An investigation of nursing student self-concept levels: a pilot survey

Exploring the relationship between first-year nursing student self-esteem and dropout: A cohort study

AIM

To describe nursing student self-esteem prior to the influence of nursing education and to explore the relationship between self-esteem and dropout.

DESIGN

Cohort study.

METHODS

At the beginning of their first year of study, in October 2017, 464 nursing students completed a questionnaire that assessed their self-esteem level via Tafarodi & Swann Scale and self-esteem profile following Mruk's model, along with sociodemographic information, state anxiety, self-efficacy, intention to continue and social support. One year later, data on grades and re-enrolment were collected. Multivariate analyses explored the factors influencing self-esteem level (multiple regression), self-esteem profile (multinomial logistic regression) and dropout (binary logistic regression).

RESULTS/FINDINGS

The mean level of self-esteem was 50.8 (9.0), scale of 16 to 80. Forty-nine per cent of self-esteem profiles were classified as 'high', 20.1% as 'defensive acceptance based', 11.2% as 'defensive achievement based' and 19.6% as 'low'. State anxiety (p < 0.0001), self-efficacy about completion of the nursing programme (p < 0.0001) and self-efficacy about internship (p < 0.0001) were associated with self-esteem. The dropout rate was 21.5%. Self-esteem level (p = 0.039) and academic performance (p < 0.0001) were associated with dropout.

CONCLUSION

While nursing student self-esteem is often described as low, we know little about its baseline before entering the nursing programme and the factors that influence it. The dropout rate among first-year nursing students is high, but self-esteem is rarely explored as a possible explanation. We found that students had medium, and potentially fragile, self-esteem when starting their nursing education, and that self-esteem was associated with dropout.

IMPACT

Given that association and the impact of self-esteem on well-being and professional behaviour, educational institutions should foster self-esteem both generally and in students with anxiety or low self-efficacy. Future research should explore nursing student self-esteem using a longitudinal mixed methods approach. Society should value nurses and nursing students.

Self-esteem and student nurses: a cross-cultural study of nursing students in Thailand and the UK

Self-esteem is a key feature in a person's perception of their own worth. This report is of a study of the reported self-esteem levels of two groups of student nurses: one in Thailand and one in the UK. Purposive samples of 120 Thai students and 101 UK undergraduate nursing students were given the Culture-Free Self-Esteem Inventory (CFSEI-2). The CFSEI-2 is a self-reported inventory, which measures an individual's perception of self. The findings of the study indicate that the perceptions of own self-esteem in undergraduate student nurses in the UK and in Thailand were comparable to the normal ranges of self-esteem as assessed by the instrument. An independent sample t-test revealed that there were no significant differences in mean overall and subscale self-esteem scores between UK and Thai nursing students. There were no indications of differences in levels of self-esteem for UK and Thai nursing students experiencing different parts of their training.

Professional self-concept of nurses: a comparative study of four strata of nursing students in a Canadian university

This study represents an effort to refine our understanding of measurement of professional self-concept by testing a tool across various strata of nursing students. The Professional Self Concept of Nurses Instrument, developed in studies of Australian nursing students, was applied to samples of basic undergraduate, post-basic and graduate students in a Canadian university nursing programme. The findings suggest that the tool is sensitive to the predictable development of professional self-concept as students advance through professional education, especially in the dimensions of professional practice and satisfaction. The authors propose that the instrument may have specific applications in evaluating the effects of traditional and innovative educational strategies upon the evolution of professional self-concept in nurses.

