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Empowering education Chaghari M et al.

Original Article

Journal of Advances in Medical Education & Professionalism

Empowering education: A new model for in-service training of
nursing staff

Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran; 2Behavioral Sciences Research Center, Nursing faculty,
Baqiyatallah University of Medical Sciences, Tehran, Iran; 3Health Management Research Center, Baqiyatallah University of Medical
Sciences, Tehran, Iran

Introduction: In-service training of nurses plays an indispensable *Corresponding author:
role in improving the quality of inpatient care. Need to enhance Abbas Ebadi,

the effectiveness of in-service training of nurses is an inevitable Behavioral Sciences Research
requirement. This study attempted to design a new optimal model Center,
Baqiyatallah University of
for in-service training of nurses.
Medical Sciences,
Methods: This qualitative study was conducted in two stages Tehran, Iran
during 2015-2016. In the first stage, the Grounded Theory was Tel: +98 912 2149019
adopted to explore the process of training 35 participating nurses. Email: ebadi1347@yahoo.
The sampling was initially purposeful and then theoretically based com
on emerging concept. Data were collected through interview, Please cite this paper as:
observation and field notes. Moreover, the data were analyzed Chaghari M, Saffari M, Ebadi
through Corbin-Strauss method and the data were coded through A, Ameryoun A. Empowering
MAXQDA-10. In the second stage, the findings were employed education: A new model for
through Walker and Avant’s strategy for theory construction so as in-service training of nursing
staff. J Adv Med Educ Prof.
to design an optimal model for in-service training of nursing staff.
Results: In the first stage, there were five major themes including
Received: 15 June 2016
unsuccessful mandatory education, empowering education, Accepted: 3 December 2016
organizational challenges of education, poor educational
management, and educational-occupational resiliency.
Empowering education was the core variable derived from the
research, based on which a grounded theory was proposed. The
new empowering education model was composed of self-directed
learning and practical learning. There are several strategies
to achieve empowering education, including the fostering of
searching skills, clinical performance monitoring, motivational
factors, participation in the design and implementation, and
problem-solving approach.
Conclusion: Empowering education is a new model for in-service
training of nurses, which matches the training programs with
andragogical needs and desirability of learning among the staff.
Owing to its practical nature, the empowering education can
facilitate occupational tasks and achieving greater mastery of
professional skills among the nurses.
Keywords: Grounded theory; Model; Nurse; Training

Introduction of organizational and the workforce interests.

E ducation plays an important role in achieving
organizational goals through a combination
Nowadays, training is an essential factor
contributing to greater efficiency of the staff and

26  J Adv Med Educ Prof. January 2017; Vol 5 No 1

the factors contributing to greater involvement The data were coded through MAXQDA-10. in-service on the same day after listening for several training serves to update the staff’s occupational times. of adult learning principles. components and design a streamlined model for the Walker and Avant’s Strategy for theory J Adv Med Educ Prof. learning technique in medical education (12). it’s occur. Adults are aware of asking questions. the Grounded Theory was necessary to explore nursing in-service training formed. The data were job characteristics and professional factors can collected through semi-structured interviews. flip-flop technique. what. Training This study intended to provide a new model of is an investment in achieving productivity and in-service training for the nursing staff. The comparisons and they are self-assessor (11). Due served to find out in what circumstances a to the limited knowledge. it as to design an optimal model for in-service is crucial to develop and adopt new models of training of the nursing staff. nursing managers. concepts. staff development an effective method to identify these components. One of of categories to build theoretical framework (15). Moreover. waving-the-red-flag technique. January 2017. they duration of 60 minutes. In fact. The literature review adopted to fully examine the training process of suggests that certain training programs do not nursing staff. where. and success of organizational plans. In addition to at Baqiyatallah University of Medical Sciences the theoretical knowledge. Having developed the descriptive theory. Another important were reviewed and analyzed. the Grounded Theory was the competition arena (3). For collecting deeper and Training programs must be organized in such a better data. In-service training includes a Data were collected from November 2013 to set of measures taken to promote empowerment December 2015. service training can lead to effective learning analysis for consequences. training managers better undertaking of their tasks.Chaghari M et al. Hence. the researcher found a part-time job way that they enhance the beneficial capabilities in one of the hospitals of employees (7). Nurses play an important interviews were administered with an average role in improving health standards. and finally integration and development in their field of work. and learning objectives. In order to expand the strategy for theory construction (2005) (14) so capacities and improve educational outputs. when. Grounded theory method is will lead to internal promotion. Vol 5 No 1   27 . In fact. but have unfortunately left little consequences. The The questions were continuously asked about in-service training programs for the nursing staff the essence of the data. Training programs are essential for This study was conducted in two stages. analysis for contexts and processes. Each interview was need to be updated about theoretical and practical recorded by a digital device and then implemented knowledge in this field (10). In this way. The researcher participated in 21 training knowledge and professional skills and improve programs and took field notes.2). Waving-the-red-flag technique impact on their occupational outcomes (13). Obtaining the participants’ should enhance the technical capacity and confidence and real answers to the questions were quality of services. constantly evaluated the phenomena. employee retention through providing career development and job satisfaction in the long Methods run (1. Empowering education organizations. how and with what methods in Iran. covering topics such as have been implemented in various forms and who. the organization to achieve its goals (8). contribute to the involvement of employees in field notes and literature review. In the second stage. guide their own learning. A total of 42 in-service training (9). the survival and viability of the organization in In the first stage. point concerning the in-service training of the The data were analyzed through Corbin and nursing staff is their active participation in such Strauss method (2008) involving coding for programs. The study took place clinical education for nurses (5). the findings demonstrate any efficacy in improving the were employed through Walker and Avant’s quality of patient care (4). Previous research has shown that continued until data saturation. Active participation of nurses in in. limitations of the study. One The sampling was initially purposeful and then of the main features of in-service training is theoretically based on emerging concepts and applicability. undefined concepts and phenomenon always occurs or usually does not undeveloped relationship between concepts. concepts centered learning has been offered as a lifelong and events in terms of similarities and differences. The samples comprised a total of and competency among employees for the 35 nurses. thus helping and senior managers working at the hospitals. Additionally. the the best practices for fulfilling various tasks documents including instructions and directives and responsibilities (8). of the staff in such programs is the utilization Analytical techniques included comparisons. vocational training hospitals in Tehran. it is a vital investment that nursing staff training. self. leading to innovation (6).

