Factors influencing implementation of innovations in clinical nursing education.

Abstract

The purposes of this study were to determine whether associate degree nursing (ADN) programs were implementing innovations in their clinical curricula, to identify recent clinical innovations in these nursing programs, and to identify attributes of innovations that influence innovation adoption. Data were obtained from two questionnaires to all directors of ADN programs in six southwestern states. The first questionnaire asked respondents to identify clinical innovations they had considered recently. The second questionnaire used a Likert Scale to seek respondents' perception of six attributes of innovations--Relative Advantage, Compatibility, Complexity, Observability, Trialability, and Cost--that come from diffusion theory. Analysis of data indicated that 77% of the respondents had implemented changes in their clinical curriculum during the past six years. The most frequently implemented innovations were computer assisted instruction, preceptorship experiences, clinical competency exams, initiating or increasing use of skills labs, and workstudy/externship experiences. Likert Scale values for perceptions of the six attributes, along with a variable created to represent the influence of the Environment, were analyzed by principal component analysis and logistic regression analysis. These analyses led to the conclusion that no one or two variables can be used to predict adoption of an innovation. Instead, a model with each of the attributes should be used in predicting adoption. These findings generally supported the model provided by diffusion theory. However, the influence of Trialability was negligible. Additionally, the Environment variable was found to be an important influence in a favorable adoption decision. Nursing program directors who seek to implement innovations could enhance successful implementation by emphasizing the positive aspects of all attributes of a proposed innovation.