EFFECT OF A STRUCTURED PEER-COACHING PROGRAM ON NURSES' CLINICAL COMPETENCE AND PROFESSIONAL CONFIDENCE: A QUASI-EXPERIMENTAL STUDY

Abstract

Background: The continuous development of clinical competence and professional confidence is essential for delivering high-quality patient care. In high-stakes environments like cardiac care, nurses require ongoing support to translate theoretical knowledge into proficient practice. Structured peer-coaching has emerged as a potential strategy to bridge the gap between education and clinical application. However, empirical evidence regarding its effectiveness in Pakistani tertiary care settings remains limited.

Objective: This study aimed to evaluate the effect of a structured peer-coaching program on the clinical competence and professional confidence of nurses at a tertiary care cardiac facility.

Methods: A quasi-experimental, one-group pre-test-post-test design was employed. The study was conducted at the Chaudhry Pervaiz Elahi Institute of Cardiology (CPEIC), Multan, over a six-month period from February to August. A total of 45 registered nurses were recruited using a purposive sampling technique. The intervention consisted of a structured peer-coaching program where senior nurses (coaches) were paired with junior nurses (coaches) for bi-weekly coaching sessions, direct observation, and feedback. Data were collected at baseline (pre-intervention) and immediately after the six-month intervention (post-intervention) using two validated instruments: The Clinical Competence Questionnaire (CCQ) and the Professional Confidence Scale (PCS). Paired sample t-tests were used to analyze the differences in mean scores.

Results: A total of 45 nurses completed the study, yielding a 100% retention rate. The analysis revealed a statistically significant improvement in both primary outcomes. The mean clinical competence score increased significantly from 152.4 (SD = 18.6) at baseline to 188.7 (SD = 14.2) post-intervention (t(44) = 15.32, p < .001, Cohen's d = 2.15). Similarly, the mean professional confidence score showed a significant increase from 68.1 (SD = 9.4) pre-intervention to 85.5 (SD = 7.1) post-intervention (t(44) = 12.88, p < .001, Cohen's d = 1.98). A strong positive correlation was found between improvements in clinical competence and professional confidence (r(43) = 0.72, p < .001).

Conclusion: The structured peer-coaching program significantly enhanced both the clinical competence and professional confidence of nurses in a cardiac care setting. This intervention proved to be an effective and practical model for professional development. It is recommended that healthcare institutions integrate structured peer-coaching into their ongoing nursing education and quality improvement frameworks to foster a culture of continuous learning and improve patient outcomes.