Background: The aim of this study is to validate a newly developed nurses' self-efficacy sources inventory. We test the validity of a five-dimensional model of sources of self-efficacy, which we contrast with the traditional four-dimensional model based on Bandura's theoretical concepts. Methods: Confirmatory factor analysis was used in the development of the newly developed self-efficacy measure. Model fit was evaluated based upon commonly recommended goodness-of-fit indices, including the χ2 of the model fit, the Root Mean Square Error of approximation (RMSEA), the Tucker-Lewis Index (TLI), the Standardized Root Mean Square Residual (SRMR), and the Bayesian Information Criterion (BIC). Results: All 22 items of the newly developed five-factor sources of self-efficacy have high factor loadings (range .40-.80). Structural equation modeling showed that a five-factor model is favoured over the four-factor model. Conclusions and implications: Results of this study show that differentiation of the vicarious experience source into a peer- and expert based source reflects better how nursing students develop self-efficacy beliefs. This has implications for clinical learning environments: a better and differentiated use of self-efficacy sources can stimulate the professional development of nursing students.
Competent practice in sport psychology is of utmost importance for the professional status of the field, and hence proper assessment of competence for sport psychology practice is needed. We describe three cycles of action research to improve the assessment of competence in a sport psychology education program. The cycles were directed at (a) empowering supervisors in their assessing role, (b) improving the assessment checklist, and (c) investigating an alternative assessment method. Although challenges remain (e.g., improve the still low interrater reliability), the action research has contributed to an improved quality and higher acceptability of the assessment in the education program.
Background: Clinical reasoning skills are considered to be among the key competencies a physiotherapist should possess. Yet, we know little about how physiotherapy students actually learn these skills in the workplace. A better understanding will benefit physiotherapy education.Objectives: To explore how undergraduate physiotherapy students learn clinical reasoning skills during placements.Design: A qualitative research design using focus groups and semi-structured interviews.Setting: European School of Physiotherapy, Amsterdam, the Netherlands.Participants: Twenty-two undergraduate physiotherapy students and eight clinical teachers participated in this study.Main outcome measures: Thematic analysis of focus groups and semi-structured interviews.Results: Three overarching factors appeared to influence the process of learning clinical reasoning skills: the learning environment, the clinical teacher and the student. Preclinical training failed to adequately prepare students for clinical practice, which expected them to integrate physiotherapeutic knowledge and skills into a cyclic reasoning process. Students’ basic knowledge and assessment structure therefore required further development during the placements. Clinical teachers expected a holistic, multifactorial problem-solving approach from their students. Both students and teachers considered feedback and reflection essential to clinical learning. Barriers to learning experienced by students included time constraints, limited patient exposure and patient communication.Conclusions: Undergraduate physiotherapy students develop clinical reasoning skills through comparison of and reflection on different reasoning approaches observed in professional therapists. Over time, students learn to synthesise these different approaches into their own individual approach. Physiotherapy programme developers should aim to include a wide variety of multidisciplinary settings and patient categories in their clinical placements.
