Professional socialisation of nursing students as an outcome of a senior clinical preceptorship experience

Nurse Education T&y (1993) If, 3-15 0 Longman Croup UK Ltd 1993

Professional socialisation of nursing students as an outcome of a senior clinical preceptorship experience Dolly Goldenberg and Carroll lwasiw

The study purpose was to examine the effects of a senior clinical preceptorship experience on the professional socialisation of nursing students. Corwin’s (196 1) conception of the professional nursing role and literature on professional socialisation provided the model for the study. A three-group, pre- and post-test design was used. The voluntary, non-randomised sample was drawn from 242 senior community college, baccalaureate and RN-BScN nursing students. Instruments were the Lawler-Corwin (1988) Nursing Role Conception Scale and the Lawler-Stone (1988) Health Care Professional Attitude Inventory. Demographic data were collected. One-way ANOVA was used to compare the mean scores among the three groups. For statistically significant (p < O-05) F tests, Student-Newman-Keuls multiple comparison tests were used to determine which pairs of groups were different. Pre-post scores were compared using paired t-tests. Following the preceptorship, on the Lawler-Stone subscales, the groups became more professional and more similar in attitude. On Corwin’s three role conceptions, the total group reported less role conflict, with the community college students having the least and the RN-BScN students the most amount of conflict, The mixed results emphasise that professional socialization requires further research, especially as an outcome of a preceptorship experience for RN-BScN students.

INTRODUCTION Professional socialisationhas been described as a issue in nursing. It is a process which occurs primarily during the period of formal education and is one of the main purposes of

crucial

Dolly Goldonbwg RN PhD, Associate Professor, Carroll lwasiw RN MScN, Associate Professor, Faculty of Nursing, University of Western Ontario, London, Ontario, Canada N6A 5Cl (Requests for offprints to DG) Manuscript accepted 4 November 1992

undergraduate nursing education (McCain 1985, Spickerman 1988). The establishment of nursing as a profession and the continued professionalisation of nursing practice have been said to rest on the professional socialisation of nurses (Hinshaw 1977, Jacox 1978, Styles 1982). Inadequate socialisation, on the other hand, not only contributes to attrition from nursing practice and education (Corwin et al 1961, Kibrick 1963, Kramer et al 1972), but could seriously undermine progress toward full professional status. The study of socialisation has emerged from 3

4

NURSE EDUCATION

three divergent

TODAY

theoretical

transformation

and methodological

of self-concept

perspectives: anthropology, psychology and sociology. The term ‘socialisation’ has a history

1989, Donius 1988, Goldenberg The goal of the preceptorship

of varied use, but it is now being viewed as an

transition

interactional

promote

process in which the socialiser and

the individual joining the group are mutually influenced (Hurley-Wilson 1988). It is a process by which

individuals

acquire

tudes, morals, knowledge

the values,

atti-

and skills, espoused

by

a group (Bragg 1976, Brim 1966, Mauksch & Styles 1982). According to Glaser 8c Strauss (1971),

socialisation

transitions status

is one

of the

many

life

from one social status to another:

passage.

Lynn,

McCain

& Boss

a

(1989)

describe it as a lifelong process of learning social roles. The purpose is to facilitate the best possible role performance (Mauksch

the group

& Styles 1982).

Professional of

by thosejoining

adult

socialisation

socialisation,

is a specific portion

a complex,

process by which the content role (skills, knowledge,

interactive

of the professional

behaviour)

is learned,

of student

professional

and a change

1989, Goldenberg

al 199 1). Kramer

McCain

1987, Watson (1980),

(Cohen

1985,

Throwe

1983). According

anticipatory

1981, Lynn & Fought

to Klein & Kitti

socialisation,

the first of six

career stages in the socialisation process, involves the acquisition of career attitudes, values, motives

and myths commonly

Kramer’s gramme

(1974) aimed

anticipatory at reducing

developing bicuhuralism. from this work. The

word ‘preceptor’

century in England, tutor or instructor.

held by society. socialisation reality

shock

Preceptorships originated

where Within

proand

values

(1974)

in self-concept

(Davis &

1987/88, Hughes

identified

et

resolution

of

The main purpose of this study was to investigate the effects of a senior clinical preceptorship experience on role socialisation and professional attitudes

of nursing

was to compare groups college

of

students.

such

nursing

completion

(those

programme);

nurses

among i.e.

aim three

community

in a S-year college

baccalaureate

university

A secondary

variables

students,

(those enrolled

(registered

are internalised

role

three role values necessary for successful transition: service, bureaucratic and professional.

