Abstract:

Objective To construct an on-the-job training management system for clinical nurses under the hospital-wide bed-sharing mode，and to explore its practical effects. Methods Based on preliminary research，combined with literature review and expert meetings，an on-the-job training management system was developed，including vertical management structure，shared teaching resources，differentiated talent cultivation，and fostering a collaborative teaching ecology. From January to June 2025，24 nursing units with 449 nurses from the top 10 specialties with the highest patient mobility for interdisciplinary admissions at a tertiary first-class hospital in Zhejiang Province were selected to apply this system. A quasi-experimental study design was employed，utilizing the Kirkpatrick Training Evaluation Model. The satisfaction and self-efficacy of nurses with the training（Level 1：Reaction），Objective Structured Clinical Examination（OSCE） scores （Level 2：Learning），nursing quality inspection scores（Level 3：Behavior），and the incidence of nursing adverse events in interdisciplinary admissions（Level 4：Results） were compared before and after implementation. Results After applying the system，93.5% of nurses expressed high satisfaction with the training management system. The OSCE assessment scores，nurses’ self-efficacy scores for interdisciplinary nursing，and nursing quality inspection scores were all higher than before implementation or in the concurrent control group，with statistically significant differences（P<0.001）. No statistically significant difference was observed in the incidence of nursing adverse events before and after system application（P>0.05）. Conclusion The implementation of the on-the-job training system for clinical nurses facilitates the integration of specialized nursing training resources，enhances nurses’ skill proficiency and self-efficacy in interdisciplinary care. Furthermore，it improves the quality of nursing services. This system provides high-quality training guarantee for the operation of the “hospital-wide bed-sharing” management mode.

Key words: Interdisciplinary Admissions, 4S Management Model, Nurses, On-the-job Training