Professional Experience Placement

This paper by Terry et al (in press) describes and discusses a study that used qualitative and quantitative methods to explore how clinical facilitators, preceptors, academics and graduates influence and were influenced by socio-cultural factors as they use the current Competency Standards in practice.

There were two major findings of the study. The first was the Standards have power and influence as a social structure and there is diverse interpretations of the Standards. Nurses support the Standards as a mechanism to support their professional identity. This study also found there was a contextual dimension to the Standards which had four themes. These were the relevance of context to competence; the disconnection between the function and application of the Standards; student introduction to the Standards and impact of roles when operationalising the Standards.

The authors discuss these findings which have implications for clinical supervisors in practice. The authors report the Standards have power and influence as social structure which creates opportunity for collective professional identity. The Standards uphold values of accountability and responsibility which are core values of the profession. Nurses also view the Standards as an integral part of the quality and safety agenda and are used for self-regulation and regulation of others’ competence. The notion of belonging to the profession and as part of professional identity as a nurse was identified in this study.

The impact of roles when operationalising the standards described there were inconsistencies in how students were assessed by supervisors in practice. The authors report there was a lack of connection with the Standards which they believed were related to workload pressures. The authors report that the language of the standards is poorly understood and there was a lack of consensus about how to operationalise the standard that was complicated by a lack of feedback given to assessee by supervisors. It was noted that supervisors were ‘gate keepers’ of competency attainment for registration. However, this assessment was objective and subjective and created tension, as there reliance on the capability of the assessor depending on the assessment tool used.

The authors conclude there is a gap in nurses’ understanding of the Standards which impacts on how assessments of competence are determined. The authors indicate that a review of the Standards is timely; they seek critical debate on the development of consistency in knowledge and skills for competence; research on the mechanisms that impact on assessment; and effective mechanisms be established from nurses regarding feedback.

If you have any comments about the findings of this study or suggestions about how the findings impact on supervision of students you are welcome to post them here. Please join us @PEPCommunity.