Norwegian nurse educators' self-rating of competencies: a nationwide cross-sectional web-survey.

BACKGROUND: Nurse educators' competencies play a crucial role in the educational quality of nurses. OBJECTIVE: This study aimed to investigate how Norwegian nurse educators self-rated their competence domains, and how these competencies were associated background variables. METHODS: The study was designed as a cross-sectional web-survey, and n=154 participated and filled out the Evaluation of Requirements of Nurse Teachers (ERNT) instrument. Educators' mean working experience was 12.9 years (SD 9.2); 86.3 % were permanently employed and 76.8 % had formal supervision training. RESULTS: The nurse educators rated their competence as good on all competence domains and single competence items, and ERNT total mean score was 4.62 (SD 0.28), with relationship with the students rated highest and personality factors rated lowest. The ERNT total mean score was significantly related to academic degree. CONCLUSIONS: Educational leaders in nursing education are recommended to establish a mentoring and supporting team for their educators.

A successful nursing education promotes newly graduated nurses' job satisfaction one year after graduation: a cross-sectional multi-country study.

BACKGROUND: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. METHODS: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. RESULTS: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. CONCLUSIONS: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients.

The nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum: a European cross-sectional study of graduating nursing students.

BACKGROUND: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students' clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher's cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries. METHODS: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher's pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018-2019. The data were analyzed using a Chi-Square test, Pearson's correlation coefficients, and linear models. RESULTS: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher's pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher's pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country. CONCLUSIONS: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students' final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers' pedagogical cooperation role within the clinical learning environment.

Patients and family members´ perceptions of interprofessional teamwork in palliative care: A qualitative descriptive study.

AIMS: To describe patients and family members' perceptions of interprofessional teamwork in specialised palliative care. BACKGROUND: Interprofessional teamwork is essential when delivering high-quality palliative care. Little attention has been paid to patients and family members' perceptions. DESIGN: A qualitative descriptive design. METHODS: Semi-structured individual interviews were conducted with 20 palliative patients and family members (n = 19) in four palliative wards, which were collected from May 2019 to November 2019. Data were analysed using inductive content analysis. COREQ guidelines were followed. RESULTS: Patients' perceptions of interprofessional teamwork were described as the nature of interprofessional teamwork, a sense of community and patient participation. Family members' perceptions of interprofessional teamwork were described as the nature of interprofessional teamwork, the diverse expertise and the sense of community. Patients and family members' perceptions of interprofessional teamwork were nearly identical and were based on observed social situations or their assumptions. They trust that professionals are working interprofessionally, even if the teamwork cannot be observed. In palliative care, the nature of interprofessional care changes together with patients' condition and family members progressively need more professional support. CONCLUSIONS: Conducting interprofessional care more openly could benefit the availability of different professionals' competence to patients and family members. In palliative care, the nature of interprofessional teamwork changes together with the patients' health condition. More information is needed about what constitutes an interprofessional framework and the required interprofessional competencies in palliative care. RELEVANCE TO CLINICAL PRACTICE: The findings show the importance of considering the patient's health status when interprofessional care is planned. However, professionals should recognise that a patient's weakening condition changes the focus more to the needs of the family members. It is acknowledged that IP teamwork requires time, but in PC settings, spending time on collaborative practices is not always possible.

Medication calculation skills of graduating nursing students within European context.

