• TABLE OF CONTENTS
HIDE
 Title Page
 Copyright
 Acknowledgement
 Table of Contents
 Abstract
 Introduction
 Review of literature
 Methodology
 Analysis of data
 Conclusion
 Permission letter
 Cover letter
 Sample of the nurses' professional...
 Demographic data, faculty...
 Means on two criterion measures...
 Bibliography
 Biographical sketch






Title: Professional socialization of students in four types of nursing education programs /
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 Material Information
Title: Professional socialization of students in four types of nursing education programs /
Physical Description: viii, 98 leaves : ; 28 cm.
Language: English
Creator: Thomas, Janice Thompson
Publication Date: 1978
Copyright Date: 1978
 Subjects
Subject: Nursing -- Study and teaching -- Florida   ( lcsh )
Professional socialization   ( lcsh )
Curriculum and Instruction thesis Ph. D
Dissertations, Academic -- Curriculum and Instruction -- UF
Genre: bibliography   ( marcgt )
non-fiction   ( marcgt )
 Notes
Thesis: Thesis--University of Florida.
Bibliography: Bibliography: leaves 88-97.
General Note: Typescript.
General Note: Vita.
Statement of Responsibility: by Janice T. Thomas.
 Record Information
Bibliographic ID: UF00098089
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: alephbibnum - 000074619
oclc - 04697515
notis - AAH9893

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Table of Contents
    Title Page
        Page i
    Copyright
        Page ii
    Acknowledgement
        Page iii
    Table of Contents
        Page iv
        Page v
    Abstract
        Page vi
        Page vii
        Page viii
    Introduction
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
    Review of literature
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
        Page 26
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
    Methodology
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
    Analysis of data
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
    Conclusion
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
    Permission letter
        Page 73
        Page 74
        Page 75
    Cover letter
        Page 76
        Page 77
    Sample of the nurses' professional orientation scale
        Page 78
        Page 79
    Demographic data, faculty and students
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
        Page 85
    Means on two criterion measures by program, faculty, and students
        Page 86
        Page 87
    Bibliography
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
        Page 95
        Page 96
        Page 97
    Biographical sketch
        Page 98
        Page 99
        Page 100
Full Text










PROFESSIONAL SOCIALIZATION OF STUDENTS IN
FOUR TYPES OF NURSING EDUCATION PROGRAMS


















By

JANICE T. THOMAS

















A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF
THE UNIVERSITY OF FLORIDA
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF DOCTOR OF PHILOSOPHY






UNIVERSITY OF FLORIDA


1978




































Copyright 1978

by

Janice T. Thomas














ACKNOWLEDGMENTS


I would like to acknowledge the faculties in the Colleges

of Nursing and Education for their contributions to my develop-

ment during the educational process.

I am indebted further to all the nursing faculty and

students who participated in this research project; to Dennis

Murphy, who arranged the computer programming; and to Anna

Marie Martin who typed the manuscript.

I would like to thank my committee chairman, Dr. James

W. Hensel, for supervising the project and providing constant

support and assistance, and my committee members, Dr. Blanche

Urey, Dr. Margaret Morgan, Dr. David Williams, and Dr.

William Alexander for their cooperation and guidance.

Finally, I would like to thank my husband, Fred L.

Thomas, for his love and faith in me, and my family and

friends, who provided encouragement along the way.


iii
















TABLE OF CONTENTS


ACKNOWLEDGMENTS . . . . . . . . .

ABSTRACT . . . . . . . . . ..

CHAPTER I INTRODUCTION TO THE PROBLEM. . .
The Socialization Process. . . . . .
Theoretical Aspects . . . . . .
Statement of the Problem . . . . . .
Patterns of Nursing Education. . . . .
Significance of the Problem. . . . . .
Purpose of the Study and Research Questions. .
Definition of Terms . . . . . .
Delimitations and Limitations. . . . .
Assumptions . . . . . . . .


CHAPI


Page

111

vi




2
4
5
9
. . 1
. . 1
. . 2
. . 4
. . 5
. . 9
. . 11
. . 13
. . 15
. . 17


'ER II REVIEW OF LITERATURE . . . . .
Professional Socialization . . . . . .
Role Conceptions . . . . . . . .
Student Characteristics. . . . . . .


CHAPTER III METHODOLOGY. . .
Population and Sampling. .
Procedure. . . . .
The Instrument . . .
Statistical Hypotheses . .
Note . . . . . .

CHAPTER IV ANALYSIS OF DATA .
Professional Orientation and
Student Characteristics. .
Faculty Characteristics. .
Interpretation of Data . .
Notes. . . . . . .


CHAPTER V


. . . . .
. . . . .
. . .






Role Conception
. . . .

. . . . .
. . . . .


SUMMARY. . . .


CHAPTER VI CONCLUSIONS AND RECOMMENDATIONS.
Conclusions . . . . .......
Recommendations . . . . ......


APPENDIX A
APPENDIX B
APPENDIX C

APPENDIX D


Permission Letter. . . . . .
Cover Letter . . . . . . .
Sample of the Nurses' Professional
Orientation Scale . . . ..
Demographic Data, Faculty and Students


S. 19
S. 25
S. 27


S 32
S 32
S 33
S 35
S 37
S 38

39
S 39
45
51
S 56
S 61

S 62

S 66
S 66
S 69

S 74
S 77

S 79
81


I









TABLE OF CONTENTS (continued)

Page

APPENDIX E Means on Two Criterion Measures by
Program, Faculty, and Students ... .87

BIBLIOGRAPHY. . . . . . . . . ... . .. 88

BIOGRAPHICAL SKETCH . . . . . . . . . 98
















Abstract of Dissertation Presented to the Graduate Council
of the University of Florida in Partial Fulfillment of
the Requirements for the Degree of Doctor of Philosophy



PROFESSIONAL SOCIALIZATION OF STUDENTS IN
FOUR TYPES OF NURSING EDUCATION PROGRAMS

By

Janice T. Thomas

August 1978

Chairman: James Hensel
Major Department: Curriculum and Instruction

Professional socialization, the process of acquiring

knowledge, attitudes, and behaviors appropriate to a profes-

sional role, formed the framework for an examination of

professional orientations of students and faculty in programs

preparing technical and professional practitioners of nursing.

The purpose of this study was to determine whether students

from four different types of nursing programs held different

professional orientations and role conceptions as a result of

the professional socialization process. Assumptions under-

lying the socialization process were derived from symbolic

interactionist theory.

The Nurses' Professional Orientation Scale (NPOS), with

reliability of .89, and construct validity reported, was ad-

ministered to a sample of 178 senior nursing students and 92



vi











faculty from six institutions representing four different types

of nursing programs (associate degree, diploma, generic bacca-

laureate, and baccalaureate for Registered Nurses). Two

methods of scoring were used, a total score measuring congruence

with professional values of a normative baccalaureate faculty

group, and a reweighted score measuring traditional and non-

traditional role conceptions. Multivariate analysis of both

scores was performed and Scheff4's method for pairwise com-

parisons was the post hoc test used for further significance

testing. Professional orientation scores did not differ

significantly from program to program, and the only signifi-

cant differences on traditional/nontraditional role concep-

tions occurred between the traditionally-oriented associate

degree and diploma programs, and the baccalaureate program for

Registered Nurses, which held the most nontraditional orienta-

tion. The faculty group held a significantly more nontradi-

tional role conception than the student group, and faculty

professional orientation was significantly different from that

of students.

Frequencies, percentages, and chi square tests of signifi-

cance were used to analyze demographic variables related to

sex, age, previous nursing experiences, previous licensure,

education, teaching experience and professional membership.

Faculty from the various programs differed significantly on

only two variables, length of time spent teaching in various


vii










programs, and the type of academic degree they held. Students

varied from program to program on all variables except the

setting of previous nursing experience (hospital). Although

at the time of graduation from a basic nursing program, stu-

dents differed in nursing and collegiate experiences, they

held similar views of the nursing profession and the role of

the nurse, no matter what type of nursing education they had

received. This failure to differentiate different types of

nursing practice through socialization processes was seen as

detrimental to efforts to establish two different categories

for nursing education. Faculty, as important instruments of

the socialization process, hold the major responsibility for

communicating attitudes and values to students which are

appropriate to the goals and objectives of each problem.

Homogeneity of program faculties on experiential variables

and professional orientation appeared to have influenced the

homogeneity of professional orientation and role conception

which was found to exist for all programs.

Recommendations of the study were that nursing curricula

should provide for the exploration of faculty and student

values, with clarification and appropriate reinforcement em-

phasized. Education programs for faculty should recognize

the importance of preparing faculty to deal more effectively

with the socialization process so that students would acquire

values and role conceptions appropriate for different cate-

gories of nursing practice.


viii














CHAPTER I

INTRODUCTION TO THE PROBLEM


The Socialization Process


Socialization is a process in which individuals are

transformed to enable them to live in stable associations with

other people in pairs, groups, and large and complex organi-

zations (Blitsten, 1971, p. 168). It is this process that

inducts individuals into their culture and has its beginning

in the early years of life. "It involves the acquisition of

attitudes and values, skills and behavior patterns making up

social roles established in persisting social systems" (Mc-

Kinney & Ingles, 1959, p. 366). Socialization processes con-

tinue into adult life, and are particularly important as in-

dividuals acquire the attitudes, skills, values, and special-

ized knowledge which characterize education for a professional

occupation. Professional socialization is seen as a special

and important case of adult socialization (McKinney & Ingles,

1959).

Nursing, like other professions, possesses its own body

of skills, knowledge, values, rules, and standards which

represent the normative principles of the professional cul-

ture. These cultural expectations codify the values of the

profession and cover a wide range of details concerning the









relations of nurses to patients, physicians, colleagues, and

the community (McKinney & Ingles, 1959). It is the function

of nursing educators to transmit, not only the skills and

knowledge of the profession, but also the attitudes, values,

and expected patterns of behavior to students aspiring to

become nurses. Teachers of nursing must assist students in

the process of orientation to the new role, helping them form

a new occupational identity and develop realistic self-images

to enable them to think of themselves as nurses. This pro-

cess of professional socialization occurs through social

interaction with significant people during the educational

process--faculty, fellow students, patients, co-workers,

physicians--the social system of the culture (McKinney &

Ingles, 1959). Of paramount importance to successful pro-

fessional orientation and role conception of nursing students

is the influence of the faculty role model.


Theoretical Aspects


The theoretical constructs underlying studies of sociali-

zation can be found in symbolic interactionist theory as

formulated by George Herbert Mead in Mind, Self, and Society

(1934). This theory provides a general social psychological

framework based on assumptions about man's distinctive

characteristics (Rose, 1962, p. 4). Those assumptions are

as follows:

1. Man lives in a symbolic environment as well as a
physical environment.









2. Through symbols, man has the capacity to stimulate
others in ways other than those in which he is
himself stimulated.

3. Through communication of symbols, man can learn
innumerable meanings and values--and, hence, ways
of acting--from other men.

4. These symbols do not occur only in isolated bits,
but often in clusters, sometimes large and complex.

5. Thinking is the process by which possible symbolic
solutions and other future courses of action are
examined, assessed for their relative advantages
and disadvantages in terms of values of the indi-
vidual, and one of them chosen for action. (Rose,
1962, pp. 5-13)

According to interactionist theory, the basic social

process is role-taking, where the individual does not so much

enact a prescribed role as he devises a performance on the

basis of an inputed "other-role." A change in one's own role

reflects a changed assessment or perception of the role of

relevant others. The response of the other serves to rein-

force or to challenge the individual's conception of the role.

