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Melissant HC, Hendriks RRA, Bakker EJM, Kox JHAM, Rietveld N, Miedema HS, Roelofs PDDM, Verhaegh KJ. Interventions that support novice nurses' transition into practice: A realist review. Int J Nurs Stud 2024; 157:104785. [PMID: 38843645 DOI: 10.1016/j.ijnurstu.2024.104785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Many transition-to-practice programs have been developed to support novice nurses during their first years into practice. These programs report improvements in retention, wellbeing and clinical competence, but the driving mechanisms of these interventions remain largely unclear. OBJECTIVE To identify how transition-to-practice programs for novice nurses work and in what contexts they work successfully. METHODS A realist review was conducted. Eligibility criteria included intervention studies aimed at novice nurses in their first two years of practice that reported outcomes on organizational or individual nurse level. The underlying theory of included transition-to-practice programs was extracted, and relevant contextual factors, mechanisms and outcomes were explored and synthesized into context-mechanism-outcome (CMO) configurations. The search was limited to studies between 2000 and 2023. RESULTS A total of 32 studies were included, evaluating 30 different transition-to-practice programs with a wide range of intervention components including stress management, clinical education, professional and peer support, and ward rotations. Transition-to-practice programs were often designed without a theoretical foundation. Driving mechanisms behind the programs pertained to psychological, professional, and social development. Contextual factors that activated the mechanisms were enabling conditions for mentors and novice nurses, selection and motivation of novice nurses and organizational culture. CONCLUSIONS Current transition-to-practice programs primarily focus on the individual and professional development of nurses. However, transition to practice can benefit from a systemic approach that includes development initiatives on the organizational level. REGISTRATION PROSPERO ID CRD42021268080, August 15, 2021. TWEETABLE ABSTRACT Context and mechanisms determine successful implementation of transition to practice programs for novice nurses. @transitiontopractice @nurseworkforce.
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Affiliation(s)
- Heleen C Melissant
- Leiden University of Applied Sciences, Department of Health, Zernikedreef 11, Postbus 382, 2300 AJ Leiden, the Netherlands
| | - Rick R A Hendriks
- Leiden University of Applied Sciences, Department of Health, Zernikedreef 11, Postbus 382, 2300 AJ Leiden, the Netherlands
| | - Ellen J M Bakker
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - Jos H A M Kox
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Natasja Rietveld
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Department of Health Sciences, Nursing Science and Education, A. Deusinglaan 1, 9713 AV Groningen, the Netherlands
| | - Kim J Verhaegh
- Leiden University of Applied Sciences, Department of Health, Zernikedreef 11, Postbus 382, 2300 AJ Leiden, the Netherlands; Alrijne Hospital, Department of Alrijne Academy, Simon Smitweg 1, 2353 GA Leiderdorp, the Netherlands.
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Tomooka M, Matsumoto C, Maeda H. Effectiveness of a preceptors' social support program to aid novice nurses' error experience on preceptors' skill and novice nurses' perception of social support: A quasi-experimental study. Jpn J Nurs Sci 2024; 21:e12563. [PMID: 37749995 DOI: 10.1111/jjns.12563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023]
Abstract
AIM To evaluate the effectiveness of the preceptors' social support program (PSSP) on preceptors' social support skill-supportive relationships and post-error support-and novice nurses' perception of received social support. METHODS This study employed a quasi-experimental pretest-posttest design with a control group of a non-random assigned sample of 47 preceptors and novice nurses and an intervention group of 48 each. Intervention group preceptors received training in building supportive relationships skill and post-error support skills three times in the PSSP over 7 months. Preceptors' social support skill and novice nurses' perception of received social support were measured as primary outcomes. Data were collected at baseline (T0), 1 month after the second session (T1), and 1 month after the last session (T2) and analyzed. RESULTS No significant differences in demographics or scores were shown at baseline (T0). Preceptors in the intervention group showed significantly better supportive relationships (T2, 101.6 ± 9 vs. 96.9 ± 7.6, 95% CI [0.95, 8.42], p = .015) and better performance of post-error support (T2, 67.6 ± 5 vs. 62 ± 6.5, 95% CI [2.78, 8.32], p < .001). Intervention group preceptors' social support skill increased or remained stable, while it decreased over time in the control group. Novice nurses in the intervention group received significantly better supportive relationships and post-error support from preceptors (T2, median 112 vs. 101, p = .007; 70.5 vs. 65, p = .028, respectively). CONCLUSIONS The PSSP improved preceptors' supportive relationship skills and post-error support performance, leading to novice nurses' perceptions of better supportive relationships and receiving greater post-error support.
