Changes in the recruitment pool: the Australian experience

NurreEducahon T&y (1991) II, 431-438 0 Longman Group UK Ltd 1991

Changes in the recruitment experience

pool: the Australian

Caroline M Wright This paper examines the changes in the recruitment pool from which we draw nursing students. In New South Wales, the change in venue from hospital to college institutions has significantly accelerated a change which began more than 20 years ago. College programmes attract more males directly from school and less mature age males than hospital programmes. There is a difference in the socioeconomic level of the household from which nursing draws its recruits in hospital and college programmes. College programmes attract more recruits from lower socioeconomic level households than hospital programmes. In New South Wales, this was found to be particularly so for the female group but not for the male group. From the national perspective, where students had the choice to enter either a hospital or higher education programme to attain a nursing qualification, it was found that there was no difference in the socioeconomic level of the household of origin between students who choose to enter a hospital programme which paid a wage while training and students who choose to enter a higher education programme which offered no such financial reward. This finding remained consistent when the study sample was cross-tabulated by state, gender and age group (young vs mature).

be completed

INTRODUCTION Nurse education period.

in Australia

In February

pioneered ation

1985,

the movement

from

the hospital

into the mainstream national

research

orientation

is in a transitional New South

Wales

of basic nurse preparapprenticeship

of higher education. the transfer

system From a

is expected

Caroline M Wright RN RMN Dip Teach (Nursing) MA (Hon.4 Senior Lecturer, Faculty of Nursing and Community Studies, University of Western Sydney, Hawkesbury, Richmond, New South Wales 2753, Australia (Requests for offprints to CMW) Manuscript accepted 23 May 1991

to

in 1992.

implications

Some

of the social and

of this move are the focus

of this paper. There

have

been

many

opponents,

both

within nursing as well as other interested over

the

transfer

expressed

concern

advantage grounds

issue.

These

opponents

that the transfer

recruits

from

who were attracted

working

parties,

would disclass

to nursing

back-

because

it provided a wage and housing while training. The implication was that the different financial situation

for students

programmes

entering

would discriminate

college

nursing

against

lower

socioeconomic groups. These claims are of interest when one examines the results of research studies on the social backgrounds of‘ nursing 431

432

NURSE EDUCATION

students

in hospital

TODAY

programmes

eral profile of higher

education

1960s

nursing percentage

hospital-based

attracted

a

daughters where

high

and

daughters

the father

position

and

homes

of

a smaller

unskilled,

are also reflected in

Anderson

from

indicate are

households

percentage

from and

(Anderson 1970;

that

the

skilled

1962). These findings

in studies of higher

& Western

which

programmes of farmers’

semiskilled

general

groups

In the

was in a high administrative

manual workers (Radford students

and the genstudents.

education

et

al

1980;

Hore 8c West 1980)

higher

socioeconomic

over-represented

in higher

ded a Catholic Technical

concerns

supported

of

the

profession

by the research

were

not

study conducted

by

Wright

(1988,

1989)

nursing

recruits

in New South Wales during the

transfer

period.

composite

which

Using

collected

a specially

socioeconomic

comparison, contrary

Wright

demonstrated

was more pronounced entering

pital and

higher

in New South hospitals

for that, edu-

Wales were

to recruit

from lower SES family origins students

variable

expectations,

programmes likely than

constructed

@ES)

(1988)

to general

data on

students

and this finding

for the female group. For

directly from school into hos-

college

programmes,

no significant

difference was found on the variable. College programmes

composite SES in New South

proportion

students have mothers have

fathers

fessional, Personal

research

In an attempt to explain this unexpec-

ted difference Wright

from

(1989)

multivariate

an economic

examined

the

(number

data

analysis of variance

results of the analysis indicated

perspective, using

technique.

the The

that the variables

of years delay between

leaving school

and entry into a nursing programme, the SES level of the household of origin and the level of income received by the mother) were related and, taken jointly, they were different in the

had

may

study

from

pro-

backgrounds.

that a high pro-

an enrolled a Tertiary

nursing Education

allowance. have

been

the possible limiimposed

study in New South

on her

Wales due to the

fact that the decision to transfer

nurse education

into the mainstream of higher education was to be effected within a S-year period. This is in contrast adopted

to the incremental transfer strategy by the other Australian states. In the

New South Wales study, this meant that only a sample in its third year of training in hospitals, instead of the ideal comparative

group from first

year was still available in 1986 to compare the

incoming

opposed

students

to second

in any

intakes

one

with

year

(as

in any one year) in

college programmes. As the aim of Wright’s study was concerned with the issue of access into college

programmes,

compare

Barclay

pro-

to come

and farmer

and received

that

the

of nursing

who were trained nurses;

data showed

Scheme

with a

qualification

general,

Wright (1989) acknowledged

age

grammes.