AIM: The aim of this study is to evaluate the medication calculation skills of graduating nursing students in six European countries and analyse the associated factors. BACKGROUND: Medication calculation skills are fundamental to medication safety, which is a substantial part of patient safety. Previous studies have raised concerns about the medication calculation skills of nurses and nursing students. DESIGN: As part of a broader research project, this study applies a multinational cross-sectional survey design with three populations: graduating nursing students, nurse managers and patients. METHODS: The students performed two calculations (tablet and fluid) testing medication calculation skills requiring different levels of conceptual understanding and arithmetic. The managers and patients answered one question about the students' medication kills. In total, 1,796 students, 538 managers and 1,327 patients participated the study. The data were analysed statistically. The STROBE guideline for cross-sectional studies was applied. RESULTS: Almost all (99%) of the students performed the tablet calculation correctly, and the majority (71%) answered the fluid calculation correctly. Older age, a previous degree in health care and satisfaction with their current degree programme was positively associated with correct fluid calculations. The patients evaluated the students' medication skills higher than the nurse managers did and the evaluations were not systematically aligned with the calculation skills tested. CONCLUSIONS: Nursing students have the skills to perform simple medication calculations, but a significant number of students have difficulties with calculations involving multiple operations and a higher level of conceptual understanding. Due to the variation in students' medication calculation skills and the unalignment between the managers' and patients' evaluations and the calculation tests, further research is needed. RELEVANCE TO CLINICAL PRACTICE: Graduating nursing students enter clinical field as qualified professionals, but there is still room for improvement in their medication calculation skills. This calls for attention in the fields of clinical nursing, education and research.

The Perspectives of Healthcare Teachers on Their Technological Pedagogical Content Knowledge of Three-Dimensional Technology: A Mixed Methods Study.

In the future, healthcare teachers will need to have evidence-based teaching strategies. Moreover, three-dimensional technology is a promising element to support teaching. This mixed methods study aimed to describe the self-reported insight of healthcare teachers in relation to their knowledge of the utilization of technology, in general, and, more specifically, three-dimensional technology, in their healthcare teaching. The Technological Pedagogical Content Knowledge framework served as the theoretical base for this study. A survey (n = 55) and interviews (n = 17) were carried out on Finnish healthcare teachers at vocational institutes. The analysis was guided by the TPACK-deep scale. Teachers found three-dimensional technology to be a positive addition to their teaching and use of three-dimensional technology was also quite incidental, focusing on three-dimensional images and three-dimensional environments rather than three-dimensional printing or three-dimensional holograms. Additionally, different themes emphasizing the elements teachers should focus on when implementing three-dimensional technology in their teaching emerged. An example of these was time usage. This study found that, despite there being several elements that teachers should prepare for and implement before utilizing three-dimensional technology, teachers should see three-dimensional technology as a promising technology for use in healthcare education.

The Appearance of Digital Competence in the Work of Health Sciences Educators: A Cross-sectional Study.

The digital competence of health sciences educators is important for the delivery and development of modern education and lifelong learning. The aim of the study was to assess the appearance of digital competence in the work of Finnish health sciences educators and to determine whether educators' background factors are related to the areas of digital competence appearance. The European Framework for the Digital Competence of Educators was used as a theoretical background. The participants were Finnish health sciences educators (n = 388). Data were collected by quantitative survey and statistically analyzed. Results show that health sciences educators had participated in continuing education to develop their expertise and used a variety of digital methods and materials. Educators need more competence to improve healthcare students' ability to use digital technology. In the area of Teaching and Learning, educators younger than 40 years rated the appearance of digital competence as better than did those between the ages of 40 and 49 years. In the future, health sciences educators' basic and continuing education could take into account the competence requirements for digital competence, and educators' expertise must be increased in areas where digital competence does not appear strong.

An Integrative Review of Interprofessional Teamwork and Required Competence in Specialized Palliative Care.

To deliver quality care, social and healthcare professionals should be competent both in their own professional work and interprofessionally. The aim of this integrative review was to describe interprofessional teamwork and the required competencies for teamwork in specialized palliative care. Totally 14 studies published between 2003 and 2020 were included in the review. Interprofessional teamwork was described from the patients and professionals' perspective. The required interprofessional competencies were described as teamwork knowledge, skills, attitudes, and values. Interprofessional teamwork is one of the essential factors in providing holistic and ethically sustainable care to palliative patients. The way how professionals confront death and dying effects the whole team; this suggests that support practices are important in palliative care settings. Ascertaining the interprofessional competence in palliative care will produce better collaborative practices and increase the care outcomes. The findings can be used as a framework when developing interventions to promote clinical and educational practices.

Final clinical practicum shapes the transition experience and occupational commitment of newly graduated nurses in Europe-A longitudinal study.

