From leadership research to district action: Integrating Workplace Learning Into Healthcare Settings: A Mixed‐Methods Study to Inform Curriculum Design, Resource Allocation and Organisational Support

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Introduction Postgraduate education is critical for advancing nursing competence, yet enrolment has declined as nurses struggle to balance clinical, academic and personal responsibilities. Workplace learning offers a flexible, context‐driven alternative, allowing nurses to integrate academic development into their clinical practice and potentially mitigating work–life conflicts. However, adoption of structured workplace learning remains limited across healthcare organisations. Aim This study aimed to explore how workplace learning can be integrated into healthcare settings to inform curriculum design, resource allocation and organisational support in postgraduate nursing education. Design and Methods An explanatory sequential mixed‐methods study comprising a single‐cohort quantitative pre–post knowledge assessment and repeated competence assessments, followed by qualitative focus groups to explain implementation enablers and barriers. Twenty‐three postgraduate nurses enrolled in a 13‐week workplace learning course participated; 22 completed the study. Quantitative data were analysed with nonparametric statistics, while qualitative data underwent thematic analysis. Results We observed a slight improvement in median knowledge scores and increasing competence scores across four time points. As this was a single‐group evaluation without a control group, quantitative findings cannot be interpreted as causal effects. Qualitative analysis generated three themes: (1) learning and assessment, (2) integration of workplace learning in the organisation and (3) organisational impact on workplace learning. Conclusion Workplace learning was feasible and valued when supported by peer learning structures, appropriately timed assessments and organisational enablers such as protected time, adequate infrastructure and leadership support. Keywords: competence assessment, leadership support, mixed methods, organisational support, postgraduate nursing education, resource allocation, workplace learning

Study methods

An explanatory sequential mixed‐methods design was used. First, quantitative data were collected from a single cohort using a pre–post knowledge assessment and repeated competence assessments at four time points to describe outcome trends across the course. Second, qualitative focus group discussions were conducted after course completion to explore participants’ experiences and to explain organisational and educational factors that may underpin the observed quantitative trends. Integration occurred at two points: (i) quantitative findings informed refinement of the qualitative interview guide (connecting) and (ii) findings were integrated during interpretation through narrative weaving across strands.

Limitations

This study has limitations. The quantitative component involved a small single cohort without a control group; changes in knowledge and competence ratings may reflect maturation, familiarity with assessment expectations or assessor‐related effects rather than intervention effects. The knowledge questionnaire was developed by a content expert and was not psychometrically validated, limiting interpretation of score changes. Furthermore, while the Clinical Assessment Tool for Competence has strong reported psychometric properties from its original validation (Tan et al., 2016), inter‐rater reliability was not reassessed among the facilitators in this specific study, which should be considered when interpreting the competence scores. The qualitative findings are based on focus group discussions, meaning the insights were co‐constructed through group interaction and reflect the collective experience of the participants. As the study was conducted in a single programme and organisational context, the findings offer a deep, context‐specific understanding rather than broad generalisability.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one recurring leadership practice described in the source. Map its participants, incentives and constraints to a district setting, then design a small reversible staff pilot with an accountable owner. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Record implementation fidelity, staff review time, task quality and unintended burdens against a baseline. Use a comparison team where feasible and document alternative explanations before expanding. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Yuhan Ho; Doreen Heng; Wentao Zhou; Emily Neo Kim Ang; Yah Shih Chan; Chiew-Jiat Rosalind Siah. Integrating Workplace Learning Into Healthcare Settings: A Mixed‐Methods Study to Inform Curriculum Design, Resource Allocation and Organisational Support. Journal of Nursing Management (2026-01-01). https://doi.org/10.1155/jonm/3021423

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.