student

In

tend

of recruits

background

fewer

hospital

who

managerial

portion

students

than

school, and more recruits

and country students. indicated that a high

more direct from school entry and career change women and males

in the college

Education

Wales attracted males, re-entry mature

that

and Further

tations

The

more

pp 2 IO-2 12) were

Assistance

edu-

cation.

cation

(1989,

sample there were fewer females who had atten-

incoming

it

was

students

important

into colleges

to with

in hospital programmes.

In the

state

(1989)

of South

Australia,

have commenced

Neil1 and

a longitudinal

study which aims to collect data on the sociodemographic

characteristics

college-based Studies

programmes

of students in South

entering Australia.

of this kind are to be congratulated

they are However,

as

able to detect changes over time. such studies have a limited focus for

comparative purposes when one seeks to compare hospital and college recruitment patterns. In New South

Wales

it was found

that the

hospital suggests different

and college groups. Such a finding that the decision-making process was in the households between the two

groups. Other

venue for nurse education continued to be a ‘political football’ from the year of implementation and continued until the state election in 1988. It was at this time that the Liberal Party

findings

formulated

of interest

in Wright’s

study

a policy for nurse education

should

NURSE EDUCATIOh’

they be elected in the forthcoming election in New South Wales. Liberal Party policy, among other concerns, was involved with changing the previous decision to transfer nurse education into the higher education system. This decision was based on an assumption that the move was disadvantaging student recruitment from working class family origins. It was Wright’s comparative study (1988) in New South Wales which demonstrated that the objection based on eouitv grounds was ill-founded. The positive outcome which resulted may well be an indication that from a political, and by implication, an economic perspective, there is a pressing need to gather data on both the social and demographic characteristics of students entering- hospital and higher education programmes . - while the ‘choice’ variable is still in operation. L

I”

1

THE METHODOLOGY AND DESIGN OF THE RESEARCH STUDY This study compares the social and demographic origins of students in hospital and higher education programmes in Australia by means of various parental and family characteristics. The questionnaire used by Wright (1988) which was adapted from the questionnaire constructed by Anderson et al (1980) was used for this study. The analysis in this paper uses the same composite SES index utilised in Wright’s New South Wales study. To obtain a status score on an individual’s family, each of the factors of father’s occupation, education and income (Wright 1988, 1989) is given a scaled score and multiplied by a factor weight as determined by the Anderson et al (1980, p 225) higher education sample. The intercorrelations of categories were occupation-income 0.47, occupationeducation 0.64 and education-income 0.42. The resultant SES scale is presented in quintiles for comparative purposes. Based on the implications for future research that came out of Wright’s study in New South Wales, the construction of the sample of the national nursing population aimed to collect data from every institution, both hospital and

TODAY

433

Table 1 Distribution of hospitals by state, geographical location and reeponee pattern*

;o;unon Queensland 01 62 03 2 66 Victoria O7 08 o6 IO

l1 12 ,3 14

Geographic location

Number returned

Country Country Metropolitan Country Metropolitan Countrv

33 20 46 24 40

32

12

11

Country Metropolitan Metrooolitan Country

56 19 14 12

54 18 14 12

Metropolitan

51

46

Country Country

24 18 12

22 13 12

12 81

12 81

39 10 31

38 10 31

554

505

Countrv

South Australia 15 Countrv 16 Metrorktan Tasmania 17 Metropolitan Country :; Metroplitan Totals

Number sent

;: 24 20

*There were no hospitals conducting preregistration nursing programmes in the Northern Territory or Western Australia

tertiary, involved in conducting nurse preparation programmes. The Directors of Nursing in the organisations identified as training hospitals (Australian Hospitals Association 1989) were contacted in July 1989, with a letter introducing the proposed survey. 19 of the 20 hospitals still conducting nurse preparation courses agreed to participate and to provide a contact person to distribute and collect the questionnaires. Where possible the first intake group in 1989 was surveyed between August and November 1989 and included general, psychiatric and mental retardation educational programmes. The hospitals included in the survey are identified in Table 1. The higher education institutions were contacted between November 1989 and March 1990. This extended period was dictated by the ethical review policies in some of the institutions as well as the introduction of five new nursing programmes in higher education institutions in

434

NURSE EDUCATION TODAY

Table 2 Distribution of higher education institutions geographic location and response patterns institution code