4-year

profession

with organisational

Barham

of that

et al 1989,

values

ceptions,

identity

of a member

role and to

into the professional

and practice skills of the health care agency, resolution of inaccuracies in nursing role con-

profession

of occupational

et al

(Clayton et al 1989, Goldenberg 1987188). Contributing to this transition is the integration of

gramme);

and sense

to graduate

socialisation

and the values, attitudes and goals integral to the which are characteristic

(Clayton

1987/88). is to assist in the

enrolled

programme).

enrolled

proin a

and KN-BScN

in a baccalaureate Since

graduates

of

these programmes have the potential to be hired into similar staff nurse positions, it is important to determine

their conceptions

of professional

nursing at the time of graduation. Finally, since most investigations have studied nursing students in the USA, this research the literature about nursing students.

socialisation

will fill a gap in of Canadian

arose

in the 15th

the word meant a nursing education

literature, the term has come to mean an intense one-to-one, reality-based, clinical learning experience between an accomplished staff nurse and a neophyte. The staff nurse coordinates and supervises the learning activities of the student, provides guidance in the refinement of psychomotor and higher-order thinking skills, offers both formative and summative evaluation, promotes student independence, role-models nursing practice and assists in the student’s

LITERATURE REVIEW Professional socialisation There is no dearth of studies on the socialisation of nurses, but most research has involved the socialisation

of graduating

students

in three

types of nursing schools or nurses practising in their first professional role. Schein’s (1978) work on professional socialisation involved career anchors, that is, a pattern of self-perceived talents, motives and values that serve to guide, constrain, stabilise and integrate the person’s

NURSE EDUCATION

career.

Hinshaw

influencing cess,

(1977)

identified

major factors

the socialisation-resocialisation

related

to the

setting,

profession,

Studies of socialisation

that, in order

role

needed

to adopt a professional

gramme, from

as part of the education

i.e. during a student’s and

when

student

new

to worker

educational

move

(resocialisation),

have

been conducted for some time. Merton, Keader & Kindall’s (1957) induction model of socialisation

depicted

fessional

students

identities

Becker

through

et al (1961)

which described fessional identity system. Becker

developing

pro-

role relationships.

created

a reaction

students developing prothrough interactions with the

Simpson

(1979),

however,

used

the

et al and Merton et al models and found

that both induction the professional

and reaction

socialisation

played a role in

process.

published

from

1972

to 1983

them under categories ception,

autonomy,

ambiguity

conflict,

and differentiation

tice of professional

and

organised

of socialisation, role

role con-

role

strain,

between the prac-

and technical

nurses.

of investigators

which students’ faculty, students’

the

concepts

inference

attitudes

being

and

values

to

the

closer

matched

their

teachers or nurses in practice, the more successful their socialisation. As students neared graduation, they were found

that

this

whose role expectations after graduation.

& Schmalenberg

perspective

could

students

(196 la) and Corwin

will encounter & Taves

(1962)

found that baccalaureate students had a higher professional role conception and experienced more

role discrepancy

than diploma

students.

This was inconsistent with Hover’s (1975) and Gortner’s (1968) investigations in which RN students

had more students.

community bureaucratic According

professional Davis

attitudes

than

reported

that

(1972)

college students expressed more values than baccalaureate students. to Jones

college students orientation

&Jones

had a higher

(1977),

community

bureaucratic

and lower professional

orientations

than

to hold similar views to

those of their faculty and to have adopted

different

revealed fessional

those of their

that

cautioned

produce conflict when students begin to practice, since it is the culture of the practising nurse

four

studied the extent matched

(1977)

of the professional

Kramer

baccalaureate

more

students

students.

of nursing

were

found

orifrom

programmes

no significant differences orientation scores. However,

traditional Whelan’s RN-BSN

types

role

and service

Thomas’s (1979) study of professional entations and role conceptions in students

Preprofessional socialisation of nursing students A number

nursing role. However,

generic

Conway (1983) reviewed and critiqued 66 studies in the nursing research literature

students

role model simi-

lar to that held by faculty. Lynn et al (1989) did find that graduating generic students were like

