The relationship between workplace learning and midwives' and nurses' self-reported competence: a cross-sectional survey.

Abstract Background Nurses have to maintain and improve their nursing competence in order to provide the best patient care possible. Workplace learning has the potential to improve nursing competence. Previous studies have examined the effect of training on competence development. However, the effects of other aspects of learning, such as learning from practice, feedback, reflection, and from others have not been investigated previously. Furthermore, it is uncertain what methods of learning nurses with different clinical experience adopt and how these learning methods relate to their self-reported competence. Objectives The objectives of this study were to identify the methods of learning used by less and more experienced nurses, and to explore what methods of workplace learning would be associated with the self-reported competence of both groups of nurses. Design A cross-sectional survey design was utilised. Settings The study was conducted at two university-affiliated hospitals in Japan. Participants A convenience sample of 954 nurses/midwives (hereafter referred to as nurses), who were involved in direct patient care, were recruited and 494 nurses returned usable questionnaires. Methods A survey method was used to collect data. The Holistic Nursing Competence Scale, the Learning Experience Scale and the Japanese version of Rosenberg's Self-esteem Scale, along with demographic questions, were included in the questionnaire. Hierarchical regression analysis was conducted to investigate the relationship between learning and nurses' self-evaluation of competence. This analysis was carried out for less experienced nurses (≤5 years of clinical experience) and experienced nurses (>5 years of experience). Results The results showed that learning was correlated with the levels of competence that nurses considered they had. When the specific types of learning were examined in relation to self-reported competence, there were a similarity and differences between less and more experienced nurses. For both groups of nurses, learning through reflection was found to relate to their self-reported competence. In addition, learning through practice and learning from others were positively correlated with the self-reported competence of less experienced nurses, while learning from feedback and training were positively associated with the self-reported competence of experienced nurses. Conclusion Learning from reflection may be useful for both less and more experienced nurses by allowing them to embrace a positive view of their competence. Moreover, creating opportunities to experiment and observe others' practice can be profitable for less experienced nurses, while offering training opportunities and feedback can be beneficial for experienced nurses.