What motivates people to commence a graduate entry nursing programme: a mixed method scoping review

Medical laboratory scientist motivation to pursue graduate education

BACKGROUND

Medical laboratory staffing shortages have persisted, with challenges in maintaining adequate medical laboratory professionals. The career trajectory for medical laboratory scientists beyond entry level is ambiguous, but advancement opportunities are enhanced with specialist certifications and advanced degrees.

OBJECTIVE

This study explored the motivation and preferences of medical laboratory scientists in pursuing graduate medical laboratory science education based on the importance of professional development, career advancement, recognition, and employment benefits.

METHODS

A quantitative, cross-sectional, and descriptive correlational study surveyed American Society for Clinical Pathology Board of Certification-credentialed medical laboratory scientists using an online questionnaire.

RESULTS

The overall response rate was 2.5%, and 1247 complete surveys were analyzed. Educational preferences varied by respondent age and amount of laboratory experience. Professional development, career advancement, recognition, and employment benefits were all important motivators for seeking graduate degrees, but those who were younger and had less experience indicated they were more important.

CONCLUSION

This study suggests several areas of improvement for educational programs, health care organizations, and professional organizations to support the motivation of medical laboratory scientists to pursue graduate education.

Reframing Burnout: Measuring "Altruistic Execution" to Understand Nurse Burnout

BACKGROUND

Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout.

OBJECTIVE

The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work.

METHODS

The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout Scale, and Satisfaction of Employees in Health Care Survey. Exploratory factor analysis examined construct validity and factor loadings. Confirmatory factor analysis verified consistency in factor structure. Linear regression assessed for convergence reliability with burnout and job satisfaction.

RESULTS

The sample included 843 acute care hospital nurses surveyed in January-March 2023. Exploratory factor analysis revealed a two-factor solution, named altruistic engagement with work and workplace barriers to altruism. Nine instrument items were retained and demonstrated strong internal consistency (Cronbach's alpha 0.79). There was a significant relationship between both factors of the NAES and both burnout and job satisfaction, demonstrating that greater altruistic execution is associated with lower burnout and greater job satisfaction.

CONCLUSION

Preliminary findings support the use of the NAES as a valid and reliable scale. Findings show there is correlation between altruistic intentions and burnout. Interventions aimed at enhancing altruistic execution may reduce nurse burnout and thereby improve retention.

Exploring the motivations, expectations, and experience of graduate-entry nursing students: A qualitative research study

Current research demonstrates a sparsity of United Kingdom-focused research into graduate-entry nursing programmes, as well as a need for further research into motivations and expectations of graduate-entry nursing students. The aim of this study was to explore a graduate-entry nursing programme from a student perspective, with a specific focus on a) motivations for enrolling, b) expectations of the programme, and c) experience of the programme to date. A qualitative descriptive design was utilised. Three focus groups and one interview were conducted with students from two cohorts at a British university at multiple points during the two years of the programme. Qualitative data were analysed thematically, and findings presented back to participants. It was found that student motivations were consistent with previous research and key stressors were identified relating to both academic and placement elements of the programme. It is proposed that the underlying cause of stress amongst graduate-entry nursing students was a lack of perceived control over their experience. This finding is supported by Karasek's (1979) Job Demand-Control Model. It is suggested that increasing students' perceived control could decrease student stress, therefore improving retention and enhancing the student experience.

Factors influencing nursing undergraduates' motivation for postgraduate entrance: a qualitative inquiry

BACKGROUND

The demand for nursing professionals with advanced education and specialized knowledge is growing, which encourages nursing undergraduates to pursue postgraduate studies. Therefore, an in-depth investigation into the barriers and facilitators affecting the motivation of nursing undergraduates to take postgraduate entrance exams was necessary. This may provide more targeted recommendations for the formulation of relevant policies and the provision of student support. The purpose of this study is to explore the barriers and facilitators affecting the motivation of nursing undergraduates for postgraduate entrance examination.

METHODS

Data for this study were collected from in-depth semi-structured interviews with 15 nursing undergraduates from Nantong University between October and December 2023. Thematic analysis was employed to analyze the data.

RESULTS

Four barriers were identified, including study pressure and internship fatigue, self-doubt and fear of failure, employment pressure, and lack of information and resources. Four facilitators were also identified, including the desire to upgrade academic qualifications and professional skills, career development and transition, escaping clinical work and delaying employment, as well as the power of role models, and social support.

