Nurse leaders are challenged to hire employees who will stay with their organization and work well with their team. Simulation-based interviewing (SBI) is one method that can be used develop interviewing skills of emerging or novice nurse leaders. This article will describe an SBI activity implemented in a graduate-level nursing leadership program and detail how a similar activity could be used in a practice setting.
As health care begins to move past the COVID-19 pandemic, nurse leaders are now faced with addressing high vacancy and turnover rates. The 2022 NSI National Health Care Retention & RN Staffing Report noted vacancy rates at 17% and turnover rates at 25.9%.
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To ensure hiring an applicant who will stay with an organization, many organizations focus on hiring for fit. Hiring for fit simply means hiring an individual who fits into the company culture rather than exclusively hiring for certain skills an individual can bring to the organization.NSI Nursing Solutions
2022 NSI national health care Retention & RN Staffing Report.
2022 NSI national health care Retention & RN Staffing Report.
https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
Date: 2022
Date accessed: June 7, 2022
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Unfortunately, hiring for fit may limit the diversity of a team and miss excellent candidates.2
So how should nurse leaders go about hiring qualified applicants? Several recommendations can be found in the literature including prehire assessments, knowledge or skills tests, and structured interviews.3
,- Kerr D.
Guide to hiring success. [White paper]. Affintus.
https://f.hubspotusercontent00.net/hubfs/2226157/Guide%20to%20Hiring%20Success%202020.pdf
Date: 2020
Date accessed: June 7, 2022
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- Schellmann H.
How Job Interviews Will Transform in the Next Decade.
in: Wall St J. 2020
https://www.wsj.com/articles/how-job-interviews-will-transform-in-the-next-decade-11578409136
Date accessed: June 7, 2022
Emerging nurse leaders may not have experience conducting structured interviews. Another approach that can be employed is the use of simulation-based interviewing (SBI). This article describes how faculty implemented SBI in a graduate-level nursing leadership program. Strategies for applying this approach to practice settings is offered.
Simulation-Based Learning in Health Care
Simulation-based learning (SBL) is not defined by technology but as a learning approach which has been applied to a variety of disciplines from aviation to the military to develop skills and safety-related behaviors such as communication and teamwork.
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In the early 1900s, SBL was introduced to nursing to teach undergraduate students basic nursing skills.6
Now, SBL is utilized to teach domain-specific skills in undergraduate and graduate nursing education, improve transition to practice for new graduates, and enhance the training of interprofessional teams.7
Application of SBL to the development of nursing leadership skills has demonstrated increased confidence in students participating in the activity.8
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Simulation-Based Interviewing
Much of the literature discussed the advantages of SBI for the interviewee. SBI has been used to prepare undergraduate and graduate nursing students for job interviews with participants viewing the activity favorably as a method to reduce anxiety and build confidence.
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Other disciplines have adopted SBI to prepare interviewees for employment interviews.12
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Literature on SBI preparation for leaders is limited. Caldas and colleagues
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incorporated an interactive hiring activity with third-year pharmacy students in which they were presented 5 pharmacy technician candidates in a lecture-style classroom. Candidate selection was done via a team and interviewed using a jeopardy style interview process.15
Data indicated the students enjoyed seeing an interview from the interviewer’s perspective.15
SBI in a Graduate Nursing Leadership Program
A leadership program in a nationally ranked nursing school has students not only in formal leadership positions but also in emerging nurse leaders with limited to no leadership experience. The nursing leadership curriculum is based on the American Organization for Nursing Leadership Nurse Manager Competencies.
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When introduced into the curriculum in the first core nursing leadership course focusing on crucial conversations and conflict resolution, SBL demonstrated increased student confidence and received favorable student feedback.8
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As a result, faculty introduced another SBL into a course focused on human resources.In the human resources SBL activity, students were introduced to interviewing concepts. Prework included review of didactic materials on interviewing including what type of questions could and could not be asked (see Table 1 for examples). In the prework, students also appraised their practice setting to determine what type of characteristics they wanted or needed in their team members. Then the students developed interview questions based on those characteristics using behavioral interviewing principles. Behavioral interviewing is a type of structured interview technique in which the applicant is asked to provide specific examples of how certain behaviors, knowledge, skills, and abilities have been demonstrated in the past.
