Elizabeth Gubler and Dr. Del la Cruz, Karen, Nursing
During the 20th century clinical nursing education underwent a drastic change. It shifted from apprentice training to faculty training, making it the responsibility of the teacher to promote learning in the clinical setting (Tang, Chou, & Chiang, 2005). Faculty have a profound influence on students’ feelings of success or failure in the clinical setting (Davidhizar & McBride, 1985), and have been proven to ‘make or break’ the practical experience (Cahill, 1996).
In a study done at a nursing school in Western Australia, undergraduate nursing students were surveyed, via the use of a questionnaire titled ‘Qualities of Leadership Survey,’ to see which qualities they perceived as being the most important in a effective clinical instructor. The ‘Qualities of Leadership Survey’ was specifically developed for this study, and steps were taken to assure the content validity of the survey (Zilembo & Monterosso, 2008). For my ORCA grant, my instructor and I modified this survey and administered it to nursing students and nursing faculty here at BYU in order to determine which characteristics each group rated as being the most important in an effective clinical instructor. We hypothesized that nursing students would experience higher levels of satisfaction when their clinical instructors demonstrated the characteristics students felt were the most important.
The method we followed to test our hypothesis included three phases. First, we obtained a copy of the ‘Qualities of Leadership Survey,’ used by the Edith Cowan University in their undergraduate nursing program in Australia, and we slightly modified it to include a section for the faculty members. Second, we created an online survey, using Qualtrics, and administered it to all nursing students who were currently participating in clinicals (all nursing students, excluding first semester students), and nursing faculty. The survey ran from mid-October to the beginning of November, and was extended to the end of November in an attempt to gain more responses. The third and final phase of our project included analyzing our results. As mentioned above, we used purposive sampling to obtain our sample size. We included nursing students from second semester up through capstone, and both fulltime and part-time faculty members. All students and faculty members fitting these requirements were sent an email inviting them to participate in the survey. 146 individuals took the survey, with 129 actually completing it. Of those respondents, 122 were students and 23 were faculty members.
Our results showed that the qualities the students rated as being the most desirable were: ‘approachable’ (with a mean score of 4.81 on a 5-point likert scale), ‘effective communication’ (4.77), ‘inspires confidence’ (4.71), ‘supportive’ (4.71), and ‘clinically competent’ (4.71). The faculty rated ‘inspires confidence’ as the most desirable (4.7), with ‘effective communication’ (4.65), ‘supportive’ (4.55), ‘approachable’ (4.55), and ‘consistent’ (4.55) following closely behind. As these initial results demonstrate, while students and faculty share some similar ideas of important leadership qualities, they differ in how they rank these characteristics. This will be important information to share with the nursing faculty to assist them in their efforts to improve the clinical experience. To assess the second part of our hypothesis, we then ran an ordinary least squares (OLS) regression using the stats program R, to see which of these characteristics, when demonstrated by the clinical instructors, predicted student satisfaction. To measure student satisfaction, students were asked to, “rate the overall quality of the clinical experience in the BYU nursing program,” on a scale of 1 to 5 (1= poor, 5= excellent). We controlled for age, sex, and semester.
Our results suggest that, of all of the characteristics possessed by clinical instructors, only three were statistically significant predictors of student satisfaction with their nursing clinical experience. Those three characteristics were: ‘supportive’ (beta = 0.396, p < 0.025), ‘motivating’ (beta = 0.311, p < 0.023), and ‘empowering’ (beta = 0.317, p < 0.011). Interestingly, those characteristics deemed most important by nursing faculty members were not statistically significant predictors of student satisfaction. Rather, these three characteristics seem most important to students. This suggests that perhaps more emphasis should be placed on these three characteristics, than on the others.
While these results are important and instructive, certain limitations apply due to the relatively small size of our sample pool. Although the survey was sent to all eligible students and faculty members, only roughly 50% of each group responded. These results will need to be verified with a more inclusive sample in the future. Even so, these results will provide valuable information to the nursing faculty in their quest to better the clinical nursing experience. We plan to present our findings to the faculty winter semester 2012. With the help of nursing faculty at the University of Colorado, we also plan to administer our survey there. Once our research is complete we plan to publish these results in an appropriate journal, such as the Nurse Educator Journal.
References
- Cahill, H. A., (1996). A qualitative analysis of student nurses’ experiences of mentorship. Journal of Advanced Nursing, 24(4), 791–799.
- Davidhizar, R. E., & McBride. A. (1985). How nursing students explain their success and failure in clinical experiences. Journal of Nursing Education, 24. 284-290.
- Tang, F., Chou, S., & Chiang, H. (2005). Students’ perceptions of effective and ineffective clinical instructors. Journal of Nursing Education, 44(4), 187.
- Zilembo, M. & Monterosso, L. (2008). Nursing students’ perceptions of desirable leadership qualities in nurse preceptors: A descriptive study. Contemporary Nurse 27(2), 194-206.