AIMS: The aim of the study was to examine the association between the characteristics of a nursing student's final clinical practicum and the success of transition of newly graduated nurses (NGNs) in six European countries. DESIGN: A longitudinal design with two data collections points (pre- and post-graduate). METHODS: The data were collected with an online survey between May 2018 and April 2020 from graduating nursing students (n = 1796) in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Altogether, 642 NGNs responded to the second questionnaire 1 year after graduation. Logistic and linear regression analyses were used to examine the associations between five clinical practicum characteristics and three indicators for the success of transition (ease of transition, turnover intentions and occupational commitment). Models were adjusted for demographic and background/workplace factors and professional competence. RESULTS: Several associations were observed between the different clinical practicum characteristics and the indicators for a successful transition. Good pedagogical atmosphere and good supervisory relationship were associated with higher likelihood of an easy transition. Good leadership style of the ward manager, good premises of nursing care on the ward and a good supervisory relationship were associated with higher occupational commitment. No consistent association with turnover intention was found. CONCLUSION: Having a good final clinical practicum before graduation can contribute to an easier transition experience for newly NGNs and strengthen their commitment to the nursing profession. IMPACT: This study adds to the limited existing knowledge about the importance of final clinical practicums in shaping the transition process and occupational commitment of NGNs. Investing in creating a good final practicum experience could help healthcare organizations engage new nursing professionals and thus alleviate the existing shortage of nurses.

Good interaction skills are not enough - competency in mental health issues in child health clinics and school health services.

BACKGROUND: Mental health problems among children and adolescents are a worldwide issue of concern. Health professionals who have sufficient competency in mental health issues are crucial for responding to this situation. AIM: The aim of the study was to describe the competency in mental health issues required by the work of public health nurses in child health clinics and school health services. METHODS: This qualitative, descriptive study was conducted with focus group interviews in March 2018. The sample consisted of public health nurses (n = 24) who were working in child health clinics or school health services in Finland. The data were analysed using inductive and deductive content analysis. RESULTS: The competency in mental health issues required by the work of public health nurses was formulated from the identified strengths and topics required in continuing education. In total, 18 competencies were identified as covering mental health promotion, as well as the alleviation and treatment of symptoms and disorders. Intuitive and interpersonal competency was identified as the main strength of public health nurses. The theoretical and evidence-based competency regarding mental health issues was identified as a main topic needed in continuing education. CONCLUSION: Public health nurses in child health clinics and school health services need competency in mental health issues for the promotion of mental health, the alleviation of symptoms and treatment of disorders. The results indicate that good interactional skills are not enough: the current competency of public health nurses in mental health issues is insufficient and does not meet the requirements of the work. The results were consistent with existing knowledge, but also provide a more comprehensive and precise insight into the current situation. In the future, the results should be verified with more studies. There is also a need for intervention studies aiming to improve competency in mental health issues.

Learning Outcomes of Digital Learning Interventions in Higher Education: A Scoping Review.

Implementing digital technologies has become a policy priority worldwide among all types of education. The COVID-19 pandemic has further accelerated educational institutions' efforts to reorganize their teaching and introduce new digital learning technologies. Although using digital technologies in higher education, including nursing, is considered a modern and innovative way of teaching and learning, uncertainty exists concerning these technologies' actual usefulness in achieving positive learning outcomes. The aim of this scoping review was to examine the current evidence related to the effects of using digital technologies on learning outcomes in higher education. The authors searched five electronic databases for relevant studies and used a scoping review method to analyze and synthesize the evidence. Eighty-six articles from six disciplines met the selection criteria. As a key finding, the outcomes of the interventions were mainly positive. Increased professional knowledge, skills, and attitudes reflect the advancement of professional competence. Academic, collaborative, and study skills, in turn, contribute to general competence development. Our findings suggest that digital technology has the potential to improve learning in various disciplines.

Clinical learning environment and graduating nursing students' competence: A multi-country cross-sectional study.

