Although nurse aides take on a high share of care activities in nursing homes, almost nothing is known about how they develop the knowledge and skills to do so. This study attempts to close this research gap by answering the following research questions: (1) How do novice aides learn and develop and how is their learning trajectory structured? (2) What are the potential and problems of these informal training schemes? (3) How can the enacted training schemes be improved to assure effective and efficient learning and development of novice aides? In total, 19 nurses were interviewed to answer these questions. The analysis revealed that novice aides learn almost exclusively through observation and imitation as well as explanations of more experienced nurses. The typical learning trajectory of aides is structured such that they start to care for residents described as “simple” and progressively proceed to take care of more “difficult” ones. Such a trajectory allows nurses to construct hierarchically ordered knowledge in a meaningful way, minimises consequences of potential errors, and attempts to avoid discouragement that leads to early dropout and turnover. Strong learning potential has been found in more formalised discussion opportunities where collective experience with residents is discussed. Problems in acquiring the required knowledge and skills arise especially when instructing nurses believe that the prior experience of novices is sufficient for the work at hand, as well as when work practices require competences that are highly opaque. Suggestions of how to avoid pitfalls and how to foster existing learning potential are given.

中文翻译：

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成为一名护士助手：对养老院现有工作场所课程的调查

尽管护士助手在疗养院中承担着很大一部分护理活动，但对于他们如何发展其知识和技能几乎一无所知。这项研究试图通过回答以下研究问题来弥合这一研究差距：（1）新手助手如何学习和发展以及他们的学习轨迹如何构成？（2）这些非正式培训计划的潜力和问题是什么？（3）如何完善已制定的培训计划，以确保新手助手的有效学习和发展？总共采访了19名护士，以回答这些问题。分析显示，新手助手几乎只能通过观察和模仿以及对更有经验的护士的解释来学习。助手的典型学习轨迹的结构使得他们开始关心被描述为“简单”的居民，并逐渐着手照顾更多“困难”的居民。这样的轨迹可以使护士以有意义的方式构造层次结构化的知识，最大程度地减少潜在错误的后果，并尝试避免导致早退和离职的灰心。在更正式的讨论机会中发现了强大的学习潜力，该讨论会讨论了与居民的集体经验。在获得必要的知识和技能时会出现问题，尤其是在指导护士认为新手的先验经验足以胜任当前工作时，以及当工作实践需要高度不透明的能力时，就会出现问题。