Strengthening soft skills as the character of student nurses through the preceptorship management model

Abstract

Background

A nurse is a profession that requires character and soft skills because nursing as a professional discipline has special domain knowledge and skills as well as attitudes or behaviors obtained through academic education and clinical practice experience. These knowledge, skills and attitudes or behaviors are used in service, so this is what distinguishes nurses as professional disciplines, not just academics (professional character).

Objective

Strengthening soft skills as the character of student nurses through a preceptorship management model.

Methods

A research and development (R&D) was conducted by using reference studies with a quasi-experimental design. The samples in this study were 123 student nurses in odd and even semester of total sampling. The measurement of the professional character of these students used the Professionals Character Questionnaire (PCQ). Data analysis in this study used both descriptive and statistical analysis of Wilcoxon.

Results

The characteristics of the student nurses were 60.9% consists of female students (34.1% of the odd semester and 26.8% of the even semester), the youngest age was 19 years and the oldest age was 50 years, the shortest practice period was one month, and the longest was 12 months. The caring character of the student nurses of the Faculty of Nursing and Health Sciences in even semester was better than the odd semester of 8.2%. The professional character of the student nurses in even semester with a good category was almost three times more than the odd semester of 37.5%. The activism character of the student nurses in even semester with a good category was twice as much compared to the odd semester of 33%. The gender influences the caring character of the student nurses of The Faculty of Nursing and Health Sciences at UNIMUS with p-value 0.039. The gender also affects the activism character of student nurse of The Faculty of Nursing and Health Sciences at UNIMUS with p-value 0.017.

Conclusion

There are differences in caring, activism and professionalism between the student nurses of The Faculty of Nursing and Health Sciences at UNIMUS in even semester and odd semester with each p-value 0.021 for caring, 0.010 for activism and 0.001 for professionalism.

Introduction

Nurses are a profession that requires character and soft skills because nursing as a professional discipline has domains of knowledge and skills as well as attitudes or behaviors obtained through academic education and clinical practice experience. These knowledge, skills and attitudes or behaviors are used in service, so this is what distinguishes nurses as professional disciplines, not just academics (professional character).

Hartiti¹ research result showed that soft skills of nursing students in the 2nd, 4th, 6th, and 8th semester have increased in each semester, this can be marked as the maturity of professional attitude. Soft skill consists of interpersonal and intra-personal skills. If both of these skills are owned, success in the workplace will be easily achieved. According to Ismail,² soft skills are the carrying capacity which is very large in attaining the success of someone entering the workforce. Even though someone has good hard skill ability, but if personality or good soft skills do not support it, it will be useless. From the total sample of 264, nursing students who have high soft skills were 32.3%, moderate soft skills are 55.7%, and low soft skills are 12%. The best soft skills of students were in teamwork and moral and professional ethics, while the lowest soft skills are the ability to lead and the ability to think critically. Soft skills are a competency that must be possessed by nurses in entering the workforce.¹ The process of forming a professional nurse character is carried out in the context of interaction with the community.

The core competency of the expected soft skills is the ability to understand culture (0.56), emotional intelligence (0.44), management of political intelligence (0.28), nurse, doctor and other professionals relations (0.28), cooperation with diverse teams (0.28), negotiation and management skills against conflict (0.16), and support for professional needs (0.80). From Hartiti³ research results in one action research at the hospital, it was found that the transformational leadership model of the head of section room was effective in increasing the soft skills of the practise nurses.

The process of professional character formation is carried out through preceptorship relationships. According to Gaberson and Oermann,⁴ preceptorship outcome encompasses cognitive domains (intellectual and knowledge skills), psychomotor domains (technology skills and skills), and affective domains (professional attitudes, values and beliefs: soft skills and character). Research conducted by HAPEQ⁵ on the competence of nurses in 32 provinces in Indonesia based on perceptions of senior nurses, users, society, practical nurses and stakeholders. The result of community perceptions was the best with 68.7% are competent, and 31.3% are incompetent, followed by perceptions of practical nurses with 53 5% are competent and 46.5% are incompetent, and the perceptions of stakeholders were 47.4% are competent and 52.6% are incompetent. All the variables measured by ethics, legal, culturally sensitive, care management and professional development.

