Role socialization of graduating student nurses: Impact of a nursing practicum on professional role conception

doi:10.1016/8755-7223(94)90037-X

Journal of Professional Nursing

Volume 10, Issue 6, November–December 1994, Pages 342-349

https://doi.org/10.1016/8755-7223(94)90037-X Get rights and content

Abstract

This study examined graduating student nurse role conception changes that occurred during a concentrated clinical preceptorial. A Nursing Role Conceptions Questionnaire was administered to nursing students before (n = 44) and immediately after (n = 41) a 4-week Nursing Practicum; to the students' staff nurse clinical teaching assoclates (n = 34); and to nursing program faculty (n = 18). Respondent perceptions of ideal nursing behaviors and actual nursing behaviors within three major nursing roles (professional, service, and bureaucratic) were identified and differences between ideal and actual scores (role discrepancy) were calculated. Findings showed that student role orientation in selected areas changed from a faculty role orientation to a staff nurse role orientation over the 4-week period. The Practicum seemed to effectively facilitate role socialization of graduating student nurses into the work setting, easing the necessary transition from education to practice.

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Cited by (19)

Final clinical practicum, transition experience and turnover intentions among newly graduated nurses: A cross sectional study
2020, Nurse Education Today
Citation Excerpt :
Elements such as gaining learning experiences that mirror the reality of what is like to be a graduated nurse, being an active member of a professional team, adequate support and a well-functioning supervisory relationship have been recognized as important in FCPs (Casey et al., 2011; Kaihlanen et al., 2018, 2019). FCP experiences have been suggested as facilitating the necessary change in role conception from student to nurse (Coudret et al., 1994) and as assisting graduating students in developing positive attitudes towards their nursing career (Tseng et al., 2013). The FCP may also be important in newly graduated nurses' recruitment and retention, as it can shape decisions about preferable future work environments (McKenna et al., 2010; Shih and Chuang, 2008; Shoqirat and Abu-Qamar, 2015).
The shortage of nurses is a global issue, and turnover rates are especially high for newly graduated nurses. The transition from student to nurse is often described as challenging, and the final clinical practicum before graduation is suggested to be important in preparing graduating students for the transition. However, little is known about the actual relationships between the final clinical practicum, transition and turnover intentions.
To examine whether the final clinical practicum experience is associated with the transition experience and turnover intentions of newly graduated nurses, and whether the transition experience mediates the potential relationship between the practicum and turnover intentions.
Cross-sectional survey study.
The study was carried out in Finland (October–December 2018).
Registered nurses graduated within the past two years (n = 712).
A new survey instrument with five subscales was developed for measuring the final clinical practicum experience. Transition experience was measured on four scales that demonstrated the emotional, physical, socio-developmental and intellectual domains of the transition: Psychological distress, sleep quality, role conflict/ambiguity, perception of transition and educational preparation. Turnover intentions from job and profession were asked about with two questions. Structural equation modelling was used to explore the associations between the variables. The models were adjusted for multiple potential confounders.
Final clinical practicum experience was associated with all domains of the transition experience and turnover intentions. The association between the practicum and turnover intentions was partly mediated by the emotional (psychological distress) and socio-developmental (role conflict and ambiguity) domains of the transition.
Our findings provide new evidence about the associations between the specific final clinical practicum dimensions and turnover intentions and the specific mechanisms linking this association. These results highlight the importance of final clinical practicums and suggest targets for improving nurses' transition processes during their first years in practice.
‘It's complicated’: Staff nurse perceptions of their influence on nursing students’ learning. A qualitative descriptive study
2018, Nurse Education Today
Citation Excerpt :
These tensions are important to understand as nursing students have reported that interactions with staff nurses influence them more than interactions with clinical instructors (Dunn and Hansford, 1997). Student–staff nurse relationships not only impact students' learning outcomes, but also students' desire to remain in the program and, ultimately, the profession (Coudret et al., 1994; Dunn and Hansford, 1997). Despite their importance, the informal interactions between staff and nursing students during teacher-led practica have been largely overlooked in the nursing literature.
During both teacher-led clinical practica and precepted practica, students interact with, and learn from, staff nurses who work on the clinical units. It is understood that learning in clinical practice is enhanced by positive interactions between staff nurses and nursing students. While much is known about preceptors' experiences of working with nursing students, there is little evidence to date about staff nurses' perspectives of their interactions with students in teacher-led practica.
To understand teacher-led clinical practica from the perspective of staff nurses.
A qualitative descriptive approach answers the question: How do staff nurses perceive their contributions to nursing students' learning during teacher-led practica? Nine staff Registered Nurses (RNs) working within a regional acute care hospital in western Canada were interviewed using semi-structured interviews. Interview transcripts were analyzed using cross case analysis to discover themes and findings were checked by several experienced RNs.
Analysis showed that nurses' interactions with nursing students are complicated. Nurses want to “train up” their future colleagues but feel a heavy burden of responsibility for students on the wards. This sense of burden for the staff nurses is influenced by several factors: the practice environment, the clinical instructor, the students themselves, and the nurses' understanding of their own contributions to student learning.
Staff nurses remain willing to support student learning despite multiple factors that contribute to a sense of burden during teacher-led practica. Workplace environment, nursing program, and personal supports are needed to support their continuing engagement in student learning. Nurses need to know how important they are as role models, and the impact their casual interactions have on student nurses' socialization into the profession.
Personality and professional commitment of students in nursing, social work, and teaching: A comparative survey
2016, International Journal of Nursing Studies
Citation Excerpt :
Studies have shown that students’ levels of empathy and altruism have a tendency to decline as they progress through their education (Hagström and Kjellberg, 2007; Nunes et al., 2011; Ward et al., 2012). One explanation for this finding is that new students often start out with an idealistic impression of the occupation, which becomes more nuanced as they experience the profession (Coudret et al., 1994). The realities of the work life of a nurse, which is dominated by carrying out bureaucratic tasks and performing under tight time constraints (Maben et al., 2006), may diminish not only individuals’ excitement and enthusiasm but also their idealistic impression of the profession.
Nurses are often portrayed as possessing specific traits and dispositions associated with care and empathy. The assumption has been that possessing these traits makes nurses competent, engaged, and well suited to their job. This proposition has been mostly normative, and few studies have investigated how this plays out empirically.
The aims of this study were to investigate (a) whether possessing a personality trait related to empathy and care was more common among nursing students than students in teaching and social work programs and (b) whether nursing students possessing an affirming personality trait judged themselves to be more suited to their future work – understood as commitment to the profession – than students in teaching and social work.
A cross-sectional survey design was used.
All first-year students attending seven Norwegian universities and university colleges were invited to participate in the study. Of the 1675 students who participated in the survey, 527 were nursing students, 668 were students in teaching, and 480 were social work students. A response rate of 65 percent was achieved.
The survey was conducted by Oslo and Akershus University College in the autumn of 2012. Data collection methods included both a paper-and-pencil questionnaire and an online survey. Instruments used included Blau's Career Commitment Scale and Orlinsky and Rønnestad's Interpersonal Adjective Scale. Analysis of variance and regression analysis were performed on the data.
Nursing students did not differ from students in teaching and social work programs in terms of the degree of affirming personality trait. Furthermore, the regression analysis revealed an equally strong association between having an affirming personality trait and being committed to the profession among all these student groups.
The results of this study indicate that the narrative of nursing students as individuals who possess a special personality characteristic does not entirely reflect reality.
A model of new nurse transition
2011, Journal of Professional Nursing
Citation Excerpt :
We found only a few studies on the effectiveness of preceptorships. One showed that practicum students shifted their conceptions of the RN role from that presented by nursing faculty to one similar to practicing RNs (Coudret et al., 1994); professionalism scores increased, and role conflict scores decreased as a result of participation in another preceptorship (Goldenberg & Iwasiw, 1993). Two studies showed increased self-reported clinical competence upon completing a preceptorship (Chung, Wong, & Cheung, 2008; Kim, 2007).
The progression from nursing student into the RN role remains difficult, despite over 30 years of effort to ease the transition for new graduates. We review the research on programs designed to help new graduates move into practice and propose a model for new nurse transition that starts during nursing education and continues 2 years into practice. The model illustrates the frequent detachment between efforts taken by nursing schools and employers to facilitate this transition. We offer recommendations for the design of future research to capture all transition efforts, from student to functioning RN, and better identify the critical elements of new nurse transition programs. Evidence such as this is needed to allow schools and employers to use their limited resources most effectively to support graduate nurses.
The CCARE model of clinical supervision: Bridging the theory-practice gap
2007, Nurse Education in Practice
Clinical supervision of nursing students is a key component of nursing education. The clinical setting provides students with an opportunity to develop a professional identity, knowledge base, and the ability to transfer classroom knowledge to the clinical setting. This paper suggests a model of clinical supervision that will address how to bridge the pre-existing theory–practice gap in nursing education through an attitude of caring and the utilization of caring behaviours based on Leininger’s theory of culture care. Key concepts included in this model are: communication, collaboration, application, reflection and evaluation, these concepts comprise the CCARE model of clinical supervision.
First birth stories of student midwives: Keys to professional affective socialization
2004, Journal of Midwifery and Women's Health
The purpose of this article was to examine the professional affective socialization of midwifery students. Students from the Community-Based Nurse-Midwifery Education Program (CNEP) tell about their first births in their Lost My Hat stories posted on the electronic bulletin board of the Frontier School of Midwifery and Family Nursing. Qualitative analysis of 38 of these stories showed internalization of the values and beliefs of the midwifery model of care by students. Themes of the Lost My Hat stories were congruent with some of the aspects of the Model of Exemplary Midwifery Practice developed by Kennedy. Major themes included the circle of safety provided by the preceptor and a woman-centered approach to care. These findings can help midwifery educators promote socialization of students in the profession.

