INTRODUCTION
Nursing is an increasingly aging profession, with nurses required to maintain resilience and high productivity within an ever-tightening financial environment. In such circumstances, nurses face constant challenges and expectations, and their dedication and expertise hold more value than ever before. To ensure nurses remain satisfied in their roles and to promote sustainability in these positions, strategies must be developed to support and foster their growth [1].
While coaching is not as widely recognized as mentoring in nursing, it has proven to be an effective tool in areas like team building, career advancement, change management, and professional growth. Its scope has further expanded to address not only organizational issues and performance enhancement but also to support individuals in achieving work-life balance and fostering personal growth. As a result, coaching has recently emerged as a significant area of focus in nursing research, reflecting its growing importance in both educational and clinical settings [2,3]. Coaching and mentoring are often used interchangeably in the literature, with diverse definitions and applications of coaching observed in the healthcare field, particularly in the nursing domain. Coaching was noted to be more structured than mentoring, providing a clear, focused environment conducive to professional development. Key benefits included enhancing communication skills, addressing specific professional challenges, and fostering personal growth by challenging existing beliefs and attitudes [4]. Mentoring shares similarities with clinical supervision in its definition. However, it signifies a deeper, long-term relationship that emphasizes support and professional socialization rather than focusing on performance-driven, actionoriented outcomes, making it distinctly different from the objectives of coaching [5]. Coaching and mentoring share commonalities as both can serve as valuable processes for offering support, boosting confidence, enhancing interpersonal skills, and improving performance. However, mentors tend to adopt a relational approach to learning and professional growth, whereas coaches prioritize the achievement of specific, agreed-upon objectives [5,6].
The International Coach Federation (2007) defined coaching as a collaborative process with clients that is both thought-provoking and creative, designed to inspire individuals to reach their personal and professional potential. Coaches are trained to actively listen, observe, and tailor their methods to meet the specific needs of each client. They aim to draw out solutions and strategies from the client, operating under the belief that clients are inherently creative and resourceful. The role of the coach is to offer support that enhances the skills, resources, and creativity already present in the client.
Coaching in nursing is widely used as a key strategy for retaining and developing staff. However, it is often used interchangeably with mentoring, and its definition varies across much of the literature. Coaching is primarily a systematic and goal-oriented process aimed at the short-term achievement of specific skills or tasks [5]. In contrast, mentoring focuses on holistic growth and career development over the long term, building on a relationship-based approach [6]. Failure to clearly distinguish these differences may lead to the misalignment of strategies and resources essential for achieving the core objectives of coaching and mentoring. Therefore, this study aims to achieve a clear understanding of the concept and ensure its consistent application in research and practice. Through concept analysis, we aim to clarify the definition, attributes, and relationships with related concepts, thereby reducing misunderstandings and confusion in clinical settings and enabling more accurate and effective communication and practice.
METHODS
1. Methodological Approach
Rodgers' evolutionary concept analysis method was selected for this study. This method emphasizes the influence of context on the nature of concepts and acknowledges that concepts evolve in response to intra-professional and social factors. It views concepts as dynamic rather than static [7], but may cyclically develop or change over time. This approach deeply analyzes the various attributes and dimensions of the concept. It helps to comprehensively understand the diverse applications of coaching in the nursing field and the resulting shifts in meaning. Additionally, it aids in connecting theoretical concepts to practical applications in nursing.
This method follows an inductive approach and involves seven steps that are iterative rather than strictly sequential. The seven steps include: 1) identifying the concept of interest, its surrogate terms, and its use in the literature; 2) determining an appropriate sample for data collection; 3) collecting data; 4) analyzing the data to uncover characteristics of the concept; 5) identifying references to the concept, including its antecedents and consequences; 6) exploring related concepts; and 7) outlining implications to guide the future development of the concept [8].
2. Data Sources and Sample
For the concept analysis, data sources were selected from peer-reviewed publications in academic journals. Searches were conducted by the corresponding author within the databases of Web of Science, Medline (PubMed), and CINAHL in May 2024. The search strategy comprised the terms “coaching” AND “Nur*” with quotation marks. Articles published in the past 30 years were selected, with only those written in English being included. Both qualitative and quantitative studies were reviewed and incorporated. Duplicates were eliminated using EndNote and manual checks across databases. A title and abstract screening was performed, resulting in 32 articles that were thoroughly reviewed against the inclusion and exclusion criteria. Reference lists were manually searched to identify significant articles that might have been missed in the systematic search, but no additional articles were found. Please see Figure 1 PRISMA flow diagram for coaching studies.
