Investigating the Adequacy of Nurses' Training based on a Hybrid Approach
Banafsheh Shafei1, Maryam Sameri2*
1. PhD in Educational Administration, Dept. of Education, Urmia Branch, Islamic Azad University, Urmia, Iran; Management of Social Security Treatment in West Azarbaijan Province, Urmia, Iran.
2. PhD in Educational Administration, Dept. of Education, Urmia Branch, Islamic Azad University, Urmia, Iran.
* Corresponding author: Maryam Sameri; E-mail: m.sameri@iaurmia.ac.ir
Abstract
Background: In the present era, training is one of the most complex tasks in the human resource management of organizations and also one of the factors in organizational productivity. This study was conducted to identify the dimensions and components of adequate training of nurses with an emphasis on psychological empowerment.
Materials and Methods: The present study is quantitative and qualitative research with a descriptive-exploratory design, and in terms of purpose, it is applied research. In the qualitative approach, to collect the necessary data, in-depth interviews were done. The sample included 30 cases consisting of university faculty members and senior managers of nurses. In the quantitative approach, 200 nurses were selected by simple random sampling. To analyze the data, Strauss and Corbin (1990) approach and fuzzy Delphi technique have been used.
Results: Based on the findings, the main components of the adequacy of nurses' education include training, evaluation and psychological empowerment. The results showed that, among these three dimensions, the largest gap for optimizing the model was related to the psychological empowerment dimension, which can be filled by focusing on the sense of competence, sense of significance and sense of effectiveness of nurses.
Conclusion: The results showed that psychological empowerment by creating a sense of competence, meaningfulness, and effectiveness led to the participation of nurses in the training courses voluntarily and without coercion because they felt they needed to know more, and by psychological empowerment, they will be able to achieve the adequacy of training.
Keywords: Training, Nurse, Empowerment, Psychological
Introduction
The importance of effective and focused training for employee development in today's competitive markets is inevitable [1]. In healthcare organizations, knowledgeable and efficient human resources are considered as key elements of effectiveness and productivity. The basic step in training and retraining useful and efficient workforce is the ability of an organization to properly and adequately educate employees and managers. Although in many countries, the Ministry of Health is more or less concerned with the training of the workforce in the health sector, its direct involvement in maintaining patients’ health and life, and its decisive role in improving the quality of services and increasing productivity, the training and retraining of the workforce in the healthcare sector should not be overlooked [2]. Fitzsimons (2017) argues that intelligent and experienced human capital in healthcare systems is considered a source of competitive advantage [3]. In healthcare systems, due to the important role of nurses in improving health standards, it is crucially important to update training, and theoretical and practical knowledge, as well as training methods for this group of medical staff. Adequate and appropriate training of nurses is essential to provide efficient and effective services and to achieve patient satisfaction. In their studies, the researchers have emphasized a direct and significant relationship between nurses' training and their performance and considered their lack of adequate training as a weakness in providing healthcare services [4]. Continuous and adequate training and improvement of nursing staff in healthcare organizations can be used as a useful method in maintaining professional skills and preventing their stagnation, as well as improving their job abilities. Therefore, currently, paying enough attention to this factor is one of the most important tasks of managers [5]. Adequacy of training is the acquisition of the necessary competence to perform obligations and duties through training. Thus, adequacy means acquiring the necessary competence, that is to say, one can achieve the necessary competence through training. Unfortunately, only about 6% of organizations base their training plans on the real needs and training adequacy of employees [6]. The effectiveness of education is the fruit of adequate and appropriate training, which is tailored to the needs of individuals and can be referred to as the adequacy of training. This type of training not only improves an individual's overall performance but also ultimately improves organizational performance and effectiveness. Senge [7], a well-known expert in the field of human resource management, considers personnel training to include four stages: needs assessment, design, learning method selection, and evaluation of learning outcomes [8]. The training and improvement of personnel in the DDE (Design, Development and Evaluation) model proposed by Garavan, Hogan, and Donnell has several distinctive features. First, in this process, the focus of attention is on contextual factors in planning personnel training. Second, employees’ growth opportunities, too, has been considered as a needs assessment factor, and third, special emphasis has been placed on the use of managers and supervisors as course instructors. Finally, the calculation of the rate of Return on Investment (ROI) has been considered and emphasized. In general, it can be said that the main focus of all these training processes is the three elements of planning, implementation and evaluation [9].
In the human development, the expansion of the necessary facilities such as training to make use of (the employees’) talents, and the development of capabilities are regarded as components of development. From this perspective, achieving the necessary level of development and adequacy includes both instrumental and non-instrumental concepts at the same time, emphasizing that achieving the necessary educational adequacy, in addition to tools and instruments, requires attention to psychological issues such as motivation building, self-esteem, etc. [7]. Training adequacy enhances effectiveness by paying attention to psychological aspects. Dehghani et al. [10], Awadh, and Ismail [11], Ateya, Maende [12], and Hammond & Churchill also obtained similar results. [13] .Healthcare organizations have undergone many changes in terms of science and technology or the use of new methods, but unfortunately, neither the efficiency nor quality of services of these organizations has improved as expected. One of the reasons for this is that in these changes, effective training and adequacy of training of employees have not received enough attention by these systems. It seems that most of the reasons for the failure of nurses’ training programs are related to lack of adequacy of training. Human resource thinkers believe that leading organizations can meet business needs with greater speed and flexibility only by using advanced and scientific models of human resource training and development, organizational learning, and strategies for the development of employees’ capabilities.
This study aims at presenting the adequacy model of training of nurses at Imam Reza Hospital affiliated to the Social Security Organization. Hence, based on different perspectives, three dimensions of training, psychological empowerment and training evaluation have been identified as indicators and factors of adequacy of training of nurses. It is clear that the composition of these factors in different organizations varies depending on their needs.
In this study, some managerial orientations in the field of adequacy of training in Iran’s 1404 Vision Policy (2025- 2026) and the general policies of the government within the vision’s period, the law of the Fourth Economic, Social, and Cultural Development Plan of the Islamic Republic of Iran, the Fifth Development Law, the general policies of the state administrative system (2010) have also been examined. In designing the present model, an attempt has been made to pay attention to the ecological approach to the adequacy of training of Social Security nurses due to the problems of training of nurses in healthcare systems. Because without deep knowledge about the political, social, cultural and economic characteristics of the country, no universal decision can be made in terms of adequacy of training [14, 15]. Emphasizing the effectiveness of the adequacy of training and being based on the ecological approach to the adequacy of training, the present study is similar to the research by Deitmor [16] and Eidi et al. [17] in this respect. By studying the theoretical foundations and seeking the opinion of supervisor professors and experts, the research framework is based on Garavan, Hogan and Donnell’s model [18] (2007). On this basis, the adequacy of training model consists of three dimensions of training, psychological empowerment and Training evaluation. Garavan, Hogan and Donnell’s model [18] (2007) provides a
more comprehensive picture of training than other models. Therefore, in designing the conceptual model of the research, the structures of the model are based on studying the theoretical foundations and validation thereof by experts according to Phillips model. In addition, the components of the structures have been identified by studying the research literature and conducting in-depth interviews with experts (senior managers, training officials, supervisors and nurses affiliated to the Social Security Organization) as well as two phases of the fuzzy Delphi method.