DEVELOPMENT AND PSYCHOMETRIC TESTING OF THE SENSE OF BELONGING IN NURSING SCHOOL SCALE

Background and Purpose: While sense of belonging is essential for human motivation, impaired belonging among nurses can impact the care and safety of patients. This article reports the development and psychometric testing of the Sense of Belonging in Nursing School (SBNS) scale to assess nursing students' sense of belonging in three different environments: Clinical, classroom, and among the student cohort. Method: Principal component exploratory factor analysis with varimax rotation was used to determine the construct validity on the 36-item SBNS scale with a sample of 110 undergraduate nursing students. Cronbach's alpha was used to determine the scale's internal consistency. Results: The scale was reduced to 19-items with high internal consistency (α = 0.914). Principal component analysis then identified four factors (sub-scales) with high internal consistency: Clinical staff (α = 0.904), clinical instructor (α = 0.926), classroom (α = 0.902), and classmates/cohort (α = 0.952). Conclusion: The SBNS scale is a reliable and valid tool to measure sense of belonging across three environments among nursing students. Further research is needed to determine the scale's predictive validity.

Male nursing students' experiences during prelicensure education: An integrative review

BACKGROUND

Males represent less than 10 % of the global nursing workforce. To increase the recruitment and representation of male nurses, their experiences in prelicensure nursing education must be understood.

OBJECTIVES

The purpose of this integrative review was to explore literature related to male nursing students' experiences during prelicensure education.

DESIGN

An integrative review of the literature was conducted using Whittemore and Knafl's methodology.

DATA SOURCES

Database searches of CINAHL, PubMed, ERIC, Emcare, and Scopus were conducted.

REVIEW METHODS

Database searches identified 237 articles for initial review. Titles, abstracts, and full-text articles were screened for relevance. Quality appraisal was evaluated using the Mixed Methods Appraisal Tool Version 2018. Data analysis was conducted using Conventional Content Analysis.

RESULTS

Twenty-two articles (19 qualitative, two quantitative, and one mixed-methods) were included in this review. The existing literature suggests that male nursing students have generally negative experiences during their prelicensure education due to external reactions from family, friends, peers, and healthcare providers to their choice of nursing as a profession; lack of male role models; extensive assistance with physical tasks in the clinical setting; exclusion in obstetrics clinical experiences; and female-gendered descriptions of nurses within the educational environment. Fostering new relationships was identified as a positive experience during prelicensure education.

CONCLUSIONS

Generally, male nursing students have negative experiences during their prelicensure education, with limited positive experiences. As such, nurse educators should implement strategies, such as avoiding gendered references when referring to the nurse, offering male mentorship when possible, and providing comparable clinical assignments to students regardless of gender, to improve male nursing students' experiences in prelicensure education and, consequently, increase the recruitment and retention of men into the nursing profession. Future research is needed to more comprehensively understand male nursing students' experiences during prelicensure education and the impact of teaching strategies on their experiences.

Career Identity and Career Success among Chinese male nurses: The mediating role of Work Engagement

AIM

This study aimed to investigate the effect of career identity on career success among Chinese male nurses and to examine the mediating role of work engagement in this relationship.

BACKGROUND

Recently, with the development of the nursing career, male nurses take up a higher share and play a more important role in the nursing team. With its own particularity and advantages, this group's stability closely relates to the future of the nursing team. Therefore, promoting the career success of the male nurses is essential to the nursing team development.

METHODS

The data were collected in China. A sample of 557 male nurses completed measures of career identity, work engagement and career success scale. Structural equation model was adopted to verify the research hypotheses.

RESULTS

Career identity was significantly and positively related to male nurses' work engagement and career success (p< .01). And work engagement partially mediated the association between career identity and career success.

CONCLUSION

Career identity are critical to predicting and enhancing male nurses' career success. Work engagement plays an intervening mechanism explaining how career identity promotes career success among male nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management should minimize the impact of the traditional concept, implement the gender equality and provide moderate care for male nurses to facilitate balanced development of gender by upgrading the management system. The administrators should carry out skill training based on male nurses' features and the need of the department. Given full play to their respective advantages, male nurses will make great progress in professional development and achieve greater career identity and work engagement. Meanwhile, the further exploration of better incentive mechanism also makes sense in improving career identity and work engagement by the reform of performance appraisal mechanism and salary adjustment according to their ability.