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Affiliation(s)
- Misa Tomooka
- Doctoral Program in Nursing, Graduate School of Health Science, Kumamoto University, Kumamoto, Japan
| | - Chiharu Matsumoto
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Budden AK, Song S, Henry A, Nesbitt-Hawes E, Wakefield CE, Abbott JA. Acute Biological Changes in Gynecologic Surgeons during Surgery: A Prospective Study. J Minim Invasive Gynecol 2023; 30:841-849. [PMID: 37379897 DOI: 10.1016/j.jmig.2023.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
STUDY OBJECTIVE To assess changes in biological measures of acute stress in surgeons during surgery in real-world settings DESIGN: A prospective cohort study. SETTING A tertiary teaching hospital. PATIENTS 8 consultant and 9 training gynecologists. INTERVENTION A total of, 161 elective gynecologic surgeries of 3 procedures: laparoscopic hysterectomy, laparoscopic excision of endometriosis, or hysteroscopic myomectomy. MEASUREMENTS AND MAIN RESULTS Changes in surgeons' biological measures of acute stress while undertaking elective surgery. Salivary cortisol, mean and maximum heart rate (HR), and indices of the HR variability were recorded before and during surgery. From baseline to during surgery over the cohort, salivary cortisol decreased from 4.1 nmol/L to 3.6 nmol/L (p = .03), maximum HR increased from 101.8 beats per min (bpm) to 106.5 bpm (p <.01), root mean square of standard deviation decreased from 51.1 ms to 39.0 ms (p <.01), and standard deviation of beat-to-beat variability decreased from 73.7 to 59.8 ms (p <.01). Analysis of individual changes in stress by participant-surgery event by paired data graphs reveal inconsistent direction of change in all measures of biological stress despite stratification by surgical experience, role in surgery, level of training, or type of surgery performed. CONCLUSION This study measured biometric stress changes at both a group and individual level in real-world, live surgical settings. Individual changes have not previously been reported and the variable direction of stress change by participant-surgery episode identified in this study demonstrates a problematic interpretation of mean cohort findings previously reported. Results from this study suggest that either live surgery with tight environment control or surgical simulation studies may identify what, if any, biological measures of stress can predict acute stress reactions during surgery.
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Affiliation(s)
- Aaron K Budden
- School of Clinical Medicine, University of New South Wales, Sydney, Australia (Drs. Budden, Song, Henry, Nesbitt-Hawes, Wakefield, and Abbott); Gynecology Research and Clinical Excellence, Royal Hospital for Women, Sydney, Australia (Drs. Budden, Song, Nesbitt-Hawes, and Abbott).
