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.
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There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.
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This speech discusses how the professorship intends to support practitioners in the nursing domain and contribute to shaping nursing leadership and each person's professional individuality. The title of the speech, “Notes on Nursing 2.0,” is particularly intended to emphasize the need for these changes in the nursing domain. Not by assuming that nothing has changed in care and nursing since Nightingale's time. There has. Being educated in the professional domain is not only a given but a requirement. The knowledge domain of care and nursing has developed far and wide in nursing diagnostics and standards. Nursing science research, which Nightingale once started as the first female statistician in the British Kingdom, has firmly established itself in education and practice. Wanting to be of significance to others out of compassion is still the professional motivation, but there is no longer a subservient servitude (Cingel van der, 2012). At the same time, wholehearted leadership is not yet taken for granted in daily practice and optimal professional practice falters due to an equality principle of differently educated caregivers and nurses that has been held for too long. That is the need for change to which this 2.0 version “Notes on Nursing” and the lectorate want to contribute in the coming years. Chapter 1, through the metaphors in the story “The Cat Who Looked at the King,” describes the vision of emancipatory action research and the change principles that the lectorate will deploy. Chapter 2 contains the reason, mission and lines of research that are interrelated within the lectorate. Chapters 3 and 4 address the themes of identity and leadership, discussing their interrelationship with professional practice and developing a research culture. In addition, specific aspects that influence practice and work culture today are addressed, and how the lectorate contributes specifically to the development of nursing leadership and the formation of professional identity in the relevant domain is described. Chapter 5 contains a summary of the principles on which the research program is based, as well as information on current and future projects. Chapter 6 provides background information on the lector and the members of the knowledge circle.
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BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.
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Community care is becoming increasingly important. In the Netherlands, the percentage of people over the age of 65 is expected to increase to 22% by 2025, leading to more elderly patients, often with long-term and complex health problems (multimorbidity). Because many of these patients continue to live at home until a very old age, nurses are increasingly working outside of institutions. The 17 Dutch Bachelor nursing programmes responded to this development with a new national education profile 'Bachelor Nursing 2020 (BN2020)’ with more elements of community care. However, despite the increase in extramural care, the Dutch labour market has a shortage of community nurses with higher professional education qualifications, partly because most nursing students focus on the general hospital setting as the environment for their future career. Whether this is based on a perception of community care that deters making this choice has never been systematically investigated. It is also unclear whether a more community-oriented curriculum will better equip students for working in community care. In response to these issues, the nursing programme at the Amsterdam University of Applied Sciences (AUAS) redesigned its curriculum to include more elements of community care. Three perspectives were chosen for the redesign: (1) the influence of lecturers as role models, (2) positive placement experiences, and (3) five new ‘community-based’ themes in education. These new themes are as follows: patient self-management, shared decision-making, collaboration with the patients’ social system, healthcare technology, and allocation of care. The redesign also includes a ‘paved way’ into community care in the form of a coherent and attractive programme for interested students.This thesis describes whether and how the curriculum-redesign within higher professional education in nursing can be effective in terms of (1) stimulating a positive perception of community care and (2) realising a form of community care in line with the new themes in BN2020. In other words, that students will base choices in their actions/nursing interventions on these new themes in the education profile.
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Objective: To obtain insight into (a) the prevalence of nursing staff–experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff–perceived promotion of functional activity. Method: Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. Results: Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. Discussion: Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff–perceived promotion of functional activity.
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Nursing Leadership is an important competence to develop in order to provide quality of care and prevent attrition of nurses. This research program looked into the perceptions and experiences of nurses on practising leadership. Next to that supporting the development of nursing leadership was addressed. The program has a mixed-method, action research design in which 75 in-depth interviews and 24 focus group interviews and quantitative data of 435 nurses form the backbone. According to hospital nurses, nursing leadership is related to proactiveness and voicing expertise in order to deliver good nursing care. Nevertheless, they do not feel fully competent and knowledge deficits were detected on aspects of the bachelor nursing profile, such as evidence based practice. Working-culture factors can either inhibit or encourage nursing leadership. The further awareness of unconsciously using expertise and knowledge deficits as well as team development towards a continuous safe learning environment are necessary steps for the enhancement of nursing leadership. A Nursing Leadership model was developed in which generic personal leadership competencies combined with expertise of the nurses' level of education and degrees form the essence of shared leadership in teams focussed on the realisation of good nursing care.
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This ‘Big Ideas’ paper will explore the relevance of the constraintsled approach (Davids et al., 2008) for nurse education, specifically when teaching nursing skills. The constraints-led approach is an applied theory, based on the ecological-dynamics framework, which explains that skill learning is a process of adjusting to the characteristics of a situation, instead of reproducing isolated, “ideal” movements out of context (Araújo et al., 2017; Seifert et al., 2017, 2019). During nurse education however, students often find themselves in isolated practice drills in which they practice a nursing skill based upon detailed protocols and/or explicit instructions by the lecturer. Following the ecological dynamics framework (Button et al., 2021), we argue that there is no single ideal way of executing a certain task. In clinical practice, there are often more than one appropriate task executions for a certain situation, and on the other hand, a certain task execution might be effective in one situation, but less effective in another. As all patients and contexts contain unique characteristics, students need to practice with representative characteristics from clinical practice, so that they learn attuning to contextual information, instead of simply following step-by-step instructions (Fajen et al., 2009; Pinder et al., 2011; Wulf and Lewthwaite, 2016).
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De bacheloropleidingen Verpleegkunde in Nederland staan voor de uitdaging het nieuwe beroepsprofiel Bachelor Nursing 2020 te vertalen naar het onderwijs. Een deel van het nieuwe curriculum gaat over de inzet van eHealth. In dit document worden 14 verpleegkundige beroepstaken omschreven waarbij eHealth wordt ingezet. Beschreven wordt welke kennis, vaardigheden en houding van een verpleegkundige worden gevraagd om elke eHealth-taak zelfstandig uit te voeren. Elke taak wordt gekoppeld aan kernbegrippen van Bachelor Nursing 2020 en aan relevante CanMEDS-rollen.
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A B S T R A C T Background: Approximately 4 years ago a new concept of learning in practice called the ‘Learning and Innovation Network (LIN)’ was introduced in The Netherlands. To develop a definition of the LIN, to identify working elements of the LIN in order to provide a preliminary framework for evaluation, a concept analysis was conducted. Method: For the concept analysis, we adopted the method of Walker and Avant. We searched for relevant publications in the EBSCO host portal, grey literature and snowball searches, as well as Google internet searches and dictionary consults. Results: Compared to other forms of workplace learning, the LIN is in the centre of the research, education and practice triangle. The most important attributes of the LIN are social learning, innovation, daily practice, reflection and co-production. Often described antecedents are societal developments, such as increasing complexity of work, and time and space to learn. Frequently identified consequences are an attractive workplace, advancements of expertise of care professionals, innovations that endorse daily practice, improvement of quality of care and the integration of education and practice. Conclusions: Based on the results of the concept analysis, we describe the LIN as ‘a group of care professionals, students and an education representatives who come together in clinical practice and are all part of a learning and innovation community in nursing. They work together on practice-based projects in which they combine best practices, research evidence and client perspectives in order to innovate and improve quality of care and in which an integration of education, research and practice takes place’. We transferred the outcomes of the concept analysis to an input-throughput-output model that can be used as a preliminary framework for future research.
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