Vastavalmistuneen sairaanhoitajan ammatillisen pätevyyden kehittymisen tukeminen siirtymävaiheen aikana: Hypoteettinen perehdytysmalli

Kirsi Lindfors

Research output: Book/ReportDoctoral thesisCollection of Articles

Abstract

Orientation can be seen as one way to strengthen a new graduate registered nurse’s (hereafter NGRN) commitment to the organisation and work community. A successful preceptorship relationship creates a safe working environment where the NGRN can practice their clinical knowledge and skills acquired during nursing studies, find and strengthen their professional identity, and become part of the work community. Orientation is a part of the NGRN’s longer transition period from a beginner to a nursing professional. During this transition, the NGRN needs support and encouragement, education and guidance, and constructive feedback from their preceptor, the work community and the superior.

In this study, the target group was both preceptors and NGNRs. The aim was to study preceptors’ perception of the elements of successful and unsuccessful orientation and NGRNs’ preceptorship experiences and professional competence development after an education intervention developed for preceptors. The objective was to develop a hypothetical model for good orientation that would support NGRNs’ professional competence development during the transition period. The objective was also to produce information to be used for developing orientation from a more comprehensive perspective.

A quasi-experimental study design was used. Participating wards were randomly assigned to intervention (n = 28) and control groups (n = 22). The study permit was applied according to the organisation’s policies. Preceptors (n = 174) from the intervention group got an 8-hour education entity about NGRN’s first year, preceptor’s role and responsibilities, how to support NGRN’s critical thinking abilities, how to give constructive feedback, and how to support NGRN during their orientation period. The data were collected from NGRNs at three measurement points: at the baseline (95 participants), at 3- months (72 participants), and at 9- months (61 participants) by using the Nurse Competence Scale (NCS) at all three measurement points and the Clinical Learning Environment Supervision and Nurse Teacher Scale (CLES+T) at the 3-month measurement point. The preceptors’ viewpoints about orientation were collected by using a SWOT- analysis tool.

More than a half (53.6 %, n = 51) of the participants were from 20 to 25 years of age and 54.7 % (n = 52) worked in inpatient wards. The participants were quite satisfied with the orientation given. Orientation was individualized and supported NGRNs’ professional competence development. The atmosphere of the nursing wards and the supervisory relationship were very good and the premises of nursing on the ward and the premises of learning on the ward were assessed as a good. NGRNs from the control group were more satisfied with the ward atmosphere and supervisory relationship than NGRNs from the intervention group. Self-assessed professional competence level remained at good level during the follow-up period. Professional competence development occurred in every competence category: however, the most development occurred in the categories Teaching-coaching, Diagnostic functions, Therapeutic interventions, Ensuring quality and Work role. When comparing the intervention and control group NGRNs, there was no statistical difference between the groups at the end of the follow-up period. Also, the effect size remained small.

A hypothetical model for good orientation was developed from the data of research articles I and II by using a deductive-inductive content analysis. The hypothetical model can be used to support and enhance NGRN’s professional competence development during the transition phase. According to this model, orientation should be goal-oriented, individualized, timely supported, and adequately resourced. The work community should provide support to both preceptor and NGRN and take part in NGRN’s orientation. The preceptor should act as a role model and create a safe working environment for the NGRN. The orientation program ensures theoretical and clinical training during NGRN’s orientation period and the superior’s role is to make sure that NGRN’s orientation period runs smoothly. The work environment should enable NGRN’s orientation to take place. Additionally, educational and labour policy decisions on the part of society have their own effects on orientation as well. The developed hypothetical model for good orientation gives an opportunity to observe NGRN’s orientation from a new point of view. In the next phase, this developed model should be tested and developed further in order to obtain an orientation model that supports NGRN’s professional competence development during their transition phase in a more comprehensive way than before.
Original languageFinnish
Place of PublicationTampere
ISBN (Electronic)978-952-03-3022-4
Publication statusPublished - 2023
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
Volume847
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028

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