This testing process serves to stabilize or modify one's own

role (Turner, 1962, p. 23).

The processes of socialization and professionalization

can be seen as a process of role-taking by the individuals

involved; a continuous process of modification of one's role

as one interacts with significant others results in role

modification which occurs to different degrees in various

individuals, according to their perceptions.

Although the symbolic interaction theory has not been

completely elaborated or rigorously tested, hypotheses used

in this study were logically consistent with the theory. The









impact of significant others, particularly faculty, on role-

taking behavior of nursing students, in concert with individual

factors which affect perception allow the researcher to pro-

pose hypotheses concerning the socialization outcomes of dif-

ferent nursing school experiences.


Statement of the Problem


Because of the diversity of educational programs pre-

paring students to practice nursing, much confusion exists

for the consumer, the employer, and the graduating nurses

themselves over what constitutes appropriate role expectations

according to the different educational modes. Faculty in

various educational settings also question what is being

taught, what should be taught and what is effective teaching

(McKinney & Ingles, 1959). Educational processes by which

neophytes are transformed into nurses include the acquisition

of attitudes and values, knowledge, skills, and behavior

patterns necessary to learn the professional role. This

process of adult socialization into an occupation is referred

to as professionalization, or professional socialization.

The Baccalaureate in Nursing program is considered by

the nursing profession to prepare nurses for professional

practice. Diploma and associate degree programs prepare

nurses for technical practice. The generic (basic) bacca-

laureate program has been the educational model for the

preparation of professional practitioners in nursing. In

the wake of the associate degree in nursing programs, upper





5



division baccalaureate programs for Registered Nurses have

appeared, purporting to transform the technical nurse into

the professional practitioner. If nursing educators have been

successful in implementing two types of nursing practice,

technical and professional, role conceptions of the two types

of graduates will demonstrate clear-cut differences as a

result of socialization processes.

The problem addressed by this study was the effect of

socialization processes in various modes of professional edu-

cation. Specifically, the problem was whether students and

faculty subscribed to differing professional values and role

conceptions depending on their association with a particular

type of nursing program and their individual nursing and edu-

cational backgrounds. Another aspect of the problem was to

determine whether socialization processes affected values and

role conceptions of students prepared first as a technical,

then as a professional practitioner.


Patterns of Nursing Education


Nursing has undergone many changes while evolving from

a less-than-respectable occupation for unfortunate women,

through a sprawling adolescence of apprenticeships in hospital-

based programs, to the first blush of maturity involving pro-

fessional preparation at the collegiate and university level.

The struggles for survival and then for academic legitimacy

have left their mark in the form of a bewildering melange of

educational institutions and degrees which characterizes the









profession (Strauss, 1966, p. 73).

In the past, nurses were prepared to practice their

profession in the hospital diploma school, modeled after the

Nightingale system which had been imported from England.

These training schools experienced phenomenal growth, as

hospitals sought to increase their supply of steady help at

a minimum cost (Strauss, 1966, p. 68). Many nursing programs

revolved around the function of providing nursing service

instead of nursing education. In an effort to upgrade the

education afforded by these diverse hospital schools, nursing

leaders began to look to the universities and their broader

educational resources. Many hospital schools became affiliated

with universities, and later, university schools of nursing

were established free from the controlling influence of

hospital administration. These programs were on the bacca-

laureate level.

Early studies on the situation in nursing education

identified three types of nurses--baccalaureate graduates,

diploma graduates, and practical nurses, and recommendations

were made that there be only two types of nurses, to reduce

confusion about their roles and functions (Rines, 1977).

Following World War II, community colleges began to

proliferate, and preparation of the nurse technician became

a viable program, providing students easy access to higher

education, regardless of age, marital status, sex, creed or

race (Rines, 1977). As proposed by Montag (1951), the gradu-

ate of the two year program, the associate degree nurse, would










function at a technical level.

In 1965, the American Nurses Association (ANA) Committee

on Nursing Education startled nurses throughout the country

with its first position paper on education for nurses (ANA,

1965). Not only did the committee declare that all those who

are licensed to practice nursing should receive their educa-

tion in institutions of higher education, but it also reiter-

ated that nursing practice would have two levels, technical

and professional. Minimum preparation for beginning profes-

sional nursing practice should be baccalaureate degree educa-

tion in nursing, and beginning technical practice should be

associate degree education in nursing. This pronouncement

provoked great controversy among nurses across the nation.

How did one differentiate between professional and technical

practice? What would become of the diploma schools? Where

did licensed practical nurses (LPNs) fit into the plan? How

many students could afford baccalaureate programs? Where

would qualified faculty come from? What was wrong with the

status quo?

Although the ANA position was not unanimously supported

by either nursing educators or nurses in practice, its impact

on nursing education cannot be ignored. In 1965, 65% of

basic nursing education took place in hospitals; in 1975,

these schools represented only 28% of basic nursing programs

(Johnson, 1977). There was also a substantial increase in

graduations of registered nurses from baccalaureate programs.

During the year 1975-1976 there were 4,759 graduations compared










to 2,337 in 1971-1972. Of these 4,759, 1,363 graduated from

53 programs that offer nursing programs to registered nurses

only (Johnson, 1977). Implicit in the ANA position paper was

the implication that a hierarchy is to exist in the practice

of nursing, and the baccalaureate is the degree that deter-

mines a nurse's status as a professional or as a technician.

Many associate degree nurses and diploma nurses began seeking

admission to baccalaureate nursing programs in an effort to

ensure their professional status. The effort of the American

Nurses' Association to define two categories of practice

represents a continuing drive on the part of the nursing pro-

fession to improve its professional status. Education must

take place in an institute of higher education, since pre-

paration for a profession involves mastery of the theory

underlying its practice, rather than on-the-job training

through apprenticeship. Technical practitioners in nursing

are performing a valuable service for the nursing profession

by developing a high degree of skill in technical tasks,

recognizing problems of a technical nature, and planning,

implementing, and evaluating their daily assignments. Their

knowledge base has been described as narrow in scope (Kohnke,

1973).

Professional (baccalaureate) nurses are described as

having a broad knowledge base, primarily theoretical, dealing

with a wide range of nursing problems. They have a strong

research orientation, identify problems of a broad nursing

scope and do total planning on a long-term basis (Kohnke,










1973). Baccalaureate education also provides the requisite

background for graduate education. This differentiation by the

ANA Committee on Nursing Education between technical and bac-

calaureate prepared nurses thus enables the nursing profession

to meet technological society's needs for skilled workers

while providing for nursing's movement along the professional-

ization continuum toward the ideal.

Educational preparation for faculty was initiated in the

early 1900's at Teachers College, Columbia University, where

postgraduate courses in teaching and administration were first

offered for graduate nurses. Since the early baccalaureate

programs were specialized in nature, there was great variability

in content among programs, and finding a common base to build

graduate education for nurse faculty posed a difficult problem.

In the 1950's, the National League for Nursing (NLN) recom-

mended that baccalaureate programs prepare nurses for general

professional nursing, and master's programs, building on pre-

viously developed competencies, should prepare for both clini-

cal and functional specialization (NLN, 1952). These develop-

ments facilitated the establishment of graduate programs for

the preparation of nursing leaders, including faculty and ad-

ministrators.

At the present time, graduate preparation is predominantly

at the master's level. A wide variety of programs exist which

prepare nurses for clinical specialization, teaching, or super-

vision in various clinical areas. A recent development is the

emergence of doctoral programs with a major in nursing leading










to the doctoral degree in nursing. Opportunities also exist

for nurses to obtain the professional doctorate in different

fields, such as education, sociology, psychology, or business,

with a minor in nursing.

While graduate programs currently offer a diversity in

clinical practice specialties, limited opportunity has been

available in the functional teaching major appropriate for

the various types of basic educational programs. Although

master's level preparation in nursing is recommended by the

NLN for teaching in all types of nursing programs, the

scarcity of appropriately prepared faculty has inhibited the

attainment of this criterion by current educational programs.


Significance of the Problem


The nursing profession today is struggling for recognition

from society as an autonomous profession. Traditionally, a

minimum of a baccalaureate degree has been essential to ensure

a liberally educated professional, whatever the field. Defin-

ing two types of nursing practice, one as technical and one as

professional, will allow nursing to enhance its credibility

as a true profession through the continued efforts of the more

theoretically prepared practitioner to add to nursing theory

through research and advanced levels of practice. Clear dis-

tinctions between the two types of nursing practice must be

made, not only in the cognitive domain, but also in role con-

ceptions and professional values and orientations.


MMM










As a basis for future curriculum decision, knowing what

the role conceptions are for the two types of practitioners is

important. Attitudes and values deemed appropriate by the pro-

fession for each type of practice need to be communicated to

students through curriculum planning and faculty role modeling.

Faculty values and attitudes should be considered individually

and as a group if faculty are to be an effective instrument of

professionalization for students. Other variables influencing

student socialization need to be investigated to achieve optimum

role socialization.

At the 1978 ANA Convention in Hawaii, resolutions were

passed in the House of Delegates which affirmed the ANA position

on nursing education of 1965. Several states are considering

legislation which will require a minimum of a baccalaureate de-

gree for entrance into the professional practice of nursing.

The lines between technical and professional education are

being drawn even tighter as the nursing profession attempts to

reduce role fragmentation in its ranks and achieve over-due

licensing reforms.

The responsibility of implementing two categories for nurs-

ing practice is a challenging task for nursing educators. Fac-

ulty and students must be knowledgeable of the differences in

philosophy, goals, and objectives of educational programs pre-

paring for different categories of practice. Nursing curricula

of these programs must be congruent with their distinctive

philosophies and goals, not only concerning the cognitive and

psychomotor components, but also those in the affective domain.










Attitudes, values, and professional orientations appropriate

for each educational program must be understood, subscribed to,

and communicated to students through the process of professional

socialization.

Students learn, not only from lecture and
demonstration, they also learn, perhaps even
more fundamentally, from sustained involvement
in that society--nursing staff, fellow students,
medical staff and students, and patients--which
constitutes life in a nursing school. . The
ways by which those students develop within the
school environment, both by intent and ordinary
circumstance, constitute the first and basic
phase of the process of professionalization.
(McKinney & Ingles, 1959)

Understanding professional socialization processes is of

primary importance to nursing educators to facilitate the dif-

ferential socialization of nursing students for technical and

professional practice of nursing.


Purpose of the Study and Research Questions


The purpose of this study was to ascertain differences

and similarities in professional orientation and role concep-

tions of fulltime faculty and graduating seniors from four

types of nursing programs, associate degree (ADN), diploma,

generic (basic) baccalaureate (BSN), and baccalaureate for

Registered Nurses (RNBSN), as measured by the nurses' profes-

sional orientation scale.

A second purpose was to identify experiential character-

istics of faculty and students which might affect professional

orientation and role conception.










The research questions were as follows:

1. Do significant differences exist in professional ori-

entation between nursing students enrolled in programs prepar-

ing for different categories of practice?

2. Do role conceptions of faculty and students on a

traditional/nontraditional dimension vary according to type

of nursing program?

3. Will professional orientations and role conceptions

held by graduating RNBSN students be similar to those held by

graduating BSN students, or will they resemble orientations

and role conceptions of associate degree and diploma students?