Factors Influencing Male Nursing Students' Adaptation to College Life in Korea

BACKGROUND

Male nursing students face challenges in the nursing profession because of its female-centered nature. In particular, most male students in South Korea must complete military service while in college. Although these kinds of situations may make it difficult for them to adapt to college life, the number of male nursing students is gradually increasing. Therefore, it is important to identify the influencing factors to promote male nursing students' successful adaptation to college life.

PURPOSE

This study was developed to investigate the relationship between self-efficacy, social support, stress coping, and adaptation to college life among male nursing students in Korea. Factors that influence their adaptation to college life were also analyzed.

METHODS

A cross-sectional study was conducted on 217 male nursing students from seven colleges in Korea. Participants completed a questionnaire that was designed to measure self-efficacy, social support, stress coping, and adaptation to college life. Data were analyzed using descriptive statistics, independent t test, one-way analysis of variance, Scheffé test, Pearson's correlation coefficient, and multiple regression.

RESULTS

Male nursing students' self-efficacy, social support, stress coping, and adaptation to college life were shown to all positively correlate with each other. The main factors influencing adaptation to college life were social support, self-efficacy, satisfaction with major, and problem-solving-centered stress coping.

CONCLUSIONS

Strategies to enhance social support, self-efficacy, satisfaction with major, and problem-solving-centered stress coping should be developed to improve male nursing students' adaptation to college life.

Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students

BACKGROUND

Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career.

OBJECTIVE

To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale.

DESIGN

Cross-sectional survey.

METHODS

Pre-registration nursing students enrolled in undergraduate nursing programs across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing.

RESULTS

Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: a) identified nursing as their first career choice (p = 0.002); b) were in their final year of program enrolment (p = 0.016); and c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions.

CONCLUSION

The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students.

IMPACT STATEMENT

Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

Male High School Students' Perceptions of Nursing as a Professional Career Choice: Nursing Pathway Project

AIM

The aim of this study was to understand male high school students' perceptions of nursing as a professional career choice.

BACKGROUND

Nursing is predominantly female, with male nurses accounting for less than 10 percent of the nursing workforce.

METHOD

A 32-item descriptive survey that contained demography items and constructs of the theory of planned behavior was administered to 820 high school students from a large Pacific Northwest school district.

RESULTS

Male students scored higher (less positive) relative to female students on all scales. When gay and bisexual male students were compared to female students, there was no statistically significant difference. Gay and bisexual male students scored significantly lower (more positive) than straight male students.

CONCLUSION

Self-identified female individuals and self-identified gay and/or bisexual male individuals have a more positive perception of the nursing profession than other self-identified male individuals. Nurse educators should work with high schools, schools of nursing, and nursing professional organizations to implement strategies to recruit male high school students.

Cross-sectional Study of the Relationship between Experiences of Incivility from Staff Nurses and Undergraduate Nursing Students’ Sense of Belonging to the Nursing Profession

AIM

This study examined the frequency of incivility for undergraduate nursing students and the relationship between staff nurse incivility and nursing students' sense of belonging. Factors between program semester and students' body mass index (BMI) to staff nurse incivility and students' sense of belonging were assessed.

BACKGROUND

Sense of belonging enhances belonging development to the profession. However, no studies address the relationship between incivility and nursing students' sense of belonging.

METHODS

A cross-sectional design assessed the relationship between staff nurse incivility and undergraduate nursing students' sense of belonging to the nursing profession. An online survey was administered to 123 pre-licensure junior and senior undergraduate nursing students from February 1, 2021, to May 5, 2021. Correlation coefficient, descriptive statistics, Fisher r-to-z transformation, 95% confidence intervals were calculated.

RESULTS

Staff nurse incivility inversely correlated with undergraduate nursing students' sense of belonging (rs=-.358; p <.001). American Indian or Alaskan Native students reported the highest mean frequency of incivility (1.25 ± .421). There were no significant differences in correlations based on semester or BMI.

CONCLUSION

Staff nurse incivility is inversely associated with sense of belonging in students. Further research is needed to test interventions mitigating the effects of incivility on belonging.

