Plain English Summary
Background and study aims
Nurses are educated to provide care, but their first period in working life is described as stressful, and they are often exposed to unhealthy stressors and experience negative symptoms. To help them cope with the demands of working life, a learning strategy called “peer learning,” which puts learning and growth in focus, will be tested. Peer learning implies that newly qualified nurses, during their introduction period, learn together in pairs without the immediate involvement of their preceptor. In this way, nurses at the same level can support each other, learn from and teach each other. This has been shown to improve communication and problem solving skills and self-confidence as well as to reduce stress and anxiety. The study aim is to investigate whether peer learning in introduction programs can help newly graduated nurses when they enter working life.
Who can participate?
Newly graduated nurses employed at four hospitals in central Sweden.
What does the study involve?
Nurses will be randomly allocated into one of two groups. Those in group 1 are assigned to the peer learning introduction program. Those in group 2 are assigned to the traditional introduction program. Peer learning means being introduced to the nursing profession with a peer. Newly graduated nurses are introduced into the work with another newly graduated nurse. They always work during the same shift for three weeks and are jointly responsible for a group of patients. They also engage in daily reflection. During the following three weeks, they are scheduled on the same shift at least three work shifts per week. The pair engage in reflection regularly every week for the next two months. The control group is introduced into the profession in the traditional manner, which involves “walking” alongside an experienced nurse for a few weeks. One experienced nurse supervises one newly graduated nurse at a time. On five occasions they complete a questionnaire where they self-rate their self-efficacy, learning and development, empowerment, well-being, stress, job satisfaction and satisfaction with given care. Before the experimental study, a pilot (small) study is done to see whether there is anything that needs to be adjusted before starting the larger study. In the pilot (small) study, the nurses complete the questionnaire (as above); they are also be interviewed and themselves audio-record reflective conversations they have together.
What are the possible benefits and risks of participating?
Peer learning may help newly graduated nurses cope with the demands of working life. If nurses are given the opportunity to develop optimism and self confidence, this can lead to meaningful experiences and a feeling of "flow" at work. This may, in turn, lead to positive organizational consequences, such as good work performance, and the nurses may experience individual and health benefits, such as well-being and job satisfaction. However, participating in the study involves answering questionnaires and interviews that may make them feel uncomfortable.
Where is the study run from?
University of Gävle, the County Council of Gävleborg, Aleris Bollnäs Hospital and TioHundra Norrtälje Hospital (Sweden).
When is the study starting and how long is it expected to run for?
April 2014 to September 2020
Who is funding the study?
University of Gävle (Sweden)
Who is the main contact?
Ylva Pålsson
ylva.palsson@hig.se
Trial website
Contact information
Type
Public
Primary contact
Ms Ylva Pålsson
ORCID ID
http://orcid.org/0000-0002-5436-3566
Contact details
University of Gävle
Faculty of Health and Occupational Studies
Department of Health and Caring Science
Kungsbäcksvägen 47
Gävle
SE- 801 76
Sweden
Type
Scientific
Additional contact
Dr Gunilla Mårtensson
ORCID ID
http://orcid.org/0000-0003-1185-061X
Contact details
University of Gävle
Faculty of Health and Occupational Studies
Department of Health and Caring Science
Kungsbäcksvägen 47
Gävle
SE- 801 76
Sweden
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
N/A
Study information
Scientific title
Does peer learning in introduction programs, in comparison to traditional introduction, professionally develop and better prepare newly graduated nurses for entering working life? A randomized controlled trial
Acronym
Study hypothesis
Newly graduated nurses who are given the opportunity to "learn the profession" with a peer have higher self-ratings of perceived capability to perform nursing-specific tasks and competences (self-efficacy), learning and development (thriving), psychological empowerment, well-being, job satisfaction and satisfaction with given care higher and self-rate less stress/demands than do new graduates in a control group who are introduced to the profession in the tradition manner.
Ethics approval
The Regional Ethical Review Board in Uppsala, Sweden, 20 August 2014, ref. 2014/192.
Study design
A randomized controlled trial (RCT). A multicenter interventional study with block-randomization to intervention and control group preceded by an exploratory pilot study.
Primary study design
Interventional
Secondary study design
Trial setting
Hospitals
Trial type
Other
Patient information sheet
Not available in web format, please contact ylapan@hig.se to request a patient information sheet.
