| BACKGROUNDCore competence of nursing postgraduate is the combined complex of attitudes, knowledge, skills, interpersonal communication, responsibility, and so on, which gradually accumulated in the education process. The pioneer of core competencies, Prahalad and Hamel, originally described it as the organization's cumulative knowledge, in particular, focusing on how to coordinate different production skills and combine technical skills and knowledge of a variety of schools. Also, they proposed three criteria for identifying core competencies:the ability to create value, expandability and inimitability.Higher nursing education of China has initially formed the three levels of nursing education systems:junior college, undergraduate, master. The beginning of master nursing education is in 1992; the Second Military Medical University and Peking Union Medical College became the first batch of which carrying out nursing master degree program, and by 2004, the number had increased to more than 30, by 2008, it had increased to 60. Domestic masters in nursing come from the undergraduate degree or undergraduate equivalent of fresh raw or clinical nurse, and accord to different recruitment ways to enroll new student, including the national examination, working staff applying for graduate and postgraduate training course. Educational system length of schooling is mostly 3 years, a few is 2 years. Research Fields of nursing postgraduate involve in clinical nursing, nursing education, nursing management, community nursing, age care, nursing psychology and other fields and very school focuses on different aspects according to the specific circumstances. Zhu Hai-Li and others discovered that there existed problems in master nursing education of china, such as unclear nursing disciplinary, single educational objectives, disordered role and function, the curriculum lack of relevance, shortage of issues and research funding, lack of qualified teachers, inaccuracy graduates'location and irrational use of master nursing students.Core competence is an important indicator to evaluate the education quality of master nursing. Therefore, it is meaningful to construct core competence evaluation system for master nursing, to investigate and study the status and influencing factors of master nursing's core competencies scientifically and effectively, and to revise and improve the master nursing's education to be more scientific and effective.OBJECTIVE1. To initial construct the Core Competencies Evaluation System for Nursing Postgraduates (CCESNP) using Delphi method, and to fabricate a self-evaluation form of master nursing's core competence.2. Through the application of CCESNP to understand the status quo and influencing factors of master nursing's core competence.3. Having an idea of the status quo and influencing factors of master nursing's core competence, provide suggestions and comments for reformation and improvement.METHODS1. To Construct CCESNP and to Fabricate a Self-evaluation Form of Master Nursing's core competence TO construct CCESNP using using Delphi method, and fabricated self-evaluation form of master nursing's core competence according third class indicators of CCESNP. This study invited 23 senior experts who come from Guangzhou, Beijing, Shanghai, Chongqing, Wuhan, Changsha, Wenzhou, Xi'an (including 10 universities and 7 hospital in all) to join the consultation. Inclusion criteria for the experts:experts with senior technical talent, undergraduate education, and more than 13 years of professional working experience. After two rounds investigation, had constructed CCESNP and fabricated a self-evaluation form of master nursing's core competence. The survey was preceded by a pilot study by using distributing self-evaluation form of master nursing's core competence to 79 full-time master nurses, and to analyze the self-evaluation form's reliability and validity in order to evaluate CCESNP.2. The Application of CCESNP——to Investigate the Status Quo and Influencing Factors of Master nursing's Core CompetenceUsing distributing-questionnaires to understand the status quo and influencing factors of master nursing's core competence. The questionnaires includes general questionnaire and self-evaluation form of master nursing's core competence. After pilot study, modified the questionnaires. By conveniently sampling, distributing questionnaires to 297 full-time master nurses, who come from 16 schools of Shanghai, Guangzhou, Chongqing, Wuhan, Changsha, Harbin, Tianjin, Jinan, Wenzhou and so on. Choose the teacher or master nursing of the institutions as investigators. We told investigators their rights and obligations through e-mail. All investigators are familiar with the contents of the questionnaire, and can give assistance to the answerers. Under the unified guidance of guidance, the investigators introduce the purposes and methods of investigation, then take back all the questionnaires on the spot.3. to analyze the dataUsing statistical software SPSS13.0 and excel to analyze the data. Using descriptive method to analyze the structure of the counselors and the status quo of nursing postgraduate's core competencies; according to indexes, such as concentration degree of expert advice, coordination level, a positive coefficient and the authority coefficient, to test the reliability and the representation of expert advice; using multiple comparisons of multiple samples'mean (One-Way ANOVA),correlation analysis and linear regression to analyze the factors of master nursing's core competence.RESULTS1. Had Constructed CCESNP and Fabricated a Self-Evaluation Form of Master Nursing's Core Competence.Whether choosing appropriate experts is the key point to Delphi method. This study invited 23 senior experts who come from Guangzhou, Beijing, Shanghai, Chongqing, Wuhan, Changsha, Wenzhou, Xi'an (including 10 universities and 7 hospitals in all) and 23 experts engaging nursing management, nursing education and clinical care in Tertiary hospitals to join the consultation. There are 2 males,21 females, aged 35-62 (average age 44.6); and 6 undergraduate degree,17 master's degree or above;16 professors, 7 associate professor; 4 PhD supervisor,15 Master Instructor and others 4; 19 people who have worked more than 20 years.The Reliability of consultation results can be measured by the experts' representativeness, positivity and authority, and coordination index of expert indicators. Experts positive index is reflected by the questionnaire'response rate, the response rates of two rounds investigation are 82.6%,91.3% respectively, far above the standard (≥50%). Authoritative coefficient of experts are above 0.8, while generally reliability coefficient (cr≥0.70) is acceptable. Therefore, experts' forecast is based on practical and theoretical basis. After the second round of the expert consultation, the coordination index is 0.301 (P<0.001), which shows that the expert opinions'coordination is significant and the survey results are acceptable.The inclusion standard of indicators is decided by the average importance value of indicators (>4.0),variation coefficient (<0.2) and selection