Behaviourist Learning Theory Directed Nursing Practice Nursing Essay

According to professional standards of the College of Nursing of Ontario, the leadership expectation is not limited to nurses who are in formal leadership positions; all nurses, no matter of what kind the positions they are, have obligation to demonstrate leadership. Leadership requires knowledge to understand not only our own beliefs, values and behaviour affecting others, but also other’s beliefs, and values to build respect, trust, and integrity in a health care team. This course requires students choose a theoretical framework to guide developing a learning plan, and then applying the theory to a practice project for the purpose of expanding their perspective of nursing practice as an independent thinkers in the organizational or global level of hospital or community setting. My project report will review and analyze how behaviourist learning theory (BLT) directs my learning activities in clinical practice as an independent thinker to prepare myself in optimizing my future nursing practice. It includes two components: knowledge and application. The knowledge component will involve reviewing and comparing relevant content about the correlation between the generations of nursing workforce and choice of leadership style from five recent scholarly articles, identifying their strength and limitation, as well as guiding my nursing practice to achieve my learning goals. The application component includes how the acquired knowledge was utilized to guide my critical thinking process for figuring out the true reality of correlation in working setting between the generations of nursing workforce and choice of leadership style, as well as the challenges I have experienced.

Knowledge Component

BLT views learning as the product of the stimulant conditions and the response; its focus is mainly on what is directly observable. Behaviourist may closely observe responses and then manipulate the environment to triage more desired stimulus to bring the intended change (Bastable, 2008, p. 54). That is the inspiration I choose the stimulant conditions – different choice of leadership style from different generation of nursing workforces in my questionnaire survey project, and the response – my learning outcome from the project, as the core concept from BLT as literature research topic to acquire related knowledge and apply it to my project about the correlation between generational diversity and choice of leadership in my clinical placement setting.

Literature Review / Five Relevant scholarly Articles

In her article, Hahn (2009) clearly realized today’s reality is that nursing workforce is made up of multigenerational staff. Nursing managers and their team members might hold different attitudes, beliefs, work ethics, and job expectations. The generation gap increases and creates more opportunities for misunderstanding and conflict. For both leaders and team members, the understanding generational differences would benefit in creating strength and opportunity or a source of stifling stress and conflict. How to deal with the challenge from the multigenerational diversity and develop a highly functioning and cohesive nursing team are current focuses for the nurse manager to be an effective leader. Although Hahn did not directly explain which leadership style would fit current workforce situation, the suggested strategies in her article for managers to effectively manage a multigenerational team indicate the transformational leadership to be the choice as an effective leader. Her argument was supported by previous researches done by Ulrich (2001), Zemke, Raines and Filipczak (2001).

According to the research done by Cummings, MacGregor, Davey, Lee, Wong and Lo, et al (2010), some forms of leadership might be possible to lead to negative outcomes. They made their research from 10 electronic databases that include 53 published quantitative studies, then used content analysis to analyze these studies; 64 outcomes emerged from their analysis were classified into five categories: (1) work environment factors, (2) productivity and effectiveness, (3) staff relationships with work, (4) staff satisfaction with work, role and pay, and (5) staff health and wellbeing. Their research found the leadership styles that focused on people and relationships, such as transformational, resonant, supportive, and consideration, were reported in 24 studies, which were associated with higher nurse job satisfaction; whereas the leadership styles that focused on tasks, such as dissonant, instrumental and management by exception, were reported in 10 studies, which were associated with lower nurse job satisfaction. Therefore, they concluded that the leadership that focused on task completion alone is not sufficient to achieve optimum outcomes for the nursing workforce; transformational and relational leadership are needed to enhance nurse satisfaction, recruitment, retention, and healthy work environments, particularly in this current multigenerational workforce.

Differently, Stanley (2008, 2010) argued that congruent leadership will be the one that can facilitate greater effectiveness when dealing with generational issues. Because this approach of leadership rests on the leaders’ values and beliefs that are demonstrated on leaders’ role modelling of their personal nursing / health care or organizational values; the actions of this leadership style are matched (or are congruent) with follower’s values and beliefs when dealing with multigenerational employees. Followers who have the same or similar values will support and follow these leaders because of their own values alignment. While realizing the difference of values and beliefs that are truly existed between the generational groups, Stanley emphasized that leader’s core nursing / health care values are likely to offer significant common ground for this leadership approach to ensure it will be employed successfully. Kowalski, Bradley and Pappas’ research (2006) seems to be in a supportive position to Stanley’s argument.

