THE RELATIONSHIP BETWEEN ADVANCED NURSING SKILL ACQUISITION IN UNDERGRADUATE NURSING STUDENTS AND THEIR COMPETENCE, CONFIDENCE AND KNOWLEDGE RETENTION

The primary goal of health science programs is to ensure that graduates can successfully enter into professional practice. Although the goal of entry-level competence seems straightforward, the process of ensuring that competence is achieved is both problematic and challenging.

Method:
N=24. Two psychometric tools measuring perceived levels of confidence and competence were utilized as well as a knowledge test on advanced cardiac knowledge.
The qualitative component was comprised of one-on-one interviews with each participant immediately following the 1 day seminar and at the 3 month time frame. A grounded theory approach was chosen for the qualitative analysis.

Data Collection:
Ethical approval was obtained from the institution where sampling occurred. All participants signed a consent to be part of a study after all risks and benefits had been discussed.

Findings:
A repeated measures ANOVA was used and found that perceptions of competence and confidence rose significantly over the three test/3 month timeframe.
The advanced cardiac skills and knowledge test demonstrated a significant gain between the pretest and the post-test number one immediately after the seminar. The interesting component of this test was the post-test number 1 to post-test number 2 (three month) interval. Although the overall score dropped (likely a reflection of basic memory loss) there still was a significant knowledge retention over the 3 month interval.
The qualitative component of the study identified 3 important themes pertaining to confidence and competence. The first dominant theme identified in the data is the anxiety and lack of confidence that participants felt in their own level of clinical competence going into the intervention. The second important theme identified relates to the role that interpersonal relationships played in confidence and competence. The last major theme identified was the immense value that participants placed on skill mastery as a source of confidence and competence.

Discussion:
Although the quantitative results were limited by the small sample size, they provide direction for future studies. Psychology has long recognized that humans have an innate desire to learn and to master skills . Skill mastery is central to the human psyche and impacts well-being and even capacity to learn . Despite the reality that students in the third or fourth year of their program would not have the capability or permissions to utilize advanced cardiac skills in practice, the reality of gaining advanced knowledge and skill gave these participants a statistically significant boost in confidence and competence. The result also illuminates the reality that there is a trickle-down benefit to learning advanced skills that percolates across a broad spectrum of capability.

Despite the limitations of the study, the importance of advanced skill and knowledge to nursing students’ confidence and competence was evident both in the quantitative and qualitative results. The decrease in anxiety as a result of possessing such skill and knowledge was also notable. The need for further study using a more controlled design was evident, but the strength of both the quantitative and qualitative results illustrated the importance of clinical skill mastery, as well as the important role of strategies to develop confidence in nursing and health science students.