Concept Analysis:Confidence/Self-confidence

nuf_230  218..230
Patricia Perry, MSN, RN, CNS, CNE
Patricia Perry, MSN, RN, CNS, CNE, is a Doctoral Student at the University of Hawaii at Manoa, School of Nursing and
Dental Hygiene, Honolulu, Hawaii, and an Assistant Professor at the Azusa Pacific University, School of Nursing, Azusa,
California, USA.
Keywords
Concept analysis, confidence,
self-confidence, self-efficacy, nurse
Correspondence
Patricia Perry, MSN, RN, CNS,
Azusa Pacific University, School of
Nursing, P.O. Box 7000, Azusa, CA
91702, USA.
E-mail: [email protected]
BACKGROUND.
Confidence and self-confidence are crucial practice ele-
ments in nursing education and practice. Nurse educators should have
an understanding of the concept of confidence in order to assist in the
accomplishment of nursing students and their learning of technical and
nontechnical skills. With the aim of facilitating trusted care of patients in
the healthcare setting, nursing professionals must exhibit confidence,
and, as such, clarification and analysis of its meaning is necessary.
PURPOSE.
The purpose of this analysis is to provide clarity to the
meaning of the concept confidence/self-confidence, while gaining a
more comprehensive understanding of its attributes, antecedents, and
consequences.
METHOD.
Walker and Avant’s eight-step method of concept analysis was
utilized for the framework of the analysis process with model, contrary,
borderline, and related cases presented along with attributes, antecedents,
consequences, and empirical referents identified.
CONCLUSION.
Understanding both the individualized development of
confidence among prelicensure nursing students and the role of the
nurse educator in the development of confident nursing practice, nurse
educators can assist students in the development of confidence and
competency. Future research surrounding the nature and development of
confidence/self-confidence in the prelicensure nursing student experi-
encing human patient simulation sessions would assist to help educators
further promote the development of confidence.
Introduction
Concepts are defined as “a word or phrase that
summarizes ideas, observations and experiences. They
are tools that provide mental images than can facilitate
communication about and understanding of phenom-
ena” (Fawcett, 2005, p. 4). Creating conceptual mean-
ings is vital to the advancement of nursing theory.
Conceptual analysis conveys a mental image of what
the phenomenon is and how it is perceived in human
experience (Chinn & Kramer, 2008; Walker & Avant,
2005). Concept analysis is a strategy to further develop
previously defined concepts and advance them to the
next level of development (Meleis, 2007). The analysis
process helps to identify the meaning of the abstract
concept and to explore the uncertainty surrounding
the concept (Rodgers, 1989). Therefore, concept
analysis is a significant undertaking.
Confidence and self-confidence are crucial practice
elements  in  prelicensure  nursing  education  and
nursing practice. Nursing is a service profession, and
those in its care must feel safe and reassured. Low
self-confidence makes others uncomfortable (Kröner
& Biermann, 2007) of trusted experts when receiving
their service, especially in the context of health care.
“When we listen to the answers of a mechanic, a
physician or any other expert and feel that they are
not confident, we also tend to fear that they do not
AN INDEPENDENT VOICE FOR NURSING
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Nursing Forum  Volume 46, No. 4, October-December 2011
know what they are talking about” (Kröner & Bier-
mann, p. 589). How can nurse educators facilitate the
nurturing and development of self-confidence in the
prelicensure nursing student?
The purpose of this analysis is to provide a concep-
tual understanding of confidence/self-confidence. In
this paper, the terms confidence and self-confidence
will be used interchangeably. Analysis will be guided by
the eight-step process, modified and simplified from
Wilson’s original 11-step process as explicated by
Walker and Avant’s (2005) classic concept analysis
method. The aim of this analysis is to provide clarity
regarding  the  meaning  of  the  concept  of  self-
confidence, while gaining a more comprehensive
understanding of its attributes, antecedents, conse-
