) occupation and career satisfaction factors. RESULTS A total of 459 (29.8% response rate) questionnaires were completed. The adjusted odds logistic regression analysis of RNs who intended to remain in their current position for the next five years, demonstrated that respondents in the 46 to 56 age group (OR: 2.65; 95% CI: 1.50 to 4.69), the importance of staff development in the organization (OR: 3.04; 95% CI: 1.13 to 8.13) northeastern Ontario lifestyle (OR: 2.61; 95% CI: 1.55 to 4.40), working in nursing for 14 to 22.5 years (OR: 2.55; 95% CI: 1.10 to 5.93), and working between 0 to 1 hour of overtime per week (OR: 1.20; 95% CI: 1.20 to 4.64) were significant factors in staying in their current position for the next five years. CONCLUSIONS This study shows that a further understanding of the work environment could assist with developing retention for rural nurses. Furthermore, employers may use such information to ameliorate the working conditions of nurses, while researchers may use such evidence to develop interventions that are applicable to improving the working conditions of nurses.

Pregnancy-specific telephone support helps reduce maternal smoking

Commentary on : Cummins SE, Tedeschi GJ, Anderson CM, et al. Telephone intervention for pregnant smokers: a randomized controlled trial. Am J Prev Med 2016;51:318–26.[OpenUrl][1] Tobacco smoking during pregnancy is a preventable cause of complications in pregnancy and adverse birth outcomes.1 In high-income countries, the prevalence of maternal smoking has declined, but it remains high among women who are more socially disadvantaged.1 ,2 According to the authors of this study, limitations of nicotine … [1]: {openurl}?query=rft.jtitle%253DAm%2BJ%2BPrev%2BMed%26rft.volume%253D51%26rft.spage%253D318%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx