Factors influencing development of professional values among nursing students and instructors: a systematic review

Nurturing ethical insight: exploring nursing students' journey to ethical competence

BACKGROUND

Ethical competence is a key competence in nursing and the development of the competence is a central part in nursing education. During clinical studies, nursing students face ethical problems that require them to apply and develop their ethical knowledge and skills. Little is known about how ethical competence evolves during students' initial clinical placements. This study explored the development of ethical competence in first-year nursing students during their first clinical placements in nursing homes.

METHODS

This exploratory-descriptive qualitative study used focus group interviews to collect data and a phenomenological hermeneutical method for analysis. Twenty-eight first-year nursing students participated in six focus groups. The data were collected between March and April 2024 at Oslo Metropolitan University in Norway.

RESULTS

The naïve reading of the data involved an awareness of the students applying their prior knowledge, modifying their prior knowledge and developing skills that allowed them to manoeuvre ethical practices that, in some cases, appeared excellent and, in other cases, grim. The structural analysis identified three themes: (i) ethical competence forges in practice, (ii) ethical competence evolves at the intersection of knowledge and skills and (iii) ethical competence unfolds through meaningful discussions. A comprehensive understanding of the data was formulated as 'Being on a journey towards ethical competence'. This presents a metaphor illustrating that nursing students embark on a journey towards ethical competence; from their point of departure, their clinical experiences forge the essential waypoints along their path, knowledge and skills fuelling their navigation in rugged terrain towards their destination.

CONCLUSIONS

Nursing students' ethical competence evolved in intricate ways during their initial clinical period. Being informed bystanders or participants in the care of nursing home residents in situations of ethical tension may be a unique position enabling students to evaluate care options differently from those immersed in the ward culture. The findings indicate that organised professional development in nursing homes needs to focus on more reflexively driven ways of supervising students in their first clinical study period. Educational institutions need to continue and further develop reflection-based learning activities and meeting points with students and their peers during their clinical placement periods.

Ethical values held by nursing students. Comparative study in two country

INTRODUCTION

Ethical values are a guideline for behavior in certain situations. They take on particular importance in patient care. Ethical values depend on many factors including culture. The aim of this study is to compare the ethical values of nursing students.

METHODS

A cross-sectional study design was used. A total of 463 students participated in the survey, including 191 from Poland and 272 from Turkiye. The study was conducted from April to June 2022. For the purposes of this study was used Ethical Values Scale (IEVS). The criteria for excluding participants from the study were nursing student status and consent to participate in the study.

RESULTS

The IEVE total score for all respondents was 68.20 and the median was 68. In the individual subscales: Love-Respect 34.76 (median 35), Justice-Honesty 21.29 (median 21) and Cooperation 12.14 (median 12). Polish students' total IEVS score average was 70.48 ± 6.81 and Turkish students' IEVS total score average was 66.61 ± 9.65. There is a statistically significant difference between the total score average on the IEVS of students from the two countries (p < 0.001).

CONCLUSION

Students in both countries generally demonstrate high ethical standards. There are noticeable differences between the responses of students from Poland and Turkiye.

The relationship between nurses' professional values and ethical attitudes to pain

Background: Pain management is a fundamental human right for everyone who experiences it. The management of pain is an ethical obligation for all health professionals. Professional values have an important place in appropriate clinical decision-making. Research aim: This study was conducted to determine the relationship between nurses' ethical attitudes in pain management and their compliance with professional values. Research design: The study was conducted as a descriptive and correlational research. The study data were collected by online survey method using the Introductory Characteristics Form, Ethical Attitude Scale for Pain Management in Nursing, and Nurses Professional Values Scale - Revised. Participants and research context: The population of the study consisted of nurses working in tertiary treatment centers in a country. A total of 388 nurses participated in the study. Ethical considerations: Ethical approval was obtained from the University Ethics Committee. Consent was obtained from the nurses. Results: The mean total score of the Ethical Attitude Scale for Pain Management in Nursing was 98.96 ± 9.37, and the mean total score of the Nurses Professional Values Scale was 101.51 ± 15.20. The scores of the Ethical Attitude Scale for Pain Management in Nursing were positively and moderately correlated with the total scores of the Professional Values Scale. Compliance with professional values explained 41% of the total variance of ethical attitude for pain management. Conclusions: In this study, it was found that nurses' ethical attitudes for pain management and compliance with professional values were at a high level, compliance with professional values was associated with ethical attitudes for pain management, and ethical attitudes for pain management decreased with increasing working years. A nurse with high ethical sensitivity and compliance with professional values can easily recognize ethical problems, effectively manage the ethical decision-making process, and provide appropriate patient care.

