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

1. UK student nurses' education values: a three-centre study Carol Haigh, Senior Lecturer in Research; Natalie Yates-Bolton, Lecturer in Nursing Martin Johnson, Professor in Nursing, School of Nursing, University of Salford, UK

2. 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

3. 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

4. Background Gerard 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’

5. 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

6. Early studies of educational values In 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.

7. 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)

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

9. 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?

10. Sample • 3 universities • Southern, Russell, Riverside • Pre-registration students (n=1133) • Diploma n=835 • Degree n=287 (11 missing responses on this variable)

11. Methods 1 William A Scott General Values Instrument (1959). This is a Likert Scale Instrument measuring general attitudes; Honesty Religiousness Intellectualism Self Control Academic 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)

12. 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)

13. 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)

14. 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

15. Demographics - Gender

16. Demographics - age ranges

17. Students with any NVQ Attainment by Centre 40.00 35.00 35.71 30.00 25.00 28.16 % of cohort 20.00 15.00 17.03 10.00 5.00 0.00 Southern N = 98 Russell N = 417 Riverside N =618 University Educational Demographics - NVQ

18. Proxy measure of educational entry level 9.00 8.00 8.5 7.00 6.8 6.5 6.00 5.00 Mean GCE and GCSE O and A level Per student 4.00 3.00 2.00 1.00 0.00 Southern N = 98 Russell N = 417 Riverside N = 618 Educational Demographics – entry level GSCE,O & A level

19. Percentage degree possession by Centre 8 7.2 7 6 Percentage 4.8 5 3.8 4 3 2 1 0 Southern N = 98 Russell N = 417 Riverside N = 618 University Educational Demographics - degree

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. Working hard to do well academicallyDiploma and Degree admire • 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

28. Studying hard to get good marks in tests and exams admire • 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

29. 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)

30. 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.

31. Thank you • Carol Haigh c.a.haigh@salford.ac.uk • Natalie Yates-Bolton n.yates-bolton@salford.ac.uk • Martin Johnson m.johnson2@salford.ac.uk