Corwin

model

and con-

to be successful,

faculty in their conceptions

pro-

professionals

with that of the faculty’s

cluded

model and individual. She advised more research in assessing the impact of these factors. process,

ideal nurse

pro-

5

TODAY

in proRN/BSN

to be less oriented

to

views of nursing than other students. (1984) study found completing students

professionally

less bureaucratic

and more

and service oriented

than enter-

ing students. Finally, in the Lawler & Rose (1987) study involving senior generic, RN baccalaureate

and

associate degree was investigated

students, using

protheir

(1961 b) Nursing

Kole

professional views of nursing (Conway 1983, Cracker & Brodie 1974, Gunden 1980, Olesen &

fessionalism adaptations

Whittaker

Conception Scale and Stone & Knopke’s (1978) Health Care Professional Attitude Inventory.

Whelan Warner fessional

1968,

Stoller

1978,

Tetrault

1976,

1984). Conversely, O’Neill (1973) and & Jones ( 198 1) saw progression of proviews over the years but a decrease

the senior year. Sharp & Anderson

(1972)

compared

in

success-

ful and unsuccessful freshman, sophomore, junior and senior students’ descriptions of the

of Corwin’s

Their findings support the contention is a difference in professionalisation graduates prepared at different

that there of nursing educational

levels. studied Other investigators socialisation in different types

professional of nursing

6

NURSE EDUCATION

TODAY

students from the perspectives of self-esteem, role perception and conflict, life transition and

service. The bureaucratic role conception is associated with rules and regulations of nursing

professional

care

1974,

status (Bradby

Hughes

et al 1991,

1992, McCain Shead 1991,

1990,

Brown

Lengacher

et al

8c Keller

1985, Ollson & Gulberg 1991, Spickerman 1988, Throwe 8c

socialisation

strategies

to enhance

the

process was stressed.

ing students’

performance

but few have focused (1988)

anticipatory

baccalaureate decreased

socialisation

students

preceptorship

experience. between

bureaucratic significant

Dobbs’

study of senior

showed

significantly scores

There

after

were

a no

pre and post scores in the

and service role conceptions, decrease

in the mean

but a

professional

role conception score. In contrast, Itano et al (1987) found no significant differences in role deprivation ceptored

and role conception

and non-preceptored

between

organisation, and

and

is

organisation.

The primary loyalty is to the hospital administration. In contrast, a professional role concepwith principles

and standards,

and is oriented decision-making

toward autonomy, and innovation.

loyalty

nurse

of the

passion,

dedication

oriented

toward

care.

have been reported,

total role deprivation

differences

on nurs-

on socialisation.

the

efficiency

is to the

independent The primary profession

of

nursing. Finally, a service role conception is associated with values such as humanity, com-

Preceptor-ships and socialisation Studies of the effects of preceptorships

within

toward

tion is associated

Fought 1987). Although the study approaches varied and the results were mixed, the importance of undertaking

delivery

oriented

The

person Jones

primary

(Corwin 1981).

and understanding, personalised,

and is

holistic

client

loyalty is to the client

196 la, Dobbs

According

as a

1988, Warner

to Corwin,

&

the three

roles are held simultaneously by all nurses varying degrees. These three role conceptions well as professional

attitudes

were

using the revised Lawler-Corwin Conception

in as

examined

Nursing

Kole

Scale (1988) and the revised Lawler-

Stone Health Care Professional

Attitude

Inven-

tory (1988).

pre-

students.

RESEARCH QUESTIONS

In a study by Clayton et al (1989) of 66 senior baccalaureate

students

Scale, preceptored non-preceptored

students

fessional socialisation the preceptor Jairath

using

students

Schwerian’s

6D

scored higher

than

on four

behaviours,

experience.

et al (1991)

of six pro-

6 months after

Using the same scale,

studied

preceptored

and

non-preceptored diploma students in the final semester of their programme. The preceptored students dimensions

scored

significantly

according

higher on one appraisals.

on three

to faculty appraisals,

dimension

CONCEPTUAL

higher according

and

to self-

As measured Care

by the revised Stone’s Health

Professional

Attitude

Inventory

(Lawler 1988), for each of the subscales and for

the three

munity

groups

college,

of students

baccalaureate

(com-

and

KN-

BScN): What are the mean

pre-preceptorship

professional attitude three groups?

scores among

the

What are the mean post-preceptorship professional

attitude

scores among

the

three groups?

