What do high academic achieving school pupils really think about a career in nursing: analysis of the narrative from paradigmatic case interviews

Contemporary public image of the nursing profession in Saudi Arabia

Background

In the Kingdom of Saudi Arabia, the nursing profession faces significant challenges including; failure to recruit high school students into nursing education, poor nursing identity, and lack of awareness about the nursing profession. The level of community awareness and public image of the nursing profession are critical to recruit and retain students into nursing education, and to improve nurses’ sense of identity.

Aim

To explore the level of community awareness and public image of the nursing profession in Saudi Arabia.

Methods

We conducted a cross-sectional study with a convenient sample of 502 adults including106 males and 396 females, their mean age was 22.93 ± 6.76 years. Data collected included; socio-cultural data, gender preference in getting nursing care, awareness, and perceived socio-cultural barriers to pursue a nursing career. Data were analyzed using SPSS version 21.0.

Results

Only 32.5% preferred to get nursing care by Saudis. The nursing profession was not viewed as a respected job as 71.5% of participants would be ashamed of having a nurse in their families. The study revealed a low median knowledge score (50.0, IQR: 50.0–66.7)). The study highlighted a number of socio-cultural barriers to pursue a nursing career including; the gender-mixed working environment (35.9%), delayed marriage of female nurses (20.3%), and the negative effect of nursing profession on social life (64.5%).

Conclusions

Half of the sample had a knowledge score below 50.0 out of 100. This level of poor awareness, in addition to socio-cultural perceived barriers are the main factors contributing to the negative public image of the nursing profession in Saudi Arabia. Understanding these factors could contribute to implementing focused intervention to improve the negative stereotype of the nursing profession among Saudis.

Does student orientation improve nursing image and positively influence the enrolment of nursing students in the University? An observational study

BACKGROUND AND AIM OF THE STUDY

Nursing has not yet received full social recognition and in general the public opinion does not have a completely positive perception of it, which regards it as an auxiliary profession to the medical profession. This study aims to investigate the image of the nurse among year 4 and 5 high school students.

METHODS

Two groups of students were interviewed, one at their institution without any previous orientation (n = 102) and one at the University of Bologna during orientation day (n = 388). A validated questionnaire (Nursing Attitude Questionnaire) of 30 items was delivered. Two additional questions were added to explore the possibility of advising relatives and acquaintances to become a nurse and therefore to choose the nursing degree course.

RESULTS

All areas of the NAQ scored significantly higher in the group where students attended the orientation day, especially the ones related to the professional role, stereotypes and professional value items. Female students ≥ 21 had a more positive image of the nurse. Both groups recognized that nurses are important figures for patients and that they are intelligent people, who must have a degree in order to carry out their work duties. Differences between the groups were recorded. Students in group 1 did not accept nursing autonomy while students in group 2 understood differences between nursing and medical careers, attributing to them the same value. A positive correlation between the positive image of the nursing profession and the interest in becoming nurses or advising others to undertake the nursing course was found. In conclusion, orientation is effective in helping high school students in the choice of their university courses. Regarding nursing, strategies to improve the image of the nurse and enrollment should be combined during orientation day with current up to date communication and learning tools, such as social media and simulation laboratories. Furthermore, it appears increasingly important to extend orientation and tutoring activities to junior high school students, families and teachers.

Peer support systems and professional identity of student nurses undertaking a UK learning disability nursing programme

This practitioner based action research examines the implementation of the peer assisted study scheme (PASS) and individual peer mentoring in a cohort of first year undergraduate nursing students. It arose out of the desire of a small number of students in one UK university to transfer from the learning (intellectual) disabilities nursing field to other fields. The number of learning disabilities nurses is falling in England, and nursing shortages and student nurse retention generally is an international concern. The peer support was evaluated by 21 completed questionnaires. All the students had found the sessions they attended useful. Four themes emerged from the study. Students reported gains in knowledge around academic skills, placements and their chosen field of nursing; students felt more confident as a result of attending the sessions; students felt supported, and the importance of the peer mentor's interpersonal skills was highlighted; and finally students had valued meeting other students in their chosen field. These findings are discussed with reference to relevant literature.

Young peoples' perceptions of the nursing profession: An integrative review

OBJECTIVES

The purpose of this integrative review was to describe young people's perceptions of the nursing profession and to identify factors influencing the perception.

DESIGN

Integrative literature review.

