The Effect of Empowerment Program for Managers of Different Levels of Nursing on Management Skills of Nursing Students

Introduction: Hospitals are one of the most important service providers that play an important role in maintaining, promoting and restoring patients' physical and mental health. Therefore, special attention should be paid to empowering health service providers, including nurses. Capable employees are competent and influential people in the work and work environment and will probably be able to anticipate and solve their work responsibilities and problems. Empowerment as a motivational structure is a process consisting of empowering employees, which is now recognized as a basic element of management effectiveness in organizations. Empowered managers use effective behaviors in their work environment that result into the authority and independence of nursing staff, more control and influence over their work or their participation in work-related decisions. On the other hand, the clinical nursing training course is one of the most sensitive and crucial stages in nursing training planning, because professional skills of students are established in this period. Empowerments as the clinical skill are considered as the ultimate goal of nursing education and include clinical skills, information and awareness, interpersonal relationships and skills, and problem-solving abilities. Thus, it is necessary that nurses and nursing students as future nurses become aware and skilled in the application of management skills. Objective: The present study aims to determine the effect of empowerment program for managers of different levels of nursing on management skills of nursing students of Tehran University of Medical Sciences. Methodology: The present study is an interventional and two groups study that was conducted in the two semesters of the academic year 2017-2018 in Imam Khomeini Hospital in Tehran. The research samples included 84 nursing students of the eighth semester in the nursing management internship course who were in the two stages before and after and in two control and experimental groups, as well as 19 nursing managers of Imam Hospital complex including head nurses (N = 9) and supervisors (N = 10) who usually participated in the education of nursing management students. In this study, the intervention was the implementation of a psychological empowerment program that was performed for nursing managers (head nurses and supervisors) interested in actively participating in the nursing managers empowerment program. Managers from the complex who did not want to participate in the empowerment program, but usually cooperated and participated in the training of nursing management students, were selected as the control group. Thus, nursing management students who were supervised by each of these two groups and in the relevant departments, were classified as students in the experimental and control groups. The criteria for selecting managers in the intervention group was the willingness to participate in clinical education of nursing management students and active participation in empowerment programs designed in this study (N = 10) and the criteria for selecting control group students in the two stages before and after; Have had internships in departments where the head nurses have announced their readiness to cooperate in educating management students, and the relevant instructor had the informed consent to assess the management skills of their students in this study. The selection of students for the experimental group in the two stages before and after, in addition to the two selection conditions mentioned for the control group, has been the desire of their supervisors to participate in empowerment programs for nursing managers. After approving the design and receiving the ethics license from the joint committee of organizational ethics of the school of nursing and midwifery and the school of rehabilitation of Tehran University of Medical Sciences (IR.TUMS.FNM.REC 1396.4276), sampling and intervention were performed. After implementing the empowerment program for nursing managers in the intervention group, assessing the management skills of students under the supervision of managers of both test and control groups, as in the pre-implementation stage of empowerment programs, using the management skills checklist by observation and questioning relevant instructors and ward supervisor were evaluated.  Data are collected using a management skills checklist and the Spritzer and Mishra psychological empowerment questionnaire before and after the intervention. Spritzer and Mishra’s psychological empowerment questionnaire measures five characteristics of empowerment (feeling of competence, autonomy, effectiveness, sense of meaning and trust). The minimum score is 15 and the maximum is 75, and the total score of 15 questions is the overall score of one’s empowerment and the higher his score, the better his empowerment. Data are analyzed using SPSS software version 16. Results: The mean pre-test score of psychological empowerment variable of nursing managers is 62.33 in the experimental group and 59.50 in the control group. While in the post-test stage, the mean score in the experimental and control groups is 68.777 and 60.700, respectively. Empowerment programs have a significant effect on increasing psychological empowerment in the nursing managers of the experimental group. The mean pre-test score of the management skills variable of the nursing students is 2.066 in the experimental group and 1.940 in the control group. Also, in the post-test stage, the mean score in the experimental group is 2.340 and in the control group is 1.939. According to the results regarding the variable of students' management skills in the experimental group, empowerment programs have significantly increased this variable by 0.274 units (13.2%). Conclusion: Based on the results of this study, empowerment of managers improves the management skills of nursing students. The results of this study can be used to persuade managers of different levels of nursing to implement empowerment programs, which ultimately leads to psychological improvement of the work environment, nurses and nursing students. To improve the performance of nursing students, nursing managers are recommended to pay attention to their managerial skills and psychological empowerment and provide the ground for increasing their empowerment by giving them freedom of action and using their opinions in making career decisions. It is suggested to conduct studies on the effective factors on the empowerment of nursing managers as well as the managerial skills of nursing students as future nurses.