Measuring Perceptions of the Clinical Career Pathway in a New Zealand Hospital  

Abstract
Clinical Career Pathways (CCPs) for nurses were introduced in the 1970s and they were first established in New Zealand during the late 1980s. The implementation of CCP programmes has met with mixed response; many nurses view it negatively as an extra and unnecessary demand from their employers while others perceive it to be a valuable form of professional development. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses’ and midwives’ knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire in two sections. The first tests knowledge of the CCP, as implemented at the study hospital, the second measures attitudes towards CCP and professional development. In this paper we describe the development of the CCPET and present some of the results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not. The authors suggest firstly that the CCPET is useful for measuring CCP knowledge and attitudes in a constantly restructuring nursing environment, and secondly that the instrument can be easily adapted for use in other hospitals and organisations.  

Keywords
Clinical Career Pathway, knowledge, attitudes, nurses   

Introduction
Nursing clinical career pathways were first developed in the 1970s in North America in response to the concern that experienced practitioners were leaving direct patient care in search of career fulfilment. Zimmer (1972) noted the lack of acknowledgement for skilled nurses within the system at that time, and the need for some form of recognition to be instated if registered nurses were to be retained. She therefore proposed a framework for the recognition of nursing excellence consisting of three developmental stages: orientation to the setting; linking of previous experiences to current, similar experiences; and providing evidence of being able to handle complex situations and teach others. This framework made an important contribution to the development of Clinical Career Pathways in North America (Roberts, 1999). Continued