Empowerment, job satisfaction and organizational commitment: a comparative analysis of nurses working in Malaysia and England

Aims To examine the relationships between nurses empowerment, job satisfaction and organizational commitment in culturally and developmentally different societies. Background Employment and retention of sufficient and well-committed nursing staff are essential for providing safe and effective health care. In light of this, nursing leaders have been searching for ways to re-engineer the healthcare system particularly by providing an environment that is conducive to staff empowerment, job satisfaction and commitment. Methods This is a descriptive correlational survey of 556 registered nurses (RNs) in two teaching hospitals in England and Malaysia. Results Although the Malaysian nurses felt more empowered and committed to their organization, the English nurses were more satisfied with their job. Conclusion The differences between these two groups of nurses show that empowerment does not generate the same results in all countries, and reflects empirical evidence from most cross cultural studies on empowerment. Implications for nursing management Nursing management should always take into consideration cultural differences in empowerment, job satisfaction and commitment of nursing staff while formulating staff policies

Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia

Background: The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence. Methodology: This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection -- A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale. Results: The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance. Conclusion: An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level. (Abstract by authors