CONCLUSIONS

The findings may help nursing undergraduates navigate the path to postgraduate entrance exams more effectively and ultimately succeed in their studies and future careers. The study underscores the importance of addressing these barriers and leveraging these facilitators to support the holistic development of nursing students.

Master of nursing programs in Australia: A desktop analysis

Background

Master of Nursing (MN) programs serve as an important structured pathway to prepare the nursing workforce to develop advanced capabilities. Little research has been done to examine the key characteristics of MN programs in Australia and their responsiveness to meeting the health needs of the community.

Aim

The aim of this desktop analysis is to provide a detailed overview of the key characteristics of MN programs in Australia.

Method

A desktop analysis of MN programs in Australia utilising content analysis of publicly available information gathered from program websites of Australian Universities.

Results

A total of 70 MN programs were analysed from the 28 that offered these programs. Nine categories were developed that describe the key characteristics of these programs: nomenclature and program focus, program outcomes, regulation and professional recognition, structure, work integrated learning, delivery mode, admission, and tuition fees. Inconsistencies were identified across all categories.

Discussion

While Australian universities offer a diverse range of MN programs, inconsistencies across the programs can impact quality and intent and have implications for students, employees, and universities.

Conclusion

There is a pressing need to ensure the quality of MN education is maintained and adequate to meet healthcare needs. The benefits and risks of professional regulation of all MN programs should be considered as a mechanism for enhancing the quality of nursing education.

Using unfolding case studies to develop critical thinking for Graduate Entry Nursing students: an educational design research study

BACKGROUND

Graduate Entry Nursing (GEN) programmes have been introduced as another entry point to nurse registration. In the development of a new GEN programme, a problem-based approach to learning was used to develop critical thinking and clinical reasoning skills of motivated and academically capable students.

OBJECTIVE

To explore and evaluate the design and delivery of course material delivered to GEN students embedded in authentic learning pedagogy from the perspectives of both GEN students and academic staff using an unfolding case study approach.

METHODS

An educational design research approach was used to explore the learning experiences of GEN students using an unfolding case study approach situated in experiential pedagogy and the teaching experiences of the academics who designed it. Data were collected through semi-structured interviews with students once they had finished the course and weekly reflective diary recordings by academic staff throughout implementation. Thematic analysis was used to analyse the data.

FINDINGS

Student reflections highlighted that this cohort had insight into how they learned and were comfortable voicing their needs to academic staff. While the unfolding case studies were not liked by all participants, for some it offered a unique learning opportunity; particularly when scaffolded with podcasts, simulation labs, tutorials and clinical placements. Staff reflections primarily aligned with student experiences.

CONCLUSION

The gaps highlighted in the delivery of the course suggest that a blended pedagogical approach to graduate entry nurse education is required. Specifically, GEN students are aware of the learning needs and are happy to express these to academic staff, thus suggesting that engaging with a co-design curriculum approach will benefit future cohorts.

Graduate entry nursing students' development of professional nursing self: A scoping review

BACKGROUND

Accelerated graduate entry nursing programmes require students to rapidly socialise to the profession. Professional identity is an important element of becoming a nurse.

OBJECTIVE

This scoping review aimed to synthesise published literature reporting the development of professional identity, belongingness and self-concept as a nurse in students enrolled in a pre-registration graduate entry nursing programme.

DESIGN

Scoping review.

SETTING

Graduate entry nursing programmes.

PARTICIPANTS

Graduate entry nursing students.

METHOD

Following a pre-registered protocol, we searched electronic databases for publications investigating graduate entry nursing students' development of professional identity, belongingness and self-concept. Screening, data extraction and analysis were initially in duplicate and independent, and then by consensus.

RESULTS

Of the 871 records identified, twenty met the inclusion criteria. Publications were from the USA, Australia, New Zealand, Canada, and the UK. We identified one overarching theme of 'professional nursing self', with four sub-themes: 1) professional socialisation, 2) professional self-concept, 3) developing nursing agency, and 4) identity formation. Socialisation into nursing and belongingness to the profession occurred concurrently as students moved through their programme of learning. Due to the accelerated nature of the programmes, rapid professional socialisation was required, supported by positive relationships in the clinical setting. Strategies that enhanced belongingness and wellbeing enabled students to feel connected to the profession.