4. Do graduating seniors and faculty from each program

hold similar professional orientations and role conceptions?

5. Are there significant differences in professional

orientation among faculty teaching in the various programs?

6. Do experiential characteristics of faculty and stu-

dents vary according to program?


Definition of Terms


For this study, the following definitions and abbrevia-

tions were used:

Associate degree in nursing program (ADN): A program

established in a junior or community college which is approxi-

mately two years in length. The graduate is eligible for

licensure as a registered nurse (RN).

Baccalaureate degree in nursing program (BSN): A bache-

lor's degree program established by a college or university










which is approximately four years in length. Two years of

liberal arts and support courses and two years in the upper

division nursing major is the typical curriculum pattern.

Congruence: The quality or state of agreeing or cor-

responding (Stein, J., ed., 1967).

Consensus: Agreement among students either with respect

to their characterizations of nursing or in the personal im-

portance that they assign to those characteristics (Davis &

Olesen, 1964).

Diploma program: A hospital-based nursing program which

varies from two to three years in length. The graduate re-

ceives a diploma in nursing without a college degree, and is

eligible for licensure as a registered nurse.

Images: Composites of a person's concepts, judgments,

preferences, or attitudes toward some comprehensive object

or cause (English & English, 1958, p. 378).

Professionalization; Professional Socialization: A form

of adult socialization in which the attitudes and values, skills

and behaviors of a subcultural group are acquired by means of

both direct and indirect learning (McKinney & Ingles, 1959).

Registered Nurse (RN): The legal designation for gradu-

ages of State Board-approved nursing programs who pass the

State Board licensing examinations.

Registered Nurse Baccalaureate in Nursing Program (RNBSN):

A program established in the upper division of a college or uni-

versity which admits registered nurses who have completed basic










nursing education in either the diploma or associate degree

program. Graduates receive a bachelor in nursing degree.

Role: A cluster of related meanings and values that

guide and direct an individual's behavior in a given social

setting (Rose, 1962, p. 10).

Role Conceptions: Images of the rights and obligations

which a person perceives to be associated with his position

(Corwin & Taves, 1962).

Role Conflict: Incompatibility of professional values

system with that of the employing system (Kramer, 1970).

Role Deprivation: The extent an ideal role conception is

perceived to be nonoperative in practice (Corwin & Taves, 1962).


Delimitations and Limitations


There are many aspects of the professional socialization

process which require further study, such as personality

characteristics, demographic variables, life styles, and

value systems of students and faculty, influences of peer

groups and learning environments; teaching and learning styles

and teacher-student interaction; curriculum patterns and

clinical experience. The focus of this study was on profes-

sional values and role conceptions of students and faculty

with different educational experiences in nursing. Demo-

graphic variables surveyed concerned only faculty and student

background experiences in nursing and education.

Student and faculty population samples were obtained

from the South Florida area. Role conceptions and professional









orientation may vary according to educational programs and

established nursing practice in various geographical areas

of the country, so findings may not be generalizable to other

populations.

The number of different programs sampled (six) represents

a very small fraction of the total number of nursing programs

in the country. In 1976, there were 642 associate degree

programs, 390 diploma programs, 341 baccalaureate programs,

and 53 RNBSN programs, a total of 1,426 programs (Johnson,

W., 1977, p. 588). It would be hazardous to assume that the

population defined for this study was representative of the

universe.

Continuing interest in studies of professional sociali-

zation has stimulated the search for adequate measurement

tools. The Olesen and Davis questionnaire (1964) has been

used by several investigators (Siegel, 1968; Brown et al.,

1974) to measure congruence of faculty and student attitudes.

Crocker and Brodie (1974) devised the nurses' professional

orientation scale in response to a need for a standardized

instrument to measure changes in students' views of the

nursing role. Since reliability and validity data for this

scale have proven satisfactory, further experimental use of

this tool is indicated.

Cross-validation testing demonstrated that the scale

measures a fairly unitary trait among nursing students,

which is evidence for the existence of a construct which was

called "professional orientation" by the authors.









Although the scale was devised to measure congruence of

faculty and student values, in this study, the scale was used

to compare faculty and student values from four different

types of nursing education programs.

A second scoring device was used which labels the unitary

construct measured by the scale, "traditional/nontraditional"

role conception. The items on the scale were weighted on the

traditional/nontraditional continuum according to the judg-

ment of one faculty group from one baccalaureate program.

Results of this scoring method may not be reflective of the

traditional views associated with an individual program.

Because of the anonymity of questionnaire respondents,

it was not possible to conduct a follow-up survey of non-

respondents. The data-producing sample obtained represented

55% of the defined population. If nonrespondents differed

from respondents for faculty and students alike, there would

be no effect on the results of the survey, which measured

faculty-student differences. If nonrespondents were different

for some programs and not others, or for faculty but not

students, or vice-versa, study results would not provide

accurate information concerning the variables under study.


Assumptions


The first three assumptions for this study were based

on symbolic interaction theory which offers an explanation

of the dynamics underlying the socialization process as it

applies to professionalization in nursing.










1. Faculty, as significant others, affect the
attitude formation of the nursing students
with whom they interact.

2. Students in a nursing program will "take
on" the role of the faculty of that program.

3. Attitudes of newly graduated students, or
students in the last nursing courses will
demonstrate more congruence with faculty
attitudes than at any other time in their
nursing program.

The last three assumptions were related to the data gathering

tool, a nurses' professional orientation scale (NPOS) which

was constructed on the basis of responses from baccalaureate

nursing program faculty.

4. Collegiate nursing programs in this country
subscribe to similar philosophies and value-
systems.

5. Answers on the NPOS will be representative
of the professional orientation values and
role conceptions of faculty and students.

6. Professional orientations and role concep-
tions of nonrespondents to the survey will
not vary according to program or faculty-
student status.
















CHAPTER II

REVIEW OF LITERATURE


The literature reviewed included studies concerning the

socialization process itself in which student role conceptions

gradually changed to more nearly resemble the ideal profes-

sional image as expressed by faculty within the professional

school; studies classifying predominant types of role concep-

tions held by nurses with implications for role conflict; and

explorations of the various factors which might affect role

conceptions and the socialization process.


Professional Socialization


The continued growth of professions in American society

has stimulated interest in the examination of professional

schools where skills and knowledge, as well as attitudes and

values, are transmitted to would-be practitioners. Profes-

sional schools embrace a social environment which facilitates

student acquisition of the professional identities he is to

assume on graduation. This professional socialization process

has been extensively studied as it applies to nursing and other

professions, and particularly as it applies to medical educa-

tion. Medical school has been described as one of the longest

rites of passage in our part of the world (Becker, Geer, Hughes,











& Strauss, 1961, p. 4). In this study, the authors focused on

the medical school as an organization in which students acquired

some basic perspectives on their later activity as doctors.

The purpose of the study was to analyze the experience and

actions of medical students in interaction with their teachers

and their tasks so that their findings could be compared with

other similar situations (Becker et al., 1961, p. 16). Findings

of this study were that the transition from young layman to a

skilled and confident physician is a slow, laborious one.

Students must learn to be medical students first and deal with

their immediate situation; the end result of the socialization

process is too remote to be considered in the day-to-day

realities of medical school.

Fredericks and Mundy (1976) conducted a ten year longitu-

dinal study of one class of 81 students who attended Loyola

School of Medicine, became interns, and eventually engaged in

the practice of medicine. Among their findings was that socio-

economic class had no relation to a student's ability to adjust

to stress and anxiety, scores on National Board examinations

correlated with academic achievement, and the judgment of

medical students that the most important feature to identify

good medical students was their ability to establish rapport

with their patients.

Huntington (1969, p. 186) found that as students move

through medical school their self-images varied as they inter-

acted with faculty members, classmates, nurses, and patients,









but that they came to think of themselves more as doctors than

students in the clinical years when they had substantial con-

tact with patients. Earlier development of this professional

self-image occurred in students who felt they had handled their

patients' problems effectively while acting in the role of

quasi-physician early in their educational program.

Martin (1969, p. 205) stated that medical educators have

long known that the physician must develop attitudes and values

appropriate to his calling if he is to provide optimum care of

the patient. He reported a study in which it was concluded

that students who felt best equipped to meet the technical

demands of the role were also those who found it least diffi-

cult to meet its requirements.

Another report reviewed some experiences which acquainted

medical students with the different types of uncertainty they

would encounter later as practicing physicians, and some of

the ways in which they learned to deal with those uncertain-

ties (Fox, 1969).

Hammond and Kern (1959) described a project at the Uni-

versity of Colorado whose objectives were to create an envi-

ronment that would foster deliberate teaching-learning tech-

niques and also involve students, faculty, and patients in a

clinic committed to the continuing, comprehensive care of the

individual.

Several investigators studied factors influencing the

professionalization of students. Individual differences in

students were found to have varying sensitizing effects on










students in respect to ability to learn, motivation, and

receptivity to components of the professional role (Reissman

& Platou, 1960). Hall (1948) reported that the established

core of professional physicians served as the major influ-

ence on socialization of the new recruit to medicine. In

the training of psychiatric residents, Khleif (1974, pp. 302,

303) stated that professionalization, as adult socialization,

depends upon structure and culture, that is, authority and

belief systems. The trainer has higher status and presumably

superior values, and thus defines for the trainee what is

desirable or undesirable. In these training situations, the

trainee's peer group is of crucial importance in stress re-

duction, morale building, and identity transformation (Evan,

1963; Geer et al., 1968).

The influence of teachers as role models for the pro-

fessionalization of the student was reported on by Reissman

and Platou (1960) and Bucher (1965). Bucher also claimed

that professions differ in the commitment they exact from

members; that nursing commands less involvement than some

other professions due to lack of intensive conversion ex-

periences, or identification with role models such that

other feminine roles of wife and mother would become sub-

ordinate to the professional role.

The process of socialization into the nursing profession

has also been studied and documented. In The Silent Dialogue,

Olesen and Whittaker (1968) recorded the progress of young,

American, middle class women through a baccalaureate degree









in nursing program. They concluded that professional sociali-

zation is comprised of the "frequently banal, sometimes dreary,

often uninteresting world of everyday living. . .These mat-

ters constitute the silent dialogue wherein are fused person,

situation, and institution. Therein lies the heart of pro-

fessional socialization" (Olesen & Whittaker, 1968, p. 297).

The authors, however, emphasized the importance of student-

peer relationships on professional socialization.

Davis and Olesen (1964) surveyed changes in student

imagery, consensus, and consonance after one year's experience

in a baccalaureate nursing program. They found that most

changes in student imagery occurred mainly during the first

year, the period of greatest stress, anxiety, and uncertainty.

A trend toward individualistic and innovative images of

nursing and away from bureaucratic images was found, but not

a significant increase in consensus among nursing students in

respect to their images of nursing. A follow-up report two

years later of these same students confirmed the original

findings (Olesen & Davis, 1966).

A variant of the Davis-Olesen study was reported by

Siegel (1968). Seniors' perceptions of nursing corresponded

closely with those of faculty members, and students did not

reach greater consensus among themselves in their characteri-

zations of nursing; these findings were similar to those of

Davis and Olesen.

In 1974, the Davis-Olesen study was replicated in a

different setting (Brown, Swift, & Oberman) and findings









also closely paralleled those in the original study. The

authors noted, however, that the process of professional

socialization in nursing is not easy, painless, or automatic,

and much role conflict and ambivalence persist in students

and graduates alike.