In her article, from the efficiency and positive outcome of management in a health care organization, Robbins and Davidhizar (2007) articulated there is a direct link between leadership style and staff retention, satisfaction and patient satisfaction. Currently, the changing faces in health care workforces pushes the management of nursing on the edge of the change in management strategy using effective and appropriate leadership to prompt greater success in gaining and maintaining staff satisfaction, staff retention, and then, in long run, improving patient satisfaction. Staff retention and satisfaction are the driving forces for achieving the patient satisfaction. Comparing with transactional leadership in leadership strategy, mission and vision, communication, relationship-building, they argued that transformational leadership is more effective in gaining and maintaining staff satisfaction, retention, and patient satisfaction in health care organizations. Poor leadership on a nursing unit leads to unhappy, unmotivated, and less dedicated staff. The underlying fundamental is that a transformational leader has the ability to effectively communicate the vision, mission, and empower nursing staff, which in turn build and promotes a healthy working environment for the entire team.

Generally, Arsenault (2004) realized that today’s workforce is more diverse than ever. There are many diverse issues. One of them is generational differences, which is created by a shared collective field of emotions, attitudes, preferences, and dispositions. Relatively, the differences in the unique attitudes, values, and beliefs of each generation determines how each generation views leadership, and ranks admired leadership characteristics, which correlates to their choice in leadership style and favourite leaders. He concluded that generational differences are a legitimate diversity issue that must be recognized and understood by organizations and needs to be addressed in developing current and future leaders. The leaders of organizations need to recognize and understand that a unique persona, which is developed from generational difference and already translated into a mind-set that demonstrated in different emotions, attitudes, beliefs, values, preferences, and embodied activities in working setting. Accordingly, this mind-set creates differences in leadership style – how a person of a generation will lead or how they prefer to be led.

In summary, five researches reached the common port, that is, the generational diversity is a current issue in workforce that organization and leaders must recognize and understand in designing effective and productive leadership strategy and style in creating a healthy working environment. However, for what is the correlation between generations and choice of leadership style, Stanley (2008, 2010)’s articles reached his unique port; it argued the congruent leadership will be the one that can facilitate greater effectiveness when dealing with generational issues. The research done Cummings, MacGregor, Davey, Lee, Wong and Lo, et al (2010) clearly reached the conclusion that transformational and relational leadership styles will enhance nurse satisfaction, recruitment, retention, and healthy work environments in today’s multigenerational workforce; because their research was based on extensive search of related database, so their conclusion derived from the evidence-based literature review is highly credential and statistically significant. Also, Hahn (2009) and Robbins and Davidhizar (2007) generally articulated the nursing leaders should take transformational leadership as the core concept of their management, but their articles do not show strong evidence to support their argument. Arsenault’s article emphasized the generational diversity of workforces and its impact on leadership, but he actually did not figure out which leadership could be the effective in current working environment.

Summary of Behaviourist Learning Theory (BLT)

According to Bastable’s book (2008, p.54-55), whether dealing with animals or people, BLT views the learning process as a relatively simple chain or cycle; the focus of BLT is mainly on the phenomenon that is directly observable stimulus conditions and the associations formed in the learning process; the learning process is understood as the product of the stimulus from the environment and the responses. In order to enhance the learning process leading to the desired result, behaviourists or learners can closely observe and manipulate the environment by utilizing operant conditioning techniques of positive or negative reinforcement (Skinner, 1974, 1989) to increase or decrease the stimulus, thus, to reinforce or decrease the responses to bring about the intended change.

Plan of Implementation

Based on my learning goal (see appendix A), I applied the acquired knowledge of BLT to my learning process through a survey project about the generational difference in the perceptive response in their admiring leadership style based on their different emotions, attitudes, beliefs, values, working ethics, preferences, and embodied activities in working setting. Each answer to the survey questionnaire is one of the stimuli for my learning process. What I learned form the project is the response of the learning process. I designed a survey questionnaire (see appendix B) about the correlation between generational difference and choice of leadership styles, randomly distributed to 55 staff in two medicine units of two hospitals, and 53 responses has been collected; the statistically valid representative sampling size is 96.36%. Statistical analysis on the response has been done (Table 1). Poster presentation (Appendix C) has been presented in my clinical placement unit for feedback.