Inclination of Nursing Students Towards Ethical Values and The Effects of Ethical Values on Their Care Behaviours

A descriptive, cross-sectional study aimed to determine the inclination of nursing students towards ethical values and the effects of these values on care behaviours. The data for this study were collected from 466 students studying from May 13-24, 2019. The data were collected using a questionnaire on the sociodemographic characteristics of the students, Inclination to Ethical Values Scale (IEVS), and Caring Behaviors Inventory-24 (CBI-24). In this study, 43.1 per cent of them belonged to families who had a protective attitude. The total mean (SD) IEVS and CBI-24 scores were 63.99 (12.68) and 117.19 (17.95), respectively. The mean item score was 4.88 (0.74). A moderate positive correlation was observed between the inclination of the students towards ethical values and their care behaviours. The general family structure of the nursing students and their participation in an ethics class affected the inclination of the nursing students to ethical values and their care behaviours. This study showed that the ethical values of the students positively affected their care behaviours.

Ethical and cultural competence of social- and health care educators from educational institutions - Cross-sectional study

BACKGROUND

The international mobility has increased cultural diversity in social- and health care. As such, ethical and cultural competence is an essential skill among educators. They are promoting the ethical and cultural competence and professional growth of students with diverse backgrounds and, therefore, must be ethically and culturally competent.

AIM

The aim of the study was to identify distinct ethical and cultural competence profiles of social- and health care educators and explore the associated factors.

RESEARCH DESIGN

A descriptive cross-sectional survey design was used to collect quantitative observational data in 2020-2021. Competence profiles were identified by K-means clustering based on answers to an instrument focussing on educators' ethical and cultural competence.

PARTICIPANTS AND RESEARCH CONTEXT

Participants (N = 1179, n = 243) were social- and health care educators based at 10 universities of applied sciences and 10 vocational colleges in Finland.

ETHICAL CONSIDERATIONS

The research adhered to good scientific practice. A research permit was received from each educational institution that participated in the study. The privacy of the participants was protected throughout the study.

RESULTS

The analysis identified three profiles of educators (A, B, C) based on self-assessed ethical and cultural competence. Profile A educators demonstrated high scores across all three competence areas. Profile B educators had high scores for ethical knowledge and intermediate scores for other competence areas. Profile C educators demonstrated intermediate scores across all three competence areas. An educator's pedagogical education was found to significantly influence which profile they belonged to.

CONCLUSIONS

The educators generally evaluated their ethical and cultural competence highly. Educators understand the importance of professional ethics in their work, but they need additional support in developing ethics skills in their daily work. Among all educators, there is a need for developing international and culturally diverse collaboration.

Pre-doctoral dental faculty perceptions toward value-based care: An exploratory study

OBJECTIVES

To explore pre-doctoral faculty perceptions toward implementation of value-based care (VBC) in didactic and clinical teaching.

METHODS

This project was a collaborative effort between CareQuest and the University of North Carolina at Chapel Hill, Adams School of Dentistry introducing VBC to pre-doctoral dental faculty as part of a new curriculum. Following a faculty development session on VBC in June 2021, faculty and subject matter experts were invited to participate in qualitative interviews. Subject matter experts were interviewed to establish a baseline for VBC knowledge and understanding. Interviews were recorded and transcribed verbatim. Analysis was conducted by two analysts using ATLAS.ti and a thematic analysis approach.

RESULTS

Six faculty and two subject matter experts participated in interviews. Although dental faculty demonstrated some understanding of VBC, they recognized that more training is required to build in-depth knowledge and implementation strategies for teaching dental students. Faculty discussed value-based concepts such as prevention-focused teaching, person-centered care, and disease management over invasive restoration of teeth, and how VBC is bringing about a paradigm shift in dentistry that needs to be reflected in dental education. They acknowledged a disconnect between VBC in didactic teaching versus clinical instruction. Those interviewed believed it would take time to shift faculty mindset and readiness to teach VBC, and continued efforts are needed at the leadership and faculty level for acceptance and implementation.

CONCLUSIONS

Although dental faculty recognize that VBC can bring a shift in dental practice, more training and guidance to implement it in didactic and clinical teaching is needed.

Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study

Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.

Professional values and perception of knowledge regarding professional ethics in physical therapy students: A STROBE compliant cross-sectional study

Undergraduate students start the acquisition of a professional identity, and begin to achieve professional values and consciousness of an ethical behavior as future health professionals. The aim of this study was describe professional values and perception of knowledge regarding professional ethics of physical therapy students. A cross-sectional study was performed. A total of 351 students participated in the study. Professional values and perception of knowledge regarding professional ethics were assessed. Ethical approval was obtained from the University Ethics Review Board. The most important value was equity, while the least one was abnegation. The second educational year showed higher scores in importance of scientific quality (P = .010 vs first year), the third year in respect for life (P = .041 vs first year, respectively), and the fourth year in respect to patient's autonomy (P = .033 vs first year). First-year students showed lower scores in perception of knowledge regarding professional ethics (P < .001 vs second, third, and fourth year), while second-year students had higher scores (P < .001 vs first and third; P = .006 vs fourth year) and no differences between third- and fourth-year students were found. Those professional values highly considered by the students were mainly shared professional values, with equity ranked highest and abnegation lowest. Furthermore, second-year students had a well-established perception of knowledge regarding professional ethics, showing significant higher scores when compared to the rest of the educational years. This is the first cross-sectional study that describes these variables among physical therapy students and it is a starting point for future. Physical therapy educators might want to take into account these findings when teaching and guiding students in developing awareness for their professional values and perception of knowledge regarding professional ethics.

