How many Times of Intramuscular Injection and Intravenous Catheter Insertion is Essential for Learning? Developing Standards according to the Learning Curves

Introduction: A main purpose of clinical training in nursing education is mastery of clinical skills, which are learnt through repetition. So there is a relation between frequency of skill performance and clinical competency. In this study we used learning curve to set standards for required performance times of two main nursing skills: intramuscular injection and intravenous catheter insertion. Methods: This time series study was conducted on 57 junior nursing students who were selected through a convenience sampling method at Mashhad nursing school during 2011. Competency score of each student for each skill performance episode was evaluated by Competency Evaluation Checklist (CEV) and recorded on learning curve till reaching a plateau. CEV was confirmed by computing content validity index and intra-rater reliability coefficients (r=.91). Results: Mean competency score of IM injection was 62.4%±21.5 (out of 100) in first time which increased by 95.1±5.9 in tenth episode. The calculated value for IV catheter insertion was 36.9±10.3 in first time and 94.1±4.3 in the thirteenth. Learning curve was reached a plateau after 7 performances for intramuscular skill and 8 performances for intravenous catheter insertion skill. The number of practice episodes in IM injection and IV Catheter insertion required for acquiring a rate of 75% in competency, by 75% of students were 6 and 7 times, respectively. Conclusion: It seems that at least 7 to 8 performances of IM injection and IV catheter insertion are considered essential to attain students’ mastery. Also designing and application of a clinical logbook is useful for documenting skills performance by nursing students.