The nurses' professional orientation scale devised by

Crocker and Brodie (1974) was used to measure faculty-student

congruence of professional values. They reported a definite

trend for students to endorse the faculty view of the pro-

fession as graduation neared, implicating either the influence

of actual clinical experiences or faculty influence as instru-

mental in bringing student and faculty value systems closer

as students progressed through the program.

Coe (1965) attempted to assess changes in self-conception

of nursing students from the beginning to the end of the

freshman year. He found some significant shifts in the self-

conceptions as demonstrated through increased identification

with nursing situations. Psathas (1968) interpreted responses

to a role projection test by freshman and senior nursing stu-

dents as reflecting the extent of their socialization into

the nursing role.

To summarize findings on socialization studies, these

researchers reported that the process is composed of day to

day events; there are many factors which influence this

process, including individual differences in students, peer

groups, faculty and other role models, as well as patients.

In nursing schools, socialization occurs after the first year;


...









there is congruence between faculty and students in collegiate

schools concerning perceptions of nursing, but consensus among

students on characterization of nursing does not increase in

the socialization process.


Role Conceptions


Many researchers identified particular image clusters of

the nursing role, or role conceptions, as outcomes of the

professional socialization process. These orientations were

seen as potential sources of role conflict for the neophyte

nurse in certain job settings, and one of the prime suspects

in attrition of new graduates from their first jobs. Corwin

(1961) and Corwin and Taves (1962) stated that there are three

conflicting orientations in role conceptions in nursing: the

service, bureaucratic, and professional. Haberstein and

Christ (1955) described these same orientations as "Profes-

sionalizer," "Traditionalizer," and "Utilizer." The three

different emphases are on nursing as a calling, nursing as

an office, and nursing as a profession. The investigators

attempted to show how role conceptions are formed, and how

they affect career goals and work performance of nurses. It

was concluded that degree students tend to develop a stronger

professional orientation and less loyalty to the hospital,

so that a sense of deprivation of the professional role due

to the hospital bureaucracy develops in the neophyte staff

nurse. This was less true of diploma nurses. Other investi-

gators studying role conflict include Benne and Bennis (1959),









Davis (1972), and Schein (1968).

Kramer is well known for her studies of role conceptions

and role deprivation in neophyte nurses (1968, 1970, 1974).

She studied collegiate nurses from three nursing programs in

their initial employment settings and found that bureaucratic

orientation of neophyte nurses increased with length of em-

ployment, as they shifted from the professionally-centered

model to the work-centered model. Role deprivation was greater

for subjects retaining instructor role models than for those

who shifted to work-centered models.

Role conceptions held by nurses at the end of the first

year of employment were identified and correlated with par-

ticipation in continuing education learning activities. Bevis

(1973) found the service component of role conception to be

the primary influence on such participation.

Another view of role conceptions in nursing is termed

the "care versus cure" dichotomy. This classifies role con-

ceptions into two dimensions, an expressive mode (care) and

an instrumental mode (cure). Johnson and Martin (1965) con-

trasted the expressive function of the nurse with the instru-

mental function of the doctor. Linn found that medical

faculty are most cure-oriented, nursing faculty most care-

oriented; nursing students and their teachers expressed very

similar attitudes towards patient care (1974). Bullough and

Sparks (1975) found that senior students from associate

degree and baccalaureate programs differ in care-cure

orientation, and faculty attitudes towards technical and









professional nursing philosophies may be related to this

perceived difference.


Student Characteristics


Student attitudes, values, needs, and characteristics

have been reported in the literature, as investigators seek

to describe and compare students from different types of

nursing programs in an attempt to shed light on the sociali-

zation process in nursing. Stein (1969) compared nursing

student needs as entering sophomores to their needs as seniors

to identify sources of stress in the socialization process,

and Gunter (1969) compared values of female college freshmen

with those of sophomore nursing students, to measure progress

towards self-actualization and emotional maturity. Tetrault

(1976) examined the association between professional attitude

and selected situational and demographic factors of 157 female

nursing students in a baccalaureate program. She found that

professional attitudes were highest in students aged 24 to

26. They had had the most formal and informal nursing ex-

perience, and perceived their teachers as taking strong posi-

tions on their beliefs. Professional attitude of students

was not related to future nursing career choice, parents'

level of education, or their placement in the sibling group.

Bayer and Schoenfeldt (1970) found that socioeconomic factors,

college plans of students, and parental encouragement during

the high school years were the differentiating variables

between nursing students in a three year diploma program and









those in a four year collegiate program. Aptitude, achieve-

ment, interests, and personality traits were found to be

similar. Gortner (1968) found professional attitudes of

registered nurse students to be greater than that of basic

senior students in 12 western universities. Data reinforced

the impression of registered nurse students as an upwardly

mobile and highly motivated group from lower socioeconomic

and educational backgrounds than that of basic students.

Determination of student characteristics which led stu-

dents to select certain types of programs included studies

by Alutto, Hrebiniak, & Alonso (1971), Jones (1976), and

Wren (1971). Associate degree students chose that program

because of location, length of program, and cost. The diploma

student was concerned with the reputation of their school,

clinical experiences available, and location. The baccalau-

reate student chose on the basis of reputation, curriculum,

and location (Wren, 1971). Alutto et al. found that person-

ality characteristics such as interpersonal trust and

authoritarianism may be reflections of student selection to

programs, rather than socialization outcomes (1971). Jones

found that demographic variables influence role conception

only indirectly, by influencing the choice of nursing program

(1976). Dustan's study of student characteristics in three

different types of nursing programs alsoindicated the impact

of selection factors, but similarities were noted in student

motivation for a nursing careers (1964). A study of psychological

characteristics of students graduating from three types of









basic nursing programs reported no significant statistical

differences in intelligence, leadership potential, responsi-

bility, emotional stability or sociability. All three groups

held similar perceptions of the real situation in nursing,

but baccalaureate students held significantly more profes-

sional ideals for nursing than did the other two groups

(Richards, 1972). Another study comparing students in the

three basic nursing education programs reported differences

in social behavior factors among the three groups (Ventura,

1976). Hover (1975) found that diploma graduates working

toward degrees in nursing held opinions and goals approaching

those of degree graduates. Meleis and Farrell studied senior

nursing students in three types of nursing programs and found

them to be essentially alike in intellectual characteristics,

self-esteem, and the consideration aspect of leadership (1974).

Other differences were reported in communication, structure

and autonomy factors of leadership, and interest in research.

Inguire (1952) described negative and positive attitudes held

by entering nursing students and their effect on student

progress.

In summary, studies of student characteristics correlated

selected demographic factors with professional attitude, found

no relationship with other demographic factors, identified

variables which differentiated students from different pro-

grams, identified some characteristics as program selection

factors, reported greater professional role conceptions for

baccalaureate and registered nurse students, found similarities









as well as differences in psychosocial variables among students

from the three types of programs, and found that student atti-

tudes were related to student progress in nursing school.

Many investigators compared student attitudes and values

with those of the faculty to identify the role-modeling effect

of faculty in the socialization process (Baker, 1964; Feldman

& Newcomb, 1969; Gliebe, 1977; Ondrack, 1975; Schein, 1967;

Schultz, 1965; Stein, 1969; and Williams, Bloch, & Blair, 1978).

These studies related the impact of the faculty on student

socialization variously to the degree of faculty commitment,

consensus and consistency of faculty values, meaningfulness

of faculty-student contact, and selected educational factors.

Williams and Williams (1959), in a six year study, noted

that the authoritarian control established by faculty at four

hospital schools and one university school was an effective

technique for socializing 524 students. Johnson (1971) com-

pared nursing school environments and found baccalaureate

schools to be more like medical schools in their emphasis on

medical education and research, while diploma schools had the

least favorable environment as perceived by faculty and stu-

dents.

This study was concerned with comparing the socialization

process in four different modes of nursing education, diploma,

associate degree, baccalaureate, and baccalaureate for

registered nurses. Congruence of graduating seniors and

program faculty as to professional orientation was part of

the study, as well as congruence of role conceptions on a






31


traditional/nontraditional continuum. Characteristics of

faculty and students of an experiential nature (nursing

experiences, type and length of education programs, teaching

experiences, membership in professional organizations) were

examined to determine the influence of these factors on

professional orientations and role conceptions.


1
















CHAPTER III

METHODOLOGY


Population and Sampling


The population defined for the study was all nursing

programs in Dade and Broward counties, in the South Florida

area. Dade and Broward counties are populous multi-ethnic

counties located on the Florida "Gold Coast." They are

currently experiencing pangs of rapid growth with increasing

problems such as a rising crime rate, inadequate housing, a

large population of elderly and retired people, illegal immi-

grations from Caribbean countries, and increasing numbers of

welfare recipients. The winter season brings an extra influx

of visitors, tourists, and migrant workers. Health care needs

of this population have stimulated hospital construction, but

many hospital wings remain unopened due to lack of nursing

personnel, especially during the winter months. Graduates

from nursing programs in this area are readily absorbed in

area agencies, and hospital recruiters fan out to the North,

Canada, and the Phillipines for additional nursing personnel.

There are no clear-cut trends by employing hospitals to

differentiate among the graduates of the various programs in

terms of salary or job placement, except for the Veteran's


M










Administration Hospital which starts the RN with a baccalaureate

degree at a higher rank than diploma or associate degree nurses.

There are six programs in this geographical area: two

generic baccalaureate programs, one in a private university

and the other in a private religious college two associate

degree programs in large, public-supported community colleges;

one diploma program affiliated with a large county hospital,

and one baccalaureate program for registered nurses only, lo-

cated in a state-supported upper division university. Students

from all six programs were invited to participate in the study

if they were enrolled in their last nursing course, or had

graduated during the previous month. All full-time under-

graduate faculty currently teaching in each program were also

invited to participate.


Procedure


Permission to distribute questionnaires was sought from

the directors of each of the nursing programs, and in two

instances, committees which review research proposals were

also contacted for such permission. Permission was received

from each program (Appendix A).

The investigator visited each program to speak to students

at a convenient time during their scheduled nursing classes.

Ten minutes were sufficient to explain the purpose of the

study, answer questions, and distribute cover letters, ques-

tionnaires, and stamped, self-addressed return envelopes to


M










those who wished to accept them. Students were asked to take

questionnaires to classmates who were absent on that day, and

to return the data in two weeks. It was explained that indi-

viduals and programs would remain anonymous, and results of

the study would be sent to all participating programs, as well

as to individuals who included their names and return addresses

with their questionnaires. In one instance, graduating seniors

were not scheduled to meet again as a group before graduation,

so thirteen questionnaires were mailed to that group with the

cover letter (Appendix B).

The investigator also visited faculty of all except one

program, following the same procedure used with the student

groups. In the case of the program where the faculty were not

invited to participate personally by the investigator, faculty

were not scheduled to meet again as a group until the following

quarter, so the program director distributed the materials

individually.

Questionnaires were distributed between December, 1977

and March, 1978. For the student group, 357 questionnaires

were distributed, and 178 returned, for a 50% return rate.

Faculty received 131 questionnaires, and 92 were returned,

for a return rate of 70%. Overall, 270 questionnaires were

returned out of 488 distributed, for a combined return rate

of 55%.


M










The Instrument


A scale developed by Crocker and Brodie (1974) was

designed to measure congruence between student nurses' per-

ceptions and faculty views of the professional nursing role.