3. Coding and Synthesizing of Data
Following Rodgers' recommendation, each article was initially reviewed in its entirety and then focused on the context of the concept, surrogate and related terms, attributes, antecedents, consequences, and exemplars. Each article was read multiple times, with specific descriptions and definitions highlighted [9].
According to Rodgers, the identification of attributes represents a primary accomplishment of concept analysis. The attributes of a concept provide a substantive definition, distinguishing it from a nominal or dictionary-based definition [9]. The researchers focused on direct definitions to identify the attributes of coaching in nursing. However, since some authors did not provide direct definitions, attention was given to statements that implied the meaning or use of coaching in nursing.
4. Related Term
Coaching and mentoring are frequently used interchangeably in the literature, with diverse definitions and applications of coaching found in healthcare, particularly within the field of nursing. Coaching can be the initiation or a part of a mentoring relationship that evolves over time and can extend beyond the achievement of specific goals [10]. Both coaching and mentoring are relationship-based, but they differ in structure, goals, and outcomes. Mentoring is a voluntary relationship that offers guidance and can be either formal or informal, often lasting for an extended period. In contrast, coaching is a structured and formal process where the coach facilitates while the individual being coached sets specific goals for their participation in the coaching process [11]. Coaching is a workoriented, short-term, and performance-focused process that emphasizes specific issues. In nursing, coaching is centered on nursing tasks and responsibilities [12]. Effective mentoring relationship has three main characteristics [19]. The first is a clearly defined purpose that helps the mentee acquire the necessary skills and develop work relationships that fit their chosen path. The second is the growth of a collaborative learning relationship, where the mentor's willingness to share knowledge and the mentee's efforts to learn are combined. The third characteristic is the recognition that the relationship between mentor and mentee evolves and grows over time, going beyond a mere relationship.
RESULTS
1. Attributes
The attributes of a concept enable the identification of situations where its appropriate usage can be determined and characterized [9]. Through this analysis, five distinct attributes were determined to define coaching in nursing: “Nursing task-focused”, “Educational”, “Facilitative”, “Processive”, “Interactive”. Please refer to Figure 2.
1) Nursing task-focused
The first attribute consistently mentioned in the literature on coaching in nursing is “Nursing task-focused”. For example, the literature states that coaching in nursing is focused on specific tasks [2] or duties related to patient care, and adopting coaching as a strategy for personal and professional development of nurses has many advantages [2]. Coaching is a task-oriented, short-term, and performance-focused process that targets specific issues. Coaching in nursing focuses on solving real nursing issues and strategies for objectively expanding and maintaining the work habits of nurses who work in high-stress environments [14]. In this way, coaching in nursing involves developing an individual’s skills and knowledge to improve job performance. It is conducted over a short period and focuses on specific skills and goals [2].
2) Educational
The second attribute consistently mentioned in the literature on coaching in nursing is “Educational”. Coaching in nursing is a collaborative educational and learning strategy that provides mutual benefits and involves learning from each other [15]. The use of coaching in nursing education enables effective communication, critical thinking, collaboration, problem-solving, confidence, competence in practice, and independent practice. Coaching has a deep history in educational practice, and is designed to be individualized, time-intensive, context-dependent, and focused on specific skills [16]. In this way, coaching in nursing is typically conducted in situations where educational intervention is necessary, and it has a strong educational aspect.
3) Facilitative
The third attribute consistently mentioned in the literature on coaching in nursing is “Facilitative”. Coaching facilitates conditions for understanding and enhances employee skill sets in a non-confrontational atmosphere, reducing role conflicts and supporting staff growth and development [17]. Coaching transcends being a mere educational tool by empowering individuals to take responsibility for their own learning [12], thus serving as a facilitator of learning and development. From this perspective, coaching, rather than teaching, facilitates the learning process and unlocks potential.
4) Processive
The fourth attribute consistently mentioned in the literature on coaching in nursing is “Processive”. Coaching is a systematic and formal process that requires the coachee to set goals for their participation in coaching, while the coach facilitates the process [11]. The coaching relationship is characterized by being time-bound with a clear beginning and end, providing intensive management and support during a specific period related to goal achievement [18]. In multiple documents, coaching was typically applied as a program and was a process with a specific framework [11]. In this way, coaching is a purpose-driven and intentional process [18]. Coaching goes beyond simple instructions or advice, serving as a multidimensional process that supports the professional development and growth of nurses.