quences, and their application to practice.
Walker and Avant (2005) modified the Wilsonian
method of concept analysis by refining and simplifying
the original method. The method includes eight steps:
(a) select a concept; (b) determine the aims or purposes
of analysis; (c) identify all uses of the concept that you
can discover; (d) determine the defining attributes; (e)
identify a model case; (f) identify borderline, related,
contrary, invented, and illegitimate cases; (g) identify
antecedents and consequences; and (h) define empiri-
cal referents (Walker & Avant, 2005, p. 65).
Utilizing the Walker and Avant method as a struc-
tured iterative process allows for revisions of the
analysis in all steps. Confidence can be perceived as
subjective in nature, and ebbs and flows within the
tide of contextual situations. The selected method
is appropriate for analyzing self-confidence, as this
conceptual characteristic trait is a dynamic and evolv-
ing quality in the prelicensure nursing student.
Method of Concept Analysis and Application
Select a Concept
The identified concept of interest is confidence/self-
confidence.
Webster’s New World Dictionary
defines self-
confidence as “firm belief; trust; reliance” (Neufeldt
& Guralnik, 1991). Merriam-Webster Online (2010b)
has a more contemporary definition and cites self-
confidence as “the belief in oneself and in one’s
powers and abilities.” Self-confidence is a person’s
belief that he or she can succeed. Self-confidence is
context-specific to particular tasks and some people
seem to display this characteristic through a wide
range of activities. Self-confidence can be related to
self-efficacy theory.
According to Bandura’s (1986) self-efficacy theory,
self-efficacy is enhanced by four main factors: success-
ful performances (competence), vicarious experience,
verbal persuasion (including praise and encourage-
ment), and arousal. Self-confidence is simply a self-
perceived measure of one’s belief in one’s own
abilities, dependent upon contextual background and
setting.
This concept analysis is based on a literature review.
Inclusion criteria included published works in English
from the United States, Canada, and the United
Kingdom. The decision to include studies from other
countries was based on the fact that constructs of
confidence/self-confidence in nursing education are
discussed in many countries. Further search inclusion
criteria limited years of publication to the past decade
(2000 to present). The time frame correlates with the
more recent development of high-fidelity simulation
in nursing education. The references on each of the
retained articles were reviewed for notable consisten-
cies among cited references.
Initial  searches  using  the  term  “confidence”
through PubMed, EBSCO, CINAHL, Academic Search
Premier, PSYCArticles, PSYCInfo, ERIC, as well as
several  incidental  finds  through  the  National
League for Nursing (NLN) publications, Simulation
Innovation Resource Center (SIRC), and research
journals yielded more than 92,000 articles. Using the
terms “confidence” and “self-confidence” resulted in
N
of 739. Adding the term “self-efficacy” yielded 72
results. Through incidental finds via web searches,
websites, and article reference lists, a final count of
84 articles were to be reviewed. Initial review and
selection through further refinement of inclusion/
exclusion criteria resulted in 51 final articles to be
reviewed for the purpose of this paper, with a break-
down of 27 articles (Table 1) from nursing, 15 articles
from psychology, six articles from medicine, and two
from the social sciences. Books, book chapters, and
dictionary sources were excluded from this conceptual
analysis review other than for defining contributions
and background information.
The cycle of confidence (Figure 1) is a dynamic
evolving multi- and bidirectional cog with antecedents
and attributes, moderating factors, influential factors of
self-efficacy, and consequences. Confidence informs
self-efficacy, which influences learning, which further
influences confidence, learning, and affective domains,
cycling on to antecedents/attributes while further
influencing confidence (consequence), whether posi-
tively or negatively (increased versus decreased).
P. Perry
Concept Analysis: Self-confidence
219
© 2011 Wiley Periodicals, Inc.
Nursing Forum  Volume 46, No. 4, October-December 2011