| | - Sophia Song
- School of Clinical Medicine, University of New South Wales, Sydney, Australia (Drs. Budden, Song, Henry, Nesbitt-Hawes, Wakefield, and Abbott); Gynecology Research and Clinical Excellence, Royal Hospital for Women, Sydney, Australia (Drs. Budden, Song, Nesbitt-Hawes, and Abbott)
| | - Amanda Henry
- School of Clinical Medicine, University of New South Wales, Sydney, Australia (Drs. Budden, Song, Henry, Nesbitt-Hawes, Wakefield, and Abbott); Department of Women's and Children's Health, St George Hospital, Sydney, Australia (Dr. Henry)
| | - Erin Nesbitt-Hawes
- School of Clinical Medicine, University of New South Wales, Sydney, Australia (Drs. Budden, Song, Henry, Nesbitt-Hawes, Wakefield, and Abbott); Gynecology Research and Clinical Excellence, Royal Hospital for Women, Sydney, Australia (Drs. Budden, Song, Nesbitt-Hawes, and Abbott)
| | - Claire E Wakefield
- School of Clinical Medicine, University of New South Wales, Sydney, Australia (Drs. Budden, Song, Henry, Nesbitt-Hawes, Wakefield, and Abbott); Kids Cancer Center, Sydney Children's Hospital, Sydney, Australia (Dr. Wakefield)
| | - Jason A Abbott
- School of Clinical Medicine, University of New South Wales, Sydney, Australia (Drs. Budden, Song, Henry, Nesbitt-Hawes, Wakefield, and Abbott); Gynecology Research and Clinical Excellence, Royal Hospital for Women, Sydney, Australia (Drs. Budden, Song, Nesbitt-Hawes, and Abbott)
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Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
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Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Sharma R, Badyal DK, Sharma R, Seth S, Singh M. Implementation of One-Minute Preceptor for Clinical Teaching in Obstetrics and Gynaecology. J Obstet Gynaecol India 2023; 73:69-76. [PMID: 36879933 PMCID: PMC9984615 DOI: 10.1007/s13224-022-01718-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 10/05/2022] [Indexed: 03/06/2023] Open
Abstract
Background In absence of a dedicated teaching curriculum for non-PG residents in Obstetrics and Gynecology department, a concise teaching learning method, One-Minute Preceptor (OMP) with feedback being its core component may be introduced to translate their theoretical knowledge into clinical practice. Methods This descriptive cross-sectional study included four faculty members and 20 residents. Each resident was exposed to three OMP sessions pertaining to common gynecological case scenarios with a gap of at least two days in between the sessions with faculties acting as preceptor and as observer. After three OMP sessions, feedback from residents and faculty regarding their teaching and learning experience after implementing this tool was obtained through separate pre-validated questionnaires graded on Likert's scale. Results The satisfaction index of the residents and faculties for OMP was found to be 96.3% and 95%, respectively. All residents and faculty members had consensus that OMP addressed the learning gaps (mean score 4.45 ± 0.51 and mean score 4.5 ± 0.57, respectively) and expressed being highly satisfied with OMP in busy clinical settings as compared to traditional method of teaching with mean score of 4.9 ± 0.30 and 4.75 ± 0.5, respectively. The faculties had consensuses that OMP can assess all domains of learning (mean score 4.75 ± 0.5). All residents and faculties opined that the time allotted to address all micro-skills was less and 60% residents advocated allotting at least 5 min time to the teaching encounter. Conclusion Our study indicates the beneficial role of OMP in time-constraint clinical environment and warrants further research to review the time frame keeping in view the learners' needs and the discipline.
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Affiliation(s)
- Ritu Sharma
- Department of Obstetrics & Gynecology, Government Institute of Medical Sciences, Greater Noida, UP 201310 India
| | - Dinesh K. Badyal
- Department of Pharmacology& Medical Education, Christian Medial College, Ludhiana, 141008 India
| | - Rakhee Sharma
- Department of Obstetrics & Gynecology, Government Institute of Medical Sciences, Greater Noida, UP 201310 India
| | - Shikha Seth
- Department of Obstetrics & Gynecology, Government Institute of Medical Sciences, Greater Noida, UP 201310 India
| | - Monika Singh
- Department of Obstetrics & Gynecology, Government Institute of Medical Sciences, Greater Noida, UP 201310 India
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Smith LC, Watson H, Fair L, Carter G, Mackay P, Lykens K, Bradstock J, Arnold K, Whalen M. Evidence-based practices in developing and maintaining clinical nurse preceptors: An integrative review. NURSE EDUCATION TODAY 2022; 117:105468. [PMID: 35863086 DOI: 10.1016/j.nedt.2022.105468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/16/2022] [Accepted: 07/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This integrative review of literature explores the best practice for establishing and maintaining a hospital-based nurse preceptor program. The intent is to provide nurse leadership and educators with guidance for optimizing preceptor programs in order to improve patient, staff, and organizational outcomes. DESIGN The project team conducted an integrative review of literature to inform best practice using the Johns Hopkins Evidence-Based Practice Model and Guidelines. DATA SOURCES Data sources included the PubMed, CINAHL, and Cochrane databases. REVIEW METHODS Each applicable article underwent a rigorous review and appraisal by the project team. The team used the Johns Hopkins Evidence-Based Practice Model to guide the appraisal process and to synthesize results to generate a comprehensive list of recommendations. RESULTS The search yielded 115 unique articles that answered the evidence-based practice question. What are best practices for establishing and maintaining a hospital-based nursing preceptor program? Due to the abundance of data, the practice question was divided into three separate sub questions that explored preceptor development, continuous preceptor support, and essential competencies of preceptors. Relevant evidence included one level I article, seven level II articles, and one level IV article. Most of the evidence was found in articles ranking as level III (n = 54) and level V (n = 52). CONCLUSIONS Many preceptorship themes and recommendations resonate throughout multiple levels of evidence. Recommendations include implementing an evidence-based, standardized curriculum that features diverse teaching modalities, critical thinking, and clinical reasoning. Common themes in the literature echo that preceptors need ongoing education, training, and support to improve nursing satisfaction, retention, and the quality of nursing care.