Exploring the Gender-Related Perceptions of Male Nursing Students in Clinical Placement in the Asian Context: A Qualitative Study

The lack of gender diversity in the nursing profession has long been recognized as a cause for concern. Female nurses in many practice settings across nations continue to outnumber their male counterparts. Male nursing students may have perceived differences in the way they are treated in clinical practice; however, limited studies have been conducted to determine the unique perspectives of these students in terms of gender bias in their clinical learning. To address this knowledge gap, this study employed a qualitative descriptive approach to explore the experiences of male nursing students in clinical learning in an Asian context. Specifically, we examined the insights emerging from the thoughts and feelings of male nursing students from interactions with their clinical mentors, patients, and peers in their encounters during their clinical placement. From November 2019 to July 2020, data were collected through semi-structured interviews from 22 male participants aged 21–30 years (mean age: 22.7), enrolled in a prelicensure Bachelor of Nursing (honors) program in Hong Kong. Four themes emerged after a qualitative content analysis: (1) while the School of Nursing welcomes men, clinical settings are another story due to pragmatic considerations; (2) you are welcomed because you may be seen as a helper with greater physical strength; (3) male nursing students feel alienated in the obstetrics and gynecology practicum; (4) more male role models are desired in the clinical setting. Our findings indicate the need to promote gender awareness among faculty and clinical mentors, understand the factors hindering and facilitating the clinical practicum for male nursing students, improve the male nursing experience during the maternity practicum, and ensure access to more male role models to boost role socialization and learning.

Does the nursing curriculum influence feelings of gender-role conflict in a cohort of nursing degree male students?

It is estimated that more than 9% of the global nursing workforce is male and that this share will gradually rise over the next decade. Although there are some positive aspects of having a male nursing workforce, men in the profession still experience discriminatory behaviours and practices. Fortunately, this does not deter a number of men entering undergraduate degree programmes. The aim of this study was to understand the experiences of 14 male nursing students in their first year of the adult Bachelor of Nursing programme. Using the Inventory of Male Friendliness in Nursing Programs and the Gender Role Conflict Scale, this study found that the male students felt welcomed, supported and included into the nursing programme. In addition, they felt no overall gender-role conflict, although feelings of success and achievement caused some challenges. The results of this study suggest that the male students did not necessarily experience those inequitable behaviours and practices reported in the literature. It has been suggested that perhaps the reality of clinical practice may change the perception of nursing for male students. Therefore, implications for further research could include a longitudinal study to ascertain where the perceptions of the nursing programme change for the male nursing students over time.

Faculty development workshop on gender-associated incivility in nursing education

BACKGROUND

Men comprise the minority of entry-level baccalaureate nursing students and are at increased risk of experiencing gender-associated incivility.

PROBLEM

Uncivil peer-to-peer behavior can negatively affect students' mental and physical well-being, and learning experience. Nursing faculty must be able to identify and address gender-associated incivility among students.

AIM

The purpose of this quality improvement program was to train nursing faculty to prevent, identify, and manage gender-associated incivility in the educational environment.

METHODS

A day-long interactive workshop utilizing trigger films, small group discussions, and interactive theater was developed to train nursing faculty to implement proactive and reactive techniques to address uncivil behavior which will enhance the learning environment for all students. Utilizing Kirkpatrick's Model of Evaluation, participants were surveyed at the conclusion of the workshop and four months postworkshop to evaluate their learning and its implementation.

RESULTS

Participants gained greater understanding of the impact of gender-associated incivility and felt both empowered and better prepared to manage gender-associated conflict.

CONCLUSION

Similar approaches may be useful for schools of nursing that wish to empower their nursing faculty to support an equitable nursing education environment free of gender-associated incivility.

Positive and negative professionalism experiences of genetic counseling students in the United States and Canada

Many aspects of genetic counseling training programs have been examined over the years. However, no study has explored professional or unprofessional behaviors genetic counseling graduate students experience during their training, and how these behaviors influence satisfaction with their training. This exploratory study examined students' experiences with program leaders, instructors, supervisors, and other trainees. Specific experiences included actions of favoritism, bias, negativity, abuse of power, and examples of positive role modeling. A survey was sent to all members of the National Society of Genetic Counselors and program directors in order to reach graduates of Accreditation Council for Genetic Counseling (ACGC)-accredited programs from 2015-2019 who were eligible to participate. Responses to questions relating to demographics, satisfaction with graduate education, behaviors experienced or seen during graduate school, and reporting of inappropriate behaviors were collected and analyzed. Results demonstrated that 95% of the genetic counseling graduates were highly satisfied with their graduate education and those who experienced inappropriate behaviors during their training were somewhat less satisfied (p = .04). Individuals who felt more prepared by their graduate education were more satisfied with their graduate education (p < .01). Being publicly embarrassed or humiliated, being made to feel like a burden in clinic, or being subjected to negative or offensive behavior based on their personal beliefs or personal characteristics (excluding areas of gender, race/ethnicity, or sexual orientation) were all negatively associated with satisfaction (all p < .04). We conclude that this survey could serve as a "Genetic Counseling Training Experiences Assessment" which could be incorporated into annual evaluations required by the ACGC. Implementation of this assessment would enhance the current evaluations of genetic counseling training programs and provide important information regarding student experiences during their training.

