Catégorie d'article: Review
Publié en ligne: 16 sept. 2024
Pages: 243 - 251
Reçu: 13 avr. 2023
Accepté: 26 sept. 2023
DOI: https://doi.org/10.2478/fon-2024-0023
Mots clés
© 2024 Luke Laari et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Crew Resource Management, a simulation-based safety training program, was the origin of soft skills in the aviation sector.1 This was meant to teach pilots and their crew about human performance limitations, cognitive mistake recognition, behavior analysis, communication, dispute resolution, and decision-making. Today, practically every business, including the health industry, uses the concept of soft skills extensively. Soft skills are referred to by researchers and therapists as non-technical skills, people’s skills, and emotional intelligence. The acceptance of the concept of soft skills in the healthcare industry is hindered by the inconsistent and ambiguous use of this concept. There have been several studies in various industries, with a few in healthcare and specifically in the nursing domain, but none of these studies has provided a clear and succinct definition to simplify soft skills in the healthcare industry.
A concept analysis approach by Walker and Avant2 is used to define and clarify soft skills in the healthcare industry. Walker and Avant3 assert that concept selection should reflect a topic or an area of interest. Soft skills are a common topic of conversation among employers in various industries, including health and specifically in nursing care practice. This has prompted an interest in exploring this concept further. Soft skills are intrapersonal traits and interpersonal skills4 that one possesses and that make one a preferred service provider. As intra- and interpersonal skills, they are essential for personal development, social participation, and workplace success.5 Soft skills are used in many industries, including engineering, aviation, and healthcare, but for this paper, the focus will be on healthcare, with a specific interest in nursing.
Soft skills are globally considered by various professionals in situations where human interactions are required to complete a task. The healthcare industry has received countless calls from researchers to incorporate soft skills into the training of professionals,1,6–11 yet a succinct definition of soft skills is lacking.
The effective training paradigm from aviation was extended to healthcare contexts and became crisis resource management, a simulation-based technique for teaching non-technical skills to medical practitioners. This simulation-based approach relied on 15 acting principles.12 According to Lindamood et al.,12 these principles include knowing the environment; anticipating and planning; calling for help early; exercising leadership and followership; distributing the workload; mobilizing all available resources; communicating effectively; using all available information; preventing and managing fixation errors; cross-checking; using cognitive aids; re-evaluating repeatedly; having good teamwork; allocating attention wisely; and establishing priorities.12 Without a doubt, these principles are important in the health industry, especially in nursing, where interactions with people are the most important thing and are needed to get good results.
Numerous authors discuss the significance of soft skills in our daily lives, indicating a global demand for these abilities. Several decades ago, individuals with outstanding academic credentials and extensive work experience were highly sought after by most employers. Today, the opposite is true. Access to the corporate world requires more than merely hard skills and experience. Employers prefer to hire and advance individuals with soft skills.13 These individuals are resourceful, ethical, self-directed, and proficient in communication. As a result, most companies view soft skills as a crucial quality in job candidates. Employers encourage new hires to possess both strong soft and hard skills.14 Most firms want to acquire and retain workers that are motivated to work and learn and have a positive outlook.15 In the corporate and business world, where human and interpersonal connections are sometimes limited, business owners have identified soft skills as essential for employment and need their existence.
Soft skills should be prioritized in the health and nursing domain, since human connection and effective communication are essential to execute most tasks. As a result, the nursing profession will enter a new era if it fully incorporates the concept of soft skills. This will be feasible only when the concept of soft skills is conceptualized and clearly articulated in nursing. Therefore, this concept analysis proposes to conduct a literature search and provide a precise definition of soft skills in nursing.
The purpose of this study was to examine the concept of soft skills in the healthcare profession. This analysis will provide academics and clinicians with a precise and succinct definition of soft skills applicable to their daily work.