Measurement of the professional self-concept of nurses: developing a measurement instrument

The professional self-concept of nurses is an important component in the professional and academic development of the nursing profession. Few studies have concentrated on the careful development of the construct of professional self-concept in nurses, using a nursing sample, and particularly an Australian sample. This study focuses on a pilot group of nurses from the Hunter Region of New South Wales to develop the multi-dimensional construct professional self concept of nurses. A 56 item instrument using Likert scales was developed to measure the constructs flexibility/creativity, knowledge, skill/competence, caring, communication, leadership and satisfaction. The instrument was administered to 170 third year students enrolled in a Diploma of Applied Science (Nursing) and the results subjected to item analysis, factor analytical studies, and reliability estimates. Three factors emerged which accounted for 40% of the variance in responses constituting the professional self-concept of nurses: 'professional practice' (incorporating the dimensions leadership, skill and flexibility), 'satisfaction', and 'communication'. The study contains suggestions for the further use and research implications for a 27 item instrument for measuring the professional self-concept of nurses which has demonstrated validity and reliability.

Factors Associated With Perceived Competency Levels of Graduating Seniors in a Baccalaureate Nursing Program

Factors hypothesized to affect perceived competency levels of graduating seniors were examined in three classes from a BSN program in a large southeastern university (N = 204). Although externship participation was unrelated to perceived competency, employment in a health care setting during the nursing program was positively related. Trait anxiety and social support were also significantly related to competency. A pervasive theme in both quantitative and qualitative data was students' desire for more practice of technical skills. Students also expressed the desire for more positive feedback from faculty. There are a number of implications of these findings, including curricular modifications, identification and intervention with highly anxious students, and increased faculty caring and support. Given the rigor of the professional nursing role, we owe it to our graduates to send them into the work arena with a healthy sense of self-confidence.

The "real world" of hospital nursing practice as perceived by nursing undergraduates

The purpose of this study was to examine the expectations of senior nursing undergraduates in the "real world" of hospital nursing practice, with particular regard to the ethical dimensions of their role. The method was qualitative; specifically, a grounded theory approach was used. The sample consisted of 23 senior baccalaureate nursing students, from a possible population of 120, who were in their final clinical rotation before graduation. Informants were volunteers who gave informed consent, having been briefed on the purposes of the study and how their confidentiality would be protected. Data were collected through audiotaped interviews and clinical logs and analyzed through the constant comparative method. The study concluded that (1) senior nursing students were not naive about the reality of practice; (2) most perceived themselves as fairly powerless; (3) they voiced a commitment to the ethical principle of respect for the client as evidenced by listening, providing information, accepting values, and encouraging a climate for self-determination; (4) they experienced guilt when they did not "say something"; and (5) they expressed disappointment that nurses did not "stand up" for patients.

Measuring the professional self-concept of nurses: a critical review

Nursing literature strongly suggests that the self-concept of nurses is an important concept for academics, administrators and clinicians to consider in the development of the profession. Many valuable research projects have added to the data base on the subject, yet there still remain some questions to be answered. This paper explores the notion of self-concept as it relates to the professional working in nursing. In particular, the paper examines nursing research relating to the professional self-concept of nursing, arguing that the 'professional' self-concept of nurses is unique and different from that of the self-concept (while inextricably linked); and that there is room for a new instrument which measures the dimensions of the professional self-concept of nurses. Suggestions for future research include replication and further validation and reliability studies of a new instrument; a cross-cultural study using samples from different countries; testing with various samples from different branches of nursing and further exploring the differences between self-concept and professional self-concept.

The Liberating Effects of RN-to-BSN Education

This study investigated whether postlicensure baccalaureate education was associated with decreased acceptance of oppressed status for nursing and the self, with behavioral changes in job performance, and in joining a professional organization. Selected writings of Freire (1970a, 1970b, 1973) concerning education of the oppressed were used to form the conceptual framework. Baccalaureate education was conceptualized as a means of overcoming oppression-related behaviors and attitudes in nurses. The criterion measures were self-reports of job performance, joining the American Nurses Association (ANA), self-concept measurements, and perception of nursing measured by a semantic differential. Except for self-concept, which remained unchanged, all the findings were in the predicted direction supporting the conceptual framework.

