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Home » Degrees » RN to MSN » Registered Nurse to Master of Science in Nursing in Administrative Leadership in Nursing » How Leaders Approach Problem-Solving

How Leaders Approach Problem-Solving

• Published On: July 12, 2022

No environment is free from problems. But, some require more creative solutions than others.

Healthcare, in particular, presents almost unlimited opportunities for things to go wrong — both in terms of patient care and inter-staff/intra-staff relationships. The problems present within healthcare settings are often a matter of life and death.

It takes effective leadership to keep all issues to a minimum and patient safety remains a priority.

What Makes a Great Leader?

If we think about the great leaders throughout time, they share a few common characteristics. Specific to nurse leaders, Indeed.com lists the following as core qualities for leaders:

• compassion/empathy
• critical thinking
• dedication to excellence
• communication
• collaboration/team building
• open-mindedness
• forward-thinking
• accessibility

Another valuable quality in leadership is being proactive in problem-solving. Good leaders handle issues as they arrive. They are capable of “putting out fires,” and that’s important. Yet, great leaders anticipate problems before they come to a head.

Core Skills Nurse Leaders Need to Possess

While some of the above resonates as more intuitive, emotional intelligence — as opposed to procedural — can be learned. Of course, there are practical skills nurse leaders need to develop as well.

Examples of these skills are healthcare finance and economics. Mastering budgets and efficiently allocating resources is important for nurse leaders. Nurses also need to know how to communicate financial demands to upper administration.

The online Registered Nurse (RN) to Master of Science in Nursing (MSN) in Administrative Leadership program from Northeastern State University (NSU) dedicates a course to heightening nurses’ skills and knowledge surrounding this responsibility.

NSU’s program also includes a course titled Organizational and Systems Management in Nursing. The course description states that nurses will learn about “contemporary influences, theories, principles, and functional strategies related to management/administration and organizational systems at the micro, meso, and macrosystem levels.”

Leadership’s Role in Addressing Lateral and Horizontal Violence (LHV)

While nurse leaders don’t necessarily need to be experts in human resources, it’s a substantial knowledge base. Human resources knowledge is especially relevant given the persistence of lateral and horizontal violence (LHV) within the nursing profession. The World Health Organization (WHO), International Council of Nurses and Public Services International have recognized this issue as a significant global public health priority.

Just how dangerous is LHV to nursing? A study published by Nurse Management describes LHV as: “all acts of meanness, hostility, disruption, discourtesy, backbiting, divisiveness, criticism, lack of unison, verbal or mental abuse, and scapegoating. [These] behaviors taint healthcare organizations; cause irreparable harm to workplace culture; breakdown team communication; and severely impact the quality of the care provided, thereby jeopardizing patient safety.”

With a solid leadership foundation, nurses can handle toxic behaviors that damage the work environment. In doing so, they change the workplace culture and guiding others to follow in their footsteps.

Empowerment Sets Everyone Up for Success

Perhaps the greatest responsibility of a nurse leader is to empower those in their charge. John Quincy Adams said, “If your actions inspire others to dream more, learn more, do more and become more, you are a leader.”

Northeastern State University recognizes empowerment as an essential skill. In the Leadership Development for the Advanced Nursing Professional course, students learn to “effectively manage change, empower others, and influence political processes.”

What Type of Leader Do You Aspire to Be?

It takes much more than “putting in your time” to become an effective leader. Nurses might rise through the ranks based on experience, but are they actually effecting change in the nursing profession? Unless they possess a robust leadership skill set, the answer is likely no. So, what kind of leader do you want to be?

Learn more about Northeastern State University’s online RN to MSN in Administrative Leadership program .

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Making Decisions and Solving Problems