Application Component

The Rationale of Choosing Behaviourist Learning Theory (BLT)

BLT suggests the learning process is the product of the stimulus from the environment and the responses to the stimulus; it views the learning process as a reoccurring chain or cycle between stimulus and response through operant conditioning techniques of positively or negatively enhancing stimulus. Learning will occur while the stimulus is positively or negatively enhanced. Such a theoretic framework can be applied to health teaching process (Bastable, 2008, p. 54-60). The designation for student’s project from the course outline is about the learning from the project about a nursing issue in a global or organizational level of a hospital or community setting. Based on the acquired knowledge from BLT, my intention of my project design is to view the responses from the survey as stimulus for my learning about the choice on leadership style in a health care team – staff would be either as a leader or a team member. Each response is one of the stimuli for my learning. More choice selectively occurred on one particular leadership style will become an enhanced stimulus for my learning that will give me the idea of which leadership is most admired in current health care team. In my future career, I would work as either a team member or a team leader; I have to prepare my self to be knowledgeable for these two roles. I am trying to apply BLT to my self teaching and self learning process. Actually, teaching and learning are the two phases of one process.

Summary of the Process Involved in Applying BLT

From the literature review, the generational difference in the perceptive response in their admiring leadership style based on their different emotions, attitudes, beliefs, values, working ethics, preferences, and embodied activities in working setting was found (Stanley, 2008, 2010; Arsenault, 2004; Weston, 2006; Kramer, 2010; Swearingen & Liberman, 2004; Robbins and Davidhizar, 2007; Hahn, 2009; Cummings, MacGregor, Davey, Lee, Wong and Lo, et al, 2010). Based on this finding, my project designed a survey questionnaire to ask two questions: (1) what is your generation? (2) transactional or transformational leader: which one you would like to be or prefer? The answers to these two questions will give me two kinds of information: what is the content of current workforces and what kind of leadership style is admired more in the working setting. The answer for each respondent could be viewed as one of the stimuli for my response – my learning result for my future choice of leadership in future career.

55 copies of questioner were randomly distributed to health care team of two medicine units of two hospitals, including nurses, social workers, physiotherapists, occupational therapists, speech therapists, manager, nursing educators, and unit supervisors / coordinators, clinical instructor, and nursing students. 53 copies of responses have been collected. Data has been coded and statistically analysed. The percentage of each generation in the health care teams, and the percentage of selecting transactional or transformational leader from each generation, and from the total sampling were calculated. The finding demonstrates the transformational leadership style is admired most in current working setting. This finding has been supported from the literature review of this report above.

Discussion of how Gained Knowledge was Integrated into Learning Process

The major components of stimulus and response of BLT were used in my learning process. Before my project survey, I had qualitative idea about the generational difference in beliefs, values, employment expectation, working ethics and orientation, but no quantitative idea about such difference, and no idea about how much their difference was in choosing working sett leadership style. Through the survey, I get the idea about how much each generation constitutes the content of health care workforce in these two units: Veterans are retired, Baby Boomers is 19%, Generation X is 53%, and Generation Y is 28%; the generation X and Y already constitutes 81% of the workforces. Among 10 answers from Baby Boomers, 2 answers chose transactional leader (20% of the generation), 8 answers chose transformational leader (80% of the generation); among 28 answers from Generation X, 4 answers chose transactional leader (14.3% of the generation), 24 answers chose transformational leader (85.7% of the generation); among 15 answers from Generation Y, 1 answer chose transactional leader (6.7% of the generation), 14 answers chose transformational leader (93.3% of the generation). Among the total samplings, 86.8% of answers chose transformational leader, only 13.2% of answer chose transactional leader. The finding also shows a trend of the major choices from each generation on the leadership style: from Baby Boomers to Generation Y, the percentage of the responses decreases in choosing transactional leader, and percentage increases in choosing transformational leader. It clearly demonstrates the significant difference between generations in admiring leadership style based on their different emotions, attitudes, beliefs, preferences, and embodied activities in working setting. The information analysed and concluded from the survey is the wanted stimulus for my learning – it gives me the idea which leadership style could be effective and productive in a health care working environment. The multiple kinds of information obtained from the survey like the enhanced stimulus positively manipulated by behaviourist to strengthen my response in advocating transformational leadership as the style I will choose to be my favourite one in working environment.

