University of Cincinnati Main Campus Nursing Theory Discussion

Instructions for response post.

Provide two scholarly references to support your response. Examples of critical discussion include:

1. Comparing your post and your peer’s post, how did theories differ in the guidance provided to design interventions and address the topic?
2. Were there any major limitations with the theory selected by your peer?
3. Each posting is to be in the Correct APA format

Person to respond to…

1. Purpose of theory, major concepts, relationship statements, and usefulness
2. Nurse burnout is costly and aids in the problem of the nursing shortage. Predictors of nurse burnout in the new graduate nurse include core competence, negative emotions, and job satisfaction (Xie et al., 2020). Using Benner’s middle-range theoretical model of skill acquisition to understand the transition of the new graduate nurse is valuable in creating a safe situation of experimental learning through high fidelity simulations to increase core competence and reduce burnout. Patricia Benner’s theoretical model of skill acquisition focuses on nurses’ development through safe experimental learning and cautions that nurses who struggle with concepts of understanding practice, interpersonal skills, and problem-solving struggle with progressing from “novice to expert” (Benner, 2004). The central concepts of this theory include competence, the importance of experimental learning, skill acquisition, clinical knowledge, and a strong educational foundation. Benner states that as a nurse gains experience, “Recognition of clinical situations moves from abstract textbook accounts of general features to an experience-based response to the situation.” (Benner, 2004, p 190). Benner’s theory contains broad conceptual outcomes like the advancement from novice to expert but lacks specific operational measures. In her book “Educating Nurses:  A Call for Radical Transformation,” she poses the question of why nurses are not asked to demonstrate skills as part of their licensure examination and describes this in aiding in the “practice-education gap” (Benner et al., 2010, p. 39). High fidelity simulation learning has been found to increase competence (Kiernan, 2018). Simulations are a viable option to decrease the “practice-education gap” (Benner et al., 2010, p. 39). Simulations can increase competence by giving new graduate nurses the skills and experiences to recognize patterns, understand their role more clearly, and apply clinical knowledge to their practice setting, increasing the likelihood of being a more active participant in real-time patient care scenarios. The goal is for the new graduate nurse to gain increased competence through setting specific, high-fidelity simulations to reduce nurse burnout as measured by Maslach Burnout Inventory (MBI) (Maslach et al., 1993) and The Nurse Competence Scale (NCS)(Meretoja et al., 2004).Benner’s Theory of Skill Acquisition: Middle Range TheoryMajor Concepts:  Core competence, experimental learning, skill acquisition, educational foundation, clinical knowledge, and experience. (Benner, 2004).Relationship Statements:*Referencing experiences will aid and guide nurse’s actions in clinical settings.*Nurses who acquire strong skills through education are more likely to become active performers in clinical scenarios.*A strong educational foundation is imperative in moving through the stages of novice to expert, increasing confidence, and reducing negative emotions.Intervention: High-fidelity simulation experiences in the new graduate nurse orientation program will increase competence and skills in standard unit situations and decrease the newly graduated nurse’s burnout.Purpose: Benner’s theory focuses on skill acquisition through a robust educational foundation to progress from novice to expert (Benner, 2004). In this scenario, we apply Benner’s theory to provide a solid educational foundation to new graduate nurses through high-fidelity simulation experiences to increase competence and decrease nurse burnout in this population.Training and materials: Knowledgeable and experienced preceptors facilitate high fidelity scenarios relevant to the practice area for new graduate nurses in a guided and interactive experience.  These scenarios will practice assessment, interventions, basic troubleshooting skills, practical skills, medication management, prioritization, and anticipating escalating care. Materials include a simulation lab equipped with human simulators or mannequins, a monitor, a medication dispensing device, and computers to simulate an electronic medical record (EMR), medication vials, medication pumps, and specific unit equipment. The simulation will be in three parts- The pre-briefing: the learner will receive patient information. The simulation: a case study is enacted with specific learning objectives. The debriefing: learners review their actions during the scenario, and constructive feedback is given.Who provides the intervention: A knowledgeable and experienced nurse preceptor with strong interpersonal skills (RN, BSN), simulation lab technicians, and a unit nurse educator (RN, MSN).Mode of delivery: A fully equipped in-person simulation lab. Face-face teaching and learning.Where: In-hospital simulation lab.How often: While in orientation, the newly graduated nurse will participate in a thirty-minute simulation experience once every two weeks in a twelve-week orientation period. The simulations will increase in complexity as the nurse progresses through their orientation.Tailoring: The simulations and equipment needed will be relevant to each specific practice setting.Outcomes: The newly graduated nurse will be assessed on the Nurse Competence Scale (NCS) (Meretoja et al., 2004) at the start of orientation, every four weeks during the twelve-week orientation period, and every twelve weeks during the first year of practice post orientation. The Maslach Burnout Inventory (MBI) (Maslach et al., 1993) will also be administered every twelve weeks from the start of the individual’s post-orientation through the first year of nursing practice to measure the relationship between simulations, competence, and nurse burnout. The goal is that new graduate nurses who participate in high-fidelity simulation experiences will rate a high level of competence and a low level of burnout on the scales mentioned above.ReferencesBenner, P. (2004). Using the dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology & Society, 24(3), 188–199. https://doi.org/10.1177/0270467604265061Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: a call for radical transformation. Jossey-Bass.Kiernan, L. C. (2018). Evaluating competence and confidence using simulation technology. Nursing, 48(10), 45–52. https://doi.org/10.1097/01.nurse.0000545022.36908….Maslach, C., Jackson, S., Stefanile, C., & Saulo Sirigatti. (1993). MBI: Maslach burnout inventory: manuale. Organizzazioni Speciali.Meretoja, R., Isoaho, H., & Leino-Kilpi, H. (2004). Nurse Competence Scale: development and psychometric testing. Journal of Advanced Nursing, 47(2), 124–133. https://doi.org/10.1111/j.1365-2648.2004.03071.xXie, J., Li, J., Wang, S., Li, L., Wang, K., Duan, Y., Liu, Q., Zhong, Z., Ding, S., & Cheng, A. S. K. (2020). Job burnout and its influencing factors among newly graduated nurses: A cross?sectional study. Journal of Clinical Nursing, 30(3-4), 508–517. https://doi.org/10.1111/jocn.15567