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Affiliation(s)
- Lisa C Smith
- Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
| | | | - Linda Fair
- Johns Hopkins Health System, Baltimore, MD, USA.
| | - Grace Carter
- Johns Hopkins Hospital, Bloomberg Children's Center, Baltimore, MD, USA.
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Jarden RJ, Jarden A, Weiland TJ, Taylor G, Bujalka H, Brockenshire N, Gerdtz MF. New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review. Int J Nurs Stud 2021; 121:103997. [PMID: 34218048 DOI: 10.1016/j.ijnurstu.2021.103997] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/30/2021] [Accepted: 05/29/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice. OBJECTIVE To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health. DESIGN Systematic review of quantitative research. DATA SOURCES Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health. REVIEW METHODS Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis. RESULTS Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity. CONCLUSIONS For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).
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Affiliation(s)
- Rebecca J Jarden
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia.
| | - Aaron Jarden
- Centre for Positive Psychology, Melbourne Graduate School of Education, The University of Melbourne, Kwong Lee Dow Building, 234 Queensberry Street, Parkville VIC, Melbourne 3053, Australia.
| | - Tracey J Weiland
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton VIC, Melbourne 3053, Australia.
| | - Glenn Taylor
- Nursing and Midwifery Health Program, Victoria, Australia.
| | - Helena Bujalka
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia.
| | - Naomi Brockenshire
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia.
| | - Marie F Gerdtz
- Professor and Head of Department, Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia.
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Kim JH, Shin HS. Exploring barriers and facilitators for successful transition in new graduate nurses: A mixed methods study. J Prof Nurs 2020; 36:560-568. [DOI: 10.1016/j.profnurs.2020.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 12/01/2022]
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Bakker EJM, Kox JHAM, Boot CRL, Francke AL, van der Beek AJ, Roelofs PDDM. Improving mental health of student and novice nurses to prevent dropout: A systematic review. J Adv Nurs 2020; 76:2494-2509. [PMID: 32538480 PMCID: PMC7540364 DOI: 10.1111/jan.14453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 01/03/2023]
Abstract
Aims To provide: (a) an overview of interventions aimed at improving mental health of student or novice nurses; and (b) an evaluation of their effectiveness on dropout‐related outcomes. Design Systematic review. Data sources Research papers published between January 1971–February 2019 were identified from the following databases: Embase, Medline, PsycInfo, CINAHL, ERIC, the Cochrane Library, Web of Science, and Google Scholar. Review methods We followed the procedures recommended by the Editorial Board of the Cochrane Collaboration Back Review Group. We included peer‐reviewed articles with a quantitative research design, examining interventions aimed at improving mental health of student and novice nurses and their effect on dropout‐related outcomes. The large variation in studies prohibited statistical pooling and a synthesis without meta‐analysis of studies was performed. Results We identified 21 studies with three areas of focus: managing stress or stressors (N = 4); facilitating the transition to nursing practice (N = 14); and a combined approach (N = 3). Five studies showed a statistically significant effect on dropout‐related outcomes. The overall risk of bias was high. Conclusion A wide range of interventions are available, but the evidence for their effectiveness is limited. There is a need for high‐quality studies in this field, preferably with a randomized controlled design.