Geographic location

Queensland* 20 Metropolitan 21 Metropolitan 22 Metropolitan 23 Counttv South Australia 24 Metropolitan 25 Metrooolitan Metropolitan 26 Metropolitan 27 Victoria** Countrv 28 29 Metropolitan 30 Country 31 Metropolitan 32 Country Tasmania 33 Metropolitan Western Australia 34 Country Metropolitan 35 Northern Territory 36 Remote Totals

by state,

Number sent

Number returned

48 55 60 66

40 53 41 59

85, 130 120 106

79 77 107 106

66 100 70 90 65

57 65 32 20 23

150

127

200 151

139 100

25

15

I 587

1140

*Four of the 6 institutions are included **Five of the 8 institutions are included

Queensland in 1990. 21 of the 23 higher education institutions involved in nurse preparation programmes agreed to participate. In higher education institutions where the EFTSU allocation was <150, the total group present at lectures on a certain day was surveyed. In institutions with an EFTSU allocation of > 150, random sampling was achieved through the utilisation of lecture groupings. Once again contact persons in each institution agreed to distribute and collect the questionnaires. Questionnaires were received from 17 of the 2 1 institutions by the closing date for questionnaire return (these late returns are now in hand and are included in the data analysis of individual state differences). The institutions included in the computation of the composite socioeconomic variable are identified in Table 2. The data were coded onto computer sheets using a code for each subject and a numeric code for each institution to preserve confidentiality of

the data. The data were processed on a personal computer using the SPSS/PC+ program for computation of the data. The chi square statistic was used to indicate whether the differences between the two sample groups were statistically significant using the 95% level of confidence.

THE STUDY POPULATION The national sample used in this analysis consists of 505 nursing students in hospital-based programmes in Queensland, Victoria, South Australia and Tasmania and 1140 students in higher education programmes in Queensland, Victoria, South Australia, Tasmania, Western Australia and the Northern Territory. Thus, both hospitals and higher education institutions are represented by a 33% sample of the population group targeted for this study.

Description of the two institutional samples Gender of respondents Nurse preparation in hospitals was more likely to attract male recruits than nurse preparation programmes in higher education institutions. From a national orientation, in the hospital sample females comprised 83.6% and males were represented at 16.4%; whereas in the higher education sample females comprised 88.8% and males were represented at 11.2%. Age of recruits

The age of the recruits to nurse preparation programmes in higher education institutions was generally of a younger age group than the recruited to hospital-based prostudents grammes. In higher education institutions, 53.7% were between the age of 17-18 years. As age in years is a very broad indicator of patterns of entry due to the fact that formal compulsory schooling requirements differ between states, the number of years between finishing school and entry into a nursing program variable was examined. In the hospital sample, 33.9% entered in the year after leaving school, whereas

NURSE EDUCATION

in the higher directly

education

sample,

51.0%

entered

from school.

Type of school attended The institutional subgroups

were very similar

with regard to the type of school attended. hospital

sample,

60.6%

attended

a state high

school, 22.0% had attended a Catholic and 11.9% had attended an independent (other

than

education

a Catholic

sample,

school).

61.4%

high school, 20.7%

In the higher

school.

tional subgroups

were cross-partitioned

differences

When

there

a state

Table 3 Distribution of the national student group on the composite socioeconomic variable by instituion Socioeconomic level

Hospital sample

SESl (lowest) SES2 SES3 SES4 SES5 (highest)

95 98 102 110 100

Totals

505 (100%)

Higher education sample

(18.8%) (19.4%) (20.2%) (21.8%) (19.8%)

235 230 227 220 228

(20.6%) (20.2%) (19.9%) (19.3%) (20.0%)

1140 (100%)

x2 = 1.76806; d.f. = 4; n.s. at 5% level

school and 12.8%

an independent

der (male vs female)

school, school

had attended

a Catholic

In the

435

TODAY

the two instituby gen-

were no significant

was similar:

17.8%

for the hospital

14.6% for the higher education

group

and

group.

detected. Occupational level of the students’ parents The

Location of school Higher education (47.4%)

programmes

were more likely

than hospitals (35.2%)

who had attended

to attract recruits

school in a capital city .

Country of birth The hospital sample comprised in which 84.0% was similar

were Australian

to the higher

which 85.1%

a student

group

born and this

education

sample

were born in Australia.

From

in the

household perspective, hospitals drew students from families in which 70.9% of the students’ fathers

were born

education

in Australia

programmes

and in higher

the percentage

was simi-

lar (69.0%). Educational level of the students’ parents of the students

institutions

were less likely to have completed

school

(46.8%)

in higher

than

the

(40.2%).