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.

Relationship between perceived organizational support and professional values of nurses: mediating effect of emotional labor

Objectives

Perceived organizational support was a benefit for the work performance of nurses, which may affect emotional labor and the development of professional values. This study aimed to explore the relationship between nurses’ perceived organizational support and professional values, and investigate the mediating role of emotional labor.

Methods

This was a cross-sectional study. The study was conducted in 3 tertiary hospitals in Wuhan from October 2020 to January 2021. The data were collected by a questionnaire consisting of demographic characteristics, the Emotional Labor Scale for Nurses, the nurses’ Perceived Organizational Support Scale, and the Nursing Professional Values Scale (NPVS-R). A convenience sample of 1017 nurses responded to the questionnaire survey. Pearson’s correlation analysis was used to test the relationship between variables. Predictor effects were tested using hierarchical multiple regressions. The structural equation model (SEM) was used to test the mediation effect of emotional labor on the pathway from perceived organizational support to professional values.

Results

A positive moderate correlation was observed between the perceived organizational support and emotional labor (r = 0.524, P < 0.01), and a positive strong correlation was observed between perceived organizational support and professional values (r = 0.609, P < 0.01). Emotional labor and perceived organizational support were positive predictors of professional values (B = 0.531, 95%CI = 0.414 ~ 0.649; B = 0.808, 95%CI = 0.715 ~ 0.901, respectively). The association between perceived organizational support and professional values was mediated by emotional labor.

Conclusions

Results showed that perceived organizational support was positively related to nurses’ emotional labor, which was in turn associated with high professional values. For nurses, improving organizational support and training nurses to engage in emotional labor through providing multiple support systems, establishing appropriate incentive mechanisms, and training nurses to regulate emotions can be effective ways to promote nurses’ professional values.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00927-w.

Redefining the concept of professionalism in nursing: an integrative review

Objective

In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics.

Methods

In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professional behavior, nursing professionalism (NP), professional attribute, and nursing.

Results

In the present study, a comprehensive search of 11 electronic databases retrieved 5738 articles. Then, 2837 duplicate articles were removed by endnote (version 8). Based on a preliminary examination of the titles and abstracts as well as the inclusion and exclusion criteria, 1517 articles were excluded. In addition, 137 articles were removed for scientific reasons. Finally, 52 articles in English and Persian were selected. Content analysis of the articles revealed four major themes, namely, individual prerequisite, professional prerequisite, appropriate structure, and socio-individual factors.

Conclusions

Professionalism in nursing is a major, multidimensional concept according to the literature that included individual prerequisites, professional prerequisites, appropriate structures, and socio-individual factors. In fact, professionalism in nursing comprises a wide range of personal characteristics, self-regulation, professional values, striving to acquire and enhance professional expertise, professional interactions, social, professional, and legal responsibility, and creation of a sense of belonging, and professional development.

Influencing Factors on Person-Centered Care Competence among Nursing Students Experienced Clinical Training

Background and Objectives: Nursing students require appropriate education to improve their person-centered care competence. Therefore, research on the various factors that influence person-centered care competence is necessary. This study aimed to identify factors influencing nursing professional values, satisfaction with major, and perception of the nursing profession on person-centered care competence. Materials and Methods: This study was a descriptive survey, and participants were nursing students from three universities in Korea. Structured self-report questionnaires were used for data collection. Results: Nursing professional values (p < 0.001) were found to be an influencing factor on person-centered care competence (Adjusted R2 = 0.244). However, the perception of the nursing profession, and the satisfaction with the major were not found to be significant influencing factors on person-centered care competence. Conclusions: The findings suggest that fostering nursing professional values in nursing students and developing educational interventions for the same are essential to improve person-centered care competence.

Effectiveness of a standard clinical training program in new graduate nurses' competencies in Vietnam: A quasi-experimental longitudinal study with a difference-in-differences design

OBJECTIVE

This study aimed to estimate the effectiveness of a standard clinical training program for new graduate nurses in Vietnam.

METHODS

A quasi-experimental longitudinal study with a difference-in-differences design was conducted. A total of 280 new graduate nurses completed a self-administered questionnaire. The intervention group consisted of 206 respondents (those having participated in standard clinical training) and the control group (those that did not receive training) of 74. Differences in mean increases in competency scores between the intervention and control groups were estimated. The effect size of the intervention was estimated by calculating Cohen's d. A generalized linear model was employed to identify the factors associated with mean increases.

RESULTS

The mean increase in total competency scores (range: 0-6 points) in the intervention group was 0.73 points greater than in the control group with an intermediate effect size (Cohen's d = 0.53; 95% CI 0.26 to 0.80). A greater reduction in standard deviation of total competency scores in the intervention group was confirmed. Participation in standard clinical training produced a positive association with a mean increase in total competency score without significance (β = 0.04, P = 0.321). Provincial hospitals as clinical training venues had a significantly positive association (β = 0.11, P = 0.007) with the mean increase in total competency scores. Competency at pre-clinical training was negatively (β = -0.75, P < 0.001) associated with the mean increase.