DATA SOURCES

The CINAHL, PubMed and Medic electronic databases were searched for research publications between 2006 and 2016. The keywords used were: perception, attitude, belief, view, knowledge, image, nurse, nursing care, career, profession, role, teen, middle school student, high school student, adolescent and pupil. A manual search was conducted of the reference lists of the identified articles.

REVIEW METHODS

Whittemore and Knafl's method for conducting an integrative review was utilized. The quality of the chosen articles was assessed with Joanna Briggs Institute's quality appraisal tools.

FINDINGS

The search resulted in eight articles. Young people described the nature of nursing work with poor working conditions, shift work and a limited level of autonomy. Nursing work was mainly seen as caring for and helping patients which was considered inferior to doctors' work. Young people did not recognize the educational requirements or the career pathways in nursing and described the status of nursing as low in society. Nurses were considered as kind and caring people who work hard and are less intellectual. The factors influencing the perception were family and relatives, friends, media, significant others and personal factors.

CONCLUSIONS

Perceptions of young people do not reflect the reality of the nursing profession and the perceived image of nursing has not changed in the last ten years. Young people and the public need realistic information of the nursing profession and the actions to change the image should take place at all levels of the society. Further research is needed to understand how the perceptions of the young people can be influenced and changed to reflect a more realistic image of a contemporary nurse.

Career choice and perceptions of nursing among healthcare students in higher educational institutions

BACKGROUND

Due to the ageing population and competition from other healthcare courses, a greater demand in the healthcare workforce has made it challenging for educational institutions to attract school leavers to enter nursing courses. Understanding the considerations of students who have chosen non-nursing healthcare courses and their perceptions of nursing can help identify specific strategies to enhance the attractiveness of nursing course. This study aims to examine the differences between healthcare career choices and perceptions of nursing as a career choice among first-year non-nursing healthcare students.

METHOD

A descriptive survey design was conducted at the beginning of the healthcare courses of seven healthcare groups and from four higher educational institutions in Singapore. A total of 451 students responded, yielding an overall response rate of 52.7%. The online survey was administered using a valid and reliable 35-item parallel scale, known as the Healthcare Career Choice and Nursing Career Choice.

RESULTS

The participants perceived prior healthcare exposure as the most influential factor and self-efficacy as the least influential factor when choosing nursing as a career. In comparison to their own healthcare career choices, nursing was perceived to have greater gender stigma and, as nurses, they would be less likely to achieve higher qualifications and career advancements, and they would be less likely to enjoy fulfilling careers. They also perceived that they would be less likely to gain their parents' support to pursue nursing and to make their parents proud.

CONCLUSIONS

This study provides educators and policy-makers with vital information to develop key strategies to improve nursing enrolment in educational institutions. These strategies include early exposure to nursing as a rewarding career during school years, addressing the issue of gender stigma, and promoting information on the career and educational advancement of a registered nurse to parents of school leavers.

Development and psychometric testing of an instrument to compare career choice influences and perceptions of nursing among healthcare students

BACKGROUND

With the availability of more healthcare courses and an increased intake of nursing students, education institutions are facing challenges to attract school leavers to enter nursing courses. The comparison of career choice influences and perception of nursing among healthcare students can provide information for recruitment strategies. An instrument to compare the influences of healthcare career choice is lacking. The purpose of this study is to develop and evaluate the psychometric properties of an instrument to compare the influences of healthcare career choice with perceptions of nursing as a career choice.

METHODS

The study was conducted in two phases. In phase one, two sets of scales with parallel items that measure the influences of healthcare career choice and perceptions of nursing as a career choice were developed through an earlier qualitative study, literature review, and expert validation. Phase two involved testing the construct validity, concurrent validity and reliability with a convenience sample of 283 first year healthcare students who were recruited at two education institutions in Singapore.

RESULTS

An exploratory factor analysis revealed 35-parallel items in a six-factor solution (personal interest, prior healthcare exposure, self-efficacy, perceived nature of work, job prospects, and social influences) that explained 59 and 64% of the variance for healthcare career choice and nursing as a career choice respectively. A high correlation (r = 0.76, p < 0.001) was obtained with an existing tool, confirming the concurrent validity. The internal consistency was sufficient with Cronbach's alpha of 0.93 for healthcare career choice and 0.94 for nursing as a career choice. The test-retest reliability was acceptable with an Intraclass Correlation Coefficient of 0.63 for healthcare career choice and 0.60 for nursing as a career choice.