This concept analysis employs the 8 steps by Walker and Avant,2 to identify the attributes, consequences, and antecedents of soft skills. We determined empirical referents and created an operational definition as stated by Walker and Avant.2
In the search method, multiple electronic databases, including CINAHL, ScienceDirect, MEDLINE on EBSCO-host, and Scopus, were consulted. No concept analysis of nursing soft skills was discovered in the literature. The search phrases “soft skills,” “nursing,” and “non-technical skills” were utilized. Only English-language articles were retrieved, regardless of publication date. We also searched English dictionaries, websites, and related textbooks in nursing and other professions. We included both qualitative and quantitative research, and identified a validated tool for measuring soft skills for nurses in Lebanon by Aridi et al.16
After removing duplicates, our search of the electronic databases revealed a total of 755 results. The title and abstract filters eliminated 711 records, because these articles did not talk about soft skills as they pertain to healthcare. The remaining research (44) was screened for full-length articles. Only 16 of the 44 papers selected for full-article screening were accepted by all authors for inclusion in this study. We omitted 28 research papers because they did not relate to the current concept analysis.
Soft skills are difficult to define and have a variety of definitions. For example,17 an online dictionary defines “soft” as something pleasing or agreeable to the senses or something that brings ease, comfort, or has a bland or mellow taste as opposed to a sharp taste. On the one hand, skills are described as the capacity to accomplish something that comes from training, experience, or practice, or the ability to employ knowledge effectively and quickly in execution or performance. In addition to dexterity and coordination, the term “skills” can also refer to the performance of acquired physical activities.
Kenton18, writing for Investopedia, defined soft skills as personality qualities and interpersonal abilities that determine an individual’s relationships with others. Soft skills are viewed as a complement to hard skills, which refer to a person’s knowledge and occupational abilities in the workplace. Sociologists may use the phrase “soft skills” to refer to the emotional intelligence quotient of a person, as opposed to their intelligence quotient. Soft skills have more to do with a person’s personality than their knowledge. As such, they encompass the attributes that determine how successfully a person interacts with others and are typically an integral aspect of a person’s personality.
According to the Indeed-Editorial-Team,19 soft skills are personality traits and behavior that aid candidates in gaining employment and achieving professional success. Soft skills, as opposed to technical or hard skills, are interpersonal and behavioral skills that enable individuals to work effectively with others and advance their careers.19 Soft skills are not job-specific and include the capacity to adapt to one’s working style and interpersonal interactions.
Doyle20 contends that soft skills are non-technical, interpersonal skills that relate to how an individual operates. They include how one interacts with colleagues, how one solves difficulties, and how one organizes one’s work.20 According to Kechagias,5 soft skills are intra-and inter-personal skills that are necessary for personal growth, social involvement, and workplace success. However, Matteson et al.21 defined soft skills as a combination of people management skills, vital to numerous professions and job positions.21
Soft skills appear to be the missing connection between evidence-based nursing and clinical practice. As a result, nursing struggles to prepare nurses to increase the quality of nursing care.22
Several initiatives have been made to integrate soft skills into nursing schools23 in order to generate qualified nursing human resources with high motivation, creativity, and interpersonal skills.24 The position of a nurse is mentally taxing and demands excellent intrapersonal traits to complement the acquired competence.25 Training the nurses in soft skills will give them emotional control and enable them to adjust effectively to stressful situations.6
Many organizations, including the health industry, acknowledge the importance of human resource traits, which are not limited to hard skills but also include soft skills.26 Soft skills create a pleasant place to work, which is good for the staff’s sense of well-being. They also help nurse managers grow in their careers and get along with their co-workers, which is good for patients.27
According to Walker and Avant,3 precise attributes draw an individual’s mind to the concept immediately. Attributes are viewed as symptoms or essential characteristics that help to distinguish between concepts with similar meanings.2 A review of the relevant literature helped us identify these attributes. Soft skills are accompanied by intrapersonal traits, interpersonal skills, and creativity in the workplace. Interpersonal and intrapersonal skills have a significant impact on the performance of nurses both partially and simultaneously. In addition, the intrapersonal traits variable is found to have the greatest influence on the performance of nurses.26
Intrapersonal traits, as defined by Merriam Webster’s dictionary in 2022, are qualities that exist within an individual’s mind or self. They view intrapersonal characteristics as innate characteristics that drive the human mind. This innate personality resembles the adage that nursing is a calling profession.