CHAPTER 6 Making Decisions and Solving Problems Rose Aguilar Welch This chapter describes the key concepts related to problem solving and decision making. The primary steps of the problem-solving and decision-making processes, as well as analytical tools used for these processes, are explored. Moreover, strategies for individual or group problem solving and decision making are presented. Objectives •  Apply a decision-making format to list options to solve a problem, identify the pros and cons of each option, rank the options, and select the best option. •  Evaluate the effect of faulty information gathering on a decision-making experience. •  Analyze the decision-making style of a nurse leader/manager. •  Critique resources on the Internet that focus on critical thinking, problem solving, and decision making. Terms to Know autocratic creativity critical thinking decision making democratic optimizing decision participative problem solving satisficing decision The Challenge Vickie Lemmon RN, MSN Director of Clinical Strategies and Operations, WellPoint, Inc., Ventura, California Healthcare managers today are faced with numerous and complex issues that pertain to providing quality services for patients within a resource-scarce environment. Stress levels among staff can escalate when problems are not resolved, leading to a decrease in morale, productivity, and quality service. This was the situation I encountered in my previous job as administrator for California Children Services (CCS). When I began my tenure as the new CCS administrator, staff expressed frustration and dissatisfaction with staffing, workload, and team communications. This was evidenced by high staff turnover, lack of teamwork, customer complaints, unmet deadlines for referral and enrollment cycle times, and poor documentation. The team was in crisis, characterized by in-fighting, blaming, lack of respectful communication, and lack of commitment to program goals and objectives. I had not worked as a case manager in this program. It was hard for me to determine how to address the problems the staff presented to me. I wanted to be fair but thought that I did not have enough information to make immediate changes. My challenge was to lead this team to greater compliance with state-mandated performance measures. What do you think you would do if you were this nurse? Introduction Problem solving and decision making are essential skills for effective nursing practice. Carol Huston (2008) identified “expert decision-making skills” as one of the eight vital leadership competencies for 2020. These processes not only are involved in managing and delivering care but also are essential for engaging in planned change. Myriad technologic, social, political, and economic changes have dramatically affected health care and nursing. Increased patient acuity, shorter hospital stays, shortage of healthcare providers, increased technology, greater emphasis on quality and patient safety, and the continuing shift from inpatient to ambulatory and home health care are some of the changes that require nurses to make rational and valid decisions. Moreover, increased diversity in patient populations, employment settings, and types of healthcare providers demands efficient and effective decision making and problem solving. More emphasis is now placed on involving patients in decision making and problem solving and using multidisciplinary teams to achieve results. Nurses must possess the basic knowledge and skills required for effective problem solving and decision making. These competencies are especially important for nurses with leadership and management responsibilities. Definitions Problem solving and decision making are not synonymous terms. However, the processes for engaging in both processes are similar. Both skills require critical thinking, which is a high-level cognitive process, and both can be improved with practice. Decision making is a purposeful and goal-directed effort that uses a systematic process to choose among options. Not all decision making begins with a problem situation. Instead, the hallmark of decision making is the identification and selection of options or alternatives. Problem solving, which includes a decision-making step, is focused on trying to solve an immediate problem, which can be viewed as a gap between “what is” and “what should be.” Effective problem solving and decision making are predicated on an individual’s ability to think critically. Although critical thinking has been defined in numerous ways, Scriven and Paul (2007) refer to it as “ the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action.” Effective critical thinkers are self-aware individuals who strive to improve their reasoning abilities by asking “why,” “what,” or “how.” A nurse who questions why a patient is restless is thinking critically. Compare the analytical abilities of a nurse who assumes a patient is restless because of anxiety related to an upcoming procedure with those of a nurse who asks if there could be another explanation and proceeds to investigate possible causes. It is important for nurse leaders and managers to assess staff members’ ability to think critically and enhance their knowledge and skills through staff-development programs, coaching, and role modeling. Establishing a positive and motivating work environment can enhance attitudes and dispositions to think critically. Creativity is essential for the generation of options or solutions. Creative individuals can conceptualize new and innovative approaches to a problem or issue by being more flexible and independent in their thinking. It takes just one person to plant a seed for new ideas to generate . The model depicted in Figure 6-1 demonstrates the relationship among related concepts such as professional judgment, decision making, problem solving, creativity, and critical thinking. Sound clinical judgment requires critical or reflective thinking. Critical thinking is the concept that interweaves and links the others. An individual, through the application of critical-thinking skills, engages in problem solving and decision making in an environment that can promote or inhibit these skills. It is the nurse leader’s and manager’s task to model these skills and promote them in others. FiGURE 6-1 Problem-solving and decision-making model. Decision Making This section presents an overview of concepts related to decision models, decision-making styles, factors affecting decision making, group decision making (advantages and challenges), and strategies and tools. The phases of the decision-making process include defining objectives, generating options, identifying advantages and disadvantages of each option, ranking the options, selecting the option most likely to achieve the predefined objectives, implementing the option, and evaluating the result. Box 6-1 contains a form that can be used to complete these steps. BOX 6-1    Decision-Making Format Objective: _____________________________________ Options Advantages Disadvantages Ranking                                 Add more rows as necessary. Rank priority of options, with “1” being most preferred. Select the best option. Implementation plan: ______________________________________________________________________________ Evaluation plan: __________________________________________________________________________________ A poor-quality decision is likely if the objectives are not clearly identified or if they are inconsistent with the values of the individual or organization. Lewis Carroll illustrates the essential step of defining the goal, purpose, or objectives in the following excerpt from Alice’s Adventures in Wonderland: One day Alice came to a fork in the road and saw a Cheshire Cat in a tree. “Which road do I take?” she asked. His response was a question: “Where do you want to go?” “I don’t know,” Alice answered. “Then,” said the cat, “it doesn’t matter.” Decision Models The decision model that a nurse uses depends on the circumstances. Is the situation routine and predictable or complex and uncertain? Is the goal of the decision to make a decision conservatively that is just good enough or one that is optimal? If the situation is fairly routine, nurse leaders and managers can use a normative or prescriptive approach. Agency policy, standard procedures, and analytical tools can be applied to situations that are structured and in which options are known. If the situation is subjective, non-routine, and unstructured or if outcomes are unknown or unpredictable, the nurse leader and manager may need to take a different approach. In this case, a descriptive or behavioral approach is required. More information will need to be gathered to address the situation effectively. Creativity, experience, and group process are useful in dealing with the unknown. In the business world, Camillus described complex problems that are difficult to describe or resolve as “wicked” (as cited in Huston, 2008 ). This term is apt in describing the issues that nurse leaders face. In these situations, it is especially important for nurse leaders to seek expert opinion and involve key stakeholders. Another strategy is satisficing. In this approach, the decision maker selects the solution that minimally meets the objective or standard for a decision. It allows for quick decisions and may be the most appropriate when time is an issue. Optimizing is a decision style in which the decision maker selects the option that is best, based on an analysis of the pros and cons associated with each option. A better decision is more likely using this approach, although it does take longer to arrive at a decision. For example, a nursing student approaching graduation is contemplating seeking employment in one of three acute care hospitals located within a 40-mile radius of home. The choices are a medium-size, not-for-profit community hospital; a large, corporate-owned hospital; and a county facility. A satisficing decision might result if the student nurse picked the hospital that offered a decent salary and benefit packet or the one closest to home. However, an optimizing decision is more likely to occur if the student nurse lists the pros and cons of each acute care hospital being considered such as salary, benefits, opportunities for advancement, staff development, and mentorship programs. Decision-Making Styles The decision-making style of a nurse manager is similar to the leadership style that the manager is likely to use. A manager who leans toward an autocratic style may choose to make decisions independent of the input or participation of others. This has been referred to as the “decide and announce” approach, an authoritative style. On the other hand, a manager who uses a democratic or participative approach to management involves the appropriate personnel in the decision-making process. It is imperative for managers to involve nursing personnel in making decisions that affect patient care. One mechanism for doing so is by seeking nursing representation on various committees or task forces. Participative management has been shown to increase work performance and productivity, decrease employee turnover, and enhance employee satisfaction. Any decision style can be used appropriately or inappropriately. Like the tenets of situational leadership theory, the situation and circumstances should dictate which decision-making style is most appropriate. A Code Blue is not the time for managers to democratically solicit volunteers for chest compressions! The autocratic method results in more rapid decision making and is appropriate in crisis situations or when groups are likely to accept this type of decision style. However, followers are generally more supportive of consultative and group approaches. Although these approaches take more time, they are more appropriate when conflict is likely to occur, when the problem is unstructured, or when the manager does not have the knowledge or skills to solve the problem. Exercise 6-1 Interview colleagues about their most preferred decision-making model and style. What barriers or obstacles to effective decision making have your colleagues encountered? What strategies are used to increase the effectiveness of the decisions made? Based on your interview, is the style effective? Why or why not? Factors Affecting Decision Making Numerous factors affect individuals and groups in the decision-making process. Tanner (2006) conducted an extensive review of the literature to develop a Clinical Judgment Model. Out of the research, she concluded that five principle factors influence decision making. (See the Literature Perspective below.) Literature Perspective Resource: Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45 (6), 204-211. Tanner engaged in an extensive review of 200 studies focusing on clinical judgment and clinical decision making to derive a model of clinical judgment that can be used as a framework for instruction. The first review summarized 120 articles and was published in 1998. The 2006 article reviewed an additional 71 studies published since 1998. Based on an analysis of the entire set of articles, Tanner proposed five conclusions which are listed below. The reader is referred to the article for detailed explanation of each of the five conclusions. The author considers clinical judgment as a “problem-solving activity.” She notes that the terms “clinical judgment,” “problem solving,” “decision making,” and “critical thinking” are often used interchangeably. For the purpose of aiding in the development of the model, Tanner defined clinical judgment as actions taken based on the assessment of the patient’s needs. Clinical reasoning is the process by which nurses make their judgments (e.g., the decision-making process of selecting the most appropriate option) ( Tanner, 2006 , p. 204): 1.  Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand. 2.  Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns. 3.  Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit. 4.  Nurses use a variety of reasoning patterns alone or in combination. 5.  Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. The Clinical Judgment Model developed through the review of the literature involves four steps that are similar to problem-solving and decision-making steps described in this chapter. The model starts with a phase called “Noticing.” In this phase, the nurse comes to expect certain responses resulting from knowledge gleaned from similar patient situations, experiences, and knowledge. External factors influence nurses in this phase such as the complexity of the environment and values and typical practices within the unit culture. The second phase of the model is “Interpreting,” during which the nurse understands the situation that requires a response. The nurse employs various reasoning patterns to make sense of the issue and to derive an appropriate action plan. The third phase is “Responding,” during which the nurse decides on the best option for handling the situation. This is followed by the fourth phase, “Reflecting,” during which the nurse assesses the patient’s responses to the actions taken. Tanner emphasized that “reflection-in-action” and “reflection-on-action” are major processes required in the model. Reflection-in-action is real-time reflection on the patient’s responses to nursing action with modifications to the plan based on the ongoing assessment. On the other hand, reflection-on-action is a review of the experience, which promotes learning for future similar experiences. Nurse educators and managers can employ this model with new and experienced nurses to aid in understanding thought processes involved in decision making. As Tanner (2006) so eloquently concludes, “If we, as nurse educators, help our students understand and develop as moral agents, advance their clinical knowledge through expert guidance and coaching, and become habitual in reflection-on-practice, they will have learned to think like a nurse” ( p. 210 ). Implications for Practice Nurse educators and managers can employ this model with new and experienced nurses to aid in understanding thought processes involved in decision making. For example, students and practicing nurses can be encouraged to maintain reflective journals to record observations and impressions from clinical experiences. In clinical post-conferences or staff development meetings, the nurse educator and manager can engage them in applying to their lived experiences the five conclusions Tanner proposed. The ultimate goal of analyzing their decisions and decision-making processes is to improve clinical judgment, problem-solving, decision-making, and critical-thinking skills. Internal and external factors can influence how the situation is perceived. Internal factors include variables such as the decision maker’s physical and emotional state, personal philosophy, biases, values, interests, experience, knowledge, attitudes, and risk-seeking or risk-avoiding behaviors. External factors include environmental conditions, time, and resources. Decision-making options are externally limited when time is short or when the environment is characterized by a “we’ve always done it this way” attitude. Values affect all aspects of decision making, from the statement of the problem/issue through the evaluation. Values, determined by one’s cultural, social, and philosophical background, provide the foundation for one’s ethical stance. The steps for engaging in ethical decision making are similar to the steps described earlier; however, alternatives or options identified in the decision-making process are evaluated with the use of ethical resources. Resources that can facilitate ethical decision making include institutional policy; principles such as autonomy, nonmaleficence, beneficence, veracity, paternalism, respect, justice, and fidelity; personal judgment; trusted co-workers; institutional ethics committees; and legal precedent. Certain personality factors, such as self-esteem and self-confidence, affect whether one is willing to take risks in solving problems or making decisions. Keynes (2008) asserts that individuals may be influenced based on social pressures. For example, are you inclined to make decisions to satisfy people to whom you are accountable or from whom you feel social pressure? Characteristics of an effective decision maker include courage, a willingness to take risks, self-awareness, energy, creativity, sensitivity, and flexibility. Ask yourself, “Do I prefer to let others make the decisions? Am I more comfortable in the role of ‘follower’ than leader? If so, why?” Exercise 6-2 Identify a current or past situation that involved resource allocation, end-of-life issues, conflict among healthcare providers or patient/family/significant others, or some other ethical dilemma. Describe how the internal and external factors previously described influenced the decision options, the option selected, and the outcome. Group Decision Making There are two primary criteria for effective decision making. First, the decision must be of a high quality; that is, it achieves the predefined goals, objectives, and outcomes. Second, those who are responsible for its implementation must accept the decision. Higher-quality decisions are more likely to result if groups are involved in the problem-solving and decision-making process. In reality, with the increased focus on quality and safety, decisions cannot be made alone. When individuals are allowed input into the process, they tend to function more productively and the quality of the decision is generally superior. Taking ownership of the process and outcome provides a smoother transition. Multidisciplinary teams should be used in the decision-making process, especially if the issue, options, or outcome involves other disciplines. Research findings suggest that groups are more likely to be effective if members are actively involved, the group is cohesive, communication is encouraged, and members demonstrate some understanding of the group process. In deciding to use the group process for decision making, it is important to consider group size and composition. If the group is too small, a limited number of options will be generated and fewer points of view expressed. Conversely, if the group is too large, it may lack structure, and consensus becomes more difficult. Homogeneous groups may be more compatible; however, heterogeneous groups may be more successful in problem solving. Research has demonstrated that the most productive groups are those that are moderately cohesive. In other words, divergent thinking is useful to create the best decision. For groups to be able to work effectively, the group facilitator or leader should carefully select members on the basis of their knowledge and skills in decision making and problem solving. Individuals who are aggressive, are authoritarian, or manifest self-oriented behaviors tend to decrease the effectiveness of groups. The nurse leader or manager should provide a nonthreatening and positive environment in which group members are encouraged to participate actively. Using tact and diplomacy, the facilitator can control aggressive individuals who tend to monopolize the discussion and can encourage more passive individuals to contribute by asking direct, open-ended questions. Providing positive feedback such as “You raised a good point,” protecting members and their suggestions from attack, and keeping the group focused on the task are strategies that create an environment conducive to problem solving. Advantages of Group Decision Making The advantages of group decision making are numerous. The adage “two heads are better than one” illustrates that when individuals with different knowledge, skills, and resources collaborate to solve a problem or make a decision, the likelihood of a quality outcome is increased. More ideas can be generated by groups than by individuals functioning alone. In addition, when followers are directly involved in this process, they are more apt to accept the decision, because they have an increased sense of ownership or commitment to the decision. Implementing solutions becomes easier when individuals have been actively involved in the decision-making process. Involvement can be enhanced by making information readily available to the appropriate personnel, requesting input, establishing committees and task forces with broad representation, and using group decision-making techniques. The group leader must establish with the participants what decision rule will be followed. Will the group strive to achieve consensus, or will the majority rule? In determining which decision rule to use, the group leader should consider the necessity for quality and acceptance of the decision. Achieving both a high-quality and an acceptable decision is possible, but it requires more involvement and approval from individuals affected by the decision. Groups will be more committed to an idea if it is derived by consensus rather than as an outcome of individual decision making or majority rule. Consensus requires that all participants agree to go along with the decision. Although achieving consensus requires considerable time, it results in both high-quality and high-acceptance decisions and reduces the risk of sabotage. Majority rule can be used to compromise when 100% agreement cannot be achieved. This method saves time, but the solution may only partially achieve the goals of quality and acceptance. In addition, majority rule carries certain risks. First, if the informal group leaders happen to fall in the minority opinion, they may not support the decision of the majority. Certain members may go so far as to build coalitions to gain support for their position and block the majority choice. After all, the majority may represent only 51% of the group. In addition, group members may support the position of the formal leader, although they do not agree with the decision, because they fear reprisal or they wish to obtain the leader’s approval. In general, as the importance of the decision increases, so does the percentage of group members required to approve it. To secure the support of the group, the leader should maintain open communication with those affected by the decision and be honest about the advantages and disadvantages of the decision. The leader should also demonstrate how the advantages outweigh the disadvantages, suggest ways the unwanted outcomes can be minimized, and be available to assist when necessary.

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8 Types of Leadership Styles in Nursing – Which One is Right for You?

Are you a nurse leader or aspiring to become one? Did you know there are several types of leadership styles that can be applied to nursing? Perhaps you have asked yourself or others, “What are the different types of leadership styles in nursing?” In this article, you will learn what leadership style in nursing means, why it is important for nurse leaders to develop a leadership style, and information about the 8 types of leadership styles in nursing, including pros, cons, and examples of each.

What Is a Leadership Style in Nursing?

5 reasons why developing a leadership style is important in nursing.

1. Effective leadership is associated with better patient outcomes. 2. When nursing teams have strong leaders, employees are typically happier, creating an environment conducive to safe, efficient patient care. 3. Nurses who work with nurse leaders that have established or developed a leadership style know what is expected of them and what they can expect from their leaders. 4. Developing a leadership style in nursing is a way of holding yourself accountable to the role and demonstrating to others that you are dedicated to the success of your team. 5. The different leadership styles in nursing contribute to lower stress, team cohesion, and self-efficacy within the nursing team.

