jkapmhn Journal of Korean Academy of Psychiatric and Mental Health Nursing J Korean Acad Psychiatr Ment Health Nurs 1225-8482 2288-4653 The Korean Academy of Psychiatric and Mental Health Nursing 10.12934/jkpmhn.2019.28.3.236 jkapmhn-28-236 Original Article Development and Effects of the Self-determination Improvement Program for Nursing Students’ Professional Competence Enhancement Park Ju Hyun 1 Park Hyun Sook 2 Assistant Professor, Department of Nursing, Sorabol College, Gyeongju, Korea Professor, College of Nursing ․ The Research Institute of Nursing Science, Daegu Catholic University, Daegu, Korea Corresponding author: Park, Hyun Sook https://orcid.org/0000-0002-4486-9053 College of Nursing, Daegu Catholic University, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 39063, Korea. Tel: +82-53-650-4827, Fax: +82-53-650-4392, E-mail: parkhs@cu.ac.kr 92019 1792019 283 236247 30072019 30082019 17092019 Copyright © 2019 The Korean Academy of Psychiatric and Mental Health Nursing 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

The purposes of this study were to develop a self-determination improvement program for enhancing nursing students’ professional competence and to evaluate effects of the intervention on nursing professionalism, communication skills, and career decision-making autonomy among nursing students.

 Methods

The study was in a pre-test, post-test 1, and post-test 2 for a nonequivalent control group design. The participants were 56 students enrolled a nursing school or college (experimental group: 28; control group: 28). The self-determination improvement program was provided in 12 sessions over 4 weeks. Data was collected from August to September 2018. Data were analyzed using SPSS/WIN 25.0 program with x2 test, Fisher's exact test, the independent t-test, and repeated measurement ANOVA.

 Results

Participants receiving the self-determination improvement program reported increased nursing professionalism, communication skills, and career decision-making autonomy that was significantly different from those in the control group.

 Conclusion

Our study findings suggest that the self-determination improvement program could be effective for enhancing career decision-making autonomy by strengthening nursing students’ professionalism and communication skills. Nursing educational program based on self-determination may be helpful for nursing students who need to prepare themselves as competent nurses in future profession.

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Conceptual framework of this study.

Self-determination Improvement Program for Professional Competence Enhancement of Nursing Students

Session Themes Theory Contents Time (minute)
1 Orientation of the program Autonomy ․ Program introduction 10
  ․ Making a motivation and connection 20
  ․ Setting up program participation rules 10
  ․ Building up goals for the program 20
2 Motivation improvement Part I Autonomy ․ Exploring the disagreement between goals and my current behavior 20
Competence ․ Watching videos about 'successful challenge' 20
  ․ My life that I want 20
3 Motivation improvement Part II Autonomy ․ My life as a nursing student 20
Competence ․ Letter to junior students 20
  ․ Finding my strengths with rolling paper 20
4 Motivation improvement Part III Autonomy ․ Discussion of nursing profession definition 15
  ․ Watching videos about 'nursing, its professional calling' 30
Competence ․ Drawing my career road-map 15
5 Nursing professionalism improvement Part I Autonomy ․ My nursing services experience 15
  ․ Expressing of my nursing image 20
  ․ Discussion of socially perceived nursing image 25
6 Nursing professionalism improvement Part II Autonomy ․ Watching videos about 'self-management' 20
Competence ․ My strengths and weaknesses for nursing profession ․ My brand power-up conditions 20 20
7 Nursing professionalism improvement Part III Autonomy ․ Social values of nursing profession 15
Competence ․ Discussion of 'jump the wolf' story ․ The vision of nursing profession, my nursing role model 15 30
8 Nursing professionalism improvement Part IV Autonomy ․ Watching videos about 'nurse's day', thinking about nurse's job 25
  and responsibilities 15
  ․ Korean nurse code of ethics  
Competence ․ Create departmental public relations material 20
9 Communication skill improvement Part I Relatedness ․ Communication skill as a professional nurse 20
  ․ Watching videos about 'stupid victor story', think about 20
  self-awareness 20
  ․ Understanding Johari's window  
10 Communication skill improvement Part II Relatedness ․ Drawing a mind-map 10
  ․ Stereotypes in communication 15
  ․ Empathy on 'cow and lion' story 15
Competence ․ 6 steps of empathy, try applying empathy 20
11 Communication skill improvement Part III Relatedness ․ Effective communication skills 25
  ․ Self-assertive communication, try applying I-message 20
Competence ․ Praise skill and praise relay game 15
12 Finishing the program Autonomy ․ Exploration of change 20
  ․ Exploring problems that have not been resolved 25
  Competence ․ Graduation ceremony 15

