Characteristics of a critical care clinical placement programme affecting critical care nursing competency of baccalaureate nursing students: A structural equation modelling.

Aim And Objectives: To evaluate and determine the characteristics of a critical care clinical placement programme affecting the critical care nursing competency of baccalaureate nursing students.

Background: The increase in global demand for competent critical care services and human resources translates to an educational focus in preparing students for their eventual role as critical care health professionals. Albeit clinical placement in critical care units can promote competency, evidence supporting such claim remains inadequate.

Design: Cross-sectional, descriptive correlational design.

Method: Employing structural equation modelling, 236 randomly selected baccalaureate nursing students from a clinically intensive university in the Philippines were recruited from January-March 2016. A three-part online survey, composed of the robotfoto, Critical Care Nursing Rotation Evaluation Questionnaire, and Intensive and Critical Care Nursing Competence Scale, was completed. The STROBE checklist was followed in reporting this study.

Results: Five characteristics of clinical placement were extracted as follows: sufficient clinical exposure, adequate area orientation, supportive clinical instructor, diversified medical cases and supplemental learning resources. Four characteristics affected critical care nursing competency and built a good model (χ /df = 1.52; comparative fit index = 0.94; parsimonious normal fit index = 0.77; root mean square error of approximation = 0.047). Adequate area orientation had the most diverse influence on all competency domains, while supportive clinical instructor had the strongest positive influence on critical care nursing skill (β = 0.30, p = 0.005).

Conclusion: The model highlights the characteristics of a critical care clinical placement programme which influences critical care nursing competency among nursing students. It emphasised the importance of a supportive clinical instructor and adequate area orientation in promoting critical care nursing skills and values and attitude.

Relevance To Clinical Practice: The proposed model highlights the role of clinical instructors and appropriate orientation which provides impetus in improving the clinical placement design to maximise competency development.