WHAT ARE THE DIFFERENT TYPES OF LEADERSHIP STYLES IN NURSING?

1. democratic leadership (a.k.a. participative leadership), about the style:, this leadership style is right for you if:, real-life example:, 2. transformational leadership, 3. autocratic leadership (a.k.a. authoritarian leadership), 4. laissez-faire leadership (a.k.a. delegative leadership), 5. servant leadership, 6. bureaucratic leadership, 7. transactional leadership, 8. charismatic leadership, ways to determine which leadership style in nursing is right for you, 1. identify your strengths., 2. identify your weaknesses., 3. know your personality traits., 4. consider what you value personally and professionally., 5. determine your ability to delegate., 6. observe other leaders., 7. ask for feedback from your leaders and subordinates., can you develop your own unique leadership style in nursing, 5 strategies to help develop your own unique leadership style in nursing, 1. practice personal discipline., 2. learn about and develop situational awareness., 3. do not be afraid to follow., 4. learn to resolve conflicts., 5. never stop learning., useful resources related to leadership styles in nursing, youtube videos, my final thoughts.

Inspiring Leadership in Nursing: Key Topics to Empower the Next Generation of Nurse Leaders

This article was written in collaboration with Christine T. and ChatGPT, our little helper developed by OpenAI.

Nursing leadership plays a crucial role in the healthcare industry, influencing the quality of patient care and the overall performance of healthcare organizations. As the nursing profession continues to evolve, aspiring nurse leaders must stay informed about the latest developments and best practices in nursing leadership. This comprehensive guide explores essential nursing leadership topics, offering valuable insights and strategies for success.

The Importance of Nursing Leadership

Impact on patient care.

Effective nursing leadership directly impacts patient care, ensuring that nurses provide safe, high-quality, and evidence-based care. Nurse leaders play a critical role in developing and implementing policies, protocols, and standards of practice that promote positive patient outcomes.

Topic Examples

• The role of nurse leaders in reducing hospital-acquired infections
• How nurse leaders can improve patient satisfaction
• The effect of nursing leadership on patient safety initiatives
• Combating health care-associated infections: a community-based approach
• Nurse leaders’ impact on the reduction of medication errors
• Promoting patient-centered care through nursing leadership
• The role of nurse leaders in implementing evidence-based practices to improve patient outcomes
• How transformational leadership can positively impact patient satisfaction
• The impact of nurse leaders on patient safety and error reduction initiatives

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Influence on Organizational Performance

Nurse leaders contribute to the overall performance of healthcare organizations by guiding and supporting nursing teams, managing resources, and participating in decision-making processes. Their leadership helps create a positive work environment, reduce staff turnover, and improve patient satisfaction.

• How nurse leaders can contribute to reducing staff turnover
• The role of nurse leaders in improving the hospital’s financial performance
• Nurse leaders as drivers of organizational culture
• The integral role of nurses in healthcare systems: the importance of education and experience
• The relationship between nurse leadership and hospital readmission rates
• How nurse leaders can contribute to reducing healthcare costs
• The role of nurse leaders in promoting interprofessional collaboration to improve organizational performance
• Strategies for nurse leaders to foster a positive work environment
• The impact of nursing leadership on employee engagement and satisfaction

Advancement of the Nursing Profession

Nurse leaders advocate for nursing, promoting professional development, innovation, and research. They also work to elevate the nursing profession’s status, fostering collaboration and interdisciplinary partnerships.

• The role of nurse leaders in shaping the future of nursing education
• How nurse leaders can advocate for the nursing profession
• The impact of nurse leaders on the development of nursing standards and policies
• Encouraging research and evidence-based practice among nursing teams
• The role of nurse leaders in promoting interprofessional collaboration
• Encouraging the pursuit of advanced nursing degrees and certifications among nursing staff
• The impact of nurse leaders on shaping healthcare policies and regulations
• How nurse leaders can advocate for improved working conditions and fair compensation for nursing staff

Essential Nursing Leadership Skills

Communication and interpersonal skills.

Effective communication and interpersonal skills are crucial for nursing leaders. They must listen actively, express themselves clearly, and demonstrate empathy and understanding when interacting with colleagues, patients, and families.

• Active listening skills for nurse leaders
• Developing emotional intelligence in nursing leadership
• The role of nonverbal communication in nursing leadership
• Strategies for nurse leaders to improve communication with their teams
• How nurse leaders can facilitate open and honest feedback
• The importance of emotional intelligence in nurse leadership
• Strategies for nurse leaders to improve their communication skills with diverse populations
• The role of nurse leaders in fostering effective communication within interdisciplinary healthcare teams

Decision-Making and Problem-Solving Abilities

Nurse leaders must be skilled in making informed decisions and solving complex problems. They should be able to analyze situations, weigh the pros and cons of various options, and choose the best course of action.

• Critical thinking skills for nurse leaders
• Ethical decision-making in nursing leadership
• The role of evidence-based practice in nursing leadership decisions
• Strategies for nurse leaders to develop effective problem-solving skills
• The importance of collaboration and teamwork in decision-making for nurse leaders
• The role of nurse leaders in crisis management and emergency preparedness
• How nurse leaders can develop effective problem-solving strategies to address complex healthcare challenges

Time Management and Organization

Managing time and resources effectively is essential for nurse leaders. They must be able to prioritize tasks, delegate responsibilities, and balance competing demands to ensure the smooth operation of their teams and organizations.

• Prioritization techniques for nurse leaders
• The role of delegation in effective time management for nursing managers
• Strategies for nurse leaders to manage workload and reduce stress
• Balancing clinical and administrative responsibilities as a nurse leader
• Time management tools and techniques for nurse leaders
• The importance of delegation in nurse leadership
• Strategies for nurse leaders to effectively manage their workload and prioritize tasks
• The role of nurse leaders in creating efficient workflows and processes within nursing teams

Embracing Diversity and Inclusivity in Nursing Leadership

The value of a diverse nursing workforce.

A diverse nursing workforce brings unique perspectives, experiences, and skills to the healthcare environment, benefiting patient care. By embracing diversity, nurse leaders can foster a more inclusive and supportive work environment that encourages collaboration and innovation.

• The benefits of diverse nursing teams for patient care
• The role of nurse leaders in recruiting and retaining diverse nursing staff
• Addressing health disparities through a diverse nursing workforce
• The impact of cultural competence on nursing practice and leadership
• Encouraging diverse perspectives and experiences in nursing teams
• Global health learning in nursing and health care disparities
• The benefits of having a diverse nursing workforce on patient outcomes and satisfaction
• Addressing health disparities through culturally competent nursing leadership

Strategies for Promoting Diversity and Inclusion

Nurse leaders can promote diversity and inclusion by implementing hiring and promotion practices that support equal opportunities, offering cultural competency training, and actively addressing discrimination and bias within their organizations.

• Overcoming unconscious bias in nursing leadership
• The role of nurse leaders in fostering an inclusive work environment
• Strategies for promoting diversity and inclusion in nursing education
• The impact of diversity and inclusion on nursing team performance
• Encouraging cultural competence and sensitivity among nursing staff
• Implementing diversity and inclusion training programs for nursing staff
• The role of nurse leaders in fostering a culture of respect and inclusivity within nursing teams
• Strategies for nurse leaders to address unconscious bias and promote equity in the workplace

Developing and Mentoring Future Nurse Leaders

Identifying and nurturing leadership potential.

Nurse leaders play an essential role in identifying and nurturing the leadership potential of their staff. By offering guidance, encouragement, and opportunities for growth, they can help prepare the next generation of nurse leaders.

• Recognizing leadership potential in nursing staff
• Strategies for nurse leaders to develop their team’s leadership skills
• The importance of succession planning in nursing leadership
• Encouraging a growth mindset among nursing teams
• The role of mentorship and coaching in nurturing future nurse leaders
• Strategies for nurse leaders to identify and develop emerging nurse leaders within their teams
• The role of nurse leaders in creating leadership development programs for nursing staff

Mentorship and Coaching

Mentorship and coaching are invaluable for aspiring nurse leaders. By sharing their knowledge, experience, and insights, experienced nurse leaders can help guide and support those looking to advance in nursing.

• The benefits of mentorship for both mentors and mentees in nursing
• Developing effective mentoring relationships in nursing
• The role of nurse leaders in fostering a mentoring culture
• Strategies for providing constructive feedback and coaching to nursing staff
• Encouraging professional growth and development through mentorship
• The benefits of mentorship relationships for both mentors and mentees in nursing
• Strategies for nurse leaders to establish effective mentorship programs within their organizations
• The role of nurse leaders in providing coaching and feedback to nursing staff for professional growth

Promoting Teamwork and Collaboration in Nursing

The importance of teamwork in healthcare.

Teamwork is crucial for delivering safe, high-quality patient care. Nurse leaders must foster a culture of collaboration, encouraging open communication, mutual support, and shared decision-making among their teams.

• The role of nurse leaders in promoting effective teamwork
• Strategies for building trust and collaboration among nursing teams
• The impact of teamwork on patient care and safety
• The benefits of interprofessional collaboration in healthcare
• The role of nurse leaders in fostering a positive team culture
• The role of nurse leaders in promoting collaboration and teamwork among nursing staff
• Strategies for nurse leaders to address and resolve conflicts within nursing teams
• The impact of effective teamwork on patient outcomes and staff satisfaction in healthcare settings

Strategies for Building Effective Nursing Teams

Nurse leaders can build effective nursing teams by promoting shared goals and values, providing clear expectations and feedback, and recognizing and celebrating team achievements. Additionally, they should facilitate team-building activities and opportunities for professional development, which can strengthen team cohesion and performance.

• The importance of clear communication and expectations in nursing teams
• Strategies for addressing and resolving conflicts within nursing teams
• The role of team-building activities in fostering collaboration and trust among nursing staff
• The impact of shared decision-making on nursing team performance
• Encouraging a culture of continuous improvement and learning within nursing teams
• The role of nurse leaders in selecting and retaining top nursing talent
• Strategies for nurse leaders to create a positive work environment that fosters teamwork and collaboration
• The importance of team-building activities and exercises for nursing staff

Advocating for Nursing and Improving Patient Care

Policy and advocacy.

Nurse leaders are responsible for advocating for policies and initiatives that support the nursing profession and improve patient care. They should be informed about healthcare legislation, engage in advocacy efforts, and encourage their teams to participate in policy-making.

• The role of nurse leaders in shaping healthcare policy
• Strategies for nurse leaders to advocate for the nursing profession at the local, state, and national levels
• The impact of nursing leadership on the development and implementation of healthcare policies and regulations
• Engaging nursing staff in policy discussions and advocacy efforts
• The importance of staying informed about current healthcare policy issues for nurse leaders
• The role of nurse leaders in advocating for policies that improve patient care and support the nursing profession
• Strategies for nurse leaders to effectively engage with policymakers and stakeholders
• The impact of nurse leaders on shaping healthcare policies at the local, state, and national levels

Driving Quality Improvement and Innovation

Nurse leaders must be committed to continuous quality improvement and innovation in patient care. By staying informed about evidence-based practices and encouraging their teams to adopt innovative approaches, they can drive positive change within their organizations and the healthcare industry.