Homogeneity Test of General Characteristics between Two Groups (N=56)

Characteristics Categories Exp. (n=28)
 Cont. (n=28)
 x2 p†
n (%) n (%)
Gender Men 3 (10.7) 4 (14.3) 0.16 .686
Women 25 (89.3) 24 (85.7)    
Age (year) ＜21 13 (46.4) 20 (71.4) 3.61 .057
≥21 15 (53.6) 8 (28.6)    
Religion Have 17 (60.7) 20 (71.4) 0.71 .397
Have not 11 (39.3) 8 (28.6)    
Health status ≤Moderate 12 (42.8) 17 (60.7) 3.48 .322
Healthy 16 (57.2) 11 (39.3)    
Academic score ＜3.0 11 (39.3) 14 (50.0) 0.65 .420
≥3.0 17 (60.7) 14 (50.0)    
Major satisfaction ≤Moderate 7 (25.0) 11 (39.3) 1.70 .192
Satisfied 21 (75.0) 17 (60.7)    
Reason for selecting nursing Profession & volunteer 15 (53.6) 10 (35.7) 1.80 .179
The others 13 (46.4) 18 (64.3)    

Exp.=experimental group; Cont.=control group;

Fisher's exact test.

Homogeneity Test of Dependent Variables between Two Groups (N=56)

Variables Exp. (n=28)
 Cont. (n=28)
 t p
M±SD M±SD
Nursing professionalism 105.39±10.15 103.61±9.85 0.66 .507
Communication skill 166.79±19.83 166.39±18.15 0.07 .939
Career decision-making autonomy 107.57±21.51 115.68±16.64 1.57 .121

Exp.=experimental group; Cont.=control group.

Comparison of Dependent Variables between Two Groups after Treatment (N=56)

Variables Groups Pre
 Post1
 Post2
 Sources F (p) Post1-Pre
 Post2-Pre
M±SD M±SD M±SD t (p) t (p)
Nursing professionalism Exp. (n=28) 105.39±10.15 118.64±12.50 118.75±10.39 G 8.94 (.006) 13.25 (.003) 13.35 (.003)
Cont. (n=28) 103.61±9.85 108.57±9.48 110.89±15.57 T 14.47 (＜.001) 4.96 (.761) 7.28 (.352)
        G×T 5.48 (.007)    
Communication skill Exp. (n=28) 166.79±19.83 190.43±21.98 187.96±22.50 G 4.21 (.050) 23.64 (.004) 21.17 (.015)
Cont. (n=28) 166.39±18.15 177.32±17.54 174.46±23.58 T 12.87 (＜.001) 10.92 (.566) 8.07 (.831)
        G×T 7.49 (.001)    
Career decision making autonomy Exp. (n=28) 107.57±21.51 126.07±21.80 123.39±22.91 G 0.12 (.726) 18.50 (.048) 15.82 (.143)
Cont. (n=28) 115.68±16.64 123.36±20.41 123.21±18.78 T 8.54 (.001) 7.67 (.852) 7.53 (.862)
        G×T 8.27 (.001)    

Exp.=experimental group; Cont.=control group; G=group; T=time.