The purpose of this study was to explore nursing students' perceptions of their final clinical learning environment and its association with their self-assessed competence, satisfaction with nursing education, and turnover intentions at graduation in six European countries. A multi-country comparative cross-sectional study was conducted with nursing students (n = 1746) from the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain using the Nurse Competence Scale and the Clinical Learning Environment and Supervision scale. Nursing students' overall perceptions of their final clinical learning environment and supervision were positive in all the countries studied. The correlation between the students' perceptions of their final clinical learning environment and competence was statistically significant and positive. Satisfaction with the nursing program and clinical practicum and no consideration of career change were related to positive perceptions of the final clinical learning environment. Highlighting the importance of the supervisory relationship and pedagogical atmosphere, nursing students' positive perceptions of the final clinical learning environment and supervision contribute to a better level of self-assessed competence and satisfaction with the nursing program and clinical practicum, leading to lower turnover intentions.

Analysis of graduating nursing students' moral courage in six European countries.

BACKGROUND: Moral courage is defined as courage to act according to one's own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses' career. AIM: To analyse graduating nursing students' moral courage and the factors associated with it in six European countries. RESEARCH DESIGN: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0-100), the questionnaire also covered several background variables. PARTICIPANTS AND RESEARCH CONTEXT: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students' moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires. ETHICAL CONSIDERATIONS: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent. RESULTS: The mean of graduating nursing students' self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0-100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students' moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves. DISCUSSION AND CONCLUSIONS: In all countries, the graduating nursing students' moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.

The development and testing of the C/WoundComp instrument for assessing chronic wound-care competence in student nurses and podiatrists.

The purpose of this study was to describe the level of chronic wound-care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.

Knowledge of patient observation among critical care nurses.

BACKGROUND: The clinical observations made by critical care nurses are vital for maintaining patient safety and making appropriate decisions in the care of patients who are critically ill. Evaluating the reliability of observations and applying analytical thinking are essential elements of patient observation. Previous studies of critical care nurses' knowledge have focused either on specific aspects of patient observation or on critical care nursing in general; therefore, the findings are not comprehensive. AIM: The aim of this study was to evaluate critical care nurses' level of knowledge in patient observation and to explore the factors that are associated with it. STUDY DESIGN: A cross-sectional knowledge test survey with critical care nurses in Finland was used. METHODS: Data were collected in seven adult intensive care units in all five university hospitals in Finland between September 2017 and January 2018 by using a knowledge test (20 items) developed for this study. All critical care nurses were eligible to participate. The data were analysed using descriptive and inferential statistics. RESULTS: Altogether, 372 nurses responded (response rate 49%). Their average scores in the knowledge test were 77% (mean 15.29/20, SD 2.41) for correct answers, 75% (mean 8.2/11, SD 1.54) in the sum-variable "Evaluating the reliability of observation" and 79% (mean 7.08, SD 1.45) for "Analytical thinking." A higher knowledge level was associated with education in special tasks in an intensive care unit. CONCLUSION: The critical care nurses' knowledge level was considered to be suboptimal. There is a need for improving knowledge of patient observation among Finnish critical care nurses to ensure safe and good quality care. RELEVANCE TO CLINICAL PRACTICE: Finnish critical care nurses' knowledge of patient observation could be improved by providing specific continuing education for new nurses entering intensive care units and for experienced critical care nurses throughout their career.

Digital Learning Interventions in Higher Education: A Scoping Review.

This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.

Health and social care educators' ethical competence.

BACKGROUND AND PURPOSE: Educators' ethical competence is of crucial importance for developing students' ethical thinking. Previous studies describe educators' ethical codes and principles. This article aims to widen the understanding of health- and social care educators' ethical competence in relation to core values and ethos. THEORETICAL BACKGROUND AND KEY CONCEPTS: The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. METHODS: Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. ETHICAL CONSIDERATIONS: The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. FINDINGS: The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. CONCLUSION: Educators' personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators' training regarding ethical competence.

Nurse managers' perceptions of the competence of newly graduated nurses: A scoping review.