CONCEPT ANALYSIS
Community health: an evolutionary concept analysis
Mary Jo Baisch
Accepted for publication 8 May 2009
Correspondence to M.J. Baisch:
e-mail: [email protected]
Mary Jo Baisch PhD RN
Assistant Professor
College of Nursing,
University of Wisconsin,
Milwaukee,
USA
BAISCH   M.J.   (2009)
BAISCH   M.J.   (2009)
Community   health:   an   evolutionary   concept   analysis.
Journal of Advanced Nursing
65
(11), 2464–2476.
doi: 10.1111/j.1365-2648.2009.05068.x
Abstract
Title. Community health: an evolutionary concept analysis.
Aim.
This paper is a report of a concept analysis of community health.
Background.
Community  health  is  a  term  that  has  been  broadly  used  in  both
research and practice. Although local communities are invested in community health
improvement, this process often occurs without a clear definition of the concept of
community health
.
Data sources.
Data sources included a sample of 537 papers covering the period
1990 to 2004 and representing the disciplines of nursing, public health, medicine
and sociology and landmark works concerning community health, six community
health  assessment  instruments  and  interviews  with  seven  key  community  health
informants.
Review methods.
Rodgers’ Evolutionary Method of Concept Analysis was used to
design the study and analyse the data. The professional literature was analysed and
compared with the use of the concept of community health in community health
assessment instruments and by key informants.
Results.
Dynamic and contextual, community health is achieved through partici-
patory,  community  development  processes  based  upon  ecological  models  that
address broad determinants of health. The primary focus of this collaborative work
is population-based health promotion and disease prevention.
Conclusion.
The definition derived from the concept analysis of community health
makes  explicit  the  importance  of  community-based  participatory  action  in  local
health improvement processes. Identification of the attributes of community health
will  enhance  communication  across  disciplines  involved  in  community  health
practice, research and education.
Keywords:
community health, concept analysis, evolutionary concept analysis,
nursing, Rodgers
Introduction
Community health is a term that is being used widely across
the  globe.  The  Healthy  Cities/Healthy  Communities  initia-
tives that began in Canada and Europe helped popularize its
use. The term is used broadly in titles of textbooks (McKenzie
et al.
2005, Nies & McEwen 2007, Clark 2008), names of
programs (World Cocoa Foundation’s Healthy Communities
Program), institutes (Association of Asian Pacific Community
Health Organizations) and governmental entities (Michigan
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JAN
JOURNAL OF ADVANCED NURSING
Department   of  Community  Health).  While  communities
across  the  globe  are  invested  in  assessing  their  health  and
developing plans for health improvement, this process often
occurs without a clear definition of their community’s health.
For this reason a qualitative concept analysis using Rodgers’
Evolutionary View of Concept Development (Rodgers 2000a,
2000b) was designed to systematically analyse the concept of
community health across disciplines and in practice.
Background
The  concept  of  community  health  is  an  interdisciplinary
phenomenon.  For  nursing,  this  concept  is  based  on  the
premise that the community is the client when the ‘focus is
on the collective or common good of the population instead
of  on  individual  health’  in  the  context  of  that  individual’s
environment  (Shuster  &  Goeppinger  2008).  In  addition,
community as client is used as a unit of analysis in a number
of  conceptual  models  of  nursing  (Cloutterbuck  &  Cherry
1998, Fawcett 2005, Keller
et al.
1998). When professionals
of different disciplines and community members collaborate
on  various  community  health  initiatives  and  research,  the
language  they  use  to  describe  their  work  may  differ,  the
meaning   they   give   to   the   same   terms   may   vary   and
approaches  they   use  for   research  and  practice  may   be
derived  from  different  disciplinary  models.  Confusion  over
the  concept  of  community  health  is  compounded,  in  part,
