Effectiveness of Adventure-Based Training Program in Enhancing Competence, Resilience and Self-Efficacy in Nursing Students Preparing for Clinical Practicum

Abstract

Background and Objectives: Clinical practice is a vital component of nursing education that provides students with real-life opportunities to practice in hospital and community settings. Nevertheless, with the increasing complexity of the health care system, accountability for patient care and expectations for higher-quality service from the general public, the clinical practicum can be a very stressful experience for nursing students that requires the development of competence, resilience and self-efficacy in school. Adventure-based training has been found to be effective in promoting resilience and self-efficacy in primary and secondary school students, but large-scale studies of its effectiveness remain scarce. It is unclear from the literature whether an adventure-based training programme could enhance nursing students’ competence, resilience and self-efficacy in preparation for their clinical practicum, so rigorous empirical scrutiny of its effectiveness is needed. Methods: Before the main interventional study, a pilot study was conducted to determine the feasibility of the study protocol, its acceptability by the participants and the appropriateness of the evaluation tools. A randomised controlled trial was then conducted (i.e., the main interventional study). Of 146 Year Two nursing students between 19 and 25 years of age recruited from a Hong Kong institution of higher education, 74 were randomly assigned to the experimental group to participate in two sessions of a 1-day adventure-based training programme, and 72 were assigned to the wait-list placebo control group to receive a placebo intervention. All subjects were assessed for competence, resilience and self-efficacy at the baseline and at 3 and 6 months after the intervention began. Results: Statistically significant differences in competence, resilience and self-efficacy were seen between the groups. Results of mixed between-subjects and within-subject analysis of variance show that the participants in the experimental group reported significantly higher levels of competence, resilience and self-efficacy than those in the wait-list placebo control group. The partial eta squared value indicated a large intervention effect size. Conclusions: This is the first randomised controlled trial to examine the effectiveness of an adventure-based training programme for nursing students in preparation for their clinica practicum. Overall results provide evidence that such training is effective in enhancing competence, resilience and self-efficacy in nursing students in preparation for their clinical practicum.