Objectives: To develop and examine the content validity of a competency assessment tool for clinical teaching in community nursing, essential for high-quality nursing education, while addressing the lack of clarity and consistency in existing methods.
Methods: A qualitative, iterative methodological development and validation study was conducted with 10 clinical teachers. The process included: (1) identification of competency domains and competencies based on national nursing regulations and Vygotsky's sociocultural perspective (71 criteria); (2) refinement of the competency assessment criteria via focus groups (20 criteria); (3) development of a 5-point Likert scale with behavioural descriptors; and (4) creation of methodological guidelines for evaluators.
Results: The tool comprises 6 competency domains and 20 criteria, described across five performance levels (poor to excellent), considering performance quality, autonomy, and application in complex contexts.
Conclusions: The instrument enhances fairness, consistency, and feedback, clarifies expectations, promotes student self-regulation, and provides a transparent tool for formative and summative assessment, with potential for adaptation in diverse community nursing settings involving individuals, families, groups, communities, and populations. Implications for an International Audience: Although developed within a Portuguese educational context, the tool addresses competencies relevant to community nursing education internationally. Its structured competency domains and behavioural descriptors provide a framework that can be adapted to different educational and clinical contexts to support transparent, consistent, and development-oriented assessment of nursing students.
Objectives: This study aimed to investigate student transfer of medication administration safety competencies to initial clinical practice after passing standardized, supervised laboratory validation check-offs.
Methods: A repeated measures observational design was used to collect performance scores with a validated tool. Researchers collected scores during lab validation, initial clinical medication administration, and first medication administration during the following semester.
Results: No statistically significant differences in performance scores were observed across settings. Consistent performance was observed, with minor challenges in patient identification and timing of medication administration.
Conclusions: This study addressed a gap in the literature on the transfer of learning between educational and clinical environments and demonstrated that appropriate scaffolding and replication of key practice elements may support transfer of clinical competencies. These results inform nursing education strategies to enhance safe medication administration.
Objectives: This study aimed to explore the most impactful clinical practice experiences of final-year nursing students and the future-oriented actions developed in response to these experiences.
Methods: A retrospective descriptive qualitative design was used. Following reflection training in the internship practice course, 134 final-year nursing students were asked to describe the experience that affected them most during clinical practice. A total of 123 written reflections were analyzed using content analysis.
Results: Three themes emerged: near-miss events, incivility behaviors, and positive preceptoring roles. Negative experiences were mainly related to patients, relatives, and nurses and often led students to feel fear and inadequacy. Students reported action plans focused on effective communication, safe patient care, and becoming positive role models.
Conclusions: These findings highlight the importance of supportive clinical learning environments and positive professional socialization during the transition from student to nurse.
Implications for international audience: Nursing students worldwide may encounter incivility and near-miss events during clinical practice, potentially adversely affecting their learning experiences and professional development.
Objectives: New graduate nurses (NGNs) experience higher rates of burnout compared to experienced nurses, and burnout is linked to intention to leave the profession. Despite its importance, the concept of burnout among NGNs is not well understood. As such, we aimed to explore and clarify the concept of burnout among NGNs by identifying its conceptual attributes, antecedents, and consequences.
Methods: Walker and Avant's concept analysis method was used. CINAHL, Scopus, and PubMed were searched for literature between 2015 and 2024 pertaining to burnout among NGNs; 16 articles were included.
Results: The defining attributes of burnout among NGNs are similar to experienced nurses. However, the antecedents differ in terms of acute manifestations and transition shock of the nursing role among NGNs.
Conclusions: The context-specific definition of burnout among NGNs can be used for future research and clinical practice in targeting future workplace policies to identify and prevent burnout among NGNs.
Implications for international audience: There is a need for healthcare organizations and nursing education programs to support NGNs through structured mentorship, preceptorship, orientation, resilience training, and healthy stress management strategies. Addressing staffing shortages, workplace culture, and mental health support may improve NGN well-being, retention, workforce sustainability, and quality of care across healthcare systems.
Objectives: This scoping review will aim to identify the pedagogical methods used to prepare entry-level nursing students for telehealth practice and to describe how these methods integrate the concept of therapeutic relational connection.
Design: The proposed scoping review will adhere to the methodology guide by (Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs 2021;77:2102-13) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension checklist.
Methods: Five key databases will be searched; grey literature will also be explored. Results will be analyzed and categorized thematically for pedagogical methods and therapeutic relational connection.
Discussion: This protocol demonstrates how the steps outlined in the (Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs 2021;77:2102-13) guide are implemented to establish a robust methodology. The scoping review will enhance understanding of the pedagogical methods used for teaching telehealth in entry-level nursing programs and the integration of the therapeutic relational connection. This protocol is registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/MT5JC).
Introduction: Clinical placements are fundamental to nursing education, yet English as an additional language (EAL) students encounter distinct barriers that impede their professional development and well-being. This study aimed to synthesize existing research for a comprehensive understanding.