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The students developed questions for both an experienced and inexperienced nurse around behavioral characteristics such as adaptability, customer service, respect, and teamwork (see Table 2 for characteristics and question examples). During a class meeting, students were paired to conduct a mock interview. Though introduced at the beginning of the semester, concepts of psychological safety and a supportive learning environment were reviewed prior to the start of the interview simulation. The activity was held virtually so students also experienced a virtual interview situation. Debriefing occurred immediately after each interview session with feedback received from both faculty and the student’s classmates. The focus of SBI was skill and confidence development of the interviewer instead of the interviewee.Society for Human Resource Management
A Guide to Conducting Behavioral Interview with Early Career Job Candidates.
A Guide to Conducting Behavioral Interview with Early Career Job Candidates.
https://www.shrm.org/LearningAndCareer/learning/Documents/Behavioral%20Interviewing%20Guide%20for%20Early%20Career%20Candidates.pdf
Date: 2016
Date accessed: June 9, 2022
Table 1Example of Questions Which Can and Cannot Be Asked
| Can Ask Questions | Cannot Ask Questions |
|---|---|
| Questions regarding information on CV or resume such as: | Age |
| Education | Date of birth |
| Experience | Marital status |
| Present job | Religion |
| Responsibilities in present job | Number of children |
| General questions such as “Tell me about yourself” or “what are your most outstanding accomplishments?” | Hobbies, clubs, activities outside of work |
Table 2Examples of Behavioral Characteristics and Questions
| Characteristic | Question |
|---|---|
| Caring | Tell me about a time when you had to develop a relationship with a patient, coworker, or peer who was upset or angry? |
| Integrity | Tell us about a time you observed unethical behavior in one of your peers. How did you respond? |
| Safety | How do you communicate a complex task to a new nurse to ensure it is completed correctly? |
| Stewardship | Describe a time you identified inefficiencies within a process you needed to follow. What did you do about it? |
| Interdisciplinary collaboration | Describe a time when you facilitated/participated in interdisciplinary collaboration aimed at solving a complex patient problem. |
| Conflict management | Describe a situation when you and an interdisciplinary member of the team (physician, pharmacist, RT) were unable to agree on the patient’s plan of care. Were you able to come to an optimal compromise for the patient? If so, how were you able to land on said compromise? |
| Communication | Talk about a time when you had not communicated well. How did you correct the situation? |
| Customer service | Describe a time when you had to deal with a difficult or demanding patient. How did you handle the situation? |
| Teamwork | Tell me about the last team you were on. What strengths did you bring that improved the team’s performance? What were the challenges faced by the team? |
| Ethics | Describe a time when you made a mistake at work. How did you deal with this situation? |
| Leadership | Tell me about a time when you performed an unassigned task that was not your responsibility? What was the outcome? |
| Adaptability | Tell me about a time you had to adjust your workload in order to help a coworker. What was the outcome? |
| Critical thinking | Tell me about a time you had to make a decision quickly, and talk me through your thought process. |
The results of the SBI activity were positive. During the debriefing, both the interviewer and interviewee were asked how they felt the interview went. Student feedback indicated the activity was a favorite among students. Students commented that it “made them critically think,” several students noted the simulations “helped build confidence and prepared them for future interviews,” and many appreciated having “a safe place to practice new skills.” These findings are similar to those in the literature where the focus has been on preparing the interviewee for job interviews. Students noted that the activity made them more aware of what they might be asked in an interview as well as how to prepare for a behavioral type of interview. Students acknowledged as an interviewer; they must be prepared to listen to the applicant’s questions and answer those as well.