CONCLUSION

Findings implied that the standard clinical training program could contribute to both increasing and standardizing new graduate nurses' competencies in Vietnam. Further studies are needed to more precisely examine the attribution of standard clinical training to better increase new graduate nurses' competencies.

Psychometric analysis of the Nurses' Professional Values Scale-3 Arabic version among student nurses

AIMS

We sought to establish the psychometric properties of the Nurses' Professional Values Scale-3 Arabic version among student nurses.

BACKGROUND

Nurses' professional values are central in the nursing profession; it encompasses principles such as respecting people rights and dignity, compassion, and caring without prejudice.

INTRODUCTION

The professional values of student nurses, most specifically in Saudi Arabia and other Arab countries, can hardly be studied due of the lack of a valid and reliable measure that is linguistically and culturally acceptable.

METHODS

In this cross-sectional study, we came up with the Arabic version of the tool and tested its psychometric properties among 350 student nurses from two universities in Saudi Arabia.

RESULTS

The principal component analysis revealed three distinct factors with eigenvalues above 1.00 and with an explained variance of 70.5%. The computed Cronbach's alpha of the tool was 0.967, while 0.964, 0.960, and 0.886 were computed for activism, caring, and professionalism, respectively. The test-retest scores (n = 85) revealed an Intraclass Correlation Coefficient of 0.827 for the entire scale, 0.826 for the subscale activism, 0.792 for caring, and 0.870 for professionalism.

CONCLUSIONS

The Nurses' Professional Values Scale-3 Arabic version had sound psychometric properties when used among Saudi student nurses.

IMPLICATION FOR NURSING

The tool can provide an accurate assessment of the professional values of Saudi nursing students and other Arabic-speaking student nurses.

IMPLICATION FOR NURSING POLICY

The tool can be utilized by nursing and nursing education policymakers in Saudi Arabia and in other Arab countries in guiding the creation of practice and education policies that gears towards improving nurses' professional values in this part of the world.

Effects of Nursing Education Using Films on Perception of Nursing, Satisfaction With Major, and Professional Nursing Values

BACKGROUND

Cinenurducation, a film-based approach to nursing education that incorporates student-centered, problem-solving, experiential, and reflective learning strategies, allows students to experience a variety of indirect experiences and improves critical thinking and self-reflection through discussion.

PURPOSE

The aims of this study were, first, to employ a cinenurducation approach to help instill a proper professional nursing identity in second-year nursing students and, second, to examine the effects of this approach on the perception of nursing, satisfaction with major, and professional nursing values of the participants.

METHODS

An experimental, pretest-and-posttest design was used to test the primary variables, including perception of nursing, satisfaction with major, and professional nursing values. The nursing educational program was developed based on the learning concepts of cinenurducation and the core concepts of nursing. The program, which included six films, addressed the following concepts: Me Before You (problem solving and professionalism), Testament of Youth (nursing management and professionalism), Girl, Interrupted (interpersonal skills and nursing knowledge), Hungry Heart (interpersonal skills and problem solving), Iris (nursing knowledge and problem solving), and Chronic (nursing knowledge and cooperation). The experimental group (n = 14) participated in the 8-week educational program, and the control group (n = 15) did not.

RESULTS

Perception of nursing, satisfaction with major, and professional nursing values all improved significantly more in the experimental group than in the control group, with large effects observed.

CONCLUSIONS

Cinenurducation is an effective approach to promoting professional nursing identity in nursing students. Educators should incorporate films into nursing education. In addition, nursing education should incorporate a variety of educational materials to provide students with opportunities for reflective learning.

Professional Values in a Sample of Nursing Students from Different Countries

AIM

This study aimed to determine the professional values of nursing students from different countries.

METHODS

This descriptive study was conducted with a convenience sample of nursing students from different countries. The data were collected using an identification form and the Nurses’ Professional Values Scale–Revised. A total of 305 nursing students from Turkey, Tanzania, and Spain were included in the analysis.

RESULTS

In this study, the mean nursing professional values scores were 113.5±12.8, 105.8±16.0, 107.9±8.4 for Turkey, Tanzania, and Spain, respectively (minimum–maximum: 44–130). There were no statistically significant differences between the Turkish and the Spanish students’ professional value scores, but the Turkish students’ scores were higher than the Tanzanian students.

CONCLUSION

The factors affecting the level of professional values of students for each country were different. For educators, it is important to develop teaching strategies to empower professional values. Understanding cultural differences can guide professional values and universal ethics in nursing practice, education, and research.

Social justice in health system; a neglected component of academic nursing education: a qualitative study

Background

In recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the main factors for teaching the concept of social justice in the nursing curriculum.

Method

This is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data.

Results

Analysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main sub-categories of the study and showed the negligence of social justice in academic nursing education.

Conclusion

Research findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators, specially training in the area of ethical ideology and social justice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00534-1.

