MEXICA

Chapters 5 and 6 have presented data from two groups of stakeholders in nurse education in acute care hospitals. Qualitative and quantitative findings informed data analysis. Themes resulting from both data sets identified the enablers and barriers to nurse educator practice. The themes arising from the group interview identified in Chapter 5 — visibility, role blurring and ambiguity, role definition, career pathways, rural contexts and the multidisciplinary nature of the role — resonated with the qualitative findings from the survey described in Chapter 6.

145 Preliminary evaluation of the ACONE and ISNER scales has demonstrated reliability and validity and are worthy of future evaluation to determine predictive validity. As these instruments have not been previously validated, it is not possible to provide normative data. The potential for floor and ceiling effects of these measures need to be considered in future investigations. Emergent themes from the qualitative data were confirmed in the quantitative data, particularly in respect of issues in the workplace.

Ensuring roles and expectations were clearly documented and monitored was a key factor emerging from both the quantitative and qualitative data. Data synthesis has resulted in the generation of a hypothetical model that may be useful in developing the nurse educator role. Ensuring clarity of the role, clear documentation of competencies and strategies to support role enactment are likely to leverage benefits.

In summary both the qualitative and quantitative date themes provided confirmatory findings. These data have generated a model to be tested in future studies.

Role ambiguity, level of education qualifications and competency standards emerged as important in moderating performance and role enactment. The recurrence of these factors across the data sets reinforces the importance of these issues in considering the nurse educator role and the workplace satisfaction of nurse educators. Fig. 6.6 has summarized how the information generated from each data set has contributed to addressing the study questions and these perspectives will be elucidated in the following chapter.

146

Figure 6.6 Summary of the Nurse Educator in Acute Care Hospitals Study

Aim: To describe the role, scope of practice and

performance standards of Nurse Educators in acute care settings in Australia

Steering Committee Group Interview

n=14

Qualitative Results:

Themes:

Challenges in enacting the role - historical perspectives, visibility, role definition, rural contexts and the multidisciplinary nature of role.

Education - qualifications, competency and career pathways. Policy and funding.

Nurse Educators and

Clinical Nurse Educators Web Based Survey

n=425

Quantitative Results:

Female 88% n=374 Master’s education qualification 21.9% n=93 Performance indicators not linked to role 69.6% n=272

High self-appraisal of performance Validated Activities and Competencies of four scales: Nurse Educator Role (ACONE), Importance of Support for

Nsurse Educator Role (ISNER), Nurse Retention Index (NRI) and Professional Practice Environment scale (PPE)

as valid and reliable tools for monitoring the role

Qualitative Results:

Themes: Role expectations and responsibilities Ambiguity, overload and role stress

Organisational culture devaluing the role

Integrated Data Summary

147 6.4 Conclusion

This chapter has presented the quantitative findings from the survey, describing the socio-demographic and educational profile of nurse educators, their reporting lines, activities and competencies, and self-appraisal of performance. It has also applied qualitative data from the group interview and survey to confirm and elucidate findings. The findings have demonstrated psychometric principles showing the ACONE, ISNER, NRI and PPE scales to be reliable and valid instruments to monitor the nurse educator role.

The key findings of the survey were: (i) role blurring and ambiguity affecting role visibility, optimization and work satisfaction; (ii) nurse educators with a Master’s qualification, were more likely to identify professional development and learning needs, and those who have regular meetings with their line manager, were more likely to identify their role using the ACONE scale items; (iii) clinical performance outcomes are necessary to demonstrate the contribution of nurse educators to patient care and education; (iv) limited engagement in research and scholarship influences evidence-based practice, role visibility and career development.

The survey provides an important baseline for future role development and capacity building initiatives for nurse educators in acute care hospitals. The integration of data highlights differences and similarities between the data sets to be explored further through the discussion of findings in Chapter 7.

148 6.5 References

Every reasonable effort has been made to acknowledge the owners of copyright material. I would be pleased to hear from any copyright owner who has been omitted or incorrectly acknowledged.

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