Impact on Self-Efficacy, Self-Direcrted Learning, Clinical Competence on Satisfaction of Clinical Practice among Nursing Students

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1 Vol.132 (Healthcare and Nursing 2016), pp Impact on Self-Efficacy, Self-Direcrted Learning, Clinical Competence on Satisfaction of Clinical Practice among Nursing Students Minsun Song 1, Namyoung Yang 2 1 Dept. of Nursing Science, Konyang University 158 KwanJeoDong-ro, Seo-gu, Daejeon, , KOREA mssong@konyang.ac.kr 2 Dept. of Nursing Science, Konyang University 158 KwanJeoDong-ro, Seo-gu, Daejeon, , KOREA Corresponding Author : nyyang@ konyang.ac.kr Abstract. This study was examined to identify the relationship between selfefficacy, self-directed learning, clinical competence, and satisfaction of clinical practice among nursing students. The sample consisted of 127 students. The data were collected at December 2014 and analyzed using descriptive statistics, t- test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. The mean scores of self-efficacy, self-directed learning, clinical competence, and satisfaction of clinical practice were above the average. Significant correlations were found between a self-efficacy and satisfaction of clinical practice, self-directed learning and satisfaction of clinical practice, clinical competence and satisfaction of clinical practice. Clinical competence was a predictor of satisfaction of clinical practice. These findings indicate that perceived selfefficacy, self-directed learning, and clinical competence may be necessary to improve satisfaction of clinical practice among nursing students. Keywords: Self-Efficacy, Self-Directed Learning, Clinical Competence, Satisfaction of Clinical Practice 1 Introduction In nursing major, nursing students directly meet patients while clinical practice training. And it s a learning process [1] that they can apply theoretical knowledges and nursing skills to clinical practice. This required curriculum can develop nursing student s abilities to be good nursing professions through experience in practical field. So national nursing education ask credits and over 1000 hours of clinical practice training [2]. But most nursing students have low level of satisfaction of clinical practice because they have clinical practice training with real patients in practical field, not in school. It brought nursing students face many problems that making relationship of ISSN: ASTL Copyright 2016 SERSC

2 patents and other medical profession and meeting some unexpected problems in new environment of clinical practice [3]. To improve satisfaction of clinical practice training, nursing student should actively confront changes of clinical environment with positive self-perception, confidence and good self-efficacy. And nursing students are required to have self-directed learning ability to adapt well in practical field because they will meet variety of medical situations [4]. Meanwhile clinical performance competence of nursing students is restructured with knowledge from theoretical education and variety of clinical examples. It makes improvement of clinical performance ability. It has been reported that the more performance of clinical practice, the higher satisfaction of clinical practice [5]. Thus it is required to figure out external factors that decrease satisfaction of clinical practice of nursing students and continually improve them. Also nursing students need to have confidence and study with self-directed learning and build clinical practice performance ability better. These will improve satisfaction of clinical practice and it will cause efficient clinical practice education. In this study, we will define relevance of self-efficacy, self-directed learning and clinical competence which are influence factors of satisfaction of clinical practice to provide baseline data for plan preparation of efficient clinical practice education. 2 Methods 2.1 Research subjects and data collection The initial sample count of this study was calculated with G*power program and 127 people were analyzed. It met the minimum sampling number 119 people. The subjects were selected who are junior in department of nursing science had one year experience of clinical practice. The means of collecting data was self-administered questionnaire of subjects who agreed questionnaire survey in December 2014 when end of clinical practice Instruments We used study tool that was developed by Sherer and others [6] for self-efficacy. This tool is consist of 23 questions and reliability of this tool is Cronbach s α =.85. We used another tool that was developed by Lee and others [7] for self-directed learning. It is consist of 45 questions, reliability of it is Cronbach's α =.90. We used the other tool that was developed by Lee and others [8] for practice competence. It is consist of 45 questions, reliability of it is Cronbach's α =.96. We used the tool that developed by Cho and Kang [9] and Lee [10] for satisfaction of clinical practice. It is consist of 31 questions, reliability of it is Cronbach's α =.92. Copyright 2016 SERSC 125

3 2.3. Data analysis Collected data was complied with SPSS/WIN 18.0 program. Frequency, percentage, average, standard deviation were confirmed with t-test and one-way ANOVA, Pearson Correlation Coefficient, Stepwise multiple regression. 3 Results 3.1 Self-efficacy, self-directed learning, clinical competence, satisfaction of clinical practice of subjects The measured score of self-efficacy of subjects was 3.32±.43 out of 5, self-directed learning was 3.41±.37 out of 5, practice competence was 3.67±.45 out of 5 and satisfaction of clinical practice was 3.65±.44 out of 5 (Table 1). Table 1. Self-efficacy, self-directed learning, clinical competence, satisfaction of clinical practice (N=127) Variables Mean±SD Self-efficacy 3.32±.43 Self-directed learning 3.41±.37 Clinical competence 3.67±.45 Satisfaction of clinical practice 3.65± Difference of satisfaction of clinical practice of subjects according to general characteristics Difference of satisfaction of clinical practice of subjects according to general characteristics shows statically significant difference depends on satisfaction of major (p <001), on thinking about nursing at entry (p=.007), thinking about nursing after clinical practice (p =.025). As postmortem result, satisfaction of major shows higher satisfaction of clinical practice then moderate and thinking about nursing at entry, thinking about nursing after clinical practice show higher positive than moderate. 126 Copyright 2016 SERSC