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Affiliation(s)
- Ellen J M Bakker
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jos H A M Kox
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of General Practice, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,NIVEL Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pepijn D D M Roelofs
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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10
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Pierce C, Corral J, Aagaard E, Harnke B, Irby DM, Stickrath C. A BEME realist synthesis review of the effectiveness of teaching strategies used in the clinical setting on the development of clinical skills among health professionals: BEME Guide No. 61. MEDICAL TEACHER 2020; 42:604-615. [PMID: 31961206 DOI: 10.1080/0142159x.2019.1708294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Literature describing the effectiveness of teaching strategies in the clinical setting is limited. This realist synthesis review focuses on understanding the effectiveness of teaching strategies used in the clinical setting.Methods: We searched ten databases for English language publications between 1 January 1970 and 31 May 2017 reporting effective teaching strategies, used in a clinical setting, of non-procedural skills. After screening, we used consensus to determine inclusion and employed a standardised instrument to capture study populations, methodology, and outcomes. We summarised what strategies worked, for whom, and in what settings.Results: The initial search netted 53,642 references after de-duplication; 2037 were retained after title and abstract review. Full text review was done on 82 references, with ultimate inclusion of 25 publications. Three specific teaching strategies demonstrated impact on educational outcomes: the One Minute Preceptor (OMP), SNAPPS, and concept mapping. Most of the literature involves physician trainees in an ambulatory environment. All three have been shown to improve skills in the domains of medical knowledge and clinical reasoning.Discussion/conclusions: Apart from the OMP, SNAPPS, and concept mapping, which target the formation of clinical knowledge and reasoning skills, the literature establishing effective teaching strategies in the clinical setting is sparse.
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Affiliation(s)
- Cason Pierce
- Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
| | - Janet Corral
- Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
| | - Eva Aagaard
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Ben Harnke
- Strauss Health Sciences Library, University of Colorado Anschutz, Aurora, CO, USA
| | - David M Irby
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Chad Stickrath
- Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
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11
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Sidhu NS, Edwards M. Deliberate teaching tools for clinical teaching encounters: A critical scoping review and thematic analysis to establish definitional clarity. MEDICAL TEACHER 2019; 41:282-296. [PMID: 29703088 DOI: 10.1080/0142159x.2018.1463087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE AND METHOD We conducted a scoping review of tools designed to add structure to clinical teaching, with a thematic analysis to establish definitional clarity. RESULTS Six thousand and forty nine citations were screened, 434 reviewed for eligibility, and 230 identified as meeting study inclusion criteria. Eighty-nine names and 51 definitions were identified. Based on a post facto thematic analysis, we propose that these tools be named "deliberate teaching tools" (DTTs) and defined as "frameworks that enable clinicians to have a purposeful and considered approach to teaching encounters by incorporating elements identified with good teaching practice." We identified 46 DTTs in the literature, with 38 (82.6%) originally described for the medical setting. Forty justification articles consisted of 16 feedback surveys, 13 controlled trials, seven pre-post intervention studies with no control group, and four observation studies. Current evidence of efficacy is not entirely conclusive, and many studies contain methodology flaws. Forty-nine clarification articles comprised 12 systematic reviews and 37 narrative reviews. The most number of DTTs described by any review was four. A common design theme was identified in approximately three-quarters of DTTs. CONCLUSIONS Applicability of DTTs to specific alternate settings should be considered in context, and appropriately designed justification studies are warranted to demonstrate efficacy.
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Affiliation(s)
- Navdeep S Sidhu
- a Department of Anaesthesia and Perioperative Medicine , North Shore Hospital , Auckland , New Zealand
- b Department of Anaesthesiology , University of Auckland , Auckland , New Zealand
| | - Morgan Edwards
- a Department of Anaesthesia and Perioperative Medicine , North Shore Hospital , Auckland , New Zealand
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12
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Piccinini CJ, Hudlun N, Branam K, Moore JM. The Effects of Preceptor Training on New Graduate Registered Nurse Transition Experiences and Organizational Outcomes. J Contin Educ Nurs 2019; 49:216-220. [PMID: 29701863 DOI: 10.3928/00220124-20180417-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/21/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND New graduate RNs (NGRNs) may experience difficulties in their transition to independent practice. The main role of preceptors is to guide, validate, and supervise the care that NGRNs provide. However, preceptors may not receive training to serve in the role. METHOD A literature review of the past 5 years was conducted, with 10 articles meeting the inclusion criteria to analyze the effects of preceptor training on NGRN outcomes. RESULTS Ten studies indicated a range of positive effects of preceptor training on NGRN transition experiences and organizational outcomes, including critical thinking and retention. Findings on NGRNs' stress levels are contradictory and ambiguous. CONCLUSION A variety of positive outcomes can be realized for NGRNs who partner with formally trained preceptors. J Contin Educ Nurs. 2018;49(5):216-220.