However,

tion of students’

fathers

completing

courses group

was similar: and

13.5%

14.5% for

the

for

of the

the proporuniversity the

higher

comprised

the father’s

11.3%;

skilled manual,

recruits

lower professional,

15.2%;

from

occupation

and semiskilled

was

11.5%; manual,

9.3%. The higher education

sample was similar:

upper

lower professional,

professional,

12.4%;

10.7%;

skilled manual,

manul

10.9%.

recruited

The

and semiskilled

proportion

from farmer

lar for the hospital

12.2%;

of

households group

students

was also simi-

(9.5%,)

and for the

higher education group (10.2%). The mothers of the students in both institutional groups fessions

were concentrated

(hospital:

18.2%),

20.4%,

clerical (14.7% (10.7%

(28.3%

and

in lower pro-

higher

education:

and 12.4%),

semiskilled

10.5%)

and

home

duties

and 29.3%)

education

fathers

hospital students

sample where

professional,

work

The fathers high

hospital

households

hospital education

RESULTS OF ANALYSES Socioeconomic There

variable

was no significant

difference

found on the

group.

socioeconomic variable at the 5.0% level between the hospital and higher education sub-groups of

A similar pattern emerged when the mothers’ highest level of education was considered. In the

is shown in Table

hospital group, ary school

33.6%

compared

education group. mothers of students

did not complete to 40.5%

second-

in the higher

The proportion of the with a nursing qualification

nursing The

students

from a national

perspective

lack of statistical

difference

continued

when the national

sample was cross-partitioned

by gender

vs male) and age (younger

mature).

(female

as

3.

vs

436

NURSE EDUCATION

TODAY

Table 4 Distribution of the hospital students on the composite socioeconomic variable by younger and mature age groups Younger age group <22 Years

Socioeconomic level SESl (lowest) SES2 SES3 SES4 SES5 (highest)

38 59 73 74 74

Totals x2 = 31.14276;

(11.9%) (18.6%) (23.0%) (23.3%) (23.3%)

318 (100%)

Mature age group >21 vears 57 39 29 36 26

(30.5%) (20.9%) (15.5%) (19.3%) (13.9%)

187 (100%)

d.f. = 4; sig. at 0.0000 level

Table 5 Distribution of higher education student sample on the composite socioeconomic variable by younger and mature age groups

Socioeconomic level

Younger age group c22 years

Mature age group >21 years

SESl (lowest) SES2 SES3 SES4 SES5 (highest)

125 148 157 177 186

110 82 70 43 42

Totals

793 (100%)

x2 = 60.59223;

(15.8%) (18.7%) (19.8%) (22.3%) (23.5%)

(31.7%) (23.6%) (20.2%) (12.4%) (12.1%)

347 (100%)

d.f. = 4; sig. at 0.0000 level

There was a significant difference at the 5.0% level on the SES variable between the younger and mature age group within each institutional subgroup in the national sample. This is demonstrated in Tables 4 and 5.

The gender variable There was a significant difference in the gender composition of nursing students in hospital and higher education institutions as is shown in Table 6.

Mode of entry There was a significant difference in the proportion of students entering direct/delayed from school in hospital and higher education institutions which is highlighted in Table 7. There was a significant difference between gender (male vs female) and entry patterns

(direct vs delayed) in hospital and higher education institution recruits in Australia. This difference is displayed in Table 8. There was no significant difference at the 5.0% level between SES, gender, direct/delayed entry patterns between the two educational institutions.

Summary

of findings

The main results of the national study can be summarised as follows: no significant difference was found in the socioeconomic level of the households of students who choose to enter hospital nursing programmes and those who choose to enter higher education programmes. This lack of significant difference in the socioeconomic level of the household between hospital and higher education groups continued when the national sample was cross-partitioned by gender (male vs female), by age group (younger vs mature) and by mode of entry (direct vs delayed). It was found that there was a significant difference in the proportion of males to females who choose to enter the hospital and higher education programmes. There was also a significant difference found in the proportion of direct and delayed entry students between the two institutional subgroups. There was no signiTable 6 Distribution

of students by institution

by gender

Gender

Hosnital samnle

Higher education samnle

Female Male

442 (83.6%) 83 (16.4%)

1012 (88.8%) 128 (11.2%)

Totals

505 (100%)

1140 (100%)

x2 = 8.02858; d.f. = 1; sig. at 0.005 level

Table 7 Distribution of students in hospital and higher education institutions by direct from school and delayed entry from school entry patterns Hospital sample