Content: A qualitative meta-synthesis was conducted via systematic searches across five databases, with quality appraisal using the CASP checklist. Thematic analysis of 11 international studies generated three core themes: (1) Language as a barrier to participation, (2) marginalization and exclusion in clinical settings, and (3) support, resilience, and coping strategies.
Summary and outlook: The synthesis confirms that EAL nursing students face challenges that require targeted interventions. Effective strategies include structured language support, culturally sensitive mentorship, and proactive inclusion by clinical educators. These findings carry clear implications for international curriculum design, staff training, and institutional policy reform. Future research should prioritize intervention-based studies to empirically evaluate the long-term effectiveness of such support mechanisms, ensuring equitable and enriching clinical environments for an increasingly diverse nursing workforce.
Background: Critical thinking (CT) among nursing students is crucial for delivering high-quality nursing care to patients. Concept mapping (CM) is one of the evidence-based pedagogies that helps to improve CT in individuals.
Objectives: The objective of this review and meta-analysis was to evaluate the impact of concept mapping on CT abilities, academic achievement, and clinical skills in nursing students.
Methods: This systematic review and meta-analysis aimed to identify published articles on the effect of CM on CT in nursing students, written in English and published from 2011 to 2024. The articles were sourced from SCOPUS, Web of Science (WoS), ScienceDirect, Google Scholar, and PubMed databases. To ensure a comprehensive and relevant search, the following MeSH terms were used: "Effectiveness" OR "Impact," AND "Concept Mapping," AND "CT," AND "Nursing Student," AND "RCT" OR "Randomized Controlled Trials" OR "Quasi-Experimental." This study used the Cochrane Collaboration's Risk of Bias (RoB) tool and Standardized Mean Difference (SMD) for outcome measurement, with results analyzed using RevMan Web.
Results: This study analyzed 14 RCTs and quasi-experimental studies involving 1,747 participants (E=870, C=877). The meta-analysis found that concept mapping enhanced nursing students' CT skills (MD=4.86, 95 % CI [2.16 to 7.56], p=0.0004), academic achievements (MD=3.38, 95 % CI [0.76 to 5.99], p=0.01), and performance in clinical practice (MD=5.94, 95 % CI [3.22 to 8.65], p<0.0001) when compared to routine instructional methods.
Conclusions: CM provides valuable insights into enhancing CT and clinical skills in nursing students, eventually preparing them to become excellent nursing professionals in the healthcare system.
The development of clinical competence in nursing education requires theoretically grounded approaches that integrate learning processes with professional progression. This paper presents the Experiential Competency Progression Framework (ECPF), a novel conceptual model that systematically integrates Kolb's Experiential Learning Theory with Benner's Novice to Expert Model to advance competency-based nursing education. While Kolb's theory explains how learners acquire knowledge through cyclical experiential processes (Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation), Benner's model describes the progressive development of clinical expertise through five developmental stages (Novice, Advanced Beginner, Competent, Proficient, and Expert). The ECPF aligns Kolb's experiential learning cycle with each of Benner's competency levels, providing a structured, evidence-based approach to designing simulation-based learning, clinical placements, reflective practice, and curriculum development. This integration addresses a significant gap in nursing education literature by moving beyond prior simulation-focused applications to offer comprehensive guidance across all educational contexts. The framework demonstrates how experiential learning occurs recursively at each developmental stage with increasing sophistication as learners progress toward expertise. The ECPF contributes to nursing education by offering a practical, theory-informed model that enhances reflective learning, clinical reasoning, and skill acquisition. It provides actionable guidance for curriculum design, faculty development, learner assessment, and institutional implementation, supporting the preparation of competent, practice-ready nursing graduates across diverse educational settings worldwide.
This study refines the concept of evidence-based practice (EBP) competence in nursing by providing an updated operational definition grounded in contemporary educational and clinical contexts. A comprehensive literature review (2013-2023) was conducted across PubMed, CINAHL, Web of Science, and MEDLINE, supplemented by grey literature and regulatory documents, yielding 39 included publications. Using Walker and Avant's concept analysis method, key defining attributes were identified: a spirit of inquiry; the ability to formulate structured clinical questions; skills in searching for, appraising, and integrating evidence; the capacity to evaluate outcomes; and competence in disseminating findings. Antecedents included research literacy, professional experience, and organisational support, while consequences encompassed improved decision-making, professional development, and enhanced team communication. Model, borderline, and contrary cases were developed to illustrate application across clinical contexts. The refined operational definition conceptualises EBP competence as the attitudes, knowledge, and skills that enable nurses to question practice, acquire and critically appraise evidence, integrate it with clinical expertise and patient preferences, evaluate outcomes, and disseminate learning. This analysis offers a conceptual foundation to inform assessment tool development and support alignment of nursing curricula with core EBP competencies, strengthening conditions that facilitate EBP implementation across healthcare settings.
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