According to Merriam Webster’s dictionary,17 interpersonal skills are the ability to relate. When nurses demonstrate their ability to communicate with patients, clients, and colleagues, they use interpersonal skills. It is generally accepted that effective and safe nurse–patient relationships depend on communication and interpersonal skills.28 Typically, social needs and factors, as well as cognitive processes that can vary on an individual level, influence interpersonal behavior. Both of these factors play a crucial role in the dissemination, evaluation, processing, and absorption of information.29
Regarding creativity, the Merriam-Webster online dictionary17 describes it as the capacity to create. Creativity has been highly regarded and extensively studied for many years in a variety of professions, yet its definition in nursing remains vague.30 Creativity is essential. In models of job performance, innovation in nursing also necessitates creative thought.31 Additionally, creativity is essential for nurses who use improvisation in practise. The ability to improvise is a crucial aspect of providing care on the frontlines. The nurse’s ability to perceive the changing patterns of patients and their environments in ways that foster creative and innovative approaches to meeting healthcare needs is expressed through improvisation.32 Therefore, creativity, innovation, and improvisation are intertwined.
Walker and Avant3 define antecedents as the events or characteristics that must occur prior to the occurrence of an idea. In this investigation, communication, teamwork, and professionalism were identified as antecedents of soft skills.
Communication in health is a developing and evolving topic that assumes new features and concepts throughout time,33 and it is directly associated with soft skills in nursing. Many patients’ safety issues, complaints, and negligence lawsuits are attributable to insufficient communication among healthcare professionals or between healthcare professionals and patients or their families34. Effective communication is frequently taken for granted, yet numerous variables contribute to it.35 Communication in nursing supports both social responsibility and citizen empowerment, and its tactics can help reduce the environmental, cultural, and socio-economic barriers that impede health-promoting knowledge and behavior adoption.33 Effective nursing communication increases family happiness, confidence in clinical decision-making, and psychological well-being.36 Studies indicate that communication with caregivers is one of the most highly valued components of care37,38; nonetheless, it is the least achieved aspect of care quality in the healthcare setting.39 In nursing, communication serves both an instrumental function that facilitates the acquisition of knowledge and a ceremonial function that reflects the social nature of humans.40 It is only communication that can communicate, and we nurse through communication.
Teamwork is an issue in the healthcare industry, and as a result, society suffers. Improving teamwork proficiency saves patients’ lives and is a global goal in conversations about reorganizing nursing care delivery.41 Successful teamwork may make a massive number of overwhelming chores bearable, whereas ineffective teamwork can leave individuals struggling to cope with the workload.42 The objective of teamwork in healthcare is to deliver professional and efficient care that is of high quality, safe, and patient-centered. Patients requiring healthcare now have more complex demands and comorbidities than in the past, and without cooperation, one individual cannot deliver all the essential treatments safely.35 Interprofessional collaboration is essential for improving healthcare performance and reducing adverse outcomes.43 Increased teamwork has a favorable impact on job satisfaction, staffing efficiencies, retention, and care delivery,44 and it is impossible to overlook the extent to which patient care quality is influenced by healthcare team performance. Brock et al.45 say that most medical mistakes that could have been avoided are caused by teams that don’t work well together.
Professionalism refers to the expected level of knowledge or ability of a professional. It is among the most influential factors on nurses’ intentions to offer care. According to studies, interventions that strengthen nursing professionalism will boost the clinical performance of nurses and lower the stress associated with their clinical practise.46 To build ideal nursing professionalism, measures for enhancing cultural understanding and cultural experiences within and beyond the curriculum are required in nursing education programs.47
Consequences are the events or occurrences that can occur as a result of the existence of a notion and that frequently generate new ideas or study areas for certain concepts.3 This analysis identified client satisfaction, improvement in client outcomes, and quality of nursing care as consequences (Table 1).