This scale was referred to by the authors as the nurses'

professional orientation scale. For convenience the investi-

gator assigned to this scale the title "Nurses' Professional

Orientation Scale," or NPOS. The NPOS consists of 59 items

which were selected from an original pool of 112 items fol-

lowing item analysis and cross-validation studies. Each item

describes a behavior frequently displayed by nurses in their

work roles. Respondents were asked to rate each behavior on

its importance for the practicing professional nurse, using

a five-point scale ranging from extremely important (5) to

undesirable (1) (Crocker & Brodie, 1974, p. 233). Sample items

include "Has a deep concern for the welfare of humanity," and

"Has a strong loyalty to the hospital in which she works"

(Appendix C).

Validity of the scale was tested by comparing class means

(freshmen, sophomores, juniors, and seniors). Each class

mean was progressively higher than the class below, indicating

increasing congruence with faculty values.

Reliability of the scale was also computed. "The internal

consistency coefficient of the nurses' professional orienta-

tion scale, computed with the generalized coefficient alpha










formula, was r = .89, indicating that the attitude measured

by the nurses' professional orientation scale was a fairly

unitary trait among student nurses" (Crocker & Brodie, 1974,

p. 234). Scores on the NPOS measure the degree of the stu-

dent's conformity to the faculty's professional standards.

High scores indicate increased congruence with the faculty

group norm. Faculty and students involved in the development

of this scale were from three baccalaureate university programs,

so responses of students and faculty from other types of pro-

grams would be measured against the generic baccalaureate, or

professional, nursing program orientation.

In addition to professional orientation, the NPOS has been

used to ascertain differences in role conceptions on a tra-

ditional/nontraditional continuum. A graduate student in

nursing at the University of Florida devised a weighting sys-

tem based on ratings of 32 University of Florida nursing pro-

gram faculty members to determine whether each item on the

NPOS was traditionally or nontraditionally oriented. A high

total score represents the traditionally oriented person, and

a low score the nontraditionally oriented person. This

scoring system was used to determine role conceptions of

nursing faculty and students."

The NPOS was originally devised to measure faculty-student

congruence of role perception. Scores comparing programs and

faculty are based on congruence with the responses of 94

nursing faculty members from four-year undergraduate,









baccalaureate nursing programs in three midwestern universities.

Comparing scores of students from associate degree, diploma,

RNBSN and generic BSN programs will in effect be comparing

them with the professional values espoused by this bacca-

laureate faculty group. Thus, these comparisons will be valid

only to the extent that this faculty group can be said to have

the typical values of professional nursing.

In addition to the NPOS, students and faculty were asked

to fill out separate questionnaires reporting sex, age, and

collegiate and professional backgrounds (Appendix D).


Statistical Hypotheses


The following null hypotheses were formulated for

statistical analysis:

1. There will be no differences between students and
faculty on either the NPOS or the traditional/
nontraditional scale.

2. There will be no difference between nursing programs
on either the NPOS or the traditional/nontraditional
scale.

3. There will be no interaction between nursing programs
and students and faculty on either the NPOS or the
traditional/nontraditional scale.





38







Note


Explanation of the traditional/nontraditional scoring
method was provided through personal communication with Ms.
Mary Lynn, graduate student in the College of Nursing, Uni-
versity of Florida, Gainesville, Florida 32610.















CHAPTER IV

ANALYSIS OF DATA


Professional Orientation and Role Conception


Multivariate analysis of variance was employed for data

analysis. Because of unequal cell sizes a nonorthogonal, step

down design (Applebaum & Cramer, 1974) was the decision-making

model used. These authors describe a model for hypothesis

testing in which bias can be minimized in estimating treatment

effects (p. 338-340). In a two-way factorial design where A

and B are factors, this decision-making model allows for both

A and B effects; the quality of this model is compared to that

of a model omitting one or more of the effects. The judgment

as to which model is most appropriate is based on the relative

magnitudes of the sum of squared errors produced by each model,

and the F test provides an additional basis for comparison

(Applebaum & Cramer, 1974, p. 339).

In this study, the two factors being tested were Program

(with four levels, community college, diploma, baccalaureate,

and RNBSN) and Status (with two levels, faculty and students).

The two criterion measures were scores on the traditional/

nontraditional role concept (Role) and scores on the Nurses'

Professional Orientation Scale (NPOS). The MANOVA computer









program was the multivariate analysis of variance program used
1
with the UNIVAC 1100 multiprocessor system. With the level of

alpha set at .05, a test of interaction between Status and

Program was performed.

Since .068 and .936 exceed alpha (.05), Status/Program

interaction was judged nonsignificant, null hypothesis number

three (there will be no interaction between nursing program,

and students and faculty, on either the NPOS, or the traditional/

nontraditional scale) was accepted. Differences between

faculty and students did not vary according to type of nursing

program (Table 1).


Table 1

Multivariate Tests for Differences on Criterion Measures due
to Interaction of Faculty and Students
in Each Nursing Program


df Hypoth- df P Less
Tests of Roots F esis Error Than R


1 through 2 1.970 6 512 .068 .210
2 through 2 .066 2 513 .936 .023

Note: Wilks' Lambda Criterion was the multivariate test of
significance used.


Testing next for Program effects, the effect of Status

was ignored by collapsing the 2 levels of status and, in

effect, performing a one way Analysis of Variance. This test

showed that a significant difference existed on the NPOS and/or

the traditional/nontraditional role scores between the various

programs (Table 2).










Table 2

Multivariate Tests for Differences Between
Programs on Criterion Measures


df Hypoth- df P Less
Test of Roots F esis Error Than R


1 through 2 2.241 6 512 .038* .188
2 through 2 2.067 2 513 .128 .126

Note: Wilks' Lambda Criterion was the multivariate test of
significance used.
*E < .05


Univariate testing further provided the information that

it was only on the traditional/nontraditional (Role) criterion

measure that the various programs differed significantly from

each other (Table 3).


Table 3

Differences Between Programs on
Each Criterion Measure
Univariate F Tests


Variable F (3,257) Mean Squares P Less Than


Role 4.343 733.473 .005*
NPOS 1.262 656.867 .288

*P < .05


Null hypothesis number two, that there will be no differences

between nursing programs either on the NPOS or the traditional/

nontraditional scale, was therefore rejected.

In order to determine which programs were significantly

different from each other on the traditional/nontraditional


M










role scores, a post hoc test was performed according to the

method of Scheff4 (Klugh, 1970, p. 265).2 This test is used

when means of groups of unequal size are to be compared for

significant differences. Because the Scheffe procedure is

more rigorous than other procedures and will lead to fewer

significant results, it is recommended that the .10 level of

significance be employed to compensate for the increased

possibility of making type I errors (Ferguson, 1976). Tables

showing the .10 critical values were found in Winer (1971).

In Table 4 it can be seen that the community college program

and the diploma program contrasted significantly with the

RNBSN program on traditional/nontraditional role scores.

Differences between the other programs were not significant.


Table 4

Differences Between Programs on
Traditional/Nontraditional Role Scores


Means Programs Diploma Baccalaureate RNBSN


117.50 Community Colleges .74 3.48 12.14**
115.685 Diploma 1.47 7.23*
113.029 Baccalaureate 2.475
109.149 RNBSN

Note: High means reflect more traditional role conceptions,
low means more nontraditional role conceptions.
*p < .10, F critical, 3,257 df = 2.08 x 3 = 6.24
**p < .05, F critical, 3,257 df = 2.64 x 3 = 7.92


Since hypothesis number two stated that there would be

no difference between nursing programs on either the NPOS or










the traditional/nontraditional scale, this hypothesis was

rejected.

The second factor, Status, was tested to examine its

effect on the criterion measures. The multivariate test

showed that the Status factor (faculty and students) made a

significant difference on one or both of the scores (NPOS and

traditional/nontraditional). The univariate test confirmed

that scoring differences between faculty and students existed

on both the NPOS and the traditional/nontraditional scales

(Tables 5, 6).


Table 5

Multivariate Test for Differences Between
Faculty and Students on Criterion Measures


df Hypoth- df P Less
Test of Roots F esis Error Than R


1 through 1 14.594 2.000 256 .001* .320

Note: Wilks' Lambda Criterion was the multivariate test of
significance used.
*p < .05


Table 6

Differences Between Faculty and
Students on Criterion Measures
Univariate F Tests


Variable F (1,257) Mean Squares P Less Than


Role 28.237 4769.045 .001*
NPOS 14.279 7435.010 .001*

*p < .05










Since significance was shown, the first null hypothesis,

that there will be no differences between students and faculty

on either the NPOS or the traditional/nontraditional scale,

was rejected.

Since it was found that status had a significant effect

on scores, it was necessary to examine faculty and student

means to determine the differences between faculty and stu-

dents (Table 7).


Table 7

Means of Criterion Measures According to Status


Status NPOS Role


Faculty 202.942 108.747
Students 180.925 117.781

Differences 22.017* 9.03*

*p < .05


Faculty professional orientation values as measured by

the NPOS were more congruent with the normative baccalaureate

faculty group values as compared to the student sample, and

significantly different from student values. In the case of

Role, students demonstrated a significantly higher mean than

faculty. This implies that students held a significantly more

traditional role conception of nursing than faculty.

Because there were no significant differences between

faculty and students depending on the type of program involved

(interaction effect) no further testing was indicated. Faculty










were not significantly different from program to program on

either the NPOS or Role scores. Students also held similar

professional orientations and role conceptions no matter what

the program. Faculty as a whole, however, held significantly

different professional orientations and role conceptions from

the student group.

A table displaying mean scores of both criterion measures

for faculty, students, and program (combined faculty and

student meansi- can be found in Appendix E.


Student Characteristics


Percentages and frequencies with chi-square probability

were done on all student demographic variables according to

nursing programs. There were 175 student responses to the

demographic data questionnaire: 52 from the community college

programs, 40 from the diploma program, 42 from the baccalaureate,

and 41 from the RNBSN program.

There were only nine males represented in the sample (5%),

seven in the diploma program, and two in the baccalaureate

programs.

Students from the community colleges and the RNBSN pro-

gram ranged in age across all five age groupings, from 18 to

over 42 years, while 95% of the diploma students and 88% of

the baccalaureate students were in the 18-29 year age group,

with no students reported over 36 years of age. Two-thirds

of the community college group were between 18 and 29 years










of age; approximately one-third of the RNBSN students were

36-41 years, and 20% were 42 or over (Table 8). Diploma and

baccalaureate students were younger on the average than stu-

dents from the other two programs. A wider range of age

groups was represented in the community college and RNBSN pro-

grams, with the older students particularly well represented

in the RNBSN program.