Countries' cultures and professional nursing values: Cross-cultural evidence from Spanish and Colombian nursing students

This study aimed to identify countries' cultural values associated with the importance given to certain professional nursing values by nursing students from Spain and Colombia. Weis and Schank's Nurses Professional Values Scale-Revised (NPVS-R) in its Spanish version and the Hofstede cultural classification were used for this purpose. The sample was composed of 880 nursing students. Nursing students from both countries showed a greater importance for professional nursing values compared to evidence from other countries. Significant differences were also found in the total score, dimensions, and items, always being higher for Colombian students. Based on regression results, the impact that the academic year had on the importance given to NPVS-R is non-linear (U-inverted). Both groups of students gave the highest importance to the same group of items. Those showing the largest difference in the rankings were associated with country culture differences based on the scores identified by Hofstede. Colombian and Spanish societies present similarities in Power Distance and Uncertainty Avoidance, as well as differences in the other cultural dimensions.

Nursing students' perspectives on observed weight bias in healthcare settings: A qualitative study

BACKGROUND

Weight bias continues to be problematic within the healthcare setting among practicing healthcare providers (HCPs). These HCPs serve as influential role models for nursing students when immersed in the clinical environment. However, if HCPs are demonstrating bias toward patients with obesity, this may influence nursing students' beliefs and practices.

AIMS

This study aimed to explore nursing students' reflections of observed weight bias within the healthcare setting.

MATERIALS & METHODS

A descriptive qualitative study design was used involving reflective journaling and qualitative content analysis. Two cohorts of third-year baccalaureate nursing students (n = 197) participated in weight sensitivity training and submitted reflective journals over one academic semester.

RESULTS

Reports of weight bias were categorized into three themes-(1) Direct Impact: Observed Implicit and Explicit Provider Weight Bias; (2) Indirect Impact: Weight Bias Due to Skills, Equipment, or Staffing/Environmental Deficits; and (3) Reactions toward HCP Weight Bias: Conflict Between Weight Bias Training and Real-World Healthcare Experiences.

DISCUSSION

Weight bias was observed in some HCPs within the healthcare setting. Student reflections explored weight bias and the opposing messages between weight sensitivity training and real-world practices.

CONCLUSION

Preventing bias through continuing education for HCPs is crucial to provide compassionate care and instill ethical values in the next generation nurses.

Is there a relationship between moral competencies and the formation of professional identity among nursing students?

Background

Moral competencies are essential for nursing work. Professional identity is a set of values and beliefs that a person has about her/his job, which includes moral values as well. The development of moral competencies and formation of professional identity in nursing students occurs mainly during their college years. The aim of this study was to investigate the relationship between moral competencies and the formation of professional identity among nursing students.

Methods

This study was designed as a descriptive-correlational study. The study population was consisted of nursing students who were enrolled in nursing schools at the time of the study. Two hundred and twenty-one nursing students completed the study tools. The research tools were a demographic questionnaire, Moral Development Scale for Professionals (MDSP), and Professional Identity Scale for Nursing Students (PISNS).

Results

The mean (SD) of MDSP and PISNS scores was 45.69 ± 5.90 and 55.61 ± 12.75, respectively. There was a significant statistical relationship between MSDP and PISNS scores (p < 0.05). A significant equation was found (f (2, 218) = 16.68, p < 0.001) with an R2 of 0.113. The MSDP scores increased 0.136 for each score of PISNS, and married students had 2.452 scores higher than single students.

Conclusions

The positive correlation between the formation of professional identity and development of morality in nursing students indicates that by strengthening students’ professional values, their moral competencies may develop positively.

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

BACKGROUND

For nursing students, close monitoring of the appropriate development of their professional values is an important educational objective, since it may influence crucial areas such as safety and quality of care. Research aims: first, to find development of specific professional values of students at different educational stages characterized by variation in learning methods; second, to examine professional values of nursing students related to their sociodemographic characteristics.

METHODS

The research consisted 261 students that were were divided into three groups based on educational level: novice, advanced, and senior students. Data were collected using the Revised Nurses' Professional Values Scale.

RESULTS

The research showed statistically significant differences were found between three groups with different levels of education and in domains of professional values such as caring, activism, and justice. However, no statistically significant differences between nursing student sociodemographic characteristics such as age, gender, status, and education and their professional values overall.

CONCLUSIONS

It can be concluded that nursing education has a significant effect on development of professional values, especially in the basic training phase, and there is a need to emphasize the application and practice of nursing values, particularly caring, activism, and justice, in theoretical courses.

Effects of Transcultural Nursing Education on the Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence of Students

Purpose: To examine the effect of Transcultural Nursing education on nursing students' Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence.Design: A posttest quasi-experimental study with a control group.Methods: The participants were second year nursing students (n = 125). The experiment group was composed of students who had enrolled in the Transcultural Nursing course (n = 65). The control group consisted of students who did not enroll in this course (n = 60).Findings: The posttest scores of the experiment group in the scales were significantly higher than those in the control group (p < .01).Conclusion: Transcultural nursing course is an effective method to increase the professional values, empathic skills, cultural sensitivity and intelligence of students.

