UK student nurses' education values: a three-centre study

Carol Haigh, SeniorLecturer in Research; Natalie Yates-Bolton, Lecturer in Nursing Martin Johnson, Professor in Nursing,

School of Nursing, University of Salford,

UK

What are Values? A cognitive and emotional disposition

towards a person, object or idea.

Attitudes are similar, but more specific. ‘Measurement’ of attitudes can suggest strength that values are held

How are values adopted? Genetic disposition (Dawkins)

Species altruism, ‘Selfish Gene’ Behaviourism and Social

Learning Theory (Bandura) Modelling and perceived

reward/status Existential/humanist (Raths)

Values chosen, freely from alternatives

BackgroundGerard Fealy (2004, Irish Context)Quotes from Attitude surveys: ‘the nurse who is good at theory is rarely

good at the practical side of nursing’ (McGowan 1980, p. 94).

university education was not appropriate for nurses (Scanlan 1991)

Underlying these views are ‘values’

Approaches to the study of values Spranger’s (1928) ‘Types of ‘men’. ”

Theoretical, Economic, Aesthetic, Social, Political, Religious

Theoretical “…since the interests of the theoretical man (sic) are empirical, critical and rational, he is necessarily an intellectualist, frequently a scientist or a philosopher.” (Vernon and Allport 1931, p233)

Allport, Vernon and Lindzey (1960) values instrument draws on this, used by several nurse researchers

Early studies of educational valuesIn a UK study Singh (1971) compared students on ‘experimental’ courses (e.g. combined degree/SRN) and Diploma/SRN) courses with ‘traditional’ SRN students but found no statistically significant difference on the ‘theoretical’ value.

Experimental 29.96

SRN 30.24

Difference = - 0.28

Singh (1971)However when he compared ‘experimental’ students (N = 229) with non-nursing ‘female undergaduates’ (N = 147) he found a notable and statistically significant difference (p < 0.001)

Experimental students

29.96

Female undergraduates

33.80

In the USA O’Neill (1973) found the opposite (p < 0.1)

Values General College Students N = 1289

Nursing students

N = 459

Mean Mean

Theoretical 35.7 37.5

Research Questions Do student nurses’ educational values

vary between different universities? Do educational values in student nurses

differ by programme of study? Do educational values in student nurses

change across time?

Sample 3 universities

Southern, Russell, Riverside

Pre-registration students (n=1133) Diploma n=835 Degree n=287

(11 missing responses on this variable)

Methods 1

William A Scott General Values Instrument (1959). This is a Likert Scale Instrument measuring general attitudes;

Honesty ReligiousnessIntellectualism Self ControlAcademic Achievement Independence Altruism

Nursing specific items added which included the Scott categories plus 2 other - Paternalism and Authority

A sub set of variables focusing upon general and professional educational values is

the focus of this presentation. We report on altruism and honesty (Johnson, Haigh and Yates-Bolton JAN, 57, 4, 366-374)

Educational values subset - Scott Reading only things that don’t pose any

intellectual challenge (S2) Working hard to do well academically (S4) Ignoring lectures and text-books that are

difficult (S7) Not letting studies interfere with one’s

social life (S24) Striving hard to get the top marks in the

group (S27) Being interested only in one’s work (S34)

Educational values subset - Johnson Little has been gained by educating nurses

in a University rather than a Hospital School of Nursing (J5)

Nursing should be a highly educated profession like Medicine and Law (J8)

Academic qualifications should not be important to nursing career advancement (J16)

Methods 2 Ethical approval obtained from participating

organisations Student questionnaire administered in class

time – 20 minutes. Investigators not particularly involved with programme

Ordinal data was analysed using SPSS Descriptive stats Correlation MANOVA

Demographics - Gender

Demographics - age ranges

RiversideRussellSouthern

Uni

250

200

150

100

50

0

Co

un

t

50-59

40-49

30-39

20-29

15-19

age ranges

Educational Demographics - NVQStudents with any NVQ Attainment by Centre

35.71

17.03

28.16

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

SouthernN = 98

Russell N = 417

Riverside N =618

University

% of coh

ort

Educational Demographics – entry level GSCE,O & A level

6.8

8.5

6.5

Proxy measure of educational entry level

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

Southern N = 98

Russell N = 417

Riverside N = 618

Me

an

GC

E a

nd

GC

SE

O a

nd

A le

vel P

er

stu

de

nt

Educational Demographics - degree

Percentage degree possession by Centre

7.2

4.8

3.8

0

1

2

3

4

5

6

7

8

Southern N = 98

Russell N = 417

Riverside N = 618

University

Percentage

Educational values relationships by university - 1

The relationship between university and admiration for those who do not let studies interfere with social life was investigated