• The role of nurse leaders in promoting a culture of continuous quality improvement
• Strategies for nurse leaders to identify and address areas for improvement in patient care
• The impact of nursing leadership on the implementation of evidence-based practices and innovations
• Encouraging a culture of creativity and innovation among nursing teams
• The role of nurse leaders in driving change and improvement in healthcare organizations
• The role of nurse leaders in leading quality improvement initiatives within their organizations
• Strategies for nurse leaders to foster a culture of continuous improvement and innovation among nursing staff
• The impact of nurse-led quality improvement projects on patient care and organizational performance

Fostering a Positive Work Environment

Creating a supportive and respectful culture.

A positive work environment is essential for nursing staff satisfaction, retention, and performance. Nurse leaders should foster a culture of support and respect where staff feels valued, empowered, and motivated to provide the best possible care.

• The role of nurse leaders in fostering a positive work environment
• Strategies for nurse leaders to promote a culture of support and respect among nursing staff
• The importance of addressing and preventing workplace bullying and incivility in nursing
• Encouraging open and honest communication within nursing teams
• The role of nurse leaders in promoting work-life balance and well-being among nursing staff

Addressing Workplace Challenges and Conflicts

Nurse leaders must be proactive in addressing workplace challenges and conflicts. They can maintain a healthy and productive work environment by developing and implementing strategies to manage issues such as workload, burnout, and interpersonal conflicts.

• The role of nurse leaders in conflict resolution within nursing teams
• Strategies for nurse leaders to address common workplace challenges, such as staffing shortages and burnout
• The importance of developing a proactive approach to addressing conflicts and challenges in nursing
• Promoting a culture of accountability and responsibility among nursing staff
• The role of nurse leaders in providing support and resources for nursing staff facing challenges and conflicts
• Conflict resolution strategies for nurse leaders
• The role of nurse leaders in mediating and resolving interprofessional conflicts within healthcare teams
• Strategies for nurse leaders to prevent and address workplace burnout among nursing staff

Lifelong Learning and Professional Development

Commitment to continuing education.

Lifelong learning is essential for nurse leaders to stay current with healthcare and nursing practice advances. They should pursue continuing education opportunities, research, and stay informed about industry trends and best practices.

• The importance of lifelong learning for nurse leaders and nursing staff
• Strategies for nurse leaders to promote a culture of continuous education and professional development within their teams
• The impact of continuing education on nursing practice and leadership
• Encouraging nursing staff to engage in professional development opportunities
• Transforming advanced nursing practice: embracing IOM recommendations and higher education
• The role of nurse leaders in staying informed about current nursing research and best practices
• The impact of continuing education on nursing practice and patient outcomes
• Strategies for nurse leaders to support and encourage continuing education among their nursing staff
• The role of nurse leaders in staying up-to-date with the latest nursing research, guidelines, and best practices

Encouraging Professional Development in Nursing Teams

Nurse leaders should support and encourage the professional development of their nursing teams. By providing resources, opportunities, and encouragement, they can help their staff grow professionally and contribute to advancing the nursing profession.

• The role of nurse leaders in identifying professional development opportunities for nursing staff
• Strategies for nurse leaders to create individualized professional development plans for their team members
• The importance of fostering a growth mindset among nursing staff
• Encouraging nursing staff to participate in conferences, workshops, and other professional development activities
• The role of nurse leaders in providing mentorship and guidance for nursing staff seeking career advancement
• The benefits of ongoing professional development for nursing staff and healthcare organizations
• Strategies for nurse leaders to create professional development opportunities within their organizations
• The role of nurse leaders in developing and implementing career advancement pathways for nursing staff

The Power of Inspiring Leadership in Nursing

Nursing leadership is a critical component of the healthcare industry, impacting patient care, organizational performance, and the advancement of the nursing profession. By mastering essential leadership skills, embracing diversity, promoting teamwork, and fostering a positive work environment, aspiring nurse leaders can make a meaningful difference in the lives of their patients, colleagues, and organizations. Committing to lifelong learning and professional development will ensure that nurse leaders remain at the forefront of their field, inspiring and empowering the next generation of nursing professionals.

Table of content

Crafted with Care:

Nursing Essays!

Precision, Passion, & Professionalism in Every Page.

Nursing Leadership: Interview on Problem-Solving Essay

Introduction, completed interview.

Leadership is essential in nursing since it makes it possible for practitioners to empower their followers, solve existing problems, and offer exemplary services. Every professional in this field should strive to develop a powerful model in an attempt to emerge successful. This paper presents the findings obtained after interviewing a competent nurse leader (NL). It goes further to describe the NL’s leadership style, philosophy, and problem-solving techniques. The next part presents a powerful strategy for implementing a culturally competent leadership approach to empower patients and staff members. The final part presents my personal leadership philosophy of nursing.

The selected interviewee is currently the NL in charge of my department. He revealed that he was always ready to show his followers direction, solve emerging problems, and focus on the experiences of the targeted patients. He remained charismatic, formulated powerful guidelines, and embraced the effectiveness of proper communication. He was always involved in different teams, allowed his followers to offer timely suggestions, and encouraged patients’ relatives to be part of the care deliver process. These attributes are essential since they support performance (Lee, Chiang, & Kuo, 2018). He was always keen to address issues that many nurses and clinicians encountered in their respective fields or duties. Occasionally, he sought guidance from the overall health manager to improve performance. He remained humble, transparent, and responsible.

Leadership Philosophy

From completed exercise, it occurred that the interviewee had a powerful philosophy of nursing leadership. He embraced the concept of integrity to ensure that all patients received quality, timely, compassionate, and safe care. He also remained accountable for all followers and ensuring that they were satisfied with their working conditions. He achieved this goal by solving problems, formulating goals, and introducing evidence-based changes whenever necessary.

The above analysis reveals that my respondent pursues an authentic leadership approach or model. This is true since he has managed to establish meaningful relationships with his followers through effective empowerment and support (Lee et al., 2018). He promotes openness, empowers nurses, and presents a sense of direction.

Problem Solving

The NL understands that problems can affect operations and the quality of services available to patients. He begins by identifying the causes or issues surrounding the targeted problem. He goes further to monitor the interests of both parties and outlines the most appropriate solutions. He evaluates each of them and eventually encourages stakeholders to focus on the best one. He also creates contingency plans to ensure that all stakeholders’ demands are met.

Culturally Competent Leadership

As a nurse, it is important to implement culturally competent leadership with my patients and staff members. It is appropriate to establish care delivery teams comprised of professionals with diverse backgrounds (Fallatah & Laschinger, 2016). This approach will make it easier for me to provide proper guidelines that reduce chances of bias. I will go further to form multidisciplinary teams that can ensure that patients’ demands are met. I will educate my followers about the existing similarities and differences and the most appropriate measures to pursue common objectives.

Whenever providing guidelines and instructions, it will also be necessary to ensure that they are personalized. This means that followers will become more empowered while patients will receive high-quality services (Wong, 2015). Attributes such as cohesion, effective communication, appreciation of cultural differences, and the willingness to focus on identified goals will be promoted in the unit. These strategies will eventfully ensure that a cultural competent leadership model is in place.

Personal Leadership Philosophy

A personal philosophy of nursing is necessary if I am to achieve my objectives and support the delivery of high-quality medical services. The best strategy or style that resonates with my aims is the authentic model. I will begin by building trust and ensuring that the needs of all my followers are met. I will create the best working environment for all my nurses and caregivers. I will encourage them to solve emerging problems amicably and be involved whenever challenges arise. It will be necessary to educate them continuously about the importance of effective communication, information sharing, and consideration of people’s demands and expectations (Fallatah & Laschinger, 2016). The next initiative is to promote a culture of excellence and patient safety in my unit.

I will ensure that all my followers relate with each other positively, take good care of each other, and focus on the intended organizational aims. I will always pursue these key concepts: lead with my heart, focus on the desired long-term goals, improve the level of transparency, remain self-aware, and avoid biases and gaps that can affect performance (Fallatah & Laschinger, 2016). I will promote the notions of self-care, teamwork, collaboration, and communication. This philosophy will eventually make me successful and transform my patients’ experiences.

The above discussion has presented leadership as a meaningful practice in nursing. The interviewed NL has succeeded because he utilizes a powerful style that resonates with the demands of his followers and patients. Nurses can lead others in a culturally competent manner to maximize health outcomes. The application or development of a superior philosophy of nursing leadership informed by the above attributes will make me successful in my career.

Fallatah, F., & Laschinger, H. K. S. (2016). The influence of authentic leadership and supportive professional practice environments on new graduate nurses’ job satisfaction. Journal of Research in Nursing, 21 (2), 125-136. Web.

Lee, H., Chiang, H., & Kuo, H. (2018). Relationship between authentic leadership and nurses’ intent to leave: The mediating role of work environment and burnout. Journal of Nursing Management, 27 (1), 52-65. Web.

Wong, C. (2015). Connecting nursing leadership and patient outcomes: State of the science. Journal of Nursing Management , 23 (1), 275-278. Web.

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IvyPanda. (2024, February 28). Nursing Leadership: Interview on Problem-Solving. https://ivypanda.com/essays/nursing-leadership-interview-on-problem-solving/

"Nursing Leadership: Interview on Problem-Solving." IvyPanda , 28 Feb. 2024, ivypanda.com/essays/nursing-leadership-interview-on-problem-solving/.

IvyPanda . (2024) 'Nursing Leadership: Interview on Problem-Solving'. 28 February.

IvyPanda . 2024. "Nursing Leadership: Interview on Problem-Solving." February 28, 2024. https://ivypanda.com/essays/nursing-leadership-interview-on-problem-solving/.

1. IvyPanda . "Nursing Leadership: Interview on Problem-Solving." February 28, 2024. https://ivypanda.com/essays/nursing-leadership-interview-on-problem-solving/.

Bibliography

IvyPanda . "Nursing Leadership: Interview on Problem-Solving." February 28, 2024. https://ivypanda.com/essays/nursing-leadership-interview-on-problem-solving/.

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East Asian societies have the world’s lowest birth rates—and are learning that ‘throwing a bit of money’ at the problem isn’t solving anything

Governments across Asia—in Singapore and Beijing, Tokyo and Seoul—are facing a crisis : plummeting birth rates. 

For several decades now, people in East Asian economies have had fewer and fewer children. Last year, South Korea beat its own record for having the world’s lowest birth rate, reporting 0.72 births per woman for 2023, down from 0.78 in 2022. Singapore reported 0.97 births per woman, the first time the rate has fallen below one. Japan has one of the world’s oldest populations, with a median age of 49.5. Hong Kong, Taiwan, and mainland China are all reporting falling birth rates as well. 

All of these economies have fertility rates far below 2.1, the “replacement rate” which allows for a stable population. They haven’t reported a rate above 2.1 for years, if not decades. 