Distribution


Table 8

of Students by Age and Program


Years
Program 18-23 24-29 30-35 36-41 42 + Totals


Community College fa 17 17 4 7 7 52
% 32.69 32.69 7.69 13.46 13.46 100
Diploma f 27 11 2 0 0 40
% 67.50 27.50 5.00 .00 .00 100
Baccalaureate f 33 4 5 0 0 42
% 78.57 9.52 11.90 .00 .00 100
RNBSN f 3 12 6 12 8 41
% 7.32 29.27 14.63 29.27 19.51 100
Totals f 80 44 17 19 15 175
% 45.71 25.14 9.71 10.86 8.57 100

af = frequency
Note: chi-square = 61.60 with 12 df; probability = .0000


Seventeen percent (9) of the community college students

were currently licensed as practical nurses (LPNs); 15% (6)

of the diploma students and 60% (25) of the baccalaureate

students were also LPNs. All of the RNBSN students were

licensed as registered nurses, with 13% (5) holding dual










licenses, RN plus LPN. Three of the baccalaureate students

were RNs. The percent of students currently or previously

licensed as LPNs thus ranged from 13% to 17% for all programs

except the baccalaureate where 60% held this license. A

possible explanation for the high percentage of licensed

baccalaureate students is that students enrolled in these two

baccalaureate programs which are located in private institu-

tions, may have taken the LPN licensing examination at some

point in their baccalaureate program so that they could work

part-time to help defray tuition costs and other necessary

expenditures (Table 9).


Table 9

Students Licensed as LPNs or RNs by Program


Program Yes No Totals


Community College f 9 43 52
% 17.31 82.69 100
Diploma f 6 34 40
% 15.00 85.00 100
Baccalaureate f 28 14 42
% 66.67 33.33 100
RNBSN f 41 0 41
% 100 .00 100

Note: chi-square = 87.36 with 3 df; probability = .0000


Of those students who had previous nursing experience,

57% of community college students (8) reported from 4 to 12

or more years; all 14 (100%) of the diploma students had 0-3

years, 83% (25) of the baccalaureate students had 0-3 years,










and all 41 of the RNBSN students had experiences ranging from

0-3 years up to 12 years or more (Table 10). These findings

appeared to be related to age of the various student bodies,

the programs with a higher percentage of older students

(community college and RNBSN) reporting more years of nursing

experience, while the programs with the youngest age ranges

(diploma and baccalaureate) had less nursing experience. Even

though the baccalaureate programs had so many previously

licensed students (28), or 67%, over three-fourths of those

individuals reported 0-3 years of experience, indicating that

their licensure was recently acquired.


Table 10

Years of Nursing Experience by Previously
Licensed Students by Program

Years
Up to
Program 0 3 4-7 8-11 12 + Totals


Community College f 3 3 2 5 1 14
% 21.43 21.43 14.29 35.71 7.14 100
Diploma f 7 7 0 0 0 14
% 50.00 50.00 .00 .00 .00 100
Baccalaureate f 8 17 3 2 0 30
% 26.67 56.67 10.00 6.67 .00 100
RNBSN f 0 7 13 10 11 41
% .00 17.07 31.71 24.39 26.83 100
Totals f 18 34 18 17 12 99
% 18.15 34.34 18.18 17.17 12.12 100

Note: chi-square = 42.20 with 12 df; probability = .0000


Eighty-seven

programs reported


out of one hundred students from all the

that the hospital was the major site of










their nursing experiences. The chi-square probability of .0904

indicates there were no significant differences shown on this

variable between the four programs.

Thirty-three percent (55) of 167 students were members of

the Student Nurses' Association. It is seen from Table 11

that the RNBSN students reported 66% membership in their or-

ganization. A possible explanation is that in this particular

school, unusual political activity was being conducted by

students in response to an administrative decision to phase

out their program.


Membership in


Table 11

Student Nurses' Association


Program Yes No Totals


Community College f 9 39 48
% 18.75 81.25 100
Diploma f 8 31 39
% 20.51 79.49 100
Baccalaureate f 13 29 42
% 30.95 69.05 100
RNBSN f 25 13 38
% 65.79 34.21 100
Totals f 55 112 167
% 32.93 67.07 100

Note: chi-square probability = 25.74 with 3 df; probability
= .0000


In relation to total years of college attendance, 85%

(145) of 170 students answering this item indicated they had










attended three or more years of college (Table 12). Seventy-

three percent (36) community college students, 72% (28)

diploma students, 100% (42) of the baccalaureate students,

and 97% (39) of the RNBSN students had 3 or more years of

college studies (Table 12). Although the associate degree

programs are traditionally two year programs, it appeared

that three-fourths of those students spent three years at the

lower division level of collegiate education. The diploma

program includes community college support courses as part of

its nursing curriculum, so that students may obtain the

associate degree from the community college by taking several

additional courses which are not part of the nursing curricu-

lum. This diploma program, the only one in the states, may

also favor selection of students with college backgrounds.


Table 12

Total Years of College Attendance of Students by Program


Years
Program 0 1 2 3 4 + Total


Community College f 0 1 12 21 15 15
% .00 2.04 24.49 42.86 30.61 100
Diploma f 1 1 9 16 12 39
% 2.56 2.56 23.08 41.03 30.77 100
Baccalaureate f 0 0 0 9 33 42
% .00 .00 .00 21.43 78.57 100
RNBSN f 0 0 1 8 31 40
% .00 .00 2.50 20.00 77.50 100
Totals f 1 2 22 54 91 170
% .59 1.18 12.94 31.76 53.53 100

Note: chi-square = 34.89 with 12 df; probability = .0005











Faculty Characteristics


Frequencies and percentages with chi-square probabilities

were obtained for the faculty demographic variables according

to program.

There were 87 females and two males represented in the

faculty sample of 89. There were 26 faculty respondents from

the community college programs, 32 from the diploma program,

26 from the baccalaureate program, and five from the RNBSN

program. Because the RNBSN sample was so much smaller than

the other faculty samples, percentages for demographic vari-

ables may be misleading.

Approximately two-thirds (63%) of all faculty were be-

tween the ages of 20 to 40 years of age, with 19% between

41-50 years, and 18% over 50 years. With chi-square proba-

bility at .6039 there were no significant differences between

faculty ages according to type of nursing program (Table 13).

There was no significant difference between programs as

to type of basic nursing preparation of the faculty (chi-

square probability = .9988). Forty-three percent had a basic

diploma program background, four percent the associate degree,

and 53% the baccalaureate degree.

Faculty teaching in the various programs reported a

variety of teaching backgrounds (Table 14).










Table 13

Age Categories of Faculty by Program


Years
20-30 31-40 41-50 51-60 61 or
Program years years years years over Total


Community College f 4 10 4 8 0 26
% 15.38 38.46 15.35 30.77 .00 100
Diploma f 13 13 3 2 1 32
% 40.63 40.63 9.38 6.25 3.13 100
Baccalaureate f 6 8 8 4 0 26
% 23.08 30.77 30.77 15.38 .00 100
RNBSN f 0 2 2 1 0 5
% .00 40.00 40.00 20.00 .00 100
Totals f 23 33 17 15 1 89
% 25.84 37.08 19.10 16.85 1.12 100

Note: chi-square = 10.15 with 12 df; probability = .6030



Table 14

Faculty Teaching Experience by Program


Teaching Experience
Faculty by Diploma ADN
Program Program Program BSN RNBSN


Community
College 44% 96% 8% 12%
Diploma 94% 7% 27% 10%
Baccalaureate 44% 28% 92% 20%
RNBSN 0 80% 50% 100%

Note: Percentages total more than 100% because faculty could
select several responses when applicable. This table
is a composite of four tables, all reporting less than
.0237 chi-square probability.










Forty-four percent of community college faculty and 44%

of baccalaureate faculty had teaching experiences in diploma

programs. Twenty-seven percent of diploma faculty and 50% of

RNBSN faculty reported teaching experience in baccalaureate

programs. Eighty percent of RNBSN faculty taught in associate

degree programs. This indicated that many faculty had taught

in more than one type of program. Only 96% of community

college faculty reported experience in teaching in the ADN

program, 94% of diploma faculty had experience in diploma

program teaching, 92% of baccalaureate faculty had taught in

baccalaureate programs, and 100% of RNBSN faculty had ex-

perience in the RNBSN program. These figures could reflect

the numbers of experienced faculty teaching in the various

programs. These percent did not reach 100% for three of the

programs; the difference may represent the percent of new

faculty in each program who were unable to report teaching

experience in their programs.

Nursing faculty in all programs had a wide range of years

of experience in nursing not including teaching. Three percent

had no experience, 20% up to 3 years, 30% 4-7 years, 19% 8-12

years, and 27% over 12 years of nursing experience. There

were no significant differences in years of nursing experiences

between faculty from the four types of programs (chi-square

probability = .9660). These nursing experiences took place

in the following settings (Table 15).










Table 15

Settings for Major Nursing Experiences of All Faculty


Community Industrial
Hospital Agency Nursing Other


Frequencies 72 8 2 2
Percentages 86% 10% 2% 2%

Note: chi-square = 1.94 with 9 df; probability = .9924.


With chi-square probability .9924, there was no signifi-

cant difference in settings for major nursing experiences be-

tween program faculty.

Program faculty varied significantly on the highest de-

gree held (chi-square probability .0002). Table 16 shows that

48% of community college faculty and 28% of baccalaureate

faculty held master's degrees in fields other than nursing;

71% of diploma faculty and 16% of the baccalaureate faculty

held the BSN as the highest degree; 52% of baccalaureate

faculty held the master's in nursing, and 80% of RNBSN faculty

also held the master's in nursing. Seventeen percent of the

community college faculty (4) had earned the doctorate, and

one person (20%) of the RNBSN faculty reported an earned

doctorate. These differences in highest degree held would

be expected, since they reflect the faculty requirements of

each type of program. The diploma school requires faculty to

have a minimum of a baccalaureate degree; the community college

requires a minimum of a master's degree in any field; in











baccalaureate programs, including the RNBSN program, a masters

in nursing is the desired minimum degree.


Table 16

Highest Degree Held by Faculty


of Each Program


BS- Master's- Earned
Program BSN Other MN Other Doctorate


Community
College 9% 9% 17% 48% 17%
Diploma 71% 0 19% 10% 0
Baccalau-
reate 16% 4% 52% 28% 0
RN 0 0 80% 0 20%
Totals 33% 4% 32% 25% 6%

Note: chi-square = 37.87 with 12 df; probability = .0002


Thirty-seven percent of all faculty held the baccalaureate

degree, and 57% the master'sas the highest degree. Doctoral

degrees had been earned by 6% of all faculty.

Faculty from all programs belonged to the American Nurses

Association (ANA) at a rate of 65%. There was no significant

difference in ANA membership between the program faculty (chi-

square = .9186).

Only 33% of the faculty belonged to specialty groups

within the nursing profession, a nonsignificant interprogram

difference with chi-square = .9134.








Interpretation of Data


Through statistical procedures it was determined that no

differences existed between the various nursing programs on the

professional orientation scale. This means that when faculty

and student scores on the NPOS for each program were combined,

views of the nursing profession were similar for all four

modes of nursing education. Some differences were found to

be significant among programs on the traditional/nontraditional

scale, however. The diploma program and the community college

program (faculty and students) held different role conceptions

from those of the RNBSN program, with both ADN and diploma

programs demonstrating a more traditional view of the nurse's

role than the RNBSN program. No significant differences in

role conception were demonstrated among the community college

program, the diploma program, and the baccalaureate program,

or between the baccalaureate program and the RNBSN program.

Community college programs had the most traditional view

of the nursing role, followed by the diploma program, the

baccalaureate program, and the RNBSN program. From this data,

answers were provided for several of the research questions:

1. Do significant differences exist in professional

orientation between nursing students enrolled in programs pre-

paring for different categories of practice?

The answer was no, there were no differences in orienta-

tion towards the nursing profession between technical and

baccalaureate prepared nurses.











2. Do role conceptions of faculty and students on a

traditional/nontraditional dimension vary according to type of

educational program?