Students' perceptions of belonging in the School of Nursing at a regional university in Australia

BACKGROUND

Attrition in pre-registration nursing degrees is a global issue. Students' perceptions of belonging is a factor that influences attrition.

OBJECTIVE

The objective of this study was to evaluate students' perception of belonging to a School of Nursing, as well as their intention to complete the pre-registration Bachelor of Nursing (BN) program following implementation of the Initiatives for Retention (IR) intervention.

DESIGN

A prospective cross-sectional survey of student nurses was undertaken using an online questionnaire.

SETTING

A large regional university in Australia.

PARTICIPANTS

Pre-registration nursing students.

METHODS

Perceptions of Belonging were evaluated using the 24-item Belonging questionnaire comprising three subscales. Data were analysed using SPSS version 25. Pearson's correlation, Student's t-tests and one way ANOVA were used to assess associations and differences in belonging scores and student demographics, study status and participation in the Initiatives for Retention (IR) intervention.

RESULTS

A total of 201 students responded to the voluntary questionnaire. The mean score for overall Belonging was 70.5 (maximum obtainable 96), mean Scores for University affiliation, University support and acceptance, and staff relations with students were 34.7, 24.1 and 11.8 respectively. Female students, those who were studying at the university for less than a year and those who participated in the IR intervention activities reported significantly higher University Belonging scores compared to their contemporaries. Logistic regression revealed that students studying the BN course for more than 3 years (OR: 0.43 95% CI 0.20-0.93, p = 0.031), and those employed (OR: 0.435, 95% CI 0.16-0.16, p = 0.022) were significant predictors of not attending the IR sessions. There were no significant differences in overall University Belonging scores based on other demographic characteristics and, study status. The majority of the students (84%) stated that they plan to continue and complete the BN program.

CONCLUSIONS

Measures designed to develop student involvement may positively contribute a successful relationship between the institution and the student, increasing the students' sense of belonging and decreasing attrition among student nurses.

PRACTICE IMPLICATIONS

Initiatives for Retention (IR) facilitate a greater sense of belonging in nursing students hence Schools of Nursing should consider embedding such strategies.

Fourth-Year Baccalaureate Nursing Students' Perceptions of Inclusive Learning Environments

BACKGROUND

Creating inclusive learning environments is a priority in nursing education, yet faculty are hindered by a dearth of evidence-based inclusive pedagogical strategies. In addition, little is known about students' perceptions of inclusive learning environments.

METHOD

Fourth-year baccalaureate nursing students from majority and underrepresented minority groups (n = 13) participated in focus groups at two time points across the academic year. Discussion topics included pedagogical strategies most strongly associated with inclusivity, facilitators and barriers to inclusivity, outcomes of inclusive learning experiences, and recommendations for promoting inclusivity in education and nursing practice.

RESULTS

Qualitative content analysis resulted in three themes: 1) underrepresented minority and majority groups described inclusive learning environments differently, 2) every aspect of the learning community affects inclusivity but teachers are especially influential, and 3) the outcomes of an inclusive learning environment extend beyond the classroom.

CONCLUSION

These findings may help create inclusive learning environments that support diversity and inclusive excellence in nursing education. [J Nurs Educ. 2020;59(5):256-262.].

Perceptions of male students in a baccalaureate nursing program: A qualitative study

Prominent nursing organizations globally have called for a concerted effort to increase diversity in nursing education. While the number of men in the nursing workforce in the United States has increased slowly over the past five decades, the proportion of men in the profession remains low in comparison to the U.S. population. In response to research indicating a less-than-optimal experience for male nursing students, faculty and students embarked on a collaborative effort to improve the experience of this student population. This paper explores the reasons that men choose to enter nursing as well as the lived experience of men in a baccalaureate prelicensure nursing program in the United States. The purpose of the study was to determine if progress had been made toward a shared goal of an improved experience for male students. Of the 19 male students who met the inclusion criteria, 13 students agreed to participate in the descriptive phenomenological study. Findings of this study indicate that previous interventions aimed at creating a more welcoming environment for male nursing students at the research site have been moderately successful. Clinically, it is evident that there is still more work left to be done, specifically regarding the maternal-newborn clinical experience.

