RESUMEN
Nursing students must be able to initiate and perform effective cardiopulmonary resuscitation (CPR) when they start their career in nursing. Studies show that students' competency in CPR is deficient, indicating that better training is necessary during nursing education. This study reports on the differences in nursing students' competence in CPR before and after a longitudinal pedagogical intervention across the curriculum. Changes in the curriculum were relocation and added testing of CPR skills, inclusion of a course in defibrillation, a knowledge test as stimuli before simulation, and more simulation practice with deteriorating patients. This was a comparative study between two cohorts of students in the bachelor in nursing education. We measured knowledge and compression performance in the students' final year of education. Students in cohort 2, who received the pedagogical intervention, had a significant higher total knowledge score than students in cohort 1. Students' mean depth and number of correct compressions was similar. Students in cohort 2 had a significantly higher mean rate of compressions, number of compressions per minute, and mean number of compressions with incorrect hand positions. Although the new curriculum afforded more hands-on practice of CPR, it was not enough to improve the students' performance to match the demands set out in national and international guidelines.
RESUMEN
BACKGROUND: Assessing clinical competence in nursing students abroad is a challenge, and requires both methods and instruments capable of capturing the multidimensional nature of the clinical competences acquired. OBJECTIVES: The aim of the study was to compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. DESIGN: A case study design was adopted in 2015. SETTING AND PARTICIPANTS: A purposeful sample of eight nursing programmes located in seven countries (Belgium, Denmark, Greece, Norway, Poland, Portugal and Italy) were approached. METHODS: Tools as instruments for evaluating competences developed in clinical training by international nursing students, and written procedures aimed at guiding the evaluation process, were scrutinised through a content analysis method. FINDINGS: All clinical competence evaluation procedures and instruments used in the nursing programmes involved were provided in English. A final evaluation of the competences was expected by all nursing programmes at the end of the clinical placement, while only four provided an intermediate evaluation. Great variability emerged in the tools, with between five and 88 items included. Through content analysis, 196 items emerged, classified into 12 different core competence categories, the majority were categorised as 'Technical skills' (=60), 'Self-learning and critical thinking' (=27) and 'Nursing care process' (=25) competences. Little emphasis was given in the tools to competences involving 'Self-adaptation', 'Inter-professional skills', 'Clinical documentation', 'Managing nursing care', 'Patient communication', and 'Theory and practice integration'. CONCLUSIONS: Institutions signing Bilateral Agreements should agree upon the competences expected from students during their clinical education abroad. The tools used in the process, as well as the role expected by the student, should also be agreed upon. Intercultural competences should be further addressed in the process of evaluation, in addition to adaptation to different settings. There is also a need to establish those competences achievable or not in the host country, aiming at increasing transparency in learning expectations and evaluation.