An-Najah National University 

 

Faculty of Graduate Studies 
 
 

 

 
 

 

LONG EXPERIENCE WITH CONTINUOUS 

EDUCATION AND IMPACT ON JOB 

PERFORMANCE AMONG NURSING  

STAFF IN HOSPITALS OF WEST BANK  

-PALESTINE- A CROSS-SECTIONAL STUDY 

 
 

By 

Olfat Mahmoud Mohamed Zubaidat 

 

 
 

Supervisor 

Dr. Asaad Ramlawi 

 
 

This Thesis is Submitted in Partial Fulfillment of the Requirements for the Degree 

of Master of Public Health Management, in the Faculty of Graduate Studies, An-

Najah National University, Nablus, Palestine. 
 

2024 



ii 

 
 

 

 

 

 

 

 

 
 

LONG EXPERIENCE WITH CONTINUOUS 

EDUCATION AND IMPACT ON JOB 

PERFORMANCE AMONG NURSING  

STAFF IN HOSPITALS OF WEST BANK  

-PALESTINE- A CROSS-SECTIONAL STUDY 

 
 

By 

Olfat Mahmoud Mohamed Zubaidat 

 
 

This Thesis was Defended Successfully on 29/02/2024 and approved by 

 

 
Dr. Asaad Al-Ramlawi 
Supervisor 

 
Signature 

Dr. Suhair Al-Ghobeish 
Co-Supervisor 

 
Signature 

 Dr. Abdul Salam Al-Khayyat 
External Examiner 

 
Signature 



iii 

Dedication 

I dedicate this master thesis to my husband, who was supportive to me when I was 

working on my master's thesis. And to my family who helped me get the courage to 

finish my master's degree، 

To everyone who supportive to me and helped me achieve my goal and successfully 

complete my thesis. 

sincerely 

 

  



iv 

Acknowledgment 

I want to start by thanking God for giving me the ability to finish this research. In 

addition, I would like to thank my supervisor, Dr. Asaad Al-Ramlawi, for his useful 

criticism of the research. I extend my sincere thanks to Dr. Mai Al-Kaila, Palestinian 

Minister of Health, and Dr. Abdullah Al-Qawasmi, Director of the Department of 

Scientific Research and Continuing Education. I also thank Dr. Director General of 

Hospitals, who played a major role in making the necessary arrangements to visit the 

hospitals. 

Many thanks to all the professors in the Public Health Management Program at An-

Najah University، 

I would like to express my gratitude to my parents, husband and friends for encouraging 

me. 

 

  



v 

Declaration 

I, the undersigned, declare that I submitted the thesis entitled: 

LONG EXPERIENCE WITH CONTINUOUS 

EDUCATION AND IMPACT ON JOB 

PERFORMANCE AMONG NURSING  

STAFF IN HOSPITALS OF WEST BANK  

-PALESTINE- A CROSS-SECTIONAL STUDY 
 

I declare that the work provided in this thesis, unless otherwise referenced, is the 

researcher’s own work, and has not been submitted elsewhere for any other degree or 

qualification. 

 

 

 

 

  



vi 

List of Contents 

 

Dedication ........................................................................................................................ iii 

Acknowledgment ............................................................................................................. iv 

Declaration ........................................................................................................................ v 

List of Contents ................................................................................................................ vi 

List of Tables ................................................................................................................. viii 

List of Figures .................................................................................................................. ix 

List of Appendices ............................................................................................................ x 

Abstract ........................................................................................................................... xii 

Chapter One: Introduction and Theoretical Background .................................................. 1 

1.1 Introduction ................................................................................................................. 1 

1.2 Problem Statement ...................................................................................................... 4 

1.3 The importance of study ............................................................................................. 5 

1.4 Aim of study ............................................................................................................... 8 

1.5 Objectives ................................................................................................................... 8 

1.6 Study hypothesis ......................................................................................................... 8 

1.7 Concepts and Operational Definition ......................................................................... 9 

1.7.1 Concepts Definition ................................................................................................. 9 

1.7.2 Operational Definition ........................................................................................... 11 

1.8 Previous Studies and Theoretical Background ......................................................... 13 

1.8.1 Western studies ...................................................................................................... 13 

1.8.2 Arab studies ........................................................................................................... 15 

1.8.3 Local studies .......................................................................................................... 17 

1.9 Summary ................................................................................................................... 18 

Chapter Two: The Methodology ..................................................................................... 19 

2.1 Study Design ............................................................................................................. 19 

2.2 Study Setting ............................................................................................................. 19 

2.3 Study Population ....................................................................................................... 19 

2.4 Study sample ............................................................................................................. 20 

2.5 Study time frame ....................................................................................................... 21 

2.6 Data collection tool ................................................................................................... 21 

2.7 Statistical Analysis Methods ..................................................................................... 25 

2.8 Working Plan ............................................................................................................ 26 

2.9 Ethical consideration ................................................................................................. 26 



vii 

Chapter Three: The Result .............................................................................................. 27 

3.1 Socio-demographic characteristics ........................................................................... 27 

3.2 The relation between demographic characteristics (age, gender, educational level, 
type of hospital, work experience) and training of nursing staff in West Bank 
hospitals ................................................................................................................... 28 

3.3 The relation between demographic characteristics (age, sex, educational level, type 
of hospital, work experience) and job performance of nursing staff in West Bank 
hospitals ................................................................................................................... 32 

3.3.1 Variable of gender ................................................................................................. 32 

3.3.2 Variable of age ....................................................................................................... 34 

3.3.3 Variable of education level .................................................................................... 35 

3.3.4 Variable of hospital type ........................................................................................ 37 

3.3.5 Variable of experience ........................................................................................... 38 

3.4 The level of job performance of nursing staff in the hospitals of west- bank in 
Palestine ................................................................................................................... 38 

3.5 The impact of training programs on the job performance of nursing staff in the 
hospitals of west- bank in Palestine ......................................................................... 38 

Chapter Four: Discussion, Conclusion, and Recommendations ..................................... 40 

4.1 Discussion ................................................................................................................. 40 

4.2 Conclusion ................................................................................................................ 42 

4.3 limitation of the study ............................................................................................... 44 

4.4 Recommendations ..................................................................................................... 45 

4.4.1 Recommendations for policy makers .................................................................... 45 

4.4.2 Recommendations for Further studies ................................................................... 46 

List of Abbreviations ...................................................................................................... 48 

Reference ........................................................................................................................ 49 

Appendices ...................................................................................................................... 54 

EFGHIب  ............................................................................................................................... ا 

 

 

 

 

  



viii 

List of Tables 

 

Table 2.1: The number population of nursing staff in each hospital .............................. 20 

Table 2.2: The validity of training scale ......................................................................... 23 

Table 2.3: The validity of job performance scale ........................................................... 24 

Table 2.4: Reliability coefficients of study tool .............................................................. 25 

Table 3.1: Distribution of the study sample according to the demographic variables 
(n=245) ........................................................................................................... 28 

Table 3.2: One way ANOVA results for the differences in training programs of nursing 
staff in the hospitals of west- bank in Palestine according to the variables of 
(gender, age, educational level, hospital type, and experience) (n= 245) ...... 29 

Table 3.3: SD post hoc results for the differences in training programs of nursing in the 
hospitals of west- bank according to educational level variable .................... 30 

Table 3.4: LSD post hoc results for the differences in training programs of nursing staff 
in the hospitals of west- bank according to hospital type variable ................. 30 

Table 3.5: The results of independent t- test for the differences in the job performance of 
nursing staff in the hospitals of west- bank in palestine according to gender 
variable (n=245) ............................................................................................. 33 

Table 3.6: One way ANOVA results for the differences in the job performance of 
nursing staff in the hospitals of west- bank in Palestine according to age 
variable (n= 245) ............................................................................................ 35 

 

 

  



ix 

List of Figures 

 

Figure 1.1: Describe Hypotheses ...................................................................................... 9 

Figure 3.1: The means of response on training program scale of nursing staff according 
to gender variable ......................................................................................... 31 

Figure 3.2: The means of response on training program scale of nursing staff according 
to education level variable ........................................................................... 31 

Figure 3.3: The means of response on training program scale of nursing staff according 
to hospital type variable ............................................................................... 32 

Figure 3.4: The means of response on the ability domain of nursing staff according to 
gender variable ............................................................................................. 33 

Figure 3.5: The means of response on the total score of job performance of nursing staff 
according to gender variable ........................................................................ 34 

Figure 3.6: The means of response on the ability domain of nursing staff according to 
education level variable ............................................................................... 36 

Figure 3.7: The means of response on the desire domain of nursing staff according to 
education level variable ............................................................................... 36 

Figure 3.8: The means of response on the total score of job performance of nursing staff 
according to education level variable .......................................................... 37 

 

 

 

  



x 

List of Appendices 

 

Appendix A: Faculty of Graduate studies approval ........................................................ 54 

Appendix B: IRB approval ............................................................................................. 55 

Appendix C: Task facility of the General Administration of Health Education and 
Scientific Research ........................................................................................... 56 

Appendix D: Consent form (Arabic version) .................................................................. 57 

Appendix E: Tool ............................................................................................................ 58 

Appendix F: Tables ......................................................................................................... 61 

Table F.1: One way ANOVA results for the differences in the job performance of 
nursing staff in the hospitals of west- bank in Palestine according to 
education level variable (n= 245) ................................................................ 61 

Table F.2: LSD post hoc results for the differences in the job performance and its two 
domains of nursing staff in the hospitals of west- bank according to 
educational level variable ............................................................................ 61 