Barriers and facilitators to recruiting and retaining men on pre-registration nursing programmes in Western countries: A systemised rapid review

BACKGROUND

The recruitment of men to pre-registration nursing programmes in many Western countries has remained static at approximately 10% per year.

AIM

To identify the experiences and attitudes of men on pre-registration nursing programmes in Western countries and the barriers and enablers to their recruitment and retention.

DESIGN

Systematized rapid review.

METHODS

Searches were undertaken in Medline (Ovid), CINAHL (EBSCO) and PsychINFO (EBSCO) databases. Studies in English were included if they were from Western countries, were published since 2000 and related to men's experiences of, or attitudes to, applying for or studying pre-registration nursing. Included papers were quality appraised and findings were thematically analysed and presented in a narrative synthesis.

RESULTS

Records were de-duplicated and 2063 records were screened and 44 articles assessed for eligibility of which 23 articles relating to 22 empirical studies were included in the review. Findings were categorised into the following themes: recruitment experiences/reasons for studying nursing; gender experiences; barriers, difficulties and challenges with programme; and factors affecting retention.

CONCLUSION

Evidence suggests that many men who come into nursing have a family member or acquaintance who is a nurse or that they have had contact with a male nurse as a patient or carer. Motivating factors such as financial security, career mobility and the opportunity to have a job in a caring profession were reported. Improved career advice at school is needed and shortened graduate programmes could be attractive. On programme, some clinical areas were easier for male students, while in others, treatment refusal could cause difficulties. Being in a minority and gender stereotyping can affect experiences. Ensuring equitable treatment, providing additional support and placements in clinical areas with more men could minimise these challenges.

A longitudinal mixed methods study describing 4th year baccalaureate nursing students' perceptions of inclusive pedagogical strategies

BACKGROUND

Creating inclusive learning environments-those in which all students thrive-is a priority as nursing educators are charged with preparing a diverse workforce to care for a diverse patient population. Yet, faculty are hindered by a dearth of evidence-based pedagogical strategies to promote inclusion.

PURPOSE

This longitudinal mixed methods study uniquely addresses this evidence gap by describing relationships among inclusive pedagogical strategies and student outcomes in 81 4th-year baccalaureate nursing students.

METHODS

Across the academic year, students participated in two focus groups and completed surveys at three timepoints on classroom and clinical belongingness, self-confidence and satisfaction with learning, and self-efficacy in the clinical setting.

RESULTS

Students' reports of satisfaction and confidence in learning, clinical self-efficacy, and clinical belongingness were significantly higher when they characterized their learning environment as inclusive. Underrepresented students, however, reported significantly lower classroom and clinical belongingness at all three survey timepoints and shared examples of unaddressed breaches in inclusivity which undermined confidence and belongingness. Focus group participants evaluated pedagogical strategies and highlighted faculty's pivotal role in creating inclusive learning environments.

CONCLUSION

Inclusive pedagogical strategies may increase students' sense of belongingness, satisfaction and confidence in learning, and self-efficacy. Study results may assist faculty and inform future interventions.

A Mixed Methods Review of Male Nursing Students' Challenges during Nursing Education and Strategies to Tackle these Challenges

BACKGROUND

Calls to action have been placed for recruitment of more men to address nursing shortage and to achieve a better balance and diversity in workforce. Studies also indicated patients' demand for male nurses. Despite this, male nursing students experience challenges during their education resulting in their attrition. No reviews have explored this research area. This review explored the challenges of male nursing students during their education and identified strategies used to tackle these challenges.

METHODS

Literature was searched within three databases using indexed search phrases and 1 mixed-methods, six quantitative, and 36 qualitative studies (n = 43), published from December 1990 to May 2018, were reviewed. The qualitative and quantitative data were separately extracted and analyzed using thematic synthesis and narrative summaries, and then compared using joint displays.

FINDINGS

"Call me a nurse" and "Male nurses understand us better: Need more men in nursing" were the prominent themes. An array of educational and clinical challenges was identified. Students used appraisal-focused, problem-focused, and social support strategies to tackle these challenges.

CONCLUSION

Considering the identified challenges, the lack of support and efforts from educators and institutions, we reiterate calls to action for strategic policies to help male nursing students adapt to educational and clinical learning environments and to increase their recruitment and retention in nursing.