Examining professional values among nursing students during education: A comparative study

Latent profile analysis of nurses' moral courage: a professional values perspective

INTRODUCTION

Nurses' moral courage (NMC) enhances care quality and patient safety. Nurses' professional values promote ethical adherence, moral obligation fulfillment, and compliance to prevent ethical violations. It is necessary to explore the current status and influencing factors of moral courage from the perspective of professional values.

AIM

To investigate the current situation of nurses' moral courage, analyze the latent profiles of nurses' moral courage, and explore the influencing factors from the perspective of professional values.

RESEARCH DESIGN

A cross-sectional design was employed.

PARTICIPANTS AND RESEARCH CONTEXT

Data were collected through convenient sampling at a tertiary hospital during May 2023 in Wuhan, Hubei province, China. A self-designed web-based questionnaire consisting of demographic characteristics, the Chinese Nurses' Professional Values Scale-Revised Version (NPVS-R-CV) and the Nurses' Moral Courage Scale (NMCS) were used for the cross-sectional survey. Latent profile analysis was conducted using the results of 3 explicit indexes of NMCS, and multivariate logistic regression was used to analyze the influencing factors of NMC.

ETHICAL CONSIDERATIONS

Research ethics approval (with the code of TJ- IRB 20220543) was obtained from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

FINDINGS

This study included 966 nurses, predominantly female and under 30 years old, with 91.10% holding a bachelor's degree. Latent profile analysis identified three moral courage profiles: low-level (31.5%), medium-level (47.2%), and high-level (21.3%). Multivariate logistic regression analysis showed significant positive correlations between professional values and moral courage, with head nurses being significantly more likely to exhibit high moral courage (OR = 3.586, p = 0.013).

CONCLUSIONS

The moral courage of nurses can be classified into 3 subgroups. Nurses' professional values positively correlate with moral courage, with head nurses showing significantly higher levels of moral courage. Strengthening professional values through training can enhance ethical behavior in nursing, potentially improving patient care and safety.

Assessment of the validity and reliability of the nurses' professional values scale-revised in Persian version among nursing students

BACKGROUND

Evaluating professional values is crucial to developing effective strategies for integrating them into professional performance and clinical education. A standard questionnaire is an instrument that can be used to evaluate professional values. This study aimed to assess the validity and reliability of the Nurses Professional Values Scale-Revised (NPVS-R) among nursing students in the Persian language.

METHODS

This methodological and cross-sectional study aimed to evaluate the validity and reliability of the Persian version of the NPVS-R among nursing students. Following a back-translation process, the Persian version was subjected to face, content, and construct validity assessments. Construct validity was examined using exploratory factor analysis (EFA) on a sample of 439 nursing students during their internships at 16 public universities of medical sciences in Iran between April and July 2019. Additionally, convergent and divergent validity were assessed on a separate sample of 105 nursing students. The reliability of the instrument was assessed using both internal consistency measures and the test-retest method. Furthermore, the psychometric properties of the questionnaire were analyzed using Samejima's Gradual Response Model. Data analysis was performed using SPSS (version 19) and MPLUS (version 5.1).

RESULTS

All components had a content validity ratio greater than 0.6 and a content validity index of 1, indicating excellent content validity. Exploratory factor analysis reduced the items to 25, with five factors explaining 52.26% of the variance. The scale exhibited strong convergent validity (r = 0.73, p < 0.001) and satisfactory divergent validity (r = 0.12, p = 0.21; r = 0.07, p = 0.47). Test-retest reliability was excellent, with an intraclass correlation coefficient (ICC) of 0.92. Cronbach's alpha coefficients ranged from 0.53 to 0.83 for the factors and 0.91 for the entire scale, showing good internal consistency. IRT analysis confirmed that alpha parameters for all items were statistically significant and at an acceptable level. Thus, the Persian NPVS-R, with 25 items and 5 factors, is a valid and reliable tool for nursing students.

CONCLUSIONS

The Persian NPVS-R, comprising 25 items and 5 factors, demonstrated excellent validity and reliability. This scale serves as a standardized tool for evaluating the professional values of nursing students, suitable for application in educational and clinical settings to enhance nursing practice and education.

Cognitive Flexibility and Professional Identity in Nursing Students: The Modeling Role

BACKGROUND

Students' professional identity is essential to build nursing competence. Cognitive flexibility plays a crucial role in developing professional identity, as well as clinical supervisors and academic teachers through role modeling. This study analyzed the role of internship and theoretical modeling in the link between cognitive flexibility and professional identity.