Yes, faculty and students in the technical programs held

a significantly more traditional view of the profession than

faculty and students from the RNBSN program.

3. Will professional orientations and role conceptions

held by graduating RNBSN students be similar to those held by

graduating BSN students, or will they resemble the orienta-

tions and role conceptions of the associate degree and diploma

students?

Professional orientations of RNBSN students were similar

to those of the generic BSN students as well as to those of

the associate degree and diploma students. Role conceptions

of RNBSN students were similar to the BSN students, but were

significantly different from those held by the associate degree

and diploma students. The RNBSN role conceptions were more

nontraditional than those of the other programs, and the

community college role conceptions were the most traditional.

In all programs, students held more traditional role concep-

tions than faculty. Diploma program faculty held the most

traditional role conceptions, RNBSN faculty the least tradi-

tional. Community college students held the most traditional

role conceptions, RNBSN the most nontraditional. Because

there was a nonsignificant interaction effect, differences










between faculty and students were not affected by the programs.

Professional orientation scores were not statistically dif-

ferent between faculty from the various programs, or between

students from the various programs.

The following research questions were answered:

4. Do graduating seniors and faculty from each pro-

gram hold similar professional orientations and role concep-

tions?

No, role conceptions were significantly different for

several programs, but professional orientations were similar

in all programs.

5. Are there significant differences in professional

attitudes among faculty teaching in the various programs?

Again, the answer is no, there was no interaction ef-

fect. Faculty orientation scores from one program were not

significantly different from faculty scores from another

program.

There were many similarities and differences among

students from the various programs. A composite picture of

a typical student from each type of program will highlight

the most important characteristics of each group.

The community college nursing student was female, was

not currently licensed in nursing, did not belong to the

student nurses' association, and had had three or more

years of college. She was likely to be anywhere from 18

to over 42 years of age.










The diploma student was female, not licensed in nursing,

did not belong to the student nurses association, and had had

three or more years of college. Her age was in the category

18-23 years.

The baccalaureate student was female, 18-23 years of age,

did not belong to the student nurses association, and had had

four or more years of college. She was licensed as an LPN,

with up to three years of experience in a hospital setting.

The RNBSN student was female, was a member of the student

nurses' association, and had had four or more years of college.

Her age ranged anywhere from 24 to over 42 years. She was

currently licensed as an RN with 4 to 12 or more years of

nursing experience in a hospital setting. Many RN students

attended college on a parttime basis while working.

The community college students and the diploma students

were similar except for age. The diploma and baccalaureate

students were similar except that the baccalaureate students

were likely to be licensed, with some nursing experience. The

RNBSN students were different from each of the other three

types of students on several variables: age, previous licen-

sure, years of nursing experience, membership in the student

nurse association, and length of college attendance.

Faculty members from the various programs were more alike

than the students. A typical faculty member was female,

originally prepared in nursing at either the diploma or the










baccalaureate level, had taught in at least two types of

nursing programs and belonged to the ANA, but not to other

specialty groups in nursing. Her age ranged anywhere from

20 to 40 years, which accounted for the variation in the

number of years of nursing experience in a hospital setting

she reported. The only variables which differed significantly

from program to program were the number of years experience

faculty had had teaching in various types of programs, and

the type of academic degrees held by faculty in the different

programs.

Research question number six asked, "Do experiential

characteristics of faculty and students vary according to

program?" The answer was affirmative, although this was not

true for all the demographic variables.














Notes


The MANOVA program is distributed by Clyde Computing
Service, Box 166, Coconut Grove Station, Miami, Florida 33133.

The Scheff6 method involves a comparison of each mean
with every other mean to form F ratios. The following formula
was used (Klugh, 1974, p. 265).

F = (XI X)2

Sw2 x nl + n2
n1n2
"12

X1 and X2 are the sample means, Sw is the within samples
estimate of variance, and n and n are the sample sizes. F
values are obtained from the F table for k-l and N-k df. TEe
F required for significance is found by multiplying this F
by k-l.


1














CHAPTER V

SUMMARY


Professional socialization, the process of acquiring

knowledge, attitudes, and behaviors appropriate to a pro-

fessional role, formed the framework for an examination of

professional orientations of students and faculty in programs

preparing technical and professional practitioners of nursing.

The problem area considered by this study concerned role

confusion in nursing as a result of the diversity of educa-

tional programs preparing students to practice nursing.

Consumers, employers, and graduating nurses themselves are

not able to distinguish graduates of the various educational

programs existing in nursing education in terms of role ex-

pectations. The nursing profession is seeking to clarify

this situation by proposing that there be two educational

models, one preparing nurses for the technical and one for

the professional practice of nursing. The specific problem

delimited for this study was to examine the impress of the

professional socialization process as measured by professional

orientation and role conception on students and faculty from

different types of nursing programs. The purpose of the study

was to determine whether students from four different types

of nursing programs held different professional orientations

and role conceptions as a reflection of values and attitudes








transmitted to them by significant others during the profes-

sional socialization process. Concepts and assumptions under-

lying the socialization process were derived from symbolic

interactionist theory.

The Nurses' Professional Orientation Scale (NPOS), with

reliability of .89, and construct validity reported, was dis-

tributed to a sample of 357 senior nursing students and 131

faculty from six institutions representing four different

types of nursing programs (associate degree, diploma, generic

baccalaureate, and baccalaureate for Registered Nurses). All

of the nursing programs were located in two counties in the

populous south Florida area. Fifty-five percent of the ques-

tionnaires distributed were completed and returned. The data-

producing sample consisted of 178 senior nursing students and

92 faculty.

Two scores were obtained from the NPOS data, a total score

measuring congruence with professional values of a normative

baccalaureate faculty group, and a reweighted score measuring

traditional and nontraditional role conceptions. Multi-

variate analysis of both scores was performed and Scheffe's

method for pairwise comparisons was the post hoc test used

for further significance testing. Professional orientation

scores did not differ significantly from program to program,

and the only significant differences on traditional/nontra-

ditional role conceptions occurred between the traditionally-

oriented associate degree and diploma programs, and the

baccalaureate program for Registered Nurses, which held the

most nontraditional orientation. The faculty group held a









significantly more nontraditional role conception than the

student group, and faculty professional orientation was

significantly different from that of students.

Frequencies, percentages, and chi square tests of

significance were used to analyze demographic variables re-

lated to sex, age, previous nursing experiences, previous

licensure, education, teaching experience and professional

membership. Faculty from the various programs differed

significantly on only two variables, length of time spent

teaching in various programs, and the type of academic degree

they held. Students varied from program to program on all

variables except the setting of previous nursing experience

(hospital). Although at the time of graduation from a basic

nursing program, students differed in nursing and collegiate

experiences, they held similar views of the nursing profes-

sion and the role of the nurse, no matter what type of nursing

education they had received. This failure to differentiate

different types of nursing practice through socialization

processes was seen as detrimental to efforts to establish

two different categories for nursing education. Faculty, as

important instruments of the socialization process, hold the

major responsibility for communicating attitudes and values

to students which are appropriate to the goals and objectives

of each problem. Homogeneity of program faculties on experi-

ential variables and professional orientation appeared to

have influenced the homogeneity of professional orientation

and role conception which was found to exist for all programs.









Conclusions drawn from the study stated that if the

recommendations of the ANA Committee on Nursing Education are

to be implemented to establish technical and professional

categories for nursing practice, educators will have to examine

closely what is being transmitted to students through formal

and informal processes of professional socialization. Gradu-

ates of each type of nursing program should demonstrate

orientations to nursing which are reflective of the different

philosophies, objectives, curricula, and roles defined by the

profession for each category of nursing practice.

Recommendations were that nursing educators recognize

the importance of socialization processes in the transmittal

of attitudes and values to nursing students. Provision for

value clarification should be provided in the curriculum for

students as well as faculty to ensure the appropriateness of

the developing value system for the educational goals and

objectives of the different nursing programs.

Faculty need to be more cognizant of the role they play

in professional socialization of students. There should be

consensus of faculty values, and appropriateness of their

values for the curriculum objectives. Educational programs

preparing nursing faculty should teach concepts of profes-

sional socialization processes in the curriculum as a vehicle

of communication with students.

Other recommendations were made to seek other data

gathering tools which might prove more sensitive indicators

of professional orientation differences between individuals

and programs.














CHAPTER VI

CONCLUSIONS AND RECOMMENDATIONS


Conclusions


Nursing education programs preparing students for dif-

ferent categories of practice demonstrated similar orienta-

tions to the nursing profession. Associate degree, diploma,

and baccalaureate programs also demonstrated similar concep-

tions of the nursing role. Although the nursing profession

is striving for professional status by establishing minimum

requirements for its professional practitioners and making

clear distinctions between programs which prepare nurses for

professional practice and those preparing nurses for techni-

cal practice, existing programs appeared to be more alike

than different in regard to professional attitudes and values.

If the recommendations of the ANA Committee on Nursing Edu-

cation are to be implemented to establish technical and pro-

fessional categories for nursing practice, educators will

have to examine closely what is being transmitted to students

through formal and informal processes of professional

socialization. Graduates of each type of nursing program

should demonstrate orientations to nursing which are reflec-

tive of the different philosophies, objectives, curricula,

and roles defined by the profession for each category of

nursing practice.


66









Although there were significant differences on experiential

and educational background characteristics among students

attending the four types of nursing education programs, some

typical patterns could be discerned. Students from all pro-

grams reported three to four years of college attendance.

Most diploma and baccalaureate students were younger than

those in the other two types of program. Associate degree

and RNBSN students were all ages. The majority of bacca-

laureate and RNBSN students had been previously licensed,

either as LPNs or RNs. RNBSN students, however, were dif-

ferent from students in basic nursing programs. It is re-

markable that, despite interprogram differences on variables

which might have affected students' images of nursing, that

students from all basic nursing programs held similar profes-

sional orientations and role conceptions. This supported one

of Davis' findings that there were no correlations between

students' work experience in nursing and their role concep-

tions (1972). Davis also found that differences between

students within a program was as great or greater than dif-

ferences between students from baccalaureate and associate

degree programs. Another researcher noted that demographic

factors did not directly influence role conceptions, but

might influence role conception indirectly by influencing

the choice of nursing program attended (Jones, 1976). She

concluded that students with different demographic profiles

within the same type of nursing program had similar role

conceptions of nursing. Findings from the present study









indicated that students with different demographic profiles

from all four types of nursing programs had similar role

conceptions.

According to symbolic interaction theory, faculty, as

role models, are important instruments of the socialization

process. In forming perceptions of their profession, students

are strongly influenced by faculty values, attitudes and

behavior. Faculty participating in this study did not differ

significantly from program to program in the characteristics

under consideration. Over half of the faculty had been pre-

pared for the practice of professional nursing, and the re-

mainder had been educated for technical practice. Many faculty

had taught in more than one type of nursing program. The

similarity of professional orientation and role conception of

all faculty as indicated by data derived from this survey

could well be a function of the homogeneity of background

characteristics and the movement of faculty between types of

nursing programs which was reported in the study. This

similarity of professional orientation for program faculty

correlates with the similarity of professional orientation

found in the student group. Faculty influence on student

values has been substantiated in the literature by several

investigators: Crocker and Brodie (1974), Davis and Olesen

(1964), Olesen and Davis (1966), and Siegel (1968). Findings

of homogeneity of student professional orientations can be

explained by the similarity of faculty characteristics and

professional orientations.









