Impact of a charge nurse development program on nurses' confidence: a quasi-experimental study in a multinational...

Charge nurses are pivotal frontline leaders in acute care, yet many assume the role without formal preparation, particularly in multicultural health systems. Confidence in leadership, clinical judgment, and communication is central to safe and effective charge nurse practice, but evidence from Gulf-region tertiary hospitals remains limited.

To evaluate the effectiveness of a structured Charge Nurse Development Program (CNDP) in improving nurses' confidence in leadership, clinical, and professional responsibilities within a large multinational tertiary hospital in the United Arab Emirates.

A quantitative quasi-experimental pre-post design was conducted with 103 nominated registered nurses working in inpatient and critical care units. The three-phase CNDP combined self-directed e-learning, a didactic workshop with simulation and case-based activities, and three supervised charge nurse shadowing shifts, guided by Bandura's Self-Efficacy Theory, adult learning principles, and experiential learning. Confidence was measured before and 1 week after the program using the 21-item Confidence in Managing Challenging Situations Scale (CMCS). Data were analyzed using paired-samples t-tests, Welch's ANOVA, and multiple linear regression; effect sizes and internal consistency (Cronbach's α) were reported.

Confidence improved significantly across all 21 items and both subscales. Leadership & Ethical Practice increased from 27.48 ± 5.31 to 32.95 ± 4.05, and Clinical & Communication Confidence from 36.26 ± 7.01 to 43.56 ± 5.43; total confidence rose from 63.74 ± 11.74 to 76.51 ± 9.26 (all p < 0.001, d ≈ 0.82-0.87). Cronbach's α for the Confidence Scale was 0.963. Baseline differences by credential favored charge nurses, but post-intervention scores no longer differed significantly. No meaningful differences were found across nationality, age, qualification, years of experience, or unit, and regression analyses showed no consistent demographic predictors of change.

The CNDP was associated with educationally meaningful improvements in nurses' self-reported leadership and clinical confidence in a highly multicultural workforce. These findings suggest that structured, theory-informed charge nurse development may support perceived readiness for frontline leadership responsibilities. Further controlled and longitudinal studies using objective behavioral, clinical, and organizational outcomes are needed to determine whether confidence gains translate into sustained practice change.