FRAMEWORK

Corwin’s (196 la) conception of the professional nursing role and literature on professional socialisation provided the model for this study. According to Cot-win, role conception has three components: bureaucratic, professional and

Are there between the torship mean

significant

differences

pre- and post-precepscores among the three

groups? As measured by the revised Corwin’s Nursing Role Conception Scale (Lawler 1988), for each of the role socialisation components and for the three groups of students:

NURSE EDUCATION

a. What are the mean

pre-preceptorship

ideal and actual role conception among the three groups?

Instrument

scores

c.

What

are

the

mean

preceptorship

pre-

scores

and

discrepancy

post-

scores,

i.e.

differences between ideal and actual role conception scores among the three groups? d. Are

there

between

the

torship

mean

significant pre- and scores

differences post-precep-

among

the three

groups? 3. What post

The instrument tionnaire.

b. What are the mean post-preceptorship ideal and actual role conception among the three groups?

the

scores

relationships and

selected

between

the

consisted

of a three-part

ques-

Part I was the Lawler-Stone

(1988)

Health Care Professional Attitude Inventory. Part II was the Lawler-Corwin (1988) Nursing Scale. The third section, Kole Conception developed by the investigators, graphic data.

requested

demo-

The Lawler-Slone Invenlo?y ( 1988) was a modification of Stone & Knopke’s

(1978)

Health Care

Professional Attitude Inventory. The original inventory, based on Dumont’s (1970) paradigm of

neo-professionalism,

statements attitudes

demographic

a series

of

care delivery

systems.

It measures

toward six aspects of professionalism:

consumer

variables?

contains

about today’s health care professions

and health

are

7

TODAY

control

(citizen

participation

in

to credentialism (lack for formal credentials)

of

health care delivery system) indifference importance superordinate

purpose

(concern

METHODS

being of others and human critical attitude (questioning

Design

in health care)

toward

traditions

for well-

welfare) and scepticism

and established

practice

A three-group pre- and post-test design was used for this descriptive study. The voluntary,

l

impatience with rate of social change (impatience with the pace of social progress)

non-randomised

l

compassion

sample

senior nursing students

was drawn

from

in a southwestern

rio city. A questionnaire

242

Onta-

The inventory items, strongly

approval

Keview Board,

administrators

from the institutional

letters

were sent to the

of the nursing programmes

seek-

ing permission to access students. Once approval was obtained, a verbal explanation and a letter of information class time.

were given to all students during Anonymity was assured. Pre-tests

were administered

to volunteer

subjects.

Keturn

of the questionnaire implied consent. Following the preceptorship experience which varied from 12-15 weeks nistered.

the

care

of

36, 7-point

from

strongly

(l),

pertaining

disagree

and delivery

Likert

agree

scale (7)

to

to the health

system.

In pilot

tests with freshman nursing students (n = 254) and first-year medical students (n = 315) item

Procedure receiving

contains

ranging

care professions

Ethics

to

was used to obtain the

data.

After

(dedication

others).

in length,

post-tests

were admi-

discrimination

indices

and

coefficient

alpha

were computed for each of the six scales: 0.610.28 (M = 0.40); 0.50-0.23 (M = 0.34). For the instrument

as a whole, the coefficients

were 0.79

and 0.72. Content, concurrent and construct validity were addressed in relation to Dumont’s (1970) six constructs. Lawler’s ( 1988) changes related to item construction, ranking scale (5point) and scoring. The Lawler-Comin Scale (1988) was based on Corwin’s ( 196 1b) Nursing Role Conception Scale. The original scale isolates the three