Methods

The research method used in this study was research and development (R&D) using reference studies to develop a preceptorship module to strengthen the professional character of Student nurses of The Faculty of Nursing and Health Sciences at UNIMUS and using modules to be applied in guidance or preceptorship in clinics. The populations in this study were students who are taking part in the nursing profession both odd and even semester with 123 people, namely 63 in the odd semester and 60 in the even semester taken in total sampling.

Results

The characteristics of the research samples

The student nurses of The Faculty of Nursing and Health Sciences at UNIMUS both odd and even semester mostly have female gender, which was 60.9% (34.1% for the odd semester and 26.8% for the even semester).

The average age of the student nurses of The Faculty of Nursing and Health Sciences at UNIMUS is 24.34 years with a standard deviation of 4.06, with the youngest age of 19 years and the oldest one of 50 years. The duration of practice of the student nurse of Fikkes at UNIMUS was 9.5 months with a standard deviation of 4.06. The shortest practice period was one month for even semester students and the longest practice period was 12 months. The student nurses in the odd semester are relatively longer than they are in even semester. Most of the nursing profession students practiced at Kariadi Hospital Semarang with the percentage of 50.4%, at Ketileng Hospital with the percentage of 24.4% and at Roemani Hospital with the percentage of 25.2%.

The description of the professional character of the student nurses of Fikkes at UNIMUS in academic year of 2017

The description of the professional character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 consists of 3 criteria, namely caring, activism and professionalism.

The caring character of the student nurses of The Faculty of Nursing and Health Sciences at UNIMUS in the academic year of 2017 was in the mean value of 42.17, and the standard deviation was 4.91 with the lowest value of 28 and the highest score of 40. To differentiate the caring character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 from the even and the odd semester can be seen in Table 1.

Table 1.

The professional character differences of the student nurses of the faculty of nursing and health sciences at UNIMUS in academic year of 2017 based on caring characters (n = 123).

No.	Caring	Odd semester		Even semester		Total
		f	%	f	%	f	%
1	Good	22	17.9	24	19.5	46	37.4
2	Adequate	30	24.4	25	20.4	55	44.8
3	Less	11	8.9	11	8.9	22	17.8
	Total	63	51.2	60	48.8	123	100

The caring character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 from the even semester was better than the odd semester of 8.2%. According to the researcher, this could happen because in the even semester the preceptor was exposed to more intensive preceptorship training in the process of guidance to students.

The activism character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 is in the average value of 40.68, and the standard deviation is 5.19 with the lowest value of 28 and the highest value of 50. To distinguish the character of the student nurses of The Faculty of Nursing and Health Sciences at UNIMUS in the academic year of 2017 from even semester and odd semester can be seen in Table 2.

Table 2.

The professional character differences of the student nurses of Fikkes at UNIMUS in academic year of 2017 based on activism characters (n = 123).

No.	Activism	Odd semester		Even semester		Total
		f	%	f	%	f	%
1	Good	15	12.2	30	24.4	45	36.6
2	Adequate	35	28.4	22	17.9	57	46.3
3	Less	13	10.6	8	6.5	21	17.1
	Total	63	51.2	60	48.8	123	100

The activism character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 from even semester with a good category is twice as much compared to odd semester which is only 50%, and from less category on activism character was 33% smaller. The activism of the even semester students is better than the odd semester students. According to the researchers’ analysis, the preceptor has better implement the preceptorship guidance process with various approaches, where the students can develop clinical competence.

The professionalism character of the student nurses of The Faculty of Nursing and Health Sciences at UNIMUS in the academic year of 2017 was in the mean value of 33.81, and the standard deviation was 4.25 with the lowest value of 28 and the highest score of 40. To distinguish the professional character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 from the even and odd semester can be seen in Table 3. The professional character of the student nurses of Fikkes at UNIMUS in the academic year of 2017 from the even semester with the good category is almost three times more than the odd semester (37.5%), and the less category is 62% smaller.