Challenge Encountered and Related Management

Because my project about learning process involves the questioner survey, the challenge comes from the design and implementation of the survey process.

The first challenge is the survey of this project is not a formal and academic survey. It is an anonymous mock survey. It does not involve in any interesting conflict and retain any private information about responder’s name, exact age, and gender, etc. Its purpose is limited to get the true information about the leadership style choice from different generation in the real working setting for my personal clinical learning process. So, it was not submitted to university ethics committee to seek pre-approval. The management strategy is anonymous survey and keeping the survey result within the learning process of this course.

The second challenge is the design of the questioner survey. As a student project, there is no funding for rewarding the participants. Staff are busying with daily assignment and don’t have spare time and compassion to answer too complicated questioner. The management strategy is to simplify the questionnaire design as much as possible, but it is still remained in detail enough to collect enough information to meet my learning goal.

The third challenge is the limitation of sampling size. As a student project, it is impossible to have adequate time and financial resource to take survey in multiple units of multiple health care facilities. The management strategy is to utilize the chance of my working unit at another hospital and clinical placement unit at St. Michael’s hospital to take my survey so that the sampling process will be more statistically valid and the finding will be more statistically representative from the limited sampling size.

Outcome of the Project and Evaluation

The outcome of the project is the finding of my survey truly demonstrates the generational difference in choosing leadership style in real working environment, which is supported from the literature review. The outcome of the project also reached my learning goal of this project: it uncovers the reality of generational difference in choosing leadership style and future trend in real working environment; and the finding is strong enough as enhanced stimulus to my response in my learning process based on BLT.

Evaluation Criteria of Self-Evaluation of Learning Plan and Planning Change

In my learning plan, the criterion of self-evaluation for knowledge component was set up as: able to select a specific theoretical model of leadership style based on current nursing environment. To better reflecting the learning experience from the project, I will modify it as: able to select related scholarly publication and a particular theoretical framework of leadership style based on current nursing working environment for literature review to acquire knowledge in guiding my learning process and practice project.

For application component, the criterion of self-evaluation was set up as: able to develop questionnaires of assessing staff nurse’s values, beliefs and expectation on their choice of leadership style. To better reflecting the learning experience from the project, I will modify it as: (1) able to develop questionnaires of assessing staff nurse’s values, beliefs and expectation on their choice of leadership style; and (2) able to analyze the survey result and figure out the significant finding.

Personal Growth and Development

Before this clinical placement, I did have general idea about the generational difference in emotions, attitudes, beliefs, values, preferences, and embodied activities in working setting. However, I did not have clear idea about the generational difference in choosing leadership style in real working environment. Through applying BLT to assess staff’s values, beliefs, expectation, attitude about the employment and work-life quality, and expectation of each generation on their choice of leadership style within the multiple generational cohorts, I found (1) current health care workforces is a three generation cohort, not a four generation cohort that was articulated in most of previous literatures, because Veteran generation is retired already; (2) from Baby Boomers to generation X and Y, the percentage of staff who choose transactional leadership style is linearly decreasing, the percentage of staff who choose transformational leadership style is linearly increasing; (3) presently, generation X is the majority in health care workforce, and generation Y is in the second place; in these two generations, the percentage of staff who chose transformational leadership style is 86% and 93%, which releases a clear information that transformational leadership style will work better for them. Totally, the outcome of the project tells me that in my future career, either as a team member or a team leader, transformational leadership was the style I should choose to work comparatively in a team or lead a team effectively.

Conclusion

According to the learning objective and teaching strategy of this course, a learning plan and practice project plan were developed based on the chosen theoretic framework. The project of survey was implemented in two medicine units of two hospitals. The survey result was statistically analysed and poster presentation was presented in the clinical placement unit. This report summarizes the acquired knowledge through the reviewing of five scholarly articles and the chosen theoretic framework, discussed the rationale on theoretic framework choosing, and the major concepts of BLT – stimulus and response, which have been applied in my learning process. Also, the outcome of the project, experienced challenges, possible personal growth and development obtained from the project are discussed.