PURPOSE: The purpose of this study was to provide basic data required to improve nursing resources management and nurse organizations. METHODS: The data were collected using a questionnaire. Participants were 294 nurses who were working at 8 hospitals with more than 500 beds located in G and C cities, Korea. Data analysis was done using t-test, ANOVA, Scheffé test, Pearson correlation coefficient and stepwise multiple regression analysis with SPSS. RESULTS: There were significant correlations between self-leadership, clinical competence, job satisfaction and job involvement. Factors affecting job involvement were job satisfaction, self-leadership, length of clinical career and length of career in current department. Job satisfaction was the most influential factor with an explanatory power of 41%. CONCLUSION: Findings show that to strengthen job involvement, identification and management of factors that affect job satisfaction and self-leadership are required and relevant training and strategies should be developed and used.
Clinical Competence ; Job Satisfaction ; Korea ; Leadership ; Nursing ; Statistics as Topic

PURPOSE: To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. METHODS: A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. RESULTS: Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. CONCLUSION: To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.
Clinical Competence ; Humans ; Judgment ; Research Design ; Statistics as Topic ; Students, Nursing ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify the correlation of critical thinking disposition and problem solving process, and the simulation-based assessment of clinical competence based on a survey of college nursing students. METHODS: In this descriptive correlation study, data for 214 nursing students were analyzed using t-test and Pearson correlation coefficients. RESULTS: Critical thinking disposition, problem solving process, and simulation-based assessment of clinical competence averaged 3.76+/-0.46 (out of 5), 3.67+/-0.47 (5), and 1.51+/-0.17 (2), respectively. A significant difference in scores for simulation-based assessment of clinical competence was found between the high-scoring group and low-scoring group in critical thinking disposition. A significant positive correlation was found between critical thinking disposition and nursing assessment, a sub-domain of clinical competence. CONCLUSION: The results suggest that success in simulation-based learning requires critical thinking disposition in the nursing students, and their critical thinking disposition plays a positive role in nursing assessment, which evaluates the patient's status in a complex situation. Simulation-based learning programs help assess the students' levels in their clinical judgement and performance, and identify their strengths and weaknesses so that the instructor can evaluate and improve the current teaching method.
Clinical Competence* ; Humans ; Learning ; Nursing Assessment ; Pediatric Nursing* ; Problem Solving* ; Statistics as Topic ; Students, Nursing* ; Teaching ; Thinking*

PURPOSE: Since 2006, Korea University Medical College has offered a medical communication skills program for third-year medical students. This study examined the relationship between medical student interview performance in a medical communications skills course and students' patient-physician interaction (PPI) scores on the Clinical Performance Examination (CPX). METHODS: Participants were 130 fourth-year students who took both the medical communication skills course in 2006 and the CPX in 2007. Students' scores in performance evaluation, assessed by SP interview, and their PPI scores were used for data analysis. RESULTS: This study hypothesized that students who performed well in the medical communication skills course would have high PPI scores on the CPX. Students' PPI total and individual item scores showed statistically significant differences by the performance level of the medical communication skills course. Some of these differences were statistically significant, even after controlling for the influence of GPA. CONCLUSION: This study has practical implications for medical communications education, demonstrating that the knowledge and skills that are acquired in a communications skills course can be maintained.
Clinical Competence ; Education, Medical ; Humans ; Korea ; Physician-Patient Relations ; Statistics as Topic ; Students, Medical

PURPOSE: A meta-analysis was conducted to evaluate effectiveness of education programs using video recording and feedback in the improvement of competency in clinical skills for health care majors. METHODS: Six databases were searched and inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled trials (NRTs) reporting level of skill competency using numerical measurements. Data analysis and synthesis were performed using Comprehensive Meta-Analysis software and Revman program. RESULTS: Of 1,568 records, 11 studies met inclusion criteria. Statistically significant effectiveness of education programs using video recording and feedback was identified. A low risk of bias was detected among both RCTs and NRTs. Meta-analysis showed that the intervention groups had more effective improvements in skill competency (standardized mean difference [SMD]: 0.74; 95% CI: 0.33~1.16). Results of subgroup analysis showed higher effects when interventions dealt with one skill, used self-reflection with expert feedback, and included instruction from instructor in the education programs. CONCLUSION: Findings suggest that schools for health care majors should actively adopt video and feedback based skill training allowing educators to design effective programs. Potential is higher for students to achieve higher competency when they train with one skill at a time, use of instruction and receive feedback from experts.
Bias (Epidemiology) ; Clinical Competence ; Delivery of Health Care* ; Education* ; Humans ; Statistics as Topic ; Video Recording*