8

NURSE EDUL4TION

TODAY

Table 1 Sample characteristics Variable

Freauencv n

%

36 18 13

54.4 26.5 19.1

63 5

86.4 13.6

35 27 3 3

50.7 39.1 4.3 4.3

41 27

59.4 39.1

27 14 12 8

44.3 23.0 19.7 13.1

Age <25 25-34 235 Gender Female Male Years in nursing programme 3 4 5 6-11 Health care experience in addition to current programme Yes No Preceptorship Area Medical-surgical Community health Maternal-child Critical care

components of a nurse’s role values: acceptance of hospital bureaucracy, perceptions of the nursing profession, and perceptions of client welfare. The tool measures the strength of each role conception. 22 situations are described: six make up a bureaucratic subscale, eight make up a professional subscale, and eight make up a service subscale. These items describe hypothetical situations in which nurses might find themselves. Kespondents are asked to indicate, on a 5-point Likert scale ranging from strongly agree (5) to strongly disagree (l), the extent to which they think each situation ‘should be the ideal’ or ‘actually does exist’ in nursing practice. The sum of item responses is the role conception subscale score. The same scoring method is used to determine the normative (ideal) score and the categorical (actual) score. Differences between the ‘actual’ and ‘ideal’ scores for each item are added to yield the total role (deprivation) discrepancy score. Content validity has been addressed in the instrument’s development (Corwin, 196 1b). Construct validity and predictive validity (0.01) were demonstrated; testretest reliability coefficients for the role conception scales were:

a. service, 0.86 b. bureaucrat.ic, 0.89 c. professional, 0.88 Lawler’s ( 1988) changes related to item additions and revisions, resulting in 28 items. The investigators modified the scoring by calculating the mean for each subscale.

Sample The non-probability, convenience sample consisted of nursing students enrolled in their senior clinical preceptorship experience which occurred in the final semester of their programmes. Baccalaureate and KN-BScN students were paired with baccalaureate nurse preceptors as much as possible, and the preceptors were employed as staff nurses, managers and educators in hospital and community settings. The community college students worked with preceptors who were staff nurses in hospitals. Volunteer subjects comprised 68 students, who completed both pre- and post-tests, 27 of whom were community college students, 24 baccalaureate students and 17 KN-BScN students (Table 1). Factors which may have contributed to the 36% response rate were the necessity to complete the same questionnaire twice, the length of the questionnaire, administration of the instrument during high-stress times for the students and difficulty in accessing subjects post-preceptorship. However, the homogeneity of the subjects (Polit 8c Hungler 1991) and the alpha level of 0.05 may have minimised the risk of’ bias in the smaller sample size. Fewer subjects are needed for a 5% level test than a 1% level test (Kraemer 8c Thieman 1987).

RESULTS AND DISCUSSION <&win’s (196 1a) conceptual framework was useful in this investigation as it provided the components with which to examine professional role conception. Answers to research question number two were facilitated using the three role conceptions.

NURSE EDUCATION

Table 2 Pre and Post mean scorest for Lawler-Stone

Professional Attitude

9

Inventory

Subscale

Total group

Community college n = 21

Baccalaureate n = 24

RN-BScN n = 17

Sig. of F values (p)

Consumer control Pre Post

2.59 2.71’

2.72 2.80

2.56 2.70

2.41 2.61

NS NS

Indifference to credentialism Pre Post

2.25 2.44*+

2.29 2.48*

2.13 2.57**

2.33 2.22

NS NS

2.23 2.28

2.24 2.35

2.58 3.36’

2.22 2.08

0.028 NS

Critical attitude Pre Post

2.52 2.56

2.62 2.61

2.53 2.55

2.37 2.50

NS NS

Impatience with social change Pre

2.77

2.93

2.83

2.44

0.002

2.82

3.00

2.81

2.62

NS

3.17 3.27’

3.35 3.51

3.13 3.24

2.95 3.02

0.025 0.022

Superordinate Pre Post

TODAY

Pairs

purpose (1,2)

&I Compassion Pre Post

tRange l-5 lp G 0.05, **p 4 0.01 on pre-post 1 = strongly disagree 5 = strongly agree

(1.3) (1.3)

differences

Data analysis For research questions la and b, and 2 a, b and c, overall F tests for one-way analysis of variance (ANOVA) were used to compare the mean scores among the three groups. If the overall F tests were found to be statistically significant (p < 0*05), the Student-Newman-Keuls (SNK) multiple comparison test was used to determine which pair(s) of groups were significantly different in the mean scores. Two-tailed, paired t-tests were used to compare pre-post scores. To answer research question 3, one-way ANOVA was used for categorical variables and Pearson correlation coefficient for continuous variables.