METHOD

Participants were first-, second-, and third-year nursing students (n = 284) at a university in northern Italy. Participants completed an online survey, and multigroup analysis was performed.

RESULTS

Internship modeling was positively associated with professional identity but not for second-year students. Theoretical modeling was not significantly associated with professional identity and cognitive flexibility. Theoretical modeling did not mediate the relationship between cognitive flexibility and professional identity. Clinical internship modeling mediated the relationship between cognitive flexibility and professional identity but not for second-year students.

CONCLUSION

Internship modeling helps students give sense and coherence to learning, which contributes to their professional identity. [J Nurs Educ. 2024;63(11):764-772.].

The effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students: A quasi-experimental study

Background: Since the increasingly complex structure of health care services brings many ethical problems, it is important to use different instructional technologies in the ethical education of future nurses.Aim: The aim of this study was to determine the effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students.Research design: A quasi-experimental study with pretest-posttest design.Participants and research context: The research was conducted in the Nursing Department of a University located in Istanbul, Turkey between October 15 and November 15, 2024. The sample of the research consisted of 3rd year nursing students. Data were collected using the Descriptive Characteristics Form, the Nursing Dilemma Test, and the Instructional Material Motivation Scale for Single-Use.Ethical considerations: Permission was obtained from Bezmialem Vakif University Non-Interventional Ethical Research Committee and the institution where the study was conducted for the implementation of the research. Written and verbal consent was obtained from all participants in accordance with the Helsinki Declaration.Findings: While there was no difference between the students' Ethical Dilemma Test Principled Thinking pre-test and post-test scores, their Practical Consideration (p = .005) and motivation levels (p = .037) post-test scores were found to be higher. There was a weak but significant negative correlation between academic achievement and pre-test teaching material motivation levels (r = -0.375, p = .041).Discussion: The use of different teaching methods and techniques in ethics education in nursing is important for future nurses to find more practical solutions to the ethical problems they will encounter during patient care.Conclusion: The results of the study indicate that the use of video-supported role play can be effective in teaching ethics courses in nursing education.

Relationships between professional identity, motivation, and innovative ability among nursing intern students: A cross-sectional study

Objective

To explore the relationships among motivation, professional identity, and innovative ability of nursing intern students.

Background

Professional identity and innovative ability are important for nursing students' core competitiveness and care quality. During the internship, nursing students integrate theoretical knowledge and practice, and have a rapid growth. Motivation is positively associated with professional identity and innovative ability. However, there are limited studies examining the professional identity, motivation, and innovative ability of nursing intern students.

Design

A descriptive cross-sectional online study.

Methods

Students in the nursing schools in southwest and central of China were included in this study and conducted from June to July 2022. A total of 474 nursing intern students were recruited from 16 nursing schools. Research data were collected with "Participants' Demographics Form", "the Professional Identity Questionnaire for Nursing Students", "the Revised Life Goals Questionnaire", and "the Revised Multidimensional Innovative Questionnaire". Independent-sample t-tests, one-way analysis of variance, correlation coefficients, and structural equation modeling were used in data analysis. This study adhered to the STROBE guidelines.

Results

A significantly positive correlation was determined among the professional identity (67.55 ± 8.42), motivation (53.38 ± 5.54), and innovative ability (47.99 ± 5.46) of nursing students (r > 0.4, P < 0.001). Motivation had a mediating effect on professional identity and innovative ability (P = 0.003), accounting for 10.9% (0.075/0.689) of the total effect.

Conclusions

There was a positive correlation among professional identity, motivation, and innovative ability. Developing motivation and professional identity can enhance nursing intern students' ability to innovate.

Measuring Professional Values Among Jordanian and Palestinian Undergraduate Nursing Students: A Comparative Study

BACKGROUND

Professional values provide a road map for guiding the behaviors of nursing students during practice and are considered standards for acceptable actions during the provision of nursing care. Nursing educators play a vital role in helping their students embrace professional values in their future career.

PURPOSE

This study was designed to assess and compare professional values among Jordanian and Palestinian undergraduate nursing students.

METHODS

In this descriptive, cross-sectional study, 182 Jordanian and 353 Palestinian nursing students completed the Nurses Professional Values Scale-Revised (NPVS-R), which covers five domains (caring, trust, justice, activism, and professionalism).

RESULTS

The mean age of the participants was 22.5 years, and most (56.6%) were female. The mean total score for the NPVS-R was 3.85, with the "justice" dimension receiving the highest mean score (4.07) and the "activism" dimension receiving the lowest mean score (3.63). The differences in mean NPVS-R total and dimension scores between the Jordanian and Palestinian students were not statistically significant.

