I want to be a nurse! : A Qualitative Descriptive Study on the Impact of an Introduction to Nursing Course

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1 I want to be a nurse! : A Qualitative Descriptive Study on the Impact of an Introduction to Nursing Course Michelle L. Edmonds PhD, ARNP-BC, CEN Jacksonville University School of Nursing Jacksonville, FL Sigma Theta Tau International Nursing Research

2 Objectives Upon completion of this lecture, the learner will be able to: Verbalize understanding of at least 2 potential benefits for the student completing an Introduction to Nursing course Verbalize understanding of at least 2 potential benefits for the School of Nursing faculty by offering an Introduction to Nursing course

3 Introduction to the Problem Recruitment is not typically a problem for nursing programs but retention of qualified students can be Voluntary withdrawal of students can affect nursing programs earlier than withdrawal due to failure but is often more permanent Students who fail usually have the opportunity to re-enter the program to repeat the course Wait list students often unable to enter the program in a timely manner after a voluntary withdrawal

4 Introduction to the Problem AACN report in 2009 indicated that 41, 385 qualified applicants were turned away from BSN programs Nursing programs have the difficult task of filling the seats with qualified applicants that are committed to nursing as a major and cannot afford to lose students to voluntary or involuntary withdraw if the nursing shortage is to be positively impacted (Sand-Jecklin & Schaeffer, 2006)

5 Purpose of the Study Examine the impact of an Introduction to Nursing course Reported benefits by students having completed this course Reported benefits for nursing programs having offered this course

6 Research Question What is the impact for nursing students who participated in an Introduction to Nursing course?

7 Review of the Literature Students who perceive greater faculty support (caring and mentoring) are more motivated and more likely to progress to graduation (Shelton, 2003) Nursing faculty must relate a realistic picture of the demands of nursing school and the profession during recruitment (Hayes, 2007; Wells, 2007) Schools of nursing have an ethical obligation offer prospective students a realistic job preview that provides insight (Crow, Hartman, McLendon, 2009)

8 Review of the Literature Few studies explore the perception of the nursing profession held by American nursing students (Sand-Jecklin & Schaeffer, 2006) Students who left nursing programs tended to hold a more stereotypical view of nursing (Sand-Jecklin & Schaeffer, 2006) Providing students with information regarding roles, responsibilities, and opportunities in nursing will increase student satisfaction with chosen career leading to student retention and entry into practice (Sand-Jecklin & Schaeffer, 2006)

9 Review of the Literature Turkish students who completed their initial nursing course held a much broader perspective of the nursing role (professional identity) including health promotion and providing care to clients as opposed to their preconceptions of nursing as portrayed in the media (Karaoz, 2004) Nurse educators should facilitate programs to promote professional socialization through engaged learning strategies (Karaoz, 2004)

10 Review of the Literature Jeffreys (2007a and 2007b) First semester nursing students are at high risk of attrition due to underestimating the academic requirements of the program Faculty and peer mentoring can be one way to provide early support to these at-risk students In-class peer friendships were described as greatly supportive for retention among non-traditional nursing students and faculty advisement was moderately supportive Nursing faculty should actively promote and enhance the web of inclusion and mentor students

11 Significance of the Study Not much existing published research on Introduction to Nursing courses for nursing students in an effort to reduce nursing student attrition Not many nursing programs offer this type of course as a pre-nursing elective May be offered by the same title but is really an introductory nursing course offered during the first semester once a student is already accepted to the nursing program

12 The Method Qualitative Descriptive Inductive approach (specific to general) Researcher brackets and obtains IRB approval Data collected from in-depth interviews until saturation occurs Data analyzed by clustering common ideas and reducing to themes Member checks to confirm findings with participants Study findings grounded in the literature

13 Rationale for Qualitative Inquiry Relatively new and poorly understood phenomenon in discipline of nursing Rich source of data collection Suited for human science as it addresses context and a multitude of influences Findings lead to implications for nursing research, education, and practice Rich understanding derived from data

14 Sample Inclusion criteria: English speaking, at least 18 years of age, currently enrolled in a nursing program, participated in an Introduction to Nursing course in either fall 2007 or fall Exclusion criteria: not meeting inclusion criteria and a current student of this researcher

15 Demographic Questionnaire Age Gender Marital Status Ethnicity Current Year in Nursing Education Sophomore or junior Year in which the Intro course was taken Freshman, sophomore, or higher