Table F.3: One way ANOVA results for the differences in the job performance of 
nursing staff in the hospitals of west- bank in Palestine according to hospital 
type variable (n= 245) .................................................................................. 62 

Table F.4: LSD post hoc results for the differences in the job performance the desire 
domain of nursing staff in the hospitals of west- bank according to hospital 
type variable ................................................................................................. 62 

Table F.5: One way ANOVA results for the differences in the job performance of 
nursing staff in the hospitals of west- bank in Palestine according to 
experience variable (n= 245) ....................................................................... 63 

Table F.6: 5- point Likert scale .................................................................................. 63 

Table F.7: Means, standard deviations, and percentages for the level of job 
performance of nursing staff in the hospitals of west- bank in Palestine (n= 
245) .............................................................................................................. 64 

Table F.8: The relationship between training and job performance of job performance 
of nursing staff in the hospitals of west- bank in Palestine (n= 245) ........... 65 

Table F.9: Summary of simple regression results for determining the effect of 
training on the job performance and its domains of nursing staff in the 
hospitals of west- bank (n= 245) .................................................................. 65 

Appendix G: Figures ....................................................................................................... 66 

Figure G.1: The means of response on the desire domain of nursing staff according 
to hospital type variable ............................................................................. 66 



xi 

Figure G.2: The means of response on the total score of job performance of nursing 
staff according to hospital type variable .................................................... 66 

Figure G.3: The impact of training programs on the domain of ability of nursing 
staff ............................................................................................................ 67 

Figure G.4: The impact of training programs on the domain of desire of nursing 
staff ............................................................................................................ 67 

Figure G.5: The impact of training programs on the total score of job performance 
of nursing stff ............................................................................................ 68 

 

 

 

 

  



xii 

LONG EXPERIENCE WITH CONTINUOUS EDUCATION AND 

IMPACT ON JOB PERFORMANCE AMONG NURSING STAFF IN 

HOSPITALS OF WEST BANK -PALESTINE- A CROSS-

SECTIONAL STUDY 
By 

Olfat Mahmoud Mohamed Zubaidat 

Supervisor 

Dr. Asaad Ramlawi 

Abstract 

The nursing staff plays a crucial role in maintaining the provision of high-quality patient 

care in the ever-changing healthcare scene. A strategic approach to provide nursing staff 

with the information, skills, and competencies needed to meet the changing needs of the 

healthcare sector is through training programmers. The study aim is Impact of training 

and its dimensions on the job performance in West Bank hospitals 

A cross-sectional study, data were collected from 245 participants using a convenience 

sampling method nursing who receiving training during their experiences, while a 

random sampling method was used to choose the location for the study. 

The results indicated that the level of job performance of nursing staff in the hospitals 

was high, as the mean of response (3.80). Also, the level of the ability and desire 

domains of job performance were high, as the means of response (3.79, and 3.82) 

respectively. And The results indicated that there was statistically significant and 

positive relationship between the training and job performance of nursing staff in the 

hospitals (r= 0.73; p ≤ 0.01). also, the training was positively and significantly 

correlated with ability and desire domains of job performance of nursing staff (r= 0.67, 

and 0.70; p ≤ 0.01), respectively. 

In light of the results of this study regarding the existence of an impact of continuing 

education on nursing performance, the study recommended establishing a continuing 

education program that would greatly benefit in improving the level of performance of 

the health care provider (nursing) for patients and enhance the results to provide 

insightful information that can guide evidence-based choices that support the delivery of 

quality health care. 

Keywords:Hospitals, Job performance, Palestine, Training, Nursing staff.  



1 

Chapter One 

Introduction and Theoretical Background 

This chapter deals in detail with the problem that this study focused on. It is divided into 

three parts: The first part, which consists of an introduction to the study, a statement of 

the study problem, a discussion of the importance of this study, the purpose and 

objectives, and research questions. The second part, discusses operational concepts and 

definitions. The third part, presented the previous studies related to the research 

problem. 

1.1 Introduction 

The healthcare sector has grown significantly in recent years. The standard of hospital 

services and medical care is highly valued by the general people. Nursing as a health 

care profession aims to provide individuals and their families with the support they need 

to recover from illness and maintain the best possible health and quality of life 

(Wakefield, Williams, Menestrel, & Flaubert, 2021). 

Nursing staff are distinguished from other medical professionals, is a vital profession 

for promoting health, preventing disease, and providing care for all people Yolanda 

Smith (2020), nurses can enhance their performance in the healthcare context and 

expand their knowledge and skill set through continuous professional development 

Osei, Antwi, Peprah, & Nimako (2019), as the backbone of patient care, job 

performance is defined as an individual's ability to carry out assigned roles and 

responsibilities in a manner directly related to patient care, others define it as 

successfully completing assigned taskswork (Sonnentag, Volmer, & Spychala, 2010). 

Performance is a complex phenomenon that is influenced by a wide range of factors, 

including personal traits, workload, job satisfaction, personal competencies, 

accomplishment recognition, social support, constructive criticism and communication, 

leadership style, and organizational climate, Sandall & Mourão (2023), the degree of 

efficacy with which a nursing fulfils his duties and obligations in relation to overseeing 

nursing care and the caliber of healthcare services is known as the nurse's work 

performance, Wakefield, Williams, Menestrel, & Flaubert (2021), therefore, nursing job 



2 

performance reflects the quality of care provided and therefore patient outcomes, and 

poor job performance is considered a risk factor for patient safety (Al-Makhaita & 

Sabra, 2014). 

The knowledge, abilities, and drive of those in charge of delivering health services, 

along with the proper allocation of human and material resources, are the primary 

determinants of the health system's effectiveness and potential benefits (Osei, Antwi, 

Peprah, & Nimako, 2019).  

The best way for a healthcare organization to retain and motivate its top talent is 

through training and development. One of the most popular strategies for raising 

employee productivity and informing staff members of the objectives of the healthcare 

organization is training (Ongori, Oluoch , & Adoyo , 2019). 

Nursing is essential to preserving patients' physical health as well as their overall 

experience while they are in the hospital.The development of the skills required to carry 

out any task has been greatly affected by technological advancement (Saddique, 

Mushtaq, Asghar, Abbas, & Nawaz, 2023).  

Therefore, there is a need for more enhanced and effective training programs to deal 

with this technological advancement, with the aim of preparing nursing staff capable of 

facing impending difficulties more easily and quickly, and thus improving their job 

performance, effective training programs help create a more appropriate and effective 

learning environment, Ortega, et al. (2015), the idea of training in the health sector has 

received great attention recently. Hospitals and the health sector need to be able to grow 

and face challenges, and since health care is one of the services that cannot wait, it also 

needs a positive outlook on declining performance and completing tasks with the 

necessary quality, Yoopetch, Nimsai, & chapatara (2021), strengthening the 

administrative empowerment of its employees through delegation of authority, 

participation in decision-making, continuous training, and capacity building are able to 

raise their level of performance, Abushammala, Al Shobak, El Talla, & Hamdan 4 

(2023), increasing employee performance is a critical goal for any corporate entity, the 

ability of health organizations to improve employee performance is threatened by 



3 

factors such as increasing competition, continuing technological advances, and changes 

in the workplace. It is emphasized that performance is the achievement of set objectives 

with certain standards of accuracy, cost, timeliness and comprehensiveness. They can be 

set up to improve production, encourage innovation in the application of new 

technologies, and have highly motivated employees, training helps in this improvement 

(Bhatti, Soomro, & Shah , 2023).  

Employee performance is a complex phenomenon that is a crucial factor in determining 

whether an organization succeeds or fails. Poor employee engagement and inadequate 

training are major causes of low health sector worker performance in developing nations 

(Sendawula, Kimuli, Juma, & Muganga, 2018).  

Health professionals are accused of being absent from work, not providing services to 

clients on time, being unproductive, acting badly towards patients, and providing subpar 

patient careSendawula, Kimuli, Juma, & Muganga (2018), one of the most popular 

ways to improve employee productivity and convey organizational goals to healthcare 

staff is through training. It is well known that organizational training initiatives in the 

healthcare industry have the potential to provide competitive advantages by raising staff 

productivity (Ongori, Muiruri, & Vasco, 2021).  

Effective training programs are necessary for employees to perform well at work and to 

develop the necessary knowledge, skills, and abilities Ma, et al. (2023), continuing 

education may also affect employee commitment and motivation (Khilukha, 2023). 

One of the most crucial factors in the improvement of job performance among the 

nursing staff is the requirement for continuous professional development (CPD).  As a 

result, any learning outside of a university education or postgraduate training that aids 

employees in maintaining and improving work performance while working to develop 

knowledge, skill, and conduct in all areas of professional practice has been defined as 

continuing professional development Naseralallah, et al. (2022), employees who  

receive the appropriate training typically stay in their positions longer than those who 

do not. In the job, training is essential. Without it, employees won't have a clear 

knowledge of their duties, and their work performance won't increase. Employee 



4 

training refers to initiatives that teach staff members new knowledge or abilities 

Khilukha, (2021), enhancing the workforce's capacity to accomplish organizational 

goals is facilitated by training and development. Training is viewed as a helpful way to 

adapt to changes brought about by technology innovation, competitive markets, 

organizational structure, and—most importantly—the improvement of staff 

performance (Gopolang Gause, Mokgaola, & Rakhudu, 2022). 

The Palestinian Ministry of Health attaches great importance to nursing education for a 

number of reasons, the most important of which is superior patient care. As front-line 

medical professionals, nurses are essential to providing high-level patient care. Proper 

training ensures that nursing staff have the abilities, knowledge and competencies 

necessary to provide safe and effective patient care in a range of healthcare settings 

(MOH, 2024). 

