| dc.description.abstract | Abstract
Background: The Nursing and Midwifery Council (NMC) are regulators for the professions of nursing and midwifery in the United Kingdom (UK) and nursing associates in England. Their role is to set professional and educational standards, maintain a register of practitioners and investigate concerns about registrants’ fitness to practise (FtP). FtP is defined as having the skills, knowledge, health, and character to deliver safe and effective care” (NMC, 2015). Responsibility for the operationalisation of FtP is devolved into Approved Education Institute which in the UK is generally a Higher Educational Institute (HEI).
Aims of Study: This study aims to identify and synthesise current research to establish what is known about the consistency and fairness of FtP processes in pre-registration nursing in the UK. Identifying the factors contributing to the consistency and fairness (or lack thereof) of FtP for pre-registration nursing students can guide regulatory and educational policy on FtP processes for nursing students. This study will also inform future research by identifying any gaps in knowledge.
Method: A systematic review was conducted based on a search of nine databases: Medline Complete, CINAHL Complete, Emcare, EMBASE, Sociology Source Ultimate, APA PsycINFO, British Education Index and Scopus. The search terms used included ‘pre-registration nursing student, fitness to practise, and policy/process.’ A forwards and backwards and hand search was conducted, and professional and governmental websites and thesis databases were also searched. All papers were quality assessed using a modified Weight of Evidence tool (Gough, 2007) and the results were recorded on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).
Results: 1356 papers were identified in the electronic search, and after the removal of duplicates and the application of a two-stage screening process a total of 11 papers met the inclusion criteria from the database search. A further 7 papers were identified in the supplementary search resulting in 18 included papers. Following data extraction, the thematic analysis identified three themes: conceptualisation of FtP, inconsistent implementation of FtP processes, and conflicting roles for nurse educators in FtP due to tensions in differences in professional expectations of novice and experienced nursing students.
Conclusion: The systematic review shows that while there is limited high-quality research focusing specifically on nursing students conceptualisation of FtP and good health and character vary between the different stakeholders. Inconsistency can occur at multiple points in the FtP process which can result in unfairness for the nursing student. There is a need to review the mechanisms for reporting and auditing FtP referrals and outcomes in nursing students as this will help inform changes to policy and practice and inform the need for future research. | en_GB |