PURPOSE: The purpose of this study was to identify core competencies for new nurses and valuate the appropriateness and capability of core competencies. METHODS: Mixed method was applied for the study. Qualitative data were obtained from preceptor and nurse manager utilizing an open-ended survey question and qualitative data analysis was conducted. The quantitative data were collected from 238 nurses (79 new nurses, 78 preceptors, 81 nurse managers) and descriptive statistics, ANOVA, χ2 tests were applied. RESULTS: Three themes (20 contents) were identified as core competencies: competency as an employee, competency to perform nursing care for patient, competency to maintain nursing expertise. New nurses recognized themselves as having higher competency as an employee and to perform nursing care for patient when compared to nurse managers. CONCLUSION: The findings identified core competencies for new nurses need to be reflected to developing human resource management strategies for hiring new nurses.
Clinical Competence ; Humans ; Methods ; Nurse Administrators ; Nursing ; Nursing Care ; Statistics as Topic

PURPOSE: The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory. METHODS: Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs. RESULTS: The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability. CONCLUSION: In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.
Clinical Competence ; Curriculum ; Data Collection ; Humans ; Judgment ; Mental Competency ; Models, Structural* ; Negotiating ; Nursing* ; Simulation Training ; Statistics as Topic ; Teaching

PURPOSE: We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory. METHODS: One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program. RESULTS: The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363. CONCLUSION: The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
Checklist ; Clinical Competence ; Decision Making ; Diagnosis, Oral ; Educational Measurement ; Ethics, Medical ; Humans ; Mental Competency ; Pilot Projects ; Statistics as Topic ; Students, Medical

PURPOSE: This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability. METHODS: Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios. RESULTS: The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ2/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p < .001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's α of the final model was .91. CONCLUSION: Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.
Clinical Competence ; Clinical Decision-Making ; Education ; Emergencies* ; Emergency Nursing ; Emergency Service, Hospital ; Factor Analysis, Statistical ; Methods ; Nursing ; Problem Solving ; Reproducibility of Results ; Statistics as Topic ; Triage*

INTRODUCTIONOver the years, performance assessment (PA) has been widely employed in medical education, Objective Structured Clinical Examination (OSCE) being an excellent example. Typically, performance assessment involves multiple raters, and therefore, consistency among the scores provided by the auditors is a precondition to ensure the accuracy of the assessment. Inter-rater agreement and inter-rater reliability are two indices that are used to ensure such scoring consistency. This research primarily examined the relationship between inter-rater agreement and inter-rater reliability.

MATERIALS AND METHODSThis study used 3 sets of simulated data that was based on raters' evaluation of student performance to examine the relationship between inter-rater agreement and inter-rater reliability.

RESULTSData set 1 had high inter-rater agreement but low inter-rater reliability, data set 2 had high inter-rater reliability but low inter-rater agreement, and data set 3 had high inter-rater agreement and high inter-rater reliability.

CONCLUSIONInter-rater agreement and inter-rater reliability can but do not necessarily coexist. The presence of one does not guarantee that of the other. Inter-rater agreement and inter-rater reliability are both important for PA. The former shows stability of scores a student receives from different raters, while the latter shows the consistence of scores across different students from different raters.

Clinical Competence ; Curriculum ; Education, Medical ; Humans ; Psychometrics ; Reproducibility of Results ; Statistics as Topic ; Statistics, Nonparametric ; Students, Medical ; Task Performance and Analysis ; Validation Studies as Topic