Nursing is involved in procedures related to disease prevention and health promotion, 

including examining patients, giving immunizations, and counseling them about good 

lifestyle choices. Continuing training gives nursing staff the experience they need to 

implement critical public health projects. 

Emphasis is placed on patient safety practices, such as drug delivery protocols, infection 

control procedures, and appropriate use of medical equipment, in nursing education. 

The interpersonal and communication skills necessary to build rapport with patients and 

maintain continuity of care throughout the healthcare journey are ensured through 

special nursing training programs (Unit, 2024). 

1.2 Problem Statement 

Nursing staff is a vital component of the dynamic and intricate ecosystem that is the 

healthcare business, as they ensure the well-being of patients and the general 

effectiveness of hospital operations. Training programs are the means by which nursing 

staff members acquire and continuously develop the knowledge, skills, and 

competences that are essential to provide effective nursing care. Nonetheless, there is 

still serious concern about how these training programmers may affect the nursing 



5 

staff's performance on the job. The issue of whether nursing staff training meets the 

needs of modern healthcare settings emerges as healthcare continues to change due to a 

growingdiversity of patient populations and quick advancements in medical technology. 

There are many elements that contribute to this issue. The complicated terrain of 

nursing education is influenced by a number of factors, including the frequency and 

consistency of training, Methods used to evaluate training effectiveness, and variations 

in the content and quality of training programs among hospitals. Furthermore, there is 

insufficient research on how much nursing staff training programs take into account the 

particular difficulties and demands of the healthcare environment, such as patient safety, 

legal compliance, and the desire for ongoing adaptation to evolving medical procedures. 

Therefore, it is essential to look at how much training affects how well hospital nursing 

staff performs on the job. By tackling this problem, It is possible to evaluate whether the 

training models used today are in line with the changing demands of the healthcare 

sector and whether they help to improve staff satisfaction, patient outcomes, and 

organizational success, in order to continue improving healthcare delivery, this study 

aims to Impact of training and its dimensions on the job performance in West Bank 

hospitals 

1.3 The importance of study 

The provision of healthcare depends heavily on the nursing profession, and patient 

outcomes are directly impacted by the performance of the nursing staff. With the 

healthcare industry always changing and new developments in medical technology and 

procedures, it is essential that nursing personnel receive ongoing education to guarantee 

they have the most recent information and abilities. The need to comprehend how long-

term exposure to continuing education programs affects nursing staff members' job 

performance is directly addressed by this study. As a consequence of ongoing 

education, nursing personnel can perform better on the job, which can improve the 

quality of patient care. Modern knowledge and abilities enable nursing to manage 

challenging medical cases, deliver effective care, and adjust to the changing demands of 

their patients. As a result, this research may improve patient outcomes and the standard 

of care provided in hospital environments. 



6 

First: Theoretical significance 

The research's theoretical significance stems from its capacity to promote knowledge 

and comprehension across various domains, such as organizational behavior and 

educational theory, health care policy, and patient care outcomes. Additionally, it offers 

useful perspectives for healthcare managers and nursing. 

The usefulness of continuing education for nursing is examined in this study. The study 

adds to our understanding of the dynamics of adult learning, professional development, 

and long-term retention of information and skills by looking at its effect on job 

performance. Knowing how continuing education affects work performance can help 

healthcare organizations better understand their HRM practices. It can provide insight 

into how training and development initiatives might improve worker productivity, 

motivation, and job satisfaction. 

The findings of this study may also help health care policy pertaining to staff education 

and training. It can help decision-makers allocate funds more wisely in order to promote 

efforts for ongoing education and raise the standard of care given by hospital nursing 

personnel. Patient outcomes are directly correlated with the nursing staff's level of 

competence. This research can improve the standard and safety of healthcare delivery 

by analyzing the effect of continuing education on work performance, which would 

eventually improve patient outcomes. 

Understanding the long-term advantages of continuous education is aided by this study. 

It can draw attention to the connection between career progression and ongoing 

education, as well as the development of nursing personal and professional lives. 

The study's methodology presents difficulties in precisely assessing the effect of 

continuing education on work performance. By addressing these issues, research 

procedures in the areas of performance evaluation and nursing education can be 

advanced, opening the door to future studies that will be more thorough. 

  



7 

Second: Applied importance 

A significant topic in the healthcare industry is covered in this study. The performance 

of nursing personnel is crucial to patient care, safety, and hospital efficiency in the 

dynamic healthcare environment: 

• Improve Patient Care: The potential for improving patient care is one of the main 

uses for this research. Better patient outcomes can be directly correlated with 

improved work performance among nursing personnel. Well-trained and self-assured 

nursing can provide more effective and efficient treatment, which lowers medical 

errors, speeds up recovery, and increases patient satisfaction. In the end, hospitals 

that fund training initiatives can save lives and raise the standard of care provided. 

• Reducing Employee Turnover: In many healthcare facilities, the turnover of nursing 

staff is a serious problem. Hospital operations are not only hampered by high 

turnover rates, but significant expenses are also incurred for hiring and training new 

staff. The results of this research provide a useful remedy for this issue. Nursing staff 

that participates in effective training programmers feel more involved and competent 

in their positions, which can increase job satisfaction and retention rates. Hospitals 

benefit financially from lower turnover rates, which also help to maintain a more 

steady and knowledgeable staff of nursing. 

• Meeting Regulatory Requirements: Hospitals must abide by strict standards because 

the healthcare sector is so controlled. To maintain compliance, training is frequently 

necessary. Hospitals must comprehend how training initiatives impact employee 

performance in order to guarantee compliance with regulations. An institution's 

reputation may suffer, penalties may be imposed, and accreditation may be revoked 

for noncompliance. 

• Continuous Improvement: Hospitals can to help their nursing departments adopt a 

continuous improvement culture. Hospitals are able to pinpoint areas in which their 

nursing staff may want further assistance by routinely evaluating the results of 

training programmers. This data-driven method of evaluating staff performance can 

be very helpful in promoting ongoing improvements in patient care and staff 

competencies. 



8 

1.4 Aim of study 

Impact of training and its dimensions on the job performance in West Bank hospitals. 

1.5 Objectives 

• To examine the relation between demographic characteristics (age, sex, educational 

level, type of hospital, work experience) and training of nursing staff in West Bank 

hospitals. 

• To assess the relation between demographic characteristics (age, sex, educational 

level, type of hospital, work experience)and job performance of nursing staff in West 

Bank hospitals. 

• To investigate the level of job performance of nursing staff in the hospitals of west- 

bank in Palestine 

• To assess the impact of training programs on the job performance of nursing staff in 

the hospitals of west- bank in Palestine. 

1.6 Study hypothesis 

• H1: There is no a statistically significance relationship at (p ≤ 0.05) between 

demographic characteristics (age, gender, educational level, years of experience 

&type of hospital) and continuance education of nursing staff in hospitals. 

• H2: There is no a statistically significance relation at (p ≤ 0.05) between 

demographic characteristics (age, gender, educational level, years of experience 

&type of hospital) and nursing job performance in hospitals. 

• H3: The level of job performance among nursing staff is positively related to the 

domains (desire and ability). 

• H4: There is no statistically significant at (p ≤ 0.05) relation between the training 

programs and Domains and the job performance (ability and desire) of the nursing 

staff in West Bank hospitals in Palestine. 



Figure 1.1 

Describe Hypotheses 

1.7 Concepts and Operational Definition

In this section, conceptual definitions and operational definitions related to this study 

are defined and include the following concepts (Training Programs, Job Performance, 

Nursing Staff, Impact and Hospitals).

1.7.1 Concepts Definition

Introduction 

The junction of considerable experience and ongoing education among nursing 

personnel has a substantial impact on work performance and patient care outcomes in 

the ever-changing health care landscape. These conceptual definitions highlight the 

significance of ongoing professional development in enhancing patient care outcomes 

by offering a theoretic

between ongoing education and long

on job performance among hospital nursing staff.

9 

Concepts and Operational Definition 

In this section, conceptual definitions and operational definitions related to this study 

are defined and include the following concepts (Training Programs, Job Performance, 

Nursing Staff, Impact and Hospitals). 

 Concepts Definition 

The junction of considerable experience and ongoing education among nursing 

stantial impact on work performance and patient care outcomes in 

changing health care landscape. These conceptual definitions highlight the 

significance of ongoing professional development in enhancing patient care outcomes 

by offering a theoretical framework for comprehending the intricate interactions 

between ongoing education and long-term experience, as well as their combined effect 

on job performance among hospital nursing staff. 

 

In this section, conceptual definitions and operational definitions related to this study 

are defined and include the following concepts (Training Programs, Job Performance, 

The junction of considerable experience and ongoing education among nursing 

stantial impact on work performance and patient care outcomes in 

changing health care landscape. These conceptual definitions highlight the 

significance of ongoing professional development in enhancing patient care outcomes 

al framework for comprehending the intricate interactions 

term experience, as well as their combined effect 



10 

Conceptual definition of continues education: for registered nursing, continuing 

education is a planned process of professional growth that goes beyond initial license or 

entry-level training to improve knowledge, skills, and competencies. It includes a wide 

range of structured learning experiences, including conferences, workshops, seminars, 

and self-directed study plans that are designed to adapt to the changing demands of the 

healthcare industry and the nursing profession (Association, 2020). 

Conceptual definition of training programs: nursing staff members' knowledge, abilities, 

and competences are developed through structured educational efforts known as training 

programmers. It consists of training exercises, seminars, workshops, online courses, 

simulations, and hands-on instruction. Which aim to improve the performance and 

capabilities of nursing professionals (Bhatti, Soomro, & Shah , 2023). 

