Abstract
BACKGROUND: The aim of this study is to systematically evaluate the training requirements of nursing assistants in clinical settings and to identify influencing factors, with the objective of developing a training requirements model to inform the design of evidence-based training programs. METHODS: A cross-sectional design was implemented using stratified sampling across 48 healthcare institutions in Jiaxing City. A total of 1,600 questionnaires were distributed to nursing assistants, yielding 1,470 valid responses (valid response rate: 91.9%). Descriptive statistics, chi-square (χ(2)) tests, and multivariate logistic regression were conducted using SPSS version 22.0 to assess training coverage, content, format, and influencing factors. RESULTS: High training coverage was observed for both pre-employment (92.6%) and on-the-job (87.0%) programs; however, the reported training durations were relatively brief. Instruction was primarily delivered via in-hospital lectures and traditional mentorship models. Key barriers to training participation included scheduling conflicts, technological limitations, and inadequate practical content. A substantial proportion (78.4%) of respondents indicated interest in retraining. Multivariate analysis demonstrated that nursing assistants with longer work experience or those employed through labor dispatch or hired directly by families exhibited lower training requirements. In contrast, higher training requirements were identified among those working under one-on-one or one-to-many care models, and among those who had previously received on-the-job training (all p < 0.05). Preferred training formats included short-term (1-3 day) sessions held at high frequency (monthly), facilitated by experienced nursing assistants and subject-matter experts. Hospitals were the most preferred venues, with on-site mentorship identified as the favored instructional method. The most desired training topics among participants were qualities and requirements of nursing assistants (67.3%), particularly communication techniques (59.2%), as well as content related to practical skills. CONCLUSION: Despite high overall training coverage, several limitations were identified, including brief training durations, limited instructional diversity, and underutilization of digital platforms. Enhancing the practical relevance of training content, incorporating blended learning approaches that combine online and in-person methods, and optimizing both training frequency and duration are recommended to improve engagement and training outcomes among nursing assistants.