Nursing Practice to Inform Learning: The Clinical Accreditation Program

The Clinical Accreditation Program (CAP) is a component of the Graduate Certificate in Neuroscience Nursing Course, offered by northern Sydney Central Coast Health (NSCCH) in collaboration with the University of Technology Sydney (UTS). The year-long course comprises three compulsory academic subjects offered by the UTS and completion of either a fourth academic subject or the CAP, which is available only to employees of NSCCH. The CAP is a structured, clinical, competency-based program founded on the standards of neuroscience nursing practice set by the Australasian Neuroscience Nurses' Association (ANNA, 2000). The theoretical foundation of the CAP promotes engagement in critical reflection on practice-based learning experiences, using appropriate theory related to neuroscience nursing. Toward this end, CAP participants develop a portfolio that contains evidence of clinical experience: performance development documentation, five compulsory competency assessments, two elective competency assessments, three case presentations, one critical incident essay, and one reflective essay. The results of an evaluation undertaken in 2004, which examined the views of all stakeholders of the CAP run in 2003, including the CAP participants and staff supporting these participants, indicated an overall satisfaction with the CAP. The feedback showed a perceived increase in the clinical competence of the CAP participants and a perception that CAP is instrumental in staff retention. These views were obtained by collecting responses to a questionnaire, in areas of orientation and structure of the CAP, clinical and course support, clinical learning strategies, and completion of the CAP. Shortcomings identified included a perceived lack of support by CAP participants and lack of understanding of what was involved in CAP on behalf of those supporting the participants. Stroke units in general wards were viewed as having limited opportunities for CAP participants to gain the same level of neuroscience nursing experience as those in neuroscience specialized units. Based on this evaluation, recommendations for the CAP included increasing preceptor awareness of the CAP participants' support needs and increasing the opportunities of participants to practice in neuroscience units and experience neuroscience related practices. The CAP is a crucial component of the Graduate Certificate in Neuroscience, and key in clinical competence and staff retention.