Evaluating undergraduate nursing students' self-efficacy and competence in writing: Effects of a writing intensive intervention

https://doi.org/10.1016/j.nepr.2014.12.002Get rights and content

Highlights

  • Competence in writing has been shown to correlate with ability to think critically.

  • Writing skills should be emphasized, not de-emphasized, in basic nursing education.

  • Scaffolded writing tasks are recommended to improve nursing students' writing skills.

  • Writing confidence can improve when repeated practice in writing tasks is provided.

Abstract

While professional nurses are expected to communicate clearly, these skills are often not explicitly taught in undergraduate nursing education. In this research study, writing self-efficacy and writing competency were evaluated in 52 nontraditional undergraduate baccalaureate completion students in two distance-mediated 16-week capstone courses. The intervention group (n = 44) experienced various genres and modalities of written assignments set in the context of evidence-based nursing practice; the comparison group (n = 8) received usual writing undergraduate curriculum instruction. Self-efficacy, measured by the Post Secondary Writerly Self-Efficacy Scale, indicated significant improvements for all self-efficacy items (all p's = 0.00). Writing competency, assessed in the intervention group using a primary trait scoring rubric (6 + 1 Trait Writing Model® of Instruction and Assessment), found significant differences in competency improvement on five of seven items. This pilot study demonstrated writing skills can improve in nontraditional undergraduate students with guided instruction. Further investigation with larger, culturally diverse samples is indicated to validate these results.

Introduction

Effective communication skills, both written and oral, are essential for professional nurses to function in leadership roles in today's increasingly dynamic and complex healthcare environment (Huston, 2014, Sullivan, 2012). Historically, nurses have relied on face-to-face communication to share ideas, exchange information, and provide patient care. This oral tradition, often informal and unstructured, is used to plan and implement appropriate, safe nursing care (Yoder-Wise, 2011). Today though, nurse leaders must go beyond face-to-face conversation to communicate more broadly across healthcare settings with other providers, ancillary support services, and non-health related services to positively impact patient and family outcomes. It is critical, then, that professional nurses in this diverse technology-driven environment are able to construct clear, coherent messages to effectively address patient care issues (Huston, 2014, Sullivan, 2012, Yoder-Wise, 2011).

Recognizing that essential communication skills are often limited or lacking in professional nursing practice, our team implemented a writing intervention targeting the generalist nursing curriculum with the intent to improve student writing skills. The goal of this pilot project was to develop and test this innovative writing intervention implemented in a typical online learning setting. Participants in this project were practicing registered nurses (nurse to degree-prepared nurse students) who were completing their undergraduate baccalaureate nursing (BSN) degree in two non-traditional nursing programs in the United States. As a result of learning higher order critical thinking, problem solving and decision-making skills through writing skill development, we hypothesized that these professional nurses would be better prepared to communicate effectively, and ultimately, demonstrate themselves to be leaders in their clinical environments.

Using a quasi-experimental, pre-post design, nurse to degree-prepared nurse (baccalaureate completion [RN-BSN]) students enrolled in their final course at two universities located in the mid-western United States participated in the 16-week project. One group received the writing intensive intervention; the comparison group received usual writing experiences consistent with preparation for the generalist nursing degree in the United States. The primary aim of this present study was to determine the efficacy of a writing intensive intervention on the outcome of writing competency in online nursing students completing their generalist nursing degree. A secondary aim of this research was to examine the influence of the writing intensive intervention on assigned writing tasks over the semester on the outcome of writing self-efficacy, a potential mediating variable. Therefore, the study questions of interest in this pilot study were:

  • 1)

    What is the difference in the change in writing self-efficacy over the semester between the intervention group and the comparison group?

  • 2)

    What is the change in writing competency for the intervention group after a semester-long writing intensive intervention?

Section snippets

Writing self-efficacy

An important factor in achieving writing competence can be explained by having confidence that one can be a successful writer, as shown in studies using Bandura's concept of self-efficacy (1997) to predict writing success (Daly and Miller, 1975, Lavelle, 1993, Pajares and Valiante, 1999, Piazza and Siebert, 2008). Bandura defined self-efficacy as the “belief in one's capabilities to organize and execute the courses of action required to produce given attainments” (1977, p. 3). The combination

Participants and setting

A convenience sample of 52 online degree completion nursing students enrolled in the final course of their generalist education at two universities in the United States were included. Inclusion criteria were enrollment in the online nursing course and successful completion of course assignments. No student enrolled in either of the two courses was excluded. At the start of the semester, students in the two courses were emailed a study recruitment information sheet through the online course

Results

During spring semester 2013, 44 (of 48; 92%) online students in the intervention group participated in the writing self-efficacy and writing competence assessments. In the comparison group, 8 (of 12; 75%) students participated in the pre- and post-course self-efficacy assessment only. Table 2 displays the demographic characteristics for each group of those who completed the study. The total sample was primarily female Caucasian nurses who were working full time in nursing. More than one-half of

Discussion

Past studies reporting writing competency and self-efficacy outcomes in all levels of student learners are extensive in the psychology, education, and rhetoric/composition literature. This pilot study, however, is the first research of its kind in nursing education to deliver a writing intervention and systematically evaluate higher order writing competence and students' beliefs about their writing abilities. These results support our hypothesis that writing competence improves if students are

Conclusion

Regrettably, student competency in writing and other communication skills is often assumed rather than explicitly taught. In clinical practice, nurses are expected to write clearly, yet when working with nursing students, nursing faculty easily fall short in preparing students to meet these expectations. This ongoing project provides the opportunity to further define and test a research-based writing composition intervention for nursing education, currently not available in the nursing

Conflict of interest statement

All authors state there are no conflicts of interest and no financial interests.

