The Study Of Present Situation And Influence Factors Of Nursing Undergraduate Interns' Core Competency In Five Tertiary Level First-class Hospitals In Chongqing

Objective: To study the the present situation of core competency of nursing undergraduate interns in five tertiary level first-class hospitals in Chongqing and to explore its influence factors. To provide theoretic basis for cultivation, objective adjustment and teaching reform of undergraduate nurses'core competency.Methods: The concept and the evaluation index for the core competeney of nursing undergraduate interns were defined with theories analysis and expert consultation. Based on the defined evaluation index, four questionnaires were selected. The formal"influencing factors of core competency of the nursing undergraduate interns questionnaire"was developed by theories analysis, expert consultation,reliability and validity testing.The four questionnaires and the independently made questionnaire of influencing factors of core competency were used to investigate 223 undergraduate nurses in five tertiary level first-class hospitals in Chongqing. The data were processed by SPSS soft ware package (version 17.0). The statistical methods are including descriptive,linear correlation analysis and linear regression analysis.Results: 1 The nursing undergraduate interns'core competence concept was defined. After two rounds of expert consultation, the critical thinking ability, the clinical decision-making ability, the clinical communication ability and the autonomous learning ability were selected as nursing undergraduate interns'core competence evaluation indexes. 2 The influencing factors of core competency of the nursing undergraduate interns questionnaire was developed. The questionnaire was composed of the following sections: family factors, personal factors,school education factors and practice teaching factors.The coefficient of scale-level CVI of the questionnaire was 0.94, while the item-level CVI was 0.83~1.0. The coefficient of scale-level re-test after the interval of two weeks was 0.81,while the coefficient of section-level re-test was 0.82~0.87. 3 The scoring rate of core competency is arranged from high to low, which goes like clinical communication ability (76.23%), the critical thinking ability (70.46%), the independent learning ability (67.67%) and the clinical decision-make ability (59.86%). Spearman correlation analysis showed that there were positive correlations among these four abilities(r=0.155～0.603, P <0.01). The average score of clinical communication ability is 85.38±10.20; and all the items are higher than 70%. The score of acute listening and harmonious relationship establishing is the highest, while the score of feeling-testify and convert effective information is the lowest.The average score of critical thinking ability was 295.92±27.95. The score of thirst for knowledge and analysis ability is the highest, while truth-seeking and systematicity is the lowest.The mean score of independent learning ability was 94.74±11.51. Self-managing ability is the highest while learning collaboration ability is the lowest.The mean score of clinical decision-making ability was 77.22±9.24. Evaluation-feedback and plan-decision ability is the highest while goal-setting ability and decision-implementation ability is the lowest. Linear correlation analysis showed that the major factors related to the nursing undergraduate interns'core competency include communicating with parents,professional attitude,learning motivation, part-time job experience,serving as student leaders, extracurricular reading habits,teaching atmosphere, teacher's critical thinking, teaching content, the overall quality and teaching attitude of teachers, multi-teaching methods, the teacher'empathy and learning together with students, care plan making collaboration. All of the affecting factors are positively related to the undergraduate nurses'core competency.Conclusions: 1 The critical thinking ability, the clinical decision-making ability, the clinical communication ability and the autonomous learning ability are the uppermost abilities of the nursing undergraduate interns'core competence. 2 The influencing factors of core competency of the nursing undergraduate interns questionnaire's reliability and validity are preferable to assess as a objective, reasonable and simple tool. 3 The results showed that the clinical communication ability is the best, while clinical decision-make ability is worst among four abilities of core competency. Critical thinking ability and independent study ability is between above mentioned. These four abilities showed a remarkable liner dependency. The main factors which have relatively strong effect on core competency are including professional attitude, learning motivation, the overall quality and teaching attitude of teachers, teaching methods and teacher-student relationship. 4. Several proposals are suggested to improve the nursing undergraduate interns'core competence: to set up the capability centered teaching philosophy and promot students'all round development;to establish a core competency cultivation-centered system and set up an educational program which fits in with the characteristics of core competency of nursing undergraduates.to strengthen the construction of teaching staff and cultivate the teachers'core competency.to establish a harmonious and democratic teaching atmosphere as well as to establish a positive and friendly relationship between teachers and students.