Journal of Korean Academy of Nursing

Research Papers

Mediating effect of grit on the influence of nurses’ silence behavior on medication safety competence: a cross-sectional study: Haengsuk Kim, Wanju Park; J Korean Acad Nurs 2025;55(1):81-92. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24088

Abstract PDF ePub: Purpose
This study investigated the mediating effect of grit in the relationship between silence behavior and medication safety competence among nurses.
Methods
The study included 166 nurses from four university hospitals and general hospitals in Seoul and Gyeonggi-do, South Korea. Data were collected from March 1 to 10, 2024, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffé’s test, and Pearson’s correlation coefficients with IBM SPSS Statistics ver. 23.0 (IBM Corp.). A mediation analysis was performed using Hayes’s PROCESS macro model 4 and the bootstrapping method.
Results
Medication safety competence showed significant correlations with silence behavior (r=–.21, p=.008) and grit (r=.43, p<.001). Furthermore, grit partially mediated the relationship between silence behavior and medication safety competence.
Conclusion
This study indicates that grit is a significant mediator in the relationship between silence behavior and medication safety competence. Therefore, an integrated approach that reduces silence behavior and promotes grit is essential for strengthening nurses’ medication safety competence. Ultimately, these strategies will help ensure patient safety by improving medication safety competence.

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Development and Effectiveness of Progressive Simulation Education Program on Medication Safety for Nursing Students: Se-Young Jung, Eun-Young Kim; J Korean Acad Nurs 2024;54(4):563-576. Published online October 14, 2024; DOI: https://doi.org/10.4040/jkan.24054

Abstract PDF ePub: Purpose
This study aimed to develop and verify a progressive simulation education program aimed at enhancing nursing students’ medication safety competency.
Methods
A non-equivalent control group pretest-posttest design was adopted. The participants were 40 third-year nursing students with no prior simulation education experience, comprising 20 each in the experimental and control groups. The experimental treatment utilized a hybrid simulation approach incorporating both full-body mannequins and standardized patients and was, conducted over three sessions with durations of 65, 80, and 95 minutes for the first, second, and third sessions, respectively, for a total of 240 minutes. The program was constructed based on Jeffries’ simulation model.
Results
The levels of medication safety competencies, communication self-efficacy, learning self-efficacy, and problem-solving abilities of the experimental group were significantly higher than that of the control group.
Conclusion
Our results confirm that the program effectively improves nursing students’ medication safety competence, communication self-efficacy, learning self-efficacy, and problem-solving ability. Therefore, this program can serve as a basis for developing educational strategies related to medication safety for nursing education institutions. Furthermore, the program is anticipated to have a positive impact on novice nurses’ education and practice in clinical settings.

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Concept Analysis of Social Intelligence of Nurses Using Hybrid Model: Lee, Kyung Ran , Lee, Na Kyoung , Oh, Hee , Park, Kyoung Ae; J Korean Acad Nurs 2024;54(3):459-474. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.23121

Abstract PDF: Purpose
The purpose of this study was to conduct a concept analysis of social intelligence in nurses so that applying social intelligence to the nursing field.
Methods
In this study, we followed the hybrid model procedure, involving the following steps: First, in the theoretical stage, the attributes and definitions of the concept of social intelligence were determined through literature review. Second, the concepts’ reality was confirmed during fieldwork. In the final analysis stage, the results confirmed in the theoretical and fieldwork stages were compared and analyzed to confirm the properties and definition of the concept.
Results
Nurses’ social intelligence consists of three dimensions: social cognitive nursing competency, human-centered social evolution, and skills for solving complex nursing situations. Nurses’ social intelligence is a professional nursing competency that flexibly coordinates complex nursing situations, developed through accumulating experiences of continuous reflection and relationship expansion based on receptive listening and social sensitivity in clinical interpersonal relationships.
Conclusion
Nurses’ social intelligence is widely used in clinical practice and is shown to have a significant direct and indirect impact on clinical nursing. To effectively apply social intelligence in the clinical context, individual and organizational efforts are required to share and transfer knowledge and capacity-building methods through collective intelligence and education.