because   an   increasing   number   of   health   professionals
practice  community  health  without  a  clearly  defined  and
universally accepted meaning for the concept. The confusion
is further exacerbated because of the interdisciplinary nature
of   community   health   practice,   education   and   research.
Although  it  is  evolving  and  its  use  is  more  evident  in  the
literature, the concept of community health is not as yet an
integral   part   of   widely   used   and   published   theoretical
frameworks for health improvement.
I  became  interested  in  the  concept  of  community  health
while   teaching   community   health   nursing,   practising   in
community health settings and participating in the develop-
ment of a 10-year statewide health plan and policy agenda. In
each of these settings – education, practice and policy – there
was confusion about the meaning of the concept. Although
these words were commonly used, review of the professional
literature  revealed  that  there  were  no  readily  identifiable,
middle-range,   multi-disciplinary   theories   of   community
health. Consistent with Paley’s (1996) approach to concept
analysis, the results of this analysis offered the potential to
create a niche in an emerging theory of community health by
contributing a theoretical rubric that may be used to structure
continued theory development.
Rodgers’  Evolutionary  View  of  Concept  Development
(Rodgers 2000a) was chosen for this concept analysis because
rigorous sample selection procedures are integrated into the
qualitative   research   methods,   and   because   the   dynamic
nature and context-dependent utility of concepts is acknowl-
edged in her model. According to Rodgers:
The focus in exploring the contextual aspects of the concept is to gain
understanding of the situations in which the concept is used, the use
of the concept in those varying situations, and its use by people with
potentially diverse perspectives. (p. 91)
Rodgers’  method  involves  testing  in  multiple  phases  the
conceptual   definition   within   its   socio-cultural   context.
Rodgers and Cowles (1993) advocated the use of other forms
of  data,  including  interviews,  to  identify  ‘diverse  perspec-
tives’.   Applying   Rodgers’   approach,   Sadler   (1997)   used
interviews  to  test  her  definition  of  caring  with  acute  care
nurses.  For  the  present  concept  analysis,  the  definition  of
community health was tested against indicators included in
community   health   assessment   instruments   and   through
interviews that elicited the perceptions of experts in commu-
nity health about the concept. Because this concept analysis
includes the perspectives of health professionals of disciplines
involved in community health, the perspectives of community
members also need to be studied and included to further a
theory   of   community   health   for   research   and   practice.
Because  of  the  emerging  development  of  this  concept,  it
was premature to include an exemplar at this time.
The goal of this study was to identify a definition of the
concept of community health that would enhance communi-
cation across and within disciplines and serve as a foundation
for  community  health  practice,   education,  research  and
policy development. The proliferation of community health
initiatives   internationally   over   the   past   several   decades
mandated a systematic analysis of this concept at this time.
A definition of community health will support an emerging
theoretical  framework  for  community  health  nursing.  A
systematic analysis of the concept of community health sets
the   stage   for   continued   research   that   will   support   the
inclusion of this concept in existing theories of nursing and/
or community health improvement or the development of an
emerging middle-range theory of community health.
Data sources
Following  Rodgers’  method  (Rodgers  2000a),  this  concept
analysis   was   designed   in   three   phases   to   test   the   use,
significance  and  application  of  community  health  in  three
different contexts: professional literature, community health
assessment  instruments  and  interviews  with  professionals
JAN: CONCEPT ANALYSIS
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Instructors criteria for concept analysis:

