The unlearning process of senior clinical nurses in rehabilitation wards

The aim of this study was to create a model and verify its fitness for focusing on unlearning of senior clinical nurses who transferred from acute to rehabilitation wards.

The processes by which nurses with experience in acute wards acquire expertise in rehabilitation wards, the 'process of unlearning', have not yet been clarified.

This research used a cross-sectional study.

Content analysis of interview data of 23 senior clinical nurses was used to reveal factors constituting nurses' unlearning and a base model was created. Data were collected between May - September 2016. For its verification, categories extracted through content analysis were used as latent variables and subcategories as observation variables. The model's fit was confirmed through a survey of 5,435 senior clinical nurses from July to September 2017.

We extracted six categories-'awareness', 'conflict', 'discard', 'acquisition', 'acceptance' and 'establishment'-and 22 subcategories of the factors constituting unlearning and created a base model. The effective response rate in the survey for verifying the fitness of the base model was 20.2%. The base model generally fulfilled the fitness, but we further studied the model fit with the data and modified it to comprise five categories, excluding 'acceptance', with 16 subcategories. The fitness of the modified model further improved. Through revalidation, we confirmed that the modified model satisfies the goodness of fit.

Our findings add to the development of rehabilitation nursing skills of nurses transferred from acute to rehabilitation wards in a Japanese community-based integrated care system.

This study revealed the unlearning process of senior clinical nurses. The unlearning process identified in this study contributes to knowledge and skills acquisition specific to nurses specializing in rehabilitation. It will be used for developing a re-education programme for rehabilitation nurses in the future.