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Original Articles

A Structural Model on the Nursing Competencies of Nursing Simulation Learners: Soo Jin Park, Eun Sun Ji; J Korean Acad Nurs 2018;48(5):588-600. Published online October 31, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.588

Abstract PDF

Purpose

The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory.

Methods

Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs.

Results

The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability.

Conclusion

In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.

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Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP): Eunmi Kwak, Heeyoung Oh; J Korean Acad Nurs 2018;48(4):419-431. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.419

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors.

Methods

The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability.

Results

The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967.

Conclusion

This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.

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Development of a Triage Competency Scale for Emergency Nurses: Sun Hee Moon, Yeon Hwan Park; J Korean Acad Nurs 2018;48(3):362-374. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.362

Abstract PDF

Abstract Purpose

This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability.

Methods

Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios.

Results

The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ ²/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's α of the final model was .91.

Conclusion

Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

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The Effects of Violence Coping Program Based on Middle-Range Theory of Resilience on Emergency Room Nurses’ Resilience, Violence Coping, Nursing Competency and Burnout: Seung Min Lee, Kyung Mi Sung; J Korean Acad Nurs 2017;47(3):332-344. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.3.332

Abstract PDF

Abstract Purpose

The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms.

Methods

A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively. The experimental group received the VCP twice per week for 8 weeks.

Results

Levels of resilience, F=59.41, p<.001, active coping behavior, c²=33.09, p<.001, and nursing competency, F=59.41 p<.001, increased significantly and levels of passive coping behavior, c²=22.92, p<.001, and burnout, F=52.74, p<.001, decreased significantly in the experimental group.

Conclusion

The results suggest that the VCP could be an effective strategy for reducing burnout and improving resilience, active coping behavior, and nursing competency. Therefore, it would be a useful intervention for improving the quality of nursing care provided in emergency rooms.

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Development of the Developmental Support Competency Scale for Nurses Caring for Preterm Infants: Jeong Soon Kim, Hee Sun Shin; J Korean Acad Nurs 2016;46(6):793-803. Published online December 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.6.793

Abstract PDF

Purpose

Developmental care has been recognized as a very important component for the development and health promotion of preterm infants. However, research on how to assess developmental nursing competency has not been studied as expected. This study was done to develop and evaluate a new scale to measure nursing competency for developmental support of preterm infants.

Methods

Concept analysis was done with using the Hybrid model of Schwartz-Barcott and Kim (2000), from which a preliminary new scale (30 items) was developed. To test the validity and reliability of the new scale being developed, data were collected from 122 NICU nurses at 4 hospitals in 3 cities in the Republic of Korea, from December, 2014 to March, 2015.

Results

The final version of the Developmental Support Competency Scale for Nurses (DSCS-N) caring for premature infants was a 4-point Likert type scale, consisting of 19 items, and categorized as 6 factors, explaining 62.5% of the total variance. Each of the factors were named as follows; ‘environmental support’ (4 items), ‘parental support’ (3 items), ‘interaction’ (3 items), ‘critical thinking’ (3 items), ‘professional development’ (3 items), and ‘partnership’ (3 items). The Cronbach's α coefficient for the scale was .83 and the reliability of the subscales ranged from .60~.76.

Conclusion

The psychometric evaluation of the new scale demonstrated an acceptable validity and reliability. Findings indicate that the DSCS-N can be used as the tool to test the effect of educational programs for nurses and contribute to advance developmental care for preterm infants.

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Developmentally Supportive Care Among Neonatal Intensive Care Unit Nurses in South Korea
Han Na Lee, Ji Hyeon Park, Haeryun Cho
Advances in Neonatal Care.2023; 23(3): E60. CrossRef
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Eun Kyoung Kim, In Young Cho, Ji Yeong Yun, Bobae Park
Journal of Pediatric Nursing.2023; 68: e27. CrossRef
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Development and Effects of Assertiveness Training applying Dongsasub Training for Nursing Students in Clinical Practice: Myoungsuk Kim; J Korean Acad Nurs 2016;46(4):490-500. Published online August 31, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.4.490

Abstract PDF

Purpose

This study was conducted to develop assertiveness training applying Dongsasub training for junior nursing students, and to verify effectiveness of the training on assertiveness behavior, self-esteem, clinical practice stress, and clinical competence.