Conceptual definitions oflong experiences: long-term nursing experiences cover a wide 

range of situations, exchanges, and lengths of time that nurses work with patients, 

families, and communities. These experiences are complex and go beyond time itself; 

they represent the body of information, abilities, and connections that form nursing 

practice. Our goal is to clarify the core of extensive experiences in nursing through 

conceptual exploration. 

Long nursing experiences are defined as an extended period of time spent providing 

patient care, going beyond isolated incidents. It includes the long-term continuity of 

nursing care, enabling thorough assessment, intervention, and evaluation along the 

whole spectrum of health and sickness (Meleis, 2012). 

Conceptual definition of job performance: the efficacy, productivity, and general caliber 

of work demonstrated by nursing staff in a hospital setting are all considered aspects of 

job performance. It includes several different competencies, including teamwork, 

clinical skills, communication, decision-making, patient care, and adherence to set rules 

and standards (Al-Makhaita & Sabra, 2014). 

Conceptual definition of nursing staff: nursing staff includes licensed practical nurses, 

registered nurses, nursing assistants, and other medical personnel who work closely 



11 

with patients in hospital settings. They are in charge of giving patients access to 

necessary healthcare services, keeping an eye on their diseases, giving treatments, and 

making sure the patients are safe and well (TEAM, 2020). 

Conceptual definition of hospitals: It is a specialized medical facility offering a wide 

range of medical services, care, and treatment with a primary emphasis on nurse 

practice. In order to promote health, prevent disease, and restore well-being, registered 

nurses and other medical professionals work together in this dynamic setting to assess, 

diagnose, plan, implement, and evaluate patient care interventions (University, 2022). 

1.7.2 Operational Definition 

Introduction 

Operational Definition describes the exact definition and measurement of the variables 

that the researchers are examining. 

The researchers assure consistency and precision in their measurements by providing 

explicit operational definitions for these words, which enhances the reliability and 

interpretability of their findings. 

Operational definitions ofcontinues education: it is a planned, continuing process that 

registered nurses and other medical professionals use to improve their knowledge, 

abilities, and competences over the course of their employment. This procedure entails 

the methodical design, execution, and assessment of educational initiatives meant to 

preserve, advance, and broaden the nursing profession's professional capacities. 

Operational definitions oflong experiences: in nursing, "long experiences" refers to 

durations of patient care or professional involvement that surpass standard timeframes. 

This could include working longer shifts, providing patient care for longer periods of 

time, or dedicating more time to training or professional development. Long-term 

nursing experiences involve working with complex patient conditions that necessitate 

lengthy times for assessment, intervention, and evaluation. These encounters sometimes 

entail overseeing long-term medical conditions, intricate treatment plans, or drawn-out 

recuperation procedures. 



12 

Operational definitions of training programs: training programs are organized 

educational interventions and activities intended to improve nursing staff members' 

knowledge, abilities, and competences. Hospitals can provide workshops, seminars, 

online courses, simulations, and practical training sessions to enhance the performance 

of their nursing staff. 

Operational definitions of job performance: the observable and quantifiable results of 

nursing staff members' work in hospitals are related to job performance. This includes 

particular metrics like the quantity of treatments that are successfully completed, the 

degree of patient happiness, the adherence to established practices, and the decrease in 

medical errors. 

Operational definitions of nursing staff: nursing staff includes licensed practical nurses, 

registered nurses, nursing assistants, and other medical personnel who work closely 

with patients in hospital settings. They are in charge of treating patients, keeping an eye 

on them, giving treatments, and making sure they are safe and well. 

Operational definition impact: indicates the measurable impacts and adjustments that 

training programmers have made to the way nursing staff performs their jobs. Improved 

patient outcomes, higher levels of job satisfaction among nursing staff, better team 

dynamics, lower rates of patient readmission, and higher-quality patient care are ways to 

gauge this. 

Operational definition hospitals: are medical facilities that provide patients with 

diagnosis, treatment, and other medical services. In this study, hospitals are the 

principal workplaces for nursing staff, and the impact of training programmers on 

nursing staff performance in these institutional contexts is investigated. 

  



13 

1.8 Previous Studies and Theoretical Background 

Introduction 

Previous published papers, which discussed the same title, objectives and keywords 

were used for this study. This gives us access to a robust database for our research. The 

keywords used in the database search are: hospitals, job performance, training effect, 

nursing. A set of keywords associated with the study title and study objectives are 

defined in advance. The review of scientific research literature is considered a basis for 

clarifying the researchers’ approach to topics related to the research topic. 

Previous studies are considered the nucleus of drawing up scientific frameworks for 

research. Scientific research cannot be conducted without previous studies. The 

following is a presentation of the most important studies available to researchers from 

the previous studies that were discussed. The subject of this study, some of which are 

directly related to the current study and others are partially related to its components. 

The focus was on the main objectives of the studies and the most important results they 

reached so that we can compare them with the results of the current research. The 

studies were presented in the form of Western studies, Arab studies, and local studies. 

1.8.1 Western studies 

In Kenya, a study was conducted by Ongori, Oluoch, & Adoyo (2019), the purpose of 

this study was to ascertain the effect of training on nursing job performance. The results 

showed that there are limitations in a variety of methods used to train nursing staff, as 

there was a statistically significant correlation between training and nursing job 

performance (2 = 34.500, df = 12, p = 0.001, v = 0.422). In addition, the results were 

indicated that inadequate training creates a barrier to providing services and affects 

nursing performance. In another context, research was conducted in Greece by Karatepe 

& Avci (2019), investigated the role of job embeddedness as a mediator between 

employee performance and support for supervisor and co-workers. According to the 

results, nurses who received adequate support performed their profession better, which 

in turn reduced their tendency to be late for work. Successful completion of work is 

supported by the assistance of nursing supervisors to achieve functional integration, 



14 

which is achieved through training. While a study conducted by Yuxiu, Kunaviktikul, & 

Thungjaroenkul (2019), which was conducted in China, sought to characterize the level 

of functional characteristics and performance and to investigate the association between 

them. The results indicated that the general functional level was Moderate. The level of 

job characteristics is one of the seven dimensions of job characteristics. The ability to 

interact with people, the relevance of the task, the feedback from the agents and the job 

were all at a high level. Other factors, such as task identification, skill diversity, and 

autonomy, were moderately high, indicating that overall work performance was 

moderate. It also revealed that there was a strong moral relationship between job 

attributes that were reinforced by training and job performance that was at a medium 

level (r=.36, p.01). In Indonesia, a study was carried out by Yusuf, Shinta, & Fransisco 

(2020), the study goal was determined how staff training affected work performance. 

The findings showed a strong correlation of 0.838, which denotes a very strong 

correlation between employee's training and their job performance according to the 

coefficient of determination (R2), which has a value of 0.702, the training variable has a 

percentage impact on employees' performance of 70.2%, while the remaining 29.8% is 

influenced by other variables. On the other hand, aydogdu (2022), did a study in Turkey 

on the significance of training for nursing personnel with the aim of examining the style 

of transformational leadership in the nursing industry. Using the operator Logical AND, 

a search for papers using the terms "transformational leadership" and "nursing" was 

conducted in the Scopus database. There were 12 articles altogether. The findings 

showed that nursing with greater leadership training is more likely to support 

transformational leadership practices, which aided in improving their work performance 

in healthcare facilities. While a study was conducted in Ghana by Osei, Antwi,Peprah,& 

Nimako (2019), its aim was to determine whether relationship between professionalism 

and persistence job development and performance as well as determining if there are 

any noticeable differences in the job performance by age, gender and clinical 

background. There was a correlational study design used. A convenience sample of 164 

registered nurses in Ghana was collected. A self-survey questionnaire for continuing 

professional development was used in the study. The results showed a fairly significant 

positive relationship between persistence and Career advancement and professional 



15 

development. When age, gender, and clinical experience were accounted for, there was 

no significant difference in job performance. In another context, a meta-analysis of how 

nursing experiences and provides opportunities for ongoing professional development 

was employed by Mlambo, Silén, & McGrath (2021), in a study carried out in Sweden. 

Examining nursing experiences in continuous professional development was the goal of 

the qualitative study. The qualitative literature was subjected to a meta-analysis. A total 

of twenty-five articles were screened after meeting the inclusion criteria. According to 

the findings, organizational culture shapes the conditions, with a supportive atmosphere 

serving as a prerequisite and attitudes and motivation aligning with nursing professional 

principles. The present synthesis underscores the need of continual professional 

development for nursing, as they see it as a prerequisite for both professionalism and 

lifetime learning. Furthermore, it has been determined that raising the bar for patient 

care requires ongoing professional growth. 

A new study carried out in Jakarta Aziz (2023), examining the crucial role that ongoing 

education and training play in the healthcare setting as well as the difficulties, tactics, 

and ramifications of putting it into practice were the goals of the study. A qualitative 

descriptive methodology was employed, utilizing data sourced from prior pertinent 

study findings. Study reveals that nursing can become leaders in best practices, foster 

innovation, and make significant contributions to raising the standard of healthcare 

through ongoing education and training. 

