New graduate nurses’ clinical competence: A mixed methods systematic review

Aim To appraise and synthesize evidence of empirical studies reporting assessment of new graduate nurses’ clinical competence in clinical settings. Design Mixed methods systematic review. Data sources The search strategy included keywords relevant to: new graduate nurse; clinical competence; and competence assessment. The searched literature databases included CINAHL, MEDLINE, Embase, PsycINFO and Web of Science. The search was limited to full‐text papers in English or French, published between 2010 –September 2019. Review Methods Inclusion criteria were: 1) empirical studies; 2) detailed method and complete results sections; 3) competence assessment in clinical settings; and 4) new graduate nurses (≤24 months). Two independent reviewers screened eligible papers, extracted data and used the Mixed Methods Appraisal Tool framework for quality appraisal. Divergences were solved through discussion. Results About 42 papers were included in this review: quantitative (N = 31), qualitative (N = 7) and mixed methods (N = 4). Findings suggest that new graduate nurses exhibit a good or adequate level of competence. Longitudinal studies show a significant increase in competence from 0–6 months, but findings are inconsistent from 6‐12 months. Conclusion There are a multitude of quantitative tools available to measure clinical competence. This suggests a need for a review of their rigor. Impact No recent reviews comprehensively synthesized the findings from new graduate nurses’ clinical competence. This review has found that new graduate nurses’ competence has been mostly assessed as good, despite the expectation that they should be more competent. Longitudinal studies did not always show a significant increase in competence. These findings can help nurse educators in providing more support to new graduate nurses throughout the transition period or design improved transition programme. This review also identified quantitative tools and qualitative methods that can be used for competence assessment. 摘要 目标 评价和综合报告新毕业护士在临床环境下临床能力评估的实证研究的证据。 设计 混合方法的系统回顾。 数据来源 搜索策略包括相关关键词:新毕业护士;临床能力;和能力评估。检索到的文献数据库包括护理学数据库(CINAHL)、联机医学文献分析和检索系统(MEDLINE)、荷兰医学文摘数据库(Embase)、心理学文摘(PsycINFO)和科学网(Web of Science)。搜索范围仅限于2010年至2019年9月期间出版的英文或法文的全文论文。 评审方法 入选标准为:1) 实证研究;2)详细的方法和完整的结果部分;3)临床环境中的能力评估;以及4)新毕业护士(工作2年内)。两位独立审稿人筛选出符合条件的论文,提取数据,并使用混合方法评价工具框架进行质量评价。通过讨论解决分歧。 结果 本文中共收录42篇论文:定量方法(N=31篇)、定性方法(N=7篇)和混合方法(N=4篇)。研究发现显示,新毕业护士表现出良好或足够的临床能力水平。纵向研究显示,工作0‐6个月的能力有显著提高,但工作6‐12个月内的能力研究发现不相一致。 结论 可用于衡量临床能