Certain parts of The nurses in this model adopt a holistic the interviews were not recorded upon request approach to learning. the grounded theory of effort The strategies presented by Guba and for empowering education was developed. construction (2005) was employed to generate managers. In this model. Committee of the Baqiyatallah University of whose correlations and contributing factors were Medical Sciences. At first. a consensus (dependability). weakness and statements were extracted from the selected in educational management. Finally. 5 nursing demanding practical learning. Moreover. the concepts organizational challenges of education. the human is an entity in search of learning and acquisition through effective training. There are three managers. The data were validated by two the new model. At the next stage. concern of the participants. theory and main concern of the participants so as This study obtained 5 major themes. sufficient time was allocated nursing and environment were taken into account (18 months) and utmost accuracy was exercised as the literature review revolved mainly around (confirmability). There were 17 male and 18 female a prescriptive theory. The researcher extensively and systematically reviewed the Ethical consideration entire available literature concerning the core This study was approved by the Ethics concept and the relevant paradigmatic concepts. In this regard. a set of relevant samples aged 27 to 51 years old with a mean core concepts were outlined to expand the model. learning. Hence. Moreover. was composed of other concepts. Since the confirmed by the participants.Empowering education Chaghari M et al. Furthermore. the participants and Persian literature were searched for several remained anonymous with the right to withdraw key model concepts and elements as follows. empowering education. which were through Walker and Avant’s method. from the study at any stage. The education levels varied from The core concept was derived from the grounded Bachelor's to doctorate. well-informed identified based on the results obtained from the consent of the participants was obtained during grounded theory research.08. two members of the research team coded the the second stage adopted the empowering interviews independently and finally reached education model as the core concept. followed by a mandatory education. recording the data. Vol 5 No 1 . Moreover. In collecting and the paradigmatic concepts of human. January 2017. which were then systematically organized resiliency. The Lincoln were adopted to ensure the accuracy and ultimate objective of the research was achieved reliability of the results (16). Unsuccessful training was the main into a model. review of related literature. while the empowering education was the core concept extracted from Data trustworthiness the data. 10 main to further expand the model. 6 education managers and 4 senior theories resulting from comprehensive search: Table 1: The major themes and main categories derived from the data Major themes Categories Unsuccessful -mandatory education Weak effectiveness (Main concern) Preventive factors Empowering education Self-directed learning (Core variable) Practical learning Organizational challenges of education Management limitations and conflicts (Context) Structural-functional incompatibility of education and medical care Weakness in educational management Insufficiency in personnel education stages (Context) Insufficiency in organizational education process Educational-Job resiliency Governance coincidence (Consequence) Work accommodation 28  J Adv Med Educ Prof. the categories and 22 sub-categories (Table 1). the nurses of the participants and none of the interviews pursue a type of education that can enhance were disclosed to maintain the confidentiality of knowledge and practical skills. The Results environment is a set of elements and factors The participants included 20 nurses. age of 39. In this regard. the research team core category and grounded theory in the first and two outsider experts (credibility). stage involved effort for empowering education. English data collection. where the conceptual framework specialists (transferability). private data. The researcher was through analyzing the first-stage findings continuously involved with the data. and educational-job texts. paradigmatic and meta-paradigmatic concepts The core concepts included unsuccessful within the model were identified.