Data from this study suggested that modifications can

occur in role conceptions of students preparing to change

from one category of nursing practice to another through the

educational process. Nursing students in diploma and associate

degree programs varied significantly from students in the

RNBSN program in role conception. Students from diploma and

associate degree programs held the most traditional concepts

of the nursing role, while the RNBSN students held the most

nontraditional views. Since RNBSN students are all diploma

or associate degree graduates, it is assumed that they, too,

held the same traditional views when they graduated from their

basic diploma and associate degree programs, but had learned

to espouse nontraditional views at the time of completion of

the postbasic baccalaureate program. Evidence from this

study supports the supposition that students can thus be

resocialized during the process of education for different

categories of nursing practice.


Recommendations


If differentiation in nursing practice is to be an

attainable objective for the nursing profession, nursing

educators should recognize the importance of socialization

processes in the transmittal of attitudes and values to

nursing students. Clarification of professional values

appropriate for each category of nursing practice should be

emphasized in the nursing curriculum, and students should be

provided opportunities to articulate, explore, compare, and











clarify their professional views. Faculty should serve as

role models to demonstrate their professional values and at-

tidues and to reinforce student attitudes and values which

are appropriate for their educational program objectives.

Consensus of faculty orientations should be obtained within

each program. Faculty espousing philosophies and values which

conflict with curriculum objectives reduce the effectiveness

of the professional socialization process and contribute to

lack of differentiation between categories of nursing practice.

Continuing education programs may be required to assist fac-

ulty who are currently teaching to identify professional values

and role expectations which are consistent with those deline-

ated for the various educational programs.

Educational programs preparing nursing faculty for vari-

ous types of nursing programs should focus on the process of

socialiation as part of the teaching strategy. Faculty need

to be more cognizant of the role they play in the profes-

sional socialization of students, both overtly and covertly.

Their own attitudes and value systems should be explored and

clarified to enable them to perceive congruencies and dis-

parities between their own professional values and those which

have been articulated for each type of nursing program.

The National League for Nursing (NLN), which is the ac-

crediting body for nursing education programs, has specified

that nursing faculty have graduate preparation in nursing,

and experience appropriate to their areas of responsibility

and to the goals of the program (National League for Nursing,










1977, 1978). Data from this study on faculty preparation re-

vealed that a significant number of faculty teaching in the

various programs did not possess the recommended preparation

for their teaching responsibilities. Although appropriate

graduate preparation does not necessarily guarantee that stu-

dents will receive appropriate socialization for their in-

tended types of practice, adherence to educational criteria

should help to achieve uniform standards for faculty in the

various educational programs. The educational programs them-

selves should articulate and differentiate their goals clearly,

both for the benefit of faculty who must adopt and subscribe

to those goals and for prospective students. Applicants to

nursing programs should be aware of the differences in role

expectations, curriculum, and professional identity which

characterize each of the different types of educational pro-

grams preparing nurses for practice in order to make an in-

formed choice for their desired career pattern.

Program faculties need to find better methods for stu-

dent selection to achieve better matching of prospective stu-

dents to fit the goals, philosophies, and objectives of each

type of program.

Additional studies of the socialization process are neces-

sary to help nursing educators prepare students to become prac-

titioners of nursing. Role conceptions and orientations ap-

propriate for the two categories of nursing practice must be

communicated to students so that consumers and nurses









themselves will have a clear understanding of the role and

professional identity of each type of practitioner, and will

recognize their complementary roles on the health team as

they work together to deliver a high quality of health care.

If additional studies are designed to differentiate the

professional orientations of students or nurses prepared for

different categories of practice, different data collecting

tools may prove more effective. The NPOS, designed to meas-

ure congruence between faculty and student values, may not

be a sensitive indicator of value differences among programs.

On the other hand, if nursing educators can clearly define

differences in the practice of nursing and can reinforce these

differences through the professional socialization process

in nursing education, the graduates of these programs would

demonstrate these differences so explicitly that there would

be no need to seek a more sensitive measurement tool.




































APPENDIX A

Permission Letter











JANICE T. THOMAS, R.N., M.N. C
12600 S.W. 80th Avenue 0
Miami, Florida 33156 P
Home: (305) 235-2727 Y
Business: (305) 552-2228

November 8, 1977









Dear Associate Deans:

The days ahead are crucial for the nursing profession. Many
states are considering legislation which would establish entry
into the profession at the baccalaureate level of education.
This issue is forcing nursing leaders to reexamine similarities
and differences in practice of nurses who have graduated from
several different modes for nursing education. One of the
differences which has been identified concerns the graduate's
view of the nursing profession as a whole, and her own role
within it. Are there, in fact, measurable differences in
student attitudes towards the nursing profession according to
educational preparation, and if differences are verified, how
stable are these attitudes when additional education is ob-
tained?

I am a doctoral student in the College of Education at the
University of Florida, and I am planning to conduct a study
of professionalism in nursing to find the answers to the
following questions:

Do students and faculty from different nursing
programs hold different attitudes towards nursing?

How do the students' attitudes compare with the
attitudes held by their nursing faculty?

Are the faculty attitudes congruent with the atti-
tudes of other faculty within the same program, or
do their attitudes reflect their own educational
background?










Page 2


I am requesting permission to distribute the Nurses' Pro-
fessional Orientation Scale to your graduating seniors and
your nursing faculty, to be completed voluntarily at their
convenience and returned to me by mail. All individuals and
institutions will remain anonymous, and I plan to furnish
participating programs with a summary of the findings of the
study.

I will contact you within ten days to receive your decision
concerning this request.


Sincerely,



Janice T. Thomas, R.N., M.N.


JTT/fa




































APPENDIX B

Cover Letter















Dear Participant:


Many states are considering legislation to restrict the

entry level to the practice of professional nursing. It is

important to determine if there are differences in perceptions

among faculty and students in different types of programs pre-

paring nurses for practice. With your assistance, I would

like to determine how faculty and students in this nursing

program perceive the role of the practicing professional nurse.

The data collected from your program will be compared with

responses from students and faculty in other nursing programs

in Florida. A summary of the study will be sent to all

participating nursing programs.

Please fill out the answer sheet with a number two pencil

according to instructions on the questionnaire.

Thank you for your time and effort in contributing to

this research study.

Sincerely,



Janice T. Thomas, R.N., M.N.

P.S. Participation in this study is voluntary, and all

participants and programs will remain anonymous.

































APPENDIX C

Sample of the Nurses' Professional Orientation Scale









Instructions: This questionnaire is composed of a list of
descriptive characteristics and behaviors.
You are asked to judge how essential each trait
is for the practicing, professional nurse in
fulfilling her role.

If you judge this trait to be:

EXTREMELY IMPORTANT Mark 5
IMPORTANT Mark 4
SLIGHTLY IMPORTANT Mark 3
NOT AT ALL IMPORTANT Mark 2
UNDESIRABLE Mark 1

There are no right or wrong answers for these
items. Judge each one in accordance with your
own personal opinion.

Please note that you have been asked to rate
these traits for the nurse as a practicing
professional only. DO NOT RATE THEIR IMPORTANCE
FOR STUDENT NURSES.

1. Quietly and obediently takes doctor's orders.

2. Questions instructions when the reason for them is not
clear.

3. Can usually think of several alternative solutions to a
problem.

4. Learns to accept the death of a patient with no overt
emotional signs.

5. Enjoys working with children.

6. Likes to be kept busy.

7. Always get a doctor's orders before she initiates care
for a patient.

8. Is willing to function as a counselor for a patient who
wants to discuss his troubles.

9. Enjoys working with patients of all ages.

10. Punctual and prompt in carrying out duties.

Note: This scale is protected by copyrights. Written per-
mission to duplicate and distribute the questionnaire was
obtained from Dr. Linda Crocker, College of Education, Uni-
versity of Florida, Gainesville, Florida 32610.



































APPENDIX D

Demographic Data, Faculty and Students

















Nursing Faculty


Directions: Please circle appropriate choice for each item.

1. Sex:

a. Female
b. Male

2. Age:

a. 20-30
b. 31-40
c. 41-50
d. 51-60
e. 61 or over

3. Type of basic nursing preparation (select one):

a. Diploma
b. Nursing Degree
c. Baccalaureate

4. Type of nursing program presently teaching in:

a. Diploma
b. Associate Degree
c. Baccalaureate Degree
d. Baccalaureate Degree for RNs only

5. Years of teaching experience in a diploma program:

a. None
b. Up to 3
c. 4-7
d. 8-12
e. More than 12

6. Years of teaching experience in an Associate Degree pro-
gram:

a. None
b. Up to 3
c. 4-7
d. 8-12
e. More than 12

81











Nursing Faculty
Page 2

7. Years of teaching experience in a Baccalaureate program:

a. None
b. Up to 3
c. 4-7
d. 8-12
e. More than 12

8. Years of teaching experience in a Baccalaureate program
for RNs only:

a. None
b. Up to 3
c. 4-7
d. 8-12
e. More than 12

9. Years of nursing experience (not including teaching):

a. None
b. Up to 3
c. 4-7
d. 8-12
e. More than 12

10. Major nursing experience (select one):

a. Hospital
b. Community agency (public health, visiting nurse, home
health agency, etc.)
c. Industrial nursing
d. Doctor's office
e. Other (specify)

11. Highest degree held:

a. Baccalaureate in nursing
b. Baccalaureate in field other than nursing
c. Masters in nursing
d. Masters in field other than nursing
e. Earned doctorate

12. Member of ANA:


a. Yes
b. No





83




Nursing Faculty
Page 3


13. Member of specialty group within nursing profession (EDNA,
AORN, CRNA, ACCN, etc.):

a. Yes
b. No












Nursing Students


Directions: Please circle the appropriate choice for each
item.


1. Sex:

a. Female
b. Male

2. Age:

a. 18-23
b. 24-29
c. 30-35
d. 36-41
e. 42 or over

3. Are you currently licensed as a nurse (LPN or RN)?

a. Yes (If you answer yes, answer all the rest of items)
b. No (If you answer no, skip to items 8 and 9)

4. Nursing program currently enrolled in:

a. Associate degree
b. Baccalaureate
c. Diploma

5. Previously licensed as:

a. LPN
b. RN
c. LPN and RN

6. Years of nursing experience:

a. None
b. Up to 3
c. 4-7
d. 8-11
e. 12 or more

7. Major nursing experience (select one):

a. Hospital
b. Community agency (public health, visiting nurse,
home health agency, etc.)











Nursing Students
Page 2


7. (continued)


c. Industrial nursing
d. Doctor's office
e. Other (specify)

8. Member of Student Nurses Association:

a. Yes
b. No

9. Total years of college attendance:

a. 0
b. 1


4 or more


I



































APPENDIX E

Means on Two Criterion Measures
by Program, Faculty, and Students
















Means on Two Criterion Measures
by Program, Faculty, and Students


Observa- Role NPOS
Program Status tions Means Means


Community College Student 54 122.370 187.704
Faculty 24 106.542 200.000
Program 78 117.500 191.490
Diploma Student 41 116.976 194.683
Faculty 32 114.031 204.531
Program 73 115.685 199.000
Baccalaureate Student 42 117.095 191.143
Faculty 26 106.462 202.231
Program 68 113.029 195.380
RNBSN Student 41 113.244 194.390
Faculty 5 97.400 210.600
Program 46 109.149 196.150














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