1.8.2 Arab studies 

A study was conducted by Elnaga & Imran (2013), aimed to study the impact of 

training on employee performance and make suggestions on how the company can 

improve the performance of its employees effective training programs. The results 

indicated that there are not enough indicators to link the relationship directly between 

training and employee performance. The results also indicated that there is a lot of 

literature that indicated the importance of training to raise the performance of 

employees. In the other hand, Huda Mansoor Al-Makhaita, Sabra, & Hafez (2014), a 

study was conducted in the Kingdom of Saudi Arabia to assess the level of job 

performance among nurses working in primary and secondary care and to identify 



16 

factors that predict performance among different levels of care. The results showed that 

most of the nurses who answered performed well, and the results were comparable 

between the primary and secondary levels of care. Primary care nurses scored higher in 

various subdomains of performance, such as teaching, communication, planning and 

personal development, while secondary care nurses scored higher in critical care. Stress, 

shifts, and job division were the factors that significantly predicted nurses' performance 

at the secondary health care level. On the other hand, a study was conducted in Libya by 

Gadalla & Mukhtad (2021), the purpose of the study was to investigate how training 

initiatives affected the performance of medical staff at the Benghazi Medical Centre 

(BMC), located in the Libyan city of Benghazi. It was a cross-sectional descriptive 

investigation. Between March and June of 2019. 51 questionnaires about the effect of 

training on employee performance were gathered. According to the findings, a sizable 

portion of the research subjects (72.5%) completed training courses offered by medical 

facilities. The majority of these participants (59.5%) engaged in training with an eye 

towards performance, and 75% of them connected the training to improved performance 

at work, according to the results. 

On the other wise, the study was carried out by Al‐Ahmadi (2009), the aim of the study 

was to determine the variables affecting hospital nursing performance in Riyadh, Saudi 

Arabia. A random selection of fifteen hospitals was made. 923 nursing out of the 1,834 

nurses working in these facilities answered the questionnaire. The findings 

demonstrated a favorable correlation between organizational dedication, job 

satisfaction, and both personal and professional factors and job performance. Nursing 

performance is highly predicted by both organizational commitment and job 

satisfactiom. Certain personal characteristics, such as years of experience, nationality, 

gender, and marital status, are positively correlated with job success. Performance and 

educational attainment are inversely correlated. 

  



17 

1.8.3 Local studies 

This is the first study to be conducted in Palestine to evaluate the impact of training 

programs of the job performance among medical staff of west-bank. but the study 

conducted by Abushammala, Al Shobak, El Talla, & Hamdan4, (2023), for medical 

staff and technicians evaluate the training affect the quality of treatmentat Al-Shifa 

Medical Complex in the governorates of southern Palestine. (For medical staff and 

technicians) numbering 2,150 workers. A questionnaire was sent to 330 employees who 

were selected as a stratified random sample and given a questionnaire. 302 

questionnaires were returned, representing 91.5% of the total. The study's finding that 

training has a statistically significant impact on raising the level of health care is among 

its most notable findings. One of the most important recommendations of the study is to 

give workers more opportunities to enhance their professional development and to focus 

more on growing programs and training courses that are in line with the requirements of 

administrative empowerment. 

This study differs from previous studies 

In contrast to earlier research carried out in more stable areas, this study of extensive 

experience with continuing education and its effect on job performance among nursing 

staff at hospitals in the West Bank, Palestine, brings special problems and 

considerations. The following are some significant variations: 

• The Conflict Zone's Context Due to its location in a conflict area, the West Bank 

presents a variety of pressures and difficulties that may have a substantial impact on 

employees' ability to execute their jobs and the success of ongoing education 

initiatives. Because of the continuous fighting, nurses working in this setting may 

have daily security concerns, resource constraints, and emotional strain. 

Consequently, it is necessary to examine the effects of ongoing education on job 

performance in this particular setting, taking into consideration the particular 

pressures and difficulties that nurses encounter. 

• Resource limitations: hospitals in conflict areas frequently face significant resource 

limitations, such as a lack of staff, equipment, and medical supplies. The availability 

and caliber of continuing education programs for nursing may be impacted by these 



18 

constraints. It is vital to comprehend how nursing maneuver around these limitations 

and utilize accessible resources to improve their abilities and output when evaluating 

the efficacy of ongoing education within this particular setting. 

• Adaptation to Adversity: to cope with the daily problems they encounter, nursing 

staff members operating in conflict areas cultivate special coping strategies and 

resilience abilities. Programs for ongoing education might need to include instruction 

in trauma-informed care, stress management, and other topics pertinent to working in 

high-stress situations. Understanding the influence of continuous education on job 

performance requires examining how it helps nurses adapt and grow in the face of 

adversity. 

• Cultural and Sociopolitical Factors: healthcare delivery and professional practice are 

influenced by the sociopolitical dynamics and cultural norms that are common in the 

West Bank. Nursing staff continuing education programs must be designed and 

implemented with cultural sensitivity and an awareness of local dynamics. Analyzing 

the interactions between these elements and ongoing education as well as work 

performance offers important insights into the particular possibilities and difficulties 

that nurses in this setting confront. 

1.9 Summary 

Thorough grasp of the particular difficulties, available resources, and contextual 

elements particular to the conflict zone in the West Bank and Palestine is necessary 

when examining the effects of extensive experience combined with ongoing education 

on the work performance of nursing staff in these institutions. Through a thorough 

examination of these factors, scholars may offer significant perspectives on how 

ongoing education initiatives might facilitate nursing personnel and improve their 

performance in demanding settings. 

  



19 

Chapter Two 

The Methodology 

In this chapter, methods that were used to answer the study objective are presented in 

details. This reflects on study design, study setting, participants, used tool, study sample 

and sampling technique. 

2.1 Study Design 

A descriptive cross-sectional study, data were collected from participants using a 

convenience sampling method nursing who receiving training during their experiences, 

while a random sampling method was used to choose the location for the study. 

2.2 Study Setting 

In Palestine, there were 93 active hospitals by the year 2022. The total number  

of hospital beds—including those in mental facilities—was 6,900, or 12.9% beds  

per 10,000 people and 1.7 hospitals per 100,000 people, with 58 hospitals in the  

West Bank and 4,286 beds overall (including a mental hospital), there are 13.4  

beds for 10,000 people and 1.8 hospitals for 100,000 people. Governmental  

hospitals, non-governmental hospitals, and private hospitals make up Palestine's three 

categories of hospitals (MOH 2022). Three different types of hospitals were used to 

conduct this study. First, government hospitals (Al-Hussein Hospital - Beit Jala,  

Khalil Suleiman Hospital - Jenin, Jericho Hospital). Second: Non-governmental 

hospitals (UNRWA Hospital - Qalqilya, Al-Isra Hospital - Tulkarm). Third, private 

hospitals (Al-Mizan Hospital - Hebron, Al-Engali Hospital - Nablus, Al-Mustaqbal 

Hospital - Ramallah). 

2.3 Study Population 

All nursing working in the mentioned hospitals in the West Bank was included who 

receiving training during their experiences. Table (2.1) shows a breakdown of 

population data (the number of nursing staff in each of the aforementioned hospitals in 

2019). 

  



20 

Table 2.1 

The number population of nursing staff in each hospital 

Name of the hospital 
The number of nursing in each 

hospital (# pop) 

Governmental Hospitals  

Beit Jala Governmental Hospital (Al Hussein Hospital 167 

Jericho Governmental Hospital 78 

Khalil Suleiman Governmental Hospital (Jenin) 201 

Non- Governmental Hospitals  

UNRWA Hospital - Qalqilya 45 

Al-Israa Hospital - Tulkarem 40 

Private Hospitals  

Al-Mizan Hospital – Hebron 89 

Al-Engili Hospital - Nablus 20 

Al-Mustaqbal Hospital - Ramallah 30 

Total 670 

Note: (Dwikat, 2023) 

• Inclusion criteria 

All nursing staff working in the hospitals who receiving training during their 

experiences that were included in this study, regardless of educational level or job 

position. 

• Exclusion criteria 

Nursing with less than one years of experience will be excluded. 

2.4 Study sample 

In order to select participants relevant to the research design, two types of research 

design were worked on. First, the hospitals were selected from a random sample. As for 

the participants, the non-probability convenience sampling technique was used by all 

nursing staff in the hospitals who receiving training during their experiences included in 

this study. with a confidence level of 95% and a margin of error of 5%. On the basis of 

the sample size formula, 245 participants were reached(Raosoft's sample size calculator, 

available at raosoft.com/sample size). 



21 

2.5 Study time frame 

The study was conducted between (October and December,2023) in hospitals in the 

northern West Bank. First, government hospitals (Al-Hussein Hospital - Beit Jala, 

Khalil Suleiman Hospital - Jenin, Jericho Hospital). Second: Non-governmental 

hospitals (UNRWA Hospital - Qalqilya, Al-Isra Hospital - Tulkarm). Third, private 

hospitals (Al-Mizan Hospital - Hebron, Al-Engali Hospital - Nablus, and Al-Mustaqbal 

Hospital - Ramallah). 

2.6 Data collection tool 

The study tool was used, which is post-training questionnaire questions about the 

learning experience, environment, and performance (Khuzam, 2020). The researcher’s 

email was used to distribute the questionnaire. A pilot study was conducted with 30 

participants to determine if the study instrument was reliable. In keeping with 

Palestinian culture, the results of this study were not included in the study sample. The 

Validity results showed that there were statistically significant correlations at the level 

(p ≥ 0.01) between the statements and the total score of the training scale, where 

Pearson correlation values ranged between (0.56 to 0.84), while Cronbach's alpha 

values were calculated for all elements of the questionnaire, the results showed 

statistically significant correlations at (p ≤ 0.01) between the statements and the total 

score of job performance scale, as the values of Pearson correlation were ranged 

between (0.51 to 0.85). The study tool translated into Arabic was used to collect data. 

Informed consent was provided in English and Arabic. Participation in this study was 

voluntary. Participants were provided with information about the purpose of this study 

and were informed that they could withdraw from the study at any time. It was 

emphasized that the privacy of the study was maintained and that it was for scientific 

research purposes throughout the study period. 