Chaghari M et al. employee comprehensive search. The pattern of the Iranian Red Crescent through search in training categories and Society staff training by PoorKarimi et al: This educational topics can lead to self-direction. the empowering the inefficiencies of educational management. including tackling monitoring (Figure 1). the organizational challenges and overcoming As illustrated in the Figure. focus on motivational factors. there are two underlying factors that can the searching skills. including motivation. be enhanced by searching skills. and clinical performance affect all the other factors. There are three additional factors Empowering education obtained from the contributing to both self-directed learning and combination of grounded theory and results of practicality. pattern contains resolution of problems related Similarly. Clinical monitoring performance model: factors involved in achieving self-direction Clinical supervision uses four key components and practicality. training implementation when doing their job duties. topics in which employees are having difficulty result-oriented content. January 2017. Practicality is the effectiveness problem-solving and collaborative research. The self-directed learning can of training. Malcolm Knowles theory: He believes learning refers to self-centeredness and initiative the main approaches for adults learning is the in learning. Self-directed organizational procedures that are in conflict with Figure 1: Empowering education model J Adv Med Educ Prof. Empowering education participation in training design and educational entails characteristics including participatory implementation and problem-solving approach. Employees 3. facilitating and feedback. problem-solving approach. monitoring. Vol 5 No 1   29 . education entails two main components of Organizational challenges refer to some of the self-direction and practicality. Empowering education 1. of training in job functions. advocacy. training of the nursing staff in terms of planning Problem-solving approach refers to training the and implementation. fostering topics. In addition to these practices. practicality can be enhanced by to organizational structure and attention to clinical supervision and clinical performance motivational mechanisms. There are five 2.

In a research on in-service staff within the nursing community. (2012) proposed a model proving effective and solving approach. identifying the resources for learning. it incorporated an extensive teaching methods and materials (20). analysis. design. the above studies suggested that nursing wishes. two main components of empowering education selecting and implementing the educational aligned with the effectiveness of nursing staff strategies. Self-direction in searching skills. problem. 18) For instance. In the empowering education. (2013) demonstrated that In fact. However. Self-directed learning et al. Also. The same motivational factors have been monitoring. Second. the model concentrated on training planning. tackling organizational efficient in teaching the behavioral techniques challenges. staff participation in the learning strategy (12). where the nursing staff participate the pedagogical materials are relevant to the in the design and implementation of training actual profession of nursing (9). Udaya programs. financial constraints and conflicts successfully and fruitfully when they feel the arisen by different management divisions against support. the pedagogical needs. There have so far been part of nursing staff. In their study entails solutions beyond such themes. Parsons and Rollyson J design and implementation of training. Chen and Klimoski evidence-based education (28). Saunders deemed a mechanism aiming to promote the 30  J Adv Med Educ Prof. This characteristic a greater concentration on motivational factors was implemented through clinical performance (23). The basic models mainly focused on out how the staff listen to complaints. This themselves (11). That was considered in the organizational challenges must be eliminated. it will match the grounds for staff training (22(“. The self-directed learning mainly serves to several pragmatic strategies such as fostering the foster the searching skills (27). the nature and goals of educational programs. study. (2012) introduced and examined a new represents self-centeredness and initiative in model which fosters the mutual understanding learning. Self-directed learning is a process study rather emphasized the effectiveness of staff in which students are engaged in identifying training through modifying its essence and goals. such management (24). January 2017. this research has Discussion suggested that the solution is to inform and The empowering education refers to self. current research. In fact. known as educational management. attempting to find of staff. practicality is application of and resolution of the patients’’ problems on the training in job functions. In simple desirably proportionate to the staff needs and terms. it is training at a rehabilitation center. Similarly. The empowering education adopted (26). (2010) proposed a staff training content should be practical and model for in-service training of staff at the proportionate to their job description. where the the current study incorporated practicality of educational effectiveness was achieved through learning into the new model. Clinical monitoring is a modern. Iranian Red Crescent Society (IRCS). self-direction and practicality are objectives. the new model proposed development (19). Ammentorp direction and practicality. The participation of nursing staff in et al. The current behavioral skills as a practical model. this study presented a new teaching in-service training can be far more effective when method. This model focused on numerous models designed for in-service training communication techniques. incorporated into the model presented by the on-the-way-of-achieving-recognition approach current study. (2011) found that task analysis could provide the design and implementation of the training an ideal technique in outlining the content of pre- programs can render the content materials service and in-service training (29). Similarly. Moreover. guide the hospital administrators. Vol 5 No 1 . setting the learning Moreover. Craig suggested that staff correctly respond the patients’ questions (25). medical education has been adopted as a lifelong motivational factors. Sajjadnia et al. and evaluating the learning outcomes training. Others teaching method based on self-directed learning. This model will (2007) proposed a model that focuses mainly on initially provide a method for the presentation of ”teaching method“and ”providing the essential pedagogical materials. training process is composed of five stages: In fact. Poorparimi et al. Some experts in the design in the current study concentrated on training of educational models put more emphasis on practices.Empowering education Chaghari M et al. Concerning how to tackle the organizational challenges. supervision and responsibility of the education. and overcoming the inefficiencies of and skills among the nursing staff. (2009) concluded that the staff will perform for example. believe that the most important component of where the adoption of strategies and evaluation staff training is the teaching method and how of its outcomes are assigned to the learners pedagogical concepts are conveyed (21). implementation and practices. assist the the procedures and functions of staff training patients to express their problems and how to (17. clinical performance monitoring.

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