The Preparation–Practice Gap: An Integrative Literature Review

Hickerson, Kirsten A; Taylor, Laura A.; Terhaar, Mary

doi:10.3928/00220124-20151230-06

Cited by 84 publications

(77 citation statements)

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“…The extensive body of research on graduate nurse transition programs shows that these programs emerged to facilitate and support the development and integration of new graduates [24, 25]. Common elements of these transition programs are formal or informal preceptorship, mentorship and supernumerary time [24, 25]. In our study, most midwives who had an internship described this as a positive learning experience that gave them skills and confidence.…”

Section: Discussionmentioning

confidence: 73%

“…The year of internship was in fact a compulsory transition program, required by the Department of Health before authorisation. The extensive body of research on graduate nurse transition programs shows that these programs emerged to facilitate and support the development and integration of new graduates [24, 25]. Common elements of these transition programs are formal or informal preceptorship, mentorship and supernumerary time [24, 25].…”

Section: Discussionmentioning

confidence: 99%

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Norwegian midwives’ opinion of their midwifery education – a mixed methods study

et al. 2017

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BackgroundMidwifery education in Norway has undergone radical reforms in the past few decades. In 2004, the compulsory year of paid internship was removed from the requirement to become an authorised midwife. Since then, authorisation as a midwife depends on the successful completion of a two-year full-time academic course, consisting of 50% clinical practice and 50% theoretical education. Our objective was to examine midwives’ opinion of their Norwegian midwifery education in relation to their midwifery practice, comparing those educated with internship to those without.MethodsWe performed a mixed-methods study based on data from a nationwide cross-sectional survey. A sample of 547 midwives completed a postal questionnaire, autumn 2014. Midwives were asked how they were educated, how their education prepared them for practice (multiple choice) and to freely comment on their midwifery education. Thematic analysis and descriptive and comparative analysis was used. Data sets were analysed independently and jointly interpreted.ResultsOf our sample, 154 (28.2%) were educated through a two-year midwifery education without internship, while 393 (71.8%) had a one-year midwifery education with internship. Compared to midwives who had internship, midwives without were four times more likely to report that their education did not, or only partially prepare them for their work as a midwife. The association lost its significance when adjusted for experience as a midwife. According to the qualitative data, the primary reason for the association was insufficient clinical practice during education. Relevant clinical placement, ample practice time with good preceptorship and internship were proposed as methods to prepare for practice as a midwife. The theory–practice gap was highlighted as another hindrance to being prepared for practice.ConclusionsAcademisation of the midwifery education has resulted in newly qualified midwives feeling less prepared for practice. Midwives would have liked more time for clinical practice and simulation training of core midwifery clinical skills included in the education. Midwifery educations need to explore ways to achieve a good balance between practice and theory. Workplaces need to explore alternative ways to internship to assist new graduates to become confident midwives with a strong midwifery identity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0917-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Norwegian midwives’ opinion of their midwifery education – a mixed methods study

et al. 2017

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“…internationally (Frenk et al, 2010;Roxburgh et al, 2008) Excellent clinical practice placements and accessible, clinically competent mentors, tutors or preceptors are very important to narrowing the gap between the university and the practice environments (Ballem & MacIntosh, ;Banks et al, 2011;Benner et al, 2010;Frenk et al, 2010;Hatcher et al, 2006;Hickerson et al, 2016). These clinical placements and mentor-guides are central to integrating a broad and well-rounded academic education.…”