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13
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Noviyanti LW, Handiyani H, Gayatri D. Improving the implementation of patient safety by nursing students using nursing instructors trained in the use of quality circles. BMC Nurs 2018; 17:53. [PMID: 30574017 PMCID: PMC6299492 DOI: 10.1186/s12912-018-0318-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background It is recognised worldwide that the skills of nursing students concerning patient safety is still not optimal. The role of clinical instructors is to instil in students the importance of patient safety. Therefore, it is important to have competent clinical instructors. Their experience can be enhanced through the application of quality circles. This study identifies the effect of quality circles on improving the safety of patients of nursing students. Patient safety is inseparable from the quality of nursing education. Existing research shows that patient safety should be emphasised at all levels of the healthcare education system. In hospitals, the ratio between nursing students and clinical instructors is disproportionately low. In Indonesia, incident data relating to patient safety involving students is not well documented, and the incidents often occur in the absence of a clinical instructor. Methods This study used a quasi-experimental research design with pre-test and post-test non-equivalent control groups. The aim of the project was to explore the implications of the quality circle on clinical instructors by comparing the students’ knowledge, attitudes, and practices of control and intervention groups. A questionnaire will be conducted to evaluate the implementation of patient safety and the impact of the intervention. The data were statistically analysed using independent t tests. The intervention was the implementation of quality circles that focused on patient safety issues for the use of clinical instructors to assess and guide student nurse behaviour in regard to patient safety. The authors of this study trained the clinical instructors on how to use quality circle methods to solve nursing problems especially with relevance to the patient safety issues of students. Results The results showed a significant increase in the behaviour of nursing students towards patient safety issues (p < 0.001; α = 0.05). Conclusions The implementation of quality circles has a significant effect on patient safety. Therefore, it is recommended to implement quality circles as a problem-solving technique to optimize patient safety.
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Affiliation(s)
- Linda Wieke Noviyanti
- 1Nursing Management Department, Brawijaya University, Malang, East Java 65145 Indonesia
| | - Hanny Handiyani
- 2Basic Nursing Department, University of Indonesia, Depok, West Java 16424 Indonesia
| | - Dewi Gayatri
- 2Basic Nursing Department, University of Indonesia, Depok, West Java 16424 Indonesia
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14
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Li W, Kou C. Prevalence and correlates of psychological stress among teachers at a national key comprehensive university in China. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2018; 24:7-16. [PMID: 30047833 DOI: 10.1080/10773525.2018.1500803] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study investigated the levels of stress and associated factors in university teachers to provide a foundation for exploring strategies for preventing teacher stress. We conducted a cross-sectional survey using a composite questionnaire with the 10-item Kessler Psychological Distress Scale (K10) as the core at a comprehensive university located in northeast China. The number of effective respondents was 603. The average K10 score was 22.87 ± 8.18, and the positive rate (K10 > 21) was 54.06%. University teachers generally experienced high stress levels. The highest stress levels were observed in teachers whose academic title was lecturer or associate professor, according to a comprehensive consideration of several factors, including age, income, and teaching tenure. Teachers of engineering and agriculture and forestry have lower stress levels than teachers of other subjects. A lack of research funding and lack of routine rest on the weekends or on statutory holidays may increase teachers' stress, whereas regular exercise may reduce stress. Academic title promotion, scientific research pressure, and lack of routine breaks and physical exercise were the main sources of stress.