CONCLUSIONS

The instrument provides opportunities for understanding the differences between influences of healthcare career choice and perceptions of nursing as a career choice. This comparative understanding of career choice influences can guide educator and policy-makers on nursing recruitment.

Graduate entry nurses' initial perspectives on nursing: Content analysis of open-ended survey questions

BACKGROUND

Graduate entry nursing courses offer individuals with prior degrees the opportunity to gain nursing qualifications and facilitate career change. While it is known that accelerated graduate entry courses are increasingly popular, the perceptions of nursing held by such individuals and the influence this has on those seeking to enter the profession are less clearly understood.

OBJECTIVE

To explore graduate entry nursing students' perceptions of nursing on entering their pre-registration course.

DESIGN

A descriptive design utilising cross-section survey with two open-ended questions: What do you believe the role of the nurse is? What things have influenced that view? were asked. Demographic data were analysed using descriptive frequencies, while the two open-ended questions were analysed using summative content analysis.

SETTING

One university-based postgraduate graduate entry nursing course in Australia PARTICIPANTS: Eight cohorts (n=286) commencing students with prior degrees other than nursing.

RESULTS

The course attracts students from diverse backgrounds. Exposure to nursing and nurses, either as a consumer of health care or other health care role, plays a primary role in influencing career change. However, similar to those found with school leavers, there remains much misinformation about nurses' roles for students in these courses. Most identify the role of caring in nursing. For some, media representations are the only information sources.

DISCUSSION

Graduate entry courses offer opportunities to attract new nurses and contribute to addressing workforce shortages. However, there is still a lack of knowledge of nursing roles among students on entry. More work is required by the profession to ensure nursing is accurately and positively represented to the community.

Why not nursing? A systematic review of factors influencing career choice among healthcare students

BACKGROUND

A global shortage of healthcare professionals calls for effective recruitment and retention strategies. The nursing profession faces greater staffing shortages compared with other healthcare professions. Identifying these factors for choosing a career in health care is an important step in structuring future nursing recruitment strategies.

AIM

This systematic review examined the motivations for choosing a career in health care, then compared them to factors that influence the choice to pursue a career in nursing.

METHODS

A literature search of the CINAHL, PubMed, Web of Science and Scopus databases for articles published between 2002 and 2013 was conducted. The search included studies that focused on factors influencing career choice among undergraduate medicine, dentistry, pharmacy and nursing students.

RESULTS

A total of 29 papers were included in the review. The themes and subthemes that emerged from this review included: (1) intrinsic factors, including a desire to help others and a personal interest in health care, (2) extrinsic factors, such as financial remuneration, job security, professional prestige and job autonomy, (3) socio-demographic factors such as gender and socio-economic status, and (4) interpersonal factors, encompassing the influence of family and other professional individuals.

DISCUSSION

Healthcare professionals were generally motivated by intrinsic factors. However, public perceptions of nursing as a low-paying and low-status job have significantly hindered the participants' choice to pursue it as a career.

CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Nursing institutions could provide more platforms to help school leavers better understand the nursing career. In turn, hospital administrators could invite parents to nursing career fairs, increase financial remuneration for nurses, and provide decision-making avenues aimed at recruiting and retaining more nurses.

The reasons students choose to undertake a nursing degree

BACKGROUND

Determining the reasons people choose to study nursing may help educators and managers develop student-focussed and enticing nursing programmes. In Australia, little research has been undertaken with students entering nursing programmes and the reasons for their choice.

OBJECTIVES

The aim of this study was to determine why new students choose to enter nursing at university.

DESIGN

A descriptive survey design.

SETTING

An urban university in Sydney, Australia.

PARTICIPANTS

Undergraduate nursing students at the beginning of their first year of study.

METHOD

An open-ended question relating to the reasons for students' choice of a nursing programme was included in the survey. The transcribed textual data were content analysed for words related to the students' choice.

RESULTS

The students' reasons for entering nursing programmes were both personal and career related, with personal being more dominant. The reasons to start nursing were: being able to help and care for people, job security, the ability to enter tertiary education and the enjoyment or love of nursing.

CONCLUSIONS

Nursing remains a career of choice for young and mature students entering university. It is seen to provide security, interest and opportunity to help and care for others. Universities must focus on this as they develop programmes for a generation where multiple changes of career appear inevitable during their lifetime. The nursing profession needs to look at career pathways after graduation that provide these challenges within nursing itself.