The questionnaire from the study of (Khuzam, 2020) was used, where the average 

internal consistency validity was 0.60, while the Cronbach alpha (reliability) values for 

the first domain were 0.85, the second domain was 0.72, the third domain was 0.74, and 



22 

the fourth domain was 0.89. A five-point Likert scale was also used. This questionnaire 

was modified, translated, and revised to suit the culture of the Palestinian community. 

The questionnaire (Key Performance Indicators KPIs) in this study was included two 

parts: 

Part One: Demographic characteristics were discussed (age, gender, educational level, 

type of hospital, years of experience). 

Part Second: A questionnaire on the impact of training on the performance of workers 

in West Bank hospitals. This questionnaire consists of four parts: 

• The impact of training courses on scientific information (6 sentences). 

• The impact of training courses on skills (5 sentences). 

• The impact of training courses on work (one sentence). 

• Employee performance (13 sentence). 

Validity and Reliability 

Validity 

The validity of the questionnaire indicates that it reflects the factors intended by it. 

(Middleton., 2019) The questionnaire was sent in its first form to the supervisor of the 

thesis and to the Public Health team at (An-Najah University), which evaluated the 

adequacy of the tool to measure what it planned to measure. The validity of the tool was 

verified. A pilot study was conducted on an external sample of the original study sample 

consisting of (35) nurses in order to ensure the internal consistency validity of training 

and job performance scales. Pearson correlation coefficients were found between the 

statements and the total score of each scale as shown in tables (2.2). 

  



23 

Table 2.2 

The validity of training scale 

N Items R- value P- value 

1 
The scientific content provided in scientific training courses is 
good and comprehensive 

0.71 0.000** 

2 
Competent trainers are selected to implement training 
programs related to scientific information 

0.80 0.000** 

3 
Trainers are able to use training techniques with high 
efficiency 

0.56 0.000** 

4 
Different methods and methods are used to provide scientific 
training (lecture method, dialogue method, discussion method, 
role-playing method, and on-the-job training) 

0.72 0.000** 

5 Scientific training courses are evaluated after their completion 0.79 0.000** 

6 
The trainee’s performance is evaluated while performing the 
work to ensure his mastery and acquisition of scientific 
information 

0.71 0.000** 

7 
The scientific content provided in training courses on nursing 
skills is good and comprehensive 

0.72 0.000** 

8 
Competent trainers are selected to implement training 
programs related to nursing skills 

0.84 0.000** 

9 
Nursing skills trainers are able to use training techniques very 
efficiently 

0.84 0.000** 

10 

Different methods and methods are used to provide training 
on work skills (lecture method, dialogue and discussion 

method, role-playing method, and on-the-job training). 
0.76 0.000** 

11 
The trainee's performance is evaluated while performing the 
work to ensure his acquisition of the skill 

0.82 0.000** 

12 On-the-job training helps Consolidating scientific information 0.56 0.000** 

* Significant correlation at (p ≤ 0.01). 

The results in table (2.2) showed statistically significant correlations at (p ≤ 0.01) 

between the statements and the total score of training scale, as the values of Pearson 

correlation were ranged between (0.56 to 0.84). These results emphasis that the 

statements measure what it is intended to measure. 

 

  



24 

Table 2.3 

The validity of job performance scale 

N Statements R- value p- value 

1 
Nurses have sufficient scientific knowledge to perform the 
work with high efficiency 

0.66 0.000** 

2 
Nurses have good communication skills to interact with 
patients 

0.70 0.000** 

3 
Nurses have the persuasion skills necessary to persuade 
patients regarding treatment plans and other matters 

0.66 0.000** 

4 
Nurses are keen to exploit the available capabilities and 
resources to work efficiently and effectively 

0.64 0.000** 

5 
After training, nurses have the ability to innovate new 
methods of work 

0.73 0.000** 

6 Nurses perform job tasks on time 0.54 0.001** 

7 
The hospital's nursing staff has the desire and enthusiasm to 
get the job done 

0.73 0.000** 

8 Nursing has the ability to take initiative and innovation 0.76 0.000** 

9 
Nursing' relationship with their superiors is characterized by 
friendliness and harmony 

0.85 0.000** 

10 Nursing' relationship with their colleagues is good 0.55 0.001** 

11 
Nursing is committed to arriving and leaving the workplace 
on time 

0.51 0.002** 

12 
Nursing who has been trained have a positive attitude towards 
work 

0.78 0.000** 

13 The feeling of working within a team increases after training 0.51 0.002** 

* Significant correlation at (p ≤ 0.01). 

The results in table (2.3) showed statistically significant correlations at (p ≤ 0.01) 

between the statements and the total score of job performance scale, as the values of 

Pearson correlation were ranged between (0.51 to 0.85). These results emphasis that the 

statements measure what it is intended to measure. 

Reliability 

An internal consistency test was called Cronbach's alpha test was used in a pilot study 

including 35 nursing staff from the target population to ensure the validity of the study 

instruments and was not included in the study including the effect of training on nursing 

job performance. A Cronbach’s alpha equation was used to ensure the reliability the 

study scales for the same pilot study as shown in table (2.4). 



25 

Table 2.4 

Reliability coefficients of study tool 

Scales No. of items Cronbach’s alpha 

Training 12 0.92 

Domain of ability 6 0.77 

Domain of desire 7 0.81 

Job performance 13 0.89 

 

The results in table (2.4) showed that the reliability coefficient for the training scale was 

(0.92). also, the coefficient of reliability for the total score of job performance was 

(0.89), and for its domains were (0.77, and 81) respectively. According to these results, 

the tow scales are reliable and achieves the study objectives. 

2.7 Statistical Analysis Methods 

The data were analyzed using SPSS V.26 using descriptive statistics including 

(averages, standard deviations, and percentages) to determine the level of job 

performance. Pearson's correlation coefficient was used to determine the relation 

between training and job performance. As well as ensuring the validity of the internal 

consistency of the study measures. To determine the impact of training programs on job 

performance and its fields, simple linear regression was used.The independent samples 

t-test was also used to determine the differences in the job performance measure 

according to the gender variable. A one-way test of variance (ANOVA) was used to 

determine differences in the two measures of training and job performance according to 

the variables of age, educational level, type of hospital, and experience. In order to 

identify the sources of significant differences when needed, the LSD (least significant 

difference) post-hoc test was used. Cronbach alpha was used to verify the reliability 

coefficients of the study scales. 

  



26 

2.8 Working Plan 

The study site was chosen using a probability strata technique by transcribing it into 

computer programs. 245 questionnaires were distributed to the nursing staff working in 

West Bank hospitals by sending a link via each participant’s private e-mail, and 

responses will be received via the researcher’s e-mail on Google Drive. A consent form 

stating that participation in the study is voluntary, that all information is confidential, 

and that it will be used for scientific research only, was distributed to each participant in 

agreement with the director of nursing in each hospital. 

2.9 Ethical consideration 

Obtaining graduate studies approval. Ethical approval from the Institutional Review 

Board “IRB” at An-Najah National University in Nablus - Palestine. Approval from the 

Department of Health Education and Scientific Research in the Palestinian Ministry of 

Health in Palestine.After agreeing to select the study sample, a consent form to 

participate in this study was distributed, where the researcher introduced himself and 

explained the purpose of this study and that the study is voluntary and participants have 

the right to withdraw from this study at any time, and the information is confidential 

and is for the purposes of scientific research. 

  



27 

Chapter Three 

The Result 

In this chapter, the sociodemographic characteristics of the study participants are 

described. We also show the relationship between demographic characteristics (age, 

sex, educational level, type of hospital, work experience) and training of nursing staff 

And also the relationship between demographic characteristics (age, sex, educational 

level, type of hospital, work experience) and job performance of nursing staff. We will 

also show the level of job performance among the nursing staff. Finally, we will show 

the relationship between training and job performance of nursing staff in West Bank 

hospitals. 

3.1 Socio-demographic characteristics 

The data was subjected to a descriptive analysis and split into ratios and numbers in 

order to determine the distribution of the variable values. The term "frequency" in 

descriptive analysis refers to the quantity of responses that respondents submitted. Table 

(3.1) presents the demographic analysis of the nursing personnel as it was found in the 

study.According to the findings, 29.4% of the study's respondents were male, whilst 

70.6% of the respondents were female. Additionally, it was demonstrated that 33.1% of 

respondents to the study belonged to Less than 30 years age group. The study also 

showed that, at a rate of 60.4%, respondents were most in favor of nursing staff that 

possess a bachelor's degree in nursing, While the highest response was from nursing 

staff who work in government hospitals at 58.8%. The data also showed that the highest 

response rate (46.1%) was seen among nursing staff with less than 10 years of work 

experience. 

  



28 

Table 3.1 

Distribution of the study sample according to the demographic variables (n=245) 

Demographic variables Level of variable N % 

Gender 

Male 72 29.4 

Female 173 70.6 

Total 245 100% 

Age 

Less than 30 years 81 33.1 

30- 39 years 125 51 

40 years and above 39 15.9 

Total 245 100% 

Education level 

Diploma 53 21.6 

Bachelor 148 60.4 

Higher studies 44 18 

Total 245 100% 

Hospital type 

Private 71 29 

Governmental 144 58.8 

Non-governmental 30 12.2 

Total 245 100% 

Experience 

Less than 10 years 113 46.1 

10- 15 years 73 29.8 

Above 15 years 59 24.1 

Total 245 100% 

 

3.2 The relation between demographic characteristics (age, gender, educational 

level, type of hospital, work experience) and training of nursing staff in West Bank 

hospitals 

The results shown in Table (3.2) indicated that There were no statistically significant 

differences at (p ≤ 0.05) in the training programs of nursing staff of west- bank in 

Palestine as perceived by nurses themselves according to the variables of age and 

experience. In addition, there was statistically significant difference at (p ≤ 0.05) in the 

training programs of nursing staff of west- bank in Palestine as perceived by nurses 

themselves according to the variable of gender in favor of female nurses as illustrated in 

figure (3.1). while There were statistically significant differences at (p ≤ 0.05) in the 



29 

training programs of nursing staff of west- bank in Palestine as perceived by nurses 

themselves according to the variables of education level and hospital types. 