5) Interactive
The fifth attribute consistently mentioned in the literature on coaching in nursing is “Interactive”. According to the literature, coaching by nurses is an intentional, outcome-oriented, relationship-based interaction aimed at achieving goals [18]. Coaching is an action used by managers to interact with employees and positively influence their work attitudes, use of knowledge, and job performance [19]. According to the International Coaching Federation, coaching is an engaging and innovative process that works collaboratively to motivate individuals to fully realize their personal and professional potential. In this way, coaching fundamentally involves dynamic and collaborative interactions based on mutual engagement between the coach and the coachee.
2. Antecedent
Data analysis identified two themes as antecedents before coaching could occur in the field of nursing. The first theme is situations requiring educational interventions. In clinical settings, most coaching occurred in situations where an educational purpose was needed. For example, like education on a specific topic, leadership training for managers [19], occurred in situations where an educational approach was needed. In other words, the aim of clinical coaching is to support nurses in enhancing aspects of their practice, which will lead to better patient outcomes. The second theme is the professional competence of the coach. Difficulties in the coaching relationship can arise from a lack of coach's competence, such as the coach's lack of experience or challenges in establishing a strong coaching relationship initially [4]. In nursing, coaching is a skill that helps move from a basic performance and knowledge level to a desired new level of performance, making the competence of the coach providing the coaching extremely important.
3. Consequences
Data analysis identified three consequences of coaching in nursing.
Coaching in nursing has recently been widely utilized in clinical practice, establishing itself as an effective tool not only for improving organizational performance but also for optimizing patient health and well-being [20].
Nurses reported a statistically significant improvement in skill levels in surveys conducted after coaching compared to surveys completed before coaching [21]. Coaching enhances staff skill sets in a non-confrontational environment, reducing role conflicts and supporting employee growth and development [17]. Coaching not only supports current nurses but also assists prospective nurses to transition from a basic level of performance and knowledge to a desired new level of performance, while fostering a role of learning and responsibility [12]. In this way, coaching has a learning-oriented nature, and this aspect is most prominent in nursing.
Another outcome of coaching in nursing is “Enhanced self-efficacy”. Coaching in nursing goes beyond mere teaching by facilitating the learning process, opening up students’ potential, and enhancing their motivation and self-efficacy to perform complex nursing skills [22]. Nursing managers also stated that the most valuable contribution of coaching is the promotion of self-efficacy and self-awareness [23]. The coaching process is described as a structured approach that focuses on developing competencies while actively addressing the participant's current situation and potential improvements. However, coaches emphasize the importance of tailoring coaching sessions to the coachee's needs and goals [4], a process that enhances the confidence of those receiving coaching.
Finally, the outcome of coaching in nursing is an improvement in organizational culture. By promoting individual growth and development through coaching [17], a positive atmosphere is created within the organization, facilitating smooth communication and collaboration. Coaching strengthens interprofessional relationships within nursing and healthcare environments, improving communication and teamwork [24], and it has been found effective in enhancing both individual and organizational efficiency for nurses [4]. And a positive organizational culture ultimately impacts patient care and safety [25].
4. Definition
Coaching in nursing is an educational approach focused on nursing tasks, involving a systematic and formal process that facilitates the learning experience through interaction rather than merely teaching.
5. Model Case
A model case serves as an illustrative example that contextually highlights the attributes, antecedents, and consequences of a concept [9]. In this study, the model case was presented with reference to qualitative research related to coaching in nursing [4,25].
After graduating from school, new nurse Kim started her first job in the neurosurgery ward. She feels a strong sense of responsibility for patient safety and nursing duties, but she is experiencing many difficulties in the initial adjustment process (Situations requiring educational interventions). The hospital operates a systematic coaching program for these new nurses. Nurse Lee, the head nurse of the neurosurgery ward, who has many years of experience, is in charge of training the new nurses (The professional competence of a coach). She explains the core tasks of neurosurgical patient care to nurse Kim, who then sets specific skills and knowledge she wants to acquire (Nursing task focused). Nurse Lee teaches preoperative and postoperative care for neurosurgical patients (Educational), supporting direct experience in these tasks. Throughout this process, they continually discuss any difficulties, interact, and provide feedback (Interactive). She also provides various materials to facilitate nurse Kim's self-directed learning (Facilitative). This coaching process is systematic and formal, with a clear beginning and end (Processive). Through this process, nurse Kim acquired essential skills for caring for neurosurgical patients (Improvement of Clinical Practice), gained confidence, and improved her ability to handle new situations (Enhanced Self-Efficacy). Additionally, she became more actively involved as a member of the department (Improvement of Organizational Culture).
