title: Fitness for practice in nursing and midwifery education in Scotland, United Kingdom.
abstract: OBJECTIVE
  The aim of this paper is to report findings from a major study that evaluated the Fitness for Practice nursing and midwifery curriculum in Scotland, UK.
  
  
  BACKGROUND
  The competence of student nurses and midwives at the point of registration has been the focus of debate and research. However, no major study, on such a large scale, had specifically evaluated pre-registration programmes to determine whether they enabled students to achieve 'fitness to practice'.
  
  
  METHODS
  The study had a broad evaluation design conducted in three phases using a mixed methodology.
  
  
  METHODS
  Phase 1 involved questionnaires, Objective Structured Clinical Examination's (OSCE) and curriculum evaluation. Phase 2 involved semi-structured interviews (some telephone) and focus groups across main stakeholders: students (n = 78), mentors (n = 78), practice-education facilitators (n = 24), academics (n = 59), senior clinical (n = 46) and education managers (n = 16), service users and carers (n = 10).
  
  
  RESULTS
  The findings suggest that the Fitness for Practice curriculum model in Scotland has on the whole been successful. The key finding is the predominant opinion of stakeholders that newly qualified nurses and midwives are perceived as being fit for practice at the point of registration. A perceived lack of confidence is, as with all transitions to new roles, an understandable outcome.
  
  
  CONCLUSIONS
  Previous concern that student nurses and midwives are not 'fit for practice' has focused on the perceived lack of clinical skills at the point of registration, not on competence to practice in general. This study demonstrates that this is an important distinction and recognises that registration is only the beginning of a life long learning experience.
  
  
  CONCLUSIONS
  Students need to be supported to develop their confidence following registration as well as additional skills in their chosen field of practice. Appropriate mentorship and a period of preceptorship should be in place to accommodate this.
authors.affiliation: School of Nursing, University of Salford, Salford, UK. k.holland@salford.ac.uk
authors.forename: Karen
authors.initials: K
authors.lastname: Holland
authors.forename: Michelle
authors.initials: M
authors.lastname: Roxburgh
authors.forename: Martin
authors.initials: M
authors.lastname: Johnson
authors.forename: Keith
authors.initials: K
authors.lastname: Topping
authors.forename: Roger
authors.initials: R
authors.lastname: Watson
authors.forename: William
authors.initials: W
authors.lastname: Lauder
authors.forename: Mary
authors.initials: M
authors.lastname: Porter
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004506:Education, Nursing; D017144:Focus Groups; D006801:Humans; D008880:Midwifery / Q000193:education*; D012606:Scotland; D011795:Surveys and Questionnaires