Table 3.

The professional character differences of the student nurses of Fikkes at UNIMUS in academic year of 2017 based on the character of professionalism (n = 123).

No.	Professionalism	Odd Semester		Even Semester		Total
		f	%	f	%	f	%
1	Good	12	9.8	32	26.0	44	35.8
2	Adequate	30	24.4	15	12.2	45	36.6
3	Less	21	17.0	13	10.6	34	27.6
	Total	63	51.2	60	48.8	123	100

The analysis of the differences between the characteristics variable and professional character of the student nurses of Fikkes at UNIMUS in academic year of 2017

The analysis of the differences between the characteristics variable and professional character of the student nurses of The Fikkes at UNIMUS in the academic year of 2017.

This study provides results that age, and duration of practice do not affect the professional character of the student nurses of Fikkes at UNIMUS in the academic year of 2017, both the character of caring, activism, and professionalism. Gender influences the caring character of the Student nurses of The Faculty of Nursing and Health Sciences at UNIMUS in academic year of 2017 with p-value 0.039. Gender also affects the activism character of the Student nurses of Fikkes at UNIMUS in academic year of 2017 with p-value 0.017. The results also show that there are differences in the character of caring, activism and professionalism between the student nurses of Fikkes at UNIMUS in academic year of 2017 from the even semester with the odd semester with each p-value of 0.021 for caring, 0.010 for activism and 0.001 for professionalism.

Discussion

The professional character values of even term and odd term students are relatively different between even term students, because the preceptor has implemented the results of the preceptorship training and follows the module directives by applying various preceptorship guidance methods according to Firtko et al.⁶

This activism component is manifested by one's involvement in activities related to the development of the nursing profession, such as participating in nursing associations, participating in carrying out nursing research, and understanding public policies related to the profession.⁷ As one health practitioner, nurses have a moral responsibility to be involved in advocating the development of health professionals and organizations and other health systems that involve the health profession.⁸

Assessment of the value of caring (caring), which is defined as feelings that address the care, respect and respect for others that can influence someone in thinking and acting.⁹ The application of caring attitude aims to develop, improve the patient's condition and also can provide comfort to the client when given nursing services.¹⁰ Good caring application by students is also influenced by clinical practice learning. As explained by Watson,¹¹ caring is based on knowledge derived from experience during clinical practice. This concept is in line with research conducted by Mlinar,¹² regarding first- and third-year student nurses’ perceptions of caring behavior, explaining that students who have learned clinical practice are better at applying perceptions of caring behavior. Another assessment of professional value is the activity value category (activism) reflects the attitude of activism, which is reflected by participating in developing the profession, participating or applying the results of nursing research.¹³ The application of good activism values because nurses’ professional curricula apply practice learning by implementing the results of nursing research. The application is mentioned in the Weish and Schank¹³ instrument, that one of the values of activism that can be assessed is by implementing the results of nursing research when implementing the nursing practice. Implementing the results of nursing research while still undergoing the educational process is the formation of a positive attitude that is expected to form professional nurses by providing services efficiently and effectively in accordance with procedures, utilizing appropriate technology and applying research results to achieve optimal health degrees.¹⁴ Another category is the value of professionals who are defined as behaviors or qualities that characterize people who act according to procedures of Rego.¹⁵ The value of professionalism has 3 precipitating factors in building professionalism into nurses namely knowledge, ethics, courtesy and psychomotor.¹⁶ Professionalism in professional study program for term 2017 students who have grades in good category, these results indicate that the application of professional values by students mostly have good categories. Nurses who undergo clinical practice have independent managment and provide holistic nursing care. Rhodes et al.,^17,18 explained that finding a curriculum to improve professionalism in students is by conducting discussions aimed at increasing student interaction and training students to think critically. The curriculum at the University of Muhammadiyah Semarang which applies tutorial learning to hone students to think more critically, wherein the process is given to the students then resolved independently which is discussed among students.

Conflict of interests

The authors declare no conflict of interest.