Award Date

12-2011

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Committee Member

Carolyn Yucha, Chair

Second Committee Member

Susan Kowalski

Third Committee Member

Cheryl Bowles

Graduate Faculty Representative

Vicki Rosser

Number of Pages

132

Abstract

The purpose of this study was to evaluate the impact of a Home Hospital Clinical Placement program on professional behaviors of nursing staff within the Home Hospital and professional behaviors of baccalaureate nursing students enrolled in the Home Hospital Clinical Placement program. The study used a conceptual model developed and tested by Manojlovich (2003).

The study was a non-experimental, cross-sectional design to compare selected attributes between students enrolled in a Home Hospital Clinical Placement and students enrolled in a traditional clinical placement and between registered nurses with high levels of teaching interaction with home hospital students and registered nurses with low levels of teaching interaction with home hospital students. The specific attributes were those included in the Manojlovich model (2003) depicting the relationships among structural empowerment, self-efficacy, and professional behaviors.

There were no significant differences noted in overall structural empowerment ratings between home hospital and non-home hospital students. However, there was a significant difference in one structural empowerment subscale. Home hospital students reported higher ratings of formal and informal power. There were no significant differences between home hospital and non-home hospital students in ratings of self-efficacy, professional autonomy, and observed leadership behaviors of clinical faculty. Additionally, no significant differences were noted between home hospital students and non-home hospital students when controlling for clinical level.

In the registered nurse (RN) sample, there was no significant difference noted in overall structural empowerment between nurses with high levels of teaching interaction and nurses with low levels of teaching interaction. However, there was a significant difference on one structural empowerment subscale of opportunity. Registered nurses with a high level of teaching interaction reported higher ratings of access to opportunity. There were no significant differences noted within the registered nurse sample in ratings of self-efficacy and professional autonomy based on level of teaching interaction. There was a significant difference in one subscale of observed leadership behaviors, Challenge the Process. Registered nurses with a high level of teaching interaction reported higher ratings of observed clinical faculty leadership behaviors on the subscale.

In both samples, nursing student and registered nurse, a significant positive relationship was noted between structural empowerment and professional practice behaviors and structural empowerment and observed clinical faculty leadership behaviors. In the nursing student sample, a significant positive relationship was also noted between structural empowerment and ratings of self-efficacy. In both samples there was a significant positive relationship between professional practice behaviors and self-efficacy. In the RN sample, there was a significant positive relationship between professional practice behaviors and observed clinical faculty leadership. In the nursing student sample there was a significant positive relationship noted between observed faculty leadership and self-efficacy.

The relationship among the study attributes of structural empowerment, selfefficacy, and professional behaviors confirmed previous findings (Manojlovich, 2003). In this study, a significant positive relationship was noted in the nursing student sample between observed faculty leadership and self-efficacy. This finding has not been previously reported. Additionally, in the registered nurse sample, the significant positive relationship between clinical faculty leadership behaviors and professional practice behaviors has not been previously reported.

In conclusion, this study revealed that the home hospital model can be an effective intervention to provide clinical instruction for nursing students. These findings demonstrated that a non-traditional approach to employing clinical faculty can be effective. Additionally, the findings of this study expand knowledge on unique characteristics of the work environment that impact the quality of a registered nurse's professional life. High levels of teaching interaction were significantly related to increased ratings of structural empowerment as it related to access to opportunity. Ratings of faculty leadership were noted to have a positive relationship to professional practice behaviors of registered nurses. This supports the premise that clinical placement models should not only be evaluated for their impact on students but also the impact on the practice environment.

Keywords

Empowerment; Health and environmental sciences; Home hospitals; Nurses; Nursing students; Professional ethics; Professional practice

Disciplines

Education | Nursing

Language

English


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