DISCUSSION
The purpose of this analysis was to define the concept of 'coaching' in the context of nursing by utilizing literature retrieved from key publications. The results of this study provide a comprehensive understanding of the concept of coaching in nursing, emphasizing its distinct characteristics and the benefits it brings to the clinical environment. This concept analysis clarifies the attributes, antecedents, and consequences of coaching in nursing, which are crucial for its effective implementation and differentiation from related concepts such as mentoring.
The analysis identified five defining attributes of coaching in nursing: nursing task-focused, educational, facilitative, processive, and interactive. These attributes highlight the structured and goal-oriented nature of coaching, which is distinct from the more relational and long-term focus of mentoring [4]. Understanding these attributes helps nurse managers and educators design and implement coaching programs that are tailored to specific clinical and educational needs.
Two main antecedents were identified: the need for educational interventions and the professional competence of the coach. These antecedents underscore the importance of context and preparation in the coaching process. Ensuring that coaches are well-trained and competent is essential for the success of coaching programs [4]. Additionally, coaching was conducted in situations requiring educational interventions. In the clinical setting, coaching was used to enhance the practice areas of nurses [26]. By identifying these antecedents, we can accurately understand the situations and conditions where coaching is needed. This understanding aids in designing and implementing coaching programs in a more systematic and effective manner. Additionally, emphasizing the professional competence of coaches suggests that education and training to enhance the skills of coaches are necessary for successful coaching.
The analysis revealed three significant outcomes of coaching in nursing: improvement of clinical practice, enhanced self-efficacy, and improvement of organizational culture. These outcomes demonstrate the multifaceted benefits of coaching, which not only enhance individual performance and confidence but also contribute to a positive and collaborative organizational environment [4]. In this way, coaching in nursing not only promotes professional growth but also leads to positive outcomes such as improving the quality of patient care, enhancing job satisfaction among nurses, and increasing organizational efficiency.
One of the key points discussed is the differentiation between coaching and mentoring. While both involve relationship-based interactions, coaching is more structured and performance-focused, aiming at specific skills and goals. Mentoring, on the other hand, involves a broader and longer-term developmental relationship [10]. Mentoring typically adopts a relationship-focused approach to learning and professional growth, while coaching emphasizes the attainment of specific objectives [5]. In other words, mentoring encompasses a broader and more holistic interpersonal process, whereas coaching is a focused and goal-oriented activity [27]. Understanding this distinction is crucial for nursing leaders and educators to apply appropriate strategies based on the desired outcomes and the needs of their staff. The differentiation between mentoring and coaching is necessary because each approach serves different purposes and offers unique benefits. Mentoring is well-suited for supporting long-term growth and career development, while coaching focuses on short-term improvement in specific skills and performance. Therefore, considering the organization's goals and individual developmental needs, effectively combining or selecting these methods is essential for establishing impactful leadership and educational strategies.
The findings from this concept analysis have practical implications for nursing management and education. By clearly defining coaching and its attributes, nurse managers can better implement coaching programs that are aligned with their organizational goals. Educational institutions can incorporate coaching strategies into their curricula to prepare future nurses for the demands of clinical practice. Furthermore, understanding the antecedents and outcomes of coaching can help in designing targeted interventions that address specific challenges in the nursing field. However, the application of coaching in various nursing contexts and its long-term impact on clinical practice and organizational outcomes must continue to be explored. Additionally, the specific coaching mechanisms in the nursing field and the optimal education and development processes for training effective coaches should be continuously studied.
In conclusion, this study makes a significant contribution to understanding the core essence of coaching by clearly defining the concept of coaching in nursing and analyzing its key attributes, antecedents, and outcomes in the clinical environment. By distinguishing coaching from mentoring and explaining its practical implications, this research contributes to the development of coaching programs that can enhance nursing practice and organizational performance.
The limitations of this study include the restriction of literature search and analysis to specific databases and languages, which may have resulted in the exclusion of certain studies or perspectives. Additionally, the definition and application of the coaching concept may vary depending on national and cultural contexts, posing challenges to the universal generalization of the study's findings across all settings.
CONCLUSION
The primary aim of this concept analysis was to present a detailed operational definition of coaching in nursing, grounded in its theoretical foundation and aligned with contemporary nursing practice.
Using Rodgers’ evolutionary method of concept analysis, related terms, attributes, antecedents, and outcomes were identified. Based on this analysis, the contemporary definition of coaching in the context of nursing is articulated as follows: “Coaching in nursing is an educational approach focused on nursing tasks, involving a systematic and formal process that facilitates the learning experience through interaction rather than merely teaching.” The outcome of this concept analysis is a contemporary descriptive statement of coaching in nursing, which explains its meaning, has transferability, and provides direction for future research, education, and clinical application.
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