Mediating effects of empathy on the association between nursing professional values and professional quality of life in Chinese female nurses: A cross-sectional survey

Aim

This study aimed to examine whether and to what extent, empathy mediates the association between nursing professional values and professional quality of life (ProQOL) in Chinese female nurses.

Design

Cross-sectional study design.

Methods

A convenience sample of 733 nurses from Xi'an, Shaanxi Province, China, was recruited. Each participant was invited to complete a self-administrated socio-demographic questionnaire, the Nursing Professional Values Scale, the Jefferson Scale of Empathy and the Professional Quality of Life Scale. Descriptive statistics, Pearson correlation analysis and the bootstrap method were employed to analyse data using SPSS 23.0 software.

Results

The participants reported a medium level of ProQOL. Nursing professional values were positively associated with compassion satisfaction but negatively associated with burnout. Empathy mediated 9.2% and 57.1% of the total observed effect of nursing professional values on compassion satisfaction and burnout, respectively.

Professional Values of Nurses and Nursing Students: a comparative study

BACKGROUND

The process of learning the professional values is started from the student's entering to the university and to the workplace. This study compared the importance of professional values from the perspectives of nurses and nursing students.

METHODS

This descriptive-analytical study was conducted on 250 nurses and 100 nursing students. Data were collected using the Nursing Professional Values Scale-Revised.

RESULTS

According to the findings, the mean scores of nurses (3.68 ± 0.16) and nursing students' (3.86 ± 0.17) perspective toward professional values were at an important level. Furthermore, the students' perspective toward the professional values' importance was significantly more favorable than those of nurses. The highest mean scores of professional values in the two groups were related to the caring and justice domains. Both groups considered activism and professionalism as the least important domains among the others.

CONCLUSIONS

As the findings suggest, we need to pay more attention to values training, especially professionalism and activism, during undergraduate education for preparing the nurses to work in today's complex healthcare context. It is necessary to conduct more comprehensive studies for exploring the gap between theory and practice in different cultures and contexts.

Perception of compassion and professional values in nursing students: A cross-sectional multivariate analysis from Turkey

Professional values have been acknowledged as the foundation of nursing care, and compassion is recognized as one of these professional values. The aim of this study was to determine the relationship between compassion and professional values and the factors that affect the perceptions of nursing students. A cross-sectional research design was used. There were two sample groups: 141 first-year and 185 third-year nursing students (N = 326). The data were collected using a Personal Information Form, a Compassion Scale and the Nursing Professional Values Scale-Revised. Study data were evaluated with univariate and multivariate regression analyses. No statistically significant difference was found between the students' compassion levels. At the same time, the mean professional values score of the third-year students was determined to be statistically significantly higher. Furthermore, it was determined that the compassion levels of female students were greater than those of male students, and the perception of professional values of those whose fathers' education levels were high was greater. This study concluded that professional values increased as education levels increased but the level of compassion did not change. It is suggested that nursing education be shaped in order to include factors affecting the perception of professional values and compassion levels.

Modeling Doctor of Pharmacy Students' Stress, Satisfaction, and Professionalism Over Time

Objective. To gauge multiple dimensions of pharmacy students' professionalism, stress, and satisfaction with the Doctor of Pharmacy (PharmD) program. Methods. An online survey of first- through fourth-year pharmacy students was conducted from 2015-2018 to gauge the degree of students' professionalism (personal reflection, patient-centric care focus, cultural and interprofessional competencies), program stress (levels, sources, and burnout syndrome), and satisfaction. Multilevel structural equation modeling (SEM) determined the relationship between stress and satisfaction, and the degree to which these impacted levels of professionalism after adjusting for potential correlates (age, sex, financial stress, relationship status, race, and employment status). Results. Seven hundred sixty-four responses to the survey were received across the four calendar years. Of the students in the sample, 51% were female with a mean (SD) age of 26.6 (3.4) years. The overall response rate to the surveys was 86.2%. Professionalism was most strongly indicated by the measures of community-centeredness, patient-centeredness, and perceived benefits of being part of a team-based environment. The SEM model demonstrated an inverse relationship between the two composite latent constructs of stress and satisfaction. When modeled simultaneously, program satisfaction was found to be the more significant predictor of professionalism than stress after adjusting for associations with age, sex, and relationship status. Conclusion. Professionalism of pharmacy students is positively associated with students' satisfaction with the program, but professionalism is not independently significantly predicted by stress. Students who have positive responses to community- and patient-centeredness and who feel they benefit from engaging in a team-based environment are most likely to have greater professionalism.

Differences in professional values between nurses and nursing students: a gender perspective

AIM

To compare Spanish nursing students' and registered nurses' perception of professional values from the perspective of gender and professional experience.

BACKGROUND

Nursing has traditionally been a female profession; however, the analysis of professional nursing values from a gender perspective has received little attention. The integration of professional values typically begins during academic life and is, thereafter, reinforced during professional activities.

