Japanese nurses’ competency on different clinical ladder levels: Using a mixed-methods approach

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  • 中堅看護師の苦手とする臨床判断能力とは
  • ～Mixed-Methods Approachを用いて～

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Abstract

<p>As on-the-job training for mid-level nurses is difficult to implement, the concept of the clinical ladder (CL) was developed. This paper aimed to describe differences in nurse competency levels, using a mixed-methods sequential explanatory design. Further, the current study aimed to research how changes could be implemented to the CL. Random sampling was used to obtain a sample of 249 nurses (93% female). In 34 of 179 questions, the rate of correct answers by nurses with proficient or above skills was greater than that by those with competent or below skills. Of these questions, 11 related to medication and seven to clinical reasoning. In eight of 179 questions, the rate of correct answers by nurses who were proficient or above was lower than those given by nurses who were competent or below. One question was subsequently discussed in an interview. Nurses at proficient or above level tended to have confidence in their skills and relied upon past experience. However, in these particular questions, this overreliance on experience led to the selection of an incorrect answer. It is necessary to improve competencies in medication and clinical judgment to support novice and advanced beginner nurses as they progress toward reaching the expert level.</p>

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