Background: There is a gap between the nursing competence acquired in basic nursing education and the ability required in clinical practice against the backdrop of advances in medical care and other factors, which is one reason for the turnover of newly graduated nurses. In order to bridge this gap, newly graduated nurses have been mandated to undergo training since 2010 and there have been many studies evaluating such training for newly graduated nurses. However, the learners’ ambitious efforts are an important factor to effectively achieve learning outcomes, and as learning is hugely dependent on characteristics of the learner, educational support must focus on the learner. The concept of engagement has been explored in the fields of psychology and education as an indication of motivational efforts and involvement in learning activities. Previous studies have clarified that students with high engagement can acquire academic achievements and desirable abilities and attitudes and that high achievement can improve nursing competence. Therefore, it is important to focus on engagement in learning by newly graduated nurses and clarify its aspects. Elucidating the aspects of engagement in learning of newly graduated nurses can clarify the current state of efforts for newly graduated nurses’ learning and provide suggestions for their educational support.
Methods: Semi-structured interviews were conducted with 16 newly graduated nurses belonging to 5 hospitals with more than 200 general beds from September to October 2018. The interview data were qualitatively and descriptively analyzed.
Outcomes: Based on the interview data, 511 codes were extracted. The codes were classified into 84 subcategories and 28 categories, and four core categories were generated: “Behavioral engagement,” “Emotional engagement,” “Cognitive engagement,” and “Agentic engagement.”
“Behavioral engagement” is a state where efforts are focused on issues and working persistently. “Emotional engagement” is a state of working with positive feelings such as interest and pleasure. “Cognitive engagement” is a state of systematically tackling the problem-solving process, and “Agentic engagement” is a state of positively contributing to the present situation.
“Behavioral engagement” was composed of 10 categories: “studying hard,” “intensively reflecting on practice,” “listening attentively,” “caring while considering safety and comfort of patients and their families,” “trying to find ways of nursing care suitable for patients,” “observing the senior nurse carefully,” “observing the doctor carefully,” “working hard to make arrangements,” “trying to grasp the condition of the patient,” and “concentrating on group training.”
“Emotional engagement” was composed of 8 categories: “having a positive feeling about practicing nursing,” “having a positive feeling about the training,” “finding the training meaningful,” “feeling responsible as a professional under studying,” “feel responsibility as a professional in nursing skills,” “feeling that communication with colleagues will be learned,” and “believing that it is important to build relationships with patients.”
“Cognitive engagement” was composed of 7 categories of “seeking variety of educational materials until they fully understand the content,” “studying systematically,” “adjusting the environment to improve learning efficiency,” “thinking in conjunction with practice,” “using knowledge in practice,” “trying to develop own insights about practice,” and “intentionally being involved with patients and their families.”
“Agentic engagement” was composed of 3 categories: “acquiring positive advice from colleagues,” “actively speaking,” and “proactively finding opportunities for acquiring knowledge and skills.”
Conclusion: In their engagement in learning activities, the newly graduated nurse is “intensively reflecting on practice,” and “caring while considering safety and comfort of patients and their families”; this concept involved persistently thinking about what kind of assistance is the best during and at the end of practice. It is said that intellectual growth will be achieved by reflecting on experience and making use of it in the future. Additionally, it is said that experts take refuge not only on actions but also in acting. It is learning that doing reflection of both remarks on practice and in practice by newly graduated nurse getting involved in learning activities.
In the engagement in learning activities, setting goals in the problem-solving process leads to an interest in the task and efforts and working persistent. In addition, newly graduated nurse will become more interested in the task if they experience pleasure in tackling it. As interest of the newly graduated nurses increases, they will have intentionally trying to acquire insights on practice.These processes begin with newly graduated nurses actively participating in the situation. As described above, it is considered that each aspect of engagement in learning activities of a newly graduated nurse functions while affecting the other.
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