Effect of extern experiences on clinical competence of graduate nurses

The purpose of this study was to examine the effect of externships, offered collaboratively between schools of nursing and hospitals, on the clinical competence of new graduates in their first nursing position. The scores of 24 pairs of graduate nurses and their preceptors (N = 48) on the Clinical Competency Rating Scale (CCRS; Scheetz, 1989) were compared in three areas: problem solving, applying theory to practice, and psychomotor skills. New graduates rated themselves higher than their preceptors on all items in the CCRS. Analyses via t tests indicated significant differences between the nurses' own ratings and those of their preceptors on problem solving, applying theory to practice, and psychomotor performance as well as total CCRS. The clinical competence of new graduates who had been externs during their nursing programs was compared to that of graduates who did not have this clinical experience. Nurses who had been externs rated themselves significantly higher than nonexterns on psychomotor performance (t = 2.72, P = .013) and the total CCRS score (t = 2.22, P = .04). Preceptor ratings, however, indicated no differences between these groups.