Achievement of Community Health Nursing Competencies through Undergraduate Clinical Experiences: A Gap Analysis

Abstract

It is widely believed that in Canada, nursing practice and health care are moving from acute care into the community. What has yet to be established, however, is the degree to which undergraduate nursing students are being prepared for community health nursing practice through their community health clinical rotations. In particular, how well non-traditional or innovative community placements prepare students for registered nursing practice in the community has never been quantified. The purposes of this province-wide multi-stakeholder mixed method research study were to: delineate the competencies required of nursing students from stakeholder (industry, faculty, and student) perspectives; understand the nature of the gap between desired and observed competency level; and establish strategies for moving forward in the preparation of new nurses for community health practice in Alberta. Findings suggest that undergraduate pre-registration nursing students are not being adequately prepared for registered nursing practice roles in community health. In all competency performance items on the survey tool, observed scores were significantly lower than desired scores. Faculty and students rated observed and desired scores higher than did community health nurses, for whom the observed-desired gap was also wider. Focus group findings reveal that perspectives differ by stakeholder group regarding what it means to be prepared for community health nursing practice and how this readiness is best accomplished. As well, faculty and student perspectives often differ significantly from perspectives of practicing nurses about what new graduates need in order to be ready for community health practice.