A low birth rate leads to a shrinking population, and a smaller workforce to produce the goods and services that lead to economic growth. Slower economic activity results in drops in fiscal revenue, giving fewer resources to a government that now needs to provide welfare for a growing elderly population. 

Academics often point to the cost of childcare, poor work-life balance, a lack of support for new parents (particularly mothers), and the stresses of modern society as reasons for falling birth rates. “In all the cosmopolitan cities, the fertility rate tends to be much lower because [people have] a lot of choices. The higher the development, [the] more urbanized, the more education that women get, the smaller the family size,” Paul Cheung, director of the Asia Competitiveness Institute at the Lee Kuan Yew School of Public Policy, says. 

Faced with this looming crisis, Asian governments have turned to a straightforward solution: Give prospective parents money if they have kids. The connection is simple to understand. If a major barrier to having children is the cost of childcare, then alleviating that cost with extra cash should change someone’s economic calculus. 

Except it hasn’t worked. Even Singapore, which Cheung suggests had a “way more generous [policy] than all the Asian countries,” has not succeeded in arresting the decline in fertility. 

“Low birth rates are a reflection of big institutional, cultural, structural problems,” said Stuart Gietel-Basten, a professor of social science and public policy at the Hong Kong University of Science and Technology. “Throwing a bit of money at it is not going to fix it.”

What are governments currently doing to stop falling birth rates?

Cheung, before his stint as an academic, was the director of Singapore’s population planning unit between 1987 and 1994. He helped start Singapore’s pronatalist policy, offering a relatively more generous set of incentives to encourage more births. The government even organized events to help single Singaporeans to meet. 

Singapore’s government officially inaugurated its baby bonus scheme in 2001. The most current payout is 11,000 Singapore dollars ($8,263) for each first and second child and 13,000 Singapore dollars ($9,766) each for the third and subsequent child. 

Other governments are also trying to dole out incentives. Japan increased its lump-sum childbirth benefit to 500,000 yen ($3,400) in April last year. Starting this October, the government will also offer 15,000 yen ($102) a month to households after the birth of a first and second child until the age of 2, and then continue providing 10,000 yen ($68) till high school. The government will offer more money to families with more than two children. 

South Korea has increased its incentives, too. The government gives 2 million Korean won ($1,519) to parents when a baby is born, which increases to 3 million won ($2,279) for the second child. Parents will also get an allowance of up to 18 million won ($13,674) in total for the first two years of the child’s life.

Hong Kong, on the other hand, is offering a one-off cash allowance of HKD 20,000 ($2,557). 

Singapore’s birth rate is declining at a slower pace than that of other Asian economies, only falling below 1.0 last year. (By comparison, Hong Kong’s fertility rate first fell below 1.0 in 2001, and hovered around that level before falling back below 1.0 again in 2020). Singapore’s population is still stable, but that may be the result of the country’s more liberal immigration policies, compared with Japan and South Korea.

All these measures seem to do is “delay the population decline a little into the future,” Cheung says. 

‘I feel sorry for the government’

The scary thought for demographers may now be that there’s no easy fix for falling fertility. Even Nordic countries, whose more generous pro-child policies were credited with keeping birth rates relatively high, have seen fertility collapse after the COVID pandemic. 

“The strange thing with fertility is nobody really knows what’s going on,” Anna Rotkirch, a research director at Family Federation of Finland’s Population Research Institute, told the Financial Times earlier this year. The demographer, who advised former prime minister Sanna Marin on population policy, now thinks fertility decline is “not primarily driven by economics or family policies. It’s something cultural, psychological, biological, cognitive.”

Research from Singapore implies that a drop in fertility could be the result of something more fundamental in how people live in modern society. Tan Poh Lin, a research fellow at the National University of Singapore, found rates of sexual intercourse among married heterosexual couples in Singapore—a “high-stress” society—were lower than the ideal frequency to conceive, generally considered to be five or six times every 30 days. There were “strong negative effects of both stress and fatigue, especially during weekdays,” she writes. Other surveys in Japan and South Korea report similar findings. 

But if monetary incentives or better social welfare programs and work-life balance, as in northern European countries, are not getting birth rates to what they should be, then what can Asian economies do to raise them?

“I feel sorry for the government because it’s the only organization or institution doing anything,” Gietel-Basten said. “In reality, everyone has to take responsibility for this. Companies have to change their attitude and recognize children are a social good, and that parents should be supported and not penalized,” he says. “But that costs money.”

Some companies in Asia have made high-profile offers to support employees having children. In February, a South Korean construction firm, the Booyoung Group, offered a bonus worth 100 million won ($76,000) to encourage female employees to have children. China’s Trip.com Group also offered some employees a 10,000 yuan ($1,391) annual bonus for households for every child under the age of five.  

But there’s no quick solution, says Gietel-Basten. Instead, he suggests that governments focus on other economic well-being issues—like youth unemployment, job security, and a sense that work is being valued—and hope that indirectly improves fertility rates.

In mainland China, “there’s not even jobs for the young people who are alive now,” he says. “Why do you want to have more children?” 

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The Philippines economy in 2024: Stronger for longer?

The Philippines ended 2023 on a high note, being the fastest growing economy across Southeast Asia with a growth rate of 5.6 percent—just shy of the government's target of 6.0 to 7.0 percent. 1 “National accounts,” Philippine Statistics Authority, January 31, 2024; "Philippine economic updates,” Bangko Sentral ng Pilipinas, November 16, 2023. Should projections hold, the Philippines is expected to, once again, show significant growth in 2024, demonstrating its resilience despite various global economic pressures (Exhibit 1). 2 “Economic forecast 2024,” International Monetary Fund, November 1, 2023; McKinsey analysis.

The growth in the Philippine economy in 2023 was driven by a resumption in commercial activities, public infrastructure spending, and growth in digital financial services. Most sectors grew, with transportation and storage (13 percent), construction (9 percent), and financial services (9 percent), performing the best (Exhibit 2). 3 “National accounts,” Philippine Statistics Authority, January 31, 2024. While the country's trade deficit narrowed in 2023, it remains elevated at $52 billion due to slowing global demand and geopolitical uncertainties. 4 “Highlights of the Philippine export and import statistics,” Philippine Statistics Authority, January 28, 2024. Looking ahead to 2024, the current economic forecast for the Philippines projects a GDP growth of between 5 and 6 percent.

Inflation rates are expected to temper between 3.2 and 3.6 percent in 2024 after ending 2023 at 6.0 percent, above the 2.0 to 4.0 percent target range set by the government. 5 “Nomura downgrades Philippine 2024 growth forecast,” Nomura, September 11, 2023; “IMF raises Philippine growth rate forecast,” International Monetary Fund, July 16, 2023.

For the purposes of this article, most of the statistics used for our analysis have come from a common thread of sources. These include the Central Bank of the Philippines (Bangko Sentral ng Pilipinas); the Department of Energy Philippines; the IT and Business Process Association of the Philippines (IBPAP); and the Philippines Statistics Authority.

The state of the Philippine economy across seven major sectors and themes

In the article, we explore the 2024 outlook for seven key sectors and themes, what may affect each of them in the coming year, and what could potentially unlock continued growth.

Financial services

The recovery of the financial services sector appears on track as year-on-year growth rates stabilize. 6 Philippines Statistics Authority, November 2023; McKinsey in partnership with Oxford Economics, November 2023. In 2024, this sector will likely continue to grow, though at a slower pace of about 5 percent.

Financial inclusion and digitalization are contributing to growth in this sector in 2024, even if new challenges emerge. Various factors are expected to impact this sector:

• Inclusive finance: Bangko Sentral ng Pilipinas continues to invest in financial inclusion initiatives. For example, basic deposit accounts (BDAs) reached $22 million in 2023 and banking penetration improved, with the proportion of adults with formal bank accounts increasing from 29 percent in 2019 to 56 percent in 2021. 7 “Financial inclusion dashboard: First quarter 2023,” Bangko Sentral ng Pilipinas, February 6, 2024.
• Digital adoption: Digital channels are expected to continue to grow, with data showing that 60 percent of adults who have a mobile phone and internet access have done a digital financial transaction. 8 “Financial inclusion dashboard: First quarter 2023,” Bangko Sentral ng Pilipinas, February 6, 2024. Businesses in this sector, however, will need to remain vigilant in navigating cybersecurity and fraud risks.
• Unsecured lending growth: Growth in unsecured lending is expected to continue, but at a slower pace than the past two to three years. For example, unsecured retail lending for the banking system alone grew by 27 percent annually from 2020 to 2022. 9 “Loan accounts: As of first quarter 2023,” Bangko Sentral ng Pilipinas, February 6, 2024; "Global banking pools,” McKinsey, November 2023. Businesses in this field are, however, expected to recalibrate their risk profiling models as segments with high nonperforming loans emerge.
• High interest rates: Key interest rates are expected to decline in the second half of 2024, creating more accommodating borrowing conditions that could boost wholesale and corporate loans.

Supportive frameworks have a pivotal role to play in unlocking growth in this sector to meet the ever-increasing demand from the financially underserved. For example, financial literacy programs and easier-to-access accounts—such as BDAs—are some measures that can help widen market access to financial services. Continued efforts are being made to build an open finance framework that could serve the needs of the unbanked population, as well as a unified credit scoring mechanism to increase the ability of historically under-financed segments, such as small and medium-sized enterprises (SMEs), to access formal credit. 10 “BSP launches credit scoring model,” Bangko Sentral ng Pilipinas, April 26, 2023.

Energy and Power

The outlook for the energy sector seems positive, with the potential to grow by 7 percent in 2024 as the country focuses on renewable energy generation. 11 McKinsey analysis based on input from industry experts. Currently, stakeholders are focused on increasing energy security, particularly on importing liquefied natural gas (LNG) to meet power plants’ requirements as production in one of the country’s main sources of natural gas, the Malampaya gas field, declines. 12 Myrna M. Velasco, “Malampaya gas field prod’n declines steeply in 2021,” Manila Bulletin , July 9, 2022. High global inflation and the fact that the Philippines is a net fuel importer are impacting electricity prices and the build-out of planned renewable energy projects. Recent regulatory moves to remove foreign ownership limits on exploration, development, and utilization of renewable energy resources could possibly accelerate growth in the country’s energy and power sector. 13 “RA 11659,” Department of Energy Philippines, June 8, 2023.

Gas, renewables, and transmission are potential growth drivers for the sector. Upgrading power grids so that they become more flexible and better able to cope with the intermittent electricity supply that comes with renewables will be critical as the sector pivots toward renewable energy. A recent coal moratorium may position natural gas as a transition fuel—this could stimulate exploration and production investments for new, indigenous natural gas fields, gas pipeline infrastructure, and LNG import terminal projects. 14 Philippine energy plan 2020–2040, Department of Energy Philippines, June 10, 2022; Power development plan 2020–2040 , Department of Energy Philippines, 2021. The increasing momentum of green energy auctions could facilitate the development of renewables at scale, as the country targets 35 percent share of renewables by 2030. 15 Power development plan 2020–2040 , 2022.