Using appreciative inquiry to transform student nurses' image of nursing

INTRODUCTION

Literature provides adequate evidence of a poor perception of nursing within the profession, resulting in high rates of attrition of student nurses and newly qualified nurses. The nursing profession, in particular nurse educators, has an ethical and professional responsibility to find innovative strategies to promote the positive image of nursing amongst student nurses.

PURPOSE

The purpose of the study was to explore the potential of appreciative inquiry (AI) as an intervention teaching strategy to transform student nurses' image of nursing.

DESIGN

A quantitative, quasi-experimental, explorative-descriptive design comprising the pretest, appreciative inquiry as intervention, and the post-test was used.

METHODS

Convenience sampling was used to select third and fourth year college and university student nurses in the Gauteng province of South Africa for the pre- and the post-test respectively. Data were collected by means of a questionnaire and analysed by SPSS version 20.0.

FINDINGS

The pretest results revealed a mix of positive and negative perceptions of the image of nursing amongst student nurses. The negative perceptions of the image of nursing that needed intervention included the working conditions of nurses, and the perception of nursing as a profession that was not respected and appreciated. The post-test results showed a significant and positive change in the student nurses' perception of the image of nursing as a respected and appreciated profession. Although AI resulted in a negative to positive change in some aspects of student nurses' image of nursing, the negative perceptions of the working conditions of nurses remained and became more negative. The positive image of gender in nursing was enhanced following the implementation of AI.

CONCLUSION

Appreciative inquiry demonstrated potential as a teaching strategy to produce a positive nursing image change and positive orientation towards nursing amongst student nurses.

Merely a stepping stone? Professional identity and career prospects following postgraduate mental health nurse training

Accelerated mental health nurse training attracts talented graduates, many with a psychology degree. Our study shows that such trainees feel incompatible with the nursing culture. Consequently, professional identification is inhibited, and on qualifying these nurses may choose to develop their careers elsewhere. Nurse educators and mentors should pay greater attention to nurturing a positive professional identity in trainees. Alongside their attainment of knowledge and skills, nursing trainees are moulded by a professional culture and inculcated to norms of beliefs and behaviour. The process of professional identification may be inhibited by accelerated nurse training and an influx of psychology graduates potentially using mental health nursing qualification as a springboard to other career opportunities. This study explored facilitators and barriers to professional identification in newly qualified nurses of accelerated postgraduate training. Qualitative interviews were conducted with 10 nurses who had recently completed a postgraduate diploma in mental health nursing at King's College London. Participants identified more with the mental health field than with the broader profession of nursing. They defined their practice in terms of values rather than skills and found difficulty in articulating a distinct role for mental health nursing. Although participants had found experience in training and as a registered practitioner rewarding, they were concerned that nursing may not fulfil their aspirations. Professional identity is likely to be a major factor in satisfaction and retention of nurses. Training and continuing professional development should promote career advancement within clinical nursing practice.

Perioperative nurses' experiences as students: the perceived status of being at university

Literature relating to student experience during post-registration education is limited, and focuses on the outcome of the education rather than on the perspectives of the practitioner about what it is like to be a student. This paper illustrates perceptions of 23 perioperative nurses (the participants) with respect to their experiences as students during continuing professional education. Interviews indicated that, whilst study could be stressful, all the nurses enjoyed their educational experiences. Possession of a university student identification card was perceived as symbolic of raised social status.

Measuring the qualities of nurses: development and testing of the Qualities of Nurses Scale

AIM

This paper reports on the creation, development and testing of a new instrument to measure qualities of nurses, known as the Qualities of Nurses (QON) scale, applicable to student nurses.

BACKGROUND

High attrition rates within nursing programs and during early postgraduate years are an international phenomena. Mismatches between idealized perceptions of nursing and the realities of education and clinical experiences have been identified as contributing factors.

METHOD

A survey method was used to elicit responses to scale items from 678 first-year nursing students at a large university.

RESULTS

A one-factor 12-item solution explaining 47 percent of variance in the construct was demonstrated.

CONCLUSION

The QON can assist in the initial assessment and ongoing monitoring of changes in students' perceptions of nurses. Using the QON, researchers and educators can identify initial student nurses' perceptions and any changes associated in educational or other events that ultimately could be manipulated to reduce attrition.