CONCLUSIONS

The development of professional identity in graduate entry nursing students is impacted by their rapid professional transition through an accelerated programme. Students' growing sense of nursing agency is embodied in their experiences of thinking and acting as a nurse. Their previous professional identity is then reconstituted in their new graduate selves; educational programmes support this transition.

TWEETABLE ABSTRACT

Scoping review finds professional identity development in graduate entry nursing students is rapid in accelerated preregistration degrees #belonging #connection.

Education pathways for graduate entry registered nurses to transition to advanced practice roles: A realist review

OBJECTIVE

Explore potential education and clinical pathways for nurses entering the profession through a Graduate Entry Nursing programme to transition to advanced practice roles.

DESIGN

Realist review.

REVIEW METHODS

A two stage process included 1) a systematic search of the following electronic databases EMCARE, MEDLINE, CINAHL, ERIC, and Scopus for published peer reviewed literature reporting academic pathways for graduates of graduate entry nursing programmes to progress to advanced nursing roles, and 2) consultation with key education programme stakeholders of graduate entry nursing programmes across Australasia, who undertook an inductive interpretive approach using realist logic to determine what works, for whom, and in what circumstances.

RESULTS

Twelve published articles that explored advanced practice academic pathways for graduate entry nursing graduates were synthesised in terms of context, mechanisms, and outcomes. Data were then interpreted as to what works, for whom, in what context, and why, to develop new understandings of opportunities for advanced practice pathways for these students. No specific tailored academic pathway for graduate entry nursing graduates to progress to advanced practice was identified. Important relationships were identified between financial imperatives, political drivers, and registration requirements.

CONCLUSIONS

Transformative strategies for new education pathways were identified as necessary to inspire innovation in nurturing graduate entry nurse graduates to progress to advanced practice roles. Effective collaboration and consultation within and across agencies and organisations are needed to both develop and implement accessible, expedient, and equitable programmes to enable this capable cohort to contribute to the health workforce.

Factors Influencing Generation Z Bachelor of Nursing Students' Decision to Choose Nursing as a Career: A Pilot Study

Introduction

Despite nurses representing the largest healthcare professional group, the number is not enough for global health coverage. Understanding Generation Z students' intrinsic and extrinsic motivations, internal and external influences, and beliefs in choosing nursing education is crucial. This knowledge empowers universities to enhance nursing program enrollment through targeted promotion and recruitment strategies.

Objective

The aim was to understand why Italian students of Generation Z choose the Nursing Degree Course.

Methods

In this pilot study, a cross-sectional design was used. A survey with closed and open answers analyzing demographics, opinions, and motivations among new enrolled nursing students was administered on the first day of the Bachelor of Nursing Degree course. Descriptive statistics were used. Quantitative data were analyzed with Chi-square and ANOVA tests and qualitative data underwent content analysis and coding. Correlation analysis explored relationships between qualitative and quantitative results.

Results

Forty first-year students (85% female, average age 22) completed the questionnaire. The choice of the degree pathway, as the first or second option, is influenced by intrinsic and extrinsic motivations, the student's opinions, and family and social influences. Significant positive and negative associations were evidenced. Negative factors affecting choice included location and the responsibility for nursing care, while positive factors included role models, family advice, passion, curiosity for healthcare, the desire to help others, and family influences on decision-making.

Conclusions

Among Italian generation Z students, the choice of the nursing degree pathway is influenced by social models, family advice, passion, the desire to help others, and curiosity. Universities should be more proactive in their recruitment and promotion efforts, transforming these events into vibrant meeting points for professionals from diverse nursing specialties. They should also implement robust information policies that highlight career possibilities spanning clinical practice, management, education, and research areas within the field.

Reasons for choosing and completing nursing studies among incoming and outgoing students: A qualitative study

BACKGROUND

The shortage of nurses is causing instability and crisis in health systems and will continue. The WHO reinforced the importance of recruiting and retaining new students. Authors of various studies recommend the need to identify and understand the reasons for pursuing a nursing degree.

OBJECTIVES

To determine students' preference for nursing studies and to identify the reasons for choosing, continuing, and completing a bachelor's degree in nursing.