Focus on the method [not the concept analyzed] and how well the author employed the method…were all steps completed? Did the article flow and provide clarity to the concept addressed? Which method seemed better to you and why…did the author state why that method was chosen?

Concept analysis.  It is a term used when concepts are analyzed.  When a concept needs analyzed, it is important to approach it in a systematic manner.  Concept analysis according to Rodgers (as cited in (McEwen, M. & Willis, E. M., 2014)it is necessary because concepts are dynamic, “fuzzy” and context dependent and possess some pragmatic unity or purpose.  By analyzing concepts in a systematic fashion these concepts will become more clear and useful for our goals and purposes. This pertains to all disciplines and not just nursing in particular.Rodgers (as cited by(McEwen, M. & Willis, E. M., 2014) used two viewpoints or schools of thought regarding concept development. One is essentialism and the other,evolutionary.

I have chosen two articles to analyze the concepts Community health andConfidence/Self-confidence.  The first article’s concept community health is contrasted using Rodgers evolutionary method.  The second article, Confidence/Self-confidence is compared and contrasted.Confidence/self-confidence concept will be analyzed utilizing Walker and Avant method.

Community health used evolutionary method of concept development that seems to be a concurrent task approach.  That is to say that several tasks will be occurring simultaneously instead of one task followed by another at a different time.The particular goal of this concept analysis will determine how they do research as it identifies the concept of interest and terms and expressions selected.  Which in turn, will incorporate a new term into the way a nurse views her particular situation, goal or circumstance warranting further analysis of that particular concept(McEwen, M. & Willis, E. M., 2014).  Thus, introducing a new concept into the discipline itself.

Further reading on these topics of concept analysis has been an eye-opening experience.It is almost like everything we do is a process and many are done in systematic organized ways. These are done on a daily basis. Yet, we don’t even think about them as being done as such.  For example, baking a cake from a box following and adhering to the steps of the particular brand.  Although, the concept maybe the same on baking a cake, its methods and approaches may be different for the results intended.

Rodgers has six steps in order for her process of concept analysis.  First is to identify the concept and associated terms.  Second, select appropriate realm (a setting or a sample) for data collection.  Third, collect data to identify the attributes of the concept and the contextual basis of the concept (I.e. Interdisciplinary, social cultural, and temporal variations).  Fourth, analyze the data regarding the characteristics of the concept.   Fifth, identify an exemplar of the concept, if appropriate.  Sixth, identify hypotheses and implications for further development.

Addressing step one of Rodgers evaluation method, at first, I sawno clear definition of community health used in this qualitative concept analysis.First article, Community health: an evolutionary concept analysis does not state the definition of community health. However, it does note that due to the involvement of various disciplines, confusion over the concept of community health is compounded.  It is also important to note that a general Webster’s dictionary definition is not used.  This concept wasn’t restated or rephrased based on a general definition that is well accepted and known in the universe.  After testing with community health assessment instruments, concept of Community health is defined as(Baisch, 2009):

Community health is grounded in philosophical beliefs of social justice and empowerment.  Dynamic and contextual, community health is achieved through participatory, community development processes based on ecological models that address broad determinants of health.  Professional of relevant disciplines who are aligned with the community’s culture facilitate community health improvement initiatives in partnership with community members.  The focus of their collaborative work is population-based health promotion and disease prevention.

Thus, indicating that it is a broader concept and an interdisciplinary phenomenon.  It is still emerging in its own way and permeating its meaning with complexity into many academic disciplines.Its intention was to enhance communication across disciplines and to serve as a foundation to community practice, education and research policy development.

Second phase for data collection this concept analysis of qualitative research method used consists of three different contexts.  One professional literature, second community health assessment instruments and third, interviews with professionals working in community settings. This is very specific to the data collection or setting a sample for this method.  This step was very detailed in the fact that it lists a systematic analysis of literature sources from various disciplines such as nursing, medicine, public health and sociology.  Time frame chosen were a span of nearly 13 years from 1990-2003.  Furthermore,with community health assessment instruments this concept was explored and identified the attributes and its uses in a community health setting.

During its data collection, literature analysis was compared to the concept identified for thetime frame between the years 1990 to 2005.  This shows a wide range of subjects and data that was collected, and reviewed was broad and not biased.

Community health assessments were included to be analyzed. These were selected from those experts who had published articles in the United States of America.  Those public agencies included Community Health Improvement Process, Mobilizing Action through Planning and Partnerships etc.

Interviews were also conducted with seven informant community health leaders including physicians, nurses and public health officials. Basis for this was to explore the concept and compare their findings with use of significance and application to the concept itself.  It is important to note the educational level of experts from sociology was as social scientist with an advanced degree.

This second step further elaborated on how the literature was obtained using various combinations of articles and references using librarians and database academic services such as elite, Medline, CINAHL and Sociological Abstracts.  This step is comprehensive in that it obtained a list of 1685 citations and published in the range of approximately 15 years with the random sample of 567 research papers.  This step used by Rogers was detailed and thorough.  In order to analyze the concept, experts in the field of community health were requested to identify a list of ‘landmark’ works.  Ultimately, giving a broader definition of what experts consider Community health concept to be understood in their field.

