Abstract:

Introduction:
A competent, qualified nurse should be able to perform proficient, safe and coordinated nursing care. Competency is defined as a combination of ability, knowledge, skills and attitudes in a professional practice. Nurses are expected to display competency when performing a range of procedures. Skill test in Hong Kong nursing education is a type of collegial assessment used to evaluate the student nurses’ skill competency in performing nursing procedures on manikins such as wound dressing, urinary catheterisation and so forth. To facilitate the student nurses’ acquisition of theoretical knowledge and practice, many of the nursing programmes require student nurses to achieve a passing grade from skill tests held in the institution before proceeding to clinical practicums. Skill test is certainly a vital component in nursing education; however, information regarding its effect on students’ learning process is lacking. This study investigates how collegial skill test affects baccalaureate student nurses’ learning.

Method:
This is a qualitative research study and semi-structured focus group interview is used.

Result:
Only 34 students fulfil the recruitment criteria. These students have participated in collegial skill test and completed the first clinical practicum in Year 3. Eventually, six of them (three males and three females) join the focus group interview. A 45-minute focus group interview is conducted, and five themes are identified, i.e. reflective learning, peer learning, self-directed learning, stress and enhanced relationship with classmates.

Discussion:
Reflective learning, peer learning and self-directed learning are related to the development of knowledge during the preparation for the skill test. These three themes are interwoven. The feedback received from teachers and the discrepancy among students lead students to reflect what is wrong in their concepts. Thus, they learn considerably from their classmates through frequent practices and discussions with them. In addition, after receiving feedback from teachers and classmates, the students take the initiative to search for additional relevant information from a variety of resources such as textbook, reference books and the Internet. Students establish that this type of learning further consolidates what they have learnt from the lectures and that the knowledge is retained in their long-term memory, which can be easily retrieved during their clinical practicum. Moreover, this learning experience facilitates their adaptation and transition from classroom to real clinical settings because it builds their confidence. Stress is a common feature when students need to cope with assessment/examination. Some may develop psychological disturbance symptoms. However, the participants of this study express that from another perspective, stress can be viewed as a positive motive because it drives them to practice frequently with classmates, look up additional references and initiate consultations with teachers. Furthermore, frequent practice with classmates enhanced their relationship and promoted mutual support. To conclude, skill test is not merely an assessment to measure the student nurses’ skill competency. Students no longer rely on memorisation of every single step of each nursing procedure. The skill test is also a good learning method which helps the students to further consolidate acquired knowledge by learning from classmates, self-reflection and self-discovery.

Keywords:

Direct observation of procedural skills, objective structured clinical examination, practical examination, clinical skills examination, nursing education.