Effects of a Virtual Community of Practice on Self-Efficacy of New Nurse Leaders

The need to innovate in health care presents nurses with the challenge of developing new clinical roles. Individuals assuming such roles are presented with unique opportunities but may not have useful past experiences on which to draw to be successful in a new role. Clinical nurse educators in long term and skill nursing centers are both educators and leaders in their clinical settings. With the increasing acuity of the patient population in skilled nursing and long-term care, clinical nurse educators will need the self-confidence to bridge the gap between education and practice to improve the quality of care in long-term and post-acute care. This is especially true in multi-site and geographically dispersed care centers which are the result of ongoing mergers in the health care industry. Nurse educators are combining clinical skills and teaching while exercising leadership skills in managing the expectations of other leaders in their organizations, both laterally, vertically, and horizontally and who are likely geographically dispersed. Nurse educators practicing in these settings may lack the self-efficacy to assume the leadership aspect of these new roles.

Self-efficacy, the belief in the ability to executive certain behaviors to particular goals, may be lacking in those in emerging clinical roles. Communities of Practice may be a vehicle that may positively affect self-efficacy. Based on one of four spheres of influence on self-efficacy described by Bandura, this pilot study assessed the degree to which shared experiences narrated and heard through a series of virtual Communities of Practice experiences affected nurse educators who practice in a new education role within a large, multi-state, skilled and long-term care organization.

Communities of practice have been determined to have positive effects on learning, relationship building and interprofessional collaboration, identity formation among peers, and creating feelings of professional autonomy. Communities of practice also have shown to reduce feelings of isolation and increase problem solving skills.

Participants engaged in six Community of Practice calls and shared experiences with each other over a three-month period and took a pre- and posttest survey to determine if three domains of self-efficacy were influenced: leader action self-efficacy, leader self-regulation efficacy, and leader means efficacy. The virtual aspect of the Community of Practice was both intentional and necessary as the research participants were practicing in several states and many do not engage one another in any face to face venues.

Because reductions in financial overhead are an important feature of health care, virtual interactions among an organization's leaders is not uncommon, especially in organizations that are multi-site and span wide distances. The purpose of the study was to assess the degree to which vicarious learning, as mediated by a virtual Community of Practice, may influence the self-efficacy of nurse educators who practice in a new role within a large long-term care organization.