16 Age of Participants 33% 17% 50% 19yo 20yo 21yo

17 Gender of Participants 17% 83% Male Female

18 Academic Level in Nursing Sophomores Juniors 67% 33%

19 Other Demographics 100% of participants were single (not married) 100% were freshman (by credit hours) at the time they took the Introduction to Nursing course All were Caucasian females except for one male who described his ethnicity as Asian and African-American

20 Introduction to Nursing Course 1-credit elective course for any student considering nursing as a major If student is accepted into nursing program, they receive 1 credit toward 2 credits of elective requirement Only required if accepted to freshman cohort Taught by nursing faculty and listed as a nursing course Offered only in fall semester, beginning 2007 Began as an effort to decrease attrition rather than increase recruitment!

21 Introduction to Nursing Course Met approximately 1 hour each week Topics discussed included: History of nursing and the work of Florence Nightingale Nursing education and various degrees in nursing Nursing burnout Licensure and certification Nursing roles (including informatics) Nursing on the front lines Nursing and faculty shortage

22 Introduction to Nursing Course Assignments completed by students: Paper on a nursing role of their preference Group presentation on one of the assigned topics Written reflection after a 3-hour observation experience in a hospital with a practicing RN Weekly 1-minute papers to summarize thoughts from class and offer questions to the instructor (which are then answered on the discussion board)

23 Semi-Structured Interview Questions Please share with me what it was like for you to engage in an Introduction to Nursing course. What motivated you to take this course? What did you discover about yourself and nursing during the course? Have you applied these discoveries to your current nursing major? Would you recommend this course to future prenursing students? Why or why not? What are your feelings about the nursing profession?

24 Findings Three essential themes: Orienting Connecting Validating

25 Themes: Orienting Becoming familiar with the expectations of nursing school Becoming familiar with the role of the nurse and specifics regarding the nursing profession Passive and active opportunities were offered to promote orienting: Faculty and senior nursing students offered their perspectives Pre-nursing students completed assignments that mimicked those required of actual nursing students

26 Themes: Connecting Establishing social relationships with peers who will become future classmates in the nursing program To a lesser degree, connecting to the nursing faculty and current nursing students Establishing a physical connection with the nursing building and feeling comfortable in the environment

27 Themes: Validating Participants finalized their decision to pursue nursing as a major after thorough appraisal of specifics regarding the nursing program and the nursing profession

28 Framework of Themes Orienting Validating Connecting

29 Implications for Nursing Nursing Education Nursing Practice Nursing Research

30 Limitations of Study Small, homogenous sample Themes well-supported however needs to be validated by further study Qualitative findings not able to be generalized Sample derived from one university in the SE United States Students may have been fellow classmates and were well-known to the researcher

31 Conclusions An Intro to Nursing course can provide an engaged learning opportunity in which students become familiar with the nursing program of study and profession of nursing Participants had the opportunity to validate their decision to pursue nursing as a major after careful appraisal Students reported feeling a close connection to the nursing program/faculty and each other and described an acquired knowledge of what to expect as a nursing major both of which could prevent attrition early in the program

32 References Crow, S., Hartman, S., & McLendon, C. (2009). The realistic job preview as a partial remedy for nursing attrition and shortages: The role of nursing schools. The Journal of Continuing Education in Nursing, 40(7), Hayes, L. (2007). Recruitment strategies for Baccalaureate nursing students in Ontario. Journal of Nursing Education, 46(6), Jeffreys, M. (2007a). Nontraditional students perceptions of variables influencing retention: A multisite study. Nurse Educator, 32 (4), Jeffreys, M. (2007b). Tracking students through program entry, progression, graduation, and licensure: Assessing undergraduate nursing student retention and success. Nurse Education Today, 27,

33 References Karaoz, S. (2004). Change in nursing students perceptions of nursing during their education: The role of the Introduction to Nursing course in this change. Nursing Education Today, 24, Sand-Jecklin, K. & Schaeffer, A. (2006). Nursing students perceptions of their chosen profession. Nursing Education Perspectives, 27(3), Shelton, E. (2003). Faculty support and student retention. Journal of Nursing Education, 42(2), Wells, M. (2007). Dreams deferred but not deterred: A qualitative study on undergraduate nursing student attrition. Journal of College Student Retention, 8(4),

34 Questions and Comments

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