Growth in the healthcare industry may slow to 2.8 percent in 2024, while pharmaceuticals manufacturing is expected to rebound with 5.2 percent growth in 2024. 16 McKinsey analysis in partnership with Oxford Economics.

Healthcare demand could grow, although the quality of care may be strained as the health worker shortage is projected to increase over the next five years. 17 McKinsey analysis. The supply-and-demand gap in nursing alone is forecast to reach a shortage of approximately 90,000 nurses by 2028. 18 McKinsey analysis. Another compounding factor straining healthcare is the higher than anticipated benefit utilization and rising healthcare costs, which, while helping to meet people's healthcare budgets, may continue to drive down profitability for health insurers.

Meanwhile, pharmaceutical companies are feeling varying effects of people becoming increasingly health conscious. Consumers are using more over the counter (OTC) medication and placing more beneficial value on organic health products, such as vitamins and supplements made from natural ingredients, which could impact demand for prescription drugs. 19 “Consumer health in the Philippines 2023,” Euromonitor, October 2023.

Businesses operating in this field may end up benefiting from universal healthcare policies. If initiatives are implemented that integrate healthcare systems, rationalize copayments, attract and retain talent, and incentivize investments, they could potentially help to strengthen healthcare provision and quality.

Businesses may also need to navigate an increasingly complex landscape of diverse health needs, digitization, and price controls. Digital and data transformations are being seen to facilitate improvements in healthcare delivery and access, with leading digital health apps getting more than one million downloads. 20 Google Play Store, September 27, 2023. Digitization may create an opportunity to develop healthcare ecosystems that unify touchpoints along the patient journey and provide offline-to-online care, as well as potentially realizing cost efficiencies.

Consumer and retail

Growth in the retail and wholesale trade and consumer goods sectors is projected to remain stable in 2024, at 4 percent and 5 percent, respectively.

Inflation, however, continues to put consumers under pressure. While inflation rates may fall—predicted to reach 4 percent in 2024—commodity prices may still remain elevated in the near term, a top concern for Filipinos. 21 “IMF raises Philippine growth forecast,” July 26, 2023; “Nomura downgrades Philippines 2024 growth forecast,” September 11, 2023. In response to challenging economic conditions, 92 percent of consumers have changed their shopping behaviors, and approximately 50 percent indicate that they are switching brands or retail providers in seek of promotions and better prices. 22 “Philippines consumer pulse survey, 2023,” McKinsey, November 2023.

Online shopping has become entrenched in Filipino consumers, as they find that they get access to a wider range of products, can compare prices more easily, and can shop with more convenience. For example, a McKinsey Philippines consumer sentiment survey in 2023 found that 80 percent of respondents, on average, use online and omnichannel to purchase footwear, toys, baby supplies, apparel, and accessories. To capture the opportunity that this shift in Filipino consumer preferences brings and to unlock growth in this sector, retail organizations could turn to omnichannel strategies to seamlessly integrate online and offline channels. Businesses may need to explore investments that increase resilience across the supply chain, alongside researching and developing new products that serve emerging consumer preferences, such as that for natural ingredients and sustainable sources.

Manufacturing

Manufacturing is a key contributor to the Philippine economy, contributing approximately 19 percent of GDP in 2022, employing about 7 percent of the country’s labor force, and growing in line with GDP at approximately 6 percent between 2023 and 2024. 23 McKinsey analysis based on input from industry experts.

Some changes could be seen in 2024 that might affect the sector moving forward. The focus toward building resilient supply chains and increasing self-sufficiency is growing. The Philippines also is likely to benefit from increasing regional trade, as well as the emerging trend of nearshoring or onshoring as countries seek to make their supply chains more resilient. With semiconductors driving approximately 45 percent of Philippine exports, the transfer of knowledge and technology, as well as the development of STEM capabilities, could help attract investments into the sector and increase the relevance of the country as a manufacturing hub. 24 McKinsey analysis based on input from industry experts.

To secure growth, public and private sector support could bolster investments in R&D and upskill the labor force. In addition, strategies to attract investment may be integral to the further development of supply chain infrastructure and manufacturing bases. Government programs to enable digital transformation and R&D, along with a strategic approach to upskilling the labor force, could help boost industry innovation in line with Industry 4.0 demand. 25 Industry 4.0 is also referred to as the Fourth Industrial Revolution. Priority products to which manufacturing industries could pivot include more complex, higher value chain electronic components in the semiconductor segment; generic OTC drugs and nature-based pharmaceuticals in the pharmaceutical sector; and, for green industries, products such as EVs, batteries, solar panels, and biomass production.

Information technology business process outsourcing

The information technology business process outsourcing (IT-BPO) sector is on track to reach its long-term targets, with $38 billion in forecast revenues in 2024. 26 Khriscielle Yalao, “WHF flexibility key to achieving growth targets—IBPAP,” Manila Bulletin , January 23, 2024. Emerging innovations in service delivery and work models are being observed, which could drive further growth in the sector.

The industry continues to outperform headcount and revenue targets, shaping its position as a country leader for employment and services. 27 McKinsey analysis based in input from industry experts. Demand from global companies for offshoring is expected to increase, due to cost containment strategies and preference for Philippine IT-BPO providers. New work setups continue to emerge, ranging from remote-first to office-first, which could translate to potential net benefits. These include a 10 to 30 percent increase in employee retention; a three- to four-hour reduction in commute times; an increase in enabled talent of 350,000; and a potential reduction in greenhouse gas emissions of 1.4 to 1.5 million tons of CO 2 per year. 28 McKinsey analysis based in input from industry experts. It is becoming increasingly more important that the IT-BPO sector adapts to new technologies as businesses begin to harness automation and generative AI (gen AI) to unlock productivity.

Talent and technology are clear areas where growth in this sector can be unlocked. The growing complexity of offshoring requirements necessitates building a proper talent hub to help bridge employee gaps and better match local talent to employers’ needs. Businesses in the industry could explore developing facilities and digital infrastructure to enable industry expansion outside the metros, especially in future “digital cities” nationwide. Introducing new service areas could capture latent demand from existing clients with evolving needs as well as unserved clients. BPO centers could explore the potential of offering higher-value services by cultivating technology-focused capabilities, such as using gen AI to unlock revenue, deliver sales excellence, and reduce general administrative costs.

Sustainability

The Philippines is considered to be the fourth most vulnerable country to climate change in the world as, due to its geographic location, the country has a higher risk of exposure to natural disasters, such as rising sea levels. 29 “The Philippines has been ranked the fourth most vulnerable country to climate change,” Global Climate Risk Index, January 2021. Approximately $3.2 billion, on average, in economic loss could occur annually because of natural disasters over the next five decades, translating to up to 7 to 8 percent of the country’s nominal GDP. 30 “The Philippines has been ranked the fourth most vulnerable country to climate change,” Global Climate Risk Index, January 2021.

The Philippines could capitalize on five green growth opportunities to operate in global value chains and catalyze growth for the nation:

• Renewable energy: The country could aim to generate 50 percent of its energy from renewables by 2040, building on its high renewable energy potential and the declining cost of producing renewable energy.
• Solar photovoltaic (PV) manufacturing: More than a twofold increase in annual output from 2023 to 2030 could be achieved, enabled by lower production costs.
• Battery production: The Philippines could aim for a $1.5 billion domestic market by 2030, capitalizing on its vast nickel reserves (the second largest globally). 31 “MineSpans,” McKinsey, November 2023.
• Electric mobility: Electric vehicles could account for 15 percent of the country’s vehicle sales by 2030 (from less than 1 percent currently), driven by incentives, local distribution, and charging infrastructure. 32 McKinsey analysis based on input from industry experts.
• Nature-based solutions: The country’s largely untapped total abatement potential could reach up to 200 to 300 metric tons of CO 2 , enabled by its biodiversity and strong demand.

The Philippine economy: Three scenarios for growth

Having grown faster than other economies in Southeast Asia in 2023 to end the year with 5.6 percent growth, the Philippines can expect a similarly healthy growth outlook for 2024. Based on our analysis, there are three potential scenarios for the country’s growth. 33 McKinsey analysis in partnership with Oxford Economics.

Slower growth: The first scenario projects GDP growth of 4.8 percent if there are challenging conditions—such as declining trade and accelerated inflation—which could keep key policy rates high at about 6.5 percent and dampen private consumption, leading to slower long-term growth.

Soft landing: The second scenario projects GDP growth of 5.2 percent if inflation moderates and global conditions turn out to be largely favorable due to a stable investment environment and regional trade demand.

Accelerated growth: In the third scenario, GDP growth is projected to reach 6.1 percent if inflation slows and public policies accommodate aspects such as loosening key policy rates and offering incentive programs to boost productivity.

Focusing on factors that could unlock growth in its seven critical sectors and themes, while adapting to the macro-economic scenario that plays out, would allow the Philippines to materialize its growth potential in 2024 and take steps towards achieving longer-term, sustainable economic growth.

Jon Canto is a partner in McKinsey’s Manila office, where Frauke Renz is an associate partner, and Vicah Villanueva is a consultant.

The authors wish to thank Charlene Chua, Charlie del Rosario, Ryan delos Reyes, Debadrita Dhara, Evelyn C. Fong, Krzysztof Kwiatkowski, Frances Lee, Aaron Ong, and Liane Tan for their contributions to this article.

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Factors Influencing on Problem Solving Ability of Nursing Students Experiencing Simulation Practice

Hyun hee jo.

1 Department of Nursing, Hyejeon College, 19 Daehak 1-gil, Hongseong-eup, Hongseong-gun 32244, Korea

Won Ju Hwang

2 College of Nursing Science, East-West Nursing Research Institute, Kyung Hee University, 26 Kyunghee-Daero, Dongdaemun-gu, Seoul 02447, Korea

Associated Data

The data presented in this study are available on request from the corresponding author.

It has become important for nurses to implement self-leadership and exercise critical thinking in problem-solving to address the health issues of patients. This has led to a need for nursing education programs in which nursing students learn to embrace self-leadership and self-evaluation approaches to develop their skills. Within 260 nursing undergraduates with experience in simulation practice as study subjects, a self-reporting survey was conducted on self-leadership, goal commitment, critical thinking, and problem-solving skills. An analysis was conducted using the SPSS/WIN 21.0 program. t -test and ANOVA were conducted to validate the difference between problem-solving abilities. Multiple regression was conducted to examine the impact of these variables on problem-solving skills. The variables of religion, satisfaction with major, goal commitment, and critical thinking were found to have a significant impact on problem-solving abilities. The results were as follows: critical thinking (β = 0.36, p < 0.05), goal commitment (β = 0.28, p < 0.05), and explanatory power of 41%. To improve the nursing undergraduates’ problem-solving abilities through simulation practice, there needs to be a method that supports them in setting goals with self-leadership and enhance goal commitment. The method also needs to support the development of their critical thinking and curiosity for questions deriving from experiencing diverse programs in order to deliver effective outcomes.

1. Introduction

1.1. background.