METHODS

A descriptive cross-sectional study was conducted with 159 students (97.4% females) and 386 registered nurses (86.8% females) from primary healthcare centres, hospitals and management positions within the public health system. The validated Spanish adaptation of the Nurses Professional Values Scale was used. This instrument measures three dimensions: ethics, commitment and professional mastery. Descriptive statistics were used to analyse the data, together with bivariate analysis using the chi-squared test.

RESULTS

Females granted more importance to professional values. Important gender differences among students were detected. Ethical values were considered to be the most important for both students and nurses, followed by professional mastery and commitment. The importance given to values progressively decreased in the groups under study: students, less-experienced nurses and expert nurses (in decreasing order).

CONCLUSIONS

Significant gender differences exist with regard to professional nursing values. The values related to professional commitment and mastery should be integrated and promoted during academic education and specifically focus on male students' perceptions. As professional experience increases, the importance attributed to professional values decreases.

IMPLICATIONS FOR NURSING POLICY

Professional nursing values should be promoted among universities, health services and professional organizations, encouraging their dissemination, implementation and evaluation.

Nursing and midwifery students' attitudes towards principles of medical ethics in Kermanshah, Iran

Background

Professional ethics is one of the important topics, which includes various rights such as respecting the patient’s right to choose (autonomy), being useful (beneficence), being harmless (non- maleficence), and respecting the justice, integrity, and confidentiality of information. Adherence to these principles can increase the quality of care and patient satisfaction. Since determining the current attitude of students towards ethics plays an important role in educational programs, this study was conducted to evaluate the attitude of nursing and midwifery students of Kermanshah University of Medical Sciences towards six principles of professional ethics.

Methods

In this cross-sectional study, 76 undergraduate nursing and midwifery students (who were at the final years of their study) were selected to participate in this study by census method. The data collection tool was a valid and reliable questionnaire on the principles of medical ethics. Data were analyzed using descriptive and inferential statistics.

Results

The study sample consisted of 49 (64.5%) nursing and 27 (35.5%) midwifery students with an average age of 23 ± 1.4 years. The mean score of nursing and midwifery students’ attitude towards medical ethics was 95.01 ± 4.8 in basis of 100, and was 94.56 ± 4.9 for nursing students and 96.04 ± 4.7 for midwifery students. Majority of the samples (96.26%) had positive attitude towards medical ethics and 3.73% had a relatively positive attitude. No statistically significant relationship was found between the attitude of students and variables of gender (t = − 0.27, p = 0.78), field of study (t = − 1.3, p = 0.99), marital status (t = − 1.378, p = 0.178), and age (F = 1.606, p = 0.2).

Conclusion

All students in this study had a positive attitude towards the principles of medical ethics, and this is a valuable asset for clinical environments. To increase the generalizability of the study, further studies with bigger sample size on the students of various disciplines of medical sciences is recommended.

The Point of View of Undergraduate Health Students on Interprofessional Collaboration: A Thematic Analysis

Interprofessional education (IPE) is essential to prepare future professionals for interprofessional collaboration (IPC). Learning together is essential for students because it is a way to understand the roles of other colleagues, improve their skills, knowledge, competencies, and attitudes to collaborate with the interprofessional teams. To explore how undergraduate students who attend IPE courses define IPC, a qualitative study using semistructured interviews followed by a thematic analysis was performed. Four main themes were identifed: IPC as a resource, requirements for IPC, emotions linked to IPC, and tutor's role to facilitate students' perception of IPC. Students considered IPE important to build IPC, where clinical placement tutors play a key role. The most important findings of the present study include the students' considerations about the importance of IPE when building their IPC definition and the key role played by the tutor during the placement in building IPC in clinical practice.

Ethics in nursing: A systematic review of the framework of evidence perspective

Aim:

To determine the current state of knowledge on nursing and ethics and to assess the knowledge and experience based on the evidence in this regard.

Background:

Although ethics is at the center of the nursing profession and the ethical issues affecting nurses are given much importance, few studies have focused on professional ethics in nursing. In this respect, ethics has become a concept that contains controversial and ambiguous situations.

Design:

The Preferred Reporting Items for Systematic Reviews and Meta-analyses guide, a basic search algorithm, was taken.

Data sources:

Cochrane, PubMed, CINAHL Complete, PsycINFO, and ULAKBIM from 2012 to 2016.

Review methods:

Following a systematic search strategy, all papers were assessed in relation to inclusion criteria and type of study. When sufficient information was not available in the title and summary of the works, the necessary data were evaluated in full texts.

Results:

This review was completed with 27 articles meeting the research criteria. The evaluation identified six themes: (1) ethics and nursing, (2) ethical difficulties/ethical dilemmas and nursing, (3) ethical competence and nursing, (4) professional ethics and nursing, (5) ethics, education, and nursing, and (6) ethics in health research.

Conclusion:

As a result of the review, a synthesis of high evidence-level research relating to nursing ethics was obtained. The emphasis was on the importance of further research and education so that the ethical aspects of nursing can be better understood throughout the studies. Nursing researchers’ level of evidence on ethics and their orientation to high research design will shed light on uncertain and controversial aspects of the subject.