Antecedents, defining attributes, and consequences of soft skills in nursing.
| Antecedents | Attributes | Consequences |
|---|---|---|
| Communication | Intrapersonal traits | Clients’ satisfaction |
| Teamwork | Interpersonal skills | Improving clients’ outcome |
| Professionalism | Individual creativity | Quality of nursing care |
Caring is the hospital strategy by which nurses achieve client satisfaction.48 One of the primary objectives of the healthcare system is to ensure customer satisfaction with given services, which indicates the degree to which services correspond to the intended quantity and quality of customers.49 According to a concept analysis by Ng and Luk,50 provider attitude, technical competence, accessibility, and efficacy are determinants of client or patient satisfaction in the healthcare environment. Patient compliance, healthcare outcomes, loyalty, and referrals are cited as the results. Understanding client experience may help practitioners incorporate client perspectives into service delivery and improve client satisfaction as the healthcare industry becomes more competitive.50 According to reports, the dissemination of information and the provision of emotional support have a positive effect on client satisfaction.51 In addition, Lotfi et al.52 revealed that more than 80% of patients were unsatisfied with the nursing care they received since they did not know their nurses. There was an association between communication between nurses and patients and client satisfaction with nursing care. Priority should be placed on enhancing the satisfaction of hospital patients by recognizing both motivating and dissatisfying elements.52
Improving client outcomes requires high-quality and rigorous research to acquire a greater knowledge of the effects of nursing care on patient-related outcomes.53 Each client is different and should be treated as such. Clients and their families will be more involved and interested in their care if they are listened to and included in it. The achievement of quality nursing care, which is the ultimate client demand, will be facilitated by the enhancement of patient outcomes.
Patients report that the quality of nursing care includes meeting their requirements, treating them pleasantly, caring for them, being competent, and giving fast treatment.54 The quality of nursing care is typically evaluated using process, structure, and outcome. However, these audit tools have flaws in which thorough documentation during process evaluation can be misinterpreted as the quality of nursing care.55 Furthermore, according to Larrabee and Bolden,54 the standards used in the literature to audit the quality of nursing care do not correspond to what the patient seeks. Variations in the quality-of-care environments appear to be closely related to differences in the quality of nurse care among hospitals. Understanding the drivers of unmet nursing care demands can assist policy decisions on system and human resource management in order to improve nurses’ understanding of their care practises and the care environment.56 Patients rated the quality of nursing care they received as superior in an atmosphere where nurses demonstrated concern.57 Some studies attribute understaffing to the insufficient care and missed actions of nurses. In the hypothetical situation of increased staffing, nurses prioritized patient reassessments, prompt medication administration, and patient education.58
Empirical referents are quantifiable evidence of the concept’s existence.3 It is the meaning of the concept. It pertains to the actual phenomena whose existence established the concept’s prevalence.
Over the years, individual abilities and soft skills have garnered the interest of scholars from a variety of disciplines,59 but there appears to be minimal consensus about the concept’s relevance in nursing due to inadequate data. It is evident from the literature that the application of soft skills in nursing practise is relevant. Soft skills facilitate positive connections with people and the achievement of personal and organizational objectives.60 Soft skills were described by Goldman and Wong61 as those relevant to working with people and teams that are primarily acquired through practise. Malik and Ahmad62 argue that in current times, academic education and soft skills are always evolving in response to market and work environment demands. Soft skills are essential in the contemporary academic environment because they enable university graduates to learn and use their acquired information in the real world. According to Wheeler,63 the majority of firms hire individuals based on their hard skills but terminate them due to their lack of soft skills.