CONCLUSIONS

The results of this study support that Jordanian and Palestinian undergraduate nursing students have an acceptable level of professional values, with the NPVS-R justice domain scoring relatively high and the NPVS-R activism domain scoring relatively low. The authors hope that the results of this study encourage nursing educators to continue improving professional values among their students, especially with regard to the relatively low-rated dimensions.

Professional Values of Undergraduate Students at a Nursing School in South Africa

Background

Nursing schools play an important role in instilling nursing professional values in undergraduate nursing students and ensuring that they produce professional nurse graduates. Several studies in various countries have been conducted to describe the professional values held by nursing students, but this has not been explored in detail in South Africa.

Aim

The purpose of this study was to describe the professional values held by undergraduate degree students at a nursing school in South Africa.

Methods

A cross-sectional survey using a self-administered questionnaire was conducted. With a population of 1,233 undergraduate nursing students across four years in the degree programme at the nursing school, a sample of 294 was calculated as the representative (95% CI, 5% error, and 50% response distribution). The 26-item nurses professional values scale revision (NPVS-R) with five value dimensions was used to collect the data. Means, frequencies, and confidence intervals were used to describe the values and Mann-Whitney U tests and Kruskal-Wallis independent sample tests were used to compare the findings with the demographic characteristics.

Results

A total number of 245 respondents completed the questionnaire (response rate of 83.3%). Overall, the nurse professional value score was high (113.1 ± 13.1). The values of trust (4.46 ± 0.61), justice (4.39 ± 0.57), and caring (4.38 ± 0.55) were rated significantly higher than those of professionalism (4.23 ± 0.64) and activism (4.22 ± 0.57). First- and final-year students had significantly higher professional value scores.

Conclusion

The study results describe the professional values of undergraduate nursing students in the school and confirmed the importance of trust, justice, and caring as the key professional values in the South African setting. Clinical Relevance. Nursing education should embed and monitor nursing professional values in the curriculum. Instilling nursing professional values in undergraduate nurses during formal training programmes improves quality patient care and service delivery for clinical practice.

Factors affecting nurses' professional values: A comprehensive integrative review

OBJECTIVES

Values should inform the care every nurse provides. Professional values equally affect patient care and organizational outcomes. In addition, they aid in forming a basis for moral judgments. The aim of this review is to elucidate the whole spectrum of factors affecting the development of nurses' professional values.

DESIGN

An integrative review approach was chosen.

DATA SOURCE

The review included searches in four databases - MEDLINE Complete, CINAHL Plus, ERIC, and Scopus - from January 2015 to November 2021, 572 articles were screened resulting in 35 quantitative and qualitative articles that met the inclusion criteria and passed the critical appraisal.

RESULT

Five major themes and subthemes emerged from the review: Individual determinants was the first theme. Education was the second theme. Experience was the third theme. The fourth theme was nurses' values perceptions. The final theme dealt with the impact of role models.

CONCLUSION

Understanding the power of nursing values as an effective influencer of nursing practice is important because nurses' values can ensure high-quality care and strengthen the professional brand.

Legal Regulations and the Anticipation of Moral Distress of Prospective Nurses: A Comparison of Selected Undergraduate Nursing Education Programmes

Moral distress is commonly experienced by nurses in all settings. This bears the risk of a reduced quality of care, burnout and withdrawal from the profession. One approach to the prevention and management of moral distress is ethical competence development in undergraduate nursing education. Profession-specific legal regulations function as a foundation for the decision on the educational content within these programmes. This theoretical article presents the extent to which legal regulations may open framework conditions that allow for the comprehensive preparation of prospective nurses to manage moral distress. The legal frameworks and the immediate responsibilities regarding their realisation in the context of undergraduate nursing education vary slightly for the three chosen examples of Switzerland, Austria and Germany. While an increased awareness of ethics’ education is represented within the nursing laws, no definite presumption can be made regarding whether undergraduate nursing students will be taught the ethical competencies required to manage moral distress. It remains up to the curriculum design, the schools of nursing and instructors to create an environment that allows for the realisation of corresponding learning content. For the future, the establishment of professional nursing associations may help to emphasise acutely relevant topics, including moral distress, in undergraduate nursing education.

Nursing students' beliefs about mental health, interest in work, and job tendencies

PURPOSE

To explore nursing students' mental health educational level, mental illness beliefs, and interest in working in mental health.