Acknowledgments

Our research team is appreciative of the support of the University of Missouri Campus Writing Program in the United States and recognizes Dr. Win Horner who introduced the writing across the curriculum concept to undergraduate education on the University of Missouri campus.

References (57)

  • A. Bandura

    Social Foundations of Thought and Action

    (1986)
  • A. Bandura

    Self-efficacy: the Exercise of Control

    (1997)
  • L.E. Berk et al.

    Scaffolding Children's Learning: Vygotsky and Early Childhood Education

    (1995)
  • J.T. Bickes et al.

    Righting writing: strategies for improving nursing student papers

    Int. J. Nurs. Educ. Scholarsh.

    (2010)
  • Campus Writing Program

    Writing Intensive Guidelines

    (2013)
  • L. Carter et al.

    A study of critical thinking, teacher-student interaction, and discipline-specific writing in an online educational setting for registered nurses

    J. Contin. Educ. Nurs.

    (2008)
  • I.L. Clark et al.

    Writing and learning in the health sciences: rhetoric, identity, genre, and performance

    WAC J.

    (2008)
  • K.V. Cowles et al.

    Collaboration for teaching innovation: writing across the curriculum in a school of nursing

    J. Nurs. Educ.

    (2001)
  • J. Daly et al.

    The empirical development of an instrument to measure writing apprehension

    Res. Teach. Engl.

    (1975)
  • S.R. Dewar

    The evidence-based practice course as an opportunity to measure writing apprehension

    Nurse Educ.

    (2012)
  • Education Northwest

    6+1 Trait® Writing Model of Instruction and Assessment

    (2013)
  • T. Flesher

    Writing to learn in mathematics

    WAC J.

    (2003)
  • S. Forsman

    Writing to learn means learning to think

  • E.A. Gazza et al.

    Facilitating scholarly writer development: the writing scaffold

    Nurs. Forum

    (2012)
  • S.B. Goodman et al.

    Efficacy and anxiety: an examination of writing attitudes in a first-year seminar

    J. Excell. Coll. Teach.

    (2009)
  • T. Grundy

    The writing program in the Beaverton School District

    OSSC Bull.

    (1986)
  • C.J. Huston

    Professional Issues in Nursing: Challenges and Opportunities

    (2014)
  • E. Lavelle

    Development and validation of an inventory to assess processes in college composition

    Br. J. Educ. Psychol.

    (1993)
  • Cited by (27)

    • Nursing Care Paper as a Writing Intensive Requirement in Clinical Nursing Courses

      2020, Teaching and Learning in Nursing
      Citation Excerpt :

      The instructor then gradually decreases and ultimately removes the scaffold as the learner progresses (Gazza and Hunker, 2012). Carefully planned and scaffolded writing assignments increase students’ writing self-efficacy and writing competence (Huerta and Garza, 2019; Miller et al., 2015). The NCP assignment incorporates reflection both in the high- and low-stakes components.

    • A curriculum-wide assessment of writing self-efficacy in a baccalaureate nursing program

      2018, Nurse Education Today
      Citation Excerpt :

      By increasing the frequency of writing, student comfort with writing will also increase, contributing to the long-term maintenance of writing skills (Kolb 2013). Numerous research studies have identified that writing self-efficacy can be improved from pre-to-post writing course (Goodman and Cirka 2009; Jones 2008; MacArthur et al. 2016; Miller et al. 2015; Mitchell et al. 2017a; Mitchell et al., 2017b; Van de Poel and Gasiorek 2012). Most of these studies were conducted on first-year cohorts of students in introductory writing courses.

    • Student Facilitation of Simulation Debrief: Measuring Reflective Thinking and Self-Efficacy

      2017, Teaching and Learning in Nursing
      Citation Excerpt :

      Self-belief combined with competency is the key to successful professional practice and is a crucial goal for nurse educators (Kennedy et al., 2015). To effect reflective capacity, nurse educators need to address students' confidence and competence in tandem (Miller et al., 2015). If students possess a high degree of self-belief for critical reflection, this can enable them to attempt critical reflection in practice, albeit simulation or clinical practicum.

    • Coping self-efficacy of Chinese nursing undergraduates with their research projects

      2016, Nurse Education Today
      Citation Excerpt :

      The evidence on direct and/or moderating effects of academic research self-efficacy in nursing students leads to the recommendation to promote training in research ability that focuses on how to cope more effectively during nursing care education. Previous studies have reported that nursing undergraduates' self-efficacy outcomes concentrated on both writing competency (Miller et al., 2015) and their ability to pursue research (research self-efficacy) with perceptions of their mentors (Lev et al., 2010). However, how nursing students develop coping self-efficacy and scientific skills as a specific ability during professional study has received little attention.

    View all citing articles on Scopus
    View full text