Table 3.2 

One way ANOVA results for the differences in training programs of nursing staff in the 

hospitals of west- bank in Palestine according to the variables of (gender, age, educational 

level, hospital type, and experience) (n= 245) 

Independent variables Level of variables N Mean± SD F P-value 

Gender 
Male 72 3.65± 0.65 

8.60 0.004* 
Female 173 3.88± 0.50 

Age 

Less than 30 years 81 3.80±0.65 

0.54 
0.585 

Ns 
30- 39 years 125 3.84± 0.48 

40 years and above 39 3.74± 0.66 

Education level 

Diploma 53 4.02± 0.50 

10.31 0.000* Bachelor 148 3.82± 0.52 

Higher studies 44 3.52± 0.69 

Hospital type 

Private 71 3.98± 0.55 

5.84 0.003* Governmental 144 3.77± 0.54 

Non-governmental 30 3.60± 0.64 

Experience 

Less than 10 years 113 3.83± 0.60 

0.16 
0.850 

Ns 
10- 15 years 73 3.78± 0.53 

Above 15 years 59 3.81± 0.56 

* Significant differences at (p ≤ 0.05); Ns= no significant. 

To determine the sources of these differences, LSD post-hoc test 

The results shown in Table (3.3) indicated that there were statistically significant 

differences at (p ≤ 0.05) in the training programs of nursing staff of west- bank in 

Palestine as perceived by nurses themselves according to the variable of education level 

between (diploma) and (Bachelor, higher studies) in favor of (diploma), and between 

(Bachelor) and (higher studies) in favor of (Bachelor), as illustrated in figure (3.2). 

  



30 

Table 3.3 

SD post hoc results for the differences in training programs of nursing in the hospitals of west- 

bank according to educational level variable 

Means of training 
program 

Educational level categories 

Diploma Bachelor Higher studies 

4.02 - 0.20* 0.50* 

3.82  - 0.30* 

3.52   - 

* Significant differences at (p ≤ 0.05). 

In addition, the results shown in Table (3.4) that there were statistically significant 

differences at (p ≤ 0.05) in the training programs of nursing staff of west- bank in 

Palestine as perceived by nurses themselves according to the variable of hospital type 

between (private) and (governmental, non-governmental) in favor of (private), and no 

statistically significant difference was noticed between governmental and non- 

governmental hospitals, as illustrated in figure (3.3). 

Table 3.4 

LSD post hoc results for the differences in training programs of nursing staff in the hospitals of 

west- bank according to hospital type variable 

Means of training 
program 

Hospital type categories 

Private Governmental Non-governmental 

3.98 - 0.21* 0.38* 

3.77  - 0.17 

3.60   - 

* Significant differences at (p ≤ 0.05). 



Figure 3.1 

The means of response on training program scale of nursing sta

Figure 3.2 

The means of response on training program scale of nursing staff accord

variable 

31 

The means of response on training program scale of nursing staff according to gender variable

The means of response on training program scale of nursing staff according to education 

ff according to gender variable 

 

ing to education level 

 



Figure 3.3 

The means of response on training program scale of nursing staff according to hospital type 

variable 

3.3 The relation between demographic characteristics (age, sex, educational level, 

type of hospital, work experience) and job performance of nursing staff 

Bank hospitals 

Independent samples t

performances and its domains according to variable of gender. Whereas, one

ANOVA test was used to determine the differences in the job performance according to 

the variables of age, educational level, hospital type, and experience. According the 

sequence of the independent variables the results were as the following

3.3.1 Variable of gender

The results shown in Table (

differences at (p ≤ 0.05)

nursing staff of west- bank in Palestine as perceived by nurses themselves according to 

the variable of gender in favor of female nurses as illustrated in figure (

statistically significant difference was found at 

nursing staff according to the variable of gender.

32 

The means of response on training program scale of nursing staff according to hospital type 

The relation between demographic characteristics (age, sex, educational level, 

type of hospital, work experience) and job performance of nursing staff 

ndependent samples t-test was used to determine the differences in the job 

mances and its domains according to variable of gender. Whereas, one

ANOVA test was used to determine the differences in the job performance according to 

the variables of age, educational level, hospital type, and experience. According the 

the independent variables the results were as the following

 Variable of gender 

The results shown in Table (3.5) indicated that there were statistically significant 

) in the total score of job performance and the ability domai

bank in Palestine as perceived by nurses themselves according to 

the variable of gender in favor of female nurses as illustrated in figure (

difference was found at (p ≤ 0.05) in the dom

according to the variable of gender. 

The means of response on training program scale of nursing staff according to hospital type 

 

The relation between demographic characteristics (age, sex, educational level, 

type of hospital, work experience) and job performance of nursing staff in West 

test was used to determine the differences in the job 

mances and its domains according to variable of gender. Whereas, one- way 

ANOVA test was used to determine the differences in the job performance according to 

the variables of age, educational level, hospital type, and experience. According the 

the independent variables the results were as the following 

) indicated that there were statistically significant 

in the total score of job performance and the ability domain of 

bank in Palestine as perceived by nurses themselves according to 

the variable of gender in favor of female nurses as illustrated in figure (3.4) & (3.5). No 

in the domain of desire for 



Table 3.5 

The results of independent t

the hospitals of west- bank in 

Domains of job performance

Ability 

Desire 

The total score 

* Significant differences at (p 

Figure 3.4 

The means of response on the ability domain of nursing sta

33 

The results of independent t- test for the differences in the job performance of nursing staff in 

bank in Palestineaccording to gender variable (n=245

Domains of job performance Gender N Mean± SD T

Male 72 3.65± 0.73 
-

Female 173 3.85± 0.58 

Male 72 3.71± 0.73 
-

Female 173 3.86± 0.45 

Male 72 3.69± 0.70 
-

Female 173 3.85± 0.48 

Significant differences at (p ≤ 0.05); Ns= no significant. 

The means of response on the ability domain of nursing staff according to gender variable

in the job performance of nursing staff in 

245) 

T-value P- value 

-2.20 0.029* 

-1.90 
0.059 

Ns 

-2.17 0.031* 

ff according to gender variable 

 



Figure 3.5 

The means of response on the total score of job performance of 

gender variable 

3.3.2 Variable of age 

The results shown in Table (

differences at (p ≤ 0.05) 

staff of west- bank in Palestine as perceived by nurses themselves according to the 

variable of age. 

 

34 

The means of response on the total score of job performance of nursing staff according to 

The results shown in Table (3.6) indicated that there were no statistically significant 

 in the total score of job performance and its domains of nursing 

bank in Palestine as perceived by nurses themselves according to the 

 

nursing staff according to 

 

) indicated that there were no statistically significant 

in the total score of job performance and its domains of nursing 

bank in Palestine as perceived by nurses themselves according to the 



35 

Table 3.6 

One way ANOVA results for the differences in the job performance of nursing staff in the 

hospitals of west- bank in Palestine according to age variable (n= 245) 

Domains of job 
performance 

Age N Mean± SD F P-value 

 

Ability 

Less than 30 years 81 3.81± 0.61 

0.60 
0.551 

Ns 
30- 39 years 125 3.80± 0.57 

40 years and above 39 3.69± 0.86 

 

Desire 

Less than 30 years 81 3.80± 0.55 

0.24 
0.784 

Ns 
30- 39 years 125 3.84± 0.52 

40 years and above 39 3.78±0.64 

 

The total score 

Less than 30 years 81 3.80± 0.55 

0.35 
0.708 

Ns 
30- 39 years 125 3.82± 0.50 

40 years and above 39 3.74± 0.72 

* Significant differences at (p ≤ 0.05); Ns= no significant. 

3.3.3 Variable of education level 

The results shown in Table (Appendix F.1) indicated that there were statistically 

significant differences at (p ≤ 0.05) in the total score of job performance and its two 

domains of nursing staff of west- bank in Palestine as perceived by nurses themselves 

according to the variable of education level. 

To determine the sources of differences, LSD post-hoc test 

The results shown in Table (Appendix F.2) indicated that there were statistically 

significant differences at (p ≤ 0.05) in the total score of job performance and its two 

domains of nursing staff of west- bank in Palestine as perceived by nurses themselves 

according to the variable of education level between (diploma) and (Bachelor, higher 

studies) in favor of (diploma), and no significant differences were noticed between 

(Bachelor) and (higher studies), as illustrated in figure (3.6),(3.7),(3.8). 



Figure 3.6 

The means of response on the ability domain of nursing staff according to education level 

variable 

Figure 3.7 

The means of response on the desire domain of nursing staff accord

variable 

 

36 

The means of response on the ability domain of nursing staff according to education level 

means of response on the desire domain of nursing staff according to education level 

The means of response on the ability domain of nursing staff according to education level 

 

ing to education level 

 



Figure 3.8 

The means of response on the total score of job performance of nursing staff accord

education level variable 

3.3.4 Variable of hospital type

The results shown in Table (Appendix F.

significant differences at 

domain of nursing staff 

according to the variable of hospital type. No statistically significant 

found at (p ≤ 0.05) in the domain of ability for nursing staff 

variable. 