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^∗: Dean, School of Nursing and Health Professions, University of Southern Indiana, Evansville, IN.

^†: Instructor, School of Nursing and Health Professions, University of Southern Indiana, Evansville, IN.

^§: Assistant Professor, School of Nursing and Health Professions, University of Southern Indiana, Evansville, IN.

^∥: Instructor, School of Nursing and Health Professions, University of Southern Indiana, Evansville, IN.

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Orginical articleRole socialization of graduating student nurses: Impact of a nursing practicum on professional role conception

Abstract

Journal of Nursing Education

Relationship between a preceptorship experience and role socialization of graduate nurses

Journal of Nursing Education

Nursing schools: Students' beacon to professionalism?

Nursing & Health Care

Measuring undergraduate nursing student professional socialization

Role conception and career aspiration: A study of identity in nursing

Sociological Quarterly

Professional socialization as subjective experience: The process of doctrinal conversion among student nurses

The senior preceptorship as a method for anticipatory socialization of baccalaureate nursing students

Journal of Nursing Education

Relationships between role models and role perceptions of new graduates

Nursing Research

Faculty consensus as a socializing agent in professional education

Nursing Research

Socialization and resocialization of nurses for professional nursing practice

A comparison of role deprivation of baccalaureate students in nursing participating in a preceptorship or a traditional clinical program

Journal of Nursing Education

The effect of preceptorship upon diploma program nursing students' transition to the professional nursing role

Journal of Nursing Education

Orginical article
Role socialization of graduating student nurses: Impact of a nursing practicum on professional role conception