There was a small weak negative statistically significant correlation between the two variables [rs= -.101 n= 1133 p =.001]

This gives of coefficient of determination of 1%

This suggests that students who attended Riverside university were more likely to admire this behaviour

Educational values relationships by university- 2 The relationship between

university and admiration for those who strive hard to get the top marks was investigated

There was a weak statistically significant correlation between the two variables [rs= .202 n= 1133 p <.001] giving a coefficient of determination of 4%

This suggests that students who attended Riverside university were more likely to admire this behaviour

Educational values relationships by programme of study - 1 The relationship between

programme of study and admiration for those who strive hard to get the top marks was investigated

There was a small weak positive statistically significant correlation between the two variables [rs= .133 n= 1133 p <.001] giving a coefficient of determination of 1.7%

This suggests that students who were enrolled on degree programmes were more likely to admire this behaviour

Educational values relationships by programme of study - 2

The relationship between programme of study and agreement with the statement ‘Nursing should be a highly educated profession like Medicine and Law’ was investigated

There was a weak positive statistically significant correlation between the two variables [rs= .104 n= 1133 p <.001] giving a coefficient of determination of 1.0%

This suggests that students who were enrolled on degree programmes were more likely to agree with this stance

Educational values relationships by year of study - 1 The relationship between

year of study and admiration for those who ignore lectures and text-books that are difficult was investigated

There was a weak negative statistically significant correlation between the two variables [rs= -.166 n= 1133 p <.001] giving a coefficient of determination of 2%

This suggests that third year students were less likely to admire this behaviour

Educational values relationships by year of study - 2

The relationship between year of study and the variable ‘little has been gained by educating nurses in a University rather than a Hospital School of Nursing’ was investigated

There was a weak negative statistically significant correlation between the two variables [rs= -.125 n= 1133 p <.001] giving a coefficient of determination of 1.5%

This suggests that third year students were less likely to agree with this statement

MANOVA Multivariate tests for statistical significance

between groups by University Programme of Study Year of study

Used Pillai’s trace as test of statistically significant differences between groups because of differences in sample sizes

Because this used multiple comparisons we applied a Bonferroni adjustment which gave a new probability value of .007

Working hard to do well academicallyDiploma and Degree

4.4

4.6

4.8

5

Diploma Degree Southern (Dip)

year 1year 2year 3

Overall students on both programmes viewed working hard to do well academically less positively by the third year. (Diploma – M 4.78, 4.74,4.70) (Degree – M 4.85, 4.83,4.64)

Southern Diploma held opposite view in year 3 (M – 4.64, 4.60.4.79)

Impact on life long learning

admire

Studying hard to get good marks in tests and exams

4.24.44.64.8

5

Diploma Degree S Dip

year 1year 2year 3

Overall Diploma and Degree students viewed studying hard to get good marks in tests and exams less favourably in the third year.

Exception Southern Diploma students

admire

Between subjects effects For the sub set ‘educational values’

University accounted for 3.6% of variance (p=.001)

Programme of study accounted for 6.1% of variance (p=>.001)

Year of study accounted for 3.2% of variance (p=>.001)

Conclusions There were some variable specific differences

between the student groups There was values congruence across the diploma

groups as there was across the degree groups The biggest difference between the student

groups was accounted for by programme of study.

For some educational values there was no evidence of improvement over time

Many students are leaving nurse education with less intellectual enthusiasm than with which they entered.

Thank you

Carol Haigh c.a.haigh@salford.ac.uk

Natalie Yates-Bolton n.yates-bolton@salford.ac.uk

Martin Johnsonm.johnson2@salford.ac.uk