To determine the sources of differences, LSD post

The results in table (Appendix F.

differences at (p ≤ 0.05)

nursing staff of West- B

the variable of hospital type between (private) and (governmental, non

favor of (private), and no statistically significant difference was noticed between 

governmental and non- 

& G.2). 

37 

The means of response on the total score of job performance of nursing staff accord

 Variable of hospital type 

The results shown in Table (Appendix F.3) indicated that there were statistically 

differences at (p ≤ 0.05) in the total score of job performance and the desire 

domain of nursing staff of West- Bank in Palestine as perceived by nurses themselv

according to the variable of hospital type. No statistically significant 

in the domain of ability for nursing staff according to hospital type 

To determine the sources of differences, LSD post-hoc test 

results in table (Appendix F.4) showed that there were statistically significant 

) in the total score of job performance and the desire domain of 

Bank in Palestine as perceived by nurses themselves according t

the variable of hospital type between (private) and (governmental, non

favor of (private), and no statistically significant difference was noticed between 

 governmental hospitals, as illustrated in figures (Appendix 

The means of response on the total score of job performance of nursing staff according to 

 

) indicated that there were statistically 

in the total score of job performance and the desire 

ank in Palestine as perceived by nurses themselves 

according to the variable of hospital type. No statistically significant difference was 

according to hospital type 

) showed that there were statistically significant 

in the total score of job performance and the desire domain of 

ank in Palestine as perceived by nurses themselves according to 

the variable of hospital type between (private) and (governmental, non-governmental) in 

favor of (private), and no statistically significant difference was noticed between 

governmental hospitals, as illustrated in figures (Appendix G.1 



38 

3.3.5 Variable of experience 

The results shown in Table (Appendix F.5) indicated that there were no statistically 

significant differences at (p ≤ 0.05) in the total score of job performance and its domains 

of nursing staff of West- Bank in Palestine as perceived by nurses themselves according 

to the variable of experience. 

3.4 The level of job performance of nursing staff in the hospitals of west- bank in 

Palestine 

To explore the level of job performance for nursing staff in hospitals of the West-Bank. 

descriptive statistics (means, standard deviations, and percentages) were calculated for 

each item and the domain to which it belongs as presented in the attached table 

(Appendix F.6). 

The results shown in table (Appendix F.7) indicated that the level of job performance of 

nursing staff in the hospitals of West- Bank in Palestine as perceived by nurses 

themselves was high, as the mean of response for the total score was (3.80). Also, the 

level of the ability and desire domains of job performance were high, as the means of 

response for the total score were (3.79, and 3.82) respectively. Concerning the items, the 

level of responses on all items was high, as the means of response ranged between (3.68 

to 3.91). furthermore, the highest response was on item (10) (nursing' relationship with 

their colleagues is good, as the mean was (3.91). whereas, the lowest response was on 

item (9) (Nursing' relationship with their superiors is characterized by friendliness and 

harmony), as mean was (3.68). 

3.5 The impact of training programs on the job performance of nursing staff in the 

hospitals of west- bank in Palestine 

The results in table (Appendix F.8) showed that there was statistically significant and 

positive relationship between the training and job performance of nursing staff in the 

hospitals of West- Bank in Palestine as perceived by nurses themselves(r= 0.73; p ≤ 

0.01). also, the training was positively and significantly correlated with ability and 

desire domains of job performance of nursing staff (r= 0.67, and 0.70; p ≤ 0.01), 

respectively. 



39 

The results of simple linear regression in table (Appendix F.9) showed that there was 

statistically significant effect of training programs on the job performance of nursing 

staff in the hospitals of West- Bank in Palestine as perceived by nurses themselves(R²= 

0.528; p ≤ 0.01). Also, there were statistically significant effects of training programs on 

the domains of ability and desire of nursing staff (R²= 0.454, and 0.493; p ≤ 0.01) 

respectively. These results mean that training programs explain (52.80%) of the total 

score of job performance, (45.40%) of the ability domain, and (49.30%) of the desire 

domain of nursing staff in the hospitals of West- Bank in Palestine as perceived by 

nurses themselvesas illustrated in the figures (Appendix G.3,G.4, G.5). 

 

  



40 

Chapter Four 

Discussion, Conclusion, and Recommendations 

In this chapter, a discussion, conclusions, and recommendations will be presented. 

4.1 Discussion 

The nursing profession is essential to the healthcare system, and patient care outcomes 

are directly impacted by the nursing staff's performance on the job. The dynamic nature 

of healthcare necessitates ongoing professional development via training programmers 

in order to guarantee that nursing staff members possess the requisite skills and 

knowledge. The purpose of this study to impact of training and its dimensions on the 

job performance in West Bank hospitals. 

The outcomes were therefore discussed. Additionally, it was compared to earlier studies 

in order to generate a number of significant recommendations that would aid decision-

makers. 

According to the study's findings, nursing female made up 70.6% of the participants, 

while nursing mal made up 29.4%. An investigation conducted by Sendawula K., 

Kimuli, Bananuka, Muganga, & Wanasika (2018), corroborated this outcome. which 

meant that women made up 68% of them. This implies that hospitals are effectively 

employing a higher proportion of female than male. The primary causes of this are 

gender stereotypes and societal expectations that have an impact on professional 

decisions. Certain occupations, like nursing and healthcare, might be seen as more 

fitting with stereotyped roles that female are expected to play. Because of this, female 

might be overrepresented in various fields, which increases the likelihood that they will 

take part in research. Additionally, it was discovered that 33.1% of study participants 

were under 30 years old. This was in line with research Sendawula K., Kimuli, Juma, & 

Muganga (2018), that found 31% of participants to be in the 25–29 age bracket. A large 

proportion of young nursing professionals has been observed to participate in this type 

of research because they often prioritize their professional development and 

advancement by expanding their knowledge and skills and enhancing their overall 



41 

competence as health care providers. This study also revealed that 60.4% of respondents 

had a bachelor's degree in nursing, with government hospital employees providing the 

largest response rate at 58.8%. This outcome was in line with Ongori, Oluoch, & Adoyo 

(2019) which found that 65% of the sample had completed high school with a diploma. 

Additionally, the findings demonstrate that every responder has completed some kind of 

post-secondary education. The research topic is more pertinent to their professional 

progress, which explains why. They might understand how training directly relates to 

their professions and how it affects job performance. 

They might be more motivated to pursue ongoing professional development. They 

might be more likely to take part in training-related research if it fits with their 

professional aspirations. 

The results also indicated that there is a positive relationship between training and job 

performance of the nursing staff in West Bank hospitals in Palestine, as seen by the 

nurses themselves. The reason is that the hospital’s senior management plays a decisive 

role in improving the effectiveness and job performance of the nursing staff. By 

providing direction and leadership to the nursing staff, through training and other 

supportive measures, they set clear goals and standards that drive the team to perform 

better. They also plan, implement and supervise training programs that increase clinical 

skills, communication and other competencies, by identifying training needs of nursing 

staff. A study by Bhatti, Soomro, & Shah (2023), refuted the findings of this study, but 

it also showed that there is no connection between learning or training and doing the 

two tasks. This is a result of senior administrations' apathy and lack of interest in 

training initiatives, which is indicative of the majority of Pakistani hospitals. on the 

same context, the findings of this study were also refuted by a study conducted by Rajan 

(2015), in India, which found that training had little effect on traits such as self-

motivation, positive outlook, ability to multitask, and ability to apply acquired 

knowledge. From the topic at work. Appropriate suggestions have been made to 

improve the effectiveness of the training programmed. While the results of this study 

supported a study by Yoopetch, Nimsa, & Kongarchapatara (2021), he pointed out in 

his study that one of the things that affects employee performance is employee learning 



42 

and training .In addition, there is a strong positive relationship between employee 

performance and career advancement and development.This was also consistent with a 

study in Libya by Gadalla & Mukhtad (2021) where the findings showed that most 

participants (59.5%) went to training in order to consider their performance, and 75% 

connected training to improved performance at work. 

Summary 

Continuing education offers possibilities for the acquisition of new knowledge, skills, 

and competences, which is crucial for the professional development of nursing 

personnel. It makes it possible for nursing to stay current with advancements in medical 

procedures and technology, improving their capacity to offer patients high-quality care. 

Researcher identify and explore a number of elements that may affect how continuing 

education affects nursing staff members' job performance. 

The significance of establishing precise outcome metrics to assess how continuing 

education affects job performance was also underlined during the session. 

This study emphasized the significance of more investigation to expand our 

comprehension of the ways in which ongoing education influences the job performance 

of hospital nursing personnel. Future research has the potential to enrich evidence-based 

practices that optimize patient care delivery by resolving methodological obstacles, 

investigating contextual factors, and proposing efficacious techniques for boosting the 

effectiveness of continuous education. 

4.2 Conclusion 

The study “Impact of long experience with continuous Education and impact on job 

performance among nursing staff in hospitals” highlights the importance of continuing 

professional development in the dynamic field of health care. By conducting a 

comprehensive analysis of current training programs, this study aims to impact of 

training and its dimensions on the job performance in West Bank hospitals. By 

providing a roadmap to improve and customize upcoming training initiatives by 

identifying important areas of knowledge and skills that training positively impacts, 



43 

decisions can be made on how best to support the professional development of nursing 

staff by stakeholders in the healthcare industry by knowing the relationship between 

participation in Training courses and improving job performance. 

The investigation of possible obstacles and enablers in the execution of training 

initiatives also emphasizes the necessity of a comprehensive strategy for the planning 

and execution of training. 

By addressing these issues, training outcomes can be improved and nurse pract