Condition
Newly graduated nurses’ introduction into the profession at four hospitals in central Sweden.
Intervention
Peer learning originates from social learning theories, which claim that experience, understanding and knowledge building are shaped and developed in interaction between humans. Peer learning is a pedagogical activity defined as persons at the same level helping each other to learn and learning through teaching. Peer learning thus allows newly graduated nurses to work in pairs and be introduced into the profession with a peer. Central to peer learning is reflection, support, collaboration, critical thinking and problem solving.
In the present trial, the intervention includes: Newly graduated nurses randomized to the intervention group will be introduced into the profession through peer learning for 3-4 weeks. During these weeks, the newly graduated nurses will always work the same shift and have joint responsibility for a group of patients. Their preceptor will provide support and feedback when needed, but in contrast to traditional introduction he/she will not play an active role in nursing activities. Using a clear structure, the pair will engage in daily reflection that is scheduled. For three weeks after the introductory period, the nurses will be scheduled on the same shift at least three work shifts per week. Joint reflection will be scheduled regularly every week from the introductory period and two months forward. The intervention period is three months. The participants will, because of practical reasons, be randomized in block of ten pairs. The control group will be introduced into the profession in the traditional manner, which involves “walking” alongside an experienced nurse for a few weeks. One preceptor supervises one newly graduated nurse at a time. The trial will be piloted to test the feasibility of the intervention, as well as to test the sample recruitment strategies and data collection occasions and instruments.
Intervention type
Other
Phase
Drug names
Primary outcome measure
1. Perceived capability to perform nursing specific tasks and competences (Self-efficacy) (validated questionnaires)
2. Psychological empowerment (validated questionnaires)
3. Learning and development (thriving) (validated questionnaires)
4. Satisfaction with given care (validated questionnaires)
5. Job satisfaction (validated questionnaires)
6. Stress/Demands (validated questionnaires)
Data will be collected at five occasions, at the beginning of the introduction period, after the introduction ends, six to eight weeks, three months and one year after participants started working as nurses. The pilot study will collect data at four occasions, at the beginning of the introduction period, after the introduction ends, six to eight weeks and three months after they started working as nurses. In addition, qualitative data will be collected in the pilot study through regular interviews about participants’ experience of the intervention, difficulties they face and how they handle these, and their experience of their first time as a nurse. They will also audio-record their reflective conversations.
Secondary outcome measures
1. Structural empowerment (validated questionnaires)
2. Lifestyle and life balance (validated questionnaires)
3. Well-being (validated questionnaires)
Secondary outcomes will be measured at the same occasions as the primary outcomes.
Overall trial start date
22/04/2014
Overall trial end date
01/09/2020
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
Newly graduated nurses who, for the first time, are being introduced into the nursing profession.
Participant type
Health professional
Age group
Adult
Gender
Both
Target number of participants
A total of 152 newly graduated nurses will be included in the RCT. 10-20 informants will be included in the pilot study.
Participant exclusion criteria
Does not meet inclusion criteria.
Recruitment start date
12/01/2015
Recruitment end date
01/06/2018
Locations
Countries of recruitment
Sweden
Trial participating centre
University of Gävle
Kungsbäcksvägen 47
Gävle
SE-801 76
Sweden
Trial participating centre
The County Council of Gävleborg
Gävle
SE-801 88
Sweden
Trial participating centre
Aleris Specialistvård Bollnäs
Bollnäs Hospital
Bollnäs
SE-821 81
Sweden
Trial participating centre
Vårdbolaget TioHundra
Norrtälje Hospital
Box 905
Norrtälje
SE- 761 29
Sweden
Sponsor information
Organisation
University of Gävle
Sponsor details
Faculty of Health and Occupational Studies
Department of Health and Caring Science
Kungsbäcksvägen 47
Gävle
SE-801 76
Sweden
+4626648500
gls@hig.se
Sponsor type
University/education
Website
Funders
Funder type
University/education
Funder name
University of Gävle
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
The first RCT study results are intended publication in 2020, there might also be a study on the 1- and 2-year outcomes later.
IPD sharing statement
The datasets generated during and/or analysed during the current study are not expected to be made available as the authors do not have permission to share the data.
Intention to publish date
31/12/2020
Participant level data
Not expected to be available
Basic results (scientific)
Publication list