DESIGN

Qualitative, descriptive study.

PARTICIPANTS

106 nursing students at the University of Huelva (Spain) participated during their first year (2017) and final year (2021) of the nursing degree.

METHODS

This study was conducted with the same group of students in two phases. Data were collected in writing in a document with open-ended questions and no maximum wordcount. The responses were analysed using content analysis.

RESULTS

A total of 76.4 % of participants stated that nursing had been their first choice. The main reasons for choosing a nursing degree were associated with fulfilment, and a desire to help others and interact with them. The reasons for completing their studies were primarily related to an interest in providing professional care, showing a deeper and more concrete knowledge of nursing care work.

CONCLUSION

For most participants, nursing was their first choice due to a strong intrinsic motivation related to self-satisfaction in helping others. The reasons for completing this degree had extrinsic motivations linked to nursing activity in hospital. Areas such as management, teaching, or research were not interesting to our students. Knowing the causes of this lack of interest could help us attract them to these areas.

Strategies to Evaluate and Enhance Accelerated Second-Degree Nursing Pathways

BACKGROUND

Health systems are facing historic staffing crises, and they require efficient pipelines of qualified students into practice. Accelerated second-degree students are helping to address pressing health care market needs.

PROBLEM

Few publications have assessed the second-degree program landscape or offered comparisons of second-degree pathways.

APPROACH

This article discusses the second-degree program landscape, including challenges in second-degree education; compares graduate-level second-degree entry against other pathway options; and presents strategies to optimize and sustain second-degree student pipelines based on these insights.

FINDINGS

The second-degree program landscape is characterized by variability. Challenges include inconsistent program nomenclature and limited national data collection. Graduate-level second-degree pathways offer financial and career advantages compared with other pathways.

CONCLUSION

Nursing education should standardize second-degree nomenclature, refine national data capture mechanisms, standardize program scope and requirements, and encourage second-degree pathways at the graduate level or above.

The Sources of Research Self-Efficacy in Postgraduate Nursing Students: A Qualitative Study

Postgraduate students are required to undertake a series of research assignments. Research self-efficacy is regarded as the sense of faith in their ability to accomplish research tasks. However, it is unclear how research self-efficacy plays a role in second-year nursing postgraduate students who have been enrolled for a period of time and have not yet met graduation requirements. This study aims to explore the sources of second-year nursing postgraduate students’ research self-efficacy in response to research tasks. A descriptive phenomenological approach was used in this study. A total of 13 second-year nursing postgraduate students participated in semi-structured interviews using a purposive sampling method. Content analysis was applied to analyze the interview data after verbatim transcription. Participants stated that they had gained a great deal of support but were somewhat less confident. Three themes were refined: (a) intrinsic sources of research self-efficacy (differences in cognitive ability, internal driving force, with successful experience), (b) extrinsic sources of research self-efficacy (family support, peer support, mentor support), and (c) unmet support may cause low self-confidence (inadequate self-support, inadequate extrinsic-support, lack of motivation from successful experiences). The postgraduate students in this study accepted the objectives of the master’s training and actively practiced research exploration. They were motivated to persevere through their internal and external support, albeit with some negative aspects that deserve our attention. Interventions for postgraduate students’ cognitive awareness, constant support during their postgraduate career, and finally, guiding summaries may have a positive impact on their self-efficacy.

Exploring the experiences and perceptions of students in a graduate entry nursing programme: A qualitative meta-synthesis

BACKGROUND

Students commencing graduate entry fast-tracked nursing programmes leading to registration are highly motivated and characterised by rich life experiences. Given their unique motivations and characteristics, gaining insight into their experiences of graduate entry programmes will inform strategic directions in education.

OBJECTIVE

To synthesise graduate entry nursing students' self-reported experiences and perceptions of their accelerated programme.

DESIGN

Qualitative meta-synthesis.

DATA SOURCES

Databases included Cumulative Index of Nursing and Allied Health Literature, Emcare, Education Resources Information Centre, Medical Literature Analysis and Retrieval System Online, Psychological Information and Scopus. Qualitative studies published in English and reporting primary data analysis including experiences and perceptions of graduate entry nursing students were considered.