In recent nursing environments, complex and strategic practices are required, and the role of nurses is recognized for its importance. In order to effectively respond to the patients’ demands, it has become important for nurses to equip themselves with specialized skills [ 1 , 2 ].

Such change requires nurses to build not only a high level of knowledge and skills, but also self-leadership to actively solve problems with independence and autonomy, as well as critical thinking to set the best goals and to identify strategies and grounds for apply clinical judgment and decision [ 3 , 4 ]. To this effect, nursing education must provide a learning environment that reflects actual practices and supports students to ultimately equip themselves with problem-solving abilities by coming up with their own measures, as well as searching and collecting the required data in order to exercise leadership and make logical and critical decisions in various situations, thereby ultimately carrying out nursing at a technical level [ 5 ]. Problem-solving abilities are an essential quality and the most notable characteristic of nursing professionals, in which they utilize their knowledge, explore and arrange information, and use it to serve the intended purposes under complex and unpredictable circumstances [ 6 ]. However, the traditional top-down education systems have limitations in teaching such practical skills and are inadequate to prepare students for many challenges in the field [ 7 ]. For nursing graduates, attitudes that are active, autonomous, responsible, and such are required in clinical practice, and many of them face difficulties to meet the requirements as they have developed passive and dependent approaches during early school years centered on university entrance exams [ 8 ].

Insufficient training on practice at nursing colleges leads to the decline in clinical practice capability of new nurses after their graduation. To complement this, more universities are adopting a high-performance simulator to enhance their training on practice [ 7 , 9 ]. The training simulators provide benefits by reproducing simulated situations which are similar to actual clinical environments, motivating the learning of students and providing direct learning effects by having students engage in activities in simulated situations. They also provide additional learning effects through post-learning evaluation and a re-design process. Furthermore, it has been reported that such practice-oriented training provides benefits of enhancing students’ critical thinking skills, allowing them to experience the outcomes of their clinical intervention, and to share with other students and reflect on their experience through de-briefing [ 10 ]. In simulated situations, trainees must apply in a critical way the theories learned to address patient issues and set their priorities to make decisions in a self-directed manner [ 11 , 12 ]. If students lack self-leadership, which is underscored in the simulated training on practice, they may not be able to improve problem-solving skills the essential skill required for change [ 13 , 14 ].

Due to the characteristics of nursing training, the result of training is directly related to practice in the field, and this has led to more attention being given to the design of training courses involving skills development and training experience for nurses aiming to develop and promote their critical-thinking and problem-solving abilities [ 15 , 16 ]. However, there is an insufficient number of studies on the relationship between self-leadership, goal commitment, critical thinking, and problem-solving abilities in nursing students. Thereby, the study results may be used as basic data for developing and operating training programs to enhance nursing undergraduates’ problem-solving skills.

1.2. Study Purpose

The purpose of this study was to identify the relationship between self-leadership, goal commitment, critical thinking, and problem-solving abilities in nursing undergraduates who experienced simulation training on practice and the impact of these variables on problem-solving processes. This involved (1) investigating the relationship between self-leadership, goal commitment, critical thinking, and problem-solving abilities; and (2) identifying the impact of self-leadership, goal commitment, and critical thinking on problem-solving abilities.

2. Methodology

2.1. study design.

This is a descriptive investigation study conducted to identify the relationship between self-leadership, goal commitment, critical thinking, and problem-solving abilities of nursing undergraduates with the experience of simulation practice training.

2.2. Sampling Strategy

The participants of this study consisted of nursing undergraduates (juniors and seniors) at 4 universities who received 30 to 60 h of simulated practice training. The training was provided in one of the following two ways; one day of simulated practice training during clinical practice or five-day simulated practice training. All universities were equipped with high-performance simulators and used them in practice training. Though equipment and materials used varied by subject, high-performance simulators and dummies were used for most subjects.

2.3. Ethical Considerations

For the bioethics and safety of study subjects, this study was conducted after deliberation by the Institutional Review Board of University and the approval (No: KHSIRB-14-059(EA)) was obtained. During study period, the guidelines of the IRB were complied with. The description of the study was provided to study subjects and the purpose and methods of the study were explained. The survey was handed out to be filled-out by subjects who agreed to participate and they were informed the data they provided would be used solely for the study’s purpose. Study subjects were provided with a small amount of compensation in appreciation of their participation.

2.4. Study Methods

• (1) Demographics

General characteristics included university, age, grade, religion, personal relationships, academic grades, major satisfaction, leadership training experience, and need for leadership. The age groups were divided into two: subjects of 22 years of age or below and subjects of 23 years of age or above. The personal relationships were classified into average, good, and very good. The major satisfaction was classified into unsatisfactory, average, satisfactory, and highly satisfactory.

• (2) Self-leadership

To measure the self-leadership of nursing undergraduates, RSLQ (Revised Self-Leadership Questionnaire) developed by Houghton and Neck [ 17 ] was used after being modified and complemented by Shin et al. [ 18 ] for Korean participants. It consists of 35 items under 3 main categories and 9 sub-categories. The Cronbach’s α by item ranged from 0.74 to 0.88 and the Cronbach’s α value in this study was between 0.72 and 0.85.

• (3) Goal commitment

To measure the goal commitment of nursing undergraduates, the tool suggested by Klein et al. [ 19 ] was used. The tool consisted of 5 items measured with the 5-point Likert scale. The higher score meant a greater goal commitment. Items 1, 2, and 3 were reverse items. The Cronbach’s α was 0.83 and the value in this study was 0.75.

• (4) Critical thinking disposition

To measure the critical thinking disposition of nursing undergraduates, the tool suggested by Yoon [ 3 ] was used. The tool consisted of a total of 27 items under 7 categories of intellectual eagerness/curiosity, prudence, self-confidence, systematicity, intellectual fairness, healthy skepticism, and objectivity. In the study by Yoon [ 3 ], the Cronbach’s α was 0.84 and the value in this study was 0.74.

• (5) Problem-solving abilities

The Social Problem Solving Inventory-Revised (SPSI-R) modified by D’Zurilla and Maydeu-Olivares [ 20 ] and translated by Choi [ 21 ] were used to measure problem-solving abilities. SPSI-R consisted of two major scales to measure the problem-solving orientation and problem-solving skills, as well as 5 sub-categories of positive problem orientation, negative problem orientation, rational problem-solving, impulsive/careless style, and avoidance coping style. The Cronbach’s α was 0.78 and the value ranged from 0.68 to 0.91 in this study.

2.5. Data Collection Method

The study data were collected from 18 September 2014 to 4 November 2014. The data were collected from juniors and seniors with an experience of simulated practice training from nursing departments at 4 universities in Seoul, and upon agreement for participation. The surveys were then handed out, filled-in, and retrieved straight away. A total of 280 copies were distributed and 276 copies were retrieved. With 16 surveys with insincere responses excluded, a total of 260 copies were used for final analysis.

2.6. Data Analysis

The data collected were analyzed using SPSS/WIN 21.0 program (IBM Corp., Armonk, NY, USA). The variables of mistakes, average, and percentage were used to identify general characteristics. The difference in problem-solving abilities by general characteristic was validated through t -test and ANOVA with additional validation through Scheffe test and Fisher’s exact test. The relationship between the subjects’ self-leadership, goal commitment, critical thinking, and problem-solving abilities was analyzed using Pearson’s correlation coefficient. A multiple regression was used to identify the impact of these variables on problem-solving abilities.

3.1. General Characteristics of Study Participants

The subjects of this study comprised 260 juniors and seniors in the nursing department with the experience of 30 to 60 h of simulated training on practice. The juniors accounted for 72.3% and the good personal relationships accounted for 56.5%. The major satisfaction was 55.4% and no leadership training experience was 61.9%. The results were as follows: self-leadership of 3.59 ± 0.71, goal commitment of 3.68 ± 0.57, critical thinking of 3.57 ± 0.57, and problem-solving abilities of 3.14 ± 0.58 ( Table 1 ).

Mean of Dependent and Independent Variables (N = 260).

M = Mean, SD = Standard Deviation

3.2. Problem-Solving Abilities According to General Characteristics

The difference in problem-solving abilities according to the general characteristics of the study subjects showed significance in grades, personal relationships, academic grades, and major satisfaction. The juniors (2.75 ± 0.62) showed higher numbers of impulsive style (t = 1.30, p = 0.003) than seniors (2.62 ± 0.46) in relation to grades. The seniors showed higher numbers of positive problem orientation (t = −0.55, p = 0.013) and rational problem-solving (t = 0.00, p = 0.039). There were significant differences in positive problem orientation (F = 5.68, p = 0.004) and negative problem orientation (F = 7.96, p < 0.001) in relation to personal relationships. The result of post-validation shows that subjects with “average (3.65 ± 0.53)” personal relationships showed a lower positive problem orientation than subjects with “very good (2.51 ± 0.72)” personal relationships. The subjects with “very good (2.51 ± 0.72)” personal relationships showed a lower negative problem orientation than subjects with “average (3.09 ± 0.66)” and “good (2.97 ± 0.71)” personal relationships. Subjects with higher academic grades showed a lower negative problem orientation (F = 3.77, p = 0.024), impulsive careless style (F = 3.78, p = 0.024), and evasive style (F = 4.65, p = 0.010) than subjects with lower academic grades. There was a significant difference in all sub-categories of problem-solving abilities in relation to major satisfaction. For positive problem orientation (F = 5.35, p < 0.001), subjects with “average (3.62 ± 0.48)” showed lower problem-solving abilities than subjects with “very satisfactory (4.10 ± 0.47)”. For negative problem orientation (F = 6.32, p < 0.001), subjects with “average (3.18 ± 0.68)” showed higher problem-solving abilities than subjects with “satisfactory (2.84 ± 0.69)” and “very satisfactory (2.59 ± 0.76)”. For rational problem solving (F = 5.10, p = 0.001), subjects with “very satisfactory (3.82 ± 0.36)” showed higher problem-solving abilities than subjects with “average (3.43 ± 0.40)” and “unsatisfactory (3.48 ± 0.69)”. For impulsive/careless style (F = 4.24, p = 0.002), subjects with “unsatisfactory (2.95 ± 0.50)” showed higher problem-solving abilities than subjects with “satisfactory (2.65 ± 0.51)” and “very satisfactory (2.45 ± 0.63)”. While there was a significant difference observed in relation to evasive style (F = 2.99 p = 0.019), no difference was observed in the post validation. ( Table 2 )

General Characteristics of Subjects’ Problem-solving Abilities (N = 260).

§ PPO = Positive Problem Orientation, ‖ NPO = Negative Problem Orientation, ¶ RPS Rational Problem Solving, # ICS = Impulsive Careless Style, ** ACS = Avoidance Coping Style, * = Fisher’s exact test. a,b,c = scheffe

3.3. Correlation between Subjects’ Self-Leadership, Goal Commitment, Critical Thinking, and Problem-Solving Abilities

A Pearson’s correlation was used to identify the correlation between general characteristics, self-leadership, goal commitment, critical thinking, and problem-solving abilities of nursing undergraduates with the experience of simulated practice training and the result shows that there was a positive correlation between problem-solving abilities and the variables of critical thinking (r = 0.54, p < 0.01), goal commitment (r = 0.47, p < 0.01), and self-leadership (r = 0.43, p < 0.05). For general characteristics, a positive correlation was observed in major satisfaction (r = 0.29, p < 0.01) and personal relationships (r = 0.21, p < 0.01; Table 3 ).