Mode of entry Direct from school Delayed entry from school

341 (67.5%)

559 (49.0%)

Totals

505 (100%)

1140 (100%)

x2 = 47.54269;

164 (32.5%)

Higher education sample 581 (51 .O%)

d.f. = 1; sig. at 0.0000 level

437

NURSE EDUCATION TODAY

Table 8 Distribution patterns

of students in hospital and higher education institutions

by gender and direct and delayed entry

Hospital sample

Higher education sample

Mode of entry

Female

Male

Direct Delayed

149 (35.3%) 273 (64.7%)

15 (18.1%) 68 (81.9%)

Totals

422 (100%)

83 (100%)

Female

Male

539 (53.3%) 473 (46.7%)

42 (32.8%) 86 (67.2%)

1012 (100%)

128 (100%)

Females: x2 = 37.74147; d.f. = 1; sig. 0.0000 level Males: x2 = 4.82616; d.f. = 1; sig 0.028 level

hcant difference delaying when

found

entry

each

between

the reason

for

and the SES of the household

institutional

group

was examined

separately.

recruits than hospital programmes the academic nating

qualification

variable

affecting

suggests that

may be the discrimichoice

of institutional

programme. The lower socioeconomic

status of the mature

age group in both hospital and higher education

DISCUSSION There

appears

to be no association

socioeconomic

level

student

to enter

choice

education

nursing

est because

the

between

household

a hospital

training

in return

for the training

to the institution are required abling

the

service

to the local

cation

hospital

programmes

providing gramme

a wage is attended

rostered to

work

age females commitments

social context,

maintain

to the

nurses thus en-

its 24-hour Higher

edu-

do not have the benefit while

training.

The

of

pro-

during normal school hours for both young and

who may have either or unpaid

ments in the household Traditionally,

shifts

community.

which may be of assistance mature

valid to argue, in the present

a service

means that apprenticed

to work

work

paid

commit-

against the move

role which resulted opportunity

Males are more grammes higher

education

less freedom

within the hospital

system of training.

The finding that higher education were more attractive

programmes

to direct from school entrv

pro-

This

finding

that mature age males have

of choice

than

the

mature

age

females. There

is some evidence

from this study which

suggests that it can no longer be assumed that the choice

of a nursing

childhood.

Many

career

students

is made do not

early make

in this

decision until after leaving school. Furthermore, the decision

in some cases is made after gaining

some experience cation

is that

in the workforce. career

by parental

to be influenced

References

implicit

hospital

counterparts.

may be an indication

access issue where

variable

likely to enter

and to enter at an older age than their

of nurse education from the hospital apprenticeship system was based on the equality of the discriminating

from a lack of educational

in their youth.

ticipation.

was assumed to be the financial reward structure

that

any individual is ‘locked into’ a lower status work

influenced

environment.

the argument

at a later

the

provided

under a block study system. Providing

past disadvantage,

and

under

a service

that

may be overcome

that it is no longer

This is of inter-

to provide

reason,

life stage. It is also suggested

or a higher

is organised

suggests

for whatever

system which pays a wage and

its recruits

institution

of

programme.

hospital

an apprenticeship requires

programmes

OF THE FINDINGS

decisions pressure

by experiential

The

impli-

are being

less

and more likely workforce

par-

Anderson D S, Boven R, Fensham P J, Powell J P 1980 Students in Australian higher education: A study of their social composition since the abolition of fees. Australian Government Printer, Canbera

438

NURSE EDUCATION TODAY

Anderson D S, Western J S 1970 Social profiles of students in four professions. Australian Council for Educational Research, Melbourne Australian Hospitals Association 1989 Hospitals health services and equipment yearbook. Peter Isaacson, Prahran, Victoria Hore T, West L H T (eds) 1980 Mature age students in Australian higher education. Higher Education Advisory and Research Unit, Monash University, Melbourne Neil J, Barclay L 1989 Sociodemographic characteristics of nursing students in higher education. Australian Journal of Advanced Nursing 7, 1: 4-l 1

Radford W C 1962 School leavers in Australia 19591960. Australian Council for Educational Research, Melbourne Wright C M 1988 Student participation in nursing programs: a study of their social composition since the transfer to colleges of advanced education. Higher Education Research and Develoument 7.2: L 15%162 Wright C M 1989 Students undertaking basic nurse preparation: a study of the social composition of students in hospital-based and college-based courses in New South Wales. M A (Hons) Thesis, School of Education, Macquarie University