The Effectiveness of an Online Learning Strategy on Changing Physical Activity Counseling Practice in Nurses

BACKGROUND

Nurses may be well poised for providing physical activity guidance and support to patients.

PURPOSE

The purposes of this study were to examine the effectiveness of a concise, evidence based online learning modules strategy (OLMS) for improving nurses' physical activity counselling.

METHODS

68 nurses were randomly assigned to either an OLMS group or control group. The OLMS group completed a series of six online learning modules aimed at improving physical activity counselling practice.

RESULTS

The OLMS group, compared to the control group, showed a trend for improvement in Physical Activity Counselling Practice (p = .063) after controlling for baseline values, and significant improvement in (a) Self-efficacy for Physical Activity Counselling (p = .001), (b) Knowledge of Physical Activity Guidelines, (p = .031), and (c) Perceived Benefits of Physical Activity Counselling (p = .014) over the course of the intervention. No significant change was found for Barriers for Providing Physical Activity Counselling (p > .05).

CONCLUSIONS

The OLMS tested may be an effective means for improving self-efficacy, knowledge, and perceived benefits of physical activity counselling, suggesting the utility of online learning strategies for improving nurses' physical activity counselling practice. Given barriers to providing physical activity counselling were not affected by the intervention, future interventions and policy change could target these barriers specifically in order to give nurses more tools and time for reaching patients and addressing physical activity counselling in practice.

Assessment of Counseling Self-Efficacy: Validation of the German Counselor Activity Self-Efficacy Scales-Revised

Background: Many authors regard counseling self-efficacy (CSE) as important in therapist development and training. The purpose of this study was to examine the factor structure, reliability, and validity of the German version of the Counselor Activity Self-Efficacy Scales-Revised (CASES-R). Method: The sample consisted of 670 German psychotherapy trainees, who completed an online survey. We examined the factor structure by applying exploratory and confirmatory factor analysis to the instrument as a whole. Results: A bifactor-exploratory structural equation modeling model with one general and five specific factors provided the best fit to the data. Omega hierarchical coefficients indicated optimal reliability for the general factor, acceptable reliability for the Action Skills-Revised (AS-R) factor, and insufficient estimates for the remaining factors. The CASES-R scales yielded significant correlations with related measures, but also with therapeutic orientations. Conclusion: We found support for the reliability and validity of the German CASES-R. However, the subdomains (except AS-R) should be interpreted with caution, and we do not recommend the CASES-R for comparisons between psychotherapeutic orientations.

Integrating video-modeling into counseling skills and techniques course and its impact on counseling self-efficacy

Counselor education requires a comprehensive curriculum including entry-level courses as counseling skills and techniques which foster students’ basic knowledge in counseling and perceived counseling self-efficacy (CSE). Counselor candidates are provided opportunities to observe skills and techniques in practice through video modeling (VM) as one of the most favored teaching methods. The use of VM is not a common method in counselor training in Turkey; therefore, first aim of the current study was to investigate how VM-integrated counseling skills and techniques course affected students’ perceived counseling techniques efficacy and CSE. The second aim was to gain a deeper understanding of the use of VM as a teaching method in this course. A mixed-methods sequential explanatory design was used. The research setting of the current study was the undergraduate counseling skills and techniques course that integrated 10 previously developed short videos about counseling techniques or processes. There were 41 third-year students enrolled in this course who participated in the study (quantitative phase). Seven voluntary students (out of 41) participated in the focus group (qualitative phase). The paired samples t-test was applied to analyze the effectiveness of VM and the content analyses were conducted to examine qualitative data. Results showed that the VM-integrated course increased students’ perceived efficacy in using techniques and general CSE. Results of the focus group were categorized under four themes and provided critical insights to better understand the factors leading to increased self-efficacy. The results of this study were discussed in the light of previous literature on counselor education.