Methods

The study design was a non-equivalent control group non-synchronized design. Participants were 63 nursing students in clinical training (31 students in the experimental group and 32 students in the control group). The assertiveness training applying Dongsasub training consisted of four sessions. Outcome variables included assertiveness behavior, self-esteem, clinical practice stress, and clinical competence. Data were analyzed using Chi-square, Fisher's exact test and independent samples t-test with SPSS/WIN 21.0.

Results

Scores of assertiveness behavior (t=-2.49, p=.015), self-esteem (t=-4.80, p<.001) and clinical competence (t=-2.33, p=.023) were significantly higher and clinical practice stress (t=4.22, p<.001) was significantly lower in the experimental group compared to the control group.

Conclusion

Results indicate that the assertiveness training applying Dongsasub training can be used as a nursing intervention to lower clinical practice stress and improve the clinical competence of nursing students.

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Heejung Heo, Yeoungsuk Song
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Development and Effects of Emotional Intelligence Program for Undergraduate Nursing Students: Mixed Methods Research: Oi Sun Lee, Mee Ock Gu; J Korean Acad Nurs 2014;44(6):682-696. Published online December 31, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.6.682

Abstract PDF

Purpose

This study was conducted to develop and test the effects of an emotional intelligence program for undergraduate nursing students.

Methods

The study design was a mixed method research. Participants were 36 nursing students (intervention group: 17, control group: 19). The emotional intelligence program was provided for 4 weeks (8 sessions, 20 hours). Data were collected between August 6 and October 4, 2013. Quantitative data were analyzed using Chi-square, Fisher's exact test, t-test, repeated measure ANOVA, and paired t-test with SPSS/WIN 18.0. Qualitative data were analyzed using content analysis.

Results

Quantitative results showed that emotional intelligence, communication skills, resilience, stress coping strategy, and clinical competence were significantly better in the experimental group compared to the control group. According to the qualitative results, the nursing students experienced improvement in emotional intelligence, interpersonal relationships, and empowerment, as well as a reduction in clinical practice stress after participation in the emotional intelligence program.

Conclusion

Study findings indicate that the emotional intelligence program for undergraduate nursing students is effective and can be recommended as an intervention for improving the clinical competence of undergraduate students in a nursing curriculum.

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Critical Thinking Disposition and Clinical Competence in General Hospital Nurses: Jin-Ah Park, Bog-Ja Kim; J Korean Acad Nurs 2009;39(6):840-850. Published online December 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.6.840

Abstract PDF

Purpose

This study was done to investigate the relationship between critical thinking disposition and clinical competence among nurses in general hospitals.

Methods

This study was a descriptive-correlational study with a convenience sample of 560 nurses from 5 general hospitals. The data were collected by self-administered questionnaires. Critical thinking disposition was measured using the Critical Thinking Disposition Scale for Nursing Students. Clinical competence was measured using the Standardized Nurse Performance Appraisal Tool.

Results

The mean score for critical thinking disposition and clinical competence was 3.37 and 4.10 respectively on a 5 point scale. A statistically significant correlation was found between critical thinking disposition and clinical competence. A regression model explained 72.8% of clinical competence. Prudence is the most significant predictor of clinical competence (R²=.728).

Conclusion

Study findings suggest that nurses with a higher level of critical thinking disposition would have a higher level of clinical competence. Furthermore, prudence might be the most important predictor of clinical competence. In order to strengthen clinical competence in nurses, the development and enhancement of critical thinking should be emphasized at the college level and nurses should be encouraged to make a clinical decision with greater prudence.

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Validity and Reliability of a Clinical Performance Examination using Standardized Patients: Ja Yun Choi, Keum Seong Jang, Soon Hee Choi, Mi Soon Hong; Journal of Korean Academy of Nursing 2008;38(1):83-91. Published online February 28, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.1.83

Abstract PDF

Purpose

The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing.

Methods

70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station

Results

There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048).

Conclusion

Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.

Citations

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