4 Table 2. Self-efficacy, self-directed learning, clinical competence, satisfaction of clinical practice according to general characteristics (N=127) Gender Characteristics Satisfaction of major Thinking about nursing at entry Thinking about nursing after clinic al practice Grade Categories Satisfaction of clinical practice Mean±SD Male 3.75±.49 Female 3.64±.43 Satisfaction a 3.76±.42 Moderate b 3.45±.40 Non-satisfaction c 3.34±.38 Positive a 3.73±.41 Moderate b 3.46±.47 Negative c 3.52±.30 Positive a 3.76±.44 Moderate b 3.54±.39 Negative c 3.63± ± ± ±.35 F/t(p) Scheffe.82(.426) 1.45(<.001) a>b 5.20(.007) a>b 3.78(.025) a>b.43(.649) 3.3 Correlation between self-efficacy, self-directed learning, clinical competence, and satisfaction of clinical practice Interrelationship of self-efficacy, self-directed learning, practice competence and satisfaction of clinical practice show significant correlation in self-efficacy and satisfaction of clinical practice(r=.38, p <.011), self-directed learning and satisfaction of clinical practice(r=.46 p <.001), clinical competence and satisfaction of clinical practice(r=.61, p <.001) Table 3. Correlation between self-efficacy, self-directed learning, clinical competence, and satisfaction of clinical practice (N=127) Variables Satisfaction of clinical practice r(p) Self-efficacy.38(<.001) Self-directed learning.46(<.001) Clinical competence.61(<.001) Copyright 2016 SERSC 127

5 3. 4 Impact factors on satisfaction of clinical practice To figure out impact factors on satisfaction of clinical practice, we conducted multiple stepwise regression analysis. The result shows significant clinical competence has explanation power of 36.7% out of total variable (Table 4). Table 4. Impact factors on satisfaction of clinical practice (N=127) Variable β t p R 2 Adjusted R 2 F p Self-efficacy Self-directed learning <.001 Clinical competence < Conclusion This study has been conducted to figure out self-efficacy, self-directed learning, clinical competence and satisfaction of clinical practice of nursing students and define impact factors on satisfaction of clinical practice. To improve satisfaction of clinical practice of nursing students, nursing students who satisfied with nursing major and think about nursing positively need to be educated individually. And education strategy is required to improve self-efficacy, self-directed learning, and clinical competence. Especially, clinical practice education course is a direct plan to improve satisfaction of clinical practice. So we re required to make an effort to change from the environment of clinical practice with observation mainly to more chance of direct nursing action. It is difficult to apply this study to all nursing students because it s conducted in only one nursing college. I suggest that subjects of study should be expanded and comparative study should be conducted on type and condition of main practice hospital. References 1. Nelwati, S., McKenna, L., Plummer, V. : Indonesian Student Nurses Perceptions of Stress in Clinical Learning: A Phenomenological Study, Journal of Nursing Education and Practice, Vol. 3, No.5, pp (2013). 2. Song, J.H., Kim, M.W. : Study on Clinical Education for Nursing in Hospitals in Korea, Journal of Korean Academic Society Nursing Education, Vol.19, No.2, pp (2013). 3. Koo, H.Y, Im, H.S. : Comparison of Factors Influencing Satisfaction of Clinical Practice between Associate and Bachelor Nursing Students, The Journal of the Korea Contents Association, Vol.13, No.3, pp (2013). 4. Jung, J.S. : Relationship of Self-directedness and Practice Satisfaction to Clinical Practice in Nursing Students: the Mediating Effect of Clinical Competence, Journal of Korean Academic Society Nursing Education, Vol.18, No.1, pp (2012). 128 Copyright 2016 SERSC

6 5. Kim, K.E., Lee, B.Y. : The Relationship between Satisfaction with Clinical Practice and Clinical Performance Ability for Nursing Students, The Journal of the Korea Contents Association, Vol.14, No.10, pp (2013). 6. Sherer, M., Maddux, J.E., Mercandante, B., Prentice-Dunn, S., Jacobs, B. : The Selfefficacy Scale: Construction and Validation Psychological Reports, Vol.51, pp (1982). 7. Lee, S.J., Chang, Y.K., Lee, H.N., Park, K.Y. : A Study on the Development of Lifeskills: Communication, Problem Solving, and Self-directed Learning, Korean Educational Development Institute (2003). 8. Lee, W.H., Kim, C.J., Yoo, J.S., Her, H.K., Kim, K.S., Im, S.M. : Development of a Clinical Competency Measurement Tool for Student, Yonsei Journal of Nursing Science, Vol.13, pp (1990). 9. Cho, K.J., Kang, H.S. : Study on Self-concept and Satisfaction of Clinical Practice, Journal of Korean Academy of Nursing, Vol.14, No.2, pp (1984). 10. Lee, S.E. : A Study on Satisfaction and Experience of Clinical Practice & Direction for Clinical Education: Focused on Maternity Nursing Practice, Journal of Korean Academic Society Nursing Education, Vol.7, No.2, pp (2001). Copyright 2016 SERSC 129