Correlations Between Problem-solving abilities and Other Variables in Participants (N = 260).

* p < 0.05. 1. Problem Solving Skills, 2. Self-Leadership, 3. Goal Commitment, 4. Critical Thinking, 5. University, 6. Age, 7. Grade, 8. Religion, 9. Interpersonal, 10. Academic Achievement, 11. Major Satisfaction, 12. Leadership Training Experience, 13. Leadership Training Needs.

3.4. Influential Factors on Problem-Solving Abilities of Nursing Undergraduates with the Experience of Simulated Practice Training

To identify the influential factors on the problem-solving abilities of nursing undergraduates with the experience of simulated practice training, the variables that showed significance difference of p < 0.5 in relation to the subjects’ general characteristics were designated as potential influential factors. These variables were self-leadership, goal commitment, critical thinking, age, religion, personal relationships, major satisfaction, and leadership training experience. A multiple regression analysis was conducted and the results were as follows: For the analysis, the general characteristics of the subjects’ age, having or not having a religious belief, having a good or not good personal relationships, and being satisfied or unsatisfied about the major were processed as dummy-coded variables. First, as a result of testing the assumptions of regression analysis, it was found that all of them were satisfied.

Having a religious belief, major satisfaction, goal commitment, and critical thinking were observed to be significant influential factors on problem-solving abilities. The results were as follows: critical thinking (β = 0.36) and goal commitment (β = 0.28). Self-leadership, age, personal relationships, and leadership training experience showed no significance, with the value of p > 0.05. The regression equation used to analyze the influential factors showed the following results: R = 0.65, R 2 = 0.42, modified R 2 = 0.41, F = 23.17, p < 0.01, and Durbin–Watson = 1.97. The Durbin–Watson value was 1.97 and close to 2, ensuring the independence of error, and the explanatory power was 41%. The tolerance limit was 1 or below and the variance inflation factor (VIF) was lower than 10, showing no problem for multi-collinearity ( Table 4 ). Next, as a result of analyzing influence using Cook’s D statistics, there was no more than 1.0 discrete in 260 subjects. Following a result of residual analysis, linearity of the model, normality of the error term, and homoscedasticity were confirmed.

The Influencing Factors on the Problem-Solving Abilities (N = 260).

SE = Standard Error, VIF = Variance Inflation Factor.

4. Discussion

Nursing education and training must provide a learning environment that reflects actual practice and enables students to set up alternative measures to solve learning problems, search and obtain required data, and equip themselves with problem-solving abilities. However, the traditional top-down education systems have limitations in teaching such practical skills and are inadequate to prepare students for many challenges in the field [ 7 ]. This study aimed to analyze the relationship between the self-leadership, goal commitment, critical thinking, and problem-solving abilities of nursing undergraduates with the experience of simulated practice training and to obtain basic data to improve the quality of simulated practice training.

The results of the study are similar to the previous studies; an average mean of 3.14 points for problem-solving skills, 3.36 points for problem-solving orientation, and 2.98 points for problem-solving abilities [ 22 ]. This suggests that nursing undergraduates evaluated their problem-solving abilities to be of intermediate level and perceived themselves as an intermediate-level problem solver. For sub-categories, the positive problem orientation showed the highest point, followed by rational problem-solving and evasive style. This implies that nursing undergraduates showed a comparatively positive emotional state when faced with problems, but had a tendency to evade problems for as long as possible rather than confront them. According to the study by Cha et al. [ 22 ], nursing undergraduates who believed they were ineffective problem-solvers tended to imagine more hardships than there actually were, when faced with problems. To address this problem, the study also stressed out the need for measures to support nursing undergraduates to experience various situations and respond in objective, rational, and cognitive manners. Problem-solving abilities refer to a process of making decisions using effective problem-solving strategies based on one’s knowledge and are regarded as very important skills for professional nurses. A study by Yang [ 23 ] stated that the current nursing education and training courses provide content and methods that are not effective in teaching nursing undergraduates about the understanding or skills of the problem-solving process, and results in many undergraduates experiencing hardships when faced with various challenges in the clinical field. As insufficient training on practice leads to a decline in the clinical practice capability of new nurses after graduation; therefore, various teaching methods should be applied to enhance students’ problem-solving abilities and to enable nursing undergraduates to solve problems in a positive, active, and rational manner.

The difference in problem-solving abilities according to the general characteristics was partially significant for grades, personal relationships, and academic grades. The major satisfaction exhibited significant differences in all sub-categories. For positive problem orientation and rational problem-solving, the subjects with a greater major satisfaction showed a higher level of problem-solving skills. For negative problem orientation and impulsive/careless style, subjects with less major satisfaction showed a higher point. These results are consistent with the results of another study [ 24 ] on critical thinking disposition, problem-solving ability, and clinical competence of nursing students in that the subjects with a lower major satisfaction had lower problem-solving skills. This means that the subjects with a greater major satisfaction had more effective, intellectual, and creative problem-solving abilities than those with less major satisfaction. This is believed to be due to factors such as academic achievement, active attitude toward problem-solving, and such, according to their level of major satisfaction.

The influential factors for problem-solving abilities were goal commitment and critical thinking. Although the general characteristics of age, satisfaction with nursing major, and personal relationships showed correlations with problem-solving skills, no significant result was observed in the regression analysis. In a study by Aubé et al. [ 25 ], a virtual management project was implemented for undergraduates to examine the data provision and goal commitment. The results showed that subjects with a higher goal commitment had a higher problem-solving performance. The study also stated that subjects could develop actual capabilities required in the field only by having a deep understanding of situations and that they could acquire problem-solving abilities required in the field by committing to the situation not as an observer, but as a learner. Therefore, to enhance problem-solving skills, various programs should be developed and implemented to improve students’ goal commitment. In addition, team projects or action-based learning programs should be implemented to promote interactions between different learning programs and enhance students’ commitment to the study. In this way, the programs may enhance the problem-solving abilities of students by motivating them.

According to the study by Han and Park [ 26 ], greater critical thinking leads to higher problem-solving skills, which in turn enhances one’s confidence in problem-solving and improves the problem-solving skills. The study found that nursing undergraduates must develop critical thinking skills in order to explore problems in diverse aspects and seek solutions in a discreet manner. Training using simulators is an effective educational method as it motivates students’ learning and provides direct learning effects through simulated activities. Furthermore, it enhances the students’ critical abilities and allows them to experience the outcomes of their clinical intervention, as well as to share with other students and reflect on their experience through de-briefing [ 10 ].

Tucker et al. [ 27 ] stated that problems can be solved through a regular method based on guidelines and algorithms, and that such guidelines and algorithms are the result of such efforts. To develop problem-solving skills, which is an essential quality for nurses, one must develop a strong goal commitment and critical thinking abilities. To this effect, nursing undergraduates should be subjected to various nursing situations and be able to establish their own goals and commitment. They should also develop an accurate understanding of situations and critical thinking abilities to accurately identify, analyze, consolidate, and utilize data. To this effect, various simulated practice trainings, action-based learning, and problem-solving-oriented teaching programs, which support a natural learning process through a repetitive process, should be implemented to have learners actively engage in learning and develop a sense of commitment as well as critical thinking.

This study suggests that, while self-leadership showed no significant impact on problem-solving skills, it had impact on the problem-solving abilities of nursing undergraduates [ 28 , 29 ]. It was also suggested that self-leadership affected the goal commitment, which impacted the problem-solving abilities and improved it. This was due to the fact that not all nursing undergraduates exercised self-leadership and the level of self-leadership varied according to the individuals’ ability, environmental factors, function, and task structure [ 17 ]. Self-leadership involves a behavior strategy and cognitive strategy. Nursing students need to be committed to this process to solve problems and must put efforts to address problems on their own in order for their problem-solving abilities to develop. To enhance problem-solving skills, they must be committed to achieving their goals. Educational and training programs should be developed and implemented to provide nursing students with circumstances in which they are able to exercise self-leadership and in which they are encouraged to develop self-leadership skills.

This study holds significance in that it suggests the need for the development and implementation of various programs involving simulated practice training to enhance the problem-solving abilities of nursing undergraduates. It also suggests the need for measures to make students set their own goals and improve the level of their goal commitment, as well as the fact that the use of self-leadership may enhance the effectiveness of the process. Furthermore, it suggests the possible synergetic effects on developing critical thinking abilities by allowing students to build critical curiosity over questions they face by experiencing various programs. On the other hand, this study had limitations in that the scope of sample was limited to nursing undergraduates with the experience of simulated practice training at certain universities in Seoul city who agreed to participate in the study, suggesting that the study results should not be used for generalization. In addition, there are limitations to defining the correlation in that a cross-sectional study method was used in which the cause and outcome variables of the collected data were measured at the same time point for analysis.

5. Conclusions

This study was conducted to identify the relationship between the self-leadership, goal commitment, critical thinking, and problem-solving abilities of nursing undergraduates with the experience of simulated practice training. The multiple regression analysis results show that the variables of goal commitment and critical thinking had a significant impact on the nursing undergraduates’ problem-solving abilities (F = 23.17, p < 0.01), with the explanatory power of 41%. In order to enhance the problem-solving abilities of nursing undergraduates, various education programs which involve discussions with simulated training on practice to demonstrate a step-by-step approach to problematic situations, an establishment of hypothesis, and team cooperation must be developed and implemented [ 30 , 31 , 32 ]. At this stage, measures are required to encourage students to set up their own goals and enhance goal commitment; the effectiveness is expected to increase if the process involves self-leadership. In addition, there may be synergetic effects from students participating in various programs, through training and classes, and developing questions and critical thinking as well as curiosity. Based on the study results, the following suggestions are made. There is a need for repetitive studies on nursing undergraduates and professional nurses under various circumstances and on self-leadership, which was explained as a parameter for problem-solving skills. In addition, a comprehensive program must be developed in which simulated practice training involves not only enhancing the learners’ problem-solving abilities and critical thinking, but also developing self-leadership and goal commitment.

Funding Statement

This research was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2017R1A2B4008496). It was also funded by the Korea Health Industry Development Institute (KHIDI) through the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1317). The funding agencies had no role in the study design, the collection, analysis, or interpretation of data, the writing of the report, or the decision to submit the article for publication (PI: WJ Hwang).

Author Contributions

(1) H.H.J.: Study conception and design, data collection, data analysis, and interpretation, and writing the manuscript. (2) W.J.H.: Study conception and design, development of design, drafting of the article, supervision, and writing of the manuscript. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

For the bioethics and safety of study subjects, this study was conducted after deliberation by the Institutional Review Board of Kyung Hee University and the approval (No: KHSIRB-14-059(EA)) was obtained.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

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