In the literature, it is suggested that soft skills can be innate or taught and enhanced over time, as they are defined as the habits, personal qualities, behaviors, and attitudes that make an individual easy to work with and improve their interactions with others.63,64 This suggests that soft skills can be viewed as intrapersonal traits, interpersonal skills, and individual creativity, implying that each nurse’s soft skills may be unique or utilized differently. Unfortunately, most graduates lack the soft skills necessary for optimal job success today.65 Tripathy66 attributes these deficiencies to modern technology, which is evolving and reshaping the world at an accelerated rate and concludes that employees should improve their hard skills and hone their soft skills to meet the needs of a world that is rapidly changing. The authors, Daly et al.,67 concur that honed soft skills will boost the ability to face obstacles because soft skills provide the required variables to affect the success of individuals and companies. You can’t say enough about how important soft skills are in nursing, and the expected benefits are huge.
Based on this analysis, the concept of soft skills would be defined as “the intrapersonal traits, interpersonal skills, and the creativity of the nurse that through professionalism, teamwork and good communication skills leads to quality of nursing care and improvement of patient/client outcome and satisfaction.”
The concept analysis provides an in-depth understanding of soft skills and distinguish it from related and similar concepts. This outcome will direct nurses of the need to hone their soft skills and incorporate them into their practise to improve holistic patient care and healthcare outcomes. Importantly, the attributes, antecedents, and consequences of soft skills will be used to clarify definitions in nursing research.68
Aharonson et al.69 argue that the low standard of care in the healthcare sector is not due to a lack of hard skills but rather a deficiency in the utilization of soft skills. To foster positive relationships among themselves and with patients and their families, healthcare personnel must develop interpersonal skills. The ability to be patient, understanding, and empathetic is more important than imparting information on a disease condition or describing a surgical procedure. Soft skills are essential for providing quality nursing care; consequently, nurses must be made aware of the positive influence of soft skills in nursing practise and encouraged to utilize them in their interactions with colleagues and patients. To achieve the interpersonal skills with technical proficiency, Ng23 asserts that the nursing curriculum should incorporate soft skills.
Changes in increased globalization, greater job insecurity, the massification of higher education, and the shift to a knowledge economy necessitate graduates having more soft skills to compete in a similar class profile. The lack of these skills is one of the reasons employers frequently blame and criticize higher education institutions for failing to adequately prepare students for today’s labor market.
Although institutes have attempted to address this issue over the years, advancements in students’ development of soft skills appear to be lacking, and some argue that soft skills are underrepresented in curriculums, making many academically brilliant students suffer due to their lack of soft skills.13,25
The nursing and midwifery council for Ghana has, for this reason, introduced therapeutic communication to introduce students to proper patient encounters. This is a basic requirement for developing soft skills like communication, teamwork, critical thinking, confidence, and situational awareness, which Widad and Abdellah70 ranked as the top 5 things to work on when developing soft skills.
Although some nursing curricula do not explicitly include the course title “soft skills,” according to Bajjaly and Saunders,71 the majority of nursing faculty view soft skills as important and feel at least some responsibility for teaching them. This serves as a foundation for developing the soft skills of novice nurses in their clinical practice and enables them to adapt more effectively in their future careers.25
To improve the teaching of soft skills, nursing programs must develop a unified, integrative model for teaching soft skills. Teaching soft skills is difficult because soft skills involve fewer measurable elements. It is essential to rethink their integration into nursing education programs through innovative learning strategies and assessment strategies.70,72 Teaching soft skills through practice has been shown to be effective in nursing education, but developing a specific, unified framework for effectively integrating soft skills is essential and should be explored.70,73 Further studies in assessment strategies and a possible integrative framework for soft skills will enhance their utilization in nursing.
To enhance the quality of nursing care, which appears to be lacking, soft skills are required. Apart from the definition, incorporation of soft skills as a course into nursing curricula in training institutions should be regarded as an urgent requirement requiring immediate action from regulatory organizations. In the name of science, it appears that the nursing community has traded compassionate care (soft skills) for competent care (hard skills). We conclude that a nurse must possess intrapersonal traits, interpersonal skills, individual creativity in communication, teamwork, and professionalism in order to provide biopsychosocial care for the client.