Implementation and Evaluation of a Training Program to Develop Professional Competencies in Nursing

Introduction: Reflective attitudes generate a highly significant practical knowledge that may lead to the development of professional competences in nursing. In the context of reflective practice, the production of narratives by nurses who have experienced significant cases in their daily practices can boost their reflective behavior. Person-Centered Care (PCC) is a framework that ensures that the patient is at the center of the provision of care, and where the formation and fostering of relationships is key for therapeutic benefits. In this sense, respect, intentional presence, and knowing the person are three core elements of every authentic, specific, and unique relationship between the nurse and the person. In this way, it is assumed that the aforementioned three fundamentals can be reflected in the behaviors, attitudes, and knowledge -professional competences- revealed in a written clinical narrative.

Purpose: A pilot quasi-experimental study was designed as a preliminary trial to help to estimate the treatment effect testing the hypothesis that the use of clinical narratives in the context of a training program for nurses would have an impact on the development of professional competences in providing a PCC.

Methods: The intervention was based on the Critical Reflective Inquiry Model (CRI), and was conducted since October 2016, to June 2017. Different strategies were developed: (1) the writing of three narratives by participants; (2) three masterclasses by experts of the research group; (3) a dialogue group between participants and members of the research group; (4) a face to face interview between each participant and a member of the research group. An evaluation tool was developed to evaluate narratives -NarratUN Evaluation Tool- (NET).

Results: Results of this research supported study hypothesis and confirmed the preliminary efficacy of using narratives on the development of professional competences in providing a PCC. Concretely, the difference of the means between before and after the intervention of respect [0.59 (IC95% 0.23-0.95%; p=0.001)], intentional presence [0.75 (IC95% 0.32-1.17; p<0.0001] and knowing the person increased, being statistically significant.

Conclusion: Being these results similar to other researches, these results show that using narratives in a specialist training program can achieve a significant change in the development of professional competences. Writing narratives can help to promote professional competences in nursing and, consequently, therapeutic relationships, from a PCC approach. The preliminary efficacy of this intervention reinforces the use of narratives to develop professional skills.