Third step included the testing of conceptual definition in multiple phases within the socio-cultural context.  That utilized the interviews so to identify diverse perspectives.  One example used is a mention of caring in acute care nurses without any further elaboration.  The study was more focused on testing the data on the definition of community health as a concept analysis.
Fourth step involves analyzing data regarding characteristics of community health. Attributes included, ecological framework with models, population health in epidemiological context, community development, health promotion and disease prevention, environmental health and access to health services.  All these were pertinent and useful in the concept analysis of community health.  Analyzing the socio-cultural context surrounding the community health concept, it is significant to take into consideration the concept of social justice.  Antecedents for the concept included beliefs insmaller government, economic models of healthservices and scare resources.  At the context of community level, concept itself was linked with social justice.  As a consequence the term community health in professional literature and described by key informants included a greater focus by the global community and health professionals on social justice amidst the widening health and economic disparities among population groups(Perry, 2011)

There is no indication of exemplar of the concept identified in the fifth step. It is clearly stated in(Baisch, 2009) that because of the emerging development of this concept, it was premature to include an exemplar. There were no real cases mentioned. Hence, there is no way to understand the characteristics of the concept in relevant contexts to enhance the clarity and effective application of the concept (McEwen, M. & Willis, E. M., 2014).

Last step in this concept analysis was identifying the implications.  As stated in(Baisch, 2009) a community changes with its members overtime, it will adapt and apply its own concept of community health to reflect evolving community beliefs and contexts.  Basically stating that as communities change overtime, each community will adapt its own concept perhaps a new one to reflect on its beliefs and contexts.  Thus, giving the ownership of the Community health concept to its members/leaders who will then plan and implement their own criteria as they see fit.  Simply put, the concept of community health has a paradigm shift in giving professional health planning control over to the community leadership, ultimately, empowering its members.

I can now see how politicians and public health officials must interact within the community to develop policies affecting communities as a whole.

For my second article, I chose Confidence/Self-confidence as the concept for analysis.  I compared and contrasted this with Walker and Avant method.  This method has eight steps.  This method was preferred as it clarifies the meanings of the term, and defines terms.  I chose this method because it clarifies the concept and further develops to define it.

Selecting the concept is the first step.  Confidence/Self-confidence has been identified clearly.  According to(Perry, 2011)Webster’s New World Dictionary defines self-confidence as “firm belief; trust; reliance.”  Self-confidence is defined as a person’s belief that he or she can succeed.  In determining the aims or purposes of analysis, which is step two, article by(Perry, 2011)provides to clarify to the meaning of the concept confidence/self-confidence, while gaining a more comprehensive understanding of its attributes, antecedents, consequences, and their application to practice.

Walker and Avant identify in their third step list all possible uses of that concept.  In this particular concept, self-confidence may be used as a noun, adverb or adjective.  It is linked to empirical measurement of educational knowledge and skills(Perry, 2011)one of the uses of this attribute is found in a clinical setting when participating in simulation exercises.  Identifying uses definitely alter the minds, feelings of panic or fear in emergency situations.  For example, in order to work in a critical thinking unit as Intensive care, or Emergency Room, one must adept to its environment.  State of panic, fear and lack of control of staff emotions can be a detriment to the safety of patient and work environment.   Other example provided is in a psychiatric setting include lack of therapeutic communication skills.  Uses vary from setting to setting and are very significant.

Defining attributes is the fourth step.  For confidence/self-confidence, emotional intelligence/emotional competence, resilience, confidence, attitude and cognitive ability, trust, intuition, depression, doubt and uncertainty are included.   These are further subdivided as positive or negative.  Each one of these attributes are defined and particularly in the contextual sense of confidence/self-confidence.In particular, the best example used is prelicensure nursing student’s confidence level and how it is affected either positively or negatively.

Model case, a fifth step is identified.  Example includes Janis a student nurse in her third semester of a prelicensure nursing program.  A full scenario was described on how Janis has a high level of self-confidence in her.  And, Janis demonstrated her self-confidence in using her nursing clinical skills in assessing and implementing a course of nursing judgment and thus taking appropriate action when caring for her two patients.  This particular example is a stage setter for the concept of what a self-confidence model should look like.
Other cases, contrary case, borderline case, related cases were discussed as the sixth step in concept analysis.  No illegitimate or contrary cases were discussed.  It would have been beneficial to discuss these to make a distinction between the two.  Examples were given in these cases.  Jeri a fifth-semester nursing student used her lack of confidence to get in the door to obtain vital signs.  For the borderline case, Steve shows lack of self-confidence in his skills and thought process to act upon his nursing judgment based on his skills and knowledge.  Amy on the other hand, in the related case was presented with a negative self-confidence example.