Research question 1 This research question concerned pre- and posttest scores on the Lawler-Stone Professional Attitude Inventory (1988). Kesults are presented in Table 2. All scores for the three groups

increased following the preceptorship experience. On both the pre- and post-tests, the community college subjects had the highest mean scores on four subscales. This result contrasts with that of Lawler & Kose (1987) who found that the KN-BScN group scored significantly higher than the community college group on four subscales. Among the three groups there were significant differences on three subscales on the pre-test and one subscale on the post-test, whereas Lawler 8c Rose found significant differences on four subscales. The total group was signiticantly more oriented (t (61 df) = -2.27; p < 0.05) toward consumer con& after the preceptorship. All subjects (t (61 df) = -3.10; p G O.Ol), community college (t (20 df) = -2.33, p S 0.05), and baccalaureate (t (23 df) = - 3.74; p s 0.01) students agreed significantly more with in&fference LOcredentialism on the post-test. For the subscales of superordinale purpose, the

10

NURSE EDUCATION

baccalaureate ficantly munity

TODAY

students scored highest and signi-

(p = 0.028) different from the comcollege students on the pretest. The

baccalaureate students’ mean score increased significantly (t (23 df) = 2.16; p < 0.05) on the post-test,

indicating

that they perceived

more

strongly that the ultimate purpose of the health care system is the concern for human welfare. There

were no significant

differences

among

(1978),

Tetrault

(198 1)

found

the total group’s = 2.07,

p 6

The

pre-test,

other

and

p G

that they viewed less bureaucratic

group

(M =

the

greatest

on both

pre-

-0.57).

On

the

it was significantly

higher

than

the

two groups

higher (p = 0.002)

significantly

(p =

group lowered

post-test.

had scores

-0.74,

laureate

college students

revealed

discrepancy

post-tests

laureate students’ mean scores were significantly On the post-test, the community

(t (6 1 df) = 2.12,

group’s scores (t (23 df)

as significantly

RN-BScN

post-test,

students.

students

after the preceptorship.

impatience with the rate of social change, on the

than the RN-BScN

scores

0.05)

actual practice

& Jones

views. In the present study

0.05) and baccalaureate

bureaucratic

college and bacca-

and Warner baccalaureate

rejected bureaucratic

the three groups and no significant pre-post changes for the subscale of crilical ut&ude. For both the community

(1976) that

0.0222).

(t(23 df) = -3.00, However,

The

their discrepancy

the

baccascore

p < 0.01) on the

negative

discrepancy

obtained the highest mean score (M = 3.00), suggesting they may have been the least satisfied

scores of all three groups demonstrated that they did not support a bureaucratic orientation

with the pace of social progress.

(Table

of compassion, the total

For the final subscale

group’s mean scores indicated that the subjects agreed with an attitude of dedication to the care of others. The community

college group’s mean

scores and pre- and post-tests were highest and significantly different (p = 0.025; p = 0.022) from

the

increase

RN-BScN

df) = -2.09; agreed

p d 0.05). following

Research question second

question

preceptorship scores among Corwin

The

pre-post (t (6 1

This showed that they

more strongly with an attitude of sensiti-

vity to others,

The

group.

for the total group was significant

ideal,

the preceptorship.

primary

that the subjects loyalty should

agreed

t.hat nurses’

be to the profession

of

nursing. On both the pre- and post-tests, the community college subjects’ ideal scores were significantly

lower (p = 0.0 125,O.OO 15) and their

actual scores 0.0275)

significantly

than the other

higher

(1962) and Jones &Jones

(p = 0.0008,

two groups,

with results of Corwin (196la),

two

involved

pre- and postand

the three groups

Nursing

indicated

consistent

Corwin & Taves

( 1977). The RN-BScN

students in the Lawler & Rose (1987) study were found to be more professional than the other

2 actual

3).

For the professional role concepion subscale, on both pre- and post-tests, the ideal mean scores

Role Conception

discrepancy

on the LawlerScale (1988).