REVIEW METHODS

Qualitative studies were systematically identified and critically appraised. The meta-synthesis used an open card sort technique to organise data into a matrix of graduate entry nursing students' experiences and perceptions.

RESULTS

Fourteen studies were included. The analysis revealed three primary themes: what I bring and what I come with, developing a sense of self and nursing self, and what I need. Within these themes we found potential enablers of student success in learning; space, working together, and balancing work and life and learning to bridge two worlds. Students reflected on the benefits of academic support and shared their experiences of learning in clinical placement. In addition, students acknowledged the importance of clinical educators and preceptors who provided bridging that was further scaffolded by simulated learning experiences.

CONCLUSIONS

Findings indicate graduate entry nursing students have important needs and expectations of support in transition. The experiences and perceptions of graduate entry nursing students differentiated into what students arrived with, what support they need in their journey to become a nurse, alongside their experience of building a sense of self and their nursing self.

SYSTEMATIC REVIEW REGISTRATION NUMBER

CRD42020220201.

Establishing quality standards for graduate entry master of nursing curricula in Australia and New Zealand: A Delphi study

AIM

To describe the common elements of Graduate Entry Master of Nursing curricula and identify a set of standards and quality indicators for benchmarking purposes within and across jurisdictions.

BACKGROUND

Internationally, there has been an increase in universities offering Graduate Entry Masters programs in Nursing. Such programs specify a bachelor degree as an entry requirement and then offer an intensive program of study that prepares graduates for registration as a nurse. To date, no formal standards exist to guide evaluation of these curricula.

DESIGN

A two phased sequential mixed-methods design comprising thematic content analysis of curricula and a Delphi study. The setting was the Australian and New Zealand tertiary education sectors. Participants were nurse academics who were recruited to participate in the Delphi study. Quota sampling was used to identify educators from the education providers meeting organisational inclusion criteria (program coordinator and one lecturer working as a subject coordinator of the program) and nominated by their Head of Department.

METHODS

Phase One of the study involved a thematic analysis of the curricula of nine Graduate Entry Master of Nursing programs to identify common elements of curricula and domains of quality. In Phase Two these themes were used in a series of Delphi rounds to identify a set of agreed quality domains, statements and indicators.

RESULTS

Participants (n = 16) responded over three Delphi rounds. A total of nine domains of quality were determined, a set of 26 quality statements were identified based on the acceptance threshold of > 75% level of agreement and 27 quality indicators were established.

CONCLUSIONS

Our research provides an agreed set of indicators for evaluating the quality of Graduate Entry Master of Nursing programs. This work will also make it possible to measure the immediate and longer-term impacts of Graduate Entry Master of Nursing programs for the nursing workforce. Future work must focus on testing feasibility and optimising utility while refining indicators across jurisdictions.

Perceptions of Slovenian elementary schoolchildren on nursing and nurses-Exploratory study

AIM

The research aimed to assess the perception on nursing and nurses among schoolchildren of Slovenian elementary schools.

BACKGROUND

Among the general public, nursing remains under-recognized as an occupation and a science. Especially young people have unrealistic perceptions of nurses.

DESIGN

A cross-sectional research design was undertaken.

METHODS

The study included 1984 eighth grade schoolchildren from 103 elementary schools. Data were collected with a structured questionnaire.

RESULTS

The research results revealed a positive general perception of nursing. Surprisingly, only 2.5% of respondents would consider a career in nursing. Girls had more understanding of nursing compared to boys (p < 0.001); having a nurse relative meant better understanding of nursing (p = 0.032). The influence of the traditional view of nursing and the biomedical model of care which describes nursing not as autonomous, but as subordinate to medicine, was considerate (p < 0.001).

CONCLUSIONS

The study shows that elementary school children do not express an interest in a career in nursing. They perceive the job of a nurse as female-dominated, they cling to the traditional perception of nursing being subordinate to medicine, and they indicated dominance of the biomedical model of care. Healthcare policy makers must remember that healthcare systems cannot function without nurses, so developing nursing is crucial. To increase interest in the profession, a national campaign promoting nursing programs and the nursing profession and presenting horizontal and vertical career opportunities is needed. Young people must have realistic information on nursing as an occupation and a science, its role in the healthcare system, and career opportunities. Activities aimed at changing public opinion on nursing must be planned.