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Affiliation(s)
- Wenjun Li
- a Department of Social Medicine and Health Management, School of Public Health , Jilin University , Changchun , China
| | - Changgui Kou
- b Department of Epidemiology and Biostatistics, School of Public Health , Jilin University , Changchun , China
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15
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Chang Y, Lam C, Chung MH. Influence of new hire transition workload on insomnia in nurses. Int J Nurs Pract 2018; 24:e12666. [PMID: 29956406 DOI: 10.1111/ijn.12666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/29/2017] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
AIMS In this study, we investigated the relationship of the prevalence and incidence of insomnia with the new hire transition workload in nurses. METHODS This retrospective study used the clinical diagnosis data of the entire nursing population in Taiwan for 2005 to 2008, drawn from the National Health Insurance Research Database. Adjusted logistic regression and Cox regression models were used to separately analyse factors related to the prevalence and incidence of insomnia. RESULTS During this period, the prevalence of insomnia increased, whereas its incidence remained stable. After adjustment for demographic variables in the logistic regression models, the higher prevalence of insomnia was associated with a longer employment duration and a higher new hire ratio. In the Cox regression models, a higher incidence of insomnia was associated with a shorter employment duration and a higher new hire ratio. Nurses with a longer employment duration had a higher prevalence, but lower incidence, of insomnia. A higher new hire ratio was associated with a higher prevalence and incidence of insomnia. CONCLUSION To mitigate the risk of insomnia, we suggest that additional support should be provided to non-new nurses to assist them in the new hire transition.
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Affiliation(s)
- Yuanmay Chang
- Institution of Long Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Calvin Lam
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
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Kang CM, Chiu HT, Lin YK, Chang WY. Development of a situational initiation training program for preceptors to retain new graduate nurses: Process and initial outcomes. NURSE EDUCATION TODAY 2016; 37:75-82. [PMID: 26710995 DOI: 10.1016/j.nedt.2015.11.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/09/2015] [Accepted: 11/17/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Most preceptor training programs consist of classroom-based courses, and only a few programs are conducted using films. Preceptors have identified most training courses as inapplicable in various clinical situations. OBJECTIVES To describe the systematic development of a situational initiation training program (SITP) for preceptors and to evaluate its impacts on the stress levels of preceptors and new graduate nurses (NGNs), the preceptor-NGN relationship, support provided by preceptors to NGNs, and the intention to leave among NGNs during a 1-year preceptorship. DESIGN The conceptual framework of development, implementation, and evaluation was used for program completion. PARTICIPANTS AND SETTINGS Preceptors and NGNs working at a teaching medical center in Taipei participated. METHODS The 1-day SITP workshop comprised four films, reflection time, and four classroom-based courses. Training outcomes were evaluated using a questionnaire survey for preceptors and NGNs at months 3, 6, 9, and 12 after employing the NGNs. Data were analyzed using descriptive statistics and analysis of variance with repeated measures. RESULTS The annual turnover rate of NGNs was 10.5%. During the first preceptorship year, the NGNs reported moderate stress levels, good to excellent relationships with their preceptors, moderate to excellent support from their preceptors, and low intention to leave their current jobs. Similarly, preceptors reported moderate stress levels, except at month 12 (mean=4.8), and good to excellent relationships with their NGNs. The SITP considerably improved the preceptor-NGN relationship for both NGNs and preceptors, whereas no improvement was observed in the stress levels, except in the stress levels of preceptors. CONCLUSIONS The SITP is clinically effective for preceptors; thus, nurse educators may apply the SITP for redesigning the existing preceptor training programs to develop highly skilled preceptors and improve training outcomes.
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Affiliation(s)
- Chun-Mei Kang
- Nursing Department, Cathay General Hospital, 280 Renai Rd, Sec.4, Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medial University, 250 Wuxing Street, Taipei 110, Taiwan.
| | - Hsiao-Ting Chiu
- Department of Information Management, Chia Nan University of Pharmacy & Science, 60, Erh-Jen RD., Sec. 1, Jen-Te, Tainan 717, Taiwan.
| | - Yen-Kuang Lin
- School of Nursing, College of Nursing, Taipei Medial University, 250 Wuxing Street, Taipei 110, Taiwan.
| | - Wen-Yin Chang
- School of Nursing, College of Nursing, Taipei Medial University, 250 Wuxing Street, Taipei 110, Taiwan.
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Underwood A. Evaluation of Work Stress, Turnover Intention, Work Experience, and Satisfaction with Preceptors of New Graduate Nurses Using a 10-Minute Preceptor Model. J Contin Educ Nurs 2015; 46:533-4. [PMID: 26641146 DOI: 10.3928/00220124-20151112-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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