Application to a Practice Setting
While this SBI activity focused on an academic setting, similar SBI activities could be implemented in a practice setting. During the orientation of novice nurse leaders, opportunities could be provided to assist these new leaders to develop a set of interview questions for their repertoire. Novice leaders may not know what types of questions can and cannot be included in an interview. Beginning an SBI activity with prework such as an appraisal of the type of characteristics desired in an applicant and formation of potential questions may be beneficial. Establishing a safe environment for the novice leader to attempt new skills and competencies is also needed. Then the actual implementation of an SBI activity with a novice leader and a more senior nurse leader could provide the novice leader the opportunity needed to develop their confidence as an interviewer. Debriefing with a more experienced interview after an interview simulation would help novice leaders refine their interviewing skills and be better prepared to hire the right person for their team. While the nursing leadership students in this project only interviewed each other, novice nurse leaders would benefit from multiple simulated candidates to refine their skills. Novice leaders should also have an opportunity to simulate a virtual interview environment as this is now becoming a more frequent format for interviews.
Conclusion
There is limited published literature on the use of SBI activities to prepare the interviewer. As nurse leaders strive to hire the best fit for their organizations and teams, in the postpandemic environment, it is even more important these leaders must be an exquisite interviewer when given the opportunity to conduct an interview. SBI activities are a viable approach to develop interviewing skills of nurse leaders.
References
- 2022 NSI national health care Retention & RN Staffing Report.(Available at:)https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdfDate: 2022Date accessed: June 7, 2022
- Is hiring for culture fit perpetuating bias?.Forbes. 2021; (Available at:)
- Guide to hiring success. [White paper]. Affintus.(Available at:)https://f.hubspotusercontent00.net/hubfs/2226157/Guide%20to%20Hiring%20Success%202020.pdfDate: 2020Date accessed: June 7, 2022
- How Job Interviews Will Transform in the Next Decade.in: Wall St J. 2020 (Available at:)https://www.wsj.com/articles/how-job-interviews-will-transform-in-the-next-decade-11578409136Date accessed: June 7, 2022
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- Front line nurse leader simulation for advanced leadership skills: a pilot study.Int J Nurs Healt Car Scie. 2022; 02: 2021-2092
- Using leadership simulation scenarios with graduate nursing learners to support front-line nurse leader competency development.Nurse Lead. 2021; 19: 405-410
- Simulated employment interviews: a collaborative approach to gaining understanding of the graduate midwife employment process.Women Birth. 2020; 33: 455-463
- Using simulation to prepare nursing students for professional roles.Holist Nurs Pract. 2016; 30: 211-215
- Mock interviews in the workplace: Giving interns the skills they need for success.J Eff Teach. 2017; 17: 23-37
- The role of mock job interviews in enhancing sport students’ employability skills: an example from the UK.J Hosp Leis Sport Tour Educ. 2019; 25: 100195
- Employment interview simulation project: Evaluating its potential for graduating social work students and its transferability to other health disciplines.J Pract Teach Learn. 2019; 16: 118-137
- Implementing interactive hiring activity in pharmacy management education.Curr Pharm Teach Learn. 2022; 14: 208-214
- AONL Nurse Manager Competencies. AONL.(Available at:)
- A Guide to Conducting Behavioral Interview with Early Career Job Candidates.(Available at:)https://www.shrm.org/LearningAndCareer/learning/Documents/Behavioral%20Interviewing%20Guide%20for%20Early%20Career%20Candidates.pdfDate: 2016Date accessed: June 9, 2022
Biography
Linda Cole, DNP, RN, APRN, CCNS, CPHQ, CNE, FCNS, is an assistant professor and track coordinator for the Nursing Leadership Program at the Cizik School of Nursing, University of Texas Health Science Center in Houston, TX. E-mail: [email protected]; Lisa Boss, EdD, PhD, RN, CEN, CNE, is an associate professor and post-master's DNP program director at the Cizik School of Nursing in Houston, TX.
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Published online: August 28, 2022
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2022 by Elsevier Inc. All rights reserved.
