| 1. |
- Oh, Hui Xian, et al.
(författare)
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The effectiveness of self-management interventions with action-taking components in improving health-related outcomes for adult stroke survivors: a systematic review and meta-analysis
- 2022
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 44:25, s. 7751-7766
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Forskningsöversikt (refereegranskat)abstract
- Purpose This systematic review and meta-analysis aims to synthesise the evidence of the effectiveness of self-management interventions with action-taking components in improving self-efficacy, health-related quality of life, basic and instrumental activities of daily living, and depression for adult stroke survivors. Materials and methods Nine electronic databases were searched for relevant studies, including grey literature and ongoing studies. Randomised controlled trials targeting adult stroke survivors comparing health-related outcomes of patients receiving self-management interventions with action-taking components to usual care, placebo, or no-treatment were included. Screening, data extraction, and methodological quality assessment were conducted by two reviewers. Meta-analyses were performed. Overall quality of evidence was assessed using the GRADE tool. Results A total of seventeen studies were included. Meta-analyses showed that the intervention may result in a slight increase in self-efficacy (SMD = 0.29, 95% CI [0.07-0.52], p = 0.010, I-2 = 47%) and basic activities of daily living (SMD = 0.31, 95% CI [0.16-0.46], p < 0.001, I-2 = 0%), but not for the other outcomes. Conclusions Self-management interventions with action-taking components may result in a slight improvement in self-efficacy and rehabilitation of basic activities of daily living. Future research should investigate which core self-management skill, or combination of them, is most effective in improving short-term and long-term outcomes.
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| 2. |
- Wu, Xi Vivien, et al.
(författare)
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A systematic review of clinical assessment for undergraduate nursing students
- 2015
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 35:2, s. 347-359
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Consolidated clinical practicum prepares pre-registration nursing students to function as beginning practitioners. The clinical competencies of final-year nursing students provide a key indication of professional standards of practice and patient safety. Thus, clinical assessment of nursing students is a crucial issue for educators and administrators.OBJECTIVE: The aim of this systematic review was to explore the clinical competency assessment for undergraduate nursing students.DATA SOURCES: PubMed, CINAHL, ScienceDirect, Web of Science, and EBSCO were systematically searched from January 2000 to December 2013.METHODS: The systematic review was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Published quantitative and qualitative studies that examined clinical assessment practices and tools used in clinical nursing education were retrieved. Quality assessment, data extraction, and analysis were completed on all included studies.RESULTS: This review screened 2073 titles, abstracts and full-text records, resulting in 33 included studies. Two reviewers assessed the quality of the included studies. Fourteen quantitative and qualitative studies were identified for this evaluation. The evidence was ordered into emergent themes; the overarching themes were current practices in clinical assessment, issues of learning and assessment, development of assessment tools, and reliability and validity of assessment tools.CONCLUSION: There is a need to develop a holistic clinical assessment tool with reasonable level of validity and reliability. Clinical assessment is a robust activity and requires collaboration between clinical partners and academia to enhance the clinical experiences of students, the professional development of preceptors, and the clinical credibility of academics.
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| 3. |
- Wu, Xi Vivien, et al.
(författare)
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Clinical nurse leaders’ and academics’ perspectives on clinical assessment of final-year nursing students: a qualitative study
- 2017
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Ingår i: Nursing and Health Sciences. - : John Wiley & Sons. - 1441-0745 .- 1442-2018. ; 19:3, s. 287-293
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Tidskriftsartikel (refereegranskat)abstract
- The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic-clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences.
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| 4. |
- Wu, Xi Vivien, et al.
(författare)
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Development and psychometric testing of Holistic Clinical Assessment Tool (HCAT) for undergraduate nursing students
- 2016
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 16, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background:A major focus in nursing education is on the judgement of clinical performance, and it is a complexprocess due to the diverse nature of nursing practice. A holistic approach in assessment of competency is advocated.Difficulties in the development of valid and reliable assessment measures in nursing competency have resulted in thedevelopment of assessment instruments with an increase in face and content validity, but few studies have testedthese instruments psychometrically. It is essential to develop a holistic assessment tool to meet the needs of the clinicaleducation. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties.Methods:The HCAT was developed based on the systematic literature review and the findings of qualitative studies.An expert panel was invited to evaluate the content validity of the tool. A total of 130 final-year nursing undergraduatestudents were recruited to evaluate the psychometric properties (i.e. factor structure, internal consistency and test-retestreliability) of the tool.Results:The HCAT has good content validity with content validity index of .979. The exploratory factor analysis revealsa four-factor structure of the tool. The internal consistency and test-retest reliability of the HCAT are satisfactory withCronbach alpha ranging from .789 to .965 and Intraclass Correlation Coefficient ranging from .881 to .979 for the foursubscales and total scale.Conclusions:HCAT has the potential to be used as a valid measure to evaluate clinical competence in nursingstudents, and provide specific and ongoing feedback to enhance the holistic clinical learning experience. In addition,HCAT functions as a tool for self-reflection, peer-assessment and guides preceptors in clinical teaching and assessment.