AIM: To summarize nurse managers' perceptions of newly graduated nurses' (NGNs) competence and connected factors. BACKGROUND: Nurse managers recruiting staff are responsible for employing competent nurses to ensure quality care and professional standards. Knowledge of managers' perceptions about the competence of NGNs is needed to understand the expectations of the health care system towards future professionals. EVALUATION: A scoping review was conducted. A total of 12 research publications met the inclusion criteria and were analysed using inductive content analysis. KEY ISSUES: Managers' perceptions can be divided into three perspectives: NGNs' competence descriptions, assessment of competences and connected factors. The NGNs' level of competence was assessed to be at least satisfactory, and dependent on prior exposure to the work setting, change in the degree of responsibility and lack of confidence. CONCLUSION: Existing knowledge about nurse managers' perceptions of NGNs' competence is limited and rather fragmented. There is a clear need for rigorous empirical studies with comprehensive views of managers, emphasizing the key role of managers in the evaluation of nurse competence. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can use the results of this review in recruitment, performance reviews and the development of job orientation programmes aimed at enhancing NGNs' transition to the nurse workforce.

Graduating student nurses' and student podiatrists' wound care competence: a cross-sectional study.

OBJECTIVE: To explore and describe graduating student nurses' (SNs) and student podiatrists' (SPs) theoretical wound care competence, as well as students' own perceptions of their wound care competence and their opinions about the received wound care education. METHOD: A descriptive cross-sectional design was used. Data were collected from five Finnish universities using a graduating SNs and SPs wound care competence (WCC) questionnaire, which included a wound care knowledge test and a wound care competence self-evaluation. Data were analysed statistically and with qualitative content analysis. RESULTS: A total of 213 students (response rate: 86%) participated in the study. Of these, 194 were SNs and 19 SPs. Students answered 48% of the knowledge test questions correctly (SNs 46%, total score 14/29; SPs 60%, total score 13/22). SPs' wound care competence was statistically significantly higher (p<0.0001) than that of SNs. Both groups self-evaluated their wound care competence to be deficient. Students who had more practical training in wound care during practical training periods scored statistically significantly better in the knowledge test. Students showed a positive attitude towards wound care by expressing an interest in it and acknowledging its importance. CONCLUSION: Graduating SNs' and SPs' theoretical wound care competence is limited. The results showed that more wound care education, especially practical training, is needed in SNs' and SPs' education curriculums to adequately respond to the increasing needs in wound care.

Competence areas for registered nurses and podiatrists in chronic wound care, and their role in wound care practice.

AIMS AND OBJECTIVES: To identify general competence areas for graduating registered nurses and podiatrists providing chronic wound care. BACKGROUND: The provision of care for chronic wounds involves a team of multiple professionals, and registered nurses and podiatrists play an important role. However, previous studies have found that registered nurses have limited competence in wound care. In addition, there are no standardised international competence areas for the provision of chronic wound care by registered nurses and podiatrists. DESIGN: A qualitative design was used in this study. METHODS: The data were collected using six focus-group interviews with the following professionals: (a) registered nurses; (b) authorised wound care nurses; (c) nurse educators; (d) physicians; (e) podiatrists; and (f) podiatry educators (N = 23). The data were analysed using inductive and deductive content analysis. COREQ guidelines were followed, See Appendix S1. RESULTS: The competence areas for registered nurses and podiatrists providing care for chronic wounds include knowledge, skills and performance in anatomy and physiology; aetiology, care and prevention of chronic wounds; and wound management and assessment. The competence areas also include a set of attitudes and values relating to chronic wound care and patients with chronic wounds. CONCLUSIONS: In nursing and podiatry education and in working life, teaching should focus on these areas of competence in chronic wound care. This would standardise and integrate education on wound care, especially that of chronic wounds. RELEVANCE TO CLINICAL PRACTICE: Wound care is an important part of clinical practice in nursing and podiatry. It is suggested that registered nurses and podiatrists need general competence in chronic wound care to carry out evidence-based, safe, high-quality and cost-effective care. These results could be used to define registered nurses' and podiatrists' competence areas and roles in evidence-based wound care as independent healthcare professionals.