rate (>70%). After first round, experts proposed 41 opinions on indicators, and came to 29 suggestions in the second round. Combining the change item proposals and the discussions of research team,4 first class indicators were chose:professional competence,professional development ability,Critical Thinking and cultural qualities, accompanied with 12 second class indicators and 54 third class indicators. To fabricate self-evaluation form of master nursing's core competence according third class indicators of CCESNP, self-evaluation form be comprised of 54 items, and belong to 4 first class indicators and 12 second class indicators. It is Using Likertt measure table to set five grades: very bad (one point), bad (two points), medium (three points), good (four points), very good(five points).In pilot study, We send out 85 questionnaires and got back 82 with a recovery rate of 96.5%. We got 79 valid questionnaires with the ratio of callback 96.3%. The result showed that The total cronbach's a coefficient of the self-evaluation form is 0.958, and after rejected any item the cronbach's a coefficient is less than 0.958. The cronbach's a coefficient of first class indicators separately is 0.885,0.912,0.906 and 0.895, the cronbach's a coefficient of second class indicators are all more than 0.70, the results of factor analysis showed that self-evaluation form has a good Construct Validity. It follows that self-evaluation form of master nursing's core competence has good reliability and validity, so can be used as a tool to evaluate core capacity of nursing postgraduate students.2. The Application of CCESNP——to Understand and Analyze the Status Quo and Influencing Factors of Master nursing's Core CompetenceAfter pilot study, modified the questionnaires according the problems of the Questionnaire fillment process, then ensure the instruction of formal investigation and form the formal investigation form.We send out 330 questionnaires in all and got back 308 with a recovery rate of 93.3%. We got 297 valid questionnaires with the ratio of callback 96.4%. Using Likertt measure table to set five grades:very bad (one point),bad (two points), medium (three points), good (four points), very good(five points). With the descriptive analysis method to the core competence, total core competencies and all 2 second class indicators got a point more than medium (3 point), and especially that legal ethics practice and coordination capacity (4.158±0.567) got a good point more than good (four points). ethical practices and cooperative capacity(4.158±0.567), professional manner and Self—regulated learning (3.848±0.634), social communication ski (3.772±0.646), ability of problem solving and clinical thought (3.613±0.477) get the best scores. English mastering (3.613±0.477), research ability (3.252±0.549), teaching(3.329±0.582), and the ability of mastering professional knowledge and skills (3.346±0.565) are the worst indicators in the second class;According to the results of multiple comparison in One-Way ANOVA, those who unmarried have better core competence than married students (F=5.591 P=0.019), with the same results between the extroverts and introverts (F=4.403 P=0.013), those who often take part in related nursing professional reports and those didn't (F=16.013 P=0.000), those who got higher scores in the graduate entrance examination and those who had lower scores (F=9.200 P=O.000), un-fresh graduate and fresh graduate (F=6.252 P=0.013), those who love nursing major and those who hates nursing major (F=16.201 P=0.000), Junior college or regular college course and those come from Technical secondary school (F=16.201 P=0.000), the Integrating theory with practice study style of compulsory courses and those just theoretical method (F=9.633 P=0.002), and those whose tutor pain more time and strength in their guidance and those who got less guidance from tutor (F=4.415 P=0.013), have better core competence. Person correlation analysis shows that there is a significant positive relation between age, seniority and the core competencies. The older, the longer seniority, the better the core competencies are.The results of multiple stepwise regression analysis shows that, according to the influence, the influencing factors of master nursing's core competence that from big to small are the attitude of the nursing profession, whether regularly take part in reports of nursing or not, admissions grades,School properties,learning style of required professional course and time and depth of tutor's guidance,marital status…… CONCLUSIONS1. To fabricate CCESNP using the Delphi method is scientific and effectiveTo fabricate CCESNP using the Delphi method, the result is reliable and typical and it is scientific and effective. The result of pilot study shows that self-evaluation form of master nursing's core competence fabricated by third class indicators of CCESNP has good reliability and validity, so can be used as a tool to evaluate core capacity of nursing postgraduate students. self-evaluation form be comprised of 54 items, and belong to 4 first class indicators and 12 second class indicators. It is Using Likertt measure table to set five grades:very bad (one point), bad (two points), medium (three points), good (four points), very good(five points).2. The Application of CCESNP——The Status Quo of Master Nursing's Core Competencies is Optimistic and Influencing Factors is Complicated.The status quo of master nursing's core competencies is optimistic, total core competencies and all 2 second class indicators got a point more than medium (3 point), and especially that legal ethics practice and coordination capacitygot a good point more than good (four points). With four best ability score including ethical practices and cooperative capacity, professional manner and Self—regulated learning, social communication ski, ability of problem solving and clinical thought. The influencing factors of master nursing's core competencies is Complicated, involved in age, personality, performance of Entering School, the attitude of the nursing profession, whether regularly take part in reports of nursing or not, and time and depth of tutor's guidance3. Guidance for research and education of master nursingAccording to today's education of nursing postgraduate, combining the status quo and influencing factors of master nursing's core competencies, we can improve education reform of Master Nursing with the following respects:to clear-cut training objective;to clear-cut professional direction and establish effective training plan; to enhance professionalism education; to increase the professional relevance theory, to build characteristic curriculum system; to fully and effectively enhance the core competence of nursing postgraduates; to strengthen study of public and professional English; to improve research capacity; to strengthen and improve the teaching practice further; to consolidate basic nursing knowledge, basic theory and basic skills; to establish evaluation system which is uniform and standard; and to strengthen the guidance time and effort of tutor……... |
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