Evaluation of Online Learning Modules for Improving Physical Activity Counseling Skills, Practices, and Knowledge of Oncology Nurses

PURPOSE/OBJECTIVES

To examine the effectiveness of online learning modules for improving physical activity counseling practices among oncology nurses. 
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DESIGN

Randomized, controlled trial.
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SETTING

Online.
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SAMPLE

54 oncology nurses.
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METHODS

Oncology nurses were randomly assigned to the learning modules group or control group. The learning modules group completed six online learning modules and quizzes focused on physical activity for cancer survivors, general physical activity principles, and motivational interviewing.
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MAIN RESEARCH VARIABLES

Percentage of cancer survivors counseled, self-efficacy for physical activity counseling, knowledge of physical activity, and perceived barriers and benefits of physical activity counseling.
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FINDINGS

Analyses of covariance revealed no significant difference between the learning modules and control groups in the percentage of cancer survivors that oncology nurses counseled. Significant differences were found in self-efficacy for physical activity counseling and perceived barriers to physical activity counseling at postintervention. 
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CONCLUSIONS

The online learning intervention tested in this study improved some parameters of physical activity counseling but did not increase the percentage of cancer survivors that oncology nurses counseled. Additional pilot work is needed to refine the intervention.
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IMPLICATIONS FOR NURSING

This study suggests the potential utility of an evidence-based online learning strategy for oncology nurses that includes information on physical activity and its benefits in cancer survivorship. The findings offer a framework on how to implement physical activity counseling skills in oncology nursing practice.

Review of the Counseling Self-Efficacy Literature

This article provides an integrative review of the counseling self-efficacy (CSE) literature conducted from 1983 to the present. First, the content, structure, and psychometric properties of the four most common constructs across the 32 studies are reviewed. Second, the findings from the literature are integrated into the larger theory by relating CSE to the major components of social cognitive theory, namely, counselor characteristics, personal agency, counselor performance, and the supervision/counseling/work environment. Third, the intervention studies that have been targeted at increasing either CSE estimations or counselor performance are presented. Fourth, studies that have examined and identified significant predictors of CSE are discussed. Fifth, the practical implications for supervisors are discussed. Finally, conclusions and recommendations for future research are presented.

The Practical Aspects of Online Counseling

This article addresses the practical aspects of online counseling, including ethics, training, supervision, technology, and competency issues. The authors discuss online counseling’s strengths and limitations and present guidelines for what types of clients and counseling psychologists may be appropriate for online counseling. To illustrate the components and skills associated with online counseling, the authors present and discuss an example of a synchronous-chat online session.

Managing hindering self-focused attention in counseling sessions

OBJECTIVE

This study examined the moderation effects of management strategies on the association between hindering self-focused attention and counseling self-efficacy.

METHOD

Participants were 160 counselor trainees. A hierarchical regression was used to analyze the data, and a simple effect analysis was used to explore the nature of the interaction.

RESULTS

Results indicated that, for trainees who used more basic counseling techniques, counseling self-efficacy remained the same no matter their hindering self-focused attention experiences. However, for those who used less basic counseling techniques, their counseling self-efficacy dropped when they had more experiences of hindering self-focused attention. Similarly, for trainees who used more self-awareness to understand clients, these trainees reported a similar level of counseling self-efficacy no matter their hindering self-focused attention experiences. Conversely, for those who used less self-awareness as a tool to understand their clients during their sessions, their counseling self-efficacy decreased when they had more experiences of hindering self-focused attention.

CONCLUSION

This is the first study that extends the literature on direct, linear relationships between hindering self-focused attention and counseling self-efficacy. Results suggested two strategies (i.e., use of basic counseling techniques and use of self-awareness to understand clients) significantly moderate the above association.

Mindfulness, Psychological Flexibility, and Counseling Self-Efficacy

The purpose of this study was to explore the mechanism by which counselor trainees’ mindfulness and psychological flexibility are positively associated with counseling self-efficacy. First, it was hypothesized that having fewer experiences of hindering self-focused attention (i.e., counselor trainees’ awareness of their own anxiety and distracting thoughts in sessions) would mediate the association between mindfulness and counseling self-efficacy. Second, it was hypothesized that having fewer experiences of hindering self-focused attention would mediate the association between psychological flexibility and counseling self-efficacy. Participants included 154 graduate counselor trainees. Results supported our hypotheses that counselor trainees with greater mindfulness reported having fewer experiences of hindering self-focused attention, which in turn was positively associated with counseling self-efficacy. Similarly, those with greater psychological flexibility also reported having fewer experiences of hindering self-focused attention, which in turn was positively associated with counseling self-efficacy. These findings were significant after controlling for age and number of practicum courses.