The negative influence of significant others on high academic achieving school pupils' choice of nursing as a career

The International Council of Nurses proposes that the shortage of nurses is global in scale and is expected to become much worse in the years ahead. A major factor impacting on the worldwide nursing shortage is the diminishing number of young people choosing nursing as a career (International Council of Nurses, 2008). One important dimension of the school pupils' career choice process is their interactions with significant others and the influence of these significant others (Hodkinson and Sparkes, 1997). As Schools/Departments of Nursing endeavour to attract more intellectual school leavers it is important to examine what advice and opinions are significant others giving regarding nursing as a career choice and how influential is this advice. This paper is based on interview data from 20 high academic achieving 5th and 6th year school pupils in Scotland, paradigmatic cases from a larger sample, who had considered nursing as a possible career choice within their career preference cluster, but then later disregarded nursing and decided to pursue medicine or another health care profession. The data was particularly striking in revealing the negative influence of significant others on high academic achieving school pupils' choice of nursing as a career. The influence of significant others, these being specifically parents, guardians, guidance teachers and career advisors was very apparent in the data in that they had a very negative view regarding nursing as a career choice for high academic achieving school pupils.

What predicts the selection of nursing as a career choice in 5th and 6th year school students?

Demand for nursing care, and nurses, is growing in the United Kingdom given an increasingly ageing patient population with long-term co-morbidities. An ageing nursing workforce and fewer school leavers entering nursing are key barriers to student nurse recruitment. This paper aims to identify the socio-demographic and correlates nursing as a career choice in 5th and 6th year school students. This cross-sectional descriptive study gathered self-administered questionnaires from a total cohort of 5th and 6th year school students (n=1059) in one educational authority in Scotland. A response rate of 100% was achieved, with 702 students expressing a career choice. Some 71.7% (n=503) of students providing a full data set would never consider nursing, even if they obtained poor grades. Only 28.3% (n=199) would ever consider nursing. Students cited nursing as a career choice if they were female, of average to below average academic ability/achievement, expressed a positive attitude to nursing as a degree subject which was shared by their career guidance teacher. Each additional higher reduced the likelihood of nursing as a career choice by 22%. Nursing is an unpopular career choice amongst school students. Strategies are required to improve the occupational image of nursing in secondary education.

Differences between African-American and Caucasian students on enrollment influences and barriers in kinesiology-based allied health education programs

Kinesiology departments have recently started to offer allied health education programs to attract additional students to teacher education units (9). Although allied health professions offer increased work opportunities, insufficient enrollment and training of minority students in these academic fields contribute to underrepresentation in the workforce (3). To improve workforce diversity, kinesiology departments must understand how enrollment influences and barriers differ by race among prospective students. Therefore, the purpose of this study was to identify differences in allied health education enrollment influences and enrollment barriers between minority and Caucasian students. Participants (n = 601) consisted of students enrolled in kinesiology-based allied health education programs. Multivariate ANOVA was used to compare group differences in enrollment decision making. "Personal influence," "career opportunity," and "physical self-efficacy" were all significantly stronger enrollment influences among African-American students than among Caucasian students, and "social influence," "experiential opportunity," "academic preparation," and "physical self-efficacy" were all perceived as significantly greater barriers compared with Caucasian students. Findings support the need to recruit African-American students through sport and physical education settings and to market program-based experiential opportunities.

The case for graduate entry to the United Kingdom nursing register

AIM

The recent decision of the United Kingdom Nursing and Midwifery Council to make nursing a degree profession is contentious and has generated debate among nurses and other stakeholders. We argue why nurses need a degree to nurse and what the implications of making a degree in nursing obligatory at the point of registration will be.

BACKGROUND

Nurses work at the forefront of any healthcare system. The complexity of their role and demands on them are increasing. To fulfil demands and expectations of employers, the public and the profession, and to be able to work collaboratively with other healthcare professions, nurses need critical thinking, problem-solving and decision-making skills, which can help them to work as independent practitioners. We argue that this can only be assured if the level of education for nurses is raised from diploma to degree, making this a prerequisite for registration as a nurse.

CONCLUSIONS

The increasingly complex role of nurses, the changing landscape of the healthcare needs and a need to improve the image and status of nursing as a profession to make it an attractive career choice are some of the important reasons that justify nursing in becoming a degree-only profession.