DESIGN AND METHODS

Descriptive research conducted with 173 nursing students which convenience sampled. The questionnaire was composed of mental illness beliefs, interest in working in mental health, and tendency to work in nursing areas.

FINDINGS

Main finding demonstarted perception of dangerous from mental illness related to low interest in working in mental health regarding all nursing students.

PRACTICE IMPLICATIONS

There is a necessity to discuss mental health beliefs within theoretical and practical learning as it may eventually can contribute to the quality of care and improve the image of mental healthcare.

Professional values in nursing students in Jordan: baccalaureate nursing students’ perception

Objective

Baccalaureate degree curricula consist of several professional values required for nursing students, which are taught in many ways. This study aimed to explore the perception of baccalaureate Jordanian nursing students regarding professional values and to assess the relationship between students’ demographics and their perception of professional values.

Methods

The study design was a descriptive, cross-sectional correlational design. A convenience sample of 182 Jordanian undergraduate nursing students enrolled at one of the most prominent universities in Jordan who completed and submitted a self-administered Nurses’ Professional Values Scale (NPVS) was considered for this study.

Results

The NPVS total score ranged from 37 to 130, with a relatively high total score mean (99.68 with a mean of 3.83 out of 5). The highest score domain in NPVS was “Justice” with a mean of 3.97, while the lowest ranked domain was “Activism” with a mean of 3.69. The correlation coefficient showed no statistically significant correlation between age nor accumulative students’ average with a total score of Nurses Professional Values Scale-revised (NPVS-R) and its subdomains. The t test results showed that gender and type of students’ enrollment (regular vs. upgrading) did not affect the means of NPVS-R and its subdomains. But differences were found to be statistically significant between the means of first year students and fourth year students in the total score of NPVS-R.

Conclusions

Findings of the study alert nursing educators to pay more attention to the importance of promoting the values related to “activism” and “professionalism” among nursing students. Suggestions for enhancing the roles of peer supervision and providing peer review to colleagues would contribute to improving nursing students’ performance and raising self-awareness because when nursing educators pay more attention to the items of these domains, better future nursing professionals, leaders, and researchers can be gained. Also, understanding nursing students’ perceptions of the importance of professional values and the difficulties in its application would be vital to enlighten educators about the areas that need improvement.

Professional values in student nurse education: An integrative literature review

AIM

The aim is to understand current research into the impact of undergraduate nursing education on the development of professional values.

BACKGROUND

Values are evident in the professional standards for nurses and the guidelines and healthcare policies of many countries. These professional values guide decisions and behaviour and are recognised as an essential component in the professions ability to provide safe and professional care. This literature review presents the current research on the impact of education on professional values in undergraduate nurse education.

DESIGN

An integrative review of the findings was conducted to provide insight into the current research on the professional value development in undergraduate nurses.

DATA SOURCES

CINAHL, PubMed and Scopus.

REVIEW METHODS

A literature search was undertaken within defined date parameters 2010-2021 using a systematic approach. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guide PRISMA was used to guide and illustrate the process. Papers were assessed for quality using the Mixed Methods Appraisal Tool.

RESULTS

Two distinct areas of inquiry were identified. (a) Changes in professional values as an outcome of undergraduate nursing education or (b) changes in professional values as an outcome of specifically designed educational content. These areas were further explored to better understand the influences of undergraduate education on students' professional values.

CONCLUSION

There is a lack of evidence in the literature to support the premise that professional values develop in line with academic year progression; however, there is strong evidence to support the inclusion of explicit learning in undergraduate education that engages students in education specifically designed to explore and develop professional values.

The Effects of Case-Based Teaching in Nursing Skill Education: Cases Do Matter

Nursing skill education plays a very important part for the nursing education. It's necessary to analyze the role of the case-based teaching (CBT) in nursing skill education, to provide insights into the nursing education. The sophomore nursing students who received nursing skill teaching from September 2019 to January 2020 were selected. The students either underwent traditional teaching (control group) or CBT (CBT group) intervention. The objective structure clinical examination (OSCE), autonomous learning ability, questionnaire for effects evaluation of CBT, and student's satisfaction level on CBT were analyzed. A total of 146 participants were included. There were no significant differences in the gender, age and the final exam score as freshman between 2 groups (all P > .05). The OSCE scores and autonomous learning ability in CBT group were significantly higher than that of control group (all P < .05). The most students favored the use of CBT, and most students were satisfied with CBT. CBT is beneficial to improve the nursing skill and comprehensive ability of students, and it's conducive to increase the interest of students, which merits application in nursing education.