Ethical consideration:

Since this was a systematic review, no ethical approval was required. There is no conflict of interest in this literature review.

The effects of nursing education on professional values: A longitudinal study

BACKGROUND

It is considered to be extremely important to ensure that nurses adopt professional values during their education in order to improve nursing practices and develop a professional identity.

OBJECTIVES

The aim of this study is to investigate the effects of nursing education on development of professional values.

DESIGN

This study was designed as a longitudinal study.

SETTINGS

The study was conducted in a nursing department at a nursing school in the western Turkey.

PARTICIPANTS

The population of the study consisted of nursing students who were enrolled in the nursing department in academic year of 2011-2012. The data of the study were collected from 59 first-year students in 2011 and 83 fourth-year students in 2015.

METHODS

The data of the study were collected using Personal Information Form and Nursing Professional Values Scale-NPVS. The participants responded to the same questionnaire in their first and fourth years in the department.

RESULTS

The scale mean score of the students in their first year was 3.44±0.635. The highest scores were obtained from the subscales of responsibility, security, and autonomy. Their scale mean score in their fourth year was 3.93±0.727. The highest scores were obtained from the subscales of dignity and autonomy. The difference between the mean scores was statistically significant (p=0.001).

CONCLUSIONS

It was concluded that nursing education had a significant effect on development of professional values.

Among nurses, how does education level impact professional values? A systematic review

BACKGROUND

Professional nursing values have been acknowledged globally as the foundation of daily nursing care practice. Understanding how nurses identify, comprehend and apply their professional nursing values is an important step towards improving nursing practice and patient care quality. Research has demonstrated that nurses' professional values are cultivated during prelicensure academic education.

AIM

The aim of this systematic review was to determine how level of education affects professional nursing values of clinical practising nurses.

METHODS

A systematic search of quantitative research published through December 2015 was performed in the following five electronic databases: CINAHL, Cochrane Library, MEDLINE, Web of Science and Religion and Philosophy Collection. The search was not limited to country of origin. The studies were assessed for methodological quality using established criteria.

RESULTS

Of 1501 articles identified through the literature search, only seven studies met the inclusion criteria with the majority being of good to high quality. Most of the studies found registered nurses pursuing a bachelor of science in nursing or higher had a greater awareness and application of professional values than nurses with lower levels of academic or non-academic education. Nurses with higher education also embraced professional values as fundamental for quality nursing care practice.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Health and academic institutions should support nurses through quality continuing and higher education that reinforces professional values, thus improving the quality of patient care.

CONCLUSIONS

The level of nurses' education appears to play an important role in developing both an awareness and an integration of professional values into practice. More research is needed to discover methods that may be used to promote nurses' professional values among nurses already practising clinically.

Facilitators and inhibitors in developing professional values in nursing students

Background:

Values are the basis of nursing practice, especially in making decisions about complicated ethical issues. Despite their key role in nursing, little information exists on the factors affecting their development and manifestation in nursing students.

Objective:

This study identifies and describes the facilitators and inhibitors of the development and manifestation of professional values based on the experiences of nursing students and instructors and nurses.

Research design:

Data were collected through 29 semi-structured interviews and two focus group interviews in 2013–2015 and were analyzed using the conventional content analysis method of Elo and Kyngäs.

Participants and research context:

In total, 18 nursing undergraduates, five nursing instructors, and five nurses from Shiraz University of Medical Sciences and one of the teaching hospitals in Shiraz were selected through purposive sampling.

Ethical considerations:

The research was approved by the Ethics Committee of Shiraz University of Medical Sciences and the teaching hospital examined.

Findings:

The findings consisted of two categories: personal and environmental factors. Personal factors consisted of the two subcategories of personal stimuli (work experience and past relationships, inner beliefs and acting on values, belief in God and a divine worldview) and personal inhibitors (the lack of professional motivation and enthusiasm, negative emotions). Environmental factors consisted of the two subcategories of environmental stimuli (cooperation, order and discipline) and environmental inhibitors (unfavorable work environment, society’s negative attitude toward nursing, the violation of rights).

Discussion and conclusion:

Given the impact of personal and environmental factors on the development and manifestation of professional values in nursing students, it is upon the education authorities to take account of them in their planning, and nursing managers are also recommended to further address these factors in their development of a proper work environment, provision of standard facilities and removal of barriers.

Factors influencing development of professional values among nursing students

OBJECTIVE

To determine the professional values of Turkish nursing students, and to explore the relationships between their characteristics.

METHODS

The cross-sectional study participants consisted of 416 nursing students who were studying in a nursing faculty in Western Turkey. A questionnaire was used to identify socio-demographic and educational characteristics and the Nursing Professional Values Scale- Revised (NPVS-R) was used for this study..

RESULTS

The total mean score of the NPVS-R was found to be 99.45±1.96, and items mean score was 3.82±0.62. The NPVS-R score was significantly higher in students who were female, and who chose their profession willingly, had information about values, and who were members of a professional organization.

CONCLUSION

The students were found to have strong professional values, and professional values affected some of the personal and educational characteristics of nursing students.