For the bureaucratic role conception subscale,

the

community college group had the highest ideal mean pre-score (M = 3.30), and it was signifi-

groups,

having

higher

fessional role conception In the current

scores

on

pro-

and attitude measures.

study, the baccalaureate

group

viewed nurses’ actual practice as least professional whereas Lawler & Rose (1987) found that

the

RN-BScN

nurses as significantly

group

viewed

practising

less professional.

from the other two groups (p =

There were also significant pre-post changes. The total group’s scores (t 61 df) = -3.17, p <

0.0006). There were no significant differences among the groups in the post-preceptorship ideal and actual bureaucratic role orientation in contrast to other published findings. Corwin

0.01) and the RN-BScN group’s scores (t (16 df) = -2.93, p < 0.01) showed they considered actual practice to be more professional after the preceptorship experience. The baccalaureate

(1961a), Corwin & Taves (1962), Davis (1972) and Jones & Jones (1977) reported that com-

group lowered their ideal professional role conception, similar to findings by O’Neil(l973) and Brown et al (1974). The community college group developed a significantly less ideal pro-

cantly different

munity college students expressed the highest bureaucratic role orientation, while Staller

NURSE EDUCATION

Table 3 Pre and post mean

11

scored for bureaucratic role concqHion Total

grow

ROIS

TODAY

Community college n = 21

Baccalaureate n = 24

RN-BScN n = 17

Sig. of F values (p)

Pairs

Pre Ideal Actual

2.72 3.15

Discrepancy

3.03 3.06

-0.43’

Post Ideal Actual

-0.03

2.77 3.01

Discrepancy

l

-0.24’

tRange l-5 lp 6 0.05, 1 = strongly disagree 5 = strongly agree

2.63 3.23 -0.60

2.84 2.87

2.41 3.15 -0.74

2.85 3.04’

-0.03

-0.19**

2.56 3.13

0.0006 NS

kfl

0.000

&I

E

-0.57

0.0222

&I

l*p G 0.01 on pre-post differences

Table 4 Pre and post mean scoreet for professional

role conception

Total group

Community college n = 21

Baccalaureate n = 24

RN-BScN n = 17

Sig. of F values (p)

Ideal

3.80

3.60

3.92

3.90

0.0125

Actual

2.78

3.04

2.71

2.50

0.0008

Discrepancy

1.02

0.56

1.21

1.40

0.0000

3.71

3.48*

3.73

3.97

0.0015

Actual

2.97**

3.18

2.85

2.87”

0.0275

KI

Discrepancy

0.74***

0.30**

0.88+‘*

1.11

0.0000

&I

Role Pre

Post Ideal

I::231 .~.

tRange l-5 lp G 0.05, 1 = strongly disagree 5 = strongly agree

l*p d 0.01, ***p C 0.001

fessional

(t (20 df) = 2.49, p < 0.05)

perception

after the preceptorship. This did not concur with results in the Lawler & Rose (1987) investigation

where

there

were no significant their

fessional

on the

scores

post discrepancy

scores

that all subjects continued

in this study indicated to believe that nursing

practice should be more professionally

ences among the groups. All three groups lowered discrepancy

differ-

Corwin dc Taves (1962), greater role discrepancy was found among baccalaureate graduates. The

mean

pro-

post-test.

The community college (t (20 df) = 3.03, p < 0.01) and baccalaureate groups (t (23 df) = 3.7 1, p < 0.001) reported significantly less professional role discrepancy following the preceptorship, while in studies by Corwin ( 196 la) and

oriented

than it actually is (Table 4). For the seruice role concephon subscale,

there

were no significant differences among the three groups’ means on the pre and post ideal and actual scores. Nevertheless, the community college group had the lowest score, as was also identified by Jones &Jones (1977). As well, the

12

NURSE EDUCATION

TODAY

Table 5 Pre and post mean scorest for service role conception

Role Pre Ideal Actual Discrepancy Post Ideal Actual Discrepancy

Total group

Community college n = 21

Baccalaureate n = 24

RN-BScN n = 17

Sig. of F values (p)