The Professional Self-Concepts of Nursing Undergraduates and Their Perceptions of Influential Forces

This article explores the professional self-concepts of senior nursing undergraduates and their perceptions of the most significant forces that influenced the process. The method was qualitative; a grounded theory approach was used. The sample included 23 senior baccalaureate nursing students in their final clinical rotation prior to graduation. Audiotaped interviews were analyzed through the constant comparative method. Informants overwhelmingly perceived themselves as caring. They valued professional competence and many identified a lack of confidence in their skills. Caring qualities, caring role models, and qualities of the role models are listed.

Potential Outcomes of Clinical Experience

This exploratory study examined potential outcomes of clinical experience. Sixteen baccalaureate nursing students completed data collection instruments. The eight students in the control group completed the clinical course as prescribed in the curriculum; the eight students in the experimental group received no assigned clinical experience. The first hypothesis, that there would be an increase in the identification of accurate clinical nursing judgments as a result of clinical experience, was not supported. The second hypothesis, that there would be progress in the development of professional identity as a result of clinical experience, was not supported. Analysis of demographic and secondary data supports a conclusion that the learning outcomes of clinical experience have yet to be identified.

The Effects of a Synthesis of Nursing Practice Course on Senior Nursing Students' Self-Concept and Role Perception

This study investigated the effects of a Synthesis of Nursing Practice course on senior nursing students' self-concept and perception of role competencies. Seventy senior baccalaureate nursing students enrolled in the Synthesis of Nursing Practice course participated in the study during their last semester in the program. The Tennessee Self-Concept Scale was used to measure self-concept and the Slater Nursing Competencies Rating Scale was used to measure perception of role competencies. These instruments were administered at the beginning of the Synthesis of Nursing Practice course and immediately following completion of the course. A t-test was used to assess the differences between pre- and posttest group means. The study findings indicated a significant increase in the students' self-concept (p = .10) and perceived role competencies (p = .001). Implications of the findings for nursing education are discussed.

The learner-centredness of two registered general nursing and two registered mental nursing courses as perceived by third-year nursing students

Using the conceptual framework of the Nottingham Andragogy Group, two first-level British courses in general nursing and two in psychiatric nursing were studied to investigate their degree of perceived learner-centredness. Boydell's Scale for Measuring the Learner-Centredness of a Course was administered to a non-random sample of all 172 third-year students at three schools of nursing. Preference for learner-centred nursing education was investigated using Boydell's Preferred Teaching Style Rating Scale with the student sample and by 31 nurse teachers. Results indicated that first-level nursing courses were perceived to be highly teacher-centred in terms of planning, direction, sequence, pace and evaluation of learning. The climate of learning proved to be moderately learner-centred though teacher-student relationships were perceived as formal. Variety of learning approach was seen as limited with a tendency towards positivism rather than relativism of knowledge. Both students and teachers of nursing expressed a slight preference for teacher-centred courses despite the former's dissatisfaction with lack of participation in determining learning objectives. Significantly greater perceived learner-centredness of a psychiatric course was attributed to variations in the philosophy of learning within a particular school rather than to the course per se.

The Effects of an Undergraduate Clinical Internship on the Self-Concept and Professional Role Mastery of Baccalaureate Nursing Students

PURPOSE

The Purpose of this investigation was to determine whether an eight-week undergraduate clinical courses would enhance students' self-concepts and increase their perception of competence in critical care, teaching/collaboration, planning/evaluation, professional development, leadership and interpersonal skills, and communication.

RESEARCH QUESTIONS

Is there a need for an undergraduate clinical internship? Will there be a difference in self-concept and perception of role mastery between the group of students who participated in the internship and those who did not participate?

METHODOLOGY

Nursing students at the University who were between their junior and senior years were offered the opportunity to enroll in the course (didactic and clinical). Eight interns enrolled in the course; five non-interns enrolled in the didactic portion only; and the remaining 36 classmates were designated as the control group.

DESIGN

A pretest-post test designed was utilized. Two instruments were used: 1) The Tennessee Self-Concept Scale and 2) The Six-Dimensional Scale of Nursing Performance.

RESULTS

One way ANOVA with .05 level of significance was used as the statistical test. There were no significant differences noted.