Seventh step is the antecedents and consequences of the Walker and Avant’s method of concept analysis.  Antecedents are identified as knowledge, perceived readiness, attitude and past performance, personal goals, rule, success, instructor influence, external stimuli, emotions, and adaptation, Self-esteem and certainty, and trust (Perry, 2011).Author also states that consequences could also be knowledge, attitude, success, emotions, adaptation and trust.  For example, the consequence of lack of confidence in developing trust between the nurse and patient relationship will diminish the job satisfaction as a nurse.

Lastly, empirical referents are discussed as the final step.  According to (Perry, 2011) empirical referents associated with confidence/self-confidence are research variables and measurements of “self-confidence” and “self-efficacy.”  Several measuring tools are developed which are found to be very reliable.  One of the efficacy tools is the NLS’s Student Satisfaction and Self-Confidence in Learning.  This tool has 13 items designed to measure student satisfaction.  The General Self-Efficacy Scale examines competence in relation to self-efficacy.  These tools are necessary part of assessment for this method.

In summary, implications are such that research surrounding this conceptof confidence/self-confidence is significant to student learning experience.  With the assistance of nurse educators, it will help further promote the development of confidence.  As with any concept, further work needs to be conducted to fully understand the concept of confidence and self-confidence.  Particularly, this would benefit in the context of simulation learning and for nurse educators in clinical setting.  Such positive stimulation will enhance and promote the growth and development of confidence/self-confidence in our learning process.

In comparison to Walker and Avant and Rodgers concept analysis, I find that both articles used are very detailed and do express the intentions and clarify the goals for the concepts chosen.  Furthermore, I find both of them to be appropriate methods to use in their respective fields/chosen.  Additionally, I find each method of analysis is significant in its unique way and contributes accordingly to the discipline of nursing profession.

Having been in the practice for nearly 30 years in nursing, I have read appropriate articles to understand more about our profession itself.  In order to gain knowledge as well in the areas of clinical skills, I educated myself via containing education. Therefore, I find these methods relevant and appropriate.

Personally, selecting one method over the other would primarily depend upon my selection of concept to be analyzed.  For example, if I was to choose social justice as my primary concept, I might use Rodgers method of analysis or Wilson’s versus if I was to choose pain as my primary concept that need further analyzing. Or when creating a new meaning or criteria specifically, I would use Walker’s method.

Both articles didn’t excellent job in defining the steps, adhering to the steps in a logical manner and clarifying their topic chosen as it pertained to concept analysis.  In my second article, author stated when she eliminated one with a justifying statement.

My preference would be to choose the Walker and Avant method in my clinical practice setting.  This method seems to be most purposeful and directly applicable for nursing.  Walker and Avant methods have been tested and used in the last 30 years.

Based on my assigned readings in both textbooks, articles and further research, I came to the understanding that Walker and Avant method is more suited and appropriate for modern nursing and more applicable to our discipline as a whole.  It is very evident and became clear to me (based on these readings and research) these methods following steps accurately and in detail.  Thus, these are comprehensive.  Choosing them appropriately for our specific topic or goals, will further advance of our knowledge and produce great results in our daily practices.
References
Baisch, M. J. (2009). Community health: An evolutionary concept analysis. Journal of Advanced Nursing, 65(11), 2464-2476. doi:10.1111/j.1365-2648.2009.05068.x
McEwen, M. & Willis, E. M. (2014). Theoretical basis for nursing (4th ed.). Philadelphia: Lippincott Williams & Wilkins.
Perry, P. (2011). Concept analysis: Confidence/self-confidence. Nursing Forum, 46(4), 218-230. doi:10.1111/j.1744-6198.2011.00230.x