Section: Refining Nursing Practice: Implications For Nursing Educatmentioning

confidence: 99%

Refining nursing practice through workplace learning: A grounded theory

Jantzen

2019

Journal of Clinical Nursing

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Aims and objectives To examine how experienced registered nurses in direct patient care learn within the constantly changing contemporary healthcare environment. The key objectives were to examine educational interactions amongst workplace, nurse and nursing practice, with a focus on the influence of context. Background Registered nurses must maintain competence throughout their careers. The related ongoing learning is triggered by external demands and nurses’ internal motivation. Experienced nurses, poised to retire, have worked through the recent tumultuous changes in health care and therefore provide insight into how they sustained excellent patient care. Design The methodology for this study was a grounded theory informed by symbolic interactionism. EQUATOR guidelines for qualitative research (COREQ) applied. Methods Data collection entailed semi‐structured interviews with experienced nurses across diverse settings and participant observation on two acute care units. Analysis of data was conducted using three‐level coding, constant comparison, theoretical sampling and extensive memoing. Results Refining nursing practice begins during nursing education and early employment. Getting grounded involves establishing key capabilities, specifically becoming self‐aware, setting high standards, cultivating healthy apprehension and seeing the whole patient picture. Three catalysts for workplace learning are mentor‐guides, workplace camaraderie and a highly functional workplace team. Refining nursing practice includes both formal and informal learning; however, significant nursing expertise is developed through puzzling and enquiring, an iterative process of learning while nursing. Conclusions Facilitating the development of capabilities for nurses’ workplace learning during nursing education and early work experiences contributes to excellent patient care. Healthcare organisations need to value and support the unique contributions of mentor‐guides in the clinical setting and promote individuals’ development of expertise by nurturing camaraderie and developing highly functional workplace teams. Relevance to clinical practice Attending to the processes and catalysts for nurses’ workplace learning will contribute to excellent patient care.

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“…Newly graduated nurses (NGNs), also known as novice nurses working in their first clinical positions after graduation (Hickerson, Taylor, & Terhaar, ), comprise an increasing part of nursing staff today. Over the past decade, the proportion of NGNs in the nurse workforce has grown in several countries (Eurostat, ; OECD, ) in response to concerns about current or possible future shortages of nurses (Chan, Tam, Lung, Wong, & Chau, ; U.S. Department of Labor, ).…”

Section: Introductionmentioning

confidence: 99%

“…Nurse managers are in key position in recruiting NGNs and ensuring their smooth transition to work. Newly graduated nurses' difficulties of transition into practice have, however, been documented (Haddad, Moxham, & Broadbent, ; Hickerson et al, ; Numminen et al, ) although various interventions have been targeted at facilitating the transition, for instance in the final clinical practicum of nursing education (Kaihlanen, Haavisto, Strandell‐Laine, & Salminen, ). Newly graduated nurses' intentions of leaving the profession have also been reported repeatedly (Aiken et al, ; Chan et al, ; Haddad et al, ).…”

Section: Introductionmentioning

confidence: 99%

Nurse managers' perceptions of the competence of newly graduated nurses: A scoping review

et al. 2019

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Aim To summarize nurse managers' perceptions of newly graduated nurses' (NGNs) competence and connected factors. Background Nurse managers recruiting staff are responsible for employing competent nurses to ensure quality care and professional standards. Knowledge of managers' perceptions about the competence of NGNs is needed to understand the expectations of the health care system towards future professionals. Evaluation A scoping review was conducted. A total of 12 research publications met the inclusion criteria and were analysed using inductive content analysis. Key issues Managers' perceptions can be divided into three perspectives: NGNs' competence descriptions, assessment of competences and connected factors. The NGNs' level of competence was assessed to be at least satisfactory, and dependent on prior exposure to the work setting, change in the degree of responsibility and lack of confidence. Conclusion Existing knowledge about nurse managers' perceptions of NGNs' competence is limited and rather fragmented. There is a clear need for rigorous empirical studies with comprehensive views of managers, emphasizing the key role of managers in the evaluation of nurse competence. Implications for Nursing Management Nurse managers can use the results of this review in recruitment, performance reviews and the development of job orientation programmes aimed at enhancing NGNs' transition to the nurse workforce.

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The Preparation–Practice Gap: An Integrative Literature Review

Cited by 84 publications

References 50 publications

Norwegian midwives’ opinion of their midwifery education – a mixed methods study

Norwegian midwives’ opinion of their midwifery education – a mixed methods study

Refining nursing practice through workplace learning: A grounded theory

Nurse managers' perceptions of the competence of newly graduated nurses: A scoping review

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