The Rightful Demise of the Sh*t Sandwich: Providing Effective Feedback

Background: As a trainee cognitive therapist in the early 1990s, I was taught the Sh*t Sandwich by my supervisor. I continued to use this technique for many years without seeing the need to extend my repertoire of feedback strategies. Aims: This article describes a number of other feedback techniques, raising awareness of the processes underpinning feedback, and facilitating reflection on feedback methods. Method: This review examines feedback and the methods of feedback used to improve clinical competence. Results: Evidence informs us that the use of good feedback has a significant effect on learners’ outcomes (Milne, 2009). However, despite recognition of its importance, many supervisors fail to give adequate feedback and utilize methods that are sub-optimal. One such problematic method is the notorious “Sh*t Sandwich” (SS), which attempts to hide criticism within a cushion of two positive statements. This paper looks at various models of giving negative and positive feedback, suggesting that our repertoire of feedback methods may require expanding. Conclusion: The review suggests that feedback is a complex process and methods that place an emphasis on the learner as an active participant in the learning process (i.e. interactive approaches) should be encouraged. The paper suggests that negative feedback should generally be avoided in favour of constructive support, accompanied by specific, descriptive, balanced feedback, with new learning being consolidated by role play. Generally, feedback should be given about the task rather than the person, but when it is personalized it should relate to effort rather than ability.

Age, Gender, and Ethnicity of Counsellor Trainees and Corresponding Counselling Self-Efficacy: Research Findings and Implications for Counsellor Educators

This study explored the counselling self-efficacy of students in a counsellor education programme, in regard to age, gender, and ethnicity characteristics. To assess counselling self-efficacy, the Counselling Self-Estimate Inventory (COSE) of Larson et al. (Counsellor Education & Supervision 41: 120-130, 1992) was administered at the end of a semester to counselling students engaged in different stages of a counsellor training program. No significant differences were found in regard to gender and age-group categories, but significant differences were found among ethnic groups. It was found that Asian and White students generally had similar and also lower counselling self-efficacy means than the other ethnic groups in the sample in regard to several counselling-specific categories. Implications for counsellor educators in training counselling students of diverse characteristics are discussed.

A narrative and meta-analytic review of helping skills training: Time to revive a dormant area of inquiry

The authors review previous narrative and meta-analytic reviews on the effectiveness of overall helping skills training programs. The authors then review narrative reviews and conduct a new meta-analysis of specific methods used to teach helping skills within these programs. Our meta-analysis found that, in the aggregate, training methods substantially outperformed no training conditions, and that effect sizes did not vary as a function of trainee educational level (graduate vs. undergraduate students) or the type of criterion measure (interview-based vs. analogue-based empathy measures). Direct comparison of the training methods revealed that modeling outperformed instruction and feedback, and multimethod outperformed single-method training. The authors critique the literature and suggest that the studies in the helping skills literature generally fail to meet contemporary methodological standards, thereby limiting the conclusions that can be drawn. The authors appeal for better research on helping skills training, especially as it is currently practiced. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Workplace Social Self-Efficacy

The authors proposed the construct of workplace social self-efficacy (WSSE) and developed an inventory to measure it. Two empirical studies were conducted to examine the psychometric properties of this new measure. In Study 1, we described the development of the WSSE inventory and explored its factor structure in a sample of 304 full-time employees. Participants in Study 2 were 137 full-time employees (who provided self-report data) and 371 coworkers of these employees (who submitted peer ratings). Results showed that the WSSE inventory had a four-factor structure (social gathering, performance in public contexts, conflict management, and seeking and offering help), high internal consistency, excellent convergent and discriminant validity, and meaningful correlation patterns with related constructs in the nomological network. Furthermore, political skill was found to mediate the relationship between WSSE and several outcome variables. In addition, the WSSE inventory was found to have some advantages over the Perceived Social Self-Efficacy scale (Smith & Betz, 2000), a general social self-efficacy measure. Theoretical and practical implications were discussed.

Therapist Personal Agency: a model for examining the training context

This study reviews the creation and testing of a model of Therapist Personal Agency during MFT training. A model including self-efficacy, trainee developmental level, supervisor working alliance, family of origin relationships, and psychological states was supported by data collected from a national sample of MFT students. The model supported by the data was consistent with much of the previous research regarding the correlates of therapist self-efficacy. Furthermore, the model accounted for 20% of the variance in therapist performance as measured by therapist reports of the working alliance. The results also highlighted the importance of attending to the relationships, interactions, and experiences that take place within the training environment and secondly, the added value that may accrue from focusing on the trainee's extended network of family relationships. A brief case example serves to illustrate the importance of tending to Therapist Personal Agency. In sum, this study provides preliminary support for holistic training methods that focus upon the whole person of the therapist.