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| 5. |
- Wu, Xi Vivien
(författare)
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Holistic clinical assessment for undergraduate nursing students
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. Difficulties in the development of valid and reliable assessment measures in nursing competency continue to pose a challenge in nursing education. A holistic approach in the assessment of competency comprises knowledge, skills and professional attitudes, wherein the notion of competency incorporates professional judgement and management skills in the clinical situation. Therefore, the thesis aims to develop a holistic clinical assessment tool with a reasonable level of validity and reliability to meet the needs of clinical education.The conceptual framework underlying this research is formed by establishing a theoretical connection between the practice of learning, and of pedagogy and assessment. This research consists of five studies. In Study I, a systematic review was conducted to explore the current assessment practices and tools for nursing undergraduates. In Studies II, III and IV, a qualitative approach with focus group discussions was adopted to explore the views of final-year undergraduate nursing students, preceptors, clinical nurse leaders and academics on the clinical assessment. Based on the multiple perspectives, it therefore addresses concerns in clinical assessment. In Study V, a holistic clinical assessment tool was developed, for which a psychometric testing was conducted.The systematic review indicated that limited studies adequately evaluate the psychometric properties of the assessment instrument. The qualitative studies have raised an awareness of professional and educational issues in relation to clinical assessment. Workload, time, availability of resources, adequate preparation of preceptors, and availability of valid and reliable clinical assessment tools were deemed to influence the quality of students’ clinical learning and assessment. In addition, the presence of support systems and formal educational programs for preceptors influenced their preparation and self-confidence. Nursing leaderships in hospitals and educational institutions have a joint responsibility in shaping the holistic clinical learning environment and making holistic clinical assessment for students. The involvement of all stakeholders in the development of a valid and reliable assessment tool for clinical competency is also essential to the process. The Holistic Clinical Assessment Tool (HCAT) was developed by the author based on the systematic review, qualitative findings and the core competencies of registered nurse from the professional nursing boards. The HCAT consists of 4 domains and 36 assessment items. Furthermore, testing of the psychometric properties indicated that the HCAT has satisfactory content validity, construct validity, internal consistency and test-retest reliability.In conclusion, the HCAT is meritorious in that it carries the potential to be used as a valid measure to evaluate clinical competency in nursing students, and provide specific and ongoing feedback to enhance the students’ holistic clinical learning experience. The HCAT not only functions as a tool for self-reflection for the students, but also guides the preceptors in clinical teaching and assessment. In addition, the HCAT can be used for peer-assessment and feedback. It is imperative that the clinical and academic institutions establish various levels of ongoing support for both students and preceptors in the process of clinical assessment.
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| 6. |
- Wu, Xi Vivien, et al.
(författare)
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The perspectives of preceptors regarding clinical assessment for undergraduate nursing students
- 2016
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Ingår i: International Nursing Review. - : Wiley. - 0020-8132 .- 1466-7657. ; 63:3, s. 473-481
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore the perspectives of preceptors about clinical assessment for undergraduate nursing students in transition to practice.BACKGROUND: The assessment of clinical competence is a complex process due to the diverse nature of nursing practice. As such, nurse preceptors play a crucial role in clinical assessment for nursing students. Although preceptors may enjoy the process of clinical teaching and assessment, they face challenges that need to be addressed to facilitate students' clinical learning and assessment.METHODS: An exploratory qualitative approach was adopted. A purposive sample of 17 preceptors from two tertiary hospitals in Singapore was recruited to participate in three focus group discussions from March to July 2014.FINDINGS: Five themes emerged from the data analysis: the need for a valid and reliable clinical assessment tool; meaningful reflection and feedback; varied methods in clinical assessment; high level of commitment and struggles with dual roles and the need to enhance the support system for preceptors.CONCLUSIONS: There is no doubt that a valid and reliable clinical assessment tool can serve as a guide for preceptors to enhance their clarity in assessment and feedback. It is essential for all stakeholders to be involved in the development of the clinical assessment tool. Workload, time, support system and formal educational programmes for preceptors influenced their preparation and self-confidence.IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The themes that emerged from the focus group discussions could assist in the development of a more reliable and valid clinical assessment tool to evaluate the clinical competence of nursing students in transition to practice. Clinical and educational institutions could collaborate closely to develop an educational programme and a preceptorship handbook, focusing on pedagogical contents for clinical education and assessment.
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| 7. |
- Wu, Xi Vivien, et al.
(författare)
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Undergraduate nursing students' perspectives on clinical assessment at transition to practice
- 2015
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Ingår i: Contemporary Nurse. - : Informa UK Limited. - 1037-6178 .- 1839-3535. ; 51:2-3, s. 272-285
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Assessment of clinical competence requires explicitly defined standards meeting the national standards of the nursing profession. This is a complex process because of the diverse nature of nursing practice.OBJECTIVES: To explore the perceptions of final-year undergraduate nursing students regarding clinical assessment at transition to practice.METHODS: An exploratory qualitative approach was adopted. Twenty-four students participated in three focus group discussions. Thematic analysis was conducted.FINDINGS: Five themes emerged: the need for a valid and reliable clinical assessment tool, the need for a flexible style of reflection and specific feedback, the dynamic clinical learning environment, students' efforts in learning and assessment, and the unclear support system for preceptors.CONCLUSIONS: Workload, time, resource availability, adequate preparation of preceptors, and the provision of valid and reliable clinical assessment tools were deemed to influence the quality of students' clinical learning and assessment. Nursing leadership in hospitals and educational institutions has a joint responsibility in shaping the clinical learning environment and providing clinical assessments for the students.
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