3.84 3.03 0.81

3.78 3.08 0.72

3.83 2.99 0.84

3.93 3.01 0.92

NS NS NS

3.72 3.22*

3.60 3.38

3.73 3.19

3.85 3.22

NS NS

0.50***

0.21**

0.54*

0.79

0.0012

tRange l-5 lp C 0.05, 1 = strongly disagree 5 = strongly agree

community

college

(t (19 df) = 2.96,

p < 0.01)

scores. However, the pre and post mean scores indicated that all subjects agreed that nurses toward personalised,

holistic

client care and that nursing should have a higher service orientation

than it actually does. Follow-

ing the preceptorship, ideal

score

and

II:31

l*p < 0.01, ***p C 0.001

and baccalaureate (t (23 df) = 2.44, p < 0.05) groups significantly lowered their discrepancy

should be oriented

Pairs

all groups decreased

increased

their

actual

their score,

suggesting that they lessened their ideal expectations of nursing practice and enhanced their perception of how nurses personalised care (Table 5).

actually

perform

Effects of the preceptorship Although

the pair-wise

differences

between

comparisons

the community

illustrate college and

other two groups, the results indicate that the preceptorship experience had a socialising effect on the community

college

and

baccalaureate

students,

with a lesser effect

on the RN-BScN

students.

This latter group began their precep-

torship with the highest level of role conflict and continued to experience the highest level following the preceptorship,

which is not surprising

since the community

college

students are neophytes

and baccalaureate

in the profession

for some time and they were probably acculturated

Research question 3

and this

was their first reality-based practice. In contrast, the RN-BScN students had been out in practice already

into the reality of the profession.

The baccalaureate

group was most affected

by

the preceptorship. They changed in all three role conceptions and significantly lowered their

The final question addressed the relationships between the post-preceptorship scores and

three

selected demographic variables. The group under age 25 had significantly higher post scores

college group started with the least role discrepancy and reduced it even further, presumably

on the ideal bureaucratic older students. There

role conception than were also significant

differences among the mean scores for the post-professional ideal role conception according to the preceptorship area: the medical-surgical group had the lowest score and the critical care group the highest.

role discrepancy

having been somewhat

scores.

The

community

socialised into the role of

a staff nurse when they began their preceptorship experience, then becoming even more so. The RN-B&N group continued to experience the highest level of role discrepancy (conHict) after the preceptorship experience. Shead ( 199 1) has suggested the provision of conHict

NUKSE

management role conflict.

in nursing

education

to minimise

IMPLICATIONS, LIMITATIONS RECOMMENDATIONS

AND

The results of this investigation intimate that the preceptorship experience should be continued, at least for community college and baccalaureate students. Preceptorships are purported to assist in the resolution of incongruency between student and graduate roles, which was the case for these two groups of students. However, the findings seem to imply that careful consideration should be given to the value of a preceptorship experience for the KN-BScN group, as little change in role conception and discrepancy occurred. During the hiring process, employers may wish to consider that graduates of different nursing programmes have dissimi1a.r levels of nrofessional socialisation. The results and implications of the study should be interpreted in light of the following limitations. A small, convenience, non-randomised sample, drawn from two programmes in only one city, limited the generalisability of the results. Attempts were not made to control variables (such as curriculum content, preceptor characteristics, clinical environment) that may have affected professional attitudes, role conception and discrepancy. Because there are insufficient data regarding factors that affect the socialisation process and the interaction between prctfessionalisaticm and nursing practice, further studies should be undertaken to examine these phenomena. investigations of professional Longitudinal socialisation might additional contribute information about this process as well. Moreover, research should include an examination of the preceptor’s role and contribution to the professional socialisation of neophytes.

EDUCA1‘ION

TODAY

13

results confirm, as well as contrast with, previous findings. This emphasises the fact that socialisation is a process that is still not clearly understood. Prbfessional socialisation of nursing students is also vague, even when examined as an outcome of a senior clinical preceptorship experience. Many questions remain unanswered, several about socialisation and preceptorships for KN-BScN students being most evident from the present investigation. One might question if the preceptorship experience is appropriate or even necessary for KN-BScN Does this experience move them students. beyond their previous level of socialisation? Would a preceptorship reinforce the discontent that may have led this group to return to school in the first place? Will their role discrepancy result in burnout, or motivate them to become change agents in the practice of nursing?

Acknowledgements

L

CONCLUSION Although literature

this study has added to the body of on professional socialisation, the

Adapted from a presentation at the Learned Societies Conference/Canadian Association of University Schools of Nursing, IO-12 June, 1992, The University of Prince

Edward Island. This project was funded in part by the University of Western Ontario and the Iota Omicron Chapter of Sigma Theta Tau, International Honor Society of Nursing.

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