A Crisis in Competency: The Strategic and Ethical Imperative to Assessing New Graduate Nurses’ Clinical Reasoning

Kavanagh, Joan; Szweda, Christine

doi:10.1097/01.nep.0000000000000112

Cited by 248 publications

(149 citation statements)

References 9 publications

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“…But, as previously discussed, the dangers of a limited epistemological position have been articulated effectively and discussed in fields such as nursing, medical practitioners and teaching cf. [82][83][84]. Therefore, there is a need for exercise praxis to move beyond dichotomous assumptions of either/or in professional knowledge [85].…”

Section: Discussionmentioning

confidence: 99%

The Hazards of a Biomedical Exercise Paradigm: Exploring the Praxis of Exercise Professionals

Gray

2019

Philosophies

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There is a belief that exercise has a major role to play in the current health and wellbeing agendas. Consequently, health interventions are implemented based upon the recommendations of the ACSM and similar exercise research organizations. However this development has been challenged through both social and political perspectives. Specifically accusations of medicalization have been raised against the increasing relationship between the exercise and medical domains. The purpose of this article is to present a similar critique of the growing emergence of a medical paradigm within the exercise domain. In this instance the focus will examine the relationship between exercise professional, exercise science and the proposed medical paradigm. Through the use of philosophical essay and systematic review of literature, it is argued that a continuing shift by exercise science to mirror the medical paradigm will cause a number of issues and potential hazards in the working practices of its professionals.

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Section: Discussionmentioning

confidence: 99%

The Hazards of a Biomedical Exercise Paradigm: Exploring the Praxis of Exercise Professionals

Gray

2019

Philosophies

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“…Enhancing nursing students' clinical reasoning skills may improve their ability to recognize a deteriorating patient and therefore improve patient outcomes. Kavanagh and Szweda (2017) reviewed the results of the Performance Based Development System, a reliable and valid competency assessment system, and identified that 76-80% of more than 5,000 inexperienced nurses do not meet the clinical reasoning expectations for new nurses. No differences were found based on the new nurses' level of education (Kavanagh & Szweda, 2017).…”

Section: Purpose Of the Studymentioning

confidence: 99%

Purposeful Simulation Role Assignment

Alexander

2020

Clinical Simulation in Nursing

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“…It is also reported by Missen et al () that while NGRNs perform adequately within their scope of practice in basic clinical skills, their advanced clinical skills remain an area of concern. Kavanagh and Szweda (, p. 57) assert that “…knowledge development in clinical practice requires experiential teaching and learning through facilitated, situated cognition with reflection…” a statement supporting Benner's () “novice to expert” model. This paper discusses the findings from the qualitative arm of a mixed methods study which explored new graduate registered nurses transition experiences particularly related to patient safety.…”

Section: Introductionmentioning

confidence: 99%

New graduate nurses’ understanding and attitudes about patient safety upon transition to practice

Murray

Sundin

Cope

2019

Journal of Clinical Nursing

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Aims To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. Background New graduate registered nurses’ transition is accompanied by a degree of shock which may be in tune with the described theory–practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. Design Qualitative descriptive approach using semi‐structured interviews. Methods Data were collected during 2017–18 from 11 participants consenting to face‐to‐face or telephone semi‐structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). Results Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses’ clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. Conclusion Transition shock leaves new graduate registered nurses’ focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. Relevance to practice Having an understanding of the new graduate registered nurses’ experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.

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A Crisis in Competency: The Strategic and Ethical Imperative to Assessing New Graduate Nurses’ Clinical Reasoning

Cited by 248 publications

References 9 publications

The Hazards of a Biomedical Exercise Paradigm: Exploring the Praxis of Exercise Professionals

The Hazards of a Biomedical Exercise Paradigm: Exploring the Praxis of Exercise Professionals

Purposeful Simulation Role Assignment

New graduate nurses’ understanding and attitudes about patient safety upon transition to practice

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