Who enters nursing schools and why do they choose nursing? A comparison with female non-nursing students using longitudinal data

Understanding who enters nursing schools and why they choose nursing is essential for the nursing profession to recruit and retain their successors. This study was conducted to examine the characteristics of nursing students and factors influencing their career decision, as compared with non-nursing students. We used public databases of the Korean Education & Employment Panel that followed 4000 high school students in their final year of school. Out of those students, 2456 students entered a college or university and 40 students (39 females and one male) entered a nursing school. Nursing students were compared with 1011 female non-nursing students. Nursing students had lower household income. Nursing students had better high school academic achievement overall and in science. A more studious attitude and lower absenteeism were found among nursing students. For nursing students, employability (55%) followed by aptitude (20%) were the most influential factors in choosing a nursing major, while conversely, aptitude (48%) followed by employability (23%) were most important to non-nursing students. About half of nursing students answered "herself/himself" as the most influential person in choosing nursing, whereas three quarters of non-nursing students did. Nursing students had a higher rate (75%) of satisfaction with their major than non-nursing students (60%).

Not choosing nursing: work experience and career choice of high academic achieving school leavers

Work experience has been a feature of the secondary school curriculum in the United Kingdom for a number of years. Usually requested by the pupil, it aims to provide opportunities for school pupils to enhance their knowledge and understanding of an occupation. The main benefits are claimed to be that it can help pupils develop an insight into the skills and attitudes required for an occupation and an awareness of career opportunities. However the quality and choice of placements are considered to be of great importance in this process and in influencing career choice [Department for Education and Skills (DfES), 2002a. Work Experience: A Guide for Employers. Department for Education and Skills, London]. As university departments of nursing experience a decline in the number of school pupils entering student nurse education programmes, and with the competition for school leavers becoming even greater, it is important to consider whether school pupils have access to appropriate work placements in nursing and what influence their experience has on pursuing nursing as a career choice. This paper is based on interview data from 20 high academic achieving fifth and sixth year school pupils in Scotland, paradigmatic cases from a larger survey sample (n=1062), who had considered nursing as a possible career choice within their career preference cluster, but then later disregarded nursing and decided to pursue medicine or another health care profession. This was partly reported by Neilson and Lauder [Neilson, G.R., Lauder, W., 2008. What do high academic achieving school pupils really think about a career in nursing: analysis of the narrative from paradigmatic case interviews. Nurse Education Today 28(6), 680-690] which examined what high academic achieving school pupils really thought about a career in nursing. However, the data was particularly striking in revealing the poor quality of nursing work experience for the pupils, and also their proposal that there was a need for work experience which was more representative of the reality of nursing. Participants reported that proper work experience in nursing could make it more attractive as a career choice but that there were difficulties and barriers in obtaining an appropriate work experience in nursing. These included unhelpful attitudes of teachers towards work experience in nursing in general and the placements themselves which were typically in a nursing home or a care home. They felt that departments of nursing within universities should have an input into organising more realistic work placements and that their involvement could foster greater interest amongst pupils in nursing as a career.

If not, why not? Reasons why Canadian postgraduate trainees chose--or did not choose--to become pathologists

Pathology has been frequently identified in the literature as an unpopular choice for medical students. For many years, there have been predictions that this unpopularity would lead to inadequate pathologist numbers, which would in turn contribute to poor quality patient care. In Canada, the predicted crisis has become a reality: after a high-profile failure of laboratory quality, a public inquiry reported that poor pathology recruitment was partially responsible and recommended that medical schools take steps to make pathology more attractive to medical students. There are several published studies into pathology recruitment, but none has asked nonpathology residents why they did not choose pathology. This study uses qualitative techniques to investigate why pathology residents chose to specialize in pathology and why clinical residents rejected a pathology career. Pathology residents across Canada were surveyed, as were clinical (nonpathology) residents in every residency training program at the University of British Columbia in Vancouver, Canada. Pathology residents overwhelmingly cited various attractive features of pathology practice, including its academic nature, the opportunity to explore basic pathogenesis, and its interesting and varied daily work. Most clinical residents rejected pathology because they preferred direct patient contact; however, a sizable minority blamed insufficient or inadequate medical school experiences in pathology. Clinical residents also cited several misconceptions and stereotypes about pathology, including misunderstandings about the role of pathologists and the nature of pathology